new pad

Jeanne caught a particularly nasty stomach bug and needed to stay home and rest today. In her stead I went to AAMC to manage Dad's transfer to Spa Creek. Dad was able to muscle himself onto a gurney and was escorted to his new pad by two ambulance drivers. He's squared away in room #103 of Spa Creek, which lucky for him is a single! The staff seems super nice and Dad was delivered The Capital personally.

I stayed through his lunch which he raved about: french onion soup minus the onions and cheese. Apparently it tasted as good as it smelled. We also shared some great conversation before he was ready to nap.

Spa Creek Center

Tomorrow afternoon Dad is moving to a rehab/hospice facility called Spa Creek Center in Annapolis.

The oncologist is not recommending radiation or chemotherapy.

sending your thoughts

Dad is still fatigued, so in lieu of many, many phone calls, please send cards with your thoughts to their home. Jeanne will share them with Dad. Should you want to visit him at AAMC, please keep your visits brief. Dad needs your love and support, but we also want him to get his rest!

oncologist visit

I talked to Dad this morning. He sounds much stronger and happier now that he is back at AAMC. Jeanne said she was so happy that he was back there that she cried. Dad's only complaint on the phone was that his legs were swelling a bit.

His oncologist met with him briefly yesterday, but wants to look over his medical information much more in depth before advising on the plan of action. He should be meeting with Dad and Jeanne this afternoon. Dad is also meeting with someone regarding his options including hospice care should he decide that is best.

to AAMC

The procedure yesterday was apparently a success. Jeanne has been pushing to get Dad moved back to AAMC where we all feel the care was much better and staff much more responsive. Only trouble is that his GP is on vacation and he hasn't yet seen the oncologist at AAMC, so since he's not the oncologist's patient yet it is doubtful that doctor would order a transfer.

Jeanne perservered and Dad is moving to AAMC today!

adjust stent

I talked to Dad this morning. Doctors are planning to do another procedure this afternoon. They are going to try to move his stent which drains bile from his liver into a bag on the outside of his body. If all goes right, the process and stent will be internal.

merry christmas

Dad was in great spirits last night. His blood pressure remained up and his transfer back to 13East ward was only delayed while we waited for the new room to be cleaned. Once up in his new room, which is much smaller than his previous room in that ward, we all crammed in and sang Christmas carols. Dad led the way.

Dylan also brought in Dad's college yearbook so we got to get a little nostaglic too.

After we probably thoroughly exhausted him he was ready for a good nights rest. The entire Krisko and Campbell clans, Jo, Dylan and his girlfriend Christine packed up and we headed home.

positive

Jeanne just called and we have the first bit of good news since Dad entered the hospital and his condition started to deteriorate. He had a good night. His blood pressure has gone back up which is great news. Dad says he's ready to get out of intensive care. They are planning to move him back to the 13East wing if his bed is still available and all goes well.

3 liters

Dad started off the day by having 3 liters of fluid drained from his abdomen and a drain was affixed from his liver to a tube that overflows into a bag outside of his body. At this time it is not clear to me whether the two bile ducts have been opened using stents. The idea was that the shortness of breath was caused by the pressure of all the fluid building up in his abdomen. After removing around 4 liters in less than 24 hours, it is clear that it has not helped his shortness of breath. The thought is now that the breathing issue is a symptom of the massive infection overwhelming his body.

Dad is hanging in there but his situation is precarious. His blood pressure dropped dangerously low during the latter procedure. They were able to artificially raise it using medication. He is now in intensive care and they are hoping that his blood pressure will stay up all on its own. If so he will be able to move back up to the penthouse room on the 13th floor. They were aiming to do this this evening or tomorrow morning, but as I left around 3pm they were still having real issues keeping his blood pressure elevated to a normal amount. In one nurse's words, "His blood pressure sucks."

I'm not sure if he was just tired, but he kept insisting that he had been in the hospital for three weeks when actually it has been 1.5 weeks. I'm sure it feels like eternity though with the the endless procedures and no significant good progress. One doctor really tried to brace me that we are most likely dealing with days or possibly weeks, rather than months. It is so heartbreaking.

quart

Talked to Jeanne and heard that they removed a quart of fluid from Dad's abdomen this evening. It was bile so it looks like they want to do a procedure tomorrow to unblock two bile ducts. This is supposed to happen first thing in the morning, but who knows anymore. Jeanne seemed to think Dad was more comfortable after the quart was removed. Bless his heart. I'm hoping that opening the two bile ducts will solve this acute problem and make him feel so much better.

same same

Alex and I visited Dad today. His progress is about the same as yesterday. The procedure has been postponed. They want to give him some plasma to help thicken up his blood, which is still a bit thin from some previously used medication. Depending on how long it takes for his blood to thicken up, the procedure will be this afternoon or tomorrow.

Rather than draining fluid from his gallbladder, they plan to remove the liquid from his abdomen. The doctors disagree as to where the fluid is coming from (it is possible that it is building up from the infection or it could be coming from the gallbladder, etc.). Removing the fluid will not fix the problem, but it will provide a great deal of relief to Dad (they believe the fluid pressure is causing his shortness of breath) and it will allow them to get diagnostic information. They will be able to determine where the liquid is coming from and learn about the infection.

In the meantime, Dad is still really sharp but conversations are slower because of the fatigue and shortness of breath. His skin color looks normal now. And he seems to be able to get more rest which is good.

Sunday update

Dad spent Saturday watching the Navy football game with his buddies. By the end of the day he was getting additional CT scans due to some shortness of breath.

After talking with Dr. Mitra today along with Jeanne, we learned more. His chest CT scan was clear. The lower third of his lungs are collapsed but apparently this is not unusual or worrisome. The doctor indicated that even the most healthy person who had been hospitalized for a week would show the same signs because the patient is lying down and taking more shallow breaths. None of the test results indicate why he has the level of shortness of breath that he does, so he is being monitored closely.

The lower CT scan shows that the cancer, which is on his pancreas and a small portion of his liver, is still blocking two bile ducts. This has caused the bile to back up and enlarge his glabladder. He will most likely have a procedure tomorrow morning to create a drain using a needle and small tube inserted in his abdomen.

In the meantime Dad is being treated with broad-spectrum antibiotics for an infection in his abdomen. This was caused by the intestinal blockage and the bacteria building up without an exit route. The infection and blockages are considered his acute condition. Dr. Mitra describes his condition as serious and "delicate." After the procedure tomorrow morning things could get better quickly or they could spiral downward quickly.

Beyond his acute condition, the prognosis is grim. It would depend on how he responds to treatment, which varies from person to person. But the first goal is to alleviate the short-term issues. Please keep Dad in your prayers.

visiting with dad

My mom and I traveled to UMMC to visit with my dad today. He's in the penthouse suite, well . . . on the top floor anyway. His skin tone is a bit yellowish from the jaundice and he has several tubes connected to him. He is weak and super exhausted. Besides having scans done in the wee hours of the morning, he's having trouble sleeping. The ambient noise just doesn't help. His bed is right next to the nurses' station and despite being thirteen floors up the traffic noise is quite disturbing. He's also very uncomfortable in the bed and has to adjust his position often.

Upon entering the room there is a dry erase board with the name of his nurse on duty. Listed below that it says, "Goal for the day: To have a BM." I'm happy to report that he accomplished his goal prior to our arrival, which is a good sign. It means the stent is indeed where it needs to be and is allowing for the proper flow. He is also able to get up and walk should he want to, but he has to unhook from all the tubes. He did get up and use the restroom once while we were there but he was winded from the exertion.

His IV of nutrients will start this evening around 9 p.m. and slowly revitalize him. The feeding will be complete around 2 or 3 p.m. We're hoping that he will feel much better very soon! They are also not planning any further procedures for this weekend so he can get his strength back.

My mom called Jeanne as we were leaving the city to give her the update. Jeanne and her daughter are headed up there this afternoon. And bringing earplugs to help him get some rest!

open and closed

So the results of the CT scan that took place at 2 a.m. this morning is that the stent is open. However, two of his bile ducts are blocked and have caused jaundice. He is so weak and exhausted that they have decided to give him parenteral feeding, which means that he will get all his nutrients and sustenance though an IV. His condition seems to be critical at this point.

They are hoping to build up his strength and then do a procedure to open his bile ducts with stents. This would be done with a needle into his abdomen rather than surgery.

I'm headed to the hospital now. Will keep the information coming...

anxiety

I talked to Jeanne again. Dad said that he had a "spell" and was sweating profusely and had some pain in his shoulder. He thought he was having a heart attack, but an EKG showed that wasn't the case. The nurse believed the high stress caused him to have an anxiety attack. Although we didn't know it until now, it apparently happened once before while in the hospital.

He's awaiting a CT scan this evening to give doctors more information and help with the decision regarding a possible surgery.

endoscopy, part II

I talked to Jeanne this afternoon. When she initially talked to the doctor at 9:30 this morning all signs pointed to the second procedure being a success. However, in the meantime Dad vomited again. Not good.

We're now waiting to find out the next course of action. Surgery to restore flow through the intestine is a possibility although removing the tumor entirely is not an option. Apparently the tumor's proximity to many tiny blood vessels would make the surgery too risky.

rough night

I called Dad today around 1 p.m. Unfortunately, I woke him up. Apparently, the stent was not working (it possibly moved) and he had spent the previous night vomiting and unable to sleep. Despite being very groggy he was able to let me know that they were going to retry the endoscopy to move or replace the stent that afternoon. I'm keeping my fingers crossed because the alternative is surgery, which he's trying to avoid.

initial results and endoscopy

The doctors gave us both good and bad news today. The bad news was that Dad definitely has cancer. The good news is that the PET scan was negative, which means that the cancer has not metastasized (spread to other parts of the body). While this was somewhat of a relief we still know that Dad most likely has a difficult road ahead. But he seems to be in good spirits and gearing up for a big fight.

The immediate concern is the blockage of his small intestine (the reason he keeps vomiting) that has been caused by pressure from the tumor located on the neck of his pancreas. Dr. Darwin performed an endoscopy procedure. This is basically a long tube inserted down his his esophagus to the location of the blockage (where the stomach meets the small intestine). The doctor was able to place a stent in the small intestine to alleviate the flow blockage and also take a biopsy, which will help them stage the cancer. This will help his future oncologist decide on the course of his treatment, which may include chemotherapy, radiation or a combination thereof.

day of tests

Dad spent the day at AAMC getting X-rays, a CT scan and a PET scan. Initial tests showed some nodes on his lungs but in the absence of the appropriate professional to read the scans, we will have to wait to hear about the findings.

Jeanne called me to let me know that his transfer to University of Maryland Medical Center in Baltimore had been expedited. Instead of being transported tomorrow, he was going tonight. I skipped plans to drop my son, Tyler, off with Oma (Grandma Jo) on my way to the hospital and instead kept my fingers crossed that they would let a two-year-old visit his Grampy. As luck would have it, the hospital officials were flexible on the rules and Tyler got to see Grampy! Dad's room was filled with many friends. Bless you all.

Dad's was still feeling lousy and needing to vomit periodically.

cancer sucks

This afternoon my Dad called me at work. I responded with a cheery, "Hi Daddy!" Little did I know the burden he was carrying. He dutifully informed me that he most likely had pancreatic cancer. He first noticed symptoms in February. Starting two days before Thanksgiving, he started to vomit. While a nurse practioner in the office of his gastrointerologist diagnosed him with atypical acid reflux, thankfully, Jeanne and dad weren't buying it. His general practioner sent him to the hospital where tests revealed the problem. While waiting for a bed to open up at Anne Arundel Medical Center he went home to "finish some business" for his church, etc.