Port replacement, no problems. Update: Port Replacement Successful
April 7: A Good Day (Dr. Yeo Apppointment)
Met with Dr. Yeo; not the best news, but, Mom was feeling good all day. Update: Olympic Training
Olympic Training
This morning we met with Dr. Charles J. Yeo, an oncology surgeon at Jefferson Hospital, to get a second opinion and discuss options. Dr. Yeo is widely regarded as one of the best oncology surgeons in the world, specifically in the “Whipple procedure”, which is the procedure Mom would need.
The meeting was via telehealth, which is like a Zoom call through Mom’s patient portal. Myself, both of my sisters, and my dad joined my Mom on the call from one of the empty bedrooms at my parent’s house.
Dr. Yeo was great. Very precise, very specific, very concrete and realistic statements. He sounded like I think you’d want a surgeon to sound. He agreed that the current chemo plan at Penn was the right course to follow, that it was exactly what he would want done at Jefferson Hospital, using the same drugs. So that felt good: in a span of 24 hours, we’ve had two of the best pancreatic docs on the planet state that course of action we are about to undertake with Mom is the best course of action.
He also stated that Mom might not make it to surgery. He felt that due to Mom’s age, and especially due to the unfortunate placement of the mass (the growth, the tumor, the thing, whatever), not only did chemo have to be done first, but it had to work.
And there was a good chance that it might not work.
So, the game board is set. The stakes are high; they are everything.
Dr. Yeo told Mom what he has told thousands of patients: this is the moment for you (Mom) to being your Olympic Training. Be active, eat right, exercise, stay away from the bad things. Get moving. And, just like an Olympian, you may train your hardest and at the competition you may deliver your all-time personal best… and that might not be enough. In fact, you still may “lose terribly” (his words).
So mom will begin her first 4 rounds of chemo next week, and after that they will see how well it is working. If the tumor shrinks, great. If the tumor stays the same size, OK. If the tumor still grows, we’ll have run out of options.
Assuming the tumor shrinks or stays the same size after the first 4 rounds of chemo, then Mom will start a second set of 4 rounds of chemo. When those are complete, another set of scans will be run, and Mom will meet with Dr. Yeo again to see if surgery makes sense.
Mom is tough. She had the strength to hear all of this, and still drop a joke or two that made the whole room laugh.
This is a tough city, and our family has been here for many generations, and it is a tough, hard-working family.
Plus, we have Rocky.
Nobody is backing down. We are ready to start training.
LFG!
The New Normal
Today was a beginning sort of a day.
My mom has cancer. My heart is broken.
I can’t believe this is our story, this is her story. I can’t believe this is the day that reality begins.
Mom had her first appointment at the Abramson Cancer Center at University of Pennsylvania; it was a meeting with Dr. Peter J. O’Dwyer, a medical oncologist.
People who know about these things felt we were so very fortunate to get an appointment with Dr. O’Dwyer. Some people felt like it was something of a miracle.
I’ll take it! We need somethings to break our way, hopefully this is a big one.
My older sister Angella, a nurse, is running point on all the medical stuff, along with my younger sister, Alia, who is also a nurse; I volunteered to be the wheel man. The driver. The Uber. I spent most of my college years at Penn for ROTC, right at the South Street bridge, and when I wasn’t playing Army I was picking my then-girlfriend-now-wife from one of the Penn dorm buildings. Now my oldest child goes to school there, so I felt very comfortable negotiating the sometimes chaotic streets.
Even still, I spent a good bit of time prepping my route. I wanted to make sure I delivered as stress-free a transport as possible; getting lost or missing turns seemed like the last thing I wanted to do.
I spent a bit of time the night before rehearsing my route with my wife, who is a far superior navigator than I am. I called an old friend who had made my trips with a spouse to this very place and got the tea on the parking situation.
Before we left, I studied the map over and over again.
It is super easy to get there, and super easy to get home, but it is a little congested in the immediate area. It is like a city within a city on those blocks, with massive buildings dedicated to being hospitals and research centers. Everywhere you look is a monolith of mirrored glass housing Western medicine’s best hope for fighting disease and illness, for helping the sick, for curing and caring.
It can be overwhelming.
My prep time was time well spent as things went perfectly on the ride down and I dropped everyone — Mom, Pop, and Angella — off at the main door exactly when we wanted to be there.
After parking I wandered through the incredibly bougie building. It is just a few years old, and it is extraordinary in every way. It felt like the saddest and yet most hopeful place in the world. Everyone in there was, in some way, living this story that we, our family, just began.
Everyone was connected.
Everyone was battling cancer.
Some were patients, some were family, some were medical staff, some were building staff… but they were all part of the same fabric.
We were all there because of one thing: cancer.
Just past the main elevators in the main entrance area is a massive display of the names of the people who helped fund this place. My friend, the one that gave me the contextual insight on how to best negotiate parking and drop-offs and pick-ups, also told me that her spouse, who had tremendous success here and is running road races and living their best life, has a family member on that way. They told me that every time they came here for an appointment, the first thing they did was notice and recognize their family member’s name on the wall, and feel a connection. Hope. Life.
I walked over and noticed their names, too. I felt a connection, to someone who helped make this wonderful building happen, and to someone who is alive because the people who work in this wonderful building did what they do best. My hope was to tap into some of that good vibe. I’ll look for the name every time I come here, too.
I tried to sit in the lobby — I was not supposed to go with Mom as she is only supposed to have 2 support people with her — but I was feeling some feelings sitting there surrounded by all of the everything and the everyone battling cancer.
I wandered out to take a walk; it was rainy, and I wasn’t up for an adventure.
Just outside I was faced with two options: a food place that sold La Colombe coffee (possibly the best coffee in the world), and a Starbucks (not the best coffee in the world, but possibly the most consistent coffee consuming experience in the world). I opted for the lesser coffee and the most expected experience. I just wanted to be someplace normal, someplace that I recognized, someplace that didn’t fee like a cancer battleground. I stand by my choice.
Except, everyone in there was either a hospital worker, a construction worker, or a weary, bleary, teary person seeking solace in a familiar cup of coffee like me. No relief for me there.
Plus there were these two men speaking Greek and, I don’t know, they kept staring at me like we were enemies. I felt like I was sitting in their seats, but they came in after me. Was this their seat? Was I violating some protocol I did not know? Why did they look like they wanted to fight? I tried to read my book, but my imagination kept running away with all of these scenarios of me fighting off an attack by too burly men speaking Greek who mistook me for some foreign agent or something. If there was going to be a thing, this chair would be useful. If I could get to the otherside of them, I could escape, or get to the hot coffee and use that. I needed to make a distraction. It was all happening too quickly… except it was not happening at all. It was just a boring old Starbucks and that was probably just the way these men looked. My mind is all over the place.
I should have gone for the La Colombe. I know this.
So I finished by coffee and left; no eye contact, no fights, nothing. I wandered back into the building, and my sister texted me that mom was still waiting to be seen, and I could easily come up and sit with them.
I decided that was the best play.
As soon as I got there, mom was called to be seen. After a while, she and my sister came out. Mom looked relieved. My sister looked relieved. Me and my dad looked scared. Mom needed some labs run, but we were able to chat, and she felt content. I relaxed.
She really liked Dr. O’Dwyer. This is going to be the place. This is where the big fight is going to go down. Abramson Cancer Center is the arena. Mom (and her fam and her new Doc and all of the people here) vs. Cancer.
We were looking at 4 rounds of chemo, each two weeks apart, and then some scans to see how well it was working. After that, 4 more rounds of chemo, and then, possibly surgery.
We went over all of the details on the ride home, all of the expected effects, all of the strategies for keeping Mom feeling strong enough to keep up the fight.
The die is cast. The fight is on.
Here we go.
The new normal.
April 6: A Good Day
Update: The New Normal
April 5: A Good Day
Mom slept very well, “no real” pain.