Supercalifragulistic Ex Peritoneal Carcinomatosis OR Looks Like We Made It

 Entry 1    4:16 p.m.

We have Jenny home.  She is tired, weak, malnourished, in pain, but remarkably in good spirits.

The surgeon did a second nerve block procedure when they did the stent procedure, but the pain persists. The C/T is clear where the pain is of anything that might be the cause. The oncologist, Doc P, who visited Jenny again last night, is baffled. Mind you, the pain is real, so real that only 20 mg. of oxy, a dose of dilaudid and muscle relaxants managed to get the pain to a tolerable level just a few minutes ago. 

While at hospital, Jenny called me crying, and I hurried as fast as I could to see her--there was a slight problem with my Jeep being covered with snow that I had to address first. I had hoped that I could talk to a doctor, but none ever arrived once I got there. Jenny had already been discharged, and was just waiting for a transporter to get her downstairs.

I am going to reach out to the palliative folks with whom which we have a meeting with on Friday.  Anyway, she is home, took a two hour bath--with me bringing extra hot water I boiled for her up to refresh the water after we used up the tank.  Note to self, tankless hot water heater.  I am just glad to have her home, and relieved.  She can eat and drink again--the first thing she did when she got home was drink a pint of water. Amazing. 

Entry 2  10:15 p.m.

Cognitive Dissonance. Frank Sinatra is singing The Christmas Waltz on the television, evoking a sense of endless possibilities. Meanwhile, I sit reading the medical record of Jenny's last several days in hospital. It isn't good. So many issues. You never want to be referred to as thin in the record or starving. Jenny and I have talked over and again that the fact she had some extra weight is always good when fighting a gastric cancer. She isn't just thin, she is cachexic and anorexic. I managed to feed her yogurt and she ate two shortbread cookies--she demanded them.  This is new. So, the surgery was a success.

The medical record confirms the suspected diagnosis of peritoneal carcinomatosis--cancer of the peritoneum. Unsurprisingly, the prognosis for someone that has mPDAC and this additional cancer is poor. It is hard to treat, although the article I read is not clear if that is because it is hard to treat generally or because it is hard to treat concurrently with mPDAC. I suspect the latter. 

Jenny's stent, which is a connection from the stomach to large instestine, is intended to treat the gastric outlet obstruction caused by the tumor pushing on the duodenum causing stenosis in a 3 cm. section. Nothing could get through. I am at a loss, given we reported these issues on December 2, why it took repeated visits to the ER, 3-4 in fact, to get the procedure done. It is frustrating, when you see this suffering patient, the mother of our children and my friend and erstwhile wife of so many years, look like she is on a hunger strike. I really feel this didn't have to happen like this. The med record, although not the patient discharge papers, note she is at high risk of refeeding syndrome. It is caused from starving. Seriously. 

I am exhausted. Physically and emotionally. Good night.