Yesterday morning we received a phone call from Virginia Mason asking if we were available to come in on Thursday morning for the biopsy. We had never heard back from the study investigator so it was a bit of a surprise.

We showed up at about 8:30 and checked in. After sitting for just 5 minutes or so, we were called back to the procedure area. The anesthesiologist, Dr. Wells, came in after Darrel was undressed and in bed with a space age blanket on him.

She told us that the port catheter had blood clots. These had been found by the VM radiologist who looked at the CT scan from the 3rd. This was news to us and I had read through the entire write up on the CT. She seemed concerned about it and was going to contact Dr. Picozzi and told me to call him this afternoon also.

She had read through his entire file, which I thought was pretty unusual, and was concerned about accessing his port for the IV needed for the procedure. She gave me a copy of the VM radiologist’s summary of the CT scan and, sure enough, he noted that there were two small thrombi adherent to the right Port-A-Cath tubing. He noted that they were not evident on the 7/9/14 exam. This could mean that his Lovenox dosage may need to be adjusted or he might need to go back in hospital to get straightened out using heparin.

The doctor, Dr. Gan, who was going to perform the procedure came in and explained what he was going to do. He would put an endoscope through the mouth into the stomach. A needle would then be inserted into the cancer mass on the pancreas through the stomach. He also explained that he was going to do a pain block on a nerve in the pancreas to, hopefully, help with the pain Darrel has been experiencing.

They inject pure alcohol into the nerve to kill it. Dr. Gan said it works about 2/3 of the time. He also said there could be some pain associated with it for a day while the nerve was dying.

When we saw Dr Picozzi last week, he did talk about a block for pain but I thought he was talking about for the biopsy procedure. So this was kind of news to us, but good news.

They took Darrel in at about 9:40 and I went to the cafeteria to get something to eat and wait. They have a pager system similar to those used in restaurants so I didn’t need to wait right there the whole time. They also have a screen on the wall with the patient’s number showing where they are in the process.

I went back and checked the screen and it said he went into recovery room at 10:11. Pretty quick work. They paged me a few minutes later and I went back to his recovery room. He was pretty groggy but everything had gone well.

Both Dr. Wells and Dr. Gan came in to tell me that everything went fine. Dr. Gan said that he was pretty sure the pain block would work because of the reaction from Darrel when they did it. He said that was a pretty positive thing.

Darrel was groaning and the nurse asked him several times if he wanted any thing for the pain. He sat up to get dressed and it increased the pain so I told him to go ahead and get some pain meds now so he wouldn’t be so uncomfortable all the way home. The nurse gave him an intravenous shot of Fentanyl. Within a few minutes Darrel sat up and said he wanted to get dressed.

I went and got the car and they brought him down and we were out of there a little after 11:00 and home by about 11:30. Darrel had some tomato soup and half a sandwich then headed to bed. He will probably be pretty wiped out today but should be ‘better’ tomorrow.

Yesterday he hardly got off the couch so that may be the new normal. But I am hoping he will start taking the pain meds more regularly since they seem to perk him up enough to be able to do things for a couple hours. He is very resistant to taking them, however.

That is all the news until I talk with the doctor.

This is picture of him with the space blanket. It has a hose attached to a machine that blows warm air into channels on the blanket. I had never seen it before.