Mon Apr 26 - The plan

Good news and bad news today. 

Had a PET/CT scan (both) this morning. They combine them for a much greater detailed 3D image of my insides to see what's really going on.

Good news
No direct radiation therapy required at this time. I'm able to swallow, so long as I chew properly, so they don't have to make the esophagus hole bigger with a direct zap to the affected area.

Bad news
Chemotherapy confirmed for 9 weeks starting next week, Wed May 5th. Followed by the aforementioned surgery. This will involve 3 separate chemo drugs. I'll have 3 direct injections of drugs, once per 3 week and days between injections will be administered with twice a day chemo pills. I'll be given prescription anti-nauseants and steroids to prevent nausia because apparently without it I WOULD throw up the pill, guarenteed.

Chemo will hopefully reduce the size and affected area of the cancer and kill areas they may not yet be aware of. The chemo is also required because some lymph nodes near my esophagus are slightly enlarged, meaning they are fighting something and it may be the cancer, so the cancer may not be just contained to the esophagus wall. The PET/CT combo scan will reveal more of its exact location.

New Appointment Dates:
Kaye and I will need some baby sitting for these:

• May 4th 9:15am to 12:00(ish): Lab work, Chemo 101 course, Dr. Dhesy-Thind consult.
  • Kaye's folks have the morning covered.
• May 5th Wed 10am to (late afternoon, 6 to 8 hrs): First round of Chemo injections + observation.
  • Shane's parents have the kid pick-up covered.
• Pre-Op clinic on May 4th is canceled because the tentative surgery on May 11th is also canceled.
• May 6th consult with Dr. John Miller is cancelled. Dr. Dhesy-Thind is taking over as doctor in charge during the chemo stage.

 Chemo medication (for those that care about this sort of thing):

• Epirubicin (aka Pharmorubicin®) - red coloured injection
• Cisplatin (aka Platinol AQ®) - clear, colourless injection
• Capecitabine (aka Xeloda®) - tablets. I'll be receiving the 150 mg variety instead of the 500 or 1000 mg variants. Therefore my symptoms will not be as severe (hopefully) as people receiving the larger doses. I still might loose some hair though. I'm planning to shave it off so I won't care...

-- Shane

Frequently Requested Schedules

Some frequently requested schedules:

• Kids leave for school around 8:15am, entry bell is 8:35am
• Tao finishes at 3:00pm and requires pickup, Zoe & Nia finish around 3:10 or 3:15 (not sure, they walk themselves home)
• Tao goes to school full days Mon, Tue and every other Friday (last Friday Apr 23rd he was at school).
• It takes Kaye and I roughly 45 minutes to get to the Hamilton St. Josephs hospital, so leaving 1 hour before an arrival time gives us 15 minutes of unexpected traffic leeway.
• This is Kaye's last weekend of her work contract with Gennum. She won't be renewing at this time so that she can help out at home/hospital once my treatment starts. Her hours this weekend are 6pm to 6am Friday night and Saturday night. So she is available for talking after 4pm Sunday.

Some frequently asked financial concerns:

• I have short and long term disability (STD and LTD) through Gennum. Short term starts after 5 consecutive sick days and lasts up to 17 weeks. Long term kicks in after 17 weeks.
• I'm currently taking 100% pay sick days for my appointments prior to taking short term disability. I have enough days to go around, so no worries there.
• STD pays 80% of my income.
• Gennum's Sun Life Assurance does pay for some hospital facilities, but it likely won't pay for it all. Also, extras like cable, phone etc. will not be covered.

Can't think of any other frequently asked questions right now. Took the kids to Karate today. Nothing else to report. -- Shane

What's coming

Here's some of what I'll be up to in the next couple of weeks:

As Deb points out to me in a comment, we may need assistance with kids during any of the times listed if they aren't in school for those hours.

• Mon April 26th, 

1. PET scan @ 8:45am (2.5 hrs) @ Fontbonne Building of St. Josephs Hospital,Hamilton
   
2. Juravinski Cancer Center @ 1:30pm, Henderson Hospital, consultation
   
 

• May 4th, Pre-Admission Assessment Clinic (Pre-Op clinic) @ 10am (2-3 hrs) @ Bishop Dowling wing of St. Joseph's hospital. Q&A about surgery and if I'm ready for it.
• May 6th @ 11am, follow-up with Dr. John Miller to go over all the diagnostic findings and finally decide on a course of action
• May 10th, will likely go on short term disability at Gennum through Sun Life Assurance group plan.
• May 11th @ 8am, tentative surgery (3 field esophagectomy) scheduled. Must arrive by 6:30am (so leave home by around 5:30am). This may not happen, but since it is easier to move a date, then it is to get a date. They've reserved this date in case they want to operate quickly. If chemotherapy will happen, surgery will likely be moved a couple of months later.

Notes:

• Surgery will have me eating nothing (not even through I.V. unless an emergency, which is why I need to gain weight and vitamins) for 5 days. Then they will hold me in the hospital for between 9 to 15 days.
• Kaye's parents, Ming and Dale Chen, have suggested they could become live-in support. Move in with us and care for the kids while Kaye's in the hospital with me, or during chemo where I (apparently) can't do much to help out.

A blog was requested, so here it is.

As people reading this blog probably already know, I have cancer. It is in the lower esophagus and I'm currently undergoing diagnosis to find out just how bad, or early stage, the cancer may be.

History:

• Late Jan, early Feb, I started having what I thought was mid back pains that needed a chiropractic appointment. One was a particularly sharp pain. So I had a chiropractic adjustment... no help. Later that week food stuck in my throat just before my stomach, hurt, and made me rush for a drink to flush it through. Twice in one week + the back pain in the same place made me think this wasn't normal.
• First or 2nd week of Feb, went to see my family doctor, Dr. Michael Gilbert. He gave me some prescription antacids and booked an endoscopy (scope) for a month and a half later.
• Apr 6th: First scope - Dr. Sawhney took a biopsy and a blood test for analysis. His comments to me at the time afterwords were "I found something ulcer like, but it looks weird." That wasn't encouraging, considering hes done this 100s of times in the past. Either it was an ulcer or it wasn't right? Or maybe it could be multiple things?
• Thu Apr 15th: My follow-up appointment with Dr. Sawhney revealed that there were cancer cells present. No other information was given. I think he had read the report just before telling me, and he looked more shocked and dismayed than I did and seemed at a loss for words. (Least encouraging sign so far.) He said he'd never seen such a thing in someone as young as I (36 yrs old) and that most doctors would not have even have sent me for a scope. That's when I told him the scope was my idea, not Dr. Gilbert's.
• Fri Apr 16th. Dr. Sawhney managed to get me quickly into a CT scan at the Milton hospital. I have a copy of the disk. It's 580+ MB of images of my innards from my neck to my lower intestines in case anyone wants to see it. I found it quite facinating, but honestly couldn't see anything in the trouble area that struck me as being a growth. But I had no healthy image to compare it against.
• Mon Apr 19th. First consult with Surgeon John Miller, head of McMaster University's thoracic surgery division and head thoracic surgeon at St. Joseph's hospital in Hamilton. He made me understand that the cancer wasn't just a lump but rather a thickening around the entire esophagus wall and in parts of the upper stomach wall lining. He suggested that chemotherapy for 2 months followed by surgery may be the required steps, but that further testing would be required before that is finally decided on.
  http://fhs.mcmaster.ca/thoracicsurgery/miller_john.html
• Mon Apr 19th. Kaye and I finally have the kick in the pants to get our Will & Testament and Power of Attorney filled with a lawyer (Richard Furlong in Milton).
• Tue Apr 20th, worked. But didn't get much done. A lot of interruptions by people asking questions, consoling me and looking shocked.
• Wed Apr 21st. Dentist, apparently radiation and chemo treatments require insanely clean teeth (especially radiation therapy, which I don't know if I'll be having yet).
• Thu Apr 22nd. 2nd endoscopy (throat,stomach) and bronchialscopy (lungs) done by Dr. John Miller, my oncologist.
  Also saw a dietitian. They have me on "ensure" or "boost" liquid meal / vitamin replacements to suplement my body's supply of vitamins for when I have surgery and can't eat for 5 days, or for chemo, whichever happens first.
• Fri, Apr 23rd. Working from home so I can actually get some work done today. Also started this blog at Debbie's request.