Busy Week

What we anticipated was going to be a quieter week, with time for some physical & emotional healing, turned out to be a crazy busy week with a new issue that has become David's biggest problem at the moment.  

We continue to go to the infusion center every day for David to receive his IV antibiotics.  On Wednesday morning, we saw Dr. Fanta (David's oncologist) & this is when the wheels really started turning.  He ordered a STAT CT to recheck David's gallbladder, liver, & biliary tree (the sources of his hospitalization for sepsis) as well as to recheck his thorax, abdomen, & pelvis as is the normal protocol for all of David's CT rechecks.  So, we went in Thursday morning for the CT study & while we were at David's infusion appointment for his IV antibiotics, we received a call from Dr. Fanta's nurse that we needed to return to the imaging center for further evaluation of a large fluid pocket that showed up on the CT study in the region of David's right shoulder.  Now we knew David's right shoulder had become a problem as he had been having a great amount of pain in it since Monday & the pain had rendered his right arm to being basically nonfunctional.  We had been treating the area with ice & rest (we put that arm in a sling as that helped to ease the pain a bit), & had set up appointments for David to see a musculoskeletal doctor & an orthopedic PT.  But, we cancelled those appointments & headed back to UCSD in La Jolla for a musculoskeletal ultrasound.  Unfortunately, the ultrasound study didn't render much more info.  Long story short (are any of my entries actually short?), after much discussion between the radiology staff, an infectious disease (ID) doctor (there had been some concern that the fluid pocket could be a new area of infection), & Dr. Fanta, the consensus opinion was that David most likely injured his rotator cuff (the presumption we had made on Monday) & that because he is on twice daily injections of a blood thinner (people with pancreatic cancer tend to clot easily), he had bled into those injured tendinous & muscular regions causing a large hematoma.  So, we have cut David's blood thinner dose in half & are continuing with our conservative measures of ice & rest.  On Friday, we saw our ID doctor & she wants David to continue on the daily IV antibiotics while she discusses the new finding on Thursday's CT that the presumed "abscesses" in David's liver are the same size to slightly larger (WHAT???!!!).  The gallbladder & biliary tree are looking happier, so she has some question as to whether the presumed "abscesses" in David's liver are actually bilomas (a collection of bile).  So, she will try to figure this out with the radiologist as she had planned to discontinue David's IV antibiotics next week if the presumed "abscesses" had resolved.  As you can see, this has been a week of confusing uncertainties!!

On this coming Tuesday, David will see the interventional radiology (IR) group for reassessment of his cholecystostomy (gallbadder) tube -- that it is patent & draining well.  In conjunction with IR & the ID doctor, Dr. Fanta will make the decision about whether the tube needs to stay in place longer, be removed & allowed to heal over, or if David might need to have his gallbladder removed.  So, stay tuned for more on this front!

Dr. Fanta has also referred David to Dr. Murphy (our original radiation oncologist) for assessment of if & when David may be able to receive radiation treatment for the cancer in the head of his pancreas.  Dr. Murphy was David's radiation oncologist in the Fall of 2013 when David received radiation therapy to the tumor in the body & tail of his pancreas.  Fortunately, the head of David's pancreas was not in that original radiation therapy field, so it can now be considered for a new course of treatment.  We have an appointment to see Dr. Murphy on March 4th.

Sure hope you all have a wonderful weekend!  Big hug, Janet