It was four months ago today that everything changed. Papa came home from four days on the road and it was immediately apparant to me that he was jaundiced. No one looks the color of a canary naturally and jaundice is never good.
Just about the time of the family reunion, August 2008, he went on a diet. Now this was not unusual because he was forever trying to lose weight. For once it was working. He lifted weights and walked when he was home from the road but that became difficult because he started having sciatic pain. Still, slowly the weight came off. It really became noticable after Christmas and just about then he started having occasional diarrhea. He said it was truck stop food or because his body was getting rid of fat from him dieting. Then once or twice he said something about his stool being clay color. Hmmm... I really should have picked up on that, being a nurse and all but I missed it. He was always so tired too. He wanted to work in the woodshop on weekends but he could never manage to get out there unless Eric and/or Ben were there to encourage him.
For me the first biggest thing was the bruising. Papa is on Coumadin because of his atrial fib problem and about March he started having abnormal bruising. He would be surprised when I pointed out a new bruise and say that he had done nothing to cause it, no bumps while winding up the landing gear, no knocks to the calf or hip area. His blood work was not really that out of whack either, not for bruises the size he was sporting. We would just adjust his Coumadin however the doctor said to and have his PT checked when they said and then re-adjust again. Well, now we know he was not metabolizing the Coumadin properly because of a blockage.
When he came home jaundiced it was a Saturday. Monday I had him in to the doctor ASAP and she thought this time it might really be gall bladder problems because of the symptoms (more about this later) but I do remember her mentioning cancer somewhat as an afterthought. Her office arranged blood work and an ultrasound. The ultrasound was done the next day and did show a gall bladder full of sludge. I was relieved and worried at the same time. When I had my gall bladder out I was off work for six weeks and I was worried about finances as Papa's work did not provide short term disability or sick pay. Six weeks without a pay check is a damn long time. But it seemed the lesser of any problems that it could possibily have been.
After she got the results of the ultrasound the doctor arranged for Papa to see a gastroenterologist. He said it appeared from the ultrasound that a gall stone was blocking the common bile duct. He ordered an MRI and after that decided to do an ERCP, an endoscopy procedure where an endoscope is passed through the mouth to the stomach. He felt that he might be able to retreive the stone that way and if not, then Papa would have to have his gall bladder removed the conventional way. I remember talking with Papa and saying... at least you don't have pancreatic cancer, that is almost always a death sentence. We talked about Michael Landon, Patrick Swayze, the woman in the chat room... all dead or dying from pancreatic cancer.
The ERCP was Friday, June 12th. The doctor did not find a gall stone, he found a tumor. That is what was blocking the bile duct. He put a stent in place to hold the duct open and did a biopsy. Then he sent a surgeon to see Papa.
Of course by this time Papa is frantic to get out of the hospital but they made him stay to get surgical clearance from his cardiac docs. I practically had to chain him to the bed. He did not feel sick and he wanted to be home with his family. The surgeon told us Papa needed a Whipple procedure and it needed to be done ASAP. I remembered that from nursing school although I had never taken care of anyone who had one. I just remembered that it was said "they take everything." He drew pictures of the procedure all over the bed sheet, outlining what he planned to do. I could see Papa turning green under his already yellow tinged skin. The surgeon said that he would look by scope first and do a more in depth biopsy and would not do the Whipple unless it was necessary. Papa finally got to come home for a day or so before going back in on Wednesday the 17th.
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