23 Jan. ‘08
Bile Duct Diaries IV
Today Jane and I met Mr. Sharma, the liver surgeon at the Royal Free who will be taking my case from the team at the Radcliffe in Oxford. About 40, in a smart pin- striped suit. He was very professional and thorough, taking about an hour to discuss a very complex situation, since no one can be 100% sure of what is going on. He discussed the operation, but since it is a major intervention with a mortality rate of its own, he wants to slow things down enough to gather as much evidence as possible, and be reassured that I am fully fit ‘mentally and physically’ for the operation. This took us back to the damned pancreatitis, which he said is tricky and can be very serious in its own right. Because of that he suspects the CT scan done in Oxford was not as helpful as it could be and wants me to do another. Then he wants a laparoscopy (keyhole surgery to get a closer look at the relevant organs) and while these are being done and analysed, the pancreatitis should be settling completely, and I should be posing for the cover of Men’s Fitness Weekly. He said, ‘if you swim one lap, I want you to start swimming two’….and, ‘If you walk for one hour, I want you to start walking for two’. Rather inspiring, actually.
Then we discussed the urgency of having a suspected malignancy, but he said there is no strong evidence that it is spreading and in the balance, it is far better to take the extra weeks and get everything right for the operation. This places the date of the operation into the mid February range, but we are all committed to taking one step at a time since there can be so many ‘slips ‘tween cup and mouth’ with my situation.
So as I reflect on this consultation, I feel relieved about stretching this out to leave more time for everyone to consider things and more time to prepare myself…..particularly since I think I am still shocked by the sudden change of life direction I am experiencing. Also I like the idea that Sharma is on board and taking things seriously…a form of second opinion…… and he seems very open to discuss things as we go forward. For example, I said I had a number of friends who were medics and they would be concerned that this is the right course of action, and he said ‘I’d be happy to speak to any of them on the phone if you’d like.’
So that’s it for now. If any of you are walking on Hampstead Heath, in the next few weeks, and you get overtaken by a blur that looks vaguely like a 64 year old man, it’s probably me.
Thanks so much once again for all the support and good wishes you have conveyed to Jane and me, each in your own way.
LoveDavid (and Jane)
Thursday 24 January 2008
Bile Duct Diaries III
11 Jan., 2008
Bile Duct Diaries III
Yesterday Jane and I went to meet the surgeon at the Radcliffe Hospital. It wasn’t easy hearing the whole situation explained in all its medical detail, and I can feel myself hearing certain things and not listening to others. They are assuming there is cancer in the bile duct/pancreas area, and the vast majority of these cancers are malignant, so they assume that too. In my favour is the fact that they have not yet detected metastasised cancer, so surgery rather than chemotherapy is favoured. This will involve cutting a lot of stuff away: parts of the stomach and pancreas, the duodenum, lymph nodes, the gall bladder and the bile duct……to name but a few. It is shocking to hear this, but this is a well known operative procedure called the Whipple Procedure (yes, sounds like it should be called the ‘whip-it-out’ procedure).
The cancer is deep within the abdomen, so they will only really be able to assess things fully with observation and biopsies, once they open me up. If they think that is sufficient, then I am on a 3 month (?) road to recovery, if they discover other things going on, then I may have to go on to chemotherapy, but let’s cross those bridges when we come to them.
They still have to wait for my pancreatitis to clam down, so the internal organs are strong enough to cope with the operation and the subsequent risk of internal bleeding, so I have to wait a few more weeks. We thought this was the best time to transfer my case to the Royal Free, which has an excellent liver/surgical department, and is easier for family and friends to arrange visits, so we will be on their case to ensure I don’t have to wait too long for this. Hopefully the operation will be early in Feb.
All you Tavi colleagues have been amazing at stepping into the breach with my cases and supervisions and courses. Everything is nearly accounted for, and I am finding it harder and harder to sustain the idea that the clinic cannot cope without me, so thanks to all of you for that. We know also there are a lot of thoughts, concern and prayers coming in our direction, and that is very supportive when we are trying to come to terms with all this….in such a short space of time, so thank you once again for this.
Love,
David (and Jane)
Bile Duct Diaries III
Yesterday Jane and I went to meet the surgeon at the Radcliffe Hospital. It wasn’t easy hearing the whole situation explained in all its medical detail, and I can feel myself hearing certain things and not listening to others. They are assuming there is cancer in the bile duct/pancreas area, and the vast majority of these cancers are malignant, so they assume that too. In my favour is the fact that they have not yet detected metastasised cancer, so surgery rather than chemotherapy is favoured. This will involve cutting a lot of stuff away: parts of the stomach and pancreas, the duodenum, lymph nodes, the gall bladder and the bile duct……to name but a few. It is shocking to hear this, but this is a well known operative procedure called the Whipple Procedure (yes, sounds like it should be called the ‘whip-it-out’ procedure).
The cancer is deep within the abdomen, so they will only really be able to assess things fully with observation and biopsies, once they open me up. If they think that is sufficient, then I am on a 3 month (?) road to recovery, if they discover other things going on, then I may have to go on to chemotherapy, but let’s cross those bridges when we come to them.
They still have to wait for my pancreatitis to clam down, so the internal organs are strong enough to cope with the operation and the subsequent risk of internal bleeding, so I have to wait a few more weeks. We thought this was the best time to transfer my case to the Royal Free, which has an excellent liver/surgical department, and is easier for family and friends to arrange visits, so we will be on their case to ensure I don’t have to wait too long for this. Hopefully the operation will be early in Feb.
All you Tavi colleagues have been amazing at stepping into the breach with my cases and supervisions and courses. Everything is nearly accounted for, and I am finding it harder and harder to sustain the idea that the clinic cannot cope without me, so thanks to all of you for that. We know also there are a lot of thoughts, concern and prayers coming in our direction, and that is very supportive when we are trying to come to terms with all this….in such a short space of time, so thank you once again for this.
Love,
David (and Jane)
Bile Duct Diaries, II
8 Jan., 2007
Bile Duct Diaries, II
Just to keep people informed, there was a hospital conference yesterday about my situation, and I have now discussed things with the lead consultant. They think the most likely cause of the bile duct constriction, is some type of cancer, and they want to operate in order to remove the bile duct and part of the pancreas. This allows them to do a thorough investigation that should answer further questions and lead to a clearer plan for treatment. The consultant said, hopefully, that the intention of this operation is ‘curative’. We shall see.
Before they can do that, I have to get over the current bout of pancreatitis and gain more strength. Jane and I are going to the Radcliffe Hospital in Oxford to discuss all this with the surgical team on Friday. I need to also think over whether that might be the best time to have my case transferred to the Royal Free. I must say, paradoxically, even though none of us wants to hear the word ‘cancer’ there is some relief in hearing a bit more certainty coming out of all the investigations so far.
For colleagues, as well as friends, I suppose a rough timetable might be an operation in 10-14 days, followed by 6 weeks’ recovery before I should think of doing any work. That takes us up to mid March. In a few days I should have a more specific date for the operation, and then I need to speak to some of you more about cases and workload, etc, but it is probably best to make general plans as though I will be out of action for weeks rather than days. Meanwhile the BBC’s Rome series, James Naughtie’s History of Music and short walks into Crouch End represent the summit of my day.
Thanks for all your continued love and support.
Love
David (and Jane)
Bile Duct Diaries, II
Just to keep people informed, there was a hospital conference yesterday about my situation, and I have now discussed things with the lead consultant. They think the most likely cause of the bile duct constriction, is some type of cancer, and they want to operate in order to remove the bile duct and part of the pancreas. This allows them to do a thorough investigation that should answer further questions and lead to a clearer plan for treatment. The consultant said, hopefully, that the intention of this operation is ‘curative’. We shall see.
Before they can do that, I have to get over the current bout of pancreatitis and gain more strength. Jane and I are going to the Radcliffe Hospital in Oxford to discuss all this with the surgical team on Friday. I need to also think over whether that might be the best time to have my case transferred to the Royal Free. I must say, paradoxically, even though none of us wants to hear the word ‘cancer’ there is some relief in hearing a bit more certainty coming out of all the investigations so far.
For colleagues, as well as friends, I suppose a rough timetable might be an operation in 10-14 days, followed by 6 weeks’ recovery before I should think of doing any work. That takes us up to mid March. In a few days I should have a more specific date for the operation, and then I need to speak to some of you more about cases and workload, etc, but it is probably best to make general plans as though I will be out of action for weeks rather than days. Meanwhile the BBC’s Rome series, James Naughtie’s History of Music and short walks into Crouch End represent the summit of my day.
Thanks for all your continued love and support.
Love
David (and Jane)
Jaundice story
Dear All,
As the only one in our family who can bear the traditional American round-robin Christmas letter, I thought I would take this opportunity to send one of my own, to say thanks for all your concern and support and to give you a summary of what has been happening, and I promise I won’t be trumpeting anybody’s GCSE results!
In Friday the 22nd, I just finished a gruelling 6 days of group relations work….probably not a great idea, but there you go. Next morning Jane and I were doing our Christmas shopping in Witney and she noticed I had turned yellow, so we went to the local clinic that had a look and said I should go straight to the John Radcliffe in Oxford. Off we went to their assessment unit to discover the cause of the jaundice. And I have been at the hospital ever since, except for two days off to go home for Christmas. They arranged a sequence of 4 assessment ‘procedures’….Ultra sound….MRI….Endoscopy (camera down the gullet) …and CT scan. Because of holiday staffing and recovery times , these have taken some time. Things were OK till I had the endoscopy when they also inserted a small tube in the bile duct to drain the bile through the system. I had a violent, reaction to this that led to pancreatitis….and this has been no fun. Put on an immediate starvation diet, that means I couldn’t eat or drink for three days, and the nausea like pain was all consuming, 24 hours a day. I felt too preoccupied with the pain to eat, read, watch telly, or have much of a conversation.
They sent me home with pain killers, yesterday and I now have a few periods where I can sit up and drink soup. But this seems like a very slow process to me who has never been in hospital and brings up all my impatience and fear of not having some control of my life. A lot to think about….eventually.
Still, there is no diagnosis. Most likely a blocked bile duct but they don’t know why. Monday is a big consultants’ case conference to look at all the results, so we’ll hope there is more news then. So I feel like I am at the end of chapter one, but have no idea how much longer this will go on. The consultant has given me a 4 week ‘sick note’ but I will play it one week at a time and keep people informed.
As you all know, I get a bit embarrassed if too much attention sneaks up on me, but I do want to say how I have been very touched by the concern that is circulating amongst you, and back to me and Jane. It is surprisingly easy to retreat into feeling sorry for oneself in these circumstances.
Also I am happy for you to pass any of this information on to colleagues who might be interested.
I’ll be in touch,
Love,
David (and Jane)
As the only one in our family who can bear the traditional American round-robin Christmas letter, I thought I would take this opportunity to send one of my own, to say thanks for all your concern and support and to give you a summary of what has been happening, and I promise I won’t be trumpeting anybody’s GCSE results!
In Friday the 22nd, I just finished a gruelling 6 days of group relations work….probably not a great idea, but there you go. Next morning Jane and I were doing our Christmas shopping in Witney and she noticed I had turned yellow, so we went to the local clinic that had a look and said I should go straight to the John Radcliffe in Oxford. Off we went to their assessment unit to discover the cause of the jaundice. And I have been at the hospital ever since, except for two days off to go home for Christmas. They arranged a sequence of 4 assessment ‘procedures’….Ultra sound….MRI….Endoscopy (camera down the gullet) …and CT scan. Because of holiday staffing and recovery times , these have taken some time. Things were OK till I had the endoscopy when they also inserted a small tube in the bile duct to drain the bile through the system. I had a violent, reaction to this that led to pancreatitis….and this has been no fun. Put on an immediate starvation diet, that means I couldn’t eat or drink for three days, and the nausea like pain was all consuming, 24 hours a day. I felt too preoccupied with the pain to eat, read, watch telly, or have much of a conversation.
They sent me home with pain killers, yesterday and I now have a few periods where I can sit up and drink soup. But this seems like a very slow process to me who has never been in hospital and brings up all my impatience and fear of not having some control of my life. A lot to think about….eventually.
Still, there is no diagnosis. Most likely a blocked bile duct but they don’t know why. Monday is a big consultants’ case conference to look at all the results, so we’ll hope there is more news then. So I feel like I am at the end of chapter one, but have no idea how much longer this will go on. The consultant has given me a 4 week ‘sick note’ but I will play it one week at a time and keep people informed.
As you all know, I get a bit embarrassed if too much attention sneaks up on me, but I do want to say how I have been very touched by the concern that is circulating amongst you, and back to me and Jane. It is surprisingly easy to retreat into feeling sorry for oneself in these circumstances.
Also I am happy for you to pass any of this information on to colleagues who might be interested.
I’ll be in touch,
Love,
David (and Jane)
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