My recent CT scan was "fantastic," according to my general physician. Which most likely means she reviewed the report by the radiologist and hopefully gave the actual imaging a quick look before having a nurse call me with the results. I got that phone call the day after my CT, so I only had to wait about 24 hours for the results. "Scanxiety" (anxiety over looming scan/scan results) is not fun. I will say that this period of scanxiety was the mildest thus far. Both time and practice have made me better at waiting. I also wasn't super nervous in the weeks before the CT scan. Oddly, going over the "worst likely case scenario" in my head and out loud is helpful. What is the worst likely case scenario? In my non-medical opinion, the worst likely case scenario would be a recurrence of my tumor. That only mildly freaks me out, as I've beat it before & I know that a recurrence isn't even close to a death sentence. Does it up the chance of death by pancreatic tumor? Sure, but it doesn't make it imminent. There are a nearly unlimited supplies of "worst case scenarios" out there, so that is why I choose to focus on only what is relatively likely given my medical history. No need to "borrow trouble" by worrying over other possible, though unlikely, scenarios.
The week following my CT scan, I met with my gastrointestinal doctor. He, too, reported that there was no recurrence of my tumor, which is excellent. The results were largely unremarkable, if you ignore my half pancreas and other "surgical changes." The radiologist did note some signs of pancreatic atrophy, though. I know enough words to know that "pancreatic atrophy" means that some of my pancreas tissue appears to be dead. I asked if that was to be expected after having a Whipple surgery, and my doctor replied "we don't really know, most patients are in their 60s and 70s when they have that surgery." He went on to explain that as we age, our insides age, too. So my pancreas looks fine, mostly, but it looks older than my 36 years. He asked how much of my pancreas was taken out. I told him what I knew. When I asked my surgeon how much of my pancreas he took out, he replied: "What I took out probably wasn't working very well anyway." I've always interpreted that particular conversation with my surgeon as "you have less than half left," but also "you have enough." Vague, but so far, so good. My doctor explained that this is something we'll have to watch. Over time, I might become a surgically-induced, insulin-dependent diabetic. I might also depend on pancreatic enzymes more so than I already do. None of this was new information; my surgeon told me all of this after my surgery. I knew the future of my pancreatic function might look a little bleak. Fortunately, though, modern medicine has caught up to sub-par pancreases. Maybe someday the future will bring us 3D printed pancreases, but for now, I will continue to be monitored and try to be kind to my surgically altered self.
Sunday, January 28, 2018
Thursday, January 18, 2018
On the lesser of the evils.
I tried two ditch two of my medications: my daily antacid and my pancreatic enzymes medication I eat with meals. There is an actual medical reason I'd like to ditch the antacid (omeprozole/Prilosec), but the only reason I'd like to ditch the enzymes (Creon) is that it's inconvenient to have to pop a pill with each and every meal. There's nothing heroic about unnecessary suffering, as I tell my husband with some regularity that it's OK to turn up the heat if you're cold. I've found that when I deviate from a low-fat diet and skip the Creon, I suffer. So, alas, I had my prescription refilled and I am again popping the pig-pancreas enzymes with fatty meals. I'd rather be inconvenienced by a pill than the alternative. If you are curious about the alternative, ask me. Some things should not be written down...
As far as the antacid, this was my second attempt to go without. I've already stated that unnecessary suffering isn't my bag, so why wouldn't I continue to take it? Well, long term use of this particular type of medication can cause a host of other problems from c-diff to bone fractures to lupus, and more! Therefore, I'd like to stop taking it, if possible. Attempt #1 was about a year ago, I lasted a few days before deciding my heartburn was too bad without it. Attempt #2 lasted about three months, and then the stomach pain returned. I was supposed to go back on it for two weeks and then off of it again, but a month later I'm still taking it. I am going to talk to my gastroenterologist about stopping again. Wish me luck! Which will ultimately be the lesser of the evils? Long term omeprozole use with the long list of potential nasty side effects, or stomach pain? Ideally, the stomach pain would cease to be even without the drug. But three years post surgery, stomach pain is still a thing for me, unfortunately.
The tumor I had is statistically unlikely to come back. However, it was even more unlikely (like millions of times more unlikely) that I'd get this tumor in the first place. The doctors (whom I trust very much) have decided that I should have diagnostic imaging done at regular intervals for the rest of my life as the tumor can show up again 5, 10, 15+ years after diagnosis. Unfortunately, the best way to see what's going on inside my pancreas & other digestive organs is a CT scan. I have lost track of how many CT scans I've had, but at my two year follow up with gastroenterology, my doctor said, "You are too young to have all of that radiation. Once every two years is enough." In the case that you didn't already know this, CT scans come with a heavy dose of radiation that can CAUSE CANCER. That's right, the imaging I get to see if I have cancer can actually cause cancer. It's a fairly small risk, but a risk nonetheless. My doctors have decided that it's a better idea to check for cancer that I have already had using a CT scan despite the radiation. To the best of their knowledge, it's more likely that the CT scan will be able to help me than it is likely to hurt me. It's the lesser of the evils, these two evils being "radiation" and "cancer."
I'm quite comfortable deferring to the medical professionals on this one. I didn't start that way; I spent enough time worrying about my pancreas and all related parts for a long while. It took medication, therapy, and time to get me to realize that I wasn't going to stave off the cancer by knowing more about it. I am no longer obsessed. Being aware of your health and being able to self-advocate is super important, of course, but obsession is harmful.
To conclude, here's a recap of the evils:
As far as the antacid, this was my second attempt to go without. I've already stated that unnecessary suffering isn't my bag, so why wouldn't I continue to take it? Well, long term use of this particular type of medication can cause a host of other problems from c-diff to bone fractures to lupus, and more! Therefore, I'd like to stop taking it, if possible. Attempt #1 was about a year ago, I lasted a few days before deciding my heartburn was too bad without it. Attempt #2 lasted about three months, and then the stomach pain returned. I was supposed to go back on it for two weeks and then off of it again, but a month later I'm still taking it. I am going to talk to my gastroenterologist about stopping again. Wish me luck! Which will ultimately be the lesser of the evils? Long term omeprozole use with the long list of potential nasty side effects, or stomach pain? Ideally, the stomach pain would cease to be even without the drug. But three years post surgery, stomach pain is still a thing for me, unfortunately.
The tumor I had is statistically unlikely to come back. However, it was even more unlikely (like millions of times more unlikely) that I'd get this tumor in the first place. The doctors (whom I trust very much) have decided that I should have diagnostic imaging done at regular intervals for the rest of my life as the tumor can show up again 5, 10, 15+ years after diagnosis. Unfortunately, the best way to see what's going on inside my pancreas & other digestive organs is a CT scan. I have lost track of how many CT scans I've had, but at my two year follow up with gastroenterology, my doctor said, "You are too young to have all of that radiation. Once every two years is enough." In the case that you didn't already know this, CT scans come with a heavy dose of radiation that can CAUSE CANCER. That's right, the imaging I get to see if I have cancer can actually cause cancer. It's a fairly small risk, but a risk nonetheless. My doctors have decided that it's a better idea to check for cancer that I have already had using a CT scan despite the radiation. To the best of their knowledge, it's more likely that the CT scan will be able to help me than it is likely to hurt me. It's the lesser of the evils, these two evils being "radiation" and "cancer."
I'm quite comfortable deferring to the medical professionals on this one. I didn't start that way; I spent enough time worrying about my pancreas and all related parts for a long while. It took medication, therapy, and time to get me to realize that I wasn't going to stave off the cancer by knowing more about it. I am no longer obsessed. Being aware of your health and being able to self-advocate is super important, of course, but obsession is harmful.
To conclude, here's a recap of the evils:
- Regular antacid vs. Stomach pain= Antacid wins
- Pancreatic enzymes vs. Intestinal Inconvenience= Enzymes win
- Radiation vs. Cancer= Radiation wins
I have had a few years to contemplate the above battles of evil, and that is where I currently stand. Thankfully, I do not fight these battles alone. My doctors & I will revisit these issues as I change and as medicine gains more knowledge.
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