Three days is a lot, especially if you have to spend them in a hospital. When the doctors told me yesterday that I wouldn’t be home until Friday, I wasn't too happy at first. I understood their point. The antibiotics treatment has to run its seven-day course before I can leave. But three days is a lot. On the other hand, having a relatively certain release date is much better than living day to day, anxiously asking every morning, “May I leave today?”
It won’t be three days of complete inaction. Yesterday morning, the doctors agreed to drain the liquid from my abdomen. This is a procedure not unlike what was done to my lung, and I’m afraid the result will be the same. The liquid will go but quickly return. Even so, it should give me temporary relief and the chance to eat as much as I need to keep my weight. And maybe the liquid will stay away.
Right after the procedure, I could feel that my belly was much less tense than before. This is what I had hoped for, and it filled me with joy. This procedure had been the right thing to do. At dinnertime, much of my joy had already dissipated. I had similar problems eating as before. I didn’t want to eat and couldn’t fit much in. The mere thought of eating now puts me in a bad mood. I don’t feel good when I eat. I’d prefer not to eat.
Not eating is obviously not an option. I need to keep my weight. If I waste away, the result is obvious. This morning, a nutritionist stopped by to discuss ways of supplementing my meals to get enough calories even when I don’t eat much. One option are energy-rich shakes that can be consumed between and after meals. I’m already doing something similar at home with protein-rich milk drinks from the grocery store. The nutritionist signed me up to something even richer, to be delivered to my door once a month.
This was only the second most exciting thing to happen today. Yesterday when I discussed various aspects of my disease with my oncologist, we got to the topic of comprehensive mutational analysis. I know the main mutation of my cancer, G13D in KRAS, but it’s entirely possible that additional mutations have accumulated during the billions of cell divisions that the cancer cells have undergone in their relentless proliferation. To identify them, one takes a bit of cancerous tissue, extracts the DNA and sequences a large number of cancer-related genes. The identified mutations might indicate new avenues for treatment. As a side note: Among those new avenues won’t be the injection of mitomycin C straight into the liver, which I had floated after Flucha’s discussion. The oncologist didn’t think this was in any way sensible.
Getting the tissue for sequencing takes a biopsy. In my case, the liver with its plentiful metastases was an obvious candidate. The procedure took place this morning, after I had received, once again and much to my surprise, no breakfast. A few hours later, I was wheeled down to the ultrasound department on the first floor.
I was a bit afraid the doctor would just take tissue from the liver, but he had things under control. With the ultrasound, he mapped the area and identified a place with few blood vessels and good access to a metastasis. Then everything was made sterile, including the ultrasound head and the cable, which were slipped into what looked like a condom fit for a horse. Thus prepared, the procedure began.
An assistant held the ultrasound head to guide the doctor’s needle. The doctor turned towards me, a syringe with a 8-cm-long needle in his hand. For the local anesthetics, he said. I almost jumped off the bed, but in the end it wasn’t half as bad. He anesthetized the skin and then the protective layer surrounding the liver. There was no pain beyond the initial injection. The doctor took another needle, even longer and thicker, inserted it into my numb skin and further into the liver and, with a loud snap, extracted tissue exactly from where he had planned. He repeated the procedure and then showed me two little worms 1 mm in diameter and 2 cm in length floating in a small plastic vial. Enough for a few sequencing runs.
None of what I’ve undergone during this stay in the hospital has been painful. But it wasn’t pleasant, and the unpleasantness adds up. This afternoon, I lay on my bed in a rather sad shape. I tried to write at the table for a while, but the bed was the more appealing proposition. Good thing that there are no procedures scheduled for tomorrow, and that I can go home on Friday.
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