Change in Plans

This week was going extremely well for Jeff...he returned to work on a full time basis and his energy levels have been great...but read on. They stopped Jeff's Neupogen (helps make white blood cells) last week and all of his blood work was back to normal. We were supposed to go to NIH for testing and clinic visit last week but they postponed the tests/visit until this week beause of the problems Jeff had getting back to normal this time. This round of chemo took a lot out of Jeff and unfortunately they let his blood levels get too low before they got him back on track. Looking back,we think they should have ordered an out of cycle blood test when things started to decline. By the time Jeff had the next regularly scheduled test four days from the previous one, things were pretty low. Luckly he's a strong man and this too he fought back from.

As for this week's tests and visits, they have added a new wrinkle. Jeff had several tests this week including the ususal MRI and CT Scans, however, this time they added an Octreotide Scan. This was a nuclear medicine study where they inject a radioactive agent that is attracted to the tumors. When they take the "pictures" it lights up the places where the tumors are still hiding. The results of this test showed that there is still a fair amount of tumor activity in the liver and from the sounds of the physicians, I think it is either much more than they would like to see or they had hoped for no liver tumor activity after these two treatments.

The Octreotide scan also showed something in Jeff's brain that they weren't expecting. Therefore Jeff has to have an MRI for additional diagnostic testing. The doctors believe that it may be a false positive but cannot confirm that until the MRI is done. All other testing was normal except for a slightly elevated insulin level. As you may remember, the tumors produce insulin so this tumor activity is still reaking some havoc on Jeff's insulin/blood sugar. However, Jeff hasn't had to take any diazoxide since the last round of chemo and even with a low appetite, his blood sugars have been wonderfully normal.

As a result of the Octreotide Scan, the surgery that Jeff was scheduled for on May 17th has been posponed. He is scheduled for an MRI of the brain on May 9th and we go back for a clinic visit on May 12th. It is the May 12th visit that we'll know the results of the MRI and what the next course of treatment will be.

Oh, did I mention that we met Dr. Richard Royal during our clinic visit on Friday. Dr. Royal is the surgeon who will be doing the surgery on the pancreas...eventually... we hope. Both Jeff and I really liked him and his bedside manner. He was very straight forward, explained things very well, and answered all of our questions.

For now, all we can do is wait and let Jeff get his strength back. He' has lost over 30 pounds in the last four months and the delay will give him time to recover a bit before the next stage. Right now we just don't know if the next step will be....surgery, another round of chemo, or something yet to be determined.