Garden of Eadens

My oncologist, Dr. Eadens, is a soft-spoken, kind-hearted, genuine man.  I don't know how anyone could talk to people about cancer all/every day so I salute you good sir.  His easy-tone and mild-manner makes shocking things seem pleasant and fine.

You have stage 4 cancer he informally states in his soothing, gentle voice at our first meeting.

Hummm, I think to myself, isn't stage 4 really bad.....????? But it didn't sound bad... Alright, no big deal.  Carry on, doc.

The primary tumor is in the pancreas and there are about half a dozen metastasizes in the liver.  

Oh.... that's a lot...

If they cannot remove the liver tumors through treatments such as chemotherapy, you may need a liver transplant.   

Whhhaaat?!  I'm 31.... who gets a liver transplant at 31?!  Who gets anything transplanted-- ever?!

"I need to lay down," I say at this point.  And I did.


There are several types of pancreatic cancer but they fall into two main categories: exocrine and endocrine.  Approximately 95 percent of pancreatic cancers begin in the exocrine cells in the ducts of the pancreas and sometimes in the cells that make pancreatic enzymes that aid digestion.  Within this category there are a number of tumor types, but about 95 percent are adenocarcinomas.

Endocrine tumors, also known as pancreatic neuroendocrine tumors (PNETs) are slower growing and develop in the islet cells, which produce hormones, such as insulin.  These cancers are rare, accounting for less than 4 percent of pancreatic cancers.  Neuroendrocrine carcinomas are hormone secreting tumors.  The type of neuroendrocrine tumors I have are called gastrinomas, named so because of the large amounts of gastrin they emit.  The normal range of gastrin in a human is less than 100 pg/mL... my tests came back at around 3,000 pg/mL.  Guess that's a bit high.

Tomorrow I have a CAT scan to get a clearer, more detailed picture of the tumors.  CAT scans are far more complete than the images we have already.  On Monday I meet with a surgeon to determine if we can operate.  Then we'll plan a strategy for treatment.

In the meantime I have a palpable blanket of love wrapped around me.  My people are so warm and kind it's overwhelming.   Trent gently took care of me while we were in Turkey (and still to this day), making sure I could eat when I was hungry and constantly had water as much of the medication I take requires me to maintain a steady flow of fluids.  The four-some: Todd, Bets, Jos and me.  What can I say?  Together forever.  My girlfriends laugh with me when I make terrible jokes about cancer.  Laughter is the best medicine and I love to laugh with these girls:  Lisa, Shelley, Julie, Amy, Sarah, Abby, Susan, Melissa, Diane.  My sister, Tiff-- your letters are the best thing anyone as ever given me, besides a refill on my Dr. Pepper.  "Stay together" (you know what that means).  Friends and family have messaged, emailed, and texted to show their support.  YES, I can feel it.  There is nothing you can do, I simply won't let you, because you have already done enough.  You are there for me, you are caring, you are thinking about me.

Thank you everyone.  If I had words or enough love to give back what you have given me, I would.  A thousand times over.







*A thousand times over is borrowed from The Kite Runner.  I think it's one of the most beautiful lines ever written and I could never come up with anything to equal it.  

Apple Cancer

The story of how it all began:

Once upon a time there was girl.  A lovely, unassuming girl.   On a spring afternoon, she went for a walk at one of her favorite spots.  The shimmer of sun on the lake mirrored the floor of her classroom after students borrow glitter from the art room to complete a project.  She turned her face to Earth’s star, with eyes closed, and soaked in the rays.  Popping in her ear buds, she started the tunes that accompany her daily exercise.  As it turned out, this would be no ordinary jaunt.  Just as her first footfalls hit the path circling the lake, she received a phone call from her doctor.  Something was odd right from the start, this call was returned too quickly in succession from the message she left just minutes before. 

The doctor had been working tirelessly over the past several weeks.  Determined to find the root of the girl's problems, she ordered legions tests and procedures.  For the sake of our story, we’ll focus on the symptoms at hand for it would require a multitude of doctors working 24 hours a day to even scratch the surface of ALL the girl’s problems.  The doctor’s attention was to the pains including but not limited to stomachaches, nausea, cramping, and weight-loss (which actually belongs in the category of “positive effects,” the lone inhabitant of this classification).   And finally, the symptom that started it all (and is most unladylike):  diarrhea.  Constant diarrhea.   

The girl diligently muddled her way through the doctor's examinations.  First up was a CT scan revealing her pancreas was swollen and there are some "nodules" in her liver.  

"Do you even need a pancreas?" the girl asked innocently.  With her limited medical knowledge, she ran through the list in her mind of the several organs it appeared doctors just remove on a whim.  It seemed like pancreas could be there... the answer, however, is YES.  You most definitely need a pancreas. 

“Oh.”  Pause for processing and storing of new information. “Of course.”

She then endured the dreaded colonoscopy/endoscopy.  The utter insanity of preparation for a colonoscopy aside, she was familiar with the procedure.  The girl assumed she would Goldilocks right through and awake to the stark lights of her recovery room.  Followed by more sleep.  This was not the case.  Unaware that endoscopy means, not in technical terms, “now it’s the other end’s turn.”  The doctor shoved a long cord down her throat and the girl was violently awakened to choking and gaging.   She desperately focused her clouded mind on this thought over and over: “Do NOT grab the cord and pull it out, do not grab the cord and pull it out, do not grab the cord and pull it out.”  Even in her state of “conscience sedation” she knew they would have to start over if she pulled it out.  Her blurred brain was able understand she just wanted to get it over.  Results of the colonoscopy were great and the girl will not require another one until she’s 50.....  At which time they can drag her kicking and screaming. 

The girl was a true champion through many, many blood tests.  Read:  A LOT of needles.  Finally, an MRI revealed a tumor in her pancreas, prompting the aforementioned phone call.  The doctor apologized as she explained to the girl she has a tumor in her pancreas which is causing her symptoms.  She told the girl it's a neuroendocrine tumor.  The girl was dumbfounded but managed to get enough words from her brain to her mouth to ask the doctor to email her all this information because, you see, she was walking at the lake and didn't have a paper and pen to write anything down.  

In a somewhat odd conversational piece, the doctor revealed this is the same tumor as "someone famous."  

"Are you familiar with Steve Jobs [founder and CEO of Apple]?" 

She was indeed.  In fact, she exclusively (and snobbily) only uses Apple products.  The problem, the girl was thinking, Steve Jobs died from cancer.  She managed to mumble a thank you (yes, she thanked the doctor for this “news”) and hung up the phone.  The girl used the remainder of her walk to cry, laugh, gasp for air, and stare at the grass which suddenly looked like the perfect place to just lay down and stay forever.  

That evening the girl learned the first rule of a diagnoses such as the one she just received.  NEVER, under ANY circumstances, Google your condition.  Around 4 am when she found herself wide awake, this is precisely what she did.   Approximately three minutes after frantically clicking and skimming several links, she slammed her laptop shut and began pacing the room.  As no one yet knew the news, the girl suffered in silence, got ready for work and finished out the week.  TGIF never had a greater meaning.

The next step was a biopsy and more blood tests.  The biopsy was scheduled one million years in the future (about two weeks).  The girl decided a few people should know about this silly tumor, which would be cleared up in no time as soon as a surgeon could get in there and snip it out, so a few people were told.  Her sister and her best friend cried. 

Five days before the biopsy the doctor informed the girl, via email, one of her blood tests was wildly off the charts.  It was a Friday again.  The test prompted them to believe this tumor is a gastrinoma.  Good to know, thought the girl, the more information, the better.   

“I have put in a referral to oncology," the doctor continued.  

Wait a minute, I'm blonde but I'm pretty sure oncology means cancer doctors... does she think I have cancer?!

"I think you have cancer."

The good doctor was right!  The biopsy confirmed it is indeed cancer.  Time to schedule an appointment with an oncologist.  So the girl did.