Yesterday we had visits from the international coordinator and the doctors. The international coordinator had dropped by to check in on us and chat a bit. She brought us some iberico ham, and some other treats. We chatted about our families and showed her all of the snow we had back home. She was quite pleased with the maple syrup we had brought for her and she mentioned that she will need to make pancakes to try them out. It is something that we did not think of, to bring a premix so that they could just add water and have some. The doctors came a couple of hours later and the two of them have fantastic bedside manners. One is from Italy and the other is from Croatia and both were super friendly. They had said that they had spoken to Mel the night before and were going to wait till the next day to chat with me. In Canada they come chat with me after surgery and I never ever remember talking to them. There were instances later where the doctors told me they gave me instructions and I do not even have a recollection of even seeing them.
The surgery went well, and they did what they had wanted to, but it was not as they had expected. The first thing that they did was drain the ascites. It was still milky and it was something that they did not expect with my diagnosis. Mel told them that this is what it was the last time, and they had mentioned that they had drained between 2 and 3l. Within the last couple of weeks there has been quite the accumulation it seems. When the discharge is coloured like this, it indicates that the lymphatic system is backed up somewhere. The second thing that was unexpected was with the cancer type that I have, you normally see nodes or bumps along the peritoneal walls and the bowels. This is generally not how the cancer presents itself, but they figured that since I was already opened up that spraying everything would not do any harm and it may help with the chylous ascites. There are a lot of potential causes for the build up and they are not sure exactly what it is. All of the findings they have seen confirmed what the other doctors had noticed. This was not a typical presentation so they decided to take samples and a larger sample of the peritoneal walls to see if the cancer is there. Visually it is not there, but they will perform a biopsy to confirm that it is there. They will also test the ascites to determine if it is a different type of cancer. I think it is worth coming here to confirm the proper treatment that we are are doing. This team specializes in this and they seemed to not be too stressed about this and the conversation was around what the treatment options would be. If the cancer is not present in the peritoneal wall and it is just a thickened wall then the PIPAC treatment does not make sense. Since they were able to open me up and check in there, and this is their expertise I think that they will be able to help inform what the best treatment options are. They may be able to isolate and identify better options that they can then continue in Canada. We would then know which other clinical trials or things that we should pursue. So on the good side, visually they can not really see the cancer, but the previous biopsy indicated it was there. Further tests are being analyzed to confirm.
During one of the consults the Croatian doctor had mentioned maple syrup and she was quite delighted when we brought her some. They discussed what to have it with and everyone had mentioned pancakes. I am glad that they enjoyed the gift and hopefully they will use it. The Croatian doctor had spent years in the US working and was explaining to the Italian doctor some different uses for it and we were telling them about it as well. We ended up the quick consultation and said that we would follow up with them in a couple of weeks to determine the next steps. The nurses have been coming in throughout the last couple of days and some of them ask me if I have pain and whether I need painkillers while some other ones just give it to me. I think some of it makes me tired as once they gave me some I wanted to take a nap right away. We asked the doctors if there were any restrictions to my eating and they lifted the soft meal diet, but I am still on the bland diet. The bland diet sucks and the food has no flavour at all. They recommended that I have some paella or enjoy the local food. When I get discharged today we will go to the market and have some delicious food.
Quoc Hao