Long Duke Valentine's Day

We arrived at Duke early enough to find a good parking place near the level 2 bridge to the Duke Clinics from the parking deck. We checked in at Clinic 1A via the arrival kiosk just prior to 8am.(Joe loves this part where he gets to scan the barcode). Soon thereafter Joe was called to the back for them to draw some blood and about 10 minutes later he was called to the back for them to take his vitals.  He's only lost 2 lbs. since his last visit 3 weeks ago. Yea!  Minokah, Dr. Zafar's nurse, came out and told us to go on up for him to have his CT Scan.  He was called to go back for his CT scan about 10 minutes after we checked in at that clinic.  They called 10 names and the waiting room emptied.  It would appear that they do them "en masse" since they called so many at one time :) .  So now I wait.

 Joe came back from his CT scan about 9:40am and now we are off back downstairs to Clinic 1A to wait some more.  Patience is a virtue that I am sorely lacking....especially now.
After 1 1/2 hours we are still waiting in Clinic 1A.  Let me emphasis how impatient a person I am.  Joe is reading from his Nook, and now trying to figure out how to get on the free Duke wi-fi.  That should keep him occupied for a little while.  I've played several games of Liquid Measure, AngryBirds and Cat Physics on my iTouch......my eyes are crossing and the caffeine from the coffee earlier has worn off.  Yawning once again.
Finally about 11:15am we were called back to the exam room.  After a couple of minutes, Dr. Zafar's nurse, Minokah, came in to check on how Joe was feeling and go over his current meds.  She left after a few minutes and then in came Kara Penne, Dr. Tyler's (Surgeon) NP.  She examined Joe, asked questions and then Dr. Tyler came in to talk with us about the results of the CT Scan and the possibility of surgery.  Apparently, the chemo and radiation seem to have had no effect at shrinking the tumor, and possibly it has grown some.  However, Dr. Tyler still feels it would be best to plan on the surgery.  But, and this is a big but, it is possible that once he begins the surgery, if there is evidence that the tumor has encompassed some vital veins, ones that can't be cut around, then he would not be able to proceed with removing any of the cancer.  After Dr. Tyler left, Dr. Zafar (Oncologist) came in just to follow up and make sure that we fully understood what Dr. Tyler had said.  We were able to re-state for him about 90% of what Dr. Tyler had said, so Dr. Zafar went over it all again for us. The scans did not show what he was hopeful for, shrinkage of tumor, and he went over what our course of action would be with both scenarios.   If the whipple (the pancreatic oncology surgery) can be performed, Joe will have a couple of months of recovery time followed by 4 months of IV chemotherapy.  If the surgery can not be performed, then after a short recovery period, he will start IV chemotherapy indefinitely.  Once Dr; Zafar left, then Dr. Czito (Radiologist) came in and although he fully agreed with both Dr. Tyler & Dr. Zafar, he felt that although the CT scan did not show shrinkage, he felt the growth was negligible and he was optimistic that the afore mentioned veins would not be engulfed by the tumor.  He stated he didn't want to paint a rosey picture, but he repeatedly stated he was optimistic.  The main point through it all was that if when the surgery starts, if there is evidence that the tumor has attached to the aforementioned veins, then he would not proceed with the surgery and Joe will go back to weekly chemotherapy indefinitely.
Our appointment for the Surgical Pre-screening clinic was for 1pm, so we were about 5 minutes late getting up there, but we only had to wait until1:30 before going back to yet another exam room.
A nurse soon came in with lots of questions and double checking his current medications and went over the procedures for the day of surgery.  Soon thereafter, the Nurse Practitioner came in and went over more questions, more medications and went into more in-depth answers about the surgery.  She had to order up more blood to be drawn and an EKG. After getting that taken care of we were finally out of the Pre-Admissions room around 3:20pm.  That's 7 1/2 hours at Duke today.
We quietly walked back to the car without much talk.  Todays news has taken the wind out of our sails somewhat. Tears have flowed some, nerves are a little frayed.
We treated ourselves to a late lunch at Elmo's and now have returned home.

Try as I might, I can't seem to come up with anything clever or humorous to say for this post.  Be patient with me, maybe next time.

Thank you to everyone who has called, texted and inquired about how Joe is doing and we continue to be grateful for your good wishes and prayers.

P.S. One bit of good news today (Tuesday). The vascular surgeon that our Surgeon, Dr. Tyler, wanted to have ready if there is the need for the artery graft from his thigh to the area next to the pancreas is available and on the schedule for that day.  At the very least, we will have the best possible team of doctors in the operating room working on Joe.