Saturday, April 27, 2013

Whipple? What's that?

The "Whipple Procedure" explained...the re-routing of my GI system.

http://m.youtube.com/watch?v=x4NJTNLq3xw

Pancreatic cancer fact:

  • Treatment options for pancreatic cancer are limited. In adenocarcinoma (the most lethal & what I was diagnosed with), the most common type of pancreatic cancer, surgical removal of the tumor is possible in only approximately 15% of patients. 

I'm one of the lucky 15%! I was a candidate for the "Whipple". I did my research, with the help of my brilliant, beautiful blonde, Tami & I knew my greatest chance of survival (5 year ~ 10%) was to get to a National Cancer Institute Facility, where I would find a highly experienced surgeon and nursing staff. Not only did I need a surgeon who performs many whipple procedures on an annual basis, but I needed an experienced nursing staff, as well. I found both at Vanderbilt University Medical Center.

Vanderbilt is one of the elite cancer treatment centers in the country.  It is a National Cancer Institute facility. These facilities are designated because of the cutting edge research they perform. It is one of only 41 Comprehensive Cancer Centers nationally.

http://www.cancer.gov/researchandfunding/extramural/cancercenters/about

Now, about my Whipple. It's called the "Granddaddy" of procedures for a reason.
If you watch the video above, it IS one of the most complicated surgeries anyone can go through.

Fortunately, I had a fabulous surgeon. I was prepared for the possibility that I may or may not be waking up to the reality of having a whipple. My Dr said that he would use a laparascope to visualize whether my tumor was isolated to my pancreas or if it had spread. If it had spread, he would not proceed. Luckily, he proceeded with the whipple. My surgery lasted a little over 7 hours. He removed a 4cm tumor that had penetrated my duodenum wall, 5 of 23 lymph nodes that were positive for cancer and he even went so far as to resect my portal vein to insure he had all negative margins. The fact he resected my PV, very well may be the difference between a significant amount of time to extend my life.

The surgery was the easy part! I spent about 12 hours in recovery, with a NG tube, catheter, JP tube, IVs, O2, EKG leads and other bells and whistles on me. Unlike most Whipple patients, I did not spend any time in ICU. I chalk it up to my youth (at 49...lol) and that I'm in pretty decent shape. I had the NG tube and catheter removed prior to moving me to the 9th floor at VUMC. This was where my recovery really began. Unlike most patients where the average stay is 7-10 days, I was only in the hospital for 5 days.

Recovery from the "whipple"...this can vary significantly from patient to patient. I do know that for anyone that has undergone this procedure, your life is FOREVER changed. Never again will you eat like you did prior to surgery.  For the first two days, I was only allowed ice chips. Talk about weight loss, the whipple is notorious for this. I lost a total of 25 pounds from my pre-whipple body. I finally began on clear liquids by day 3. On day 4, before they would consider letting me leave the hospital, I finally began some "real" food. Fortunately, my sister went to Trader Joe's and Whole Foods and brought me good food to the hospital. I found that fruit smoothies were my best option in the early days.

My newly re-routed GI system was tough in the first 4 weeks. Without Reglan, I found most food was difficult to hold down. Anything with fat in it was a definite no-no. I'm now 10 weeks post-op and I'm finally stabilizing my weight loss and even have gained about 5 pounds back. It's been tough. Most days are still a struggle with an appetite and determining what my stomach will tolerate. I now have to take many meds just to be able to eat a meal. A lot of my once favorite foods are either off limits or are too much for me to handle.

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