The Start Of a Different Journey

A different Journey

April 24, 2015

Dr. Hugh Tildesley

For the faithful followers, you know these blogs are usually about travel. Written in part to inform friends as to our activities and also to serve as a historical document to aid failing memories as to what did we really do. This blog will have a different theme.

 

The last few weeks have been a whirlwind of tests, disturbing results and the realization that challenges have arisen, which will be stressful on all those around me. I have been diagnosed with metastatic pancreatic cancer. That is a cancer in the tail of the pancreas that has spread to the liver. Due to it’s stage, therapeutic options are limited, cure unlikely. I will share with you this journey, and as usual it is all about me. Merely writing about my predicament serves as a catharsis, but I want to share with friends as to how I am doing. Thus if someone asks and I do not feel like providing a long-winded, technical explanation, I will be able to merely say..... “ read my blog”.

Haystack Mountain Cannon Beach OR

My goal is to remain informative, up beat and when ever possible see the funny side.

The First week:

We returned from a marvelous road trip to LA on Good Friday (April 3, 2015. We had traveled down the Oregon and California coasts, cut across to the Napa valley and made our way to Torrance.In fact we visited the vineyard in which we were married.

Freemark Abbey, the sight of our marriage

Deborah and me, the site of our marriage in the background

Deborah has a sister Judy and brother Dan living there and we stayed a few nights with Judy and Connie before moving to our Manhattan Beach apartment. The two weeks was one big family reunion, and a chance to share with our son Hamish, his UCLA experience and meet many of his friends. He is in last year of screen writing and in our in depth talks I was so impressed with his knowledge and how undaunted he is to competing in a very tough industry. In addition Catherine, our daughter in first year law , flew down for a long weekend, a wonderful gathering !

Hamish, me, Deborah and Catherine

Our drive home was more direct than the meandering trip down, unfortunately the intermittent swelling and discomfort in my legs, which had started a few weeks earlier, was not getting better.

By Easter Monday I was very concerned that I was not improving and ordered some blood tests including a screening test for blood clots. This came back markedly positive. It shouldn’t have as I was on blood thinners. Developing clots on blood thinners is a bad omen and is cancer until proven otherwise. 

My colleague Adam White organized the definitive Doppler studies and I contacted Heather Leitch, a St. Pauls hematologist, to get advise re anticoagulation. She advised switching to Dalteparin, an injectable, low molecular weight heparin. I picked up the prescription and $1200.00 later took home a batch of prefilled syringes.

Let me rant here. The picture of the syringe looks benign enough but the needle is large, dull and too long for a sub cutaneous (SQ) injection. Compare the dimensions with a simple insulin syringe. This device is like something out of a diabetes museum describing injection techniques from the 1920’s! 

The needle on the right is 25% longer and twice as wide. Not shown is the dullness factor, the needle on the left is a simple insulin syringe ( from this century), this photo says it all. Shame on the manufacturer!

The next day lower limb ultrasound documented extensive clotting in both legs. Next was a CT of the chest, abdomen and pelvis, I was fitted in on a Friday afternoon and being a physician was able to sit with the radiologist, Pattrick Vos and see the scan “ hot off the press”. It documented a small tumour on the tail of the pancreas and multiple spots on the liver. The diagnosis was all but sealed, primary pancreatic cancer with significant spread to the liver.

I felt for Pattrick, we are colleagues, but not friends. He usually describes images that culmonate in a typed report. It is then up to the ordering physician to give the news to the patient. It was just the two of us, digesting bad news. To his credit he immediately got Dr. Leitch on the phone and we had a brief chat. He then organized the liver biopsy for the first thing the following Monday, this was done in minutes. I was very thankful for his genuine concern and professionalism.

My worst fears were now documented.