This past year has led me down many roads and meandering paths. I still have travel pictures and stories to tell. This photo was going to start my story of our exploration of the Philippine Islands in February. I was ill with what I thought was food poisoning when in Hong Kong and felt okay for most of the trip until the end when I felt a bit funky so I made some doctor appointments when I got home.
March came and life took me on an extraordinarily different road than the one I planned for myself visiting friends and family in South Carolina, Georgia and Florida. Many of you know what happened next and some have just a few facts. Here I will connect the dots of the story for some of you.
I know the following statement is an oxymoron, however, I was very lucky to have gotten acute pancreatitis on March 26th. The sudden sweats and crushing chest pain prompted my mother to call 911 and I got an ambulance ride to the Nyack Emergency Room. I am most grateful to my mother’s judgement, pancreatitis and the ER staff at Nyack Hospital because this is how my cancer was found.
I have Gallbladder Cancer at stage T2N1C0 which is considered partially both stage 2 and 3. It’s a rare one and very hard to detect. The ER doctors at Nyack found the Pancreatitis first but then I developed septic shock. I was admitted into the ICU with dangerously low blood pressure, the pancreatitis and septic shock for 9 days. Other tests were conducted during that time to determine the cause of the pancreatitis. A mass in the gallbladder was found.
I needed an experienced surgeon so I was transferred to Montefiore Memorial Hospital. The gallbladder with the tumor ( 5.3 cm x 3.7 x 3.5), connecting tissue between the gallbladder, part of the bile duct, a lymph node and part of the liver were removed. My scar is shaped like a backwards capital ‘L’ with my belly button at the corner. Yow! Hard to move up or down, right or left. Sleeping for any length of time is impossible.
I was released 5 days after the surgery but admitted again the night of Day 6 (Easter) with a fever, increasing abdominal pain, nausea and diarrhea. The fever and pain were caused by an abscess. The diarrhea was not so easy to diagnose. The gastroenterologist there wanted to rule out c-diff, parasites or pancreatic malfunction. Thankfully, they found treatments that are working. The most exciting part of this 4 night hospital stay was the 27 hours I spent in the Montefiore ER. I have been in several ERs and this one is the biggest one by far. When they suspected c-diff, I was put in an isolation room for hours without a call bell but even when I had one, it did no good.
The doctors tell me surgery was part of the cure but because cancer was found in the lymph node I will need chemotherapy. The treatments will be on a three week cycle of two weeks with chemo and one week off. Chemo treatments will be two drugs given one day a week and will run for 6 months. I’ve done this before with my ovarian cancer and from what I’ve been told this treatment will NOT be as harsh. Phew!
So, between the treatments I plan to get out and do the things I love: hike, tutor, theater, fun with friends, Book Club and weekend get-aways. I am grateful it is Spring and the flowers and trees are blooming. I am so excited to see the Mountain Laurels bloom. The lessons of The Camino de Santiago live in me. I have faith that this bump in road will lead me to situations I am to learn from and people I was meant to meet.
Thank you for your prayers and positive thoughts. They have held me up in some of the dark hours. I am grateful for the love of my family and friends. I so fortunate to be living a life I love and am ready for whatever may come along the way.
May peace prevail on earth and with you!
Buen Camino Mi Amigos!
Below is information from the Memorial Sloan Kettering Cancer website. If you’d like to read more go to their link.
Gallbladder and bile duct cancer are relatively rare. According to the American Cancer Society, approximately 9,500 new cases of gallbladder and bile duct cancer are diagnosed each year in the United States.
The Gallbladder & Bile Ducts
The gallbladder is a small, pear-shaped organ located just underneath the liver. The gallbladder stores and concentrates bile, a fluid made by the liver that helps digest fats in the small intestine. The gallbladder contracts during digestion, releasing bile into the small intestine.
Bile ducts within the liver join together to form one main bile duct, located immediately outside the liver, which carries bile to the small intestine. This main bile duct is called the common hepatic duct. The cystic duct joins the gallbladder to the common hepatic duct, and the combined duct is called the common bile duct.
Types of Gallbladder and Bile Duct Cancer
Most primary gallbladder and bile duct cancers are adenocarcinomas, growths that begin in the mucus glands that line the insides of the gallbladder and bile ducts.
Bile duct tumors are known as cholangiocarcinoma. These tumors can occur in the main bile duct outside the liver (extrahepatic) or within the liver (intrahepatic).
Risk Factors for Gallbladder Cancer
Gallbladder cancer typically strikes older people (aged 70 and above). It is more common among Mexican Americans, southwestern Native Americans, and people from certain South American countries, particularly Chile.
- Gallstones and Inflammation
Gallstones — hard, rocklike formations made of cholesterol and other substances in the gallbladder —are the biggest risk factor for gallbladder cancer. Up to 90 percent of people diagnosed with gallbladder cancer also have gallstones and chronic inflammation of the gallbladder. These conditions are more common in women, who are twice as likely as men to develop gallbladder cancer. People with larger gallstones (3 centimeters) are ten times more likely to develop gallbladder cancer than those with small stones (1 centimeter). However, gallstones are very common, and most people with gallstones never develop gallbladder or bile duct cancer.
Other risk factors for gallbladder cancer include:
- Porcelain Gallbladder
This is a condition in which the gallbladder becomes covered in calcium deposits, resembling porcelain ceramic. Porcelain gallbladder can occur when the gallbladder becomes inflamed. - Typhoid
People who are chronically, or persistently, infected with salmonella (the bacterium that causes typhoid) are six times more likely to develop gallbladder cancer than those who are not infected. - Obesity
Many patients with gallbladder cancer are overweight or obese, and have a high-carbohydrate or low-fiber diet. - Family History
Gallbladder cancer sometimes runs in families. - Gallbladder Polyps
Gallbladder polyps are growths that protrude from the gallbladder’s mucous membrane. These polyps are usually symptomless. Some polyps are precancerous and can progress to cancer. Polyps that are 1 centimeter or larger, appear to be growing, or have a broad base should be removed to prevent cancer.
Risk Factors for Bile Duct Cancer
Like gallstones, smaller stones that form in the bile ducts can lead to chronic inflammation and increase the risk of developing bile duct cancer. Other inflammatory conditions can increase the risk of developing bile duct cancer:
- Ulcerative Colitis
Ulcerative colitis is an inflammation of the large intestine that is often associated with inflammation of the bile duct (a condition known as sclerosing cholangitis). Ulcerative colitis can progress to cancer, particularly in people exposed to other carcinogens such as cigarette smoke. - Biliary Parasites
Although rarely seen in the United States, food- or water-borne parasites that reside in the bile ducts are common in Asia and raise the risk of developing bile duct cancer. - Congenital Bile Duct Cysts (Choledochal Cysts)
These bile-filled sacs are connected to the common bile duct. Congenital bile duct cysts are typically diagnosed in childhood. The lining of these sacs often contains precancerous cells that increase the risk of developing cancer later in life. - Chronic Hepatitis C
This inflammatory disease — the most common risk factor for liver cancer —also is considered a risk factor for cancer of the intrahepatic bile ducts. (For more information about hepatitis, visit the Risk Factors section of the Primary Liver Cancer overview.) - Smoking
A recent study suggests that intrahepatic bile duct cancer is more common among heavy smokers. - Diabetes
This condition appears to be an increasingly important risk factor for intrahepatic bile duct cancer.
Symptoms
Gallbladder and bile duct cancer cause few symptoms until they reach an advanced stage and have spread to other organs and tissues.
Jaundice (a condition in which the skin and the whites of the eyes become yellow, urine darkens, and the color of stool becomes lighter than normal) and itchy skin (which can occur when a tumor blocks the bile duct) often are the first signs of bile duct cancer.
Other symptoms may include:
- general feeling of poor health or weakness
- loss of appetite
- weight loss
- fever
- fatigue
- bloating
- swelling of the legs
1 Welzel TM, Graubard BI, El-Serag HB, Shaib YH, Hsing AW, Davila JA, McGlynn KA. Risk factors for intrahepatic and extrahepatic cholangiocarcinoma in the United States.
Buen Camino 