Clinic Visit - Day 50

Today's Scripture readings were from Psalm 37:4-5.

Delight in Me, the Lord says
Commit your way to Me
Trust in Me.
His desires to become the desires of my heart
as I live in the light of His love
And He will give
And it shall be...
(c) CMOL


This morning Jim had blood drawn at MedLabs. Dr. Butler's office called at 12:40 p.m., with results - INR reading is 2.7. He is to take a 3 mg tab nightly the rest of the week and have it checked again on Monday.

We arrived at UIHC for Jim's 4-week clinic with his surgeon, Dr. Parekh, a few minutes early for our 2:30 p.m. appointment.
Vitals:
weight - 133.6 pounds (without shoes)
blood pressure - 91/53
pulse - 63

Dr. Parekh gave us 10-15 minutes of his time, which is doing pretty good for a surgeon. We were satisfied with the answers he gave to our questions.

When Jim was having problems with severe indigestion late Saturday/Sunday/Monday, June 6-8, and we ended up calling the thoracic fellow on-call at UIHC early Sunday, we were told Jim needed to be on pantoprazole (Jim was on this medicine prior to the May 12 surgery.). The on-call doctor said pantoprazole helps with acid reflux.

Well, Dr. Parekh said Jim didn't need pantoprazole. With the esophagectomy, there should be no heartburn or acid reflux problems. I think he said the glands were taken out that produce acid, so there is no point in taking the medication.

So we asked him about dicyclomine, another medicine taken before but not continued after surgery. Dicyclomine is for irritable bowel syndrome. Dr. Parekh recommended he resume taking it.

Jim asked what he could eat. The on-call doctor said to avoid red sauces because of the acid it produces. Dr. Parekh said it's not the red sauces, but things like bread. He said to avoid high carb and high starch foods. Jim will have to experiment with foods over the next few months to determine what he can or can't eat without getting sick.

And then we asked about AFib, that lovely little problem he acquired after the first surgery, when he was put on Amiodarone and Coumadin. His heart has stayed in rhythm since the second surgery June 11 for the small bowel obstruction and was in rhythm today when checked. Dr. Parekh said to stop the Amiodarone. No need to take that. He also thought there was no need to take the coumadin either, since his heart was in rhythm, but ordered an EKG. Preliminary results showed sinus rhythm normal, but left anterior fascicular block was abnormal - whatever that means. We are to go with whatever the cardiologist thinks, but also said if we wanted to change doctors, we could come to UIHC.

I remember when Jim first started seeing Dr. Li, the cardiologist, on June 22, she said Amiodarone can affect the thyroid and liver and that with longterm use of the medication, side effects increase. My thinking was then why is he taking it?!

Dr. Parekh's nurse, Joan, will fax information to Dr. Li about changes in medication and EKG results. I think I will ask her to also send information to Jim's primary care doctor.

Also, on a side note, the doctor said some of his patients have lost as much as 30 to 40 pounds with this surgery -- Jim can't afford to lose that much! Pray he stops losing and starts gaining.

Jim is to come back in October for his three-month checkup.

Jim was able to produce No. 2 before bedtime.

Test Results Favorable

Praise the Lord! The PET/CT scan Jim had Tuesday morning does not show any indication the cancer has spread to the lymph nodes. A definite answer to much prayer from a great many people.

There appears to be two nodules on his lung, which could be benign. It seems I remember from some time ago, when he's had a CT or MRI, there was something there, but nothing concrete.

We met with Jim's surgeon, Dr. Kalpay Parekh (pronounced Pare-ek) and his nurse, Joan. Dr. Parekh said the endoscopic ultrasound scheduled for March 31 would probably still be performed - to see if any tumors are found in the area of the esophagus.

A team of multi-disciplinary doctors will meet early Tuesday, March 10, to discuss Jim's case and determine the best course of action. That same day we will receive a call indicating their recommendation.

Since the cancer was diagnosed in its early stages, it is possible Jim might not need radiation or chemo. Surgery is definite and it is major, even if minimally-invasive. Surgery could be as early as mid-April.

This morning in reading my devotional, it said, "Refuse to Worry!"

And in an earlier reading, when God and Moses were communing, God said to him, "My Presence will go with you, and I will give you rest." ~ Exodus 33:14.

His Presence is with us is His promise. And we live and move in that promise.