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Posted by David Shuster at 09:56AM (-08:00)<br />
Only a Little Improvement<br />
Friday, January 20, 2012<br />
Repeat endoscopy and dilatation today by Dr. Cano has resulted in mild symptomatic<br />
improvement. I don't think he dilated any more than Dr. Lewis. He removed some food<br />
impacted in the distal esophagus, and the spasms have improved, but attempts to eat<br />
small amounts of chicken broth, chocolate pudding and Boost+ have resulted in only mild<br />
success. I have regurgitated some of these, but <strong>with</strong>out as much pain as yesterday, and<br />
some seems to have gone down. I don't think he dilated as much as planned as he was<br />
concerned <strong>with</strong> inflammation in the esophagus. You can't appreciate how we take for<br />
granted the ability to eat, chew, swallow and digest food. I don't know if I will ever be able<br />
to do so. It is very depressing. If my <strong>Merkel</strong> cell cancer is "cured', the cure may be as bad<br />
as the disease.<br />
I will see Dr. Lewis next week, and maybe he will have something else to offer. I have<br />
heard of esophageal stents being used but there is a very high rate of complications, and<br />
they are not recommended for benign strictures.<br />
In the meantime, I will stay home, trying to distract myself. Sorry, KP Docs, I will not be<br />
up to working tomorrow.<br />
GO 49ers!<br />
Posted by David Shuster at 09:43PM (-08:00)<br />
Sunday Morning Coming Down. Two Days After<br />
Dilatation #2<br />
Sunday, January 22, 2012<br />
I have had two decent nights sleep, <strong>with</strong> mild back pain (likely esophageal in origin) and<br />
<strong>with</strong>out much regurgitation. This morning, I could down a bottle of Boost+ in about 15<br />
minutes. Yesterday, it took much longer. <strong>My</strong> weight is down to 147 lbs. I was at about 180<br />
when I first discovered my tumor 20 months ago.<br />
On the bright side, people are telling me I look good.<br />
I have stopped taking the Hydrocodone-Homatropine cough syrup, <strong>with</strong>out <strong>with</strong>drawal<br />
symptoms. In fact, <strong>with</strong> no solid food going down, my colon has been surprisingly active.<br />
Although the 20 mg generic Prilosec tablet is tiny, I have not taken it yet today, fearing it<br />
is enough to block my esophagus. I am looking into finding the liquid form.<br />
I think there is slow improvement, and I might be able to start eating food again, perhaps<br />
after more dilatations.<br />
I will follow up <strong>with</strong> Dr. Lewis.<br />
Taking a step back, I think I need to see Dr. Flam, to get his input. It is probably important<br />
to get a repeat CT scan to make sure I do not have a recurrent tumor around my<br />
esophagus or elsewhere. Will I need a PEG tube? (Percutaneous Gastrostomy) for<br />
feeding? Sometimes, radiation strictures require multiple dilatations, up to 6 before there<br />
is relief of symptoms. Sometimes there is no relief. The latest treatment is biodegradable<br />
stents. These have been tried in Europe <strong>with</strong> good success. There is a product on the<br />
market in Europe called the SX Ella BD Biodegradable stent, by UK Medical. I have<br />
emailed the company, but I don't think the stent is FDA approved. Another study is being<br />
done led by Dr. Alessandro Repici in Italy, a multi-country trial. I emailed Dr. Repici and<br />
he responded today. The stent is in clinical trials and will not be available in the USA for 2<br />
<strong>My</strong> <strong>Battle</strong> <strong>with</strong> <strong>Merkel</strong> <strong>Cell</strong> <strong>Cancer</strong><br />
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