My Battle with Merkel Cell Cancer

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evealed Staph Aureus, but not the antibiotic resistant type. My port had to be removed and I went on vein destroying IV nutrition. Every venipuncture was agony. I had blood transfusions, platelet transfusions, drugs to encourage WBC production, labs, regular blood sugar measurements with oversized lancets, insulin. After 2 weeks I was ready to go home, but my esophageal stent had been removed and I could not swallow. The day after discharge, I was back for a PEG tube and stent replacement. I was home again, relatively comfortable for about 2 weeks when my heart rate went up to 180. No chest pain or other symptoms. In Dr Flam's office, he diagnosed atrial fibrillation and converted me to sinus rhythm with drugs. Today, I saw Dr. Dale Merrill, an old colleague and cardiologist who confirmed I am on the right track. Biopsies of my esophagus showed Merkel Cell cancer, but the repeat biopsy at the time of insertion of the smaller recent stent showed a lattice of connective tissue without living Merkel cells. Dr Lewis thinks it is an optimistic sigh that the Topotican worked. Dr Flam thinks it is an artifact of crushed cells. Probably I will have a follow-up PET scan in the next 2 weeks to learn more. So, after lying in my hospital bed conjuring up methods to hasten my demise, I now have room for optimism. Tonight, I plan to briefly appear at the Lady Antebellum concert at the Save Mart Center. I hope to be alive to celebrate 50 years of marriage to Judy, who has been a rock in support of me. Posted by David Shuster at 04:15PM (-07:00) Status Quo except increasing right sided pain Monday, April 09, 2012 Here is the latest update of my physical and mental status. I am awake and oriented, relatively alert although with decreased ability to concentrate. Last Friday night, we had a miniature Seder with Gary, Dana, Eva, Sara and Bel. A very much abbreviated service in which the Four Questions were asked and the Afikomen was hidden was followed by a great dinner, of which I was only able to partake of a small amount. The highlight was gifts given to the girls for returning the Afikomen. Judy worked very hard to make this a success. We went to see the Trans Siberian Orchestra on Tuesday at the SaveMart Center and I was able to stay for much of the show. Brian was in town for a follow-up visit with his Doctor so we got an extra ticket for him. It was a great show. I have been able to climb the stairs with some difficulty and to take showers in our upstair shower, much better than sponge baths in the downstairs bathroom. I was also able to lie down in our bed, a pleasure very much missed in the past few months. We have had a few close friends come for brief visits. My heart rate is generally well controlled in the mid 80's by Amiodarone, 200 mg bid. I am also taking Prilosec, 200 mg BID as well as medication to shrink my prostate to combat occasional urgency incontinence, a sleep aide, and pain medication. Aleve twice daily seemed to work well, but I have been having worsening right sided upper back pain and right rib pain for which I have just resumed taking hydrocodone. I seem to be improved this morning. My shortness of breath also seems improved. I fear this pain is due to bone metastases, and will have a PET scan next week to shed some light on this problem and determine the extent of disease. My Battle with Merkel Cell Cancer 131
132 Although with the esophageal stent present, I can eat almost anything, but I have little desire to eat. Perhaps it is because of dry mouth, for which I am using Biotene with some relief. Most of my calories are ingested through my gastrostomy tube. I do have some symptoms of gastric overfilling and worry about the cancer pressing on my duodenum. But enough drowning in self pity. The sky is clear. It's warm ouside. I shall sit out and catch some rays. I can get around quite well with my walker. It is only 1 1/2 months until Judy and I celebrate 50 years of marriage. Sara turns 5 today. She and Bel will visit this afternoon. Posted by David Shuster at 11:38AM (-07:00) PET Results Saturday, April 14, 2012 Friday, I had a PET scan. it looks like the Topotican did me no good. A 3 cm node in the gastrohepatic area now measures up to 8 or 9 cm, pressing on my stomach. The esophageal mass is also larger, and may be compressing my left main bronchus. I have had respiratory difficulties with 2 episodes at night of what seemed like acute asthma. I am now on home oxygen and with it, attempted to go upstairs for a shower. That was a failure as I had the third asthma-like attack. It looks like I have a choice of waiting to die or going on Votrient. I somehow doubt my Insurance will pay and I think it will cost a lot of money. Dr. Nghiem is encouraging about this, saying it helps in about 50% of cases and if Dr Bhatia and Dr Flam agree (Appointment with Dr Flam Monday), this seems to be the last arrow in my quiver. Posted by David Shuster at 05:13PM (-07:00) About the Author -- Curriculum Vitae Monday, April 16, 2012 CURRICULUM VITAE DAVID N. SHUSTER, M.D. PERSONAL DATA: Date of Birth: August 18, 1940 Place of Birth: Montreal, Canada Marital Status: Married (Judy) Address: [redacted] Fresno, CA 93720 Telephone: Business: [redacted] Home: [redacted] EDUCATION: COLLEGE: McGill University B.S., 1961 MEDICAL SCHOOL: McGill University M.D.C.M., 1966 INTERNSHIP: Jewish General Hospital-Montreal June 1966 - June 1967 RESIDENCY: Jewish Hospital-Brooklyn, N.Y. Obstetrics and Gynecology June 1967 - December 1967 Brookdale Hospital-Brooklyn, N.Y. Pathology January 1968 - June 1968 McGill University-Jewish General Hospital Radiology July 1968 - June 1971 PRACTICE: Diagnostic Radiology St. Mary's Hospital, Montreal June 1971 - August 1976 Saint Agnes Hospital, Fresno, California September 1976 - April 1993 My Battle with Merkel Cell Cancer
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My Battle with MCC My Battle with M
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Contents I Discover a Mass in my Fa
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A Brief break, Then 3-5 Months of C
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Esophageal Dilatation: My Experienc
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I Discover a Mass in my Face Friday
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I Have Surgery Saturday, July 24, 2
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Posted by docshu at 10:54AM (-07:00
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In the absence of a tumor mass to i
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Friday, July 2: I plan to work in t
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I plan to add photographs to this b
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deformity and a facial droop on his
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of taste. I have now completed 11 o
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there. They visited from Valencia,
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SARA, age 3, The Kissing Doctor Wha
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Hooray. I passed!!! Friday, August
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survives. Posted by docshu at 08:49
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Below is a photo of our dog, Rocky
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Not Much New Thursday, September 16
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Posted by docshu at 05:09PM (-07:00
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That's Jon on my right and Robert o
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Nghiem in Seattle on November 30. U
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Posted by docshu at 07:20PM (-08:00
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ook last-minute, as I have canceled
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Sandy, and from my sister Ellie, wi
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out. I do not have a definite date
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old. We had a very nice visit with
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I continue to work, although my sch
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Surgery Wednesday 10:00 AM Monday,
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do very much. On the other hand, I
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circumference. What that all means
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Montreal and on my return, have a p
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Here is a photo of Alex and yours t
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The bad news is that the experiment
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This is the best photo I could find
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the symptom gets worse. The generic
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DNA present in ~80% MCC tumors MCPy
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Rocky woke us up this morning with
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=Bingo!=we were the next ones seate
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My colon feels like It wants to blo
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In any event, Dr Flam says I should
Page 82 and 83: No More Chemo (for now) Tuesday, Ju
Page 84 and 85: The Plan is Finalized Tuesday, July
Page 86 and 87: Not a Good Day Today, + Real Estate
Page 88 and 89: was down. I had no appetite. No foo
Page 90 and 91: my lower esophagus. An experimental
Page 92 and 93: Here is the rant. My appointment wa
Page 94 and 95: peripheral neuropathy is unchanged.
Page 96 and 97: have stopped the zinc. I am also ha
Page 98 and 99: Axial CT Image Here, we see a large
Page 100 and 101: I'm Back! Tuesday, October 18, 2011
Page 102 and 103: My brother Jon Shuster arrived Thur
Page 104 and 105: sessions, and for the first time si
Page 106 and 107: the skull. When the catheter was in
Page 108 and 109: to a pediatrician, who said that th
Page 110 and 111: PM. I will post again when I get ho
Page 112 and 113: Posted by David Shuster at 09:56AM
Page 114 and 115: obesity and emaciation." One of the
Page 116 and 117: Last night, I had the most sleep I'
Page 118 and 119: done frequently since having the pr
Page 120 and 121: they did help, they didn't help eno
Page 122 and 123: I hope that my dad is well enough t
Page 124 and 125: WBC count 4.5-11.0 K/mcL Platelet 1
Page 126 and 127: It is such great news. There are do
Page 128 and 129: so he can sleep. 2:00 Dana takes Be
Page 130 and 131: Cicero says of the Sword of Damocle
Page 134 and 135: Fresno Imaging Center Medical Group
Page 136 and 137: Obituary Saturday, April 21, 2012 T
Page 138 and 139: manner of other names, as my dad di
Page 140 and 141: Eva had asked that I tell him she l
Page 142 and 143: document the final part of that tra
Page 144 and 145: Subject: docdave back at hospital T
Page 146 and 147: We got word that the ER doctor want
Page 148 and 149: used it), some stuff for my mom, an
Page 150 and 151: your brain and body work. As the ox
Page 152 and 153: who seemed competent and caring. Th
Page 154 and 155: in a voice I'd never heard her use
Page 156 and 157: In facing death, dad decided to tru
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My Battle with Merkel Cell Cancer

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