My Battle with Merkel Cell Cancer

circumference.
What that all means is that the small bowel tumor has been completely removed. The
good thing is that the nodes are not involved. The bad news is that it got to the surface of
the bowel and I am at risk for cells having been shedded from the surface taking hold in
the peritoneum and growing there.
This was obviously the cause of my anemia and was close to causing a small bowel
obstruction. It was also causing my weight loss.
My last Hemoglobin was 8 grams. I need to get this up. I have had 2 iron transfusions
and have begun oral iron supplements as well.
My appetite has improved and my colon has begun behaving normally.
I was feeling very discouraged last night thinking I was having too much abdominal pain
for this late after the surgery. This prompted a careful inspection of my abdomen. I realize
that there is a 6cm horizontal incision in my right upper abdomen. This is larger than I
had originally reported. I thought the largest was in the umbilicus. However it makes
sense that the specimen was removed intact and measured up to 4.5 cm. This cheered
me up, thinking that the continued pain is appropriate. I have taken some Advil for pain
but did not fill my prescription for narcotic pain relief. A heating pad has been helpful as
well for back spasms.
Yesterday, I called my accountant and asked him to get an extension for the deadline for
filing my taxes for 2010. Then, in the mail, I get an audit notice for 2009.
I also got a Jury Summons. I requested a postponement based on the likelyhood of
needing chemotherapy.
So here is the plan.
Follow-up with Dr Felix Monday afternoon. (April 4).
CBC Monday morning (to be drawn at Dr Flam's lab.
Follow-up with Dr Flam April 12
?Chemo? I don't think I can get away from it.
Posted by David Shuster at 09:46AM (-07:00)
12 Days Post-Op
Monday, April 04, 2011
Today I had my follow-up appointment with Dr. Felix. I never cease to be amazed at the
way communications seem to fail. When I made this appointment, Dr. Felix wanted me to
get a CBC. His office was supposed to fax a request to Dr. Flam's lab. When I arrived at
Dr Flam's lab this morning to get my blood drawn, nobody had the request. They drew
the blood and did the studies in any event. I requested that the report be faxed it to Dr.
Felix's office. When I arrived for my appointment at 1:45 PM, of course, the results which
take about 5 min. to obtain, were unavailable. I also learned from Dr. Felix that he had to
read the path report on my blog. It was never sent to him from the hospital. Chalk one up
for the universal medical record.
When the result was finally available, it turns out that my hemoglobin was 11.5 g. This is
a substantial improvement from 8 g when I left the hospital.
All of the incisions on my abdominal wall are healing well. There are no stitches to
remove, and I will be able to finally wash my abdomen with soap. Of interest is that
although the pathology report suggested the tumor reached the serosa (outer lining) of
the small bowel, Dr. Felix thinks that this is a result of the surgery. When the tumor is
removed, it is actually placed within a plastic bag and then pulled through the incision.
This trauma damaged the outer surface of the specimen, which showed no gross
evidence of tumor infiltration at the time of surgery.
My apologies to Dr. Felix. I reported that the incision was about 6 cm in length. Actually,
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