Suzanne Bianchi's Journal
Written Jul 24, 2013 12:24am by Jennifer Browning
This will hopefully be a shorter update tonight for you all since bottom line, we are still waiting. My mom was feeling a bit better today with pain finally under more control. My mom will be in the hospital for at least a couple more days. They are trying to find the source of her infection and get that under control too. The goal is to treat the infection, and they now do not seem very concerned about a possible obstruction. If they get the infection under control, they can then think about chemotherapy.
In looking at the CT scan from last night, they discovered a blood clot in her lungs. Don't panic! (We did a little). But apparently this happens relatively frequently with pancreatic cancer patients, and they have ways to address it. They ran another CT scan of her chest to get a better look. They are now using blood thinners to prevent further clotting (except when they need to do certain procedures). Existing blood clots will eventually go away by themselves, but we want to prevent any further ones. The doctors did not seem too concerned by the clot, but they are monitoring it and keeping it in mind as they decide on other tests and procedures.
Tomorrow they will insert a needle into her abdomen (simple procedure done in her room) to remove as much fluid as possible. This will provide relief since she is very bloated. It will also allow them to test the fluid for more information on the infection. We are hoping that they are able to get a good amount of fluid out. Some of the fluid is complex and thick so it might be difficult to removw. But the nurse practitioner thought that she should be able to at least remove enough to give her some relief.
In spite of the continues bloating, my mom was feeling a bit better by the end of the day and was able to eat dinner! She actually was hungry! She has graduated to the "Regular Menu" that comes with a nice cover with a photo of real palm trees on the front. Yesterday's "Clear Liquids Menu" comes with the same fancy cover and photo. But it's a bit thinner.
We are getting used to the rhythm of hospital life- my mom most of anyone. We saw an endless stream of doctors and nurses today- that nice one from the Midwest, the communicatve gastroenterologist who brought along his boss and two friends in white coats, then a totally new pharmaceutics doctor, and finally, one Fellow that reminds you of that TA you had for your second semester college calculus course- you know, the one who was brilliant, nice, and fluent in a couple languages instead of English. In addition to distinguishing between doctors, we learned to distinguish the different beeps of her machines to know when something needed to be changed and when it was just resetting. My mom says the hospital nights are good because they offer some peace and quiet- no pesky husbands or daughters around. Last night she was able to get a good rest, and she should again tonight!
So pray that they will get the infection under control soon. Then we can move to hoping that she will still be able to start chemo at some point soon- They the first round of which they might want to do from the hospital for better monitoring. So we are glad that my mom's condition has not deteriorated and if anything is improving with her pain under control and a small appetite coming back. So, we are hoping for the best tomorrow! Thanks again for the continued support. Oops! thusfar, I seem incapable of writing a brief update once I get started!Love,
Jen and Mark, James, Josh, and Suzanne
Written Jul 23, 2013 12:04am by Jennifer Browning
Thanks so much for the outpouring of support.
We had a setback today which hopefully will be temporary. My mom could not start chemotherapy and is in the hospital to treat an infection, rehydrate, and figure out the cause of the problems, probably a blockage. We were not entirely surprised because her bloating and nausea had worsened in the past few days since my last entry.
When we talked to her oncologist yesterday, he told her to come early for blood work to determine whether she would start chemo. The blood tests revealed a very high white blood cell count at 31,000. As a comparison, the last time she was tested, her count was 9,000. This suggests that she has an infection. It also seems fairly certain that she has a blockage. Luckily, an x-ray showed that she did not appear to have an an abdominal obstruction. Abdominal blockages are more difficult to address than other types of blockages.
The oncologist worried that my mom was dehydrated. So he put her on an IV and called to admit her to the hospital- luckily even closer to our house- only 4 blocks away! And indeed, after two rehydration packets, she did look better and felt a bit better too. The port they put in last week to receive chemo or now, rehydration fluid or blood tests has also been wonderful- meaning my mom rarely needs to be jabbed with a needle.
Then we moved to the hospital. In the hallway, we ran into her pain specialist- very fortunate! We like her pain specialist a lot- how can you not like a nice, smart young woman from the Midwest?! Her pain specialist is on call at this hospital this week so she told my mom to have the nurses page her if she has any pain issues. This really was a huge blessing because the doctors have not really figured out yet how to manage the pain.
My mom was thus able to meet with her internist whom she really really likes and who is directing the effort at the same time as her pain specialist. We also saw a very helpful gastroenterologist. He was an amazingly good communicator- a trait I am coming to prize as a rare specialty among specialized doctors. And we saw an oncologist who is in contact with my mother’s oncologist as well as the other doctors.
They have her on an “on demand” pain medication dispenser (or PCA which I guess if I had ever taken decent science class, I would tell you is the very scientific acronym that surely stands for an even more sophisticated, medical term). This should help them finally get a handle on the right dosage of pain medication by allowing them to review her usage.
They are going to run another CT scan to figure out where the obstruction is and if the infection is related to the obstruction. Then, they will decide how to address the obstruction and how to target the infection; there are several different procedures for obstructions.
However, I do have to mention that there is a possibility that what they find could eliminate chemotherapy as an option. It is not by any means the most likely possibility right now, but one of various possibilities. So we are hopeful that they will be able to cure the infection, address the obstruction, and get her in better shape for chemo.
I know everyone thought she was starting chemo today so this hospitalization news will come as a bit of a shock. But as I reflect, it really is better that they figure out exactly what is going on, whatever it is. If she had started chemo unaware of an obstruction and an infection, that could have been disastrous. I think my mom really needed to have the attention she is now receiving in the hospital. We (thankfully) are all new at this so it was difficult to know when to contact doctors and what might be serious; now we do not have to worry. She is being monitored constantly and will hopefully get a much needed good night’s sleep tonight!
So give your thoughts and prayers to treating this relatively quickly and being able to start chemo soon.
Thanks again for all of the kind words, gestures, and gifts- I really can’t tell you how much it means. And how it helps us get in a few more smiles during the day.Love,
Jen and Mark, James, Josh, and Suzanne
Written Jul 18, 2013 1:23pm by Jennifer Browning
It is with great sadness that my mom and our family learned that she has metastatic pancreatic cancer. She has the more common form of pancreatic cancer- ductal adenocarcinoma, and it has spread- at least to her liver and probably her lungs. Surgery is not an option for such cases. She is going to start chemotherapy this Monday, July 22. But even though we would wish this news very different, we also are reminded of how much we love our mom and wife.
Our mother had been having stomach pain that started about 8 weeks ago. There are many causes of stomach pain so she did not think much of it. She and my dad had a great trip to England and Italy. They spent their anniversary hiking in Cinque Terre and saw our Bianchi relatives in Arezzo. They then came to Princeton for my graduation with a Master in Public Affairs from the Woodrow Wilson School.
Upon their return to LA, my parents consulted a doctor since the stomach pain had not subsided. We had thought that maybe she had gallstones, but an ultrasound revealed masses around the pancreas. A biopsy through an endoscopic ultrasound that took a fine needle aspirate unfortunately revealed cancerous cells. Phew! I wish DC public schools, ranked 51 out of 50 nationally, had not messed up my 9th grade biology class so bear with me!
Pancreatic cancer develops very slowly. It usually takes about 9 years before patients become symptomatic. This is also what makes pancreatic cancer such a bad cancer; they usually do not catch it until it has already spread. It thus did not matter that my mother waited about 6 weeks before seeing someone and instead spent it living well with my dad, eating pasta and gazing at the Mediterranean. The oncologist said her cancer would not have looked different if she had come in right away.
We saw the oncologist on Monday, July 8 and he confirmed that the cancer had metastasized. For us public school dummies (ok ok, I was all public until Princeton), this is a medical term meaning the cancer has spread, making it inoperable. My mother cannot undergo radiation because it is ineffective when the cancer has spread. Chemotherapy is the only treatment that will attack cancerous cells that may have spread to other parts of her body. There are now some new chemotherapy treatments for pancreatic cancer.
For chemotherapy, my mother will start a three drug treatment Flofirinox on Monday for 8 weeks, in two week segments. Luckily, she will be able to take most of the treatment from home. The drugs will be released for 2 days with 12 days off. She will spend about 6 hours at the oncologist's on the first day (Monday) of treatment and then go home for the rest of the 48 hours. She will get the pump taken out on the morning of the third day (Wednesday).
The oncologist said that the goal is that my mom live as long and as well as possible. Research has shown that patients who go on chemotherapy do better and live longer on average than patients who do not opt for treatment. He said that the cancer will start to bother my mother a lot if she does not treat it so that we might as well give it a try. No one can say how successful chemotherapy will be in extending a patients’ life. But in studies, the median survival rate is one year, and we are hoping my mother, who has always been in good health until now, will be in the 50% who do better than that! So think of us and pray that she tolerates the chemo relatively well. We will keep you updated.
It is a blessing to be living in Santa Monica with the fabulous weather and the ocean 11 blocks away, but also because one of the country’s best medical centers is located within 9 blocks. My mom can walk to her appointments which is huge! The oncologist is an expert in his field and is involved in cutting edge clinical trials as a fellow Professor at UCLA.
My mother has been in a good deal of pain recently. However, today we saw a pain management specialist who deals regularly with cancer pain. So hope and pray that this visit will help my mom feel a bit better as we prepare for the chemotherapy.
We would like to thank our family and friends who have reached out to us and who are thinking and praying for us. In any situation, there is beauty. And, it has really come through with all of your kind words and support.
As you see, we are thinking positively. As my cousin Gianni in Italy likes to say, us Bianchis, we are positive people! My mom has been healthy her whole life- something to be very grateful for! So she does not have any of the conditions that can complicate treatment. We are thus hoping for the best; that she will tolerate the treatment and it will shrink or at least keep the cancer from growing.
This update is much longer than most probably will be, but we really appreciate everyone’s interest and wanting to stay abreast of her condition. Feel free to email, text, and call us. We might be slower than usual about getting back to you, but it really helps!
Suzanne bianchi *AT* ucla.edu 202-271-4524
Mark msjjjbrowning *AT* gmail.com 202-907-9617
Jen jennie.browning *AT* gmail.com 202-906-9400
James jamesbrowning86 *AT* gmail.com 202-907-9616
Josh jonbrowning1990 *AT* gmail.com 202-487-7473
So enough writing, I’ll leave you with two videos (you'll have to copy and paste the links):
1) Very informative video on pancreatic cancer from the Simms/Mann UCLA Center for Integrative Oncology :
--See first 30 minutes since my mother’s cancer is not operable:
0:00-15:00: Overview of pancreatic cancer
15:00-28:00: Symptoms and Diagnosis of disease
2) Funny video on positive thinking (41 seconds): http://www.youtube.com/watch?v=8B6NURiPKE0
*Warning- you must like my brother James’ unique sense of humor. This is from his favorite show, Trailer Park Boys.
We love you!
Jen and James, Josh, Mark, and Suzanne