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RAUL THE CUBAN CRABBER My husband Raul,54, is a Commercial Blue Crab Fisherman here in Charleston, SC. We also have a seafood business as well. He took the time to see the doctor every 6 months for blood work for his cholesterol levels because he was on lipitor. He had a colonoscopy in 1998 and had a few polyps removed. He had a physical Dec. 27,2004 with blood work and all liver functions were normal. The only thing 'off' about him was this grouchy mood he had been in for about 3 months. It was surely not normal. We thought it was the stress of the house renovation. He was also VERY fatigued also during that 3 month time frame.
Picture of
Blue Bird                           Picture of
Raul cleaning
Feb. 14, 2005 as we celebrated our birthdays and a house renovation completion he became bronze colored but it was hard to tell if it was his olive Cuban skin color or something else. He was peeing brown urine. His eyes were yellowish and he was itching terribly for about 3 days. That went on for 3 days and I took him to the doctor on Monday and she looked at him, took a urine sample, blood work, (liver functions were 465 and bilirubin 2.4) sent him yo have an ultrasound of the abdomen. At this point we thought it was the gallbladder. Well, it was a dilated bile duct and the next day, Tuesday, Raul had a ct that confirmed a 1.3 cm tumor at the distal common bile duct. I had a good GI doctor (Dr. James Ravenel of Charleston Gastroenterolgy Specialists) and had the family doctor get us in to see him the next day on WED. Raul saw him and he wanted an ERCP for Raul so a Stent could be placed in the bile duct to open the flow.(I'm STILL thinking about the gallbladder). Oh and by the way the Dr. Ravenel asks me if I have a surgeon in mind just to have on call. I said I trust your judgement. He said' I think Dr. Telfair Parker of Surgical Associates of Charleston'.

On Friday Feb. 28, 05 Raul has the ERCP at 3:30 p.m. It took along time to place the stent, and at 7:30 p.m. the ERCP doctor tells me Raul had a tumor. I ask benign, Dr. says VERY doubtful. I fall to pieces. Here is my big, stron Cuban man and they want me to tell him this?? Worst night of my life. And I hated crying in front of Dr. and Raul. Dr. Corless makes the call to Dr. Parker and he agrees to see Raul MONDAY morning!

Long weekend, Raul still itching but with stent placed the jaundice clears fast.

Monday A.M. surgeon visit with Dr. Parker, draws us this diagram on exam paper and schedules Raul for the following Tuesday for the whipple. He never laeads on to anything negative or what-if's.

20 Days after Raul goes to doctor for jaundice he has a 7 hour whipple operation that takes 5 surgeons on a team. It is a pylorus sparing whipple. Best scenario for this surgery because he is not compromised with as many nutrition issues. He stays 3 days in ICU with morphine epi-dural that drives him nuts. That and no sleep. Gets to a private room on day 4 and gets the epi-dural out and is on Dialudid for pain. I get him up and walking on day 5. It wakes up the bowel.

Patholgy report STAGE 3, shows a 1.9 cm. adenocarcinoma tumor at the distal common bile duct and head of Pancreas. Severe pancreatitis, 3 out of 16 nodes around fat of pancreas positive and necrotizing fat around pancreas. Peri-neural invasion. CLEAR MARGINS. It amazes me that this tumor is a size of a nickel. It had doubled in size in the 20 days between dx of ct and the surgery. Time is of the essense for the surgery.

He went home on day 10 with the Jackson-Pratt drain tubes.He lost about 25 lbs. with the surgery. He is eating small meals and frequently.

On week 3 at home the drainiage tubes start putting out a grey fluid and Raul starts to run a low grade fever that starts at 100.6 escalates to 102.4 in 4 days. He is sleeping all the time and I repeatedly call the doctor and get him readmitted. He has an abdominal abcess. BAD NEWS!! The right side of the ^^chevron^^ incision has to be reopened and suctioned for 8 days anong with IV anti-biotics. It has to be packed daily for a month with sea-sorb algeanate packing to heal from the inside out. I bring him StarBucks Frappaccino's 2 times a day. He luckily isn't diabetic and so he likes it and it picks his spirits up. He is (Type A personality) Cuban. We manage and make it through those bad days. He was recovering for 2 months at home with the business shut down, the boat on the hill, and the dogs at his feet. We would walk up the street and back. No driving the truckfor a month. Also no hernia!!! I highly recommend getting your loved one and abdominal support. It supports the abdomen muscles. Also drive them around.

Raul had 6 months adjuvant chemo therapy of Gemzar over a 30 min. infusion plus Tarceva pill. 3weeks on and 1 week off. He drank lots and lots of water. He would have the chemo, come home that day at 3 p.m. and then get up the next morning, fish the pots again, and then come home. Side effects were gout, achyness and toe infections. He gained back all his weight and then a few extra pounds.

Picture of Raul with crab He is now 1 yr. post-whipple. He bluecrabs,& runs the shop. The follow up blood work is about every 6 weeks and the ct scans are about every 3 months for this second year. So Far no recurrance as of late March 2006.

Striving to Survive, and remaining vigilent. We keep the GI doctors phone number handy.

Blue Bird

Posted 03/28/2006 08:44 am by Blue Bird
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