My First Oncology Consult

[tawni's mom]

Well, really not sure what to think of the doctor, he is a bit of an oddity LOL but has 39 years experience in oncology. A bit disorganized, oh hell... a lot disorganized! Was indeed thorough with answering my questions, before I could ask them. But still, he's a quack!

So here's the run down:
MRI of rectal tumor on Thursday. He says that a biopsy is more beneficial than the PET, so liver biopsy at the crack of dawn on Friday. Power Port install on Tuesday afternoon, followed by my first round of Folfox Wednesday morning. He gave me prescriptions for Zofran & Compazine (?), said diarhea shouldn't be too much of an issue so didn't give me a script for that

I have the liver biopsy on friday, guessing I will be in pain? but no pain meds have been prescribed
I am a bit concerned about getting the port on a tuesday & chemo on wednesday only 16 hrs later. I have never had surgery (at least not for 25 years, and that was a mild proceedure) so not sure how nausiated/awake/ in pain I will be in, to turn around and have someone stabbing a needle into a freshly installed port in a shoulder that hasn't had time to heal.

The cocktail of choice is Folfox/Avastin? with 5FU/ Oxaliplatin. Scheduled to be given over a 3 hr drip every 14 days, with a 48hr continual 'fanny pack' after each IV treament. They are trying to find a home health company to come & unplug me after that 48 hrs.

Oh and I was informed today that I am not a candidate for liver resection to get rid of any mets, due to "there are multiple solid masses identified thoughout the entire liver". They are not grouped together, but all over. Yeah me

The immodium you folks have talked about for diarhea, is that the same stuff you by next to the Pepto? or something different?

[Bob in Watson]

Immodium is the stuff next to the Pepto, etc. Read the active ingredients on a real Immodium bottle, then buy the generic, house brand. It will be a lot cheaper. Don't take the Immodium per the directions on the container. It won't be strong enough. My onc recommended 2 tablets every two hours (or four hours at night) until 12 hours without loose stools have passed.
It has been effective for me.
YMMV

Bob

[raym]

If the port is to be used immediatly after insertion, they typically leave it accessed (needle in) as part of the surgery (or soon after)? I don't know the logicistics, I just know that can be setup for use as part of the surgical procedure.

[Coppercent]

I had my port placement one day and chemo the next day. Which turns out it is very good that way because if you let your surgeon know that you will be having chemo the next day they insert the needle while you are still asleep and you miss out on the first needle insertion. The port placement is an easy procedure and they just make you sleepy and not do a general so you are not drowsy for long. I had surgery, the next morning chemo for 5 hours then I went back into work. It wasn't bad at all.

[pog451]

I have the liver biopsy on friday, guessing I will be in pain? but no pain meds have been prescribed

If its anyrthing like mine you will have a small cut to get them through the skin, then the needle you dont feel until it punctures the membrane around the liver which is uncomfortable rather than painful. The needle then goes "schnipp" and takes a chunk of liver out which is again unpleasant rather than really painful. Afterwards you shoudnt be in any significant pain at all. A bit sore is all.

I am a bit concerned about getting the port on a tuesday & chemo on wednesday only 16 hrs later. I have never had surgery (at least not for 25 years, and that was a mild proceedure) so not sure how nausiated/awake/ in pain I will be in, to turn around and have someone stabbing a needle into a freshly installed port in a shoulder that hasn't had time to heal.

I had my port in on Thursday and chemo on Friday - As others have said get the surgeon to pre-install a needle for the chemo and they just need to hook you up. I had my port put in under local anasthetic and although its wasnt something Id do for fun, it wasnt too bad.

Oh and I was informed today that I am not a candidate for liver resection to get rid of any mets, due to "there are multiple solid masses identified thoughout the entire liver". They are not grouped together, but all over. Yeah me

Who said this? If it wasnt a surgeon specialising in liver resections, get a second opinion from one. My PET scan report said pretty much exactly that "multiple lesions in all segments and regions of the liver" and my onc and myself assumed that meant "non-resectable". Last week I was in a consultation with the surgeons and they said I was very resectable. That may not be true for you but make sure the person saying you are unresectable is thw person who would be doing the resection if it was possible, not someone taking a wild (if educated) guess.

The immodium you folks have talked about for diarhea, is that the same stuff you by next to the Pepto? or something different?

Immodium is a brand name for the medication Loperamide. According to Wikipedia that is indeed what is in Pepto (Brand names can be Lopex, Imodium, Dimor, Fortasec, Lopedium, and Pepto Diarrhea Control). I generally take generics bought online but I never have fewer than 5 packs in the cupboard

[RayGirl]

I had my port place in the morning and first chemo that afternoon. Definitely request that they leave the port accessed if you oncology nurse hasn't already, because you will be a bit sore for a few days. They'll leave the needle (similar to the end of the record player) and a short piece of tubing that is clamped and plugged off. They oncology nurses simply twist of the end of the tube and connect the IV tube. My onc nurse wrote in capital letters on the orders to leave accessed, apparently she's been punch a few times when she's accessed a port less than 24 hours of install

Good luck!

[tawni's mom]

Thanks for the insight to the port & chemo. I will tell them to leave an access active. I am also going to the store tomorrow to stock pile on Immodium.
I think I am going to ask the refering surgeon to get me a different oncology doctor tho. This one is just too much of a disorganized twit. The more I think about the office consult, he was not very professional, crusing & swearing every 5 minutes about one thing or another, leaving me sitting there while he went and answered his phone, etc... I am putting my life in someone's hands, I have to be comfortable with them, right? Not sure if this guy fits the positon.

Were any of you given any sort of pain relief after the port install?

[justin case]

Well, really not sure what to think of the doctor, he is a bit of an oddity LOL but has 39 years experience in oncology. A bit disorganized, oh hell... a lot disorganized! Was indeed thorough with answering my questions, before I could ask them. But still, he's a quack!

So here's the run down:
MRI of rectal tumor on Thursday. He says that a biopsy is more beneficial than the PET, so liver biopsy at the crack of dawn on Friday. Power Port install on Tuesday afternoon, followed by my first round of Folfox Wednesday morning. He gave me prescriptions for Zofran & Compazine (?), said diarhea shouldn't be too much of an issue so didn't give me a script for that

I have the liver biopsy on friday, guessing I will be in pain? but no pain meds have been prescribed
I am a bit concerned about getting the port on a tuesday & chemo on wednesday only 16 hrs later. I have never had surgery (at least not for 25 years, and that was a mild proceedure) so not sure how nausiated/awake/ in pain I will be in, to turn around and have someone stabbing a needle into a freshly installed port in a shoulder that hasn't had time to heal.

The cocktail of choice is Folfox/Avastin? with 5FU/ Oxaliplatin. Scheduled to be given over a 3 hr drip every 14 days, with a 48hr continual 'fanny pack' after each IV treament. They are trying to find a home health company to come & unplug me after that 48 hrs.

Oh and I was informed today that I am not a candidate for liver resection to get rid of any mets, due to "there are multiple solid masses identified thoughout the entire liver". They are not grouped together, but all over. Yeah me

The immodium you folks have talked about for diarhea, is that the same stuff you by next to the Pepto? or something different?

Immodium is Immodium, and it might be next to the Pepto, it certainly isn't next to the Exlax. Just to clarify, Folfox is an acronym for 5FU/Oxiloplatin & Leukovorin. I don't know what the addition of Avistan does, but perhaps someone with more experience with this cocktail, will be along to comment.
Regards,
Michael

[consdrs]

I had my port installed early in the morning and by 10 am was getting my first chemo. They should leave it accessed just let them know. As for stock piling Immodium... IDK about that. chemo always makes me constipated even irrinotican. I would hold off on the "pile" till you know which way it is going to go. Good luck to you!

Connie

[RayGirl]

I was given a script for pain from the port.

I also tended to constipation on FOLFOX, so I would only have a mini-stockpile for the first round until you know.

[jgall]

Oh and I was informed today that I am not a candidate for liver resection to get rid of any mets, due to "there are multiple solid masses identified thoughout the entire liver". They are not grouped together, but all over. Yeah me

The immodium you folks have talked about for diarhea, is that the same stuff you by next to the Pepto? or something different?

Maybe he meant you aren't a candidate right now. The first course of action when you are stage 4, especially with multiple mets, is chemo. That doesn't mean it's never in your future. My husband had "inumerable" mets to liver. After 6 months of chemo and a really good response, he was a candidate. They did a massive surgery and took out the primary in colon, appendix, gall bladder, ceacum, and 20 tumors in his liver throughout his entire liver (some through RFA and some via resection). I know this bought him precious time...maybe even years!

About the immodium, we found a generic form, in a bottle - about 50 pills for a little more than you buy 12 pills of the name brand stuff.

good luck!
Julia