PEG tube and ulcer update

What does the PEG tube look like? I've been assimilated by the Borg.



Apologies for not providing an update on my ulcer. It took two weeks after the PEG tube surgery before the pain from the ulcer was gone. Thank goodness it did not take longer.

The whole time, I was quite puzzled as to why the ulcer pain started immediately after the surgery and lead me to think that the pain initially was from the surgery itself. Two days after the surgery, it finally occurred to me that the pain is from the ulcer. But if I had the ulcer before the surgery, why was there no ulcer pain prior to surgery?

On the day that the ulcer pain was nearly gone, I got a letter from my GI surgeon stating he had performed a biopsy on my ulcer to test for Helicobacter pylori, which is associated with 80% of all ulcers. Well, the results were negative, which is good, but the doctor failed to mention to me that he had done the biopsy during the day of my PEG tube surgery. I'm no doctor, but I'm guessing the biopsy may have contributed to the two weeks of pain and discomfort! I thought the doctor did a great job, but perhaps he could have mentioned those minor details to me on the day of surgery.

Round Two Completed

It has been five days now since my 5-FU pump was removed but only two days since I have really been able to eat without any discomfort from all the acid, gas, and nastiness in my digestive tract. The acid was enough to even make sleeping difficult. I'm glad that's now all over.

My AST level last week was back to normal at 16. The ALT level was still high at 78 but that's lower than the previous week. More blood tests tomorrow.

Elevation in liver enzymes

So last week, my potassium level was low but has returned to normal after taking the potassium pills prescribed by my oncologist. This week, my liver enzymes are high.

I'm not sure exactly what this means yet as I have not spoken with my oncologist about it. Does this mean the chemo is damaging my liver?

Epstein Barr Virus (EPV)

Although there is no scientific proof that the Epstein Barr Virus (EPV) contributes to nasopharyngeal carcinoma (NPC), studies have shown that there is a high probability that it plays a role in the development of NPC.

As part of my weekly blood tests, my oncologist ordered, starting this week, the EPV panel in addition to my regular blood work.

Below are the results. Ideally, we would like to see the concentration of EPV decrease throughout my treatment. Data from various studies have shown that a lower concentration of EPV may mean a lower risk of recurrence of the cancer after the cancer is in remission.

Preparing for Round Two

This past Thursday, I met my oncologist for my post-chemo evaluation. She said the elevated white blood count is due to the daily Neupogen shots that I have been receiving, starting the day after my 5-FU pump was removed. There was no need to be alarmed as the Neupogen was doing it's job, but I probably didn't need any of the shots for my first round of chemo. Normally, Neupogen is given starting with the second round of chemo. She adjusted my Neupogen schedule from 10 shots over 10 days to 7 shots over 7 days for the next chemo round.

My doctor prescribed potassium pills to help my potassium level, which had dropped to 3.2 MMOL/L; standard range is 3.6-5.0 MMOL/L. If my potassium level drops too low (hypokalemia), I can become very weak. Also, your muscles, especially your heart, need potassium to function properly.

I mentioned to my oncologist how much pain the ulcer has been. She recommended taking the Prilosec 20 mg twice a day for the rest of my treatment. There is a possiblity that the ulcer was present even before treatment, but the chemo drugs and all the other pills that I took made the ulcer much worse. She cleared me for my second round of chemo, which will start this Thursday.