Peeing dark yellow

[Bang Bang]

8 hours ago, banK said:

Pathology results Sunday

 

bank

Just stumbled on this thread on a sleepless Friday night. I wish you the best.

 

And very glad to hear that your dealings with insurance have been nothing but pleasant. I imagine it would be intolerable to do battle with illness and an insurance company at the same time. Hmm, time to rethink my own plan.

 

Added: banK can I ask where you signed up with Cigna? Here/UK? If here did you go through a broker?

Thanks.

[banK]

Good morning

 

I signed up with Cigna directly myself, telephoned them from Thailand, they conducted a question and answer session on the phone, they put it to their underwriters and was accepted. I had no exclusions as I had no preexisting conditions.

 

Had no call to use them for around 18 months - then it was one thing  after another. If you want further info just ask.

 

banK

[banK]

Booked into to 'hotel Bkk Med. Centre' couple hours ago.

 

Had an upgrade from standard room to superior room (twice the price but FOC) as all standard rooms occupied.

Had consultation with surgeon (Prof. Tanaphon), a Q and A session.

Questions asked:

1. Feeding tube - where situated and for how long,   -   Can eat by mouth but extra nutrition via tube as required, this can be for up to one month..

 

2. Have a tube via nose - to enable release gas! What a place to have it!! - this for 3 or 4 days post operation.

 

3. Follow up visit to hospital after discharge - 2 weeks, maybe can have follow up in Khon Kaen.

 

4.  What extracted in whipple operation.  -  1/2 of bile duct, pancreas head, part of stomach and associated pipework, also gallbladder.

 

5. The yellowness will take about 3 weeks to resolve to natural colour.

 

6. Its ok to exercise post op. -  as soon as feel able to.

 

7. He did say that must wait for the the pathology report to see whether followup chemo. will be necessary. If so, then probably a 6 month regime. (I sincerely hope I do not have to have it).

 

8. I also asked what ratio was it for someone to have the tumor in the position where it is ( right next to the bile duct, giving me an indication of the presence of a tumor). I think he said in Asian people about 10/100,000. As for European he didn't know. I think that is what he said - I didn't want to dwell on the fact because it was not relevant to my condition except for my curiosity, which is why I did not question him further so am not 100 percent sure of whether it is in fact what he said.

 

So, here I am for the next 10 or 11 days - will post as am able.

 

banK

[BritManToo]

Good luck banK, get well soon.

All sounds a bit scary to me!

[simon43]

Yes very good luck tomorrow - you are in safe hands ????

[banK]

19 minutes ago, BritManToo said:

Good luck banK, get well soon.

All sounds a bit scary to me!

 

9 minutes ago, simon43 said:

Yes very good luck tomorrow - you are in safe hands ????

Thanks for the "good luck" messages . It is a bit scary! However........

 

banK

[Sheryl]

I'm sure I speak for all TV members when I say our thoughts and good wishes are with you.

I'm currently accompanying a Cambodian friend in hospital for surgery tomorrow. But while waiting for results of her Op I will also have you in mind.

Don't burden yourself with worry re chemo now. Take it day by day. This time tmorrow the surgery will be over and recovery phase begun. It won't be fun but it will improve daily . And they'll give you meds for the pain especially in the 1st 24-48 hours. So you'll intermittently sleep through most of those first few days.

The tube in the nose will be attached to suction, it keeps your stomach emptied of gas and fluid until the GI tract starts moving again. It prevents nausea and vomiting in the meantime as after surgery on the GI tract it takes a while for things to start moving again. So while it sounds unpleasant it will actually make you more confortable than you'd be without it. How long it has to stay in depends on how soon the GI tract resumes normal activity and this varies by individual.

Narcotics slow down that process so after the initial day or so (when there is no avoiding the need for the narcotics), to the extent you can minimize use it will speed up recovery. So will early ambulation (getting up to sit in a chair; walking) which they will start encouraging you to do after the first day or so.

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[banK]

9 minutes ago, Sheryl said:

I'm sure I speak for all TV members when I say our thoughts and good wishes are with you.

I'm currently accompanying a Cambodian friend in hospital for surgery tomorrow. But while waiting for results of her Op I will also have you in mind.

Don't burden yourself with worry re chemo now. Take it day by day. This time tmorrow the surgery will be over and recovery phase begun. It won't be fun but it will improve daily . And they'll give you meds for the pain especially in the 1st 24-48 hours. So you'll intermittently sleep through most of those first few days.

The tube in the nose will be attached to suction, it keeps your stomach emptied of gas and fluid until the GI tract starts moving again. It prevents nausea and vomiting in the meantime as after surgery on the GI tract it takes a while for things to start moving again. So while it sounds unpleasant it will actually make you more confortable than you'd be without it. How long it has to stay in depends on how soon the GI tract resumes normal activity and this varies by individual.

Narcotics slow down that process so after the initial day or so (when there is no avoiding the need for the narcotics), to the extent you can minimize use it will speed up recovery. So will early ambulation (getting up to sit in a chair; walking) which they will start encouraging you to do after the first day or so.

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Top line post for me - Thanks Sheryl, I'm starting to understand a bit more as time goes on.

 

I will attempt to come off the "narcs" asap!

 

Good wishes for your friend's operation tomorrow - hopefully good news for both of us!

 

banK

[xylophone]

6 minutes ago, banK said:

Top line post for me - Thanks Sheryl, I'm starting to understand a bit more as time goes on.

 

I will attempt to come off the "narcs" asap!

 

Good wishes for your friend's operation tomorrow - hopefully good news for both of us!

 

banK

ALL THE VERY BEST for your op banK............stay positive, and the thoughts of many on here are with you.

[faraday]

I've sent a message to someone called Prayoot - or a similar name, & asked him to pray for you. So, as we were spared the big storm due to his divine offering, I'm sure you'll be ok.

 

You're in my thoughts, & we're all thinking of you, wishing you a speedy recovery.

 

????

 

 

[banK]

4 minutes ago, faraday said:

I've sent a message to someone called Prayoot - or a similar name, & asked him to pray for you. So, as we were spared the big storm due to his divine offering, I'm sure you'll be ok.

 

You're in my thoughts, & we're all thinking of you, wishing you a speedy recovery.

 

????

 

 

Ha Ha, After all it is Buddha day today!

 

Thanks for everything

 

banK 

[Jai Dee]

Good luck banK... get well soon.

[banK]

Right - signing off till I come out the other side!!........

 

banK

 

 

[fertilizer]

banK - we  hope your surgery went according to the plan and your recovery will be good. All the best to you!

[Sheryl]

banK - we  hope your surgery went according to the plan and your recovery will be good. All the best to you!

+1

This will be post op day 3 for him. He'll still be on pain meds so groggy and still hooked up to gastric drainage etc but we may be able to hear from him in a couple of days time.

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[faraday]

Hey Bank, I looked at your profile & saw that you visited on Friday, guess your feeling too poorly to post anything.

 

You'll feel better soon.

 

☺️

[Sheryl]

Yes, do post when you can. We are all rooting for you and eager to know how you are

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[banK]

Hi Everyone,

 

Am now out the otherside!

The whole experience has been an up and down affair - which is why I am now posting as opposed to earlier.

 

The Operation went well, had a swift transit via a 2 day stay in ICU to the room.

Tubewise - 1 in the back for pain on demand killer, 2 drains in the bowel area, 1 drain from the stomach via the nose, 1 feeding tube into the intestine and finally one feeding tube for vitamins via the neck vein.

 

They have come out one by one leaving only the feeding tube into the intestine left, still to be used for 10 days or so to suppliment food via mouth.

 

Was waiting on tenterhooks for the result of the pathology- it was only today that I was told the results (9 days after the op.).

 

Yesterday, I took courage in my hands and looked up on the internet about pancreatic cancer - some surprises there. Far from being a quick aggressive cancer it's in fact the opposite -  from zero growth to killing you is about a 20 year span!

 

Why it is so deadly is that is largely goes unnoticed until it had spread to various organs and a symptom occurs. By that time an operation is out of question, it can remain undetected for a long time.

 

I was lucky in the fact that the tumor was located right next the the bile duct causing jaundice.

 

It was a carcinoma common to the pancreas with some small lymph nodes. all  nodes were not malignant and tumor not near an artery.

 

In 2016 - that PET scan revealed only the lung tumor so the pancreatic tumor was post that time. One doctor suggested that it could have been growing for 6 to 12 months.

 

I have to see the oncologist for a consultation and his advice. It will be my choice on what I will do (chemo or not). But to my mind it would seem that the threat has been removed.

 

Similar outcome to the stage one lung cancer in 2016.

[banK]

Oh Yes, will be discharged tomorrow. Will stay in the A1 motel for a few days until followups/consultations have been completed.

 

Thank you all for the encouragements and concern shown to me on this forum.

 

PS Sheryl - Hope all went well with your friends op. the same day as mine.

 

banK

[Sheryl]

Great news!!!

I'm so happy to hear it. I have been thinking of you.

My friend's OP seems to have gone well also. Thanks for asking.

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[colinneil]

12 minutes ago, banK said:

Oh Yes, will be discharged tomorrow. Will stay in the A1 motel for a few days until followups/consultations have been completed.

 

Thank you all for the encouragements and concern shown to me on this forum.

 

PS Sheryl - Hope all went well with your friends op. the same day as mine.

 

banK

Happy to hear your doing ok, chin up mate, think positive, and be happy.

[faraday]

Great to hear from you.

 

Onwards & upwards!

 

☺️

[banK]

Hi All

Back home now up country.

Had followup and explanation of pathology report. Not as rosy as I thought!

 

staging is 1B.

Meaning that the stage one with a tumor size between 2 - 4 cm. (mine 2.2cm). Moderately differentiated. 13 benign lymph nodes various organs.

At the margins of various organs taken out "Uninvolved by invasive carcinoma."

Lymphovascular and Perineural invasion present. (This within the tumor). (hope it stayed there!!).

the above as I understood the oncologist.

 

It was recommended to have follow up adjuvant chemotherpy with lab tests. Propose to start 16/2/19 in Bkk. Oncologist recommends to have 6 cycles (1 cycle = 3 doses). The first one with an overnight stay to evaluate tolerance Med is GEMZAR.

 

This lot aint cheap. For one cycle 154688 Baht + lab tests 19960 baht.

 

If this goes for 6 cycles plus PET scan and other lab tests then it's about another million.

 

The Whipple operation and hospital stay came to 1.5 Million. So all up at the finish will be about 2.5 million.

 

Follow up checks over the coming years I suppose cigna will pay for.

 

banK

[Sheryl]

Glad to hear you are back home!

 

Actually stage 1 is good news. Only around 10% of people with pancreatic cancer ate diagnosed that early.

 

Hemo is standard and only reason to not do it would be if you were not healthy enough to withstand it.

 

Cigna should cover the chemo, inpt or out. Not sure re follow up checks, will depend on what they entail. Uf scan then probably yes.

 

BTW I was impressed to hear the hospital provided post op epidural analgesia. Was this attached to a device you could control yourself?

 

 

 

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[banK]

42 minutes ago, Sheryl said:

Glad to hear you are back home!

 

Actually stage 1 is good news. Only around 10% of people with pancreatic cancer ate diagnosed that early.

 

Hemo is standard and only reason to not do it would be if you were not healthy enough to withstand it.

 

Cigna should cover the chemo, inpt or out. Not sure re follow up checks, will depend on what they entail. Uf scan then probably yes.

 

BTW I was impressed to hear the hospital provided post op epidural analgesia. Was this attached to a device you could control yourself?

 

 

 

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Yes - this was on demand (had a button for it). it wasn't Morphine but another drug beginning with P. I think the doc said it was a stronger pain relief med.

 

banK

 

 

 

 

 

 

[Sheryl]

Pethidine?

 

You were fortunate, patient controlled analgesia is very uncommon here.

 

 

 

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[banK]

Spot on with the word Pethidine.

 

I only used it maybe 3 or 4 times.

 

I never asked for it but the surgeon told me he placed it in the back for me.

 

In the short time I was in the hospital, the surgeon Prof. THANAPON MAIPANG did 3 Whipple operations, age maybe early fifties - instills a lot of confidence.

 

banK

[faraday]

Glad to hear that you are home - in your own bed. Lovely.

Was only thinking about you last night, & it's good to know that you must be feeling more comfortable.

 

☺️

 

 

[puukao]

I'm happy you are taking this serious, seeing a doctor, and letting strangers maybe help you through a difficult situation.

 

I wish you the best.  

[banK]

An update.

A bit of an emotional up and down. (Normal I'm told).

 

Prior to starting the adjudicative chemo on the 16th Feb. I visited immigration in Khon Kaen to ask whether it would be possible to renew my extension early (due on 6th April). This was end of January.

Had my medical records with me and showed the IO the scar! - Too much information! as I still had a feeding tube in my stomach!! She invited me to apply that day, she took a photo copy of one of the medical docs. and asked me to write an explanation as to why I wanted to apply early - I had an embassy letter less than 6 months old, so done and dusted that day.

 

The next thing was my driving license was due to expire in May this year. Went to Chumpae DVLC and asked the same thing - No can do because the computer says "no"!! They feed in the old license and the computer will only accept that it can be done not more than 90 days in advance. Went back 2 days later on 13th Feb. and the computer now says "yes". This 2 days before going to Bangkok for 1st chemo cycle.

I didn't fancy going in May as am unsure what state I will be in half way through chemo.

 

I went through the pathology report again with the oncologist - the pluses and minuses. One thing in the blood tests that gave me concern was the ca19-9 numbers. Prior to the operation it was 181 (should be <37). The reading on 16th Feb. was 124 prior to chemo. She uhmed and haad about it on the 16th Feb. Gave me the impression not too good. The following week I did a bit of research on the internet visualising all sorts in my mind. That was a down phase for a day or so. Talked to myself in the mirror to get back on an even keel.

Went through the path report with a fine tooth comb, including the still high ca19-9, a bit reassured on that. Que sera sera...

I am staying in Bangkok for the duration of each cycle and will go back to the village on the 2 weeks off.

So far have had 2 injections of GEMZAR.

 

Insurance: The cost of this chemo - the initial dose + a battery of blood test cost 74000 baht, the subsequent one was 51000 baht. So for 18 of these at say 50000 a pop will come to about 1 million.

 

The annual renewal this march is 4690gbp. This compare with last years premium of 3800gbp. However, the prior renewal to 3800gb was 4100gbp - so in actual fact there was a reduction last year. So I'm happy with that.

The only bug bear with the insurance, (Cigna Gold Plan), is if I ever become palliative care then they will only pay 3250gbp for the lifetime of the policy. At the price over here maybe 1 cycle. If I had platinum then they would have fully paid palliative care. Silver plan pays 1650gbp.

If it comes to it, I will go back to the UK to continue with what needs to be done. Again, Que Sera Sera.

 

I tipped up last Saturday for the 2nd dose and just as they were injecting the GEMZAR they ask will the insurance be paying for it? Of course I said - then the 3rd party insurance dept. in the hospital realised that they did not have a GOP from Cigna. It was suggested that I pay for it! No way I said! A while later just before finishing the nurse came in and said that It's ok all I have to do is sign for it.

 

I paid the third party insurance dept.  a visit to ask for an explanation. They said that on the 16th Feb. (date of 1st chemo) they applied to Cigna for the next chemo. They didn't get a reply and neglected to follow up the initial request!!

They assured me that it won't happen again......

 

That's as it stands at this time. Have had no effect from the chemo so far except feeling a bit of nausea yesterday afternoon. Have various meds to take if needed for various things. 

I am doing a lot of walking for exercise did 23km last week! I hope this helps.

 

Later

banK