Although it started out hopeful on Monday, by Tuesday we began several touch-and-go days with Tim being hospitalized. The roller coaster ride continues.

On Monday Tim met with his second opinion Oncologist at UCSF. The Oncologist had a different interpretation of Tim’s latest PET scan than his Oncologist at Kaiser. Instead of seeing it as evidence of the cancer growing, the Oncologist felt it showed possible infection or inflammation but not active tumor growth. Because Tim just had his stent unblocked and was still not feeling that well, the Oncologist recommended postponing starting chemo at least for a few weeks if not a couple months. That seemed like a more hopeful interpretation, so Tim made the decision to postpone chemo.

The next day (Tuesday), Tim started feeling very nauseated and near fainting whenever he stood up. Additionally, he evidence of blood in his stools. He made an appointment that afternoon to see our general practitioner at Kaiser. She was alarmed because Tim’s symptoms were a definite indicator of some internal bleeding. She sent Tim immediately over to the Emergency Department at Kaiser.

Tim was hospitalized and they gave him two blood transfusions on Tuesday night. On Wednesday, Tim had a one-hour endoscopy. After the procedure, the surgeon said she had good news and “indeterminate” news. The good news was that the bleeding was not caused by an ulcer. She did not see any active bleeding. There was a mysterious patch near his stent that she biopsied.

Tim's condition stabilized enough so that he was discharged from the hospital on Thursday afternoon. On Friday, the surgeon called to say that the biopsy showed that the cancer had begun to spread into the small intestine.

At first, Tim's Oncologist wanted him to start on a new regime of chemo this coming Monday February 5. Later, she and her colleagues decided it was risky to start on chemo right away since it might trigger more internal bleeding. Instead, they recommended Tim start radiation in order to treat the area before starting chemo. Tim has an appointment with the Radiation Oncologist on Tuesday to plan out the radiation regime.

Paul continues to slowly climb out of the post-transplant and post-chemo side-effects. Still some nausea and fatigue, but definitely better than before.

Anacapa Island, Channel Islands National Park