Timeline from Diagnosis

April 2016 – Tests for suspected lung cancer reveal cysts on the pancreas. This was never disclosed to Pat, no follow up was recommended and it was considered insignificant. The first we knew of it was after the Pancreatic cancer diagnosis in May 2017.

5 May 2017 – Admitted to ICU with Pulmonary Embolism from DVT. Mass on pancreas detected on CT. Bloodwork completed showed elevated CA19-9 at around 8000.

20 May 2017 – Returned to Australia to begin investigation and treatment of cancer

22 May 2017 – GP for referral. GP believed there’s no cancer – highly critical of Thai doctors and diagnosis. Suggests there’s nothing to worry about. Haemotologist in the afternoon – he was more concerned

26 May 2017 – first appointment with oncologist. Our worst fears were confirmed. He believes it is undoubtedly pancreatic cancer. Recommendation of immediate referral to the public health system for treatment.

31 May 2017 – First appointment with public health oncologist. Recommendation for a biopsy and PET scan. There’s a possibility it’s not a carcinoma but a lymphoma, this is a good thing.

1 June 2017 – PET Scan

5 June – PET scan results. Cancer has been detected in pancreas, spleen, liver, kidneys and lymph nodes. Decision to biopsy the groin has been made as a general anesthetic isn’t considered safe with a pulmonary embolism.

9 June – Biopsy of metastasised tumor in groin

19 June – Appointment to discuss results of groin biopsy. No cells were detected in the biopsy. A new biopsy is required.

21 June – After a 5 hour wait (and overnight fasting) the biopsy is rescheduled for the next day

22 June – a successful endoscopic biopsy of the mass in the pancreas.

26 June – 51 days after the diagnosis in Bangkok, the doctors in Australia confirm the diagnosis of pancreatic cancer. Due to the widespread nature it’s consider metastatic and stage 4. Chemo regime of Abraxane & Gemcitabine and  is recommended to slow the growth and will begin within days

29 June – Chemo round 1, dose 1. No side effects. Supported with steriods for symptom management. Joined by his son Trent

6 July – Chemo Round 1 dose 2 – side effects limited to sore throat. Joined by his son Trent

13 July – Chemo Round 1 dose 3 – sore throat continues. Begin daily gargles with bicarb soda to relieve symptoms. Joined by daughter in law Tamara

20 July – Week off!! No chemo

27 July – Chemo round 2 dose 1. Joined by his daughter Megan

3 August – Chemo round 2 dose 2. Joined by his son Trent

6 August – All family support leave to return to home in Bangkok

10 August  – Chemo round 2 dose 3.

17 August – No chemo

21 August – appointment with dietician to address options for lack of appetite

23 August –  lung scan finds lung inflammation, a rare side effect of chemo. Chemo is stopped pending further investigation

24 August – bronchoscopy & CT scan to investigate lung inflammation

30 August –  results of tests show cancer markers down from 16,000 to 4,900 but tumor on spleen has grown and is now pressing on the heart and lungs

31 August – new chemo regime starts Irinotecan & tablet form of 5FU (capcitabine)

6 September – Doctor suggests Pat investigate setting up a power of attorney

8 January – Doctors say there is no more that can be done to fight the cancer and to consider hospice and palliative care options

17 January – Pat suffers a stroke at home and is transferred to hospital. The stroke caused right side paralysis and loss of speech. The team supporting Pat decide to place him on a “care of the dying” pathway and remove all non-essential care and interventions

18  January – Pat’s family arrive from interstate and overseas and Pat has an afternoon or relative lucidity, allowing everyone to say their goodbyes

19 January – Pat’s condition deteriorates quickly. Friday morning he was okay, similar to the previous day – thirsty and lucid at moments. From lunchtime his condition worsens, his breathing is laboured, erratic and rattly. The medical staff suggest starting morphine to manage pain, though Pat continues to say he has no pain. Morphine pump is started and quickly thereafter Pat needs regular top ups to manage pain and symptoms of dying. Late in the evening Pat’s family leave to allow him to die without them watching as that was what he wanted

20 January – Pat’s family are informed at 3am that he had died. Nurses had checked on him and found he was quite distressed, so had given his more medications and when they returned to check on him, he had died.

25 January – Pat’s funeral is attended by in excess of 100 family and friends