Dr. Appointment and Pierogies

My Post-Appointment Lunch in the East Village
Veselka
144 2nd Ave NYC

Yesterday, I had my follow-up appointment with Dr. Nash, who checked my wound. He said that it looked like it was healing nicely, and was more shallow than last week. He estimated that it will take another few weeks to fully heal, and wants to see me again next Thursday. I'm really glad that Dr. Nash is continuing to see me every week, it gives Gary and I a lot of peace of mind.

After my appointment, we went to our favorite Ukrainian diner for lunch: Veselka. If you've never been to Veselka - GO! The food is amazing. So, while we enjoyed our usual meals (Gary: stuffed cabbage vege combo; me: pierogies), we reviewed what we learned today from the nutritionist / nurse, Rachael (another nurse - whom we absolutely adore) and Dr. Nash.

1. Dr. Nash never got a copy of the pathology on the three small polyps that were removed by Dr. Maloney during my colonoscopy - he will follow up this week. Most likely, if I didn't hear anything, the pathology came back clear. Interestingly, I found out that the polyps were not in the part of my colon that was removed during surgery.

2. The most likely place for the carcinoid cancer to reoccur is in the lymph nodes or liver.

3. The best screening method for carcinoid tumors is regular CT scans; blood markers are too inconsistent for any meaningful results, and CT scans have gotten so good that they are now considered superior to octreoscans.

4. Some of the medical literature suggests a tenuous connection between gastrointestinal carcinoid tumors and an increased risk for other types of cancers, such as colon cancer; because of this, a colonoscopy should be preformed every three years instead of every five.

5. I should finish the entire 30-day supply of Pantoprazole (reduces stomach acid, thereby decreasing the risk of a stress ulcer) and follow up with my primary care doctor if I experience any reflux after I stop the medication.

6. I can take nausea medication for as long as I need to. The medication that works best for me is Ondansetron 4mg (Zofran), which dissolves under your tongue. I have also tried Metoclopramide 10 mg (Reglan) with minimum success. There doesn't seem to be any issues with safety - both are good for long-term use and have few side effects, it's just a matter of which one works. (Fun Fact: Reglan can also be used to treat hiccups.)

7. I can slowly introduce a few fibrous foods into my diet, like smooth peanut butter or a small salad, and adjust my Colace (100 mg up to 3x a day) accordingly. It is very important that I eat protein, which will help speed the healing process for my wound. In this regard, I confirmed that I CAN EAT SUSHI (even the seaweed)! YES!

8. Since I am off the prescription pain meds (as of Tuesday), I can test whether or not I'm able to drive by getting into the car and pushing down as hard as I can on the breaks - if it hurts, I can't drive and vice-versa.

Just a note on pain meds - there are different options out there, and in connection with my past two surgeries I have tried: Hydromorphone 2mg, Vicodin 5/500 mg, and Percocet 5/325 mg. Out of these three, the only one that works for me is Hydromorphone (Vicodin does not kill the pain and Percocet just makes me loopy). Also, it didn't take me that long to switch from Hydromorphone over to Advil for the pain (I averaged 4-5 pills a day right after surgery, and decreased the amount by one pill every three days, so I only had to be on the "heavy duty" stuff for 9 days following discharge).

9. There is no problem with Gary and I going to the beach as long as I only go in the water for a short period of time (10-15 min) and immediately rinse off and repack the wound when I get out.

10. Since nearly all exercise involves your core muscles, I should wait about 8 weeks before resuming any exercise routine.

Overall, everything was good news at the appointment, and it feels like I'm slowly getting back to my old self.