Tuesday, September 22, 2009  No. Just no.  Fucking pancreatic
cancer.  It is a goddamn awful diagnosis and an exceedingly
difficult one to make until it's too late.  Perhaps that is why
newFNP's patient received her diagnosis when the tumor was
already unresectable and had metastasized to her liver,
intestine and lymph nodes.    NewFNP took one look at her today
and knew that something wasn't right.  She had lost way too much
weight for that amount of time, and not in a healthy-appearing
way.  NewFNP had seen her six weeks ago and noted scleral
jaundice.  At that time, she drew STAT labs.  Her acute
hepatitis panel was normal, her bilirubin, alk phos, AST and ALT
were sky high.  NewFNP's colleague sent her to the emergency
room where, during the course of her three-week inpatient stay,
she received her terminal diagnosis.  She was born the year
after newFNP -- she in in her 30's.  She has four kids under the
age of eighteen.    She has three to six months to live.  If
that.  Her oncology appointment is in fou