Update On Mawmaw

This morning at Starbucks.... 

Ever since Ryan was little everyone has called my mom "Mawmaw" instead of Norma... or mom... or whatever. Just like most people call me "Aunt Heather" or "Nana" or "Mom", my dad is Pop and my brother is "Uncle Bubba". We're Southern that way.

Yesterday a little before two, Mawmaw's doctors' office called and said they had what they needed - the results - and asked if she could come down to the office. It's about 45 minutes away so I had time to contact my kids and my brother and my sister-in-law to let them know that results were in and we were just waiting to hear back from Mawmaw. You know that the tell you good news over the phone and ask you to come in when it's bad news. I tried not to think of it that way but it's true. I used the time to make Russian Tea Mix - it's a mixture of ice tea mix with lemon and tang and cloves, cinnamon and allspice. I would give you the exact amounts but I don't measure, I just do it by taste and ... I'm not sure I got the balance right this time but it was a good distraction.

Mom has a neuroendocrine tumor in her pancreas. It's in the same carcinoid family as the tumor she had in her colon a few years back.... maybe 2010? It's a hormone driven cancer that is rare - only about 5% of pancreatic cancer is this type of cancer. It has to come out but the surgery has to be done at Emory (in Atlanta) so they're scheduling it as soon as they can. Once the tumor comes out I think they can grade/stage or whatever they do. If I understood correctly the doctor said this is the better cancer to have.

From what I've found online (Dr. Google to the rescue!) the pancreas has two types of cells: endocrine and exocrine. The endocrine cells make hormones such as insulin. The exocrine cells make digestive enzymes. Pancreatic endocrine tumors can be benign or malignant, they are rarer than exocrine tumors and have a much better prognosis. (according to http://www.cancer.gov/types/pancreatic/patient/pnet-treatment-pdq )  Neuroendocrine tumors are either functional or non-functional. The functional ones create extra hormones that cause symptoms like fluctuating blood sugars, etc. The non-functional ones do not make extra hormones and their symptoms occur as they spread and grow. Non-functional ones are usually malignant.

I'm going to cut and paste this next bit from the website listed above because I don't want to summarize it and get any of the information confused. It details the typical hormonal responses that can be caused by functional neuroendocrine tumors.

Pancreatic NETs make different kinds of hormones such as gastrin, insulin, and glucagon. Functional pancreatic NETs include the following:

• Gastrinoma: A tumor that forms in cells that make gastrin. Gastrin is a hormone that causes the stomach to release an acid that helps digest food. Both gastrin and stomach acid are increased by gastrinomas. When increased stomach acid, stomachulcers, and diarrhea are caused by a tumor that makes gastrin, it is called Zollinger-Ellison syndrome. A gastrinoma usually forms in the head of the pancreas and sometimes forms in the small intestine. Most gastrinomas are malignant (cancer).
• Insulinoma: A tumor that forms in cells that make insulin. Insulin is a hormone that controls the amount of glucose (sugar) in the blood. It moves glucose into the cells, where it can be used by the body for energy. Insulinomas are usually slow-growing tumors that rarely spread. An insulinoma forms in the head, body, or tail of the pancreas. Insulinomas are usually benign (not cancer).
• Glucagonoma: A tumor that forms in cells that make glucagon. Glucagon is a hormone that increases the amount of glucose in the blood. It causes the liver to break down glycogen. Too much glucagon causes hyperglycemia (high blood sugar). A glucagonoma usually forms in the tail of the pancreas. Most glucagonomas are malignant (cancer).
• Other types of tumors: There are other rare types of functional pancreatic NETs that make hormones, including hormones that control the balance of sugar, salt, and water in the body. These tumors include:
  • VIPomas, which make vasoactive intestinal peptide. VIPoma may also be called Verner-Morrison syndrome.
  • Somatostatinomas, which make somatostatin.
  These other types of tumors are grouped together because they are treated in much the same way.

I feel like my mom has had some of these symptoms, specifically the gastrinoma. Of course, all that will be sorted out by an oncologist who has more than a Google education. Just wanted to put this information here for family members, like my kids, who want to know as much as they can about Mawmaw's condition. I hope that my grandkids will love me even half as much as my kids love their Mawmaw.

The website goes into much more additional detail and if you're curious, I would encourage you to check it out. The bottom line is that she is in a good bit of pain and feels pretty crappy. Unfortunately the way chronic pain works is that you don't feel better just because someone else feels worse. I'm doing some things that my mom would normally do and struggling a bit in the process. I'm not able to take on many of her chores and I am nowhere near her attention to detail in keeping house. I took Austin to work this morning and Tasha and I did a little food shopping. When I got home from the store mom reminded me that we would need to pick Austin up from work this afternoon and I just about cried. I was hoping that my day would be over after grocery shopping. Tasha's going to see if her parents can pick him up.

So that's the long and short of it. Mawmaw will have surgery at a undetermined time in the near future. We'll know more when that happens and in the meantime we're just all keeping our spirits as high as we can!

Cody gave me the ok to show the Jolly Ollie picture I mentioned yesterday. I never had chubby babies and I am just crazy about Ollie's chubbiness! You can't look at that belly without wanting to blow raspberries on it! And those dark eyes and fuzzy little head! I know I'm prejudice but honestly, I have the prettiest grandchildren!

I'll end on that happy note. Thanks for your concern and love and prayers for Mawmaw. I know she appreciates it as well. Love and hugs back to you!