I have my Pathology Report

The tumor is reported in a two page dissertation describing the specimen grossly and microscopic with multiple special stains.The bottom line is that the lesion is an ulcerated and necrotic focus of metastatic Merkel cell carcinoma, extending through the bowel wall and involving the serosal surface. The small bowel margins are clear. 6 lymph nodes in the mesentary have no Merkel involvement.There is no involvement of mesenteric fat. The entire specimen measures 10.5 cm in length and up to 4.5 cm in diameter. The tumor is described as ulcerating and fungating involving 85% of the small bowel circumference.
What that all means is that the small bowel tumor has been completely removed. The good thing is that the nodes are not involved. The bad news is that it got to the surface of the bowel and I am at risk for cells having been shedded from the surface taking hold in the peritoneum and growing there.
This was obviously the cause of my anemia and was close to causing a small bowel obstruction. It was also causing my weight loss.
My last Hemoglobin was 8 grams. I need to get this up. I have had 2 iron transfusions and have begun oral iron supplements as well.
My appetite has improved and my colon has begun behaving normally.
I was feeling very discouraged last night thinking I was having too much abdominal pain for this late after the surgery. This prompted a careful inspection of my abdomen. I realize that there is a 6cm horizontal incision in my right upper abdomen. This is larger than I had originally reported. I thought the largest was in the umbilicus. However it makes sense that the specimen was removed intact and measured up to 4.5 cm. This cheered me up, thinking that the continued pain is appropriate. I have taken some Advil for pain but did not fill my prescription for narcotic pain relief. A heating pad has been helpful as well for back spasms.
Yesterday, I called my accountant and asked him to get an extension for the deadline for filing my taxes for 2010. Then, in the mail, I get an audit notice for 2009.
I also got a Jury Summons. I requested a postponement based on the likelyhood of needing chemotherapy.
So here is the plan.
Follow-up with Dr Felix Monday afternoon. (April 4).
CBC Monday morning (to be drawn at Dr Flam's lab.
Follow-up with Dr Flam April 12
?Chemo? I don't think I can get away from it.