So how and when it all started or really when did I become aware something was wrong.  The mean time from actual start of pancreatic cancer to awareness is 14 months.  I became aware in August 2020 that something was not right.  I was having a lot of stomach pain that antacids did not quell.  

I contacted my GI doc and scheduled an EGD (Upper Endoscopy).  That was done on Sept 8th 2020.  It showed the usual stuff for a guy with GERD (gastro-reflux disease) for which I take pantoprazole 40 mg. Because there was a little bit of food in my stomach the PA (physician assistant) called it gastroparesis, abnormally slow movement of food through stomach. And put me on Zelnorm. So I was scheduled for a gastric clearing scan on Oct 12th, which was normal.  

So next up in the medical sequence of events was an abdominal ultrasound which was performed on Oct 22nd.  At that point I was expecting gallbladder issues.  Previously, I had my primary doc order an amylase/lipase to check for pancreatitis which were normal. The ultrasound was pretty normal for an over weight 67 y/o. Some fat in the liver and some sludge in the gallbladder.  A small inclusion on the liver was suspected to be a fat deposit, which 25% of patients have.  Still no worries, but still have abdominal pain, which has migrated from the top of my stomach to both sides. The pancreas was not visible on the ultrasound, hidden behind a small bowel loop. 

On November 12th a MRI of the abdomen was ordered with and without contrast.  My healthcare provider Baycare of Tampa Bay permits patients to view their imaging results the next day. This is when I first learned there was big trouble.  Ironically on Friday the 13th.  The radiologist impression follows: "Evidence of a 3 cm mass within the head of the pancreas concerning for a primary pancreatic neoplasm.  Multiple liver lesions which have features that are most consistent with metastatic disease."  My life then instantly changed.  I knew what that meant.