On 6/15/2012 when I got my final diagnosis, they said time was of the essence and wanted to do the Whipple the next morning- a Saturday. I asked for a delay until 6/18/2012 when they did the Whipple with portal vein resection. Pathology was invasion into the portal vein wall, 11/22 nodes positive, high grade and poorly differentiated. One week later a CT was done to check if there was an intestinal blockage. That is when metastatic disease was detected in the liver. From the initial diagnostic scan on 6/12/2012 until the second scan on 6/25/2012, the micrometastatic disease grew enough to now be detected by CT. So that is how I ended up getting a Whipple when I was already stage IV. Had the diagnostic scan occurred a week later, the Whipple would not have been done. Conclusions by oncologists-the Whipple did not result in cure-it was the aggressive chemotherapy that began with Gemzar that was given for palliative care making matters worse because it did not work at all. That is when I began aggressively advocating.