Stick a Pin in It

I'm sure that's what Mom would like to do to her belly right now, because although she's had two little tiny teases of toots, her belly is still very distended and uncomfortable. She's up and moving as much as she can tolerate, and otherwise her hematocrit is back up, her blood pressure is back to her norm, and she is ready to go home!

It's been so great to see her so chipper. Amazing it's only been 3 days!

Chicken Soup for the Bowels

No, not the name of my new novel. Mom's friend brought chicken soup from Crown (a major hit last year) and it's really gotten the tummy grumbling! She went for a long walk this evening, climbed a flight of stairs, and is doing everything in her power to get things moving.

She took to the 2 units of blood well, and she's just had labs drawn to check if her hematocrit is on the rise.

I'm hoping she gets a good night of rest, without sheet issues, and hopefully tomorrow will be the day. In the meantime, we're just hanging here sharing a grape soda (totally organic and sugar free) planning the Thanksgiving menu. GRAVY!

Stinkin' Sheets

Sorry for the late post last night- long day and I was pooped. Mom had an okay night. She didn’t wake up feeling terribly well-rested, and believe it or not, it was her sheets' fault! They were all bunched and messy and she just couldn’t seem to get settled, but she doesn’t remember anyone coming in the room, taking vital signs, etc. so we figure she just conked out and slept right through it.

Unfortunately, her hematocrit dropped to 21 this morning down from 24 yesterday, so she’s scored herself 2 units of blood today. Her blood pressure is still low for her, but within stable limits. No gas, but improved bowel sounds. She was able to have some cream of wheat and crackers for breakfast, and I snuck her some fresh watermelon too.

Her spirits are top notch, she’s starting to read some emails and check out the blog. She walked the hallways herself today, and we’re hoping this blood will speed up the process. I’m feeling pretty confident that if this transfusion does its job and she’s able to get her gut moving, maybe tomorrow we can go home.

I know I mention this a lot, but my Mom's health is being directly impacted by the generosity and effort from a complete stranger. Donating blood is one of the easiest ways to help save lives, and it makes you feel so good. You know that feeling you had walking out of the polls on November 4th? Multiply that by 10!

D/C the PCA and Move to PO

What?

Mom's nurse was a new graduate, so I can completely empathize, but she was a little heavy on the acronyms! To translate, Mom's Patient Controlled Analgesia (a pump through which she can self-administer pain medication) was discontinued, and she's now taking pain pills when needed by mouth. This symbolizes a huge step in the right direction, because her pain is well managed, not to mention that she's had not one bit of nausea, has walked the halls twice, and is hoping to try solids tomorrow- providing things move along tonight, if you know what I'm sayin'...

We met with Dr. Nelson bright and early, who was happy with Mom's progress, and graciously and patiently explained and re-explained many details of the surgery since Mom's memory of yesterday is limited. The only main concern throughout the course of the day was her extremely low blood pressure, which was causing waves of intense dizziness. It was explained that this could be due to the combination of extreme blood loss during surgery and the anesthesia. As I mentioned before, her hematocrit (measure of whole blood circulating) was also down to 30 yesterday post-op from a healthier 37 pre-op (42 or greater is ideal in adult women). By this morning it had dropped to 25, then 24 this afternoon, and we were sure a blood transfusion was on the horizon. To combat her low blood pressure, she was being pumped up with tons of IV fluids, but by the afternoon, she started peeing a ton and her blood pressure rose a bit and she really perked up.

Dr. Nelson said her hematocrit and blood pressure certainly warrant close watch, but often times from so much fluid, the hematocrit can get a bit diluted, but as the body regulates by releasing that excess fluid as urine, things can re-regulate themselves. Hopefully, no blood transfusion.

Overall, Mom had such a great day. She had visits from friends, received a ton of emails through St. Frannie's patient care website (Kudos to Tante Charlotte for sending two in one day!), and had one great nurse after another.

This recovery experience has already been drastically different than last year, it's certainly providing me with great hope and relief, and I can only imagine how happy my Mom must be.

Since her pain and nausea are well controlled, she just needs to pass le gas, tolerate a full diet, and have a symphony of bowel sounds. Then- home we go!

Finally Getting Some R&R

Mom was moved from the recovery holding area to her room on the oncology floor at about 4pm and is doing extremely well. Her pain is well controlled thanks to her PCA (patient controlled analgesic), she's had no nausea, and has been able to nap on and off since arriving to the floor.



Since she was so out of it in recovery, Dr. Nelson didn't try to explain anything about the procedure to Mom, so Coco and I were able to introduce the information to her and Dr. Nelson will be by later this evening to fill in the blanks and answer our questions. I can't say Mom was thrilled to learn it was a recurrence or that she will have to undergo chemotherapy, but she's been able to let go a little and just allow herself to rest. We have plenty of time to process and talk things over later.

As for now, Coco and I are just camped out in Mom's room while she naps, hoping Dr. Nelson stops by before my stomach eats itself.

Aha! The resident who assisted in the surgery just popped in, echoing all the wonderful things we've heard repeatedly about Dr. Nelson, and also mentioned that the surgery was certainly not an easy task given all the residual scar tissue. Not surprised. Mom likes to keep people on their toes.

In Recovery, and No Sign of Howard...Phew!

Mom's surgeon, Dr. Nelson, came to speak with us at 1pm immediately after Mom had been rolled into recovery. She did very well during the surgery, however the vast majority of it ended up being done manually rather than with da Vinci due to the amount of scar tissue. The biopsy on the ovary showed that this cancer is not a primary ovarian or gynecological cancer, but rather a recurrence of the ureter cancer she had last December. It is a positive thing that she does not have a new type of cancer, but a negative finding that her previous cancer has come back.

The best explanation is that some microscopic cells remained in her body and latched themselves on to her ovary and grew rapidly over the past few months, since there was no detection or evidence of this cancer on her previous CAT scan.

Out came the two ovaries, two fallopian tubes, and uterus. The cervix stayed since it was well adhered to the bladder, and to take it out might have caused more damage than it was worth. Everything will be sent off to pathology, but Dr. Nelson felt fairly positive that the tumor was contained in the ovary. Based on our knowledge that this cancer cell (transitional cell cancer) clearly wasn't eradicated by Mom's last chemo, she's definitely going to have to undergo another round of chemotherapy starting in 3 weeks. What chemotherapeutic drugs they decide to use will depend on what further pathology results show, and what Dr. Rhaman decides would be the best choice. He will replace Mom's primary oncologist (Dr. Donadio) while she's on maternity leave through February.

A bit of an unexpected twist in the adventure, but bottom line is Mom is safe and stable. It will just have to be one step at a time, one day at a time, but we feel more than confident in her team and now it's just a matter of getting her good and strong to kick the ass out of chemo again!

Over and Out. I mean Ovary Out.

We'd just gotten back to St. Frannie's and barely turned on our computers when Jeff called me in the waiting room. They were able to use the da Vinci robot for part of the surgery, but because of the impressive amount of scar tissue and the sheer size of her ovary, it's going to go forward as open abdominal surgery as opposed to primarily laproscopic.

Now that the ovary is out, there's a 15 minute break during which the pathology tests are run, which will indicate the type of cancer present in her ovary, then dictate how much they need to do. At this point, we already know she's having a hysterectomy (uterus, ovaries, tubes, cervix), but they may also biopsy some surrounding areas and/or remove lymph nodes.

Stacy, the family liaison, just sat down with us in the waiting room and assured us that she keeps her eyes and ears out to make sure we get information as soon as possible, and further reassured me that I'll be at my mom's side as soon as possible!