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.
Monday, November 17, 2008
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!
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!
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!
Large And In Charge
That's what I called mom this morning in pre-op holding- her belly is quite sizable these days, no wonder since she's carrying around an ovary the size of a cantaloupe! Yes, that's right- eat your heart out grapefruits, she's moving up in the world.
Coco and I drove her in the early morning darkness. It's almost comical how opposite she is going in to this surgery based on her last experience. This time- NOTHING goes to the hospital that will have to come back home for fear of carrying home any delicious buggies. We've even been instructed to bring tilex spray (apparently the most potent and only bleach-containing spray), gloves, dry wipes, and disposable toiletries. That's it. And we're too wipe down the things in her hospital room whenever possible. Do you think her last experience with c.diff has put her a bit over the edge? Sometimes knowing "too much" can have it's benefits though- she used Nair hair-removal lotion on both of her arms yesterday because nothing was more painful, then having tape ripped off her arm hair. Genius!
And I have a Howard development! Remember the miserable post-op nurse Mom had who made her cry??? He still works there! To every person we encountered, Mom plead her case: "I had such a bad experience last time, can I please please please have my daughter with me in post-op?" It's usually a very big no-no because it's a busy place with lots going on, but after hearing it enough, they relented. After she had her IV's placed (yes- two- ouch), we met her OR nurse, Jeff, who has been the nurse working the da Vinci robot since it's arrival to St. Frannie's a year and a half ago. He snuck me in to the pre-op holding area (also a no-no) so I could meet all the other bodies who would be in the OR with Mom. He gave me all the answers to my "what-ifs" and spoke to the nurse manager about making sure I can be right there when Mom is rolled out.
The all-star line up includes Jeff, her fantastic da Vinci OR nurse who's also proved to be Mom's best advocate right off the bat. Dr. Spark, the anesthesiologist who's ID was so worn thin I had to believe there's no one more experienced to be at her bedside. Jim, the nurse anesthetist (hooray, another NURSE) who will be at her head managing airway, vital signs, medications, fluids, etc. with the help of Dr. Spark. Dr. Boyle is Dr. Kennedy's partner who will place the stents in her two ureters from Lil' Lefty so everyone can visualize and protect the little buggers during surgery. Last but not least- Dr. Nelson. I have to admit my eyes welled up the second I saw her! She immediately puts those around her at ease, and I can see why Mom loved her so much when they met two weeks ago. She just listened to everything Mom had to say with a hand on her arm, completely zoned in despite the group of doctors standing at the bedside talking to one another.
This is a really perfect example of many different disciplines in medicine and nursing coming together to help one person. They're communication with one another, and each person's ability to fill in the blanks based on their experience caring for Mom will play a huge part in the outcome of this surgery. What do I mean you might ask? Well, you can imagine our surprise when her anesthesiologist didn't seem to know she'd already had a kidney and ureter out less than a year ago! Enter Dr. Boyle who filled him in and then they were all on the same page again.
The surgery will be anywhere between 3-6 hours depending on what the ovarian biopsy indicates. I'll be hanging waiting-room style by 10am since that's the earliest possible time she will be out.
Best be getting back to St. Frannie's now! Will post as soon as I'm able this afternoon.
Coco and I drove her in the early morning darkness. It's almost comical how opposite she is going in to this surgery based on her last experience. This time- NOTHING goes to the hospital that will have to come back home for fear of carrying home any delicious buggies. We've even been instructed to bring tilex spray (apparently the most potent and only bleach-containing spray), gloves, dry wipes, and disposable toiletries. That's it. And we're too wipe down the things in her hospital room whenever possible. Do you think her last experience with c.diff has put her a bit over the edge? Sometimes knowing "too much" can have it's benefits though- she used Nair hair-removal lotion on both of her arms yesterday because nothing was more painful, then having tape ripped off her arm hair. Genius!
And I have a Howard development! Remember the miserable post-op nurse Mom had who made her cry??? He still works there! To every person we encountered, Mom plead her case: "I had such a bad experience last time, can I please please please have my daughter with me in post-op?" It's usually a very big no-no because it's a busy place with lots going on, but after hearing it enough, they relented. After she had her IV's placed (yes- two- ouch), we met her OR nurse, Jeff, who has been the nurse working the da Vinci robot since it's arrival to St. Frannie's a year and a half ago. He snuck me in to the pre-op holding area (also a no-no) so I could meet all the other bodies who would be in the OR with Mom. He gave me all the answers to my "what-ifs" and spoke to the nurse manager about making sure I can be right there when Mom is rolled out.
The all-star line up includes Jeff, her fantastic da Vinci OR nurse who's also proved to be Mom's best advocate right off the bat. Dr. Spark, the anesthesiologist who's ID was so worn thin I had to believe there's no one more experienced to be at her bedside. Jim, the nurse anesthetist (hooray, another NURSE) who will be at her head managing airway, vital signs, medications, fluids, etc. with the help of Dr. Spark. Dr. Boyle is Dr. Kennedy's partner who will place the stents in her two ureters from Lil' Lefty so everyone can visualize and protect the little buggers during surgery. Last but not least- Dr. Nelson. I have to admit my eyes welled up the second I saw her! She immediately puts those around her at ease, and I can see why Mom loved her so much when they met two weeks ago. She just listened to everything Mom had to say with a hand on her arm, completely zoned in despite the group of doctors standing at the bedside talking to one another.
This is a really perfect example of many different disciplines in medicine and nursing coming together to help one person. They're communication with one another, and each person's ability to fill in the blanks based on their experience caring for Mom will play a huge part in the outcome of this surgery. What do I mean you might ask? Well, you can imagine our surprise when her anesthesiologist didn't seem to know she'd already had a kidney and ureter out less than a year ago! Enter Dr. Boyle who filled him in and then they were all on the same page again.
The surgery will be anywhere between 3-6 hours depending on what the ovarian biopsy indicates. I'll be hanging waiting-room style by 10am since that's the earliest possible time she will be out.
Best be getting back to St. Frannie's now! Will post as soon as I'm able this afternoon.
Saturday, November 15, 2008
Final Countdown
As of tonight, Mom can't enjoy anything but her bowel clean-out fluid, which for those of you who have had a colonoscopy, know isn't the tastiest beverage this world has to offer. The past week has gotten progressively more challenging secondary to what we're assuming is the continuing growth of her ovary. Mom says the only thing she can really compare it to is being pregnant! She can't button her pants, she has to eat very small frequent meals if she can tolerate even that, and is feeling very ready to get this ovary and co. out! Despite the discomfort, her spirits are in excellent shape. Mom's arrived at a place of understanding and is at peace with the plan.
I blog tonight from work- my last shift for the next two weeks! And Gwennie arrives home for 3 weeks in just a few days. Amazing how this has turned in to a positive opportunity for us all to be home together.
I'll make sure to update the blog as soon as possible on Monday. We report at 5:30am, so I am hoping to have something good to post by mid-afternoon.
As soon as we're needing resources, we'll reach out to Susan Eastman to coordinate, our Helping Hands superstar! Thanks to all of you who've reached out with endless love and support.
I blog tonight from work- my last shift for the next two weeks! And Gwennie arrives home for 3 weeks in just a few days. Amazing how this has turned in to a positive opportunity for us all to be home together.
I'll make sure to update the blog as soon as possible on Monday. We report at 5:30am, so I am hoping to have something good to post by mid-afternoon.
As soon as we're needing resources, we'll reach out to Susan Eastman to coordinate, our Helping Hands superstar! Thanks to all of you who've reached out with endless love and support.
Monday, November 10, 2008
FYI: Blog Post Alerts
Coco made a good point in a comment- there is a way for readers to get email notifications of when I post on this blog if you're interested. Here is what I found under frequently asked questions:
How do I notify people of updates to my blog?
We’ve got a few suggestions:
Use the BlogSend feature to email folks when you update your blog.
Get your friends hooked on feeds and give them the feed of your blog.
Feedburner also has a Subscribe via Email widget you can add to your blog after burning your feed.
Blogarithm is a service that will let your friends and family subscribe to your blog and be notified by email when you have new content.
Blog Alert will send your family and friends daily email notifications when there are new posts to your blog. They don't need an account. They just need to enter your feed URL and their email address.
Hope this is helpful!
How do I notify people of updates to my blog?
We’ve got a few suggestions:
Use the BlogSend feature to email folks when you update your blog.
Get your friends hooked on feeds and give them the feed of your blog.
Feedburner also has a Subscribe via Email widget you can add to your blog after burning your feed.
Blogarithm is a service that will let your friends and family subscribe to your blog and be notified by email when you have new content.
Blog Alert will send your family and friends daily email notifications when there are new posts to your blog. They don't need an account. They just need to enter your feed URL and their email address.
Hope this is helpful!
Endometrial Polyp = Clean
I received the following in an email from Mom this morning:
Good news so far. The endometrial biopsy showed no signs of cancer. Also no signs of hyperdysplasia (abnormal cells). So that’s a good start. They will biopsy the entire kit’n’kaboodle during surgery for further, more comprehensive results. Meanwhile, my belly is round and hard. I look like Alfred Hitchcock.
As we say in our house, we're preparing for the worst and hoping for the best- but this is very promising. Even if the ovary is cancerous, it doesn't necessarily mean it has spread. Frankly, I was more worried about this polyp than the ovary in some ways, so hooray!
Good news so far. The endometrial biopsy showed no signs of cancer. Also no signs of hyperdysplasia (abnormal cells). So that’s a good start. They will biopsy the entire kit’n’kaboodle during surgery for further, more comprehensive results. Meanwhile, my belly is round and hard. I look like Alfred Hitchcock.
As we say in our house, we're preparing for the worst and hoping for the best- but this is very promising. Even if the ovary is cancerous, it doesn't necessarily mean it has spread. Frankly, I was more worried about this polyp than the ovary in some ways, so hooray!
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