It's been awhile since I last posted so I'll just let you in on what we've been doing this past week.
This last weekend, Jeff and I and a group of friends of ours went down to Galveston and stayed at our Aunt and Uncle's beach house. The weather was beautiful and we had a great time relaxing, watching football and playing games. It was so nice to get out of the house for a change. We really enjoyed ourselves.
Monday-Friday I've had lab. The good thing is I did it at the Bay Area Clinic so I didn't have to go all the way into Houston except for one day. This helps a lot since I can go by myself.
Tuesday I went shopping with a friend of mine from work. I haven't been to the mall since May! I even bought a new LSU hat and a pair of jeans. I really enjoyed myself.
Thursday NASA and UT held a get together for all the UT grads that work at NASA. It was pretty cool to see how many alums work there now. It was a good turnout.
Now I have a funny story about what happened today. I was going into the building to get my lab work done and I was waiting for the elevator. There was a man there waiting with his daughter who was maybe 3 years old. She was talking away and then she looked back at me and said "She's a pirate!" (because I was wearing a scarf on my head). I started laughing but the dad looked embarrassed and apologized for his daughter's comment. I told him it was alright, it was pretty funny. Anyway, thought ya'll might enjoy that. Have a good day!
Friday, September 28, 2007
Friday, September 21, 2007
Blood transfusion
Sorry I didn't get a chance to post yesterday, but I got a blood/platelet transfusion which took FOREVER! I left the house at 8am and didn't get back until 10pm. LONG day, but well worth it. I got 2 units of PRBC's and 6 units of platelets. I feel so good today! Amazing what a little extra blood will do for you.
Tonight I think we are going to eat with friends and then going to play some board games at their house. Should be fun. It'll be nice to get out while I feel good. Hopefully this feeling will last and I won't be so tired anymore.
Hope everyone has a great weekend!
Tonight I think we are going to eat with friends and then going to play some board games at their house. Should be fun. It'll be nice to get out while I feel good. Hopefully this feeling will last and I won't be so tired anymore.
Hope everyone has a great weekend!
Tuesday, September 18, 2007
The Plan
Lauri and I met with the Thoracic Surgeon today. We discussed what kind of surgery Lauri will have, the risks involved, schedule, and recovery. This will be another long post, with plenty detail on the surgery procedure. For those who prefer, here is the cliff notes version:
Lauri is scheduled for the first of two surgeries on October 17. The surgeon will work on Lauri's left lung to remove the tumor that is nearest the heart first. Six weeks later, on or near November 28, Lauri will undergo the second surgery to remove the two tumors in the right lung. After each surgery, a 5-7 day stay at the MD Anderson Hospital is expected, followed by recovery continuing at home.
And now for the details...
The Thoracic Surgeon confirmed that a "Stage Thoracotomy" is the preferred approach for Lauri's condition as opposed to a Sternotomy. A Sternotomy involves accessing the lungs via incision in the center of the chest, breaking the sternum bone, as in open heart surgery. This method, while providing access to both lungs simultaneously, generally results in the surgeon removing larger portions of lung tissue.
A Stage Thoracotomy involves working on one lung at a time. The surgeon generally only takes small sections of lung tissue in this case. For Lauri, the surgeon will work on her left lung first. There will be a ~4-5 inch incision parallel to the ribs, located around the middle of the rib cage on the left side of her back. Once incised, muscle is moved out of the way (a process referred to as "muscle sparing") and the ribs are literally spread apart enough to gain access to the lung.
The surgeon will use his hands and a bronchial scope (a scope placed through the trachea into the lung) to locate the tumor. The tumor will then be recessed (cut out) along with margin. Margin is simply surrounding tissue (about a millimeter to a couple millimeters thick), which is removed to guarantee the surgeon gets all of the cancer cells. According to the surgeon, he will not have to remove very much extra lung tissue, such as removing an entire lobe, to remove the tumor.
Chest tubes will be placed at the site to allow for drainage of fluids out of the area surrounding the lung. The chest tube is a large tube (perhaps 1 inch in diameter) that is placed near the lung, through the incision site, and connected to a container to collect the drainage. Once the wound is no longer draining, the tube will be removed. We expect this to occur around 2-3 days after surgery.
Lauri will be put to sleep during the surgery, as well as receive epidural pain medication during and after surgery. The epidural line will remain in place for around 3 days. Afterwards, Lauri will be put on oral pain medication for as long as she needs it...Yeah, that's what I'm thinking too...
We expect to be discharged from the hospital 5 to 7 days after the surgery. We will continue recovery at home, with expected "pain and discomfort" to persist for about 4 to 6 weeks. We will return to the hospital for the second surgery on the right lung 6 weeks after the first surgery, or around November 28. It is expected that Lauri will retain much of her lung capacity after both surgeries are completed.
The surgeon has decided to work on the left lung first because the tumor in the left lung is located near the heart. The two tumors in the right lung are not near other organs, and are considered lower priority (they can wait...).
The greatest risk of this surgery is the risk of pneumonia. To combat pneumonia, Lauri will have to do very frequent lung exercises using a tool called an "Incentive Spirometer". Open heart surgery patients use these too, so you may be familiar with them. The Incentive Spirometer requires the patient to inhale deeply and slowly, trying to draw enough air to keep a marker "ball" within a specified location. The device exercises the lungs while also providing a measure of lung capacity, and causing the patient to inhale deeply. Short breaths can lead to a pneumonia condition, and patients with chest pain are known to draw short breaths.
Lauri will also have to do arm exercises, basically stretches, to maintain full range of motion of the arms as the incision heals. She will not be permitted to pick up anything heavier than a newborn (so this means she can work then??). The information we received actually says that the patient cannot use a vacuum cleaner either, due to the pushing action....figures...
We really like our Thoracic Surgeon. He is very patient with us, and covered all of the details thoroughly. He has a good handle on Lauri's condition, and is very proactive in getting us all the help and information we need. He is also very straight with us, and wanted us to understand a very important point:
The chemotherapy and surgery process is 30-40% effective in curing the disease. While these odds are better than nothing, they are far short of a guarantee. We need to be prepared in the event the surgery is not successful in completely removing the disease. While Lauri's three nodules show up clearly in the CT scans, there may be more nodules out there, small enough to not show up on the scans and small enough that he cannot feel them during surgery. It only takes a single cell to split and grow into a tumor. If the tumors return, we will likely continue chemotherapy, followed by additional surgery.
I mention the above statement because while we have fought hard and fought well, the fight truly never ends. Even if we are cancer free after this surgery, others are not. We all have to work to prevent, in addition to cure, the cancer.
We are confident that the surgery will be successful in removing the tumors from Lauri's lungs. We must accomplish at least this in order to get to our final goal of becoming cancer free. We are blessed to have great doctors, family, and friends that fight along side us and keep us going.
It has been a hard path so far, having to stand by and watch as Lauri has lost hair, weight, and sometimes her lunch... But one thing she has never lost is her heart. It has been an inspiration to watch her continue to push forward even in the midst of great difficulty and pain. I pray that this surgery finally brings some release and reprieve from the cancer. But I am thankful that I am blessed to walk through life with such a great friend and wife.
Lauri is scheduled for the first of two surgeries on October 17. The surgeon will work on Lauri's left lung to remove the tumor that is nearest the heart first. Six weeks later, on or near November 28, Lauri will undergo the second surgery to remove the two tumors in the right lung. After each surgery, a 5-7 day stay at the MD Anderson Hospital is expected, followed by recovery continuing at home.
And now for the details...
The Thoracic Surgeon confirmed that a "Stage Thoracotomy" is the preferred approach for Lauri's condition as opposed to a Sternotomy. A Sternotomy involves accessing the lungs via incision in the center of the chest, breaking the sternum bone, as in open heart surgery. This method, while providing access to both lungs simultaneously, generally results in the surgeon removing larger portions of lung tissue.
A Stage Thoracotomy involves working on one lung at a time. The surgeon generally only takes small sections of lung tissue in this case. For Lauri, the surgeon will work on her left lung first. There will be a ~4-5 inch incision parallel to the ribs, located around the middle of the rib cage on the left side of her back. Once incised, muscle is moved out of the way (a process referred to as "muscle sparing") and the ribs are literally spread apart enough to gain access to the lung.
The surgeon will use his hands and a bronchial scope (a scope placed through the trachea into the lung) to locate the tumor. The tumor will then be recessed (cut out) along with margin. Margin is simply surrounding tissue (about a millimeter to a couple millimeters thick), which is removed to guarantee the surgeon gets all of the cancer cells. According to the surgeon, he will not have to remove very much extra lung tissue, such as removing an entire lobe, to remove the tumor.
Chest tubes will be placed at the site to allow for drainage of fluids out of the area surrounding the lung. The chest tube is a large tube (perhaps 1 inch in diameter) that is placed near the lung, through the incision site, and connected to a container to collect the drainage. Once the wound is no longer draining, the tube will be removed. We expect this to occur around 2-3 days after surgery.
Lauri will be put to sleep during the surgery, as well as receive epidural pain medication during and after surgery. The epidural line will remain in place for around 3 days. Afterwards, Lauri will be put on oral pain medication for as long as she needs it...Yeah, that's what I'm thinking too...
We expect to be discharged from the hospital 5 to 7 days after the surgery. We will continue recovery at home, with expected "pain and discomfort" to persist for about 4 to 6 weeks. We will return to the hospital for the second surgery on the right lung 6 weeks after the first surgery, or around November 28. It is expected that Lauri will retain much of her lung capacity after both surgeries are completed.
The surgeon has decided to work on the left lung first because the tumor in the left lung is located near the heart. The two tumors in the right lung are not near other organs, and are considered lower priority (they can wait...).
The greatest risk of this surgery is the risk of pneumonia. To combat pneumonia, Lauri will have to do very frequent lung exercises using a tool called an "Incentive Spirometer". Open heart surgery patients use these too, so you may be familiar with them. The Incentive Spirometer requires the patient to inhale deeply and slowly, trying to draw enough air to keep a marker "ball" within a specified location. The device exercises the lungs while also providing a measure of lung capacity, and causing the patient to inhale deeply. Short breaths can lead to a pneumonia condition, and patients with chest pain are known to draw short breaths.
Lauri will also have to do arm exercises, basically stretches, to maintain full range of motion of the arms as the incision heals. She will not be permitted to pick up anything heavier than a newborn (so this means she can work then??). The information we received actually says that the patient cannot use a vacuum cleaner either, due to the pushing action....figures...
We really like our Thoracic Surgeon. He is very patient with us, and covered all of the details thoroughly. He has a good handle on Lauri's condition, and is very proactive in getting us all the help and information we need. He is also very straight with us, and wanted us to understand a very important point:
The chemotherapy and surgery process is 30-40% effective in curing the disease. While these odds are better than nothing, they are far short of a guarantee. We need to be prepared in the event the surgery is not successful in completely removing the disease. While Lauri's three nodules show up clearly in the CT scans, there may be more nodules out there, small enough to not show up on the scans and small enough that he cannot feel them during surgery. It only takes a single cell to split and grow into a tumor. If the tumors return, we will likely continue chemotherapy, followed by additional surgery.
I mention the above statement because while we have fought hard and fought well, the fight truly never ends. Even if we are cancer free after this surgery, others are not. We all have to work to prevent, in addition to cure, the cancer.
We are confident that the surgery will be successful in removing the tumors from Lauri's lungs. We must accomplish at least this in order to get to our final goal of becoming cancer free. We are blessed to have great doctors, family, and friends that fight along side us and keep us going.
It has been a hard path so far, having to stand by and watch as Lauri has lost hair, weight, and sometimes her lunch... But one thing she has never lost is her heart. It has been an inspiration to watch her continue to push forward even in the midst of great difficulty and pain. I pray that this surgery finally brings some release and reprieve from the cancer. But I am thankful that I am blessed to walk through life with such a great friend and wife.
Monday, September 17, 2007
The weekend review and appointment with surgeon
This weekend was pretty relaxing. Friday night we celebrated the end of chemo with some friends at a local Mexican restaurant and then went back to Cory and Erin's for some Catchphrase. The girls team lost this round, but we'll be back to get them the next time around! Saturday we went to our other friend's house to watch the UT game. We left at halftime to meet our next round of visitors at our house, Papa and Debbie. We went out for some good fried seafood from Abe's for dinner. Sunday was a lazy day of watching pro football. It was nice not doing anything for a change.
Today I went to the clinic and had my lab drawn. Everything looked good today, but the doc assumes I'm going to need blood and/or platelets by the end of the week. I'm feeling kinda tired even right now, so it might do me some good.
We also got our appointments for the surgeon, which is tomorrow at 8:00am. Kinda sucks since I don't need to go to the medical center until Wed and Fri and they have my appt tomorrow. I also have a pulmonary function test scheduled for this week and guess when they have it...Thursday. Can't these people get my stuff all on the same day? Sheesh. Now I have to go every day this week to the medical center. Anyway, enough complaining. At least I will get some answers tomorrow from the surgeon. We'll keep you posted on what he says.
Today I went to the clinic and had my lab drawn. Everything looked good today, but the doc assumes I'm going to need blood and/or platelets by the end of the week. I'm feeling kinda tired even right now, so it might do me some good.
We also got our appointments for the surgeon, which is tomorrow at 8:00am. Kinda sucks since I don't need to go to the medical center until Wed and Fri and they have my appt tomorrow. I also have a pulmonary function test scheduled for this week and guess when they have it...Thursday. Can't these people get my stuff all on the same day? Sheesh. Now I have to go every day this week to the medical center. Anyway, enough complaining. At least I will get some answers tomorrow from the surgeon. We'll keep you posted on what he says.
Thursday, September 13, 2007
Final Round
Lauri finished her fourth and final day of chemotherapy today! She is doing well, feeling a little tired but ready to get rid of the backpack... We go back tomorrow (9/14) to get unhooked, hopefully for the last time! To say we are excited would be an understatement...
Our Oncologist met with the Thoracic Surgeons on Wednesday to discuss Lauri's case. Our good news was confirmed, the surgeons believe they can do the surgery and remove all of the cancerous tumors! Our Oncologist said she was very fortunate that the two best surgeons in the Thoracic group meet with her (she called them both "phenomenal surgeons"). She has put in the paperwork for us to work with either one of them, whichever is available.
We expect to hear word on when our appointment with the Thoracic surgeon will be within a week from now. We anticipate discussing the surgical procedure, expected dates of the surgery, and what kind of recovery process will be required. Lauri is also being scheduled for a pulmonary test in order to determine how her lungs function now, which will help the surgeons decide how much lung tissue they can remove.
On another note, the Artist formerly known as Lauri has created another masterpiece. I am really impressed with her ability. I think she is impressed too, but won't admit it. She says she isn't really any good. I told her that if you ever meet an artist that thinks he or she is good, then walk away. The art is guaranteed to be garbage...
For your viewing pleasure
Our Oncologist met with the Thoracic Surgeons on Wednesday to discuss Lauri's case. Our good news was confirmed, the surgeons believe they can do the surgery and remove all of the cancerous tumors! Our Oncologist said she was very fortunate that the two best surgeons in the Thoracic group meet with her (she called them both "phenomenal surgeons"). She has put in the paperwork for us to work with either one of them, whichever is available.
We expect to hear word on when our appointment with the Thoracic surgeon will be within a week from now. We anticipate discussing the surgical procedure, expected dates of the surgery, and what kind of recovery process will be required. Lauri is also being scheduled for a pulmonary test in order to determine how her lungs function now, which will help the surgeons decide how much lung tissue they can remove.
On another note, the Artist formerly known as Lauri has created another masterpiece. I am really impressed with her ability. I think she is impressed too, but won't admit it. She says she isn't really any good. I told her that if you ever meet an artist that thinks he or she is good, then walk away. The art is guaranteed to be garbage...
For your viewing pleasure
A big day tomorrow, the final unhook, and the last day of chemotherapy! Its been a long time coming, and an exhausting path the get here, but we are truly happy to be through this big step. We are very optimistic about the surgery. We have the best of the best Thoracic Surgeons working on our situation. They do this stuff every day, and we have no doubt they will do their job well. We will keep you posted when we hear more details about schedule and surgery. Thanks for fighting along with us, we are almost there!
Monday, September 10, 2007
One down, 3 to go...
Today was the first day of my last week of chemo!! I still feel pretty good. Just a little tired and yes, already annoyed with my backpack. Today Jeff's dad came with me to chemo. And if you didn't know, he's an artist, a very good one at that (check out his work at http://www.chuckmauldin.com). And if you know me at all, you know I don't have a crafty or artistic bone in my body. That said, he brought his watercolors to the hospital in an effort to get me to paint something. I was hesitant at first, since I can't even draw a stick figure straight, but I just thought, what the heck, let's go for it. So he patiently taught me the rough ends and outs of watercolor, which is supposed to be the hardest thing to paint with. So after a few hours here's what mine looked like:
And yes, this really is mine and not his. I'm pretty pleased with it. It came out WAY better than I was expecting.
Onto another topic. As if anyone didn't know, this weekend was a big one for football fans. The great LSU played an outstanding game against Virginia Tech and came out with a big victory. As most of you know, we are HUGE LSU fans and even Maggie, our dog participates in the celebrating. Here is a picture of her pre-game with her LSU bandanna on, lovingly given to her by my best friend, thanks Michelle!
That's all the news for now. More later on...
And yes, this really is mine and not his. I'm pretty pleased with it. It came out WAY better than I was expecting.Onto another topic. As if anyone didn't know, this weekend was a big one for football fans. The great LSU played an outstanding game against Virginia Tech and came out with a big victory. As most of you know, we are HUGE LSU fans and even Maggie, our dog participates in the celebrating. Here is a picture of her pre-game with her LSU bandanna on, lovingly given to her by my best friend, thanks Michelle!
Here is Maggie after the game, all pooped out from celebrating all the touchdowns LSU scored. She was pooped!
Also, a couple of my really good friends from Austin came by for a few days last week and brought me a surprise. A beautiful quilt made of pictures of me, Jeff and the friends I worked with at Seton in Austin. It came out awesome! I hope the pictures come out so you can see them. Thanks, Lesa and Krislyn! I love it!
That's all the news for now. More later on...
Friday, September 7, 2007
Results Day - End of Cycle 5
We had our big meeting with our Oncologist today. This is a really long post, so if you need the cliff notes... The bottom line: Lauri's tumors have shrunk compared to the baseline CT scan taken on May 24! We will proceed with the 6th cycle of chemotherapy, followed closely by surgery to remove the nodules. Now for the details...
Our Oncologist showed us the CT scan images taken yesterday along with the images taken right before we began chemotherapy (May 24), and we could all see visible reduction in size of the three tumors. The tumors are not melting away, but they are gradually shrinking. The official report from the Radiologist says there is no visible change, however they typically only compare the current images to those take most recently (3 to 6 weeks ago). The short term change in the tumor size is very little, but the cumulative change, which is what we looked at today, is more noticeable.
Since the tumors are not shrinking dramatically, the Oncologist sees no additional benefit of continuing chemotherapy past the 6th cycle. Therefore, the 6th cycle, which begins on Monday, will be the final cycle! As we have seen with Lauri, the longer she is exposed to chemotherapy, the longer it takes for her blood counts to recover. Adding chemotherapy cycles increases the risk to Lauri by extending the time with low blood counts, during which time she has an increased risk of infection, fatigue, and uncontrolled bleeding. Since we have gotten the disease under control, as is exhibited by the fact that her tumors have shrunk compared to when we started, our Oncologist decided the chemotherapy has done its job, and there is no need for any more cycles after cycle 6.
As for the "stuff" in the left lung, I am very pleased to announce that the "stuff" was indeed due to infection. Lauri's left lung is completely clear of the "stuff" in the CT scan we saw today. This made the Oncologist very happy, claiming that we nearly gave her a heart attack when we had that stuff show up the first time on Lauri's CT! We agreed that our heart attack was probably worse than hers when she told us it might be additional tumor growth... Thankfully, it was only an infection that has been eliminated with antibiotics.
Where do we go next?
Lauri will proceed with cycle 6 of chemotherapy on Monday. This will be her final cycle of chemotherapy. On Wednesday (9/12), our Oncologist will meet with a group of Thoracic Surgeons to discuss Lauri's case and possible surgical options. We expect to get the results of this conference on Thursday (9/13).
*The following is what we expect to happen next based on our Oncologist's experience. Be advised, we have NOT received confirmation from the Thoracic Surgeons yet, so nothing has been scheduled, and all plans are subject to drastic changes...
Our Oncologist expects to clear Lauri for surgery 4 weeks after the beginning of her final round. In terms of dates, Lauri will be ready for surgery as soon as October 8. Typically, the Thoracic surgeons work on one lung at a time. This process is referred to as a "Stage Thoracotomy."
For a Stage Thoracotomy, the surgeon will work on lung "A" first, sew everything back up, and allow around 6 weeks for healing. After 6 weeks, a second surgery to address lung "B" will be conducted. About 8 weeks after the second surgery, we would meet with our Oncologist to see how things are going. If we prove to be cancer free, then we return to the 3 month checkup schedule we were on before (i.e. return to normal life...).
As for the operation(s) itself, we don't have details yet. We have been told that the surgeon typically goes in from the side of the torso, as opposed to the front (break the chest bone, similar to open heart surgery). Our Oncologist added that two of the three nodules in Lauri's lung may be "tricky" to remove, but should be possible. The one nodule of concern is located on the outside edge of the right lung, attached to the "pleura", which is the sack that surrounds the lung. Nodules located here can be tricky to remove, according to our Oncologist. The other nodule of concern is located within the left lung, just behind the heart. The issue for this nodule is access, trying to get the "nodule plus margin" without damaging the heart.
You may recall from emails sent during Lauri's first surgery that in order to remove a tumor, the Surgeon must take not only the tumor, but also the surrounding tissue. The surrounding tissue is removed in order to guarantee that all of the cancer cells are removed. Leaving only one behind provides the chance for the cancer to return. In Lauri's case, the surrounding tissue may mean just a few centimeters of lung material surrounding the tumor, or perhaps an entire lobe. Unfortunately, we won't likely know how much tissue the Surgeon will take until the surgery is over. This decision is made during surgery, with the Surgeon doing everything he or she must to remove all of the cancer.
The surgery will undoubtedly be very dangerous and full of risk. However, we are confident since these Thoracic Surgeons do this literally every day, and are some of the world's best. This is also our only hope for being cancer free.
That's about all we have right now. Overall, Lauri and I view the day as a win for the home team. We got what we wanted: shrinkage of the tumors, and a chance to be cancer free. The alternative to doing surgery is to find a way to live with the cancer, having to endure chemotherapy in varying dosages and varieties for the rest of her life. Chemo is not fun, so we choose to take our shot and deliver the final blow to this disease. This is what we have wanted from the beginning, a chance to win...
Our Oncologist showed us the CT scan images taken yesterday along with the images taken right before we began chemotherapy (May 24), and we could all see visible reduction in size of the three tumors. The tumors are not melting away, but they are gradually shrinking. The official report from the Radiologist says there is no visible change, however they typically only compare the current images to those take most recently (3 to 6 weeks ago). The short term change in the tumor size is very little, but the cumulative change, which is what we looked at today, is more noticeable.
Since the tumors are not shrinking dramatically, the Oncologist sees no additional benefit of continuing chemotherapy past the 6th cycle. Therefore, the 6th cycle, which begins on Monday, will be the final cycle! As we have seen with Lauri, the longer she is exposed to chemotherapy, the longer it takes for her blood counts to recover. Adding chemotherapy cycles increases the risk to Lauri by extending the time with low blood counts, during which time she has an increased risk of infection, fatigue, and uncontrolled bleeding. Since we have gotten the disease under control, as is exhibited by the fact that her tumors have shrunk compared to when we started, our Oncologist decided the chemotherapy has done its job, and there is no need for any more cycles after cycle 6.
As for the "stuff" in the left lung, I am very pleased to announce that the "stuff" was indeed due to infection. Lauri's left lung is completely clear of the "stuff" in the CT scan we saw today. This made the Oncologist very happy, claiming that we nearly gave her a heart attack when we had that stuff show up the first time on Lauri's CT! We agreed that our heart attack was probably worse than hers when she told us it might be additional tumor growth... Thankfully, it was only an infection that has been eliminated with antibiotics.
Where do we go next?
Lauri will proceed with cycle 6 of chemotherapy on Monday. This will be her final cycle of chemotherapy. On Wednesday (9/12), our Oncologist will meet with a group of Thoracic Surgeons to discuss Lauri's case and possible surgical options. We expect to get the results of this conference on Thursday (9/13).
*The following is what we expect to happen next based on our Oncologist's experience. Be advised, we have NOT received confirmation from the Thoracic Surgeons yet, so nothing has been scheduled, and all plans are subject to drastic changes...
Our Oncologist expects to clear Lauri for surgery 4 weeks after the beginning of her final round. In terms of dates, Lauri will be ready for surgery as soon as October 8. Typically, the Thoracic surgeons work on one lung at a time. This process is referred to as a "Stage Thoracotomy."
For a Stage Thoracotomy, the surgeon will work on lung "A" first, sew everything back up, and allow around 6 weeks for healing. After 6 weeks, a second surgery to address lung "B" will be conducted. About 8 weeks after the second surgery, we would meet with our Oncologist to see how things are going. If we prove to be cancer free, then we return to the 3 month checkup schedule we were on before (i.e. return to normal life...).
As for the operation(s) itself, we don't have details yet. We have been told that the surgeon typically goes in from the side of the torso, as opposed to the front (break the chest bone, similar to open heart surgery). Our Oncologist added that two of the three nodules in Lauri's lung may be "tricky" to remove, but should be possible. The one nodule of concern is located on the outside edge of the right lung, attached to the "pleura", which is the sack that surrounds the lung. Nodules located here can be tricky to remove, according to our Oncologist. The other nodule of concern is located within the left lung, just behind the heart. The issue for this nodule is access, trying to get the "nodule plus margin" without damaging the heart.
You may recall from emails sent during Lauri's first surgery that in order to remove a tumor, the Surgeon must take not only the tumor, but also the surrounding tissue. The surrounding tissue is removed in order to guarantee that all of the cancer cells are removed. Leaving only one behind provides the chance for the cancer to return. In Lauri's case, the surrounding tissue may mean just a few centimeters of lung material surrounding the tumor, or perhaps an entire lobe. Unfortunately, we won't likely know how much tissue the Surgeon will take until the surgery is over. This decision is made during surgery, with the Surgeon doing everything he or she must to remove all of the cancer.
The surgery will undoubtedly be very dangerous and full of risk. However, we are confident since these Thoracic Surgeons do this literally every day, and are some of the world's best. This is also our only hope for being cancer free.
That's about all we have right now. Overall, Lauri and I view the day as a win for the home team. We got what we wanted: shrinkage of the tumors, and a chance to be cancer free. The alternative to doing surgery is to find a way to live with the cancer, having to endure chemotherapy in varying dosages and varieties for the rest of her life. Chemo is not fun, so we choose to take our shot and deliver the final blow to this disease. This is what we have wanted from the beginning, a chance to win...
Thursday, September 6, 2007
Test Day
Today we went to the hospital for lab, a doctor's appointment, chest xray, and ct scan. Not sure what the labs looked like, except for my platelets. They were 69 today. They ideally should be around 100 before I get chemo again, so hopefully in the next few days they'll come up. I saw my study doctor today. This will be my last round with the Pallafermin. It's only done for 6 rounds of chemo, so if I do rounds 7 and 8, I will not get the drug. I have my appointment with my chemo doctor tomorrow afternoon to get the results of the ct scan. I'm anxious to see if my tumors have shrunk. We're praying that they have. I think I will have another ct scan in 3 weeks to determine if we're going to stop there or go on to rounds 7 and 8. I'm excited to be almost done with this. So tomorrow I'll post what the results were from my ct scan. Stay tuned...
Monday, September 3, 2007
Weekend Review
I know it's been a few days since I posted something so I'll try to let you know what's been going on these last few days. I've been feeling really good and I didn't have to go to the hospital! Yeah! Anyway, here's what's been going on:
Friday: I ended up needing platelets. I got to get them here in Clearlake, which was nice. I had to get admit ed to St. John's hospital. I went to outpatient surgery, got my own room with a bathroom and TV and received the platelets. They give you IV benedryl before you get any kind of transfusion, so I was out, taking a nice long nap during most of it. The whole transfusion still took awhile, but I was done at 4:30 and only had to fight NASA 1 traffic instead of Houston traffic. Much nicer! I felt pretty good that night so we headed to the movies to meet some friends to watch The Bourne Ultimatum. It was really good!!!
Saturday: Had more lab work to do, so we headed down to MD Anderson since the Clearlake clinic is closed on the weekends and holidays. Labs looked OK, no transfusion of blood needed, which was good. We meet some friends for lunch, then hung out for awhile. We watched some good college football games that night. We are both excited that football season is here again!
Sunday: We woke up super early to go get lab done in case I needed a transfusion. We had some good friends coming to visit from Baton Rouge and wanted to be home by the time they arrived. Labs looked pretty good again, so no transfusion today. We made it home before our friends arrived. They came in the afternoon and we had a nice barbecue dinner that Jeff made on the grill. It was yummy!! We ended up just hanging out at the house and watching movies that night.
Monday: Got to sleep in a little this morning. We ate some breakfast, then saw our friends off. We headed back into the car right after they left, back to MD for more lab work. Turns out, no transfusion needed again today. My hemoglobin is 7.5, so I'm borderline still, but hopefully tomorrow my counts will be going back up. If not, then I get my transfusion here in Clearlake, so that will be nice.
So that pretty much sums up our weekend. Wish we could have gone somewhere fun instead of MD every day, but that's the way it goes. We had a good time with all our friends instead. That's all for now...
Friday: I ended up needing platelets. I got to get them here in Clearlake, which was nice. I had to get admit ed to St. John's hospital. I went to outpatient surgery, got my own room with a bathroom and TV and received the platelets. They give you IV benedryl before you get any kind of transfusion, so I was out, taking a nice long nap during most of it. The whole transfusion still took awhile, but I was done at 4:30 and only had to fight NASA 1 traffic instead of Houston traffic. Much nicer! I felt pretty good that night so we headed to the movies to meet some friends to watch The Bourne Ultimatum. It was really good!!!
Saturday: Had more lab work to do, so we headed down to MD Anderson since the Clearlake clinic is closed on the weekends and holidays. Labs looked OK, no transfusion of blood needed, which was good. We meet some friends for lunch, then hung out for awhile. We watched some good college football games that night. We are both excited that football season is here again!
Sunday: We woke up super early to go get lab done in case I needed a transfusion. We had some good friends coming to visit from Baton Rouge and wanted to be home by the time they arrived. Labs looked pretty good again, so no transfusion today. We made it home before our friends arrived. They came in the afternoon and we had a nice barbecue dinner that Jeff made on the grill. It was yummy!! We ended up just hanging out at the house and watching movies that night.
Monday: Got to sleep in a little this morning. We ate some breakfast, then saw our friends off. We headed back into the car right after they left, back to MD for more lab work. Turns out, no transfusion needed again today. My hemoglobin is 7.5, so I'm borderline still, but hopefully tomorrow my counts will be going back up. If not, then I get my transfusion here in Clearlake, so that will be nice.
So that pretty much sums up our weekend. Wish we could have gone somewhere fun instead of MD every day, but that's the way it goes. We had a good time with all our friends instead. That's all for now...
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