Monthly Archives: December, 2012

What’s that on the horizon

Francis came through the exploratory surgery this morning just fine.  The anesthesia is still wearing off, so we’re resting in our hotel room before returning to Tallahassee and Couper and Riley tomorrow evening.

Thanks to all for your comments, emails, texts, and prayers.  I wish I could respond personally to all the messages, but am a bit overwhelmed by all the news from today and what lies ahead.  Just know that the encouragement and kind words do not go unnoticed, and we cherish our friends and family for continuing to be there for us when we need you.

Now to the details.  The surgeon, Dr. Keith Fournier, met with me following the procedure to let me know that things looked good, all things considered, and that there were no surprises.  He shared pictures of what Francis’s abdomen looks like on the inside, and for the first time I got to see what this horrible beast looks like.

To describe it as best I can, imagine a little ball of white lint about the size of the end of a ball point pen.  There are several of them that cluster around each other, some touching and some not, looking like a bad case of acne.  In places where the cancer is more advanced, it looks more like a thin, narrow piece of elastic that has been stretched out between two points.

All in all, we received a bit of an early Christmas present today.  After getting eyes on the cancer, Dr. Fournier determined that Francis is a good candidate for the tumor debulking and HIPEC procedure.

It isn’t a magic bullet, and there’s still a chance that Dr. Fournier could get into the abdomen and decide it isn’t possible to do the procedure.  However, Dr. Fournier is at least comfortable enough to make the large incision and schedule all the supporting cast (urology and plastic surgery) to perform their various roles to protect necessary organs and functions and to repair areas of the body that will be damaged in an effort to remove all of the cancer.

We’re thankful for the good news about a plan to move forward.  We’re hopeful that this is a great option for us to see the end of this cancer and for Francis to have a long and healthy life after clearing this very large hurdle.

Thank you again for your concern, and for reading this blog.  I’ll continue to update the blog with more information and certainly through Francis’s next surgery and recovery.  Feel free to share with family and friends, and encourage them to sign up to follow the blog if they are interested in getting the latests posts by email as soon as they are posted.

We wish you all a very merry Christmas!

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So we wait…

It’s becoming clear to me that I have serious issues with patience in hospital/doctors’ offices waiting rooms.  I’m not the only one.  Seems that little pockets of angst bubble over every now and then among the clusters of patients and family members sitting here in the hallway with us waiting to be called.

We arrived at MD Anderson at 8:20 this morning.  We waited in the hallway until 9:00 to be called back to another waiting room.  This time we at least had a TV, although I find all the news is rather frustrating or depressing.

We waited in the small waiting room (capacity 4 people) about 20 minutes before being called in to do pre-op paperwork with the nurse.  Then back to the hallway, sans television, to wait with the larger crowd of waiters.

The nurse, after an impressive New Orleans-style rendition of happy birthday for Francis, informed us that the next step is holding.  There you take off anything you weren’t born with and change into a hospital gown.  After holding, you have an hour of surgery prep, a 30 minute (at most) procedure, and another hour of post-op recovery and stabilization before I’ll get to lay eyes on him.

The surgery was scheduled for 30 minutes at 10:45.  The nurse informed us that they have a 2-hour window on either side (early or late) in which to perform the surgery.  She said they were running on time today.  I guess “on time” means late, as all the places we’ve waited on our visits here have a board indicating they’re on time.

My type-A personality is itching to do something about this while I outwardly look for ways to remain calm and not be one of those family members who melts down in the hallway.  Hope to be on our way soon…

Houston, we have an exploratory surgery

When we started down this road with Francis’s colon cancer diagnosis, we often discussed going to the best facilities and the best specialists.  The long term prognosis for advanced stage colon cancer like Francis’s is frightening, and we’re determined to try every option we have  available to us until we find a cure.

After several rounds of chemotherapy and a couple of CT scans, we began to discuss more seriously the likelihood of a trip to Houston, Texas, to visit MD Anderson Cancer Center.  Ranked as the #1 best hospital for cancer care by U.S. News and World Report, we began to work toward getting a second opinion from their doctors.

After eight rounds of chemo, Francis had to take a break from treatment.  Among the variety of outwardly visible side effects are a myriad of unseen side effects of chemotherapy.  Chemo causes the body to have difficulty producing red blood cells, white blood cells, and platelets.  The morning of the ninth planned round of chemo, Francis’s blood work showed a low platelet count.  It wasn’t completely unexpected, but it’s still not what we wanted to hear.  Fortunately, the level was not dangerously low and his blood work was otherwise normal.

Francis was grateful for an extra week “off.” The outward side effects from the particular chemo regimen he is on cause him to have gastrointestinal upset, neuropathy (tingling and numbness) in his hands and feet, and peeling skin and blistering on his hands and feet.  There are other side effects that may or may not make an appearance after each round.

It is common at some point during the three week treatment period for Francis to experience nausea.  It’s never the same, and it can come on with little or no warning.

After the first round of chemo back in June, we rushed to the car and drove straight back to Tallahassee from Mayo in Jacksonville (about 3 hours).  Pulling into our neighborhood, Francis mentioned that he was beginning to feel ill.  We raced onto our street and into the driveway.  Francis couldn’t make it into the house, jumping from the car to get sick just outside the garage.  Fortunately, that’s the last time that has happened like that.

He’s gotten sick a few times since, but thankfully the anti-nausea medications he’s been prescribed help us keep the nausea mostly in check.

During Francis’s week off from chemo, we heard back from MD Anderson that Francis would have a series of appointments the following week.  We quickly made travel arrangements and my mom did the same so that we could meet in Houston in just a few days time.

Off we all went, to do consultations with Dr. Keith Fournier and Dr. Cathy Eng.  Francis also had a CT scan and blood work done during our three days there.

After reviewing the scan, we met with Dr. Fournier to determine whether Francis would be a candidate for a radical and somewhat controversial surgical procedure known as tumor debulking and hyperthermic intraperitoneal chemotherapy (HIPEC).

Debulking and HIPEC takes an average of 10 hours and is followed by an average hospital stay of 22 days.  The procedure requires the opening of the abdominal cavity and removal of each individual cancerous spot in the cavity and removal of any affected organs that aren’t necessary for the body to function.

After the tumors are removed, the abdominal cavity is flooded with liquid chemotherapy that is heated to approximately 107 degrees while the patient lies on a cooling pad to maintain a safe body temperature.  The chemotherapy stays in the abdomen for approximately 90 minutes before being flushed.  Radiation may also be done during this treatment phase of the procedure.  After the surgeon is pleased with the progress and outcome of the debulking, the abdomen is closed and the patient is moved to recovery.

In many cases, the patient is placed into the intensive care unit of the hospital.  There is a high likelihood of complications from the procedure.  Many patients experience infections at the wound site because chemotherapy prevents the skin from healing normally.

It seems that this is the best hope for removal of the cancer, and while Francis is feeling well, we want to be as aggressive as possible.  Outcomes from this procedure aren’t well documented, but the statistics we’ve seen are very promising and have given us a lot of hope for beating this horrible disease.

So this brings me to today.  Francis and I have left our babies in good hands (Mawmaw Holdman’s) in Tallahassee to make the trip to Houston for an exploratory procedure to determine whether Francis is a candidate for the debulking and HIPEC.  Dr. Fournier wants to get his own eyes on the cancer to make the determination.

We’re excited, nervous, hopeful, anxious, cautiously optimistic, and desperately missing Couper and Riley.  To be frank, we need to be excited, nervous, hopeful, anxious, and cautiously optimistic before a much bigger procedure (debulking and HIPEC) happening sometime early next year.  After what feels like a whole lot of bad news about Francis’s health this year, we could really use some good news.

Many people have asked what the goal is and how to pray for us, so this is what we need now.  We need to get through tomorrow’s procedure safely without any complications so we can head home and then enjoy a wonderful Christmas with family.  We need good news that Francis is a candidate for the debulking and HIPEC procedure.  If not, we need guidance on what to do next.

Thanks in advance for thoughts and prayers.  I will do my best to update everyone as soon as we have any news.  We are hopeful that we’ll have the surgeon’s decision after the procedure, but we may not get that until after the holidays.  In the meantime, we wish you all a very Merry Christmas and a happy and healthy 2013 (assuming the world doesn’t end this week)!

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