Monday February 21, 2011

Hello All!

Sorry it has been so long since our last update.  Honestly, mom has been doing well and there has been little information to update outside of mom's forward progress.  (At that is all very good!)

It's hard to believe that tomorrow marks four weeks post surgery!  What a long road mom has traveled!
Today, we had our follow up visit with her surgeon, Dr. Ahmad.  He is more than pleased with her progress!  In his words, "you are doing better than most of my patients that are half your age".
We were really hoping to have mom's feeding tube removed today, however, Dr. Ahmad wants to keep in it until her next appointment (in three weeks).  He prefers to keep the feeding tubes in a little longer to be assured that there are no side effects.  Mom was a little disappointed but certainly understands the significance of its placement.  It's easy to understand her disappointment as she has had a tube "sticking out of her" for three months now! (Especially since she's not using it!)

She did get to have her staples removed today.  The nurse let me do that.  If I ever had a chance to get even with her for anything she ever did to me as a child, THAT was my opportunity!! HAHA!!  I did make it a point to remind her how gentle I was though! She was thankful!

She stills has a small portion of the incision that is draining.  That means nothing more than a dressing change twice a day.  It is healing very well!

The other point of the follow up today was to begin the discussion of her next course of treatment.  This is of course the chemotherapy and radiation therapy.  Dr. Ahmad still believes mom to be a little too week to begin that therapy, so we will discuss that in more detail in three weeks.  However, we do know that if we decide to take this phase of the treatment that she will receive the chemo agent Gemcitabine. She will receive the treatment once a week for about 12 weeks.  She will also receive radiation therapy five days a week for five weeks.  More information will follow in the coming weeks as to our next course of action. 

In the meantime, mom is focusing her attention on gaining more strength, increasing her caloric intake to assist in her recovery, and increasing her mobility.  All of which she is doing VERY well with!  She continues to be a true amazement to her medical team.  (Not to mention a significant source of motivation for me!)

Please pray for our continued clarity in decision making and moms continued success in her recovery!

Thank you!

Will

Mom's Recovery Continues At Home

Hello all! Mom has been home for two days now and is glad to be able to recover in comfort.  He recovery continues to go well.  This is a slow process, but mom is one of the MOST patient people I know! She continues to take things slow while waiting for a follow up with her cardiologist next Tuesday.  Prayerfully, mom will be able to come off of some of the new cardiac meds that she was prescribed due to her arrythmias in the hospital.

Home health care has been arranged to visit a couple of times a week to help with anything that needs to be done (dressing changes, flushing of the feeding tube etc.) Physical Therapy will also be visiting her a couple of times a week to assist her in gaining some of her strength back.

Unfortunately, mom has developed a little bit of a cold which has been making her a little more tired than usual.  This too shall pass. We pray that it does not develop into anything beyond that of the common cold.

Mom is scheduled to follow up with the surgeon on February 21st. If at that time he is pleased with her progress and eating, he will remove the feeding tube!

As always, thanks for the prayers, thoughts, and well wishes!!! We will keep you posted!!

Will

MOM IS DISCHARGED!

Just received confirmation that mom was given her "walking papers" this morning!  She will be discharged from the SICU.  The process is underway and should take a few hours.  God has been good and timely!  We are so blessed!  Thank you all for your continued thoughts and prayers.  Her recovery will now continue at home where she will be so much more comfortable! 

Updates on her recovery and future doctor's appointments will continue to be posted on this blog.  There is still quite a journey ahead, however, it looks very bright!

Thank you all so much!

Will

Tuesday, February 8th Update

Wow, what an exhausting couple of days. Mom as of this morning is STILL in the SICU.  She is there for two reasons: 1. They are still waiting for an available room on the step down floor. 2.  They can monitor her heart more closely and treat any arrhythmias in the SICU.

They have been watching her heart very closely for the past 48 hours trying to determine if her heart rhythm was going to stabilize itself.  She was taken off of the intravenous Amiodarone and placed on an oral form.  It appears that this has worked.  Mom has sustained a sinus (normal) rhythm since! All other aspects of recovery are still coming along great! With this, the Chief Surgery Resident is going to evaluate her first thing this morning on rounds.  If there were no changes over night, then she will be released today!!

Please pray that this is the case!  Mom is really looking forward to coming home! God remains in control and we know that mom has been well taken care of through all of this.  Although she is anxious to get home, she knows that what happens is ultimately God's plan.  This has given her patience and strength during these long periods of waiting.

I will post another update this morning on the results of that evaluation!

Thanks all!

Will

Saturday Update

Well, today marks the 11th day mom has been in the hospital. Whew! What a long haul for her.  She's still in the SICU.  There are no beds available on the step-down floor.  We still have plans for discharge tomorrow, however there is still a little concern for her heart that seems to be a little irritated. She's developing some premature ventricular contractions ( PVC's) which isn't a major concern for the normal person. But, if you combine that with mom's history of heart failure, it's something that needs to be watched a little more closely.  She was placed back on an Amiodarone drip to help knock the PVCs out.  She'll stay on that tonight until she's re-evaluated tomorrow morning.  At that point, we're hoping her docs are content enough to release her!

Other than that....she continues to improve on the surgical aspect of things.  Her self-mobility is becoming better every day.  She's certainly looking forward to going home where she can maneuver more comfortably.

Hopefully, this will be the last update while in the hospital.  We pray for stability in mom's heart rhythm, comfort and discharge tomorrow!

Thanks all!!

Will

Friday Update

Mom got her transfer papers to get out of the SICU today!  She converted back into a normal sinus rhythm last night.  She was monitored through out the day today with no issues.  Dr. Ahmad visited her today and was very pleased. She will be transferred back up to the 9th floor tonight sometime. If nothing changes, she will be sent home Sunday! (Just in time for the Super Bowl!)

All of her medications have been discontinued. She's not even on any pain medication.  She says that the discomfort she does have is tolerable enough not to need any more medication. We feel very blessed to have her discharged from the hospital after such a surgery and have no prescribed medication!

Mom got back up and walked a great deal today.  I guess she was making up for yesterday when the staff wouldn't let her walk so much because of her heart rhythm.

We will be scheduling a follow up visit with Dr. Ahmad for two weeks from now.  If her eating continues the way it has been, then they will remove her feeding tube at that visit.  She is not receiving any feeds through it now.  Her going home with the feeding tube is merely a precaution should any issues arise with her eating.

We passed this little bump in the road.  Mom says she can now see the light at the end of the tunnel!  So can I!!!!

We now pray for no further complications!!! Thanks all!!

Will

Thursday Update

Good Evening All!

Mom's had a couple of rough nights these past two nights.  Her heart (when the rate went up the other night) went into Atrial Fibrillation (A-Fib).  The cardiology team continues to try to convert her back into a normal rhythm with medication.  So far, no luck.  Due to mom's history of heart failure, her medical staff decided to move her back to the SICU at about midnight last night as a precaution.  Obviously, this caused some unrest for mom as she proceeded through the early morning. This is not the first time she has been in A-Fib, so she is very familiar with how it works. What brought this irregualr ryhthm on is uncertain.

Even through this, she continues to progress through the surgical part of her receovery well.  This is merely a hiccup in the process.  She is having no real ill-effect of the irregular heart rhythm (other than just being tired from the lack of sleep).  We're not sure how this will impact her discharge.  We will have to see how she progresses through this tonight and tomorrow morning.

In the mean time, we did receive word that the mass that was removed from moms pancreas was malignant. I must say, that we weren't completely surprised.   The good news is that all the surrounding tissue came back with negative margins indicating no spread of the cancer!!  Long term treatment will involve some chemo and radiation.  However, right now the focus is the short term goal of discharge and complete recovery from the surgery. 

Our prayers were answered with her tube feedings!  They have completely removed her from the tube feeding as she appears to be eating just well enough on her own!!  There was an indication from Dr. Ahmad that if mom continued to eat well, they may remove the feeding tube altogether prior to her going home!This would be great!!

We remain focused on all the positive (as these is a great deal of positive) aspects of mom's recovery.  We have 100% complete faith that God will guide us through this bump in the road. God is good and faithful!!

We continue to pray for mom's strength in the ongoing recovery process, her conversion back into a normal cardiac rhythm, and therefore a quick discharge home!!!

Thanks all!!!

Will

Wednesday, February 2nd Update

Sorry it's been a while since the last update.  Over the course of the last two days, mom has adjusted to being on the step down floor (9th floor, room 9012).  She has gained a considerable amount of strength, now getting in and out of bed/chair by herself.  There was some initial talk about her being discharged yesterday.  Apparently, there was some miscommunication between doctors.  This was not the case.  Mom was looking forward to going home, so there was a short period of time where she was a little discouraged.  This is certainly understandable, but she does realize that this recovery process is very complex and takes time. Right now, we're on track for discharge on Thursday or Friday.

The staff seems to be having somewhat of a hard time balancing her tube feeds along with her oral intake.  Mom has been receiving a considerable amount of tube feeding and therefore doesn't have much of an appetite to eat regular food.  I am hoping that as time progresses, they allow for smaller amounts of tube feed to allow here to east more by mouth.

Around 3AM this morning, mom's heart rate jumped up.  It appears that this was medication induced.  It was placed under control relatively quickly without ill-effect.  Mom has always been and will always be very sensitive to medication.  Certain medications really seem to have a potentiated effect on her.  This was the case last night.  There was some slight talk about moving her back to the SICU this morning, however, they realized that the likely cause was the medication she was receiving and therefore they kept her on the floor.

Today she has been getting up on her own and walking well.  Although she was a little more sleepy today (due to her lack of sleep overnight), she still feels pretty well over all. 

Still no word on on the results of the biopsy.  Any news on that front will certainly be posted!

With all that being said, she is still doing very well and we continue to pray for her continued progress and increased strength.  We also pray for her medical staff to find a balance with her feeding!

Thank you all!!!

Will

Monday Update

Wow! What an amazing couple of days!  Mom was discharged from the SICU yesterday at about 5PM!  A bed FINALLY became available.  She was discharged to a step-down floor that specializes in post abdominal surgeries.  The staff there is specially trained to deal with patients who have had Whipple's done.  This was very comforting!

Mom continues to eat well, eating three meals a day while being supplemented by tube feeds.  She is also still sitting up in a chair most of the day and going for 2 to 3 walks around the floor a day.  She gets stronger day by day! Her pain is well managed with the exception of moving around a little.  For some reason, the 44 staples she got causes her a little discomfort!!

Her epidural is out and she has not had any pain medication since!  In fact, mom is doing so well, they are planning on discharging her tomorrow!!!!  We are not certain it will happen but that's their plan! Mom is looking forward to that just so she can eat at home!

Still no word on the mass they removed.  Maybe tomorrow??  I will keep everyone posted as to whether mom stays or goes home tomorrow. 

Thanks all!!!!

Will

Sunday Update

Hell all!  Sorry I missed an update yesterday!  However, all things continue to go very well!  There is so much to say! Mom's transfer out of the ICU was issued Friday morning.  However, all the beds were full on the step-down floor. Therefore, she's still in the ICU.

So, where to begin this update??  Mom started taking food orally yesterday!  She had three "meals" including jello, tomato soup, chicken broth and juices.  She tolerated them well which appears to be an indication that her stomach is functioning normally! She will receive more of a solid food diet today!

She has been getting up and walking a couple of times a day.  She has been doing rounds around the ICU for now.  She spends most of her day out of bed.  She still requires a little assistance getting in and out of bed, (mostly because of her electronics being attached to her). It appears that she is gaining more strength ever day!

The bandage was removed from her surgical incision yesterday.  The site looks great and appears to be healing very well.  Mom's red blood cells are on the rise (with no extra blood given to her), while her white blood cells are on the decline!  All a sign that she is healing very well!

Her central line was removed yesterday as well.  Right now, she still has her epidural.  She is getting a constant low dose of pain medication.  The plan is to discontinue that in the next couple of days. Her pain is very much under control.  Of course it hurts her to cough, or laugh as these activities seem to move her abdominal muscles around a bit too much!

The drains that were inserted into her sutured areas have been removed also.  There was little to no drainage emitting from these sites! This is also a very good sign that mom is healing well from the inside!

Blood tests reveal that her pancreas is functioning normally as well with normal blood sugar levels and positive enzymes!  "Wow", is all I can say!! At this point, it appears that mom has dodged all ill-side effects and complications of Whipple's and is on the solid road to recovery!!

So, at this point were are awaiting word that a bed has opened up on the step-down floor allowing mom to be transferred.  I will certainly let everyone know when that has occurred.

We are hoping to get the results of the biopsy tomorrow or Tuesday.  However, I must say that regardless of that outcome (malignant or benign) mom is ready to deal with whatever God's plan is for her.

Now, we just pray for continued success in mom's recovery, and a benign result to the biopsy!  Thanks again and again for the continued thoughts and prayers!  Please, keep them coming!

Will

Friday Evening Update

Yet another day of progress!  Mom was able to get up and walk around the SICU today.  She walked the entire pod!! And, with a pretty good degree of ease!  In addition to that, they started her tube feeds.  They were tolerated well.  Now, mom can begin replenishing her body with some decent nourishment.  This will allow her to meet the physical demands of her recovery.

Perhaps the biggest relief for mom today was the removal of her NG tube!  She's been looking forward to that moment since she awoke from surgery! 

Mom spends most of her day in her chair, sitting up, awake.  Occasionally she will catch a nap here and there.  This allows her to really rest well at night. 

Pain is well managed at this point.  Mom describes herself as not really having any pain at all, rather a "soreness" across her abdomen. Her doctor continues to be impressed with her recovery.

Tomorrow, they will start discussing discharge to a step down unit.  This means that they will most likely remove her central line tomorrow.  It also means that visiting hours will be less restricted.  At that point, people wishing to see her will be able to do so.  The SICU is pretty strict with visiting guidelines.

Still no signs of complications!! God continues to be faithful!  Please help us pray that mom begins to receive substantial nourishment from her tube feeds and, in turn, physical strength.  Also, for continued wisdom on behalf of her medical staff!

Thanks!

Will

Thursday Update

Mom had another good day!  More progress!  Mom stood up, took some steps, and did some leg exercises today!  She is a little more tired today due to all of the activity though.

We should meet some big benchmarks tomorrow.  Her NG tube should be removed and they want to start her tube feeds as well.  I'm not sure how long her central line is going to stay in place. 

She did receive a little blood today as her counts dipped a little.  Nothing that they consider unusual.  So, with all that being said, we are still complication free!  I have found that telemetry doesn't like when you tap on her ECG leads to make it look like she's in V-Fib!

Dr. Ahmad visited again today and stated that he was still VERY pleased with her progress. Mom is apparently the talk of the ICU.  Medical students keep her room very busy as they are studying her case very closely.  You can hear talk from across the ICU...."See her? She's the one!" Ha!

Anyway, lots of benchmarks to meet tomorrow! 

Thanks for reading!  And as always, keep those prayers coming!

Will

Wednesday Evening Update

Well, all goals for mom today were met!  Still no signs of complications.  We are still very watchful and approach all of our successes with cautious optimism! Mom got up out of bed twice today and sat in her chair for a couple hours at a time.  Her arterial line was removed today leaving her central line and IV in place.

Dr. Ahmad stopped by today to discuss her progress and obviously, he is pleased.  Tomorrow, the goals are to remain watchful for side effects as well as get mom to walk (yes, walk!!), and remove her central line.  If all continues to go well, they could release her from the SICU within the next day or two. 

We discussed a comprehensive plan with her pain management team to help control her pain, yet balance any ill side effects of the medication.  They are very open to ideas while still following their protocols.  However, it appears that our plans "B" and "C" will not need to be implemented now as it seems to be well under control.  Her biggest complaint now is a sore throat from the intubation during surgery and her NG tube that is still in place.

Mom is sitting in her chair across from me now as I type. I can't help but to think of and be thankful for the blessings we have been given! I wish everyone could see the miracle I can see right now!

As always, thanks to everyone for the continued support and prayers! Mom says "thank you" and feels very blessed to be surrounded by such great friends and family!

Will

Wednesday Morning Update

Mom had a great night last night!  Her vitals remained stable...pain management was good...blood work was normal!  She had a slight issue with her blood pressure dropping a little last evening.  This was a normal response to the medication she was giving herself through her epidural for pain management. That has since stabled out.

This morning, the goal is to get her to sit up! We continue to watch for signs of complications....excessive drainage from her drains, fever, and wavering vital signs.  Prayerfully, these will not show up!! 

We are also praying that her internal parts (stomach, pancreas, bile duct) function normally, and that her outputs are all good as well!

Thanks all!!

Will

Status Update

We've spent the last 2 hours with mom. She is in the SICU.  She has been awake, alert, talking and joking! Truly a miracle!  She looks as if she had a great nights sleep having no ill side effects of her anesthesia.  She has a self dosing epidural that has her pain very much under control. 

Final reports from surgery are that she did very well.  They were able to remove all the necessary components as well as the mass.  The mass has already been sent down to patho.  We should have the final results of that within 5 days or so.  There was minimal to no bleeding during the procedure, so there was no need for a transfusion.  (Good news as this always reduces the possibilities of some complications.) Again, there is no evidence of any spread of this mass!!

They were able to remove the bile drain which she has had in since November.  She was relieved to hear THAT news when she woke up!!!  Right now, she has two drains in to relieve any drainage from her internal sutures.  Hopefully, these won't leak and can be taken out prior to her discharge.  Dr. Ahmad has no reason to believe that this will not be the case as he feels good about the suturing itself. 

So, where do we go from here?  Well, they will continue to monitor mom VERY closely over the next two days in the ICU.  They will keep a close eye on her heart and the development of any side effects of the procedure. Starting tomorrow, they will start sitting her up to get her mobile slowly. 

The staff here has been incredible! We are truly thankful for the excellent care she has received thus far!!

Things to pray for now...continued wisdom and clarity on behalf of mom's caregivers.  NO SIDE EFFECTS of the surgery including, infection, delayed gastric emptying, more than normal leakage from her drains, as well as continued pain management and comfort for her. We also pray that the mass comes back benign.  That would mean that mom is DONE with this episode in her life!!

If the mass turns out to be malignant, then a few light treatments of chemo and radiation will be in her future.  But again, as noted before, very "gentle" chemo and radiation.  Nothing that would cause hair or weight loss.

Thank you all again....and again....for your support and prayers.  A true miracle was performed today!  God remains faithfull and in control...."His will be done!"

Thank you!!

Will

MOM'S OUT OF SURGERY!!

Mom's surgery is complete!  It was a success!!  Dr. Ahmad stated that she did as well as she could have.  She remained stable through out the entire surgery.  The tumor was removed for biopsy and there is no evidence of spread.  The next day or two will be critical for mom while she is in the ICU.  However, the docs are optimistic based on her performance in surgery.  More details to follow.  We hope to get to see mom in the next hour or two.  Again, thank you all for the continued thoughts and prayers!  God has been faithful!  We pray for moms continued endurance in her recovery!

Will

SURGERY UPDATE

Just received a call from Lisa (a nurse in the operating room with mom)... mom is doing great!  They have removed everything they need to remove and are in the process of putting everything back together.  Mom is tolerating the surgery very well! Obviously, there is still a great deal of ground to cover however, things are going well so far. 

For so long it seems like we have been running two races....a sprint and a marathon.  Hopefully, the sprint will start to come to an end and we can then focus on the marathon.  Regardless of what race we are running, God has on the running shoes. We pray for continued strength for mom and continued strength in faith for the family.

Thanks all!

Will

Day of Surgery

Finally, the day mom has been waiting for has arrived!  We just got the word that mom is now back in the OR. Everyone got an early start to the day, getting down here at UC at 5AM.  Mom was in GREAT spirits this morning!  We said our temporary "good byes" to mom at about 06:30.  There was lots of work to do to prep her (central line, arterial line, epidural, etc.).  We know she is in the best hands available.  We are so blessed to have these medical resources at our back door! We continue to pray for mom's strength, clarity and wisdom on behalf of mom's medical staff, and strength for all our family members! Thanks to all!

Will

Last Day Pre-Op!

Mom finished all of her pre-op orders today and is very upbeat about her surgery tomorrow.  We're reporting to UC at 05:30.  Surgery is scheduled to begin at 07:30.  The surgery is slated to last about 6 hours. I'll continue to post as things progress tomorrow.  Thanks again for all of your thoughts, support and prayers!! God remains in control!

Will

Mom's Appointment Rescheduled

Mom’s appointment with the anesthesiologist was rescheduled for Thursday, January 13^th.  She will have all of her pre-op work done at that time.  Mom continues to get stronger every day!  She really feels good and is looking forward to moving forward with the surgery!

Thanks again for your continued thoughts and prayers!

Will

Surgery Scheduled!!

Good Evening All!!

Mom's surgery has finally been scheduled!  She will undergo Whipple's Procedure on January 25th.  She is slated for 07:30 that morning.  Some pre-surgical consult work will need to be done which includes x-rays, blood work, and an interview with her anesthesiologist.  That appointment is scheduled for January 11th.  The surgery will be conducted at University Hospital.  We feel very blessed to have the resources of their medical facility in our back yard! (So to speak!)

Please pray for continued strength for mom as well as vision and wisdom for the doctors in charge of her care!  God is in control!

Thanks!

Will