Surgery Day & THE Update

First, thanks to everyone via Facebook and this blog and whatever way you’ve communicated your thoughts and prayers for mom and all of us!  She hasn’t seen all of them yet, but she will soon…and as promised, here’s how the day has gone so far.

You know, 0300 is early.  But we had an 0500 report time to Loma Linda Medical Center for surgical check in, so early shower and coffee fixed (mine!) and away we went.  After mom was sent up to pre-op stage 2 and they kicked me out, I went down and signed up for the text updates…pretty nice system.  I got the text that “surgery started at 8:19 and Nan is doing fine”. 

We were told by Dr. DeVera last Friday at the pre-op appointment that the first part of the surgery would involve some more pathology tests, since officially they hadn’t formally confirmed that this is cancer and confirming a diagnosis was the first step.  This would be within the first two hours or so.  If they found anything outside of the pancreas, they’d close her up and not do the planned Whipple procedure because the cancer needed to be isolated to the pancreas only for that to be done.

By about 1030, I got the text that I needed to call the OR9, figured this would be the news regarding the pathology.  I called and spoke with the doc who explained that he had started the surgery laparoscopically (much smaller incisions for a camera and instruments and a quicker recovery), but due to scar tissue she’s got from other abdominal surgeries, he had to make a full incision.  Then the news that, indeed, they got a positive test from some lymph nodes near the liver, which means no Whipple.  And the same information also confirms that with cancer in the lymph system, it’s already spreading, so the next step would need to be chemo…not really the news anyone wished to hear, but not a huge surprise either.

So, they closed her back up and to recovery she went.  Thinking we had a couple of hours in recovery before she’d get to a room, I had a hankering to get a computer-carrying day pack from a nearby Office Depot since I forgot my daypack at home and carrying this laptop and my iPad was a bit heavy in a BYOB bag! (It’s easier for me to type and update the blog on my laptop, and mom has already commandeered my iPad as I currently type…she’s a solitaire addict! ;)  But of course, while we were out for about 20 minutes (successful purchase in hand), we got a text to talk to the doc.  Hmmm…already did…what’s this for?  We hustled back, I called to hear that she was in recovery asking for me, but of course I couldn't go in there...so I got the run down on when she’d get transferred to a room.

Although Dale & I talked with the doctor, we weren’t sure if the doc was going to talk with mom before we saw her or if we’d be the one to break the news about the surgery and the results.  Sort of thankfully, the doc got to her first…and much to both of our surprise, mom even remembered what he said!  Surprised because she was still in that drug induced stupor you see similar to those viral videos parents embarrass their kids with after they get their wisdom teeth out…but we were nice, the cameras stayed in the pockets. ;)

The important thing to emphasize right now is mom is completely aware and knows the story and wants you to know too...there are no secrets at this point.  The bottom line is that it is indeed pancreatic cancer and it’s staged at about a 3.5, considering the lymphatic involvement.  She’s not thrilled with the news nor the need to make more decisions.  However, at least we all have some definitive answers as to what she is facing and some of the battles ahead.  Her mood remains the same, thinking positively and keeping the spirits up…which is also requested to continue from everyone as it is helpful for us all to do the same.  Attitude is everything when it comes to getting the most out of the fight!

And, to help improve the prognosis for a good attitude while making tough decisions, the primary goal for now will be pain management.  She’s currently being assessed as to the viability of providing a “celiac plexus block”.  Instead of the standard method of the procedure, they’re looking to do this via endoscopic for her.  Here’s a layman’s description of what that is from medcentral.org:

“What is a celiac plexus block?
A celiac plexus block is an injection of local anesthetic into or around the celiac plexus of nerves that surrounds the aorta, the main artery in the abdomen. Normally these nerves control basic nerve functions. In certain conditions, these nerves can carry pain information from the gut or abdominal organ tissues back to the spinal cord and brain.“

And why do this from John’s Hopkins:

“The celiac plexus is a group of nerves that supply organs in the abdomen.  A celiac plexus block may be performed if you are experiencing severe chronic abdominal pain or abdominal pain from cancer.“

Because of the large incision and to monitor the block procedure (if done) and pain control, she will be in the hospital for about 5 days.  The doc anticipates her going home by the weekend, as long as she’s moving, peeing, and eating to their satisfaction too, of course.

This afternoon in between snoozes she's been awake, playing solitaire and as cantankerous as ever...particularly because she is very hungry and thirsty...as we have heard *multiple* times. ;) The answer is still no for that as of yet...so she continues to suck on her sponge pops.  She is in a step-down unit, sharing the room and I will not be able to stay here tonight nor are visitors welcomed as of yet.  However, please feel free to leave a message here and we'll be sure she gets it.

Thanks again to everyone.  This "new way" is still being discovered and navigated by us all, your support is much appreciated...stay tuned for more when we've got it, but for now...good night!