Update on Surgery

Throughout the day of surgery and the first couple of days afterwards I was posting updates on Facebook, but I realized today that the Facebook prioritization system caused many of you to miss some of the updates.  Therefore, so everybody is up to date I will provide a total summary here from the day of surgery through today.

When the hospital called on Thursday (9/28) to give us the surgery time, they told us to check in at the hospital at 10:00am and that we would be Dr. Robertson's 3rd and last surgery of the day (the other 2 were predictable out-patient surgeries).  We arrived on time on Friday and she was taken back and changed clothes and got all hooked up with IVs, etc.  Dr. Robertson came by around 11:30am and went over the surgery again and explained that he wanted Julie to be his last surgery so he could take whatever time he needed to make sure he got all of the cancer -- he was preparing us for a long surgery, but we didn't realize how long (neither did he).  Around noon, they took Julie back to the OR to begin to clean her and prepare her for surgery and to begin anesthesia.  At 1:55pm, we receive a call in the waiting room from the OR that actual surgery had just begun.  We didn't receive any more information until around 9:00pm when the receptionist was leaving for the day and called the OR and they confirmed that she was still in surgery and that Dr. Robertson would come talk to us as soon as he was finished.  Around 9:30pm, Dr. Robertson came out and briefed us on the surgery and said that his team was completing the installation of the J trap drains, and sewing her up and would be moving her to ICU and that we should go to the ICU waiting room and wait for them to let us know when she was in ICU and what the procedure would be for when we could see her, etc.  Based on what Dr. Robertson had said he had done in the surgery and the time of the day it was, we assumed we would not get to see her, but would just get information.  At around 11:30pm, the ICU nurse came out and said she was awake and asking for us.  It turns out she had arrived in the ICU not long after Dr. Robertson had talked with us, but they had spent 2 hours trying to stabilize her vital signs.  Mayo allowed Betty (a close friend and nurse) to spend the night with her in the ICU, which is absolutely unheard of in most hospitals.

Dr. Robertson had previously had Julie sign the consent of treatment, which had a fairly long list of possible things he could have to do in surgery (even though he didn't expect to do them all), and then a catch-all of "and anything else I have to do to get all of the cancer and to keep you alive."  Without going into all of the details of what was done during the surgery, I will just say that I think there was only one thing on his fairly-exhaustive list that he didn't have to do and he did have to do one that was in the "whatever is necessary......." catch-all clause.  During the 7 1/2 hour surgery, Julie lost 3 liters of blood and was given 8 units plus platelets, and blood volume builder (I don't know the technical name of it).  The most important thing about the surgery though is that Dr. Robertson was able to achieve the R0 resection, which is a technical way of saying that he was able to find and remove all of the cancer that was large enough to be seen with the naked eye.  There are no more tumors or cancer deposits, but there are still cancer cells, which is why she has to have 9 more weeks of  chemo before they scan to see if she is in remission.

Julie stayed in ICU about 21 hours.  About 16 hours after arriving in the ICU, they had her standing up and moving her to a recliner chair, but it was a very difficult move and it was all Julie could do to stand for the few minutes it took them to move the bed and put the chair behind her.  After getting in a regular room late Saturday afternoon, they worked further to get her up and walking.  On Sunday, she walked down the hall three times and on Monday she walked the full "block" around our part of the floor of the hospital and then walked 2 more times with a regular walker instead of the platform walker.  As of tonight (10/2/2017), she has had most of the tubes, etc. removed.  This afternoon was the first she was able to eat or drink anything other than a very limited number of ice chips.  All of her digestive system finally started working again today, which made today the most difficult day because suddenly gases and digestive juices are flowing through a very raw digestive system that has been cut on, pulled on, poked on sewed on, etc.  The doctors are very happy with her progress, but she has a long way to go.

I think my Facebook posts have confused a few people a little as I have chosen to emphasize the positive more than the negative.  The positive is that it was a successful surgery in that they were able to remove the cancer.  It is also positive that each time I have reported something it was a normal step in recovery that occurred either on a normal schedule or ahead of schedule.  This means when I say she is doing "great" it means she is on a normal recovery schedule or better.  However, my positive comments do not mean she is without pain or that there is anything about this that was easy or will be easy.  Recovery was originally anticipated to be 4 to 6 weeks, but now just one part of it is typically 8 to 10 weeks without the delay in healing caused by chemo, which has to be restarted at some point.  My positive comments does not mean she isn't on an emotional roller-coaster of having to learn to deal with the realities of some of the things she will now have to deal with as a result of some of the things that had to be done in surgery and of having to take longer to recover.  When I am positive in my comments, I am giving God the praise He is due for the work He has done and continues to do to her body and I am not dwelling on the things that we will have to deal with or the difficulties and adjustments she and I both have to make.

We don't know yet how long we will be in the hospital.  Dr. Robertson had told us Friday night after the surgery to expect at least 10 days.  After we leave the hospital we should have a home health nurse come to the house every 3 to 5 days for some length of time.  As of right now, I really cannot leave the room for more than a couple of minutes unless somebody else is here with her.  This means that I am coordinating with close friends and family that are wanting to visit to have them come on different days so they won't overwhelm her with too much at once and also so that they can stay with her long enough for me to go get a shower and grab a bite to eat each afternoon or evening.  We also do not yet know when chemo will begin again -- it was originally scheduled for 10/16, but that was "iffy" anyway as it was originally based on a 9/25 surgery date and Dr. Colon had already said it was possible we would have to push it back a week.  However, pushing it back one week was not assuming such a difficult surgery to heal from so we will have to wait and see.

We thank you for your prayers and messages of encouragement.  Julie is not quite in the frame of mind to be on Facebook yet, so please give her grace if you are messaging her there.

Ben