i's dotted and t's crossed.

Today I got the call finalizing all the things about surgery.

I will be having surgery at Butterworth on Monday February 12 at 10:00 AM

5 Days left and I am doing the things required of me before surgery.

As I go through surgery I am aware this a bit of exploratory surgery.   This means while the main goal is to remove the tumor or collection of Lymph nodes, there is the possibility the surgeon will need to reconstruct the bile duct.  It's a bit unusual how they actually do this and as much as I'd like to explain it to you, I don't completely understand how it all works.

We hope they can leave my bile duct the way it is, however I'd rather them get all infected areas if  they are able to.

I will be in the hospital for 4 - 7 days depending  if they need to reconstruct bile duct.  

My job over the next several weeks is to do everything I can to heal and get back to normal

I know it's difficult to get excited about surgery,  this surgery to me means less chemo and puts an end date to my cancer treatment plan.  

I'm sure someone will update the blog early next week as to how I'm doing.

~ Kent

When no words say everything!

 It is only Tuesday, but Kent has had a very busy week! 

Monday afternoon Kent had a CT scan as he awaits surgery. (no results yet on this)  Monday evening he prepared for Tuesday as he had Colonoscopy as yet another pre surgery requirement.  Many of you who know Kent know that he handles stressful situations in one of two ways.  Kent jokes or he is silent. 

Today (Tuesday) we made our way and arrived at the Colonoscopy Center early.   We did so to account for traffic and rain and yet still trying familiarize ourselves to the place we make the trip to every three years. On the ride there Kent was very chatty and joking a lot.  Kent checked in and we got ourselves situated in the very busy waiting room.  Kent sat next to me quietly playing games on his phone as he waited for his name to get called.  I sat next to him. I could do nothing but sit and watch one after another names being called  but not his.  Finally a nurse rounded the corner from where we were sitting and called Kent.  We both stood up and entered the pre-scope area. When Kent was all ready and all the pre-scope questions were asked,  both pre- registeration and pre-scope nurse had left the holding area.  I sat in a chair to the side and slightly behind Kent's head.  I sat quietly praying for the results we so desperately wanted to hear.  Out of the corner of my eye I see Kent's hand reach back for mine, his head tilted back and I looked into his eyes.  No words needed!  I saw tears trickle down his face and felt a hand squeeze.  I asked him, "Are you ok?" He shook his head, I gave him a kiss and said, "We'll get through this together!"  No words, said everything! He had been here before (roughly 10 years ago) getting results that would change what his life looked like moving forward.  His life has been forever changed by Colon Cancer and you could see it scared him to go down that road again.  I am happy to share today's scope we heard the opposite news, No cancer in the Colon!

So as of this date ( today Tuesday, Jan 30.) we have cancer in one location!  We are thankful for this.  The only spot is around the Portal Vein by the Bile Duct.  The surgery that awaits Kent is to take the cancer out  of that suurounding area.  We pray that he does NOT need reconstruction of the Bile Duct! The Bile Duct is a bit thicker due to the stent placed in Kent in May. ( this is good news as it will help hold sutures after surgery. ) I have been told the Bile Duct is thin like tissue paper but because Kent has had a stent it is thicker a bit like construction paper.  ( sorry for the pre school refrence) This will be a tricky surgery.

Now we wait! We pray and ask God to give Kent just what he needs every step of the way, but....When we have no words and we sit silent I am sure glad we worship a God who knows everything! We will thank God for giving us a hand squeeze and when we shed a tear he will sit right by our side and tell us he is there!

~Leah

a note.... When we have a confirmed time for Feb 12 and a confirmed location we will pop back on the blog and pass that along.  

We continuely thank you for your ongoing prayers.

We have a goal.

This afternoon I had a Pre Operation Authoriztion Appointment.  This appointment literally went through all the things that could be a risk for surgery. My Surgeons office arranged for a visit with a NP. Pretty much many of the risks did not apply to me until the NP mentioned antibiotics and asked if I was taking antibiotics.  The answer was yes and so I explained why I was taking them in the first place. I then shared  that I was still taking them.  After a 40 minute discussion about me the NP explained what meds I should and should not take the morning of surgery.  Besides giving me a soap for washing the day of surgery and a week's worth Glucerna which they encourage me to take before surgery to help with the nutrition I will lose as a result of surgery. I then was asked and told I needed an EKG and Labs.  Due to an overly chatty nurse the EKG and Labs took  30 minutes or more at which point we were dismissed.  I am officially cleared for surgery.  Today I was told I will be called with a place and time no more than 5 days before.

From almost the first indication of the return of cancer my goal has been to have the cancer surgically removed.  This allows me to not have an indefinite amount of chemo.  It is coming closer to that reality for which I am thankful.

I talked with a former coworker today (who has been an amazing prayer warrior during my first cancer journery) who works for a ministry whose goal is to share the gospel and make disciples.  Yesterday I got a notification about his upcoming birthday.  I realized I had his phone number so I sent him a text with the news of my current journey.  After chatting on text yesterday, today he asked if I had 4 minutes for a call and that he'd like to pray with me.  During our call he also told me he added me to the ministries prayer time they begin each day with. 

I really appreciate everyone's prayers while I go through this journey.  

16 more days until surgery.

~ Kent

36 days left

Thursday was my scheduled appointment with my PA.  My plan was to chat with My PA, tell her the plan and do a formal meet and greet with my new Oncologist.  The day started early and we headed downtown to Lemmon Holton for Labs at 9:15.  

My appointment was supposed to be a simple 30 minutes,  and ended up being a while after that.  During my meeting My PA popped out of the room to find the Oncologist and returned empty handed so to speak.  She proceeded to discuss that my Oncologist wanted to resume chemo just holding Avastin. ( this drug prevents the growth of new blood vessels).  New blood vessel growth is a necessity after surgically removing things.  After hearing they wanted to resume chemo, I reiterated that when talking with my former oncologist he told me to hold chemo until surgery happened.  My PA pulled out her phone and started texting him while I was in the room.  The result of that text message was that he agreed with what he told me otherwise I would have been told to sit in a chair and tapped against my will.

She went out of the room again for another try at the new Oncologist.  When she returned so did my new Oncologist.  We chatted with her for a few minutes and She seemed nice.  My PA informed her of the plan I would not start chemo until post surgery.  So they politely scheduled me with anther meeting with my PA and treatment to follow on Thursday Feb 29th.  This is 2 and half weeks after surgery.  I remember that taking place 4 - 6 weeks post op 10 years ago.  I'll reach out to the RN at my surgeon's office to clarify when they would want first chemo treatment following surgery.

I also got a message in my My Chart app to schedule my CT.  The date on that is Jan 29th however I wan't able to pick Lemmon Holton as the location and that is where I'm most confortable with the staff and process.  So tomorrow my job is to call and schedule my CT and then call my RN in my Surgeon's office.

36 more days until Surgery.

~Kent

Cut it out!

Today we had an appointment with the Surgical Oncologist we requested to meet with.  The subject was this cancerous tumor I have surrounding my Portal Vein.  More on that in a minute.  We checked in at the desk and received the usual clipboard of information I needed to fill out.  Shortly after we were called back to a room.  I got the oxygen meter on my finger and the blood pressure cuff by the tech.  Across the room there was a list of names from the doctor I was there to see. All the way down the scale of names included to the Nurse tech I was assigned.  We first saw the NP assigned to the case who remembered me from 10 years ago.  I didn't remember her but she knew we met before.  She asked about my chemo treatments and apetite since the chemo. I gave her the information she requested and chatted with ther shortly.  

Next came the Doctor.  She was good and thourough but there was a lot of information presented in a short amount of time.  She first talked about the tumor.  She expalined how there are dozens of lymph nodes in that area.  Based on the scans she looked at, she decribed the tumor as a collection of enlarged lymph nodes pressing on the bile duct.  She then shared the details like... surgery time will be 3 - 5 hours as she's removing a number of lymph nodes.  Per hospital stay, it largely depends on what she finds during surgery.  It is possible she would have to remove and reconstruct the bile duct.  If that happens my stay in Hotel Butterworth will be roughly 7 days.  If she can remove the lymp nodes but not have to reconstruct the bile duct then my stay will be more like 4 days. When the conversation turned to recovery and time away from work,  I made clear I work at home and can sit in my office as easily as in another chair in the house. The doctor mentioned she would suggest me taking 2 weeks to fully rest after being discharged before returning to work.  She also wants a few things completed before surgery.  First an updated CT, Second a Colonoscopy, and third seeing the surgery preperation center to be cleared for surgery.

Per the bile duct it is better for me to have a stent in it as it makes the bile duct thicken and easier to get sutures in. She obviously will not touch the bile duct unless absolutely necessary and has my saftey in mind during the surgery.  

The third and final person we saw was the RN listed on the board I mentioned earlier.  She is my point person and was the person responsible for crossing all the T's and dotting the I's.  I was given 2 dates for surgery and I selected Feb 12 as the date for surgery.  So for the next 6 weeks I'll be getting phone calls for scheduling and going through those tests and appointments.  

On Thursday I will meet my new Oncologist during a meeting with My PA.  I was told to hold chemo until surgery by my previous oncologist so I expect the message will be the same in fact we'll try to communicate the same when in that meeting.  

More here after Thursday's meeting.....

~Kent

Prayer

The last post I wrote was us talking to the PA about a chemo break for the month.  That was granted and up until recently I was planning on resuming chemo on January 4.  

Recently (as in a few days ago) I received a call from my Oncologist.  He told me that his meeting with the tumor board met and the surgeons thought it possible to perform surgery.  He put in a referral to the surgeon we wished to have a consult with.  I'll continue this thought in a bit.  So please stick with me.

Fast forward with me from the Surgeons call to my visit to the vetrinarian last Thursday.  Miranda had a toenail fall out and her toe never healed properly so we were in to see a vet I trusted.  He spent a few minutes on the floor looking at the toe and then got up and said.  "I don't really want to add any more to your plate."  What I told him when he asked how I was is that my cancer returned and I had 12 treatments.  He followed  by telling me He believed Miranda's toe was likely cancer.  He did some talking to ask me pertinent questions and inform the tech what the plan is.  The tech stepped out of the room and what happened next is why this is applicable to my journey.  The vet (who we know well) knelt down by the chair I was sitting in, Put his hand on my shoulder and began praying for me, Miranda and our family.  I don't know if I ever can say until now that I was prayed for in the Vetrinarians office.  

Since I often joke when stress gets to high I began saying don't drink the water at home.  Leah began saying there are 2 with cancer (me and the dog) and 2 with a missing toe (Leah and the dog).   To be honest, her surgery went well and we had her toe sent in for path reults although that likely won't change our future decision for her.

Now back to the referral.  Yesterday I got a call from the Surgical Oncology office saying they had a referral from my Oncologist and would like to get me scheduled.  I missed the call at that time so today it was on my schedule to return that call.  I was given 2 dates prior to Jan 4 and what worked best was the morning of Jan 2.  My current Oncologist told me in the phone call he would suggest holding chemo until surgery.

So Jan 2  I will have a surgical consult and then Jan 4 I have a meeting with my PA for my oncologist and she will pull my new oncologist into the meeting.  During that meeting I will reiterate that I will hold chemo until surgery happens and I will have the chance to meet my new Oncologist.  My regular chemo nurse is returning to the blue pod after the first of the year.  She's sad she won't see us for while.  If we're in the building you never know what might happen.

Many days I hear about someone new that is praying for me.  And the Christmas Cards this year have had a similar theme of  "we are praying for you".  To all of you reading this, I/we appreciate your prayers for each step in this journery.  We serve a Mighty God who answers prayer.

~ Kent

Am I staying?

Today was my appointment with the PA and Chemo.  We packed and planned as if we were going through with Chemo even though we were trying our hardest to get a well deserved break from Chemo.   Physically and mentally I need some time to live a bit normal.  

While visiting with the PA we went over the scan results ( refer to the last post if you didn't hear about this) which was good news.  We quickly shifted the discussion to ask, is the tumor shrinking toward or away from the Portal Vein? Is Doc bringing my case to the tumor board to discuss surgical options?  The next question was can we have this Chemo break over the next 2 treatment days (today and Dec 21)?  Our PA wrote everything down and didn't have a lot to say other than "Let me step out and check with your doc and I'll be back"

So what was several minutes but seemed like an eternity, Leah and I waited in the exam room together with no distractions.  When the PA came back in she said, "I was not presented to the tumor board today." so, Doc will present my case before them next Thursday.  All GI Oncology Docs are present in this tumor board as are Surgical Oncology Doctors. They will discuss me as it pertains to treatment/ surgery. I should hear back from my Doc Thursday or Friday next week.  In regards to how the tumor is shrinking, the Doctor said surgeons have amazing methods to see how it is postioned relative to the Portal Vein.  All that to say is it is really up to surgeons to determine where the tumor is positioned and if that leads to a possible surgery.

Per the Chemo break my PA said, he reacted in the manner of "a month?".  We/she did enough convincing that neither my current or new Oncologist said, "No" to the break.  So the next treatment is scheduled on Jan 4.  We should know more about any surgical options by then and if we are planning on surgery we would need to hold one of the medications I recieve during treatment.  So from that perspective this is good pre planning.

I just need more than 1 week (consecutively) that I can live life normal and have a relatively "normal" amout of energy.  I'm thankful I'll be able to see family during the Christmas season (and remember it).

Until I have more news next week...

~Kent