Busy Day

Well if all goes as well as it has been, John will indeed be discharged sometime tomorrow.  Today was "Nancy Goes to School" Day.  We've had an IV pole; two pumps; numerous tubes, bags, syringes, accessories; a pump backpack; etc. delivered to my mother's house for John's at-home "Bag-O-Meal" program.   I had to learn how to set up, prime and run the pump.  I also had to learn how to flush John's feeding tube as well as clean and dress the area.  There are a lot of nurses in my side of the family, including my mother.  I never thought I'd be one.  Oh the irony...
John's doing very well.  His final chest tube was pulled late this morning, so he's footloose and fancy free for his strolls up and down the hall.  He's a little more tired and feeling some of the aches and pains that come with surgery a little more, but on the whole...he's super.  But then I ALWAYS knew that.
We got his pathology report yesterday afternoon.  It was very good.  Not super-duper, but VERY good.  The cut lines on his esophagus were clean for cancer which is wonderful.  The doctors removed a total of 15 lymph nodes from the immediate area where the tumor was as well as from other areas of his chest.  Some of those showed cancer cells still active.  What this means is that the "Tumor Board" and Virginia Mason will review his results, as will his oncologists at St. Joe's in Bellingham.  They will make a recommendation on whether or not John will need post-surgical chemo.  I have a hunch they will make that recommendation -- which is not a bad thing.  I look at it as kind of insurance; an extra one-two punch to get rid of the disease.
For now we will be staying with my mom until probably Thursday should anyone want to visit.  I think it's a good idea to stay close to VM until we know that John can process regular food.  (Regular food the consistency of smooth pudding, that is...yum-yum.)
Writing this blog has been very cathartic for me and I've tried to keep things light and interesting.  I'll continue to keep you apprised of John's progress as he gets weaned off of his "Bag-O-Meal" regimen and back on solid food.  I'm sure there will be some humorous stories to share as we go down this particular path on our cancer journey.
To everyone who has sent email notes, comments, cards, calls, prayers...Thank you.  John and I truly have the greatest life because you are all part of it.  I'm keeping you all -- even those of you who I have not personally met yet but have sent best wishes -- in my breast pocket, close to my heart.  I'll be talking to you...Nancy

Fewer Tubes and Grape Juice

As of this morning, John is down to just one chest tube (which should come out tomorrow afternoon) and his "Bag-O-Meal" feeding tube (which will be with him for up to four months).  All is going great.  As I was typing this, Dr. Low came by with the news that John's target discharge day will be Sunday.  Wow...Only six days after surgery!  John rocks!  We'll stay at my mom's for a few days as a "just in case of emergency" access to the hospital.  And we are still awaiting the pathology report.
Yesterday was a good day with lots of visitors.  Neighbor Laura from Bothell; our niece Emory (Danielle); and long-time friend from WSU, Shannon.
We've been introduced to at-home nutrition procedures.  We will be going home with a pump and IV pole so that John can enjoy his "Bag-O-Meals" at home.  We'll be taking a class on how to use the pump, flush and clean his feeding tube, etc.  For two full days after discharge, John's diet will consist of "Bag-O-Meal" and a limited intake of clear fluids.  (No, wine does not qualify.)  Then we move to cooked/pureed foods for 7-14 days (think "infant" baby food).  No bread.  No oatmeal...Very limited fiber. After that...well, I save those menus for later.  I'm kind of going into overload with all the new instructions we're starting to get.
So it's all good news  John said to thank you all for your support.  I say thank you for all your prayers and positive thoughts...Will keep you posted on life at Virginia Mason "Spa and Hotel" and news when we get his path report back...Love to all...Nancy

Swallowing Test

This morning John went in for a swallowing test.  He had to swallow some barium, a couple of nuclear (wow!) things, some water, etc. etc. etc.  They literally turned him upside down and tracked how everything travelled via CAT scan imaging.  Dr. Low was very pleased!  So hopefully he will be able to have a few sips of water today.
In addition his catheter may come out.  They are also planning to remove his epidural line through which he is currently receiving his pain medication.  If they do so, he'll receive those meds via his feeding tube.
As I type John is out for his first real walk of the day with his student nurse (from U.W. School of Nursing...Oh my!  I hope she makes it back in one piece!).  He did five walks up and down the hall yesterday, on which three of those walks he completed three laps each.  I continue to be amazed at his attitude and determination.  I am so proud of him!
The next "hurdle" will be dependent upon the pathology results which should be in tomorrow.  Holding good thoughts for a clean result.
I will let you know about today's events tomorrow.  Love and thanks to you all....Nancy

Hospital Update...

Yesterday went as written except for a spike in John's temperature; not unusual post-surgery.  So after administering a dose of Tylenol (he can't swallow ANYTHING so use your imagination as to how he got his Tylenol) and a few laps up and down the hall, his temp went down.
This a.m. Dr. Low and entourage visited around 8:45 and all were very positive.  One of John's chest tubes was removed and as I write, he's having a sponge bath and preparing for his first walk of the day.  He still has one chest tube, catheter, nasal tube and IV for pain medication.  Cath may come out today; second chest tube perhaps tomorrow; nasal tube perhaps the day after that.
So the next few days will be the same routine (HOPEFULLY):  A minimum of 4 or 5 hallway strolls, breathing exercises, more time out of bed in a chair...and no unusual complications.  If anyone in the area wants to visit later this week, John should be up for some company.  And -- rumor has it -- he's getting a private room.  Yea!
Thank you (I say that a lot and it's starting to sound lame...But I truly mean it) for keeping us in your hearts, thoughts and prayers...I'll let you all know how things progress...Nancy

The Day After...

After a 7-plus-hour procedure and a 15-plus-hour wait, John came through surgery with flying colors.  Dr. Low came out to the waiting room to deliver the good news that John had remained stable throughout the entire procedure and he has every confidence that John will convalesce well.  He said that John's positive attitude -- which has actually been a huge support for me through these last few months -- is indicative of a patient who will recover well from this procedure.  We expect a pathology report in a few days which will tell doctors whether or not John will need any post-operative chemo.  We are, naturally, hoping results will be negative.
As I write this, John's having his first post-surgical "meal:" A high-calorie breakfast/lunch/dinner in a bag.  Because his new esophagus-made-from-stomach will take some time to heal, he will be enjoying his "Bag-O-Meals" via a feed tube connected directly into his small intestine for a while.  (I wonder if Martha Stewart has any recipes?)  He is now in a regular hospital room after spending last night in post-surgical CCU.  His nurse, Jeanine, is great.  (For single men out there, she's 45, extremely attractive smart...and I would highly recommend a coffee date.)  It's still too soon to know how long he'll be in hospital, but I would guess it will be at least 10 days.
Bless you all and thank you for your care.  Thank you to Laura, our neighbor and best-friend-ever from Bothell for staying with me all day yesterday while waiting.  To Gail (thanks for the jigsaw puzzle -- it will go to the Bellingham Cancer Center after we put it together);  Birch Bay-neighbor Sunny (thanks for the Cougar -- it's gracing John's hospital room); sister-in-law Linda and John's brother Ray for your visits, help and support.  Thanks to Mike and Kathy Wright for your gift.  (John hasn't opened it yet...He will this afternoon when he wakes up from his siesta.)  And thanks to my Mom who came down and wiled away some time with me during the long hours yesterday.  Besides being my Mom, I'd pick you for a mother-in-law any day.  John's lucky to have you.  Your love and support means everything.  And for everyone who has been praying, lighting incense, shaking rattles, chanting...whatever...Thank you!  I'll keep you posted...Nancy

Surgery Tomorrow

Well we're finally down to crunch time.  Packing the cats and heading to "Grandma's" house this morning.  John will start his pre-surgery prep this afternoon.  Not unlike getting ready for a colonoscopy, only much less "beverage" to take.  Just one small bottle.  Breakfast this a.m. will be scrambled eggs and toast.  I feel kind of bad making such a mundane meal since it will be a while before John gets to eat real food.
It's a drizzly morning with rain in the forecast for a few days.  But the bergenia in our front yard is in full pink bloom.  The dogwood and ginko trees are nicely leafing out.  And I harvested the first crop of rhubarb which I'll take to Mom's and make a batch of sauce for the two of us to have in the mornings for breakfast.
I have every confidence that John's surgery will go well.  After all, he has all of you rooting him on, praying for him and working on those jigsaw puzzles, sending "good juju."  Since John's procedure is a long one and he'll be in recovery for a while, I won't have any concrete info until late tomorrow.  So I'll probably be posting either very late Monday night or on Tuesday.  Thank you for your friendship and support.  You are all appreciated more than I can ever say.  As Peter Pan said, "Come, everybody.  Here we go!"....Nancy

Final Tests Before Surgery

Yesterday was a 6-hour day at Virginia Mason, having a CAT scan, meeting with John's surgeon Dr. Low and having a consult in the anesthesia clinic with a very young Dr. Adcock (who may or may not be John's anesthetist on day of surgery).  Surgery is, indeed, scheduled for May 16.  So the blog may be a little quiet between now and then as -- mercifully -- there is only one appointment left to take care of between now and then.  Sometime within two weeks of surgery John needs to have a blood draw to type his blood. Antibodies and who-knows-what-else can then be matched to a supply which will available in the unlikely event he should need a transfusion during his surgical procedure.
Dr. Low (surgeon) went over the actual procedure which will take anywhere from 6 to 9 hours.  They will initially "go in" under John's sternum (breastbone) and somehow not have to go through muscle.  For those of you who have had abdominal surgery, myself included, you know this is a plus.  A second incision will be made on John's right side between two ribs.  Between these two locations, Dr. Low will remove his esophagus and lymph nodes in the previously cancerous area, take his stomach and refashion it into a tube-like structure and create a new esophagus.  The result will be a much smaller stomach and a "new" esophagus.  The removed organ(s) will be sent to pathology for a 3-4 day examination, looking for any malignant cells.  We are hoping that the path report will show only (if any) dead cancer cells.
So we're about halfway there and, thank God, all the progress has been positive.  Thank you so much for the cards, phone calls, prayers well wishes on this journey.  I know I keep asking, but keep those prayers and good vibes coming.  You are, each one of you, so very much appreciated.
I'm also offering you a challenge:  Beginning May 16 (when John goes into hospital), get a jigsaw puzzle.  Spend some time with your family, or go solo, putting it together.  Have fun, think of John and -- after your puzzle is completed and you've taken the requisite photo of your accomplishment -- take it apart.  Put it back in the box and take it to your local cancer center or hospital for use in a waiting room.  Those puzzles help patients, friends and family connect with each other and for a short time forget their troubles.  As Martha Stewart says, "It's a good thing."  I'll stay in touch over the next few weeks and will definitely let you know how things go in May.  Love to you all...Nancy