The prep went a little better this time, according to the nurse that looked after me at hospital the prep treatment being used is more gentle than the fleet that they used to use.
While waiting for the nurses to "muck around" - the colo-rectal surgeon's words, I asked the surgeon if he could see the pathology results from my lung resection. He looked them up and said that they had got the lesion, it was secondary colon cancer and had clear separation around it - so a good result.
The colonoscopy was normal, no polyps or other abnormalities. The instrument went right to the end of the colon, which is also good.
I am feeling good now, I did sleep most of the afternoon. Back to work and to normal tomorrow.
Monday, August 29, 2011
Wednesday, August 24, 2011
Status Update
Recovery has been going well, I am pretty much pain free now. But yesterday afternoon through to this morning I have been feeling a bit ill, almost like I have a cold or flu, but no hard symptoms. Last night I felt like a temperature was building but it was not. I have the idea that I have some congestion stuck in my lungs, but it might be scar tissue, I guess. I am also still affected by the chemo, no doubt this is slowing me down as well.
I have started feeling somewhat better this morning now that I am up and moving around, the weather forecast is good so I hope to go for a reasonable walk. I did have the idea that all going well I would be doing some work from home today and perhaps getting into work tomorrow, I don't think that will happen, perhaps it will be a day later.
Next steps:
I have started feeling somewhat better this morning now that I am up and moving around, the weather forecast is good so I hope to go for a reasonable walk. I did have the idea that all going well I would be doing some work from home today and perhaps getting into work tomorrow, I don't think that will happen, perhaps it will be a day later.
Next steps:
- Nurse visit due today to review and clean the wound and dressing - now done, wound and general recovery is all very good.
- Next Sunday 28th, prepare for colonoscopy, I am really looking forward to that (NOT!).
- Monday 29th, Colonoscopy, I really don't have a problem with this procedure, I will be sedated.
- Tuesday 30th, Nurse visit to remove stitches from my drain site.
- Thursday 1st September, meet with Liver Surgeon to schedule liver resection, should also have pathology results from the lung resection last week.
Sunday, August 21, 2011
At Home, With A Smaller Lung
Last Friday morning we arrived at the Day Of Surgery Admission (DOSA) office at Christchurch Public Hospital. All went apparently well and at 8:30 AM I was in the CT scan waiting area for insertion of the wire marker. Only problem was that the DOSA people had missed the requirement for a blood clotting test. This took about 30 minutes to arrange so I was behind in the project shortly after start up.
Shortly after 9:00 AM the procedure to insert the wire started. First up I was scanned and marks drawn on my chest to indicate the position and depth of the tumor. This was followed with a local anesthetic injection into my chest wall, which was OK, just the normal sting. Then a longer needle was used to inject local into my lung, that was a very strange feeling.
A small cut was made in my chest with s scalpel and then various needles and tubes were inserted. After each insertion I was rescanned to make sure the main tube was lining up with the tumor. Once this was confirmed a wire coil was pushed down into the lung along with some blue dye to help the surgeon find the tumor. Finally one last CT scan and a chest X-Ray to make sure all was as it should be.
At about 10:00 AM I was wheeled into the prep room and then into the operating theater. Most of my discussion at this point was to the anesthesia team. I then got a wee injection and woke up about two hours later in recovery. All had gone well and a wedge was removed from my lung with the wire coil attached. The surgeons had not been able to actually locate the tumor, but were highly confident that it was in the center of the wedge removed - the problem was that the tumor was so small it could not even be found by palpating by hand. After about a week the results of the pathology evaluation will be available, the surgeon will call me then.
As usual the hospital care was great, but I was not able to sleep well, there was far too much going on in the ward. I have a wound under my breast area about 5 cm long, another smaller one down my right side, and a stitched hole where my wound drain had exited. These will all be tidied up in about a week, but I can shower from now on.
While in the hospital I was strongly encouraged to walk and do deep breathing exercises, I need to keep those up for several weeks. I feel OK now, very tender and at times painful from my right shoulder down. This should come right in the next 3-4 days. I am also very tired, this should also resolve within the next week.
Shortly after 9:00 AM the procedure to insert the wire started. First up I was scanned and marks drawn on my chest to indicate the position and depth of the tumor. This was followed with a local anesthetic injection into my chest wall, which was OK, just the normal sting. Then a longer needle was used to inject local into my lung, that was a very strange feeling.
A small cut was made in my chest with s scalpel and then various needles and tubes were inserted. After each insertion I was rescanned to make sure the main tube was lining up with the tumor. Once this was confirmed a wire coil was pushed down into the lung along with some blue dye to help the surgeon find the tumor. Finally one last CT scan and a chest X-Ray to make sure all was as it should be.
At about 10:00 AM I was wheeled into the prep room and then into the operating theater. Most of my discussion at this point was to the anesthesia team. I then got a wee injection and woke up about two hours later in recovery. All had gone well and a wedge was removed from my lung with the wire coil attached. The surgeons had not been able to actually locate the tumor, but were highly confident that it was in the center of the wedge removed - the problem was that the tumor was so small it could not even be found by palpating by hand. After about a week the results of the pathology evaluation will be available, the surgeon will call me then.
As usual the hospital care was great, but I was not able to sleep well, there was far too much going on in the ward. I have a wound under my breast area about 5 cm long, another smaller one down my right side, and a stitched hole where my wound drain had exited. These will all be tidied up in about a week, but I can shower from now on.
While in the hospital I was strongly encouraged to walk and do deep breathing exercises, I need to keep those up for several weeks. I feel OK now, very tender and at times painful from my right shoulder down. This should come right in the next 3-4 days. I am also very tired, this should also resolve within the next week.
Tuesday, August 16, 2011
Progress, Despite The Snow
We are in the middle of an unusual weather event, heavy snow, which has affected a large part of New Zealand. We have had about 40 cm of snow over the past two days at our house, this is a one in 20 year event here. Travel on the roads has been difficult, but I made it in to work this morning and to the hospital this afternoon.
This afternoon I attended my scheduled appointment at the respiratory clinic. My lung functions were tested with a Body Plethysmography, this was quite a demanding process and took about 30 minutes, results are all normal. In addition my blood was tested for dissolved gases, this proved to be a bit of a problem. The clinician needed to take arterial blood from my wrist, in order to get the best results. She had to have 3 attempts to get a good result from an artery, both wrists were punctured, in the finish we had to resort to local anesthetic as the pain was getting to both me and the clinician.
Following the lung function tests I went to the cardio-thoracic ward for preadmission tests and to give my formal consent to the lung resection. This all took quite a bit of time, but we are now all go for the surgery.
I need to be at the hospital at 7:15 AM this coming Friday, 19th August. First procedure, due at 8:30 AM is to insert a hook wire into my lung to identify the precise location of my tumour. Then shortly after I will have the video assisted surgery to remove the tumour. All going well I will be in hospital for one to two days, then home.
This afternoon I attended my scheduled appointment at the respiratory clinic. My lung functions were tested with a Body Plethysmography, this was quite a demanding process and took about 30 minutes, results are all normal. In addition my blood was tested for dissolved gases, this proved to be a bit of a problem. The clinician needed to take arterial blood from my wrist, in order to get the best results. She had to have 3 attempts to get a good result from an artery, both wrists were punctured, in the finish we had to resort to local anesthetic as the pain was getting to both me and the clinician.
Following the lung function tests I went to the cardio-thoracic ward for preadmission tests and to give my formal consent to the lung resection. This all took quite a bit of time, but we are now all go for the surgery.
I need to be at the hospital at 7:15 AM this coming Friday, 19th August. First procedure, due at 8:30 AM is to insert a hook wire into my lung to identify the precise location of my tumour. Then shortly after I will have the video assisted surgery to remove the tumour. All going well I will be in hospital for one to two days, then home.
Thursday, August 11, 2011
Lung Surgery Scheduled
Today we met with the Clinical Director of Cardiothoracic Surgery at Christchurch Public Hospital, Harsh Singh. We talked about the surgery to remove the tumor on my lung. The biggest challenge is that the tumor is now 12mm in size - it has shrunk from 29mm. The problem is that a 12mm "lump" in my lung will be quite hard to find so the plan is to do some more 3D modelling to better define the location of the tumor.
What I had not expected is that he has scheduled the surgery for next Thursday 18th August, much sooner than I had expected. I am very happy with that as the sooner the tumor is out, the less chance of further cancer spreading from it, but is was quite a surprise.
The expectation is that the surgery will be non-invasive laparoscopic surgery, but if there is difficulty finding the tumor, it may require invasive surgery via spread and/or removed ribs. Assuming the non-invasive surgery does the trick, I should be out of hospital within 2-3 days and back at work in about a week. My understanding is that invasive surgery will about double those times.
It looks like the liver tumor will be dealt with in about 4-6 weeks, after my liver has recovered from the chemo. At the moment I am still very fatigued, most likely that is caused by my liver not functioning correctly, and it does feel similar to my recovery from my earlier liver resection.
I am feeling really good about the treatment I am receiving, it seems to be as good as any available anywhere, despite the fact that it is being delivered by the free public hospital system. However I am struggling to keep positive, the surgery is daunting and realistically I only have about a 20% chance of 5 year survival, this is on my mind quite a lot. It would be nice to take a break and get away and enjoy ourselves for a week or so, unfortunately the weather and hospital appointments are conspiring against this. Work is also challenging, but I am well supported by my employer and so work is secondary to my treatment.
What I had not expected is that he has scheduled the surgery for next Thursday 18th August, much sooner than I had expected. I am very happy with that as the sooner the tumor is out, the less chance of further cancer spreading from it, but is was quite a surprise.
The expectation is that the surgery will be non-invasive laparoscopic surgery, but if there is difficulty finding the tumor, it may require invasive surgery via spread and/or removed ribs. Assuming the non-invasive surgery does the trick, I should be out of hospital within 2-3 days and back at work in about a week. My understanding is that invasive surgery will about double those times.
It looks like the liver tumor will be dealt with in about 4-6 weeks, after my liver has recovered from the chemo. At the moment I am still very fatigued, most likely that is caused by my liver not functioning correctly, and it does feel similar to my recovery from my earlier liver resection.
I am feeling really good about the treatment I am receiving, it seems to be as good as any available anywhere, despite the fact that it is being delivered by the free public hospital system. However I am struggling to keep positive, the surgery is daunting and realistically I only have about a 20% chance of 5 year survival, this is on my mind quite a lot. It would be nice to take a break and get away and enjoy ourselves for a week or so, unfortunately the weather and hospital appointments are conspiring against this. Work is also challenging, but I am well supported by my employer and so work is secondary to my treatment.
Thursday, August 4, 2011
All Go For Surgery
As planned, we met with the liver surgeon today. He confirmed that my main two tumors (one each in a lung and in my liver) had shrunk considerably following chemotherapy and that the 2 smaller liver ones were no longer visible on the CT scan. Apart from improving the probability of surgery being viable, it also means my current variety of cancer is able to be managed by chemo, which offers opportunities in the future if surgery was not feasible.
We discussed the options, do nothing, further chemo or attempt to remove both tumors. We agreed the best way forward is to attempt to remove the tumors, this is a radical and aggressive approach which only 18 months ago would not have been considered. The surgery will be rough and the probability of a cure is likely about 30% but is the best opportunity to give me several years of good life.
The next step is a meeting with the cardio-thoracic team. They will also schedule a colonoscopy, just to make sure that there is no more primary colon cancer developing. Likely the surgery will happen mid to late September once I have recovered from the chemo and all the preparatory tests etc. have been done. At this stage it is probable that the lung tumour will be removed first, followed a few weeks later by removal of the liver tumor, however it is possible both may be done at once.
The PICC line was also removed, this is great, I can now have a proper shower and a bath if I like, I miss my baths. Likely I will get another PICC line during or after surgery as I would expect another short course of chemo after surgery.
I am still suffering from the effects of my last chemo, feeling tired most of the time and still have very mixed up taste buds, hopefully this will improve over the next few weeks.
We discussed the options, do nothing, further chemo or attempt to remove both tumors. We agreed the best way forward is to attempt to remove the tumors, this is a radical and aggressive approach which only 18 months ago would not have been considered. The surgery will be rough and the probability of a cure is likely about 30% but is the best opportunity to give me several years of good life.
The next step is a meeting with the cardio-thoracic team. They will also schedule a colonoscopy, just to make sure that there is no more primary colon cancer developing. Likely the surgery will happen mid to late September once I have recovered from the chemo and all the preparatory tests etc. have been done. At this stage it is probable that the lung tumour will be removed first, followed a few weeks later by removal of the liver tumor, however it is possible both may be done at once.
The PICC line was also removed, this is great, I can now have a proper shower and a bath if I like, I miss my baths. Likely I will get another PICC line during or after surgery as I would expect another short course of chemo after surgery.
I am still suffering from the effects of my last chemo, feeling tired most of the time and still have very mixed up taste buds, hopefully this will improve over the next few weeks.
Tuesday, August 2, 2011
No Chemo Tomorrow
Late this afternoon I got a call from the Chemo day ward, my chemo for tomorrow and subsequent chemo sessions have been cancelled.
Apparently this afternoon the chemo day ward reviewed my blood results and found one test slightly out of range for chemo, no big deal and normally my session would just be deferred for a day or so. But they referred the result to the oncologist for his advice, he had the results back already from my CT scan this morning and due to the exceptional response I have had from chemo they have cancelled chemo and I am now being fast tracked for surgery. No doubt I will have more detail after my visit to the surgical clinic on Thursday.
I have not really absorbed the news yet, I guess I should feel over the moon, the surgery, particularly the lung resection, is a bit daunting, but is my only real chance for a cure.
Apparently this afternoon the chemo day ward reviewed my blood results and found one test slightly out of range for chemo, no big deal and normally my session would just be deferred for a day or so. But they referred the result to the oncologist for his advice, he had the results back already from my CT scan this morning and due to the exceptional response I have had from chemo they have cancelled chemo and I am now being fast tracked for surgery. No doubt I will have more detail after my visit to the surgical clinic on Thursday.
I have not really absorbed the news yet, I guess I should feel over the moon, the surgery, particularly the lung resection, is a bit daunting, but is my only real chance for a cure.
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