Triton Confirmed

I saw my doctor Monday. Everything from the surgery looks great. The pathology did come back positive for a high grade malignant sarcoma. To sum things up, here's an email I sent out after finding the results.

"my side feels much better.

the hand is about the same, maybe better.

i'm a little bummed about the results. so is ashley. regardless of knowing the probable result to be what it was, it's still a bit heavy to know for sure now that the cancer spread to my lung.

we'll just keep holding on to the positive fact that it was a single nodule and pray that it was a first/last occurrence. i still feel good about the whole thing, just a little down at the moment.

at least i knocked out my blog post while writing you."

like i said. we figured this. it's a bit crazy. in two weeks from detection to removal, the nodule grew from 0.5cm to 0.9cm. i'm glad we moved fast.

ashley and i had a great time at a wedding in the outer banks over the past weekend. life goes on...

Nothing yet.

Although getting good news from the pathogists would be more unlikely than Wake Forest's football season last year, we're still waiting for the results. Both my thorasic surgeon and regular oncologyst know I'm eager for the findings. I'll post them as soon as I hear something.

As far as healing from this last surgery, I'm doing great. There is a little tenderness in my side which is to be expected for another week or so, but the pain has subsided enough to come off the pain medicine they perscribed for this surgery. Getting off the others might have a closer resemblance to a bad scene for Trainspotting. Regardless, after sleeping a few days in a chair and rearranging the living room slightly to accomodate my television addiction, hopefully, the worst has past. I would say that I'm pretty much back to my normal. It's a good thing that I'm a fast healer in case Dad tries to avenge his Labor Day weekend broken rib from years back. Way back...like 6 years ago.

CP

Good Visit...Good Vibes

After all the drama, here's a nice light uplifting post. I think we could all use one.

Fleming helped me make my appointment with my hand specialist today. Because I was still sore from surgery, she literally pushed me out the door from across the inside of her car to drop me off. Today she was both a welcomed companion in waiting and the doctor's office as well as the ultimate pharmaceutical collector/enforcer. She was like the greatest percription bouty hunter off all time. The red tape would have easily tied up Boba Fett like the arms of the Sarlacc on Toatooine. Duane "Dog" Chapman doesn't have the brains under that dreadlocked mullet to calculate the odd ways to fill scripts to get around insurance company's BS regarding what they think I should be taking for pain. Insurance companies beware! Fleming will get creative with dosage sizes and refill times, run across the clinic in Flip-Flops and lime green back pack to get new persciptions, flying past the front desk area to make sure everything gets in under the wire so her baby brother has the pain medication he needs. Thanks Fleming, no matter what we're doing, it's always a good time. You Rock.

We had a lengthy discussion with an intern who we gradually persuaded to believe we weren't retards (no offense, Mac). After telling him the whole story, which was in the chart in front of him, I explained to him the details of having just been discharged following a thoroscopy two days ago. I then explained my whole pain situation, and yes, how it did hurt everywhere in my hand (like my chart said), especially when you have it twisted upside down with the fingers pulled every direction except where they wanted to go. At that point I reminded him that I had just had surgery that week and that he could stop acting out Jack Bower fantasies. Did I mention it was all in a file sitting in his lap? What a retard...

Truthfully it was an inspirational appointment. The hand specialist was absolutely amazed at how well I could move my fingers. What seemed like a limited range of motion to me showed true promise to the doctor. The forearm and hand especially had the odds stacked against them, from the surgeries, to the radiations, to the grafting, and even the extended immobilization time. There was very little muscle trying to pull my fingers through a cement wall of scar tissue. When he saw them move today, he said it was one of the reasons he found purpose in his job and life. He really said, "Your fingers are moving, and I don't know where it's coming from." His positive attitude and optimistic view of the future really summed up how we feel and want to see this challenge through. Perseverance, determination, attitude and faith and guts from everyone will generate the positive energy needed to make miracles happen. Let's be honest...great medicine helps, as does prayer, God Himself, and well-mastered holistic treatments. Friendships, family, and all the support they create and provide are incredibly crucial. The ladies in my life are tough to beat. Ash, Ruth, Fleming and Betty are a force to be reckoned with. They have a perfect track record and a "Get'R Dun" attitude when it comes to helping. Again, thanks to everyone from the surgeons to the people I don't even know mailing me loving "get well" cards.

You can take this tube and shove it!

12 hours after surgery. What else you got?











When is one IV ever really enough








It's just after three in the morning, which also happens to be the cutoff time for me to take a leak on my own into one of those plastic hospital jugs. Why is that important? Because since they pulled out my catheter eight hours ago, which Clark thoroughly enjoyed watching, and if I had not produced 400mL, the catheter had to go back in. Let's just leave that at it's something you don’t won't performed unless you're asleep under anesthesia for surgery. TMI?? Of course it is!

So why did they pull out the catheter early? Answer: because the stupid epidural for pain management finally got voted off the island after slipping through way to many pain assessment elimination ceremonies. The result of that scenario: my handling the pain with only my normal home meds and a little red pillow to squeeze on when it hurt. And when I say hurt, I'm referring to the pain caused by both the surgery itself and a rather large drainage tube souvenir stuck directly into the surgery site and between a couple of ribs before existing my body. When I first woke up and they realized the epidural (which was later found to be ineffective) wasn't even running, I received a high dose of IV pain meds to help the situation. A situation which hurt too bad to breathe, move, lie still, or even moan. Not as bad as jerking directly on my exposed median nerve, but up there nonetheless as far as experiences I wouldn't even wish upon the guys who shot Tupac or Biggie...well, maybe those guys.

So what's going on at 3am? Just typing while I'm briefly awake long enough to have my vital signs taken and hit the buttons on my PCA machine containing hydromorphine to effectively relieve the pain and help me fall back asleep. The new pain management system is great and so far I've been lucky to have three of the best nurses I've had here take care of me this time. Actually and coincidentally, I’m fading fast.

The tumor was removed without any unexpected complications. It didn’t look like regular lung cancer, and the pathology on the nodule should be back next week to verify it being a Triton. The chuck of lung taken was about the size of half a stick of butter. Speaking of sticks of butter, Fleming brought cupcakes that Kirk made. We all had one to celebrate her birthday and my surgeon graciously took the last one later that day during his rounds upon learning they were homemade. I think that should cover it at this time. I’m seeing double and this post took almost two hours to write (probably an hour to finish the last paragraph) on account of numerous typos but mainly my falling asleep at least half a dozen or so times. They upped my pain medication delivery while I was writing. More pics to follow and several new ones on the Triton Photos. I might get out of here today. Ash is sleeping next to me in the recliner. I just fell asleep again holding the delete button and lost 1/3 of this. Thank God for the undo feature and with that, thank God for another safely completed surgery.

And thanks to you all for the multitude of kindness we’ve received, especially over the past month.

CP

9:15pm Post Script We made it out today after lunch. The criteria for being discharged includes using the bathroom, holding down liquids and solid foods, standing and walking on your own, and completing a little paperwork. If you get all that finished and the docs think you're good to go, you are...and I was. Quite a laundry list of everyday things to go home to enjoy everyday things. Tonight we're napping, eating take out, and watching a movie...a wonderful list to celebrate coming home.

On a final thought, here are a couple of shots of me and my beloved PCA machine. PCA stands for "Patient Controlled Analgeisa," allowing the patient to administer the pain medication as needed in a safe dose. Judging from the completely unexaggerated look on my face, I'd hate to see what a dangerous dose would be....

Correction!

In my haste to get out the post describing the CT results, I wrote the nodule was 5cm by 5cm. That would be huge. It was 5mm by 5mm. Still signifigant (because it was there at all) but not anything close to the size I described it.

I hope that relives a few people's worries by 45 millimeters.

Regardless of the size, that bad boy is coming out Tuesday.

Happy Birthday, Fleming.

Surgery has been set for Tuesday, August 14, which also happens to be my sister's birthday. For my present to her, I hope to finish this saga with my final surgery at Duke. Dramatic? Yes. Being a cheapskate? Damn Skippy.

Using a technique resembling arthroscopic surgery, the doctors plan to remove the tumor with around 2-3cm of margin, about the size of a golf ball. They will go in from my right side and below my right nipple leaving two incisions which most likely will be relatively small. There is a possibility that the entry to my back might require a larger opening, but it is unexpected. I should be able to recover in a day or two if everything goes as anticipated. After surgery, the large scar count will total 11, including the skin graft.

After the nodule is removed, the pathologist will determine if it was indeed a Triton tumor. The watch will continue. Scans will remain every three months. It sounds like chemo would be unlikely, but I'll have to discuss that with that particular doctor. Had multiple nodules been detected, chemo would be more likely. I am speculating here and can't be sure until after surgery, pathology and speaking with my "chemo doctor".

On a completely different note, we found my new doctor in the food court eating fried chicken and my orthopaedic oncologist in a hospital hallway red handed with a bag of McDonald's in his scrubs. I'm not sure what it means exactly, but I like these guys style... Anyone who can remove the majority of my forearm in the morning and put down a super-sized Big Mac with fries for lunch gets my vote. My entourage (Ashley, Dad, and myself) also crossed paths with a doctor from the hyperbaric chamber clinic as well as the ortho doc's nurse/assistant, an incredible woman, who embraced me with two hugs and her prayers... I've said it before. It's a special place with wonderful people; some whose eating habits are better than others. As for me, popcorn and Goobers made a nice dinner at the movie that evening.

We're going to head back to the beach in the morning and relax tonight. Last night's bed Kumate and spending all day at Duke left us both pretty exhausted. Next week, I'll have my pre-op meetings on Monday, surgery Tuesday, and should be home before the weekend. If Bret doesn't get rid of Lacy, he's a moron.

Thanks again for all your love and support last week when you shared my news with me.

PS I’m going to guess Fleming will probably get more (but not better) than great news from Duke, even if good news is all she wanted for her birthday. I'll add "birthday wishes" to the list of kind gestures I've received. Thanks Beetle. (Don’t ask)

Tuesday's News: The bone scan we took on Monday came back negative. The bones are clean.

Doh!

From the CT horses mouth:

Findings: New nodular opacity measures 5mmx5mm. Lungs otherwise normal.

Impression: Interval development of a right middle lobe 5mm nodule. Given the history of malignancy, this is concerning for metastatic disease. Recommend 3 month follow-up.

My Impression: Crap.

Our plan: Meeting with a thoracic oncologist Monday to discuss options. Screw waiting three months.

What might happen: Biopsy (less likely because small size) or surgically remove it and do pathology (very likely), if malignant consider chemo.

Surgery options: Scope out the nodule or cut into chest, spread ribs and cut the sucker out.

What then: Keep scanning chest. Hope this nightmare is over.

That really is it in a nutshell. We've yelled, cried, and bought a ton of wine. Still off to the beach. I'll write my findings after Monday.

This sucks...it really, really sucks. We'll get through it like we always do.

Chin is up.