1/14 is my day of freedom!

I got word today that I'll be going home tomorrow! They're stopping
the TPN nutrition today and I'm continuing to eat a normal diet.
Looks like it'll be a weekend watching NFL football and enjoying the
new recliners Amy bought this week!

The doctor also signed the order today for a home health PT to help
get my body in shape to ride my bike again. I am very excited about
kicking this off. The thought of being able to ride again almost brought a tear to my eye.

Livestrong,

Andrew

Food!!!

Well, since Andrew was handling the full liquids good, and he actually got some through the digestive tract several times, rather than going backwards to water, they have decided to move on forward just slowly. So, he got to start a soft diet today. So far so good. He hasn't been feeling full and things seem to go down fine. The doctors are planning to keep him a bit longer in the hospital, but don't anticipate any problems. :)

I mentioned that I thought he was looking a bit yellow this morning, so they ordered a liver panel. Everything looked fine, but his bilirubin was a bit low (it would be high with jaundice). The TPN can cause some issues like this because TPN is processed by the liver. So, it's working harder. I'm sure it will resolve once they get him off the TPN, and it looks like that won't be a problem since eating is going well.

LiveStrong,

Amy

Latest Idea

The surgeon thinks there is still a partial blockage, which could cause some problems, and ultimately feel Andrew will need surgery. However, they want to try to postpone it as long as possible and try to get him healthier. The current idea is to send him home on TPN and allow water only. After a few months he'd be further out from chemo, and possibly in better shape nutritionally. He weighs about 126, down from 196 in June. They think he could gain on TPN. At least he could improve is prealbumin number which was at 3 earlier in the week, should be closer to 20. If they could get him in better shape for surgery, they could go in to operate on the obstruction.

Right now this is just an idea they are tossing around, we'll have to see how things go over the next few days. Right now Andrew is feeling really full even with a small amount of juice. The doctors feel this could be a result of the partial obstruction.

I guess time will tell. He did get the NG tube out today, and after several Kleenex, he was feeling much better. Much easier coming out than going in. :) Though there is a risk that it may have to go back in he felt it was worth it, just to get some relief from the nostril tube.

LiveStrong,

Amy

What a week!

Hello again, it's good to be back. I had all kinds of funny stuff to blog when they were giving me regular morphine. I am just very humbled by this experience and I continue to pray for it to be be resolved.

LIVESTRONG = Andrew

X-rays

The surgeon said today they'll do another contrast dye test to see how Andrew is digesting. If all looks good, they'll take out the NG tube today or tomorrow, and he'll start with a little water. If no nausea they'll keep stepping it up.

LiveStrong,

Amy

Can I have water, please?

Andrew is doing great! He seems in MUCH better spirits, which I guess is to be expected. :) We all are! It's been such a wonderful day, truly a gift. Andrew is just very thirsty, and can't wait for that first glass of water. He told the nurse that will be a special day. :) He keeps asking, but of course, the doctors are hesitant. The bile is continuing through his system with no problems, so it would seem that the blockage has past. Yeah!

What a roller-coaster! Yesterday the two options were horrible or worse, and today was just such a relief. We were all very terrified, and today very grateful. Thanks to everyone for all of the prayers and support, the calls and e-mails. It means so much to have such a network of people available to help, and friends who truly care.

LiveStrong,

Amy

Power of Prayer and Positive Thinking :)

We talked to the doctor again. He said the surgeons feel that a CT would show them what they already know, that the bulging pressure is gone, because the blockage allowed the bile through. So, they wait to see if Andrew keeps moving bile through. If so, in a couple of days they'll take the NG tube out and try some water. If Andrew doesn't get nauseous or vomit, they'll try a bit of food, and so on. Right now, they just aren't sure if the blockage was forced over to allow the building pressure through and eventually the pressure will build again, or if there was a plug that has actually passed.

Whoo!!!Hoo!!! I'll take it for now, and hopefully the news just gets better.

Amy

Update

Just about 10-15 minutes prior to them coming to get Andrew for surgery. He had a bowel "explosion." (Sorry, but that is the best way to describe what happened). :) Anyway, that could be a VERY good sign. The contents seemed to be bile, and they tested it for blood, and there was blood present. It didn't seem that this was a blockage that would pass on its own, so we're not positive exactly what happened. The internal medicine doc says that maybe the pressure building for so long could've forced its way through. Anyway, the doc called the surgeons and they've held up the surgery. I haven't heard from the surgeon, but I'm assuming they'll want a new CT scan to see
what the blockage looks like at this point.

Keep the prayers coming!

Amy

Surgery Today

Andrew is going in for surgery today. They have warned us that this will be a very difficult surgery, and they gave Andrew the option to go on hospice. Andrew is determined to eat again. They told him no promises, and he said that if he does nothing he definitely won't eat again. So, they will go in and see what they find, and if there is anything they can do to make him more comfortable they will. It could mean a diversion rather than a resection of the tumor/tissue. Their concern is not the removal of cancer (if it turns out to be tumor), but making him feel better.

Andrew says, "Stay Positive, LiveStrong"

What Condition His Condition Is In

Andrew has recently developed a significant bowel obstruction. It seems to the doctors that this is a mechanical (tumor, scar tissue, etc.)blockage, and will require a very difficult surgery to resolve it. They have been withholding food and draining the stomach via NG tube to let the stomach/bowels rest. Once they've confirmed that it is a mechanical obstruction, we will begin plans for surgery.

We're in hopes that we can find a local surgeon willing to and confident about performing the surgery. Dr. Jacobson (IU)referred us to a colleague (very highly recommended trauma surgeon) at university of Oklahoma hospital who has given us recommendations for surgeons at St. John's, but also she would be willing to have him transported to her group at University of Oklahoma hospital in Oklahoma City if necessary.

Andrew's oncologist has great concerns about Andrew's ability to handle a surgical procedure. He said if it were his personal choice, he would not do the surgery. He says Andrew could opt to go home with the NG tube and IV feeds and that could sustain him for a few weeks to a month. Andrew says he doesn't want to starve to death, and that he will go ahead with surgery and take his chances. Based on nutrition tests his prealbumin is very low, which does mean that he will be a poor prognosis patient for surgery. They've since changed his TPN to a higher fat/protein content so he's getting over 2000 calories, which is a good amount considering how inactive he is. Even with a successful surgery, and making it through recovery okay, this will be a big set-back, as Andrew will not be able to continue chemotherapy for some time. If this is tumor in the bowel, it could likely come back, and cause new problems shortly. However, the surgery would possibly bring some relief and the ability to eat again.

Tomorrow morning we should have a plan of action. We were warned by the internal medicine doctor that the plan could mean surgery as early as tomorrow. Andrew received a contrast dye test, and they've been taking x-rays every hour to check the progress. Last check the barium was moving through, but hadn't reached the area of concern. So, keep your fingers crossed.

Hopefully I wasn't rambling to terribly, and some of this makes sense. :) I'll keep everyone posted.

Send lots of prayers and good thoughts our way!

LiveStrong,

Amy Molenda