What everyone
wants to know:
·
No cancer was identified in Jen's sentinel lymph
node and the tumors looked better (smaller) than the doctor expected
·
Transplant reconstruction looks good (or “great”
if you are the reconstruction doc), the next 48 hours are critical to ensure it
sticks and there’s no complications with clotting
·
Jen’s in a lot of pain (7 of 10), nauseous due
to the narcotics and that’s with the morphine and “pain ball” in her stomach
that has her abdomen completely numb – BUT she looks great!
·
Next steps on the journey:
o Get
past the next 48 hours w/o clotting or infection and get discharged from
Highland Hospital on Sunday (visitors limited to 2 at a time (and welcome), no
one younger than 14 because it’s flu season, but no hour limitations)
o Receive
final pathology in 10 days followed by a “conversation” between her surgeon,
oncologist, and reconstructionist to determine if chemo or radiation are going
to be necessary – indications continue to be that this is not likely – great news
at this stage
o Get
better and begin recovery – in the near term requiring Dave to effectively
empty three drains 2x-3x a day for the next 10 days or so and Jen to keep her
sanity
How we got here:
Jen got even more sick over Wednesday night, if that was
even possible, which as you can imagine had an extremely calming effect on her
anxiety level which for fun and excitement we decided to amplify by taking my
partners in crime - Will and James to her nuclear injection at 8:30 in the
morning. This is the shot that provided the marking liquid so that the doctors
could find Jen's sentinel lymph node during surgery. While the shot hurt a ton,
it was a smaller needle and a helluva lot less painful than the hollow needle biopsy
she went through in October and was a non-event otherwise. It was delayed 45
minutes leading to a little more uncertainty about when surgery could occur as
there was supposed to be a 4-hour delay between the injection and surgery. Jen
tried to get an answer as to whether she would be going in for surgery that day
- in an attempt to avoid the shot. No luck as it turns out in Rochester the
only inhibitors to major surgery are a fever or green phlegm. If you have
neither you are good to go. Cough, congestion, runny nose - those are all
distractions for those of us that obtain their real time degree via WebMD such
as yours truly. In any event the nurse said - this is a pretty simple procedure
– “just head down to same day surgery. Uh-no. Jen was like this isn't
"same day" I'm going to be here for 4 days. "No kidding."
So we left the hospital to drop the boys off at Jen's wonderful brother and
sister-in-law’s house for the evening/weekend still not knowing whether surgery
was going to happen.
Upon our return, Jen was admitted and immediately struck
a chord with the admitting nurse who was a trip.
Nurse: Name?
Jen: Jennifer Weaver
Nurse: Husbands last name?
Jen: Kuder
Nurse: Hmm...are you going to take his name? Kuder-Weaver
or Weaver-Kuder?
Jen: Probably not
Nurse: You know I grew up in this neighborhood where the
field where everyone used to play soccer on the weekends was on Beaver St. The
cross street was Eaton - so everyone just said in response to the question what
are you doing this weekend – “Eaton Beaver”. “Kuder-Weaver”, that's in the same
ballpark - good decision.
Jen: I love her
It became fairly evident around that time that they were
likely going to allow Jen to go into surgery. With the caveat that it appears
that things have turned out excellent, I can't say that the next 45 minutes
gave me any more confidence in the near term hope for our medical system. From
the admitting nurses saying it was going to be a 3-4 hour procedure, to the
reconstructionist saying his portion alone was going to be 5 hours alone, to our
surgeon saying, I just looked at the MRI and the tumors look further away from
the skin than I thought. (No kidding, I’m glad that was on your To Do’s 30
minutes before you head into the OR.) Our admitting nurse said we would not be
seeing the reconstructionist before she went under anesthesia, however the surgeon
suggested it was supposed to happen. “He's in the OR now (presumably conducting
surgery) let me just wander in there and get him to come out now and see you.”
Pretty casual around here at Highland, eh? Sure, why not? It’s not Jen in
there. (Also interesting was realizing that in the middle of Jen’s 7 hour
surgery, that the reconstructionist got to take his 30 minutes for lunch. Never
thought about that – I guess that makes sense, we all have to eat.) Soo…doc
comes out and they have the meeting of the minds in front of Jen about how this
surgery is actually going to work, where they are going to make incisions, what
they are both trying to accomplish, etc. Total time together, about 3 minutes
and that's generous. As Jen and I were chatting this AM, it's not even clear to
us that the reconstructionist had planned to take 2 flaps (basically one from
each side of her stomach, significantly complicating and lengthening (doubling)
the overall surgery time) before that exact moment. Now you (or I) could make
the agreement that they could have met months ago, with Jen and discussed it,
and it would have taken the same amount of time, with all the logistical
hurdles of making that happen with two very busy and in demand physicians, thus
why they do it 30 minutes before game time. I guess I was hoping that this was
more than a 3 minute discussion and a little more back-and-forth. Isn't there a
better way? My take was it was apparent that regardless of the facility we were
going to use (Cleveland, Strong, General) they all were going to use a similar
approach. Disconcerting but apparently the best blend of efficiency and
effectiveness in today’s day and age. Never had an opportunity to see the
Nip/Tuck operation and artistry first hand, all I can say is the magnitude of
tissue they took out of her stomach was significant – think of a smile starting
at each hip with about 6 inches at the center. This was my first time meeting the
reconstructionist in person and he was solid – the kind of individual you would
trust your loved one with, someone who it was apparent had the confidence and
conviction with what he was about to do to not talk about risks and was focused
on the outcome/results. Similar with her surgeon. Would recommend both without hesitation. The system/process - not so much.
And I was off to
the waiting room at about 1:15 - a one-hour change from her scheduled time of 12:15.
She finally went into surgery around 2:30. My first call was from the surgeon
around 4:30 to let me know the good news that the initial sentinel node
pathology turned out negative but she looked good and had several hours to go. No
news until 8:30 when I was paged (she was the only patient still in surgery at
this point, they had started vacuuming the waiting room and locked up the front
door) to let me know they were just starting to close up and it would still be awhile.
Doc came out at 9:30 to let me know he had just finished and things looked
great. I don’t remember much from the conversation other then him reminding me
there are not many folks in the world that would even attempt this and while
this type of surgery normally takes 12 hours, he does this so often, he can get
it done in 6. Hey, at least he’s modest. ;) He noted there was some significant
complexity beyond the normal for Jen (as he had to tie together 2 arteries and
2 veins complicated by some former surgery in her abdomen from a prior C-section
and combine them to replace a single breast). I was finally able to see Jen
around 10:45 but she wasn’t really conscious through the evening (or was that me)
until this AM. He’s either really bad at managing expectations (which I can’t imagine)
or she’s going to look fantastic as he was very happy with the result. She’s
now in recovery, sleeping on-and-off, and will be here until Sunday at least –
assuming everything goes well. They are checking her transplant with a Doppler device
every hour to ensure blood is still flowing and will send her back into
emergency surgery if there’s a clot or complication. She won’t be eating solid
food until tomorrow and has to sit in a recliner to minimize the chance for
fluid to collect in her lungs. (i.e., pneumonia). She’s up for visitors but
Saturday is probably better given she’s drifting in and out of sleep today.
Apologies for the length (and delay) of the post – until our
next update.
