Monday, October 31, 2022

Recovery Day 14

2 weeks ago he was in the LONGEST surgery! 


Thank you for the prayers! Today has been fabulous! He has movement! Everything is working again!


He got the tube out this morning! He started back on a liquid diet!


He had a shower! And we went to the observation floor again!


He also admitted he has overdone a little bit the past two days. He walked like 9 times yesterday for a total of 2.67 miles. So we are taking things a little easier today!


Pray he continues on a successful recovery and release with no setbacks. 

Sunday, October 30, 2022

Recovery Day 13

Thirteen Days! He's doing AMAZING! Over 2 miles walked yesterday. Amy and Alan enjoyed the Observation Floor and the Astros win!


Today Keith came and hung out during the morning, while I got the house back in order and went to H‑E‑B. Before I got here, Alan had already walked 1.34 miles over 6 walks. We have walked twice more, including a lengthy visit to the Observation Floor. We had a great view of the NRG! 


The big news of the day is that at 9 am, he started a gravity test on the NG Tube. A gravity test is where they disconnect him from the suction for 4 hours. And then for an hour, they connect him back to suction to see how much is removed from his stomach. The goal was to have less than 200 ml suctioned out. He passed! He only had 50! But we still haven't seen much out of the end of the bowels. So Dr. Ylu (Classy) and we agreed to keep the NG tube overnight. We would rather not have to redo it again! So he is back on ice chips now and waiting for movement!


Before I leave for the night, we will walk at least once more, maybe twice! Pray for everything to move along and for more progress tomorrow!


- Mel

Saturday, October 29, 2022

Recovery Day 12

So not going to hide anything. Today sucked. We are struggling. Both of us. The waiting game is hard. The body has its own schedule and it doesn't match what we wanted or expected. 


Early on we were told that the average stay is 10-11 days. But they always plan for at least 14 days inpatient. Alan told me his goal was 9, and I admonished him that his goal is whenever is best. Dr. Wise One told us the other day that his patients have the longest stays of any surgery.


Alan is struggling with nothing happening. I am struggling with nothing happening. We are struggling with it being the finals of band season and him being in the hospital and not at competitions. 


So tonight I FaceTimed Alan and his sister, Amy, from UIL Area Finals, which I raced to from the hospital. 


We are trying to focus on the positives. While that has been hard today, here are my positives. I successfully changed the colostomy bag!!! We went to the observation floor again today! And then when I could tell he was really not good, we went outside! He will have walked over 2 miles today! And some really good buddies texted and called to encourage him! 


So while I would give the day a C overall, we can always find bright spots. We just have to look!


And Go Astros and Go Aggies!


- Mel

Friday, October 28, 2022

Recovery Day 11

Thankful God is with us. This setback could have happened after Alan was released. We could have been rushing him down to the MDA ER. But God. His timing is perfect. He allowed this valley to occur the night before release was suppose to happen!


This morning at around 3:30 Alan had the NG tube placed again. It was definitely the right call. The amount it immediately and has continued to suction out of his stomach explains all of vomiting and nausea. 


All the doctors have concluded that his bowels and stomach all decided to shut back down. They said Psych! Given the trauma they have been subjected to, I can't really blame them. Dr. Wise One, Dr. You, and their teams have all reassured us that this is common for HIPEC patients. So we will keep walking to wake up his GI tract! 


By 3:30 he's done almost a mile around the floor today. I expect it will be close to a mile and half by the end of the day. 


There isn't much else to update. We are just playing a waiting game for his organs to stop playing games! They need to wake up and work. No estimated time of departure from this place until he is back off the NG Tube. 


Prayer Needs:

  • Competition for girls and TWHS Band tomorrow
  • Patience
  • GI Tract to work and stop playing games
  • Wisdom for doctors
- Mel

Thursday, October 27, 2022

Recovery Day 10

Alright so today has not been what we planned. And trust me it has totally gotten to me. I am mad. He was suppose to come home! I am tired. There is a reason I don't work in town! I am sad. My girls haven't seen their dad other than FaceTime since 10/16! I am angry. Cancer sucks and even after it's gone the effects still stay!


Alan has continued to be nauseated all day. He hasn't vomited since before 7 am. But he is on 3 different anti-nausea meds to try and control it. If he vomits again, they will place the NG tube back in. So yay, prayers are working for 9 hours now. 


Take that back. He just vomited at 4:10 as I was writing this. 


I HATE CANCER!


Both Dr. Wise One and Dr. Big Sis stopped by. Dr. F reassured us that this is not a stomach bug but quite normal for Shake N Bake patients. He believes in 12 to 36 hours Alan will be better. Dr. Big Sis defers to Dr. Wise One's insight on HIPEC. He also said that his patients have the longest stays because of this very thing. The recovery is not a straight vertical line like most surgeries. It has a lot of hills and valleys. We have hit the first valley. 


Lord, please stop the nausea and heal my husband so he can come home!


- Mel

The Setback

The setback. He was bound to have one right? I mean he can't just fly the coup today like we were planning yesterday. Yep, you read that right. When Dr. F came by with the fabulous pathology report, he told us he was going to cut us loose today. 


Funny how quickly things can change. Which is why I didn't share that tidbit until we were walking out of the hospital. I've learned with this SuperUnicorn, that things and plans can change on a dime. 


Last night after having some gas trouble in the early evening. Alan battled nausea and then at 2 am began vomiting. They did X-Rays and said that Dr. F would make the call on what to do this morning. So at 4:30 I left to make sure I got here before any doctors came by. 


One of Dr. Big Sis's fellows came by close to 6:30, not long after he threw up massively again. She hadn't seen the X-Ray but was concerned since they had moved him to nothing by mouth again overnight. She said the last drain would come out today! Yay! But that she would coordinate on his troubles with Dr. Wise One's team. 


With 5 minutes, Dr. Classy, one of Wise One's fellows, stopped by. She said the X-Ray showed no obstruction and his white cell count was elevated slightly yesterday. She is hoping he just somehow caught the 24 hr stomach bug that is "going around." The plan is to monitor him and if it gets worse then they will put the NG Tube back in. He does not want that. He would do anything to avoid it. 


So we need some prayers. Prayers for whatever is plaguing his GI System to go away! Prayers for NO NG tube replacement. Prayers for no more setbacks. Prayers for his heart as he was ready to come home. Prayers for patience. Prayers for wisdom for the team, specially Dr. Wise One (Fournier), Dr. Classy (Ylu), Dr. Bubbly (Dana) and Dr. Big Sis (You) and her team. Everyone else had cleared him to be discharged today. So prayers for their wisdom on when that is now realistic. 


Thank you all for walking this journey. 


- Mel

Wednesday, October 26, 2022

Pathology Report

What a mighty God we serve! What a mighty, mighty God! 


Of the 13 areas that were taken in surgery, 1 was Mooney with active present cancer. To quote Dr. Wise One, "which would have killed you." Pathology showed that it had been altered by immunotherapy and still had cancer. Thank God for Dr. Big Sis and Dr. Wise One operating. 


4 other areas that they removed while suspicious had no evidence of cancer ever having been present. Huge praise!!


The 8 remaining areas all had evidence of previous cancer. BUT currently there was none! So while we only ever saw 3 tumors on the scans, at some point there were 3 times that amount of tumors. It appears immunotherapy worked on all but Mooney! 


Additionally, all 16 lymph nodes removed were negative for cancer! All around an incredible report. 


So while Mooney was a stubborn little booger! A scalpel took care of him! And all visible signs of cancer are gone. NED - No Evidence of Disease so far with another set of tests and results coming back in 6-10 weeks!


Next steps: 


Discharge

6-10 more weeks of recovery

Follow ups next week

CTDNA Blood Test in 2-4 weeks to test for microscopic evidence of disease

CTDNA Results 4-6 weeks after test m

Regular Follow Up Scans etc


From this point forward, Dr. Dude, Dr. Big Sis and Dr. Wise One will be actively following Alan! We cannot begin to express our gratitude! While we still have a long way to go on his recovery and on adjusting to some permanent changes, he's here! Praise the Lord, he's here. 


Thank you all for your prayers! This could not be a better report! Thank you, thank you, thank you!


Recovery Day 9

He's doing so well, but there have been challenges. And there definitely still will be while he recovers at home. Yes I said home! We aren't there yet but getting much closer!


Today will be known as Drains be gone day! All the drains from plastics are gone now! Dr. F's fellow removed his drain today! Now we just need Dr. Y's drain, and he will be tube free!


We took two big walks! We went up to the observation floor again. And then later we went down to floor two and walked around "The Park."


He is struggling with some stomach gas issues this evening. We are praying that gets resolved soon. Otherwise it's been a good day!

Tuesday, October 25, 2022

Recovery Day 8

Two more tubes are gone!!! He's down to "just" three drains and the IV is in but not connected! Alan was able to eat more today! They also gave him the 4 vaccines he needs since he no longer has a spleen. 

This morning we took an adventure walk! Alan wanted to ventured off the 10th floor and went to the Observation Floor! Such beautiful views! It was a big walk and three different elevators involved. I was so proud of him. 

We also had the pleasure of a visit from one of our dear friends, Paul. Mr. Brown has been texting Alan and I daily throughout his cancer journey. It was wonderful to spend some time with him. 

There has been some issues with his colostomy bag. We are working through them. A lot of this will be trial and error as we figure out what works. Part of the challenge is how close it is to his incision. The other challenge is that just learning his body and what's going to work for him.  

Lord, give us and the doctors wisdom. We have lots of little details and things we are working on before release. Pray for the rest of the drains to go. Please also continue to pray for the girls with school and UIL Area Competition this Saturday.  

- Mel

Monday, October 24, 2022

Recovery Day 7

What an incredible day! So a full night without the NG Tube was much easier on his ability to sleep! 

First thing this morning he was moved to soft foods! So breakfast consisted of eggs and half a banana! Then lots of walks!

We received some training for when he gets released. Yes, those discussions are starting! That's a great thing. His epidural was capped to test if he was ready to have it removed. He was also switched to oral meds!

He had some lunch as our awesome pastor, Justin came by for a visit! Alan enjoyed the visit, but was tired so it was short. His fabulous wife, Jennifer brought me lunch and I got some girl time!

When I got back from my lunch date, Alan's epidural had been removed! His mom also came to visit! After a nap, his catheter was removed! More walks! And more walks! 

Then the best news of the day! HE HAD A SHOWER!!! It was challenging with 4 drains and an IV still in place, but he managed with assistance! Now we are walking after his grilled salmon, mashed potatoes, and strawberry jello dinner. 

Dr. Wise One said this morning that he has never seen someone walk this much! I cannot sing Our Lord's gracious praises enough. He has managed Alan's pain and given Alan incredible strength and fortitude for this fight! I am so grateful for a man who fights this hard! 

- Mel

Sunday, October 23, 2022

Recovery Day 6

Grateful. Beyond words grateful. Amy Bush Amspoker, you are such a blessing to your brother and I. 

Yesterday Amy was Alan's allowed caregiver. She was incredible in helping him and keeping me informed. Yesterday was hard on Alan and I. Being apart since his first diagnosis has been hard. But leaving him in the hospital while I did Homecoming with the girls was harder. Amy was his cheerleader when I couldn't be. 

Yesterday, Alan had a fabulous day. He walked more times than ever for well over 1/2 a mile total. Impressive! He battled with a low grade fever but that seems to be gone now. He did another NG Tube gravity test and at 10 pm last night they concluded the tube needed to go! So he has 1 less tube, the one he has been so desperate to get rid of!

This morning I got my first text in a week from my husband! I have missed seeing his notifications pop up. We texted briefly and then I hightailed it down here the minute the freshman girls had been picked up from the sleepover! Oh how I have missed this face! We have already walked a couple of times together and he has walked a few times without me. 

Today he gets to start clear liquids VERY slowly. So we ordered some jello and apple juice! We will see how he tolerates little sips/pieces of that. He's hopeful to get the epidural out tomorrow, as they told him it definitely stays for 7 days. So we will see!

The key things between now and release are walking, removal of "tubes" - drains, epidural, etc, and toleration of nutrition by mouth. But this is a SLOW process. You can't rush this. So my focus is on keeping Alan encouraged while the progress will seem slow. And starting to have important discussions we haven't been able to have while he had the NG Tube. 

Prayer Requests:
  • Continued strength and protection for his body 
  • Continued mental stamina
  • Safety for Mel traveling back and forth
  • Girls emotional fortitude
  • Girls time management with a game coming Friday and competition all day Saturday. 
  • Positive discussions and eduction on how we help him heal best
  • All of our fears
  • Awareness of the gravity of this and of how to handle each other
  • Wisdom for Alan with his medical care
  • Fatigue
  • Alan being cautious with overdoing 
  • Pathology results - clear margins and all really gone. 
  • Sleep for Alan 

- Mel 

Saturday, October 22, 2022

Recovery Day 5

Alan walked 7 times yesterday for a total of 1200 ft, but his body was not ready for any more tube removal. When you think of all his body went through, it's truly amazing he is walking! Let alone already lost some tubes!


Last night's nurse was wonderful! This is a huge praise since I left before meeting her. He did have some NG Tube issues during the night that the nurse couldn't get corrected. However, she was engaged and tried everything she could and then she called in the doctor to resolve it. 


While waiting on the NG Tube to be resolved, Alan walked two laps in the middle of the night. Never one to just sit around!


Nurse L this morning seems good! Amy is with him most of the day. She said he is very tired from last night but in good spirits. He already walked 2 laps again this morning. So before 8, he's two walks and 600 ft down! Way to go, SuperAlan!


While being apart from him is hard, I knew I was where I was suppose to be last night when Rebekah saw her Fathead in the stands during the performance! It was such a joy to see the whole show for the first time! And they killed it! It was also nice to see so many students stay and watch the band! These kids work so hard. Two weeks til BOA Super Regional and State! Pray that the girls enjoy every moment of this time together in band!


- Mel

Friday, October 21, 2022

Recovery Day 4

 Alan got a better night's sleep than he has since getting here! Huge praise. He did not walk again after I left because he knew he needed to rest!

Sadly he hadn't had much assistance from the new day nurse. So when I got here just before 8, I waited to see what this new nurse was like. 


When the comment about something he said to her came up a couple minutes later and the response was, I'm sorry I hadn't been paying attention, I was done! So I go into Alan Lawyer mode. So Nurse J, how long have you been at MDA? Since Feb. And how long have you been a nurse? Since Feb. 


Alan emphasized again how he wanted to get up and walk. She said she had two more patients to do meds for and would be back. I asked if Caleb (friend of Matthew) who was also helpful yesterday could help. She said he is on other things today and said she would be back at 9:30, that was over an hour away. 


Nope, nope, nope. So I went looking for the Leader Nurse Alice who assisted Matthew with getting some things he needed yesterday. I couldn't find her but happened across the floor manager, Dan. He listened to my issues and immediately jumped into action. 


Alice came and assisted me in getting him out of bed and then he walked the hallway (not around the pod) which is 50 Ft longer.  Then he sat for a bit before walking again!


Dr. Wise One and Dr. Bubbly came by. They were in great moods and gave us great news! He is now doing a gravity test on the NG Tube! If by 3 he passes it, they will remove the NG Tube! This would be massive! Also they said he was good enough to not have to wait on the nurses to walk!!


So we've done 4 walks of 800 total feet already today since I am able to help him with all the tubes! So proud of his drive. The four teams of docs that check on him daily emphasize how important 2 things are: walking and breathing exercises!


If you know Alan, you know how fixated he can get on a mission. Well the boy wants the NG Tube out! The quickest way to accomplish that is walking. So he is hyper focused on walking!


Please cover Alan and I as I have Homecoming duties with the girls from 7 tonight until 10ish Sunday! Others will help him and be the bulldog for him if needed, like I was today. Being apart may be the hardest phase as I am able to anticipate his needs. Also I am nervous what nursing staff will be like over the weekend. Without me here, esp. Pray that I can be fully present with the girls for this major event. Pray for Alan's heart with not being able to be there for Homecoming!


- Mel

Thursday, October 20, 2022

Progress and Regress

Today at MD Anderson was a good day. Spoke with his patient advocate about a few issues (night nurse and clergy visits) and it was super productive.


Alan continues to make progress. But considering what his body has been through any steps forward are progress. He is obviously not getting better overnight. And I think he's accepted that. 


Hell was his descriptive word of choice for how he is today. And I can think of no better description. His body has been cut into pieces on the inside, put back together (kinda) and then scraped, scalded with hot chemo and shook for 90 min while they tried to get the chemo to go everywhere. Then he was stitched back up. 


His body is obviously distressed. His fatigue is insane! You try having chemo inside your abdomen! His drive is intact, but while his spirit says go, go, go, sometimes it is all he can do to grunt. His body, mind and spirit are not currently in sync.


I don't know that I have the fortitude to do this procedure. My husband is BAD ASS! Sorry but that he is willing to try this Hail Mary play to live longer to be here with the girls and I is like Next Level Warrior! He is stronger than all y'all! No offense!


Today his goal from the team was 3-5 times walking. He had walked 5 times when I left for a total of 7 laps. He planned to walk once more after I left for 2 more laps to "beat yesterday." So I will let you know in the morning if he met his personal goal!


He also had a couple of new or advancing side effects! His swelling has continued to increase, but this will hopefully subside some in the coming days but could be a problem for several weeks. Chemo sucks! Also, he has developed a couple of blisters that we are watching and trying to treat with care to avoid having bedsores develop. It's not like the boy can stand around all day, YET!


Praise, our nurse, Matthew, was an incredible help to Alan and I.  Having a male nurse to help a male patient with things he doesn't really even want his wife's help with was AWESOME. Matthew truly lived up to his name (gift of God) with his assistance, encouragement and conversations. Plus I loved his Jehovah Rapha and Philippines 4:4-6 tattoos!


Wednesday and Today I have been getting out of the house before or as the girls leave and getting home around 8:30 to 8:45. Tuesday and yesterday I crashed pretty hard and very fast. Tonight, the girls waited to eat with me, but sadly things did not go well. Fear mixed with stress of Homecoming Week has one daughter really struggling. And the other daughter struggling not to co-parent. This is 6 years of tough crap. And that's a lot for me to deal with. Now try being a TEENAGE girl! Yeah... this is not for the faint of heart as a kid or as a parent of a kid. 


There are scars from the last six years that I didn't reference in my I Hate Cancer post from last night. The things I could write about the impacts this has had on each girl could fill more blog posts than anyone would read! 17 and 14 is tough, period. 12th and 9th grades are tough, period. Dealing with cancer since 8 and 11 is tough, period. Add all that together and again I'll use Alan's word for today, it's Hell.


So tonight I covet your prayers. I am not going to give a list because it would take too long to get it all! So my cliff notes version: that we have Matthew again tomorrow, Audrey, Rebekah, Alan, Me. 


Thanks again for walking through the realness with us! I'm grateful that we have HOPE in Christ or else I don't know why any one of us would choose to still battle on. 


- Mel

Recovery Day 3

Last night was so much better! Praise the Lord! First I didn't leave until I met the night nurse and as the Lord would have it, his night nurse was Sonny. She was his nurse Monday night when he got to the TPACU. She was so apologetic that he had such a horrible experience the previous night. 

He had a better day yesterday than Tuesday which was awesome! We had expected some setbacks. But instead he ended up doing 6 walks of 8 total laps. A lap is 150 ft. So 1200 ft yesterday. He also asked if he could not have the blood pressure cuff at night. Dr. F agreed his vitals had been fabulously stable! So they downgraded his monitoring to that of a regular floor patient! Which meant if a room became available on a regular floor, he could be moved! Sonny promised me if he was moved she would ensure the new night nurse would take good care of him. And he did get moved!

The other advantage to being on regular monitoring, he got his arterial line, heart monitor, blood pressure cuff and pulse ox removed. 4 less cords to contend with every time he moves! Plus a 3rd IV line was taken out earlier in the day! So now instead 3 IV lines, there's only 1! And instead of 13 different lines coming out of his body, he's down to 8! We are hoping 1 or 2 more go today!

So goals for today:

  • 3 to 5 walks
  • 3 to 5 sitting in a chair
  • A shower!!!
  • Continued Pain Management
  • Continued increase in alertness
  • Good day and night nurses! Day have been fabulous. Last night's nurse didn't know what one of his tubes even was! 
Thank you all for caring and your continued prayers and support. This has been a lot harder on him that he anticipated. 

- Mel

Wednesday, October 19, 2022

I HATE Cancer

I'm currently sitting in our bed alone crying. No not just crying. Bawling. 


Please know that I don't regret the choice I made last night to go to the band thing or the choice I made tonight to not go to the Homecoming Parade, Pep Rally and Senior Band Parent Skit. I refuse to regret. But I do still mourn the choices I must make. 


Cancer has taken so much from my family for so long now. And I hate it. My girls have missed out on the normalcy of life for 6 years. I hate how they have each lost friends because they cope with things differently than others and that isn't always compatible. I hate that some school assignments are triggers for them. I HATE that they worry about their dad dying. 


I hate cancer so much that as I get pictures sent to me of my girls having fun at their ONLY Homecoming together, as I watch the video of the senior parent skit we should have been in, I can't stop the tears from falling. I hate it so much. Like major curse words hate it. Like punched in the gut hate. I'm tired of having things taken from my family because of this horrible, awful disease. 


I hate watching my husband struggle to stay awake. I hate watching him plod slowly around the TPACU when he was running 5 miles just a week ago. I hate seeing the effects this surgery is currently having on his body, his spirits, and his energy. I $/):&;&/(:);&:):&:):(/&- HATE cancer. 


So while I hate something with a passion so deep in my core that could make me bitter in no time flat, I have learned I have to find the positives. It's why I keep doing daily positivity posts. To keep my focus on God's goodness to keep from growing bitter about all the things cancer has taken from us. So to the bitter, small people in the political world that have mocked me for my positive posts, Kiss Off! Because I will continue to find positive no matter what because I refuse to become bitter!


Tonight my positive is my husband is HERE enduring the HELL that is the recovery from this surgery BUT he is here. And every day I have with him is joyous! Because there is no better man here on earth. This man is a warrior unlike any other! He walked 5 times today with a total of 7 laps! He walked 1050 ft, less than 48 hours postop! He is killing it. Because he is determined to not let cancer OR the treatments of cancer kill him! That is a warrior! 


To my incredible friends in their own cancer battles or with a spouse, child, parent, or friend that have battled or are battling, YOU are all warriors! Fighting is what makes us warriors, not victory or defeat! Fighting. Sometimes for that next step, that next treatment, that next battle, or that next breath after our warriors are gone. We keep fighting, determined to find the positive, determined to find God's goodness in the midst of our living hell. 


To all of you warriors, I see you, I pray for you! Battle On!


-Mel

Recovery Day 2 Morning Update

"I missed you. So glad you are here."

"How was last night?"

"My night nurse was awful. I didn't get any sleep."

"Were you in the chair all night?"

"Yes she never offered to get me into the bed."

*****

So that's how my wife guilt is going right now. I am not leaving until after shift change tonight and I speak with the night nurse. IF I leave. 

Now for the good news. PT came just after I got here this morning. They got him up quickly and he went on a FULL lap around the TPACU. 

Goals for today:

  • 3 more times of 1 lap
  • 1 time of 2 laps
The anesthesia is now out of his system so he's starting to feel the pain more. They are giving him a lidocaine patch for local numbing on his abdomen. They are bumping the epidural up by a 1/4th so he still isn't back to yesterday's level. But it is more to combat the anesthesia going away. 

Prayer Requests:
  • That I don't flip out on the charge nurse about last night. 
  • Pain management
  • Continued progress
  • Rest
  • That the girls and I stay healthy with the cool front and activities. 
  • Wisdom for today's team
Thank you for walking this road with us. 

- Mel

Tuesday, October 18, 2022

Recovery Day 1 Evening Update

Tonight was UIL Region band competition for our girls and TWHS Band. I am so grateful to our band framily for their support of the girls, Alan and I! Tonight for competition some other framily joined to love on the girls. Thank you ladies for coming and watching with me. 

Always thinking of others, true to his core, Alan insisted that cancer would not take anything else from our girls and that I would still attend every competition. So tonight I left him, watched the best HS Band on the planet and came home to actually sleep. 

Dr. Wise One came by and said he isn't surprised at the small struggles Alan has had today. He said he expects tomorrow to be similar if not worse. Coming off of the anesthesia and with the epidural, Alan's blood pressure plagued us for most of the day. He was running low already and then when he would stand to try to walk, it would bottom  out and cause lightheaded was making it impossible to stay standing or to walk. 

After multiple attempts, they tried tapering back some on the epidural, reducing it by a third. This did in fact help enough that Alan was able to have two small walks this afternoon. He is in no way ready to run a marathon but I am sure in no time, he will be! His attitude has continued to be awesome. 

The other side effect of the anesthesia and pain meds (not to mention having gone through such MASSIVE surgery) is that his body is exhausted. Conversations of any length take a toll on him. He struggled today to keep his eyes open during interactions even as short as 5 minutes. This too got a little better with the reduced epidural meds. 

So right now we are figuring out that fine line on how to keep his pain reduced and to stay awake to do the things he needs to in order to get better and break out of MDA eventually. 

He did do super well with his breathing exercises! He also sat in the chair all day! Super job and stood roughly every two hours to either try to walk or to walk! So he met 3 of the 5 goals for the day! Tomorrow we will be shooting for the same goals.

I will update in the morning if anything overnight to note. Otherwise I may just update at the end of the day. 

Thank you all for the texts and calls. Please understand if I don't respond right away, I will eventually. Alan may not be up to communication with the outside world until Friday. We will just have to see! We take things day by day and based on how he feels at the moment.

- Mel 

Recovery Day 1

Alan has been moved to the Transitional PACU. This is like a step above a regular floor but a step below ICU. Dr. Wise One (Fournier) sends his patients here for 3-4 days because they have specific protocols for dealing with HIPEC patients that are more than a normal floor can handle. 


There are five patients in our unit, with three nurses. Two of the patients are Dr. Wise One! Another I would ask you to work for patient J who had his second craniotomy for metastatic melanoma. I had the pleasure of speaking with his daughter yesterday in the waiting area and now we are here in the TPACU together!


The goals for today: 

  • Standing 5 times
  • Walking a few steps 5 times
  • Sitting up in the chair most of the day (doesn't have to be awake)
  • Breathing exercises - two things 10 times an hour each!
  • Pain management

He's been in the chair since about 6:30! He's doing awesome! He's stood twice, once to get in the chair and once since! So fabulous progress. 


Please continue to keep the above in your prayers as well as no complications, like infections at the drain sites or incision. 


I'll try to update once or twice a day. 


- Mel

Monday, October 17, 2022

Almost Done!

6 pm update:

They started the shake portion of the shake and bake around 4:30. It is a 90 minute process. So when they finish that they will transition him off that, which is "a big transition" to begin the ostomy. 

8 pm update:

Dr. F came by. There was a 2.5 cm mass in the omentum on the left side. Pinprick spots on the small intestine that were able to be scraped off. His spleen had an implant of some kind so it was taken completely. His liver had ONLY a cyst that was removed. Nothing on the gallbladder, pancreas, or kidneys!  The left peritoneum had suspicious spots and had been location of Marvin and K so he removed it completely. And his belly button had a small hard spot behind it that might be cancer so it is gone too! The PCI score to determine if the heated chemo was needed was at max an 11 but maybe less once pathology is back. After removal, they score based on what is left, 0 to 3. 3 being 2.5 cm worth left, 0 being nothing visible left. Dr. F rates Alan as a 0. The shake n bake went well. He tolerated it very well. 

Nurse called to update. Dr. Padilla is working on closing him. It's complicated and involves moving his abdominal muscles. He is still doing well. If Dr. P doesn't finish before 10, someone else will call and update me. 

Midway update? Maybe

It's about midway through... maybe. 

They took him back right at 7 am. We were here at 5 am. No traffic but a nice bit of rain on the way down. 

Surgery "began" at 7:56 according to my text alerts. And the nurse said Dr. You (Big Sis) got started at 8:37. All was good at the 10 am update. 

The 12:30 update was that Dr. Fournier (Wise One) had sent four sites off to pathology. One was the spleen (expected), one in the left paracolic gutter (one of the recurrent tumors were previously there), one in the "lower quadrant," and the omentum (again expected).  

I was surprised to hear that they had his surgery slated to go until 10 pm from the nurse, but she emphasized that it might not be that late. 

Everything has been going as expected and his vitals are strong. Thank you all for the prayers. I will try to update again when done. But seeing as I have been up since 3, it kind of depends on how late surgery runs if I will have the energy.

Sunday, October 16, 2022

Prayer Requests

I'm sure this is not an exhaustive list, so please pray as the Lord leads. But in case you want our specific requests. 

  • We will be a witness to everyone we encounter. 
  • Doctors' hands to be precise. 
  • Wisdom for the doctors as they are making decisions. 
  • All cancer to be removed. 
  • No surprises in surgery. 
  • No complications in surgery. 
  • Girls minds to stay occupied and not to worry while going about their day. 
  • Girls to stay safe and not be distracted in driving or in band (esp. with props). 
  • Peace for those that are unable to be present due to visitor restrictions. 
  • Calm in midst of busy week with homecoming and band competition. 
  • Travel mercies driving to and from med center. 
  • Wisdom for Melanie on physically where to be when and what help to request and when. 

Wednesday, October 12, 2022

Cold Brew Shake 'N Bake MOAS

Conversation went like this:


Dr. Friend: I did a couple of your surgeries in residency. We called it a Shake 'N Bake!


Alan, laughing: So wait, mine is a Cold Brew Shake & Bake! Ya know, since they lower my body temp to 38 degrees.


Dr. Friend: hahaha, yeah sounds about right!


Me: just sitting there shaking my head at them. 


So now the MOAS has a second name, Cold Brew Shake 'N Bake!


Yesterday and today have been full of appointments, while last week and Monday were full on insurance and MDA finance details. 


So last week we discovered that our insurance is a grandfathered plan and doesn't allow for the "standard of care" items the trial needed covered by insurance to be covered. In fact NOTHING associated with clinical trials or experimental drugs is covered. But in order to get on the trial, Alan had to be enrolled prior to surgery which meant financial clearance had to be achieved first via insurance or cash pay. So we have spent several days working out details on that. I am so grateful to The Lord for His provision of options. Most don't have the options I do since I still own a business. For the moment we have agreed to cash pay (not that we can really afford it long term) and put down a deposit, but will be making some insurance changes come Jan 1 for Alan. Again at this point I am just grateful we have options. 


My heart breaks for those that don't and for those on my current insurance plan. Cancer treatment is and will continue to need trials in order to eradicate it. Any plan that excludes standard of care during a trial is short-sighted and sentencing people like Alan to just wait around to die. This is wrong! 


Sorry, off my soapbox. Yesterday was a full day of appointments. We consulted with the ostomy nurse gaining knowledge on ileostomy and colostomy. We don't know for sure yet if Alan will have to temporarily have one nor do we know which one if he does. So everything we learned is just theoretical at the moment. Next Monday night, while he is probably still be out of it, I will learn more and start figuring out what needs to be done. 


After more blood work, we waited (Alan slept) on our appointment with Kevin, the anesthesia PA. Once back, it was quick and easy. We did talk more about the resection when the bag goes away (if he has to have a bag). That discussion left us with more questions for Dr. Big Sis. 


With every appointment, the reality of how major this is hits. From side effects, to complications, to recovery facts, to surgery details, all show just how serious this is. Last night as we were going to bed, Alan said, had I known, I still would have done it, since treatment isn't working. But dang, if treatment was working, uh no way! 


This morning's appointment was with Plastics. He will be the one to close Alan up and oversee any wounds or infections at the incision site. He explained how it is possible that with a "Shake 'N Bake" that bloating or expansion of the organs could occur and that he would be watching for that. It was funny today to hear the words Shake 'N Bake from one of the doctors on his team. He proceeded to praise Dr. Wise One and Dr. Big Sis, saying he has the easy job. He laughed when Alan said it was going to be a party in the OR. 


So my burning question after meeting with Dr. Padilla. The plastics doctors on TV always have good hair. Is that a requirement in Med School? In order to go into Plastics, you must have good hair? While Dr. Padilla is obviously still young, he shall be Dr. Good Hair from this point forward. 


Then as we walked away to get a snack before Dr. Big Sis's preOp, Alan had one of his wise takeaways from Dr. Good Hair. Post Op he will have "More Drains than Brains." And I joked that I am going to have to label each drain with a doctor's initial to know who to call if we have issues. His markings from radiation are now gone. His markings for the ostomy are set. So what's a little more sharpie on the body! Sorry, but if you've followed our journey at all, you know we have to find things to laugh about. 


Dr. You (Big Sis) had a long day. I don't know what her morning was like but she was 3 hours late for our noon appointment. After a quick in office procedure, we went over a lot of details regarding the removal of the tumor and resection. There are so many moving parts. We have plans A, B and C based on contingencies on how surgery goes. Everything depends on the blood supply to his remaining colon. We also discussed the potential timing for the second surgery to undo the temporary bag should he require it. 


We also discussed my idea of labeling the drains after she told us he would have a drain from her as well. She said she asks the interns to do that but "their interns" and often don't. She said it would be very smart and then we all joked Octopus Drain Boy! 


Friday brings his Covid test and virtual meeting with the coordinator for everything. Prep for surgery on Sunday and then SURGERY DAY. 


Please pray for his colon to have good blood supply and be save-able in surgery. Please also pray for the precious next 4 days - that we will have great family time and get done all we need to before surgery.


Thank you all for walking this journey with us. It's been a long year; heck, 5 plus years. Thank you for loving on us and caring. Thank you for the texts, prayers, and well EVERYTHING. 


- Mel

Wednesday, October 5, 2022

MOAS - "Mother Of All Surgeries"

Yesterday was a LONG day at MDA. Appt with Dr. Ludmir (Phineas!!) was quick. He basically said Alan will hate him next week, but this week shouldn't be too bad. So we are mentally trying to prep for that. His radiation dosage is pretty high since it is such a short course. 


We had fun discussing "good music" - Journey, Aerosmith, any rock prior to 1990! He then told Alan that we are basically going old school on his treatment plan with the radiation and then surgery quickly after. So while he will be cursing Dr. Phineas at the end of next week, surgery will happen so soon that he will quickly switch to cursing Dr. You (big sis) and Dr. Fournier (nickname to come)!


Radiation was super fast and no problem. Loved that we ran into Roy when heading to see the doctor. His spirit uplifted us so much! Some people just have a joy that is contagious! He has to be majorly blessing people at MDA like he blessed us that many moons ago at 21 Waterway! (See Alan's independent Facebook post about Roy!)


Next up was Dr. Fournier - peritoneal surgeon - he's the wise professor we all had who has probably saved more lives than anyone would ever know but if the more down to earth humble guy! He and Karen, his PA, outlined so much. The time with them was so good. We learned more than we imagined and came away with great hope in the results of the MOAS - Mother Of All Surgeries!


While Dr. Big Sis will concentrate on removing Mooney and Mooney's twin and resecting the area impacted by them, Dr. Wise One will focus on everything else. He will remove the omentum (the tumor sponge as he called it). Then he will scour every surface in Alan's abdomen and remove any peritoneal tumors. He showed us multiple concerning spots on the scan that haven't been called a tumor by the radiologist but in Dr. Wise One's experience will be. He emphasized that CT Scans are notorious for underestimating the number of peritoneal implants. For example, due to a previously noted "cyst," Alan's spleen is very likely to be removed. 


This MOAS is technically called a HIPEC surgery. HIPEC - Hyperthermic intraperitoneal chemotherapy! They remove every visible spot of cancer and then before closing him back up, they lower his body temp to 38 degrees and then fill his abdomen with chemo heated to 104 degrees. They then spend about 1.5 hours - sloshing it around in him - rocking his body back and forth to make sure it gets every nook and cranny! 


The side effects can be pretty harsh and recovery will likely take 8-12 weeks with an average hospital stay of 10-11 days instead of the 4-7 days with his original onset surgery. 50% of patients experience some complications, but most are very minor. 


To put it in perspective, Dr. Wise One emphasized how he doesn't do this surgery on 50% of cases presented to him because it just isn't effective in cases with implants everywhere. There is a grading system and under 20 is likely to have good outcomes. Most cases have a laparoscopy first, not really time in our case. In that laparoscopy, an additional 20% of cases become ineligible due to the PCI score being over 20. He believes Alan fits that criteria even with any underestimation from the CT. Plus Alan has so much GOOD going for him, age, general health and physical fitness! 


Now for the incredible hope, yesterday left us with! He has 2 patients that are still cancer free and unable to qualify for the trial right now, 1 year post op! Without the vaccine trial (see previous posts for info), the average life expectancy is 62 months from the date of surgery with his longest patients making it 9-10 years. That's a lot of time for other treatments! 


We have called this plan, everything including the kitchen sink, the Hail Mary play, and today old school! New hotness (insert Men in Black flashback) treatments have not worked YET. So we are going to kick it with old and busted (Tommy Lee Jones style - again MIB reference)! Old school will hopefully give us more time for New Hotness to be created and work, killing the Alien growing inside my husband! 


Prayer Needs: 

  • Entire list from Monday's post
  • Girls - hearts, fears, connection within the family, anxiety
  • Alan - better than expected recovery, minimal to no side effects, no depression with slow healing process and longer hospital stay with extremely limited visitors, patience with recovery 
  • Doctors - wisdom, steady hands and God given talent
  • Mel - peace, management of time, schedules, work, appointments, feelings, everything...


Thank you all again for your love and support. 


- Mel