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