Again with the Oncologist 3/29/12

The last few blood tests came in more negative that we wanted.  Sheila’s cancer marker was at 41 prior to the surgery and then 2 weeks after the surgery it was at 14.  The doctors wanted to see it less than 5.  Her blood was tested again last week and was at 7.  The MSI tests came back and they were a bit negative also.  The results of these tests were concerning enough to the oncologist doctor that we needed to revisit the spots that were noted on her liver during the first CT Scan.  An ultrasound of the liver also showed one of these spots at about 1 cm or ½ inch.  A PET Scan was ordered.  A PET Scan is similar to a CT scan except it is more precise in detecting cancer.  We got a call from the oncologist doctor prior to our spring break trip. He informed us that the spots on the liver were NOT cancerous.  These results obviously made us very happy!  We did not have to go from a stage 2A to a stage 4 with Chemo included, but we were braced for the worst! 

We have lately supposed that with the prescribed “vigilant surveillance” we may get some false alarms, so we will try to be more careful releasing results until we are surer of the prognosis!

It has been a tender mercy that we have been able to visit with Rob, Laura, and grandbaby Robbie in Portland.  Grandma could not be happier!!  Again, thanks to all for your prayers and concerns for our family.  We are truly blessed with all our friends who live around us!

With the Oncologist 2/27/12

We met with the oncologist, Doctor Stinnett and his staff today.  Sheila’s cancer was classed as a stage 2A.  We had thought that we were in the grey area between the end of stage 1 and the beginning of stage 2.  The actual rating is a T3,N0,M0.  This roughly means that the cancer because of size, shape, penetration past the colon muscle into the colon layers, was classed as T3, there was no migration into the lymph nodes, and there was no evidence of metastases.   We are awaiting the blood test results that will be checking the level of the cancer marker against the original marker blood test when the cancer was present.  They will also be sending in a test for the microsatellite instability (MSI) this week.

The present recommendation of the doctor, pending any adverse information from the 2 incoming tests above, is to NOT proceed with Chemotherapy.  Vigilant surveillance is recommended which means a blood test to look at the cancer marker every 3 months, a CT scan every 6 months, and a colonoscopy every year for the next few years.  While some of the vigilant surveillance testing is uncomfortable, we feel that the side effects are much less than those from Chemo!

We have certainly received many great blessings during this ordeal, and while it is not over yet, we are pausing to ponder the blessings we have received from our friends and from above.  Thanks to all of you who have helped by taking care for our children in many ways, by helping with our physical, emotional and spiritual needs.  The outpouring of love, compassion, and kindness has been truly staggering and humbling.  How blessed we are to live among those who are truly saints!  Blessings have been pronounced and very many prayers were offered in our behalf and we have felt the power from these!!

After Surgery Day 12 - 2/17/12

It has been a really hard week for Sheila.  Vomiting and Diarrhea have been the norm for all but the last 1 ½ days.  We think that we have turned a corner in that she has learned out to control the nausea.  Boost and similar drinks is all she was able to eat for most of the week. 

We went to the Surgeon for a follow up visit today.  He said Sheila was healing well.  She has been off of the pain pills for about 3 days.  Because she has had such a problem with nausea he wanted to wait a week before referring her to an oncologist who is the specialist we will need to see to determine if chemo-therapy is in our future. 

I suppose this means we will not know much more about Sheila’s therapy future for a couple of weeks.  What I do know is that there are a bunch of good cooks near us and my family has been well taken care of.  Thanks to all!!

After Surgery Day 5 - 2/10/12)

Morning:

Sheila woke more refreshed this morning and was able to keep some breakfast down.  Doctor Oberg visited us early this morning.  We should be getting off the IV, taking a shower, and trying an oral pain medication.  We need to see the results of these things before we can progress to the next step (going home).

The pathology report was not available at 6:30, but Dr. Oberg just called me (9:00 am) to relate the results.  The cancer is a low grade Adeno Carcinoma.  It has worked its way through the bowel muscle, but has not broke through the outer lining of the intestine wall.  This means it had not grown into nearby organs.  We had a 16 lymph node sample and all lymph node migration biopsies were negative to the present of the cancer.  I did not get an answer to the MSI, but we may still be in a stage 1 type cancer although because of the size it may still be considered a stage 2. 

It is good news that the lymph nodes have not been affected!  This would be stage 3 and chemo is almost always prescribed for that.  Life expectancy is less too!  We will not know if chemo will be prescribed for Sheila’s case until we meet with the specialist.  This meeting will not be next week, but soon thereafter I suppose.  We will meet with Dr Oberg again in 1 week to see where we go from here and get a recommendation for a specialist from him.

http://www.cancer.org/Cancer/ColonandRectumCancer/DetailedGuide/colorectal-cancer-treating-by-stage-colon

http://en.wikipedia.org/wiki/Colorectal_cancer

Rest of the Day:

We were waiting to see some real good progress and we did today!  We are out of here!  Homeward bound and this will be the last blog from the hospital for this stay!  We will plan on updating the blog when we see Dr. Oberg next week, or if another significant event happens. 

Thanks to all for your love, support, thoughts, prayers, and kindnesses.  We are going to fight this thing and we a planning on winning!  Sheila’s Fight is may not be over yet, but she has given it a hero’s fight this week!

After Surgery Day 4 (Morning 2/9)

Morning

Sheila had a hard night. The pain pill she was given made her nauseous. They gave her several things for this, which delayed the end result to be while the surgeon was visiting in the morning. He had the opportunity to catch it in the barf bucket. TMI! (Too Much Information). This was good however because he ordered her different medications and she is sleeping well now. The colon has started working so she is being upgraded to a full liquid diet. I think that we will see some real good progress throughout the rest of today.

 Rest of the Day:

Well, so much for my optimism this morning!  The nausea continued and then the colon got active, and then hyper active.  The IV leaked out of the vein and her hand swelled up like a softball.  She told them it was hurting, but they said that was because it was a different kind of fluid going in.  She is sleeping well now (10:30 pm).  We will hope for that real good progress tomorrow.  We did not get the pathology report like we thought we would today and will hope for good news there tomorrow as well.

Many people have helped with our children over the last few days.  The fridge is full as are the tummies!  The children have been so well taken care of that it may seem harder for them with their mother at home!!  I don’t think they missed too many scout or YW meetings, ball games, or even ball practice!  Rick has acquired a steady part time job this week doing janitorial work for some of the local schools and has not been able to provide as much help with rides as we were initially planning. If this blog were not published too far and too wide I would mention that his Mother is sure proud of him.  I am told that all of the children have performed as well as could be expected without their mother or father being around much.  I am sure that this was, at least in part, because of the help they received from friends.  Again Thanks to all for your help.  

After Surgery Day 3 - 2/8/12

Sheila’s mobility has increased and she was able to get off of the IV pump this morning.  The outer bandage was removed and the wound looked good.  There was no re-occurrence of the fever during the night.  We talked to the Doctor and tried to determine the stage of the cancer, but he said that we would be referred to a specialist in patient treatment after cancer removal to determine the stage of the cancer.  The specialist would help determine the best course of action after looking at the pathology report on the part of the colon and cancer mass that was removed.  Dr Oberg thought that with the size of the mass that chemo would probably be prescribed, but said there are a lot of other factors and a specialist would be able to give the best diagnosis.  I think this means that even though we will get the results of the pathology, probably Thursday, we will not know the diagnosis for after surgery treatment until after meeting with the specialist.

Later today we had a real battle with nausea. Since we were off of the IV, pain pills were prescribed instead of the morphine IV pump.  Either the pills, or the fact that things were not moving through the bowel, or something unknown, made Sheila very nauseated. It took at least 5 hours and a couple of medications to get this under control.  Many say that the 3^rd day after this kind of surgery is the worst.  We are hoping that this will be the case here and that we are home for the week-end.

Thanks to all for the help with our children at home.  I could not be here with Sheila, if it were not for all of you.  THANK YOU!

After Surgery Day 2 - 2/7/12

Thanks to all of you for your support and prayers!!

Sheila was alert and attentive most of the morning.  She was out of bed on 7-8 occasions making trips to the water-closet and a couple trips down the hall.  I am sure these felt like marathons to her.  The staff agreed that she is doing very well after this type of surgery and may be a bit ahead on the recovery path.

In the early evening Sheila’s condition worsened a little.  She developed a low grade fever (99.5).  She was doing so well earlier that we had decided to take the kids over to see her.  Our children ended up visiting her during this down time.  She was not able to communicate much so we took them home quickly and had her sleep.  After another 2-3 hours of rest she woke up, trekked to the in room facilities, and laid back down.  The fever had subsided and she appeared to be much better than earlier.  She is also developing lower abdomen noises indicating that the colon may be waking up.  This is what we need to have happen next.

I was doing some research and found the following link that discusses the stages of the colon cancer.  We are not exactly sure of the stage we are in yet.  The pathology report will indicate if the cancer has spread to the lymph nodes.  From visual inspections we think we are between stage 1 and stage 2.  I need to ask the Doctor if the cancer had broken through the colon wall which would make it a stage 2.  Stage 1 and some Stage 2 cancer treatments do not include Chemo or Radiation treatments.  What we do not want is stage 3 where the cancer would have traveled to the lymph nodes.  Chemo and some Radiation are usually prescribed in Stage 3 cases.

http://www.cancer.org/Cancer/ColonandRectumCancer/DetailedGuide/colorectal-cancer-treating-by-stage-colon

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001308/