The Struggle Has Ended

Greg Hewlett passed away on January 17th after nearly eight years of battling colon cancer. While we grieve his loss, we are comforted to know that he is with his Lord.

If you would like to leave your thoughts on Greg, please see this thread.

If you would like to make a charitable donation in Greg's honor, please see this thread.

Monday, January 15, 2007

Free printed cancer materials

The National Comprehensive Cancer Network provides some high-quality booklets that are written by groups of oncologists at the top cancer institutes in the country. They are about 30-pages each and are kept up-to-date every couple years. These are good for patients, family members, pastors, friends, or anyone who would like trustworthy high-level information on various cancers and cancer-related treatment issues. The catalog is here. The booklets are also available electronically.

Saturday, January 13, 2007

Some celebrating

Carl, Sue, Christine and I went out last night to Trinity Pub down at Mockingbird Station for some Irish dining and music. A little celebrating of life. I was maxed out on pain killers at the time, so I don't remember how it was. They tell me we had a good time.


Thursday, January 11, 2007

Home Sweet Home

Last night, we flew back to Dallas. Sue and Carl drove back their car and ours so we could fly. It is so refreshing to be back home. I am thankful at so many levels. Still dominating my thoughts is how great it feels to be on the other side of that epidural-less hour. I still have pain now, but knowing what pain can be makes it easy to be thankful.


Looking back, when I left for Houston, there were so many things possible. And so many of them were difficult to contemplate. There was even the chance I had to be somewhat prepared for that I would not come back. And now here I am only a week later and on the quick path back to health.

I am on a couple different narcotics each day, so am not permitted to drive. I'll be just sitting here at home except when I'm not out taking one of my required walks. Being at home, though, is a good thing.

Here I am with Sir Koff-A-Lot and the other little one I hug to make me feel better (my other hug-when-hurting friend is taking the picture!). Can a guy be surrounded with more love?


Tuesday, January 9, 2007

Hospital checklist for surgery

Here is my checklist for what to bring to the hospital if you will be in-patient, particularly for surgery recovery. These things are also good gift ideas for your friend or family member who is going through cancer.

1. Robe. Due to all the tubes going into and out of your body, you cannot really wear anything except the all-purpose configurable hospital gown. And they will be asking you to walk a lot to recover from surgery quickly and without infection. Bring a good robe to wear over everything so you don't moon everybody on the floor.

bear.jpg2. Soft stocking cap. A stocking cap is the best way to quickly regulate temperatue. And it will keep you warm at night. Instead of always relying on nurses to answer your call button and mess with the thermostat every time you get hot-cold-hot-cold, just have that cap nearby.

3. Eye mask. This is the best kept secret for pleasant hospital stays. The lights in a hospital room are never completely out. And even if they are, the door is always opening in the middle of the night. Escape into darkness and try to get some good sleep by using a high quality padded mask. Ear plugs are probably good, too, but be careful - you will want to be able to hear your IV pump beeping. I have an especially hard time doing due to my poor hearing.

4. Comfort quilt. Bring your favorite soft cotton quilt or blanket to lay over your blankets. (You can also bring a favorite pillow-cover, but pillows are not usually allowed or will get lost). They never give you enough blankets and the ones they do are all scratchy. Your quilt will make you more comfortable and the room will feel a bit more like home. I've got an old tattered one my great-grandmother stiched together. I have always brought it to the hospital over the years. It's a Linus thing.

remover.gif5. Medical adhesive remover. The amount of tape and dressings your skin will be subjected to is unbelievable. When they replace them or take them off, the adhesive gum left behind can take days or weeks to get off with soap and water. And the adhesive material can irritate your weak-from-chemo skin. Discomfort also comes from the residue causing your skin to stick to your clothing and sheets. Sometimes, I think doctors and nurses just leave these random pieces of tape or band-aids for no reason at all. Bring a box of adhesive remover pads like these. Get a loving friend or family member to carefully work off all the tape and residual gunk. It's not only less irritating, but is a small way to get "away" from pesty cancer reminders as soon as possible.

6. Small mirror. Useful for all sorts of things - brushing teeth, cleaning face, being able to see skin problems, etc. If you're a guy, you won't naturally have one of these in your purse, so sneak into the makeup aisle and buy one.

7. Itch helps. Anesthesia and narcotics can make your skin itch like crazy. The nurses will offer to give you a sedating anti-itch drug like IV-Benadril. I prefer to keep your mind alert so I refuse the drugs. First, I ease the itching with over-the-counter hydrocortisone (check with the doc first). Also, I will have a soft scratcher within reach. This is also something your loving friend can help with. Get them to gently rub your back with a warm washcloth to relieve the itching. Be careful - once I asked my sister to keep doing this for so long that my skin then got all red from the scratching! (It was still worth it)

8. TV Guide for the week. You'll want to know what stuff is on all hours of the day, when you cannot sleep or are bored and in pain.

9. A big plastic cup. Like the ones they serve cokes in at the ballpark. The doctors tell you to drink a lot and then they give you these dinky little styrofoam cups that tip over everytime you reach your arm across the tray. Get a big favorite cup that you can fill with a big-gulp-sized refreshing gatorade or drink of choice.

10. Take-out menus from local restaurants. People will ask if they pick something up for you on the way to visit. Or bored relatives will keep asking what they can do to help. With menus in hand, you can give them that specific thing you are craving and avoid the hospital food. You can often get the menus from online restaurant web sites.

11. Comforable regular clothing. Aside from what I said in #1 (that with all the tubes and wires, you're pretty much restricted to the hospital gown), in certain cases, you'll be able to wear things like warm up pants, sweat shirts, pajamas, etc. Bring a change or two of your favorite casual wear. Wear it instead of what they give you. It is a way of inner resistance and rebellion against being a numbered institutional subject. And it keeps you thinking the situation is temporary and you're getting out as soon as you can.

12. Index cards with verses. If you are a Christian, you might want to write some Bible passages on cards that you can keep by your bedside to remind you of words Christ has revealed to us - especially to those who are weak, sick, or oppressed in times like these. Psalms are a good place to start. This is a great gift for a close friend who will be staying in the hospital, too.

Monday, January 8, 2007

Get out of here!

I was told to expect around a week stay in the hospital. I also heard five to seven days. To my great delight and surprise, this morning they discharged me! I did wake up with pretty bad pain this morning, but they figured out quickly how to address it with oral medication. So with pain relatively under control, and all systems in working order, I left. I am amazed and keep thinking there must be something wrong! My response is simply thanksgiving.

Believe it or not, the orders for my leaving were written up by our good friend Judy Wu (now Judy Dominick). You may remember me writing about Judy here or here.


Now some of you might be wondering if I slipped Judy some cash or somehow used my inside connection to get those orders signed. I'm going to invoke patient-doctor confidentiality on that one.

So here I am, back in my hotel room with Christine. I have to stay in Houston at least two nights in case complications arise. Now that I am out of the hospital, I am looking forward to some good rest.

Sunday, January 7, 2007

Treating liver mets in stage IV colon cancer

Colon cancer which has spread to the liver has traditionally been seen as inoperable, especially when there are more than one lesions in the liver. MD Anderson's philosophy, which they used in treating me, is showing good results. See this article for more. I had two liver metastases and had 76% of the liver removed in December 2003. The liver is still clean as of August 2007.

Fast escape?

The chest drainage number that has to be low for me to leave was remarkably low today. As a result, to my surprise, they decided to pull the chest tube and told me I might be leaving tomorrow. Wow. I was originally told the tube would be in four or five days. In addition, I got a bunch of other unpleasant stuff unhooked today. This morning I woke up tethered to the hospital room with nine tubes and wires. Tonight I have only two. When we hit zero, I can bolt.

The last major thing left is to pull the epidural and work with oral meds until the pain can be managed. When they find the right dosage and mix for pain to be well under control, I can leave. They began the process tonight by capping off the catheter without removing it and giving me some oxycodone and super-tylenol. They will follow me closely through the night into tomorrow.

Lung exercise

The three devices I exercise the lungs with all day (yes, I'm bored)
device1.jpg device2.jpg device3.jpg

And Sir Koff-A-Lot.

Saturday, January 6, 2007

Walking around

Hi, Greg here.

I am so happy. After yesterday night's pain, all things are wonderful. Thanks everyone for the love and support.

I awoke yesterday from the surgery without a working epidural - Civil-War-battlefield-screaming-type-pain. They couldn't give me general stuff because you have to be awake for epidural placement. Sitting up and leaning over to get the second one inserted took about about an hour and I believe may be the greatest accomplishment of my life. All downhill from here.

They gave me this great little bear (comes free with the surgery!) to squeeze when I cough. He's got this cute little MD Anderson t-shirt and his given name is Sir Koff-Alot.

All day, they make me cough, breath into machines, and walk. Here I am on my first walk this morning.

I'm watching the game with Mom and Dad. I just shouted a hooray as Romo connected on 4th and 2 to Crayton for a TD. Oooo, that hurt!

Pain is Much Better Now

The pain last night was excruciating. It was made worse because he had to sit up and hunch over so the anesthetist could insert the second epidural needle near his spine.

However, the second epidural needle found the right place, and Greg is now feeling much better than he was last night. He called Susan to update her this morning, and reported that he has been able to get up and move around a little bit. He is very, very thankful for everyone's prayers and hopes to be able to post his own updates soon.

Thanks to everyone for their prayers last night as he waited for that relief, and thanks and praise to God for answering those prayers in this way. Please continue to pray for relief of Christine's pain, and for God to strengthen her as she ministers to her husband.

Friday, January 5, 2007

Lots of Pain

The epidural is not working and Greg is in a lot of pain. They are taking it out and putting in a new one.

Christine has arrived in Houston. She also is in a lot of pain and her medicines don't seem to be helping.

Please pray that the Lord will take away both Greg's and Christine's pain so they can rest.

Very Successful Surgery

The surgery went very well! They found just the two expected nodules and removed them without complications. The doctor was very pleased with the outcome. Christine is on her way down to Houston right now.

Greg will be in ICU for the next two hours. Praise God for a very good outcome and please pray for quick healing.

Starting now (4:30)

Greg's surgeon was called into an emergency surgery sometime after the last update but before he could begin Greg's procedure. This led to several hours' delay.

We're told that Greg is now under anesthesia and will begin surgery very soon.

Started at 12:30

Telephone liveblogging by Greg's dad Jim...

There was pretty severe overbooking of surgeries today, not enough rooms (30ish) for surgeries (100+), so Greg didn't get started until about 12:30. The surgery will probably be over by 2pm, and we should have an update sometime after that.

A Short Delay

Greg called a few minutes ago. There will be a short delay due to an earlier case, so surgery is now looking more like 11. More as I have it ...

Thursday, January 4, 2007

Last Meal

Last "meal" before pre-surgery fasting... chocolate meringue at House of Pies!


Surgery tomorrow (Friday)

I am sitting at my laptop the eve of a major surgery, as is my tradition. (How many repeated events makes a tradition? Three, four?) Today I went in for a couple of supposedly short appointments at 1 and 2 pm. I left the hospital at 7pm. Thus, the name "MD" Anderson ("Most of the Day")

I check in for surgery at 8:45am. It is the second thoracotomy of the day, I believe, of three or four being performed by Dr. Hoffstetter tomorrow. It is straightforward from his perspective - one to two hours.

Many folks have asked me questions and several keep popping up. Here are some answers.

Q. "Why have they waited so long to do this - they've seen these spots all along, haven't they?"
A. Because when stage IV colon cancer is diagnosed, there may be hundreds of metastatic seeds planted before they take out the primary tumor. And they do not consider it beneficial to do traumatic lung surgery so early in treatment is there could be many more tumors lurcking beneath the surface. For me, now that I have been relatively stable for over three years, with only a handful of mets showing in the lungs and no evidence of disease elsewhere, they think that they may be getting most or all out with lung surgery - thus it is worth the effort.

Q. Doesn't your lung pop when they cut it? How do they repair it?
A. OK, here is a novice explanation. The lung is more like a sponge than a balloon. The surgeon deflates the lung then feels around. When he feels the nodule, he pinches it, and pulls it outward in a sort-of-stretching fashion. He then cuts and staple behind it with some fancy gadget, leaving intact the remaining lung structure. (Thanks, Judy, for finally explaining this to me in a satisfactory way!)

Q. How long will you be in the hospital?
A. Around five to six days seems typical from what I've heard.

Q. Does it hurt?
A. Yes.

Q. Will you be groggy in the hospital room?
A. The first few days, I'll have an epidural. So I will be alert and actually feeling little pain. Then when they pull it, they will have to give me narcotics, which will cause groginess. Of course, my wife and co-workers can attest that I'm a bit spaced out sometimes anyway, so they may not notice the difference.

Q. What about the right lung?
A. I am having surgery on only my left lung tomorrow. Dr. Hoffstetter would like to work on the right lung maybe a couple months after the left. There are nodules in both - larger ones are in the left. And the CT scan yesterday showed slight growth in the right ones. So we won't want to wait too long on those.

Q. What happened to the Owls?
A. Must you ask such quesions about such a difficult topic?

Q. Will you notice changes in your breathing?
A. The doc is planning on taking out about 5% of my lung tissue. The fatigue and chest pain subsides in a month or two, at which point he thinks I won't notice the difference in breathing.

Q. Where's the incision?
A. In the back under my shoulder blade. I originally thought it was my side, but I was wrong.

Q. How are you feeling about all this?
A. As for potential complications, worrying really gets me no where. I trust that I am in the hands of a loving God who is working out his plan for me, whether or not I enjoy the plan (right now, not). As for recovery, I'm not looking forward to the pain, but my goal is to endure one five-minute chunk at a time. I often recite Psalm 23, or similar passages, which I've brushed up on so I can focus during the most difficult moments. Some people think I must have gotten used to pain or have a high threshold for it. I don't really think so. It's not courage so much as not having any other choice. And to be frank, I'm not happy about any of this. I'd rather not have to rely on my faith, which is a weak muscle.

Some requests for prayer:
- That Dr. Hoffstetter will find and successfully pluck out the three nodules they can see on the scans. And that he will be able to detect and remove any others that are there.
- That I'll make it through the surgery without any of the major complications mentioned in the release form today.
- That Christine's pain and migraines will subside and she will be able to be right beside me during recovery process.
- That the pain will subside quickly and not be chronic, as is the issue in some cases.

My brother-in-law, Mark, will keep this blog updated tomorrow with surgery results and updates.