Discharged

Another quick update. I am being discharged. The pain is far better than last time. In fact, I am on the medication I was on at weeks 3-4 of the same surgery in January! Hopefully, this means quicker recovery in terms of time back to driving, sleeping laying down, working, being mobile and able to use my arm, etc.

I did have a complication today. Some air got into my chest cavity today when they pulled the chest tube. Thus, I need to come back in tomorrow for an x-ray to see if it is stable. So I am out of the hospital, but not released to Dallas yet.

Likely leaving the hospital today

Quick update -
The lung leak has healed. They just pulled my chest tube out and capped off my epidural. We'll know in about another hour how much pain I will have without the epidural and thus will need to combat with oral medication. If pain is under control this afternoon, I can leave.

Some pics

I've been having wi-fi troubles and have not been able to post pictures. Until this morning. Here are a couple.

Here is my traditional picture of the "first walk". It was taken on Friday night.




Early today, when this bustling institution was still quiet, I awoke and took my early walk. One of my favorite places to walk is this big atrium down on the second floor. It is full of plants and trees and, of course, the Starbucks coffee bar. The Park, as they call it, has outdoor furniture, so you feel like you've escaped the hospital. A good place for peace and thinking.

Update from floor seven

The pain is turning out to be much better this time. I have a new bear, Sir Koff-A-Lot II. I am finding this go-around that it is not always necessary to grab for him to cough. Last time I had to squeeze him hard to even make it bearable. (again, no pun intended) Maybe this is the result of a good epidural, which is still in. But I do remember having much more pain last time. They say pain varies wildly and unpredictably when it comes to through-the-rib surgery. I'm thinking I may be having less severe nerve irritation than last time.

I am having one "common" problem - some air leakage from my lung into the chest cavity. Little bubbles that escape the lung into the cavity and out the drainage tube. Dr. Hofstetter says that will take an extra day or two to heal. Otherwise, the recovery as far as drainage volume is going better. In all, we're looking at probable departure time of Tuesday, or possibly Wednesday.

I am pushing (and being pushed) to walk many times a day and do the breathing and coughing exercises. I was told once by a nurse to treat surgery recovery in the hospital as work, not rest. You rest when you get home. That way of thinking has helped.

My lung and lunch capactiy are increasing.

New Morning

Hi. Greg here.

The moment I awoke from surgery, I rejoiced. It is scary going under, as this surgery is serious enough that some don't make it through. I was reciting Psalm 23 in my mind as I drifted into the deep sleep and the next thing I know I was emerging from the valley of the shadow of death.

I hear that it went very smoothly. The surgeon estimated I only lost about 5% lung capacity from this surgery. And that he got all four mets. With nothing else on the CT scan, I am now, really for the first time in four years, clear of any visible signs of cancer. I don't know if they'll want me to take more chemo. Time is the only way now to find out if there is any more cancer. OK, I'm getting ahead of myself.

With the epidural working, this has been a completely different experience than last time. Carefully and calmly, they adjusted the medicine to get me comfortable. I came into consciousness gently. No screaming or hitting. By the afternoon, I was in my standard room up on the 7th floor. I was determined to walk and did so later that evening. I also got special permission, unlike last time, to eat. They say that with the anesthesia wearing off, eating can make one nauseated or even vomit. What do they know? I asked (begged?) the resident and he said OK. I ordered dinner, had a few bites, then threw up. Hmmm. Maybe there was something to that warning.

I didn't get much sleep from the pain, discomfort, and tangle of tubes running in me from all directions. The pain is not too bad; it is just there. This morning, the nurse rolled in her laptop station to show me an instructional powerpoint presentation on how to breathe. I watched then took the opportunity to write you all.

Thanks for your support everybody! And thanks, Mark, Rollin, and Christine, for the blog entries to keep everyone up to date.

Recovery Continues Well

So far, the first day post-surgery has gone well. Greg has been able to get up and walk around, and his pain has been manageable. No recurrence of the epidural problems from last time, thanks be to God.

Please continue to pray for Greg's recovery, for relief of Christine's suffering, and for Jim and Judy's health and rest (they were up at 4am today).

Surgery complete

Greg's surgery is complete - they got going right away at 7:45 and finished around 9am.

The doctor described it as very routine, and said it went well.

There were 4 lesions, but they did not have to remove very much lung tissue at all - his lunch lung capacity should still be very good.

Greg is now recovering, and so far all is well. Since Greg did so well last time, the doctor does not expect to have any problems, so they are hoping he will be able to get out quickly.

Praise God, they got everything they know about at this time.

Surgery Time

Greg was scheduled to report this morning for surgery prep at 5:30am, so if you would like to pray for him, he estimates that he will be in surgery from about 7:00 - 9:30.

Prayer requests:

- that the epidural (for pain relief) would work. He will have this put in at around 7:00am. We didn't discover until his last surgery that failure of the epidural was a possibility, when Greg experienced the worst pain of his life.

- that the surgeon would successfully find and remove all 4 nodules (and any others on the right sight.)

- that Greg would lose a mimimum of his lung capacity

- that there would be no complications (blood loss, infection, etc.)

- that Greg would get decent sleep in the hospital

- that he would have good follow-up care from the nurses and physicians

- that Greg would sense the Lord's presence and feel strengthened for his recovery in the hospital. Last time Greg was blessed with a renewed attitude of enthusiasm towards his recovery. We know that this is rare, especially given the weariness that Greg and I have often felt toward his almost four years of treatment.

- that God would refresh Jim, Judy, me and others to be his support system. For the first time, I was not able to accompany Greg to Houston for his surgery due to a great amount of pain. Please pray that the new medications I have just begun will make a difference. Jim and Judy are with Greg for the weekend, however, Judy is recovering from bronchitis. We are so thankful for the support and help of family and friends. A dear friend from our church and fellow cancer survivor, John Rawley, will replace Greg's parents in Houston on Monday and stay with him for the remainder of his time in Houston. (Last time, Greg was released from the hospital after 3 days - Mon. - although Greg could be there as long as 7 days, and will need to stay in Houston an additional two days.)

- All during this time it is important for Greg to do his breathing exercises and walk about 4x a day to prevent pneumonia, even though he will be dealing with pain and fatigue. And of course this is all the more difficult with one leg! Pray that Greg and his caretakers would be diligent in pursuing full recovery, and also for good pain control and limited fatigue. Chronic pain is one of the possible risks.

- Finally, pray that this would all lead to Greg's body being healed of cancer.

We are so thankful for the strength we get from your continued prayers and concern!

Scan report good. Ready to go.

The ab scan paid off. It was clear. That means no new signs of cancer after four and a half months since being off chemo. Also, the left lung, which was operated on in January, was clear. This is all reason to sigh (no pun intended) and give thanks.

The right lung, which is the focus tomorrow, has four lesions. The largest was 6mm in Jan, 8mm in Mar, and 11mm yesterday. The arrow below is pointing to this 11mm lesion (it is a light-gray circle). This pic is a slice of my chest looking up (right is left, bottom is back). Most of the little spots in the lungs are blood vessels. They can pick up the tumors by the shape, density, and relation to other slices. The other three lesions are in other slices, so you cannot see them here.

The largest lesion is in the lower lobe of the right lung. The other three lesions are in the upper lobe. There are four lobes per lung. (We EE's always knew binary is the natural numbering system of the cosmos). How much Dr. Hofstetter has to remove depends on the location of the lesions with respect to the bronchial branching structure. It turns out that this largest lesion is close enough to the center of the structure, that it may require removal of that whole lobe. If he can remove it with good marin and keep the lobe, he will. He thinks he has a good shot at it. At the end of the day, I will be at anywhere from 65% to over 80% full lung capacity. You can survive on much less than 50%, but obviously, you want as much left over as possible.

Lots of good news. Now comes the hard part.


Dr. Hofstetter, me and his RN, Susan Knippel

Christine

Unfortunately, Christine�s pain has been about as bad as it has ever been in the past week. Pain in her limbs and hips as well as a migraine for several days. We went to her doctor Monday about it. He changed one med, but nothing drastic.

This is heart-breaking for both of us as it is coming at a particularly bad time. She is in Dallas and is still longing to come down to Houston, but we are not sure she will be able. I will still have the surgery tomorrow and my parents are coming for the surgery and weekend. My friend, John Rawley, who has assisted me on many chemo day trips in Dallas, is flying down Monday for the week. He'll help me in the hospital and hotel and will drive the car back. So I will be cared for.

Even though these MD Anderson trips are never "fun", Christine and I have actually cherished them as special shared times: the drive, the long hours sitting together in waiting rooms, the empty evenings to be filled as we wish, the tears, the small joys, rough appointments with doctors, and sweet times with our friends in Houston. So we are sad to be apart and still hope that a remarkable turnaround will result in her being able to come down for part of the time here.

Scans complete, with some tinkering

Today I meet with Dr. Hoffstetter to discuss tomorrow's surgery details. Yesterday I went to the CT Scan, which was again only for the lungs. I got to thinking that I had not had an abdomen CT since November. So I brought it up to the nurse. I have not had chemo since November and no one has scanned my abdomen since then, even though that is where the primary and one met was. Even in remission, they will do a scan every three months. Four seemed a long time. I figured this lung-only scan order could have been due to a gap in coverage. Dr. Hoffstetter focuses on the lungs, so he is going to order chest scans. Dr. Eng, who would have ordered the ab scan, has not seen me in a long time because I've been doing lung surgeries. Then there's me.

One part of me did not want to bring this up. If there is no scan, there can be no bad news. And the thought entered my mind that if something showed up on the scan, it could jeopardize even having the surgery. Not to mention, the abdominal scan is quite unpleasant (they fill the intestines with barium from both directions) and causes problems the rest of the day. On the other hand, I figure that more information can only help. Not scanning is not the same thing as being clean.

My pesky questions resulted in the radiology nurse calling my doctor and getting the order changed to be my whole torso. Did they just humor me, or was this a good idea? Was this an institutional slip-through-the-crack, or were they merely satisfying the customer. I'll never know.

The extent to which I can affect my own care is unnerving. Most people, including me, assume that the doctors call the shots and the patient follows. My treatment path has been significantly affected by my proactive tinkering. Since I know just how little I know about this stuff, it makes me wonder. At times like these, I appreciate more sharply the Biblical idea that I can exercise the will and affect things, and yet at the same time trust that all the days ordained for me were written by God before I was born.

One more day to enter tourney

You can enter your NCAA tourney bracket for Greg's Place hoops contest up until the first game, which is tomorrow (3/15) at around 11am central time. Even if you don't know much about basketball, it is easy to fill out. See my previous blog entry for info on how to sign up.

Not everyday you get a chance to beat up on on a guy while he's in a hospital bed. (Although some have been known to crush me in chess while I'm on benadryl)

NCAA hoop picks, anyone?

You have been invited to join gregoryhewlett's Private Group in Yahoo! Sports Tournament Pick'em. Enter your bracket and compete with your friends.

Winner gets to be crowned Greg's Place Hoops Champ of 2007.

In order to join the group, click here.

Once there, Click on "Join A Group". Then pick "Private group". When prompted, enter the following information:

For our group enter...
Group ID#: 119929
Password: ihatecancer


Fill in your bracket before the tournament begins.

Surgery date set Mar 23

I will have lung surgery on March 23, 2007 at MD Anderson in Houston. Dr. Hoffstetter will be performing the same operation as last time, only this time on the right lung. More info to come...