Surgery scheduled for Sept 19

After meeting with my clinical and surgical oncologists Monday and Tuesday, it is clear that the unanimous decision is to go forward with surgery to remove the colon tumor. The surgery will be the morning of September 19. After surgery and recovery, I will resume chemo to shrink the liver tumor. Liver surgery will then be at some future date. The hospital stay for the surgery next week is typically 5-7 days, followed by home rest for 2-4 weeks.

I am currently in Houston, staying with our good friends, Pete and Sally Rasmussen. Should the unfortunate situation arise where I become blocked again before surgery, I want to be close to MD Anderson rather than be in Dallas.

Christine is in Dallas recovering from her serious migraine attack last weekend and will hopefully join me in Houston today or tomorrow.

Parole

They released me last night from the hospital. My attending physician was supposed to sign discharge papers around 3 or 4pm, but he got pulled into a major surgery and didn't show up until 8. He apologized and told me it was an unfortunate change of schedule. "Big tumor we had to pull out..." he recalled, "rough surgery." Made me wonder for a moment what they'll be saying when they open me up.


Christine and I were planning on going out to celebrate, but by the time I got home I was exhausted and crashed for about 11 hours. Even though I had been in bed for a week, I still needed to rest. Ironically, hospitals are terrible places to rest. They come in the room for all sorts of reasons almost hourly to wake you up and talk to you, stick you with needles, probe you or just take out your trash. I've thought carefully about it this week and I think this is how it works: They have a sophisticated system of timers - one for each room. A given timer is set for 90 minutes when they leave a patient's room. When your timer goes off, they think of a new reason to come in to make sure you don't go too long without interruption. It is a remarkably well-organized operation that requires great teamwork.
Christine awoke today with an unbearable headache that responded to no meds she had. I had little energy to help, and called our friend Tom Kistner. He was kind enough to drive her to the ER to get a narcotic treatment. So right now, a mere 18 hours after I was released, Christine is at the hospital. And I'm at home facing the task of packing as soon as possible to get the Houston. I may fly down ahead of her so she can be relieved of having to prepare in half a day for a month trip. I hope she comes soon. She was a wonderful companion in the hospital, sleeping in the room most nights, overseeing my care, and giving me great comfort.
It looks like I'm going to spend the next month or two in Houston. I'll go right away so I can be there in case another obstruction occurs. Surgery is scheduled for the 19th, but that will be confirmed once I meet with my doctor on Monday. I believe recovery takes a few weeks - the first week or so in the hospital and a couple weeks rest. Then, I'll get back on chemo.
To be candid, I am terrified of being obstructed again. The pain was about as severe as any I've encountered and the vacuum "treatment" was nearly as bad. I wouldn't mind fasting for two weeks, but they want me eating, so I am back on solid foods. Please pray that I would not be obstructed again and that the surgery or whatever they prescribe will be successful. Also, pray that Christine will recover and will be able to join me there soon.
On a good note, Dr. Hoff called me yesterday afternoon to discuss my situation. He advised me not to panic and told me that surgery is a good thing to do now. I asked if this was a major setback as far as the long term prognosis goes. He answered with an emphatic "no". The chemo is just as effective after surgery as before and it is just as well that we get that primary tumor out of there and eliminate the chance of another interruption like this one.
I'm thankful to be out of pain and at home right now. It is a wonderful feeling to be home.

Out tomorrow

Today, I'm feeling even better. I've also been promoted from ice chips to a liquid diet. After making sure that works for one day, I should be released. So Friday is estimated departure date. My attending doctor here has made it his goal to get me back in shape enough so that I can get to Houston. He agrees I should get back to my primary team. So immediate surgery here seems unlikely. I hope to travel this weekend. Monday and Tuesday I am scheduled to meet with my doctors at MDACC. It seems that surgery might be a good plan. I've had good response from the chemo, and to continue good response, I can't continue interruptions like this week. So colon surgery followed by resumed chemo and eventual liver surgery seems a likely route. But I'm going to count most on what Dr. Hoff says on Monday.

What's for dinner?

So how am I surviving while fasting day after day? Well, the secret is not ice chips, but Total Parenteral Nutrition (TPN). TPN is a milky looking potion that they feed directly into my veins. Its everything I need for daily nutrition. Cool. Who needs food? I wonder if this is the stuff the Matrix feeds to all the people hooked up to itself? In fact, you could all be receiving TPN right now and just think you're eating steak and fries. I'm the only one who really knows what I'm eating...

"You know, I know this steak doesn't exist. I know that when I put it in my mouth, the Matrix is telling my brain that it is juicy and delicious. After nine years, you know what I realize? [Takes a bite of steak] Ignorance is bliss. " - Cypher

Done with colonoscopy

Thanks, Mark, for keeping folks up to date.

I finished the colonoscopy this afternoon in which they rexamined the size of the "hole" through which everythinig must pass. Even though the tumors have shrunk drastically, the hole size is pretty much the same. There is also a growing consensous among the docs here at UTSW that I had a temporary obstrcution and the painful symptoms that drove me to the emergency room Monday morning were because at that time, everything was clogged at the site of the tumor. They managed to get it under control and my system running again via vacuum tubes (I've found that everyone here at UTSW likes sticking tubes in various places, just like they do at MDACC)

The nose-to-stomach vacuum tube kept me from talking much and was extremely irritating. The tube worked well for a couple days and was supposed to remain in all week, but it came out as I was I blowing my nose last night. Not sure if they believe that I didn't just take it out myself! (I can't say that the thought hadn't crossed my mind...). This reminds me of the hole-in-one I hit at a Delaware golf course one year after leaning to play golf. Par 3-149yards. I was golfing alone at the time, so my story is all anyone can go by. You'll just have to take me at my word on both the tube and the hole-in-one story. Anwyway, the tube was supposed to remain "just in case", but I'll just enjoy not having it and pray there won't be a "just in case". I have considered this accident as a merciful gift from my Lord. Meanwhile, I've only eaten ice chips since Sunday, and the big question still remains - what will happen when food is reintroduced?

We are now trying to make the difficult decision of having the colon part of my necessary surgery here in Dallas (very soon) or getting ourselves to Houston to see what they think, with possible liquid diet and surgery there on the 19th. Or even possibly treat this as an isolated event and keep going with chemo on a more restrictive diet. The decision is difficult and the stakes are high. In any case, our smoothly running plan has hit a speed bump. Hopefully it turns out to be a small bump. I'll be trying to get more input from doctors here and at MDACC by tomorrow.

So we may be headed to Houston again as soon as I am able to travel. We'll see how the next day goes. That's really the best plan I've been able to come up with anyway - get through today... "Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own." -Jesus (Mt 6:34)

Yours,
Greg, writing from my hopsital room

Staying Until Friday

Greg remains in the hospital, and the current outlook has him staying there until Friday. A colonoscopy is planned for tomorrow (Wednesday) to confirm the exact status of his intestine and they are focused on getting his digestion and aftereffects functioning properly again. Any resumption of chemo is pretty much off the table until he can eat and Christine can give a good report to G'pa.

Thankfully, Christine has been able to remain at his side apart from a trip home to get some necessary items. Please pray for her stamina and for relief of her pain as she ministers to Greg.

Please pray for the entire family and the church as we struggle to support both Greg and Christine: that our hearts would be filled with compassion, that our service would be unstinting and without selfish conditions, that we would find the balance both to support them and to take care of ourselves and our families, and that in this time of difficulty the Lord would draw us closer together when the stress threatens to drive us apart.

No Labor Day Rest

This morning Greg was admitted to the emergency room at St. Paul with severe abdominal pain. What was initially feared to be an intestinal blockage now is thought to be side effects of the chemotherapy. We hope he will be home either later today or tomorrow; for the moment, chemo has been suspended (though it may resume in a few days after consultation with the doctors).

Please continue to pray for both Greg and Christine in their suffering. Pray for the family and the church as we seek to be the body of Christ, a real physical presence and comfort, to them both. And pray for daily wisdom in deciphering the myriad symptoms of unknown origin that can so easily cause panic.