Phil Post Surgery Update (01/22/2015)

It’s been a while since my last update. And since so much has transpired I will try to do a high level update to cover the ground quickly. As a matter of fact I’m guessing that most of you already know some of the details as they have been communicated via word-of-mouth and other means.

The chemo I took before the surgery truly was tough. I suffered through more severe side-affects than any previous treatments. Nevertheless, we toughed it out through all six planned treatments before doing the surgery. That brings me up to 29 total chemo treatments (to date).

The surgery took place on Friday, December 5 as planned. However this surgery was a bit more involved than previous procedures. They ended up taking out 40% of my liver and gallbladder. In addition to that I lost blood during this surgery and required a transfusion. All that said, the surgery was a success:

1. Three tumors were removed from my liver, all with clear margins.
2. My post-operative CEA level dropped to less than 1.0 (very good sign that cancer activity has ceased)
3. I made it out of the hospital in record time. I expected to be in the hospital for seven days following surgery. I was only in the hospital for 4 ½ days. Wow!

Being discharged early left me with expectations that maybe I was on the FASTEST road to full recovery yet? Unfortunately, there have been several challenges on this trip.

The first challenge was a bout with the flu. Just before Christmas I fell victim to the flu, not unlike many of you. The complication turned out to be related to the coughing brought on by the flu. The coughing caused trauma to the surgery site resulting in increased fluids draining from a surgical drain. I was down to a level where the drain would have been removed had this trauma not occurred. But instead of getting it removed the drain stayed in and the fluid levels stayed high for a lot longer than expected.

After the flu ended I seemed to continue to battle flu-like symptoms. Low-grade fevers, chills, increased fatigue. This was challenging in that we didn’t know if this was another flu virus or an infection. I started an antibiotic and a week later I seemed to be over these symptoms, however the drain activity continued remain elevated.

The surgeon suspected that the antibiotic and use of ibuprofen may have been affecting other symptoms so he had me stop these medications. So last week, not taking any medication, I seemed to improve. Including the flow of fluid through the drain – it started to diminish. However the low-grade fever, chills, and fatigue has returned (this week).

Yesterday we drove into Ann Arbor for an appointment with my oncologist (Dr. Krauss) and another appointment with my surgeon (Dr. Knol). The snow made it a much longer and more treacherous drive than normal but we made it there and back safely. This visit was to get scan results, talk about next steps, and follow-up on the surgical drain.

Dr. Krauss (my oncologist) quickly gave us the update that the scans were all clear, and the CEA continued to be under 1.0. He then discussed that he wants to begin a conservative chemo treatment in four weeks, assuming I continue to heal and don’t have any major setbacks. He is going to have me begin taking Erbitux once again. This is a drug I used in the past that seemed to have maximum impact on cancer activity. Unfortunately, the side-effects of this drug is a nasty rash. Reference the 2/16/2013 update where I blogged about the Erbitux rash.

If my healing progresses as we all hope he will add additional drugs to the treatment to make it a more potent concoction. Although he assures me it will not be as rough as the six rounds I did pre-surgery. The hope is that this follow-up chemo (over the next year) will kill any remaining cancer cells and prevent a reoccurrence.

After discussing the return of the chills and fever with Dr. Knoll (my surgeon), he decided to put me back on a different antibiotic and to begin the “process” of removing the surgical drain. In the past the surgical drains were simply pulled out while I was in the hospital. There was some discomfort but it was done quickly and really wasn’t a big deal. I guess I should have expected that there may be a different process for removing this drain given that it was in me for over six weeks.

The “process” is to remove the drain one inch every two days. And he warned me and my wife, the first inch is painful. And he wasn’t kidding. I about hit the roof when he pulled out the first inch yesterday morning. The issue with the first inch is that tissue begins to grow around the surgical drain and that is pulled lose when pulling the first inch out. Additionally, the tube has a larger coupler that has to be pulled through a small (and very irritated and sore) hole in the skin. OUCH!

In addition to the doctor visits we also learned that the insurance has denied a claim for a PET scan. They are claiming that the PET scan was not medically necessary. The odd thing is that the insurance has paid for PET scans in the past without issue. And so we stopped in to visit with a UMHS administrator to find out what to do about this financial issue. We need to file another appeal with the insurance company. I pray the insurance company will ultimately pay for the test as this is a significant bill that we do not have in the budget. As if the cancer battle is not enough?

Anyway, I had a rough afternoon yesterday and a tough night trying to sleep last night. Nonetheless with the help of a little Tylenol the pain seems to be dissipating.

So, here it is, week six since surgery. I’m beginning to work, still struggling with some fatigue, chills, fever, and pain. When I started this cancer battle I was told this is a marathon. And here I am (maybe near the end of this race?) and I feel like I’m hitting the wall. I feel the pain and fatigue every morning and evening. I struggle with the cold and chills and frustration. But we simply keep on keeping on! With faith that our situation will improve. And in between the drops of gloom we manage to do a lot of living and loving. Some of the highlights from over the holiday season…

• Our family Christmas was wonderful. The house was filled with kids and dogs and activity. And the activity continued for a couple weekends after Christmas as well.
• Matt and Sarah announced their wedding engagement. So in addition to planning CJ and Anna’s wedding for July 2015 we are now also planning Matt and Sarah’s wedding for April of 2016.
• We scheduled a spring vacation for April 2015. We are going to visit Sarah and Matt in Boston. And we are all looking forward to our time with them.
• We finally accomplished a few of our home improvement projects as well. Note that these projects were planned over a year ago so getting them done was a good feeling. 

So, maybe I’m hitting the wall? But my plan is to bust through the wall! And Lord willing, I’ll be cancer free on the other side! Whatever lies ahead, we will continue to press on, for we know that the Lord has a plan.

Your continued prayers are truly appreciated!

Love and light to you today!

Sincerely,

Phil