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Tuesday, February 15, 2011

Valentine Day - 2nd Neck Surgery

Wow. Is today only Tuesday February 15, 2011? The weekend seems weeks ago... Yesterday (only yesterday, really?) was Monday February 14, 2011, Valentines Day, which we celebrated by taking Carl to Froedtert Hospital for a surgery - for "Cervical Device Failure".

"Cervical Device Failure" - I just had to google that. We (almost all humans) have cervical vertebrae (vertebrae which are in the neck), and almost all women have a cervix which can get cervical cancer, which is a cancer south of the belly button. NO WONDER Doctors have to go to school for so long, these very different parts share a common name. How confusing. Can you imagine opening a catalog for Cervical devices? Spine things and cervical caps all on the same page. ( But I digress.)

We were scheduled to come to the hospital at 8:30AM for a 10:30AM surgery, but a nurse called and asked us to come earlier. Apparently one of the surgeries before us was going to be a no-show. Did they cancel out or did they die? We could only guess. [4-22-2011 note: Wow, in retrospect as I re-read this in April, that comes off very harsh. The humor did not work. I never for a minute really thought the patient might actually have died.]

Carl's procedure started at 9:45AM, and the surgeon's first incision started around 11:45AM. Before that the medical team put in a breathing tube through the nose while Carl was awake, put Carl out with a general anesthetic, established more IV's including something called an arterial IV, inserted a catheter, did positioning things and X-rays and more. I guess that's why surgery is called an invasive procedure. The surgery went longer then I expected. It wasn't over until about 2:30PM when Carl was moved to the recovery area, where the medical people keep him until they think he is responsive and stabilized, usually about two hours.

I went and shuttled my children around two counties, and came back to the hospital shortly after Carl was moved to his room in the spine injury area - 5SE room 6. They were giving Carl morphine (4mg) as I arrived, and giving Carl more morphine (4mg) as I left two hours later. Carl rated his pain at about a 6 on a 10 point scale. Carl walked several steps to earn the reward of the catheter being removed.

Interestingly enough, Carl's memory starts later. His memory starts with him waking up after the catheter was out. He didn't remember me being there, but then (when reminded) he remembered me saying to the nurse that I was going to go gather my children from a two county region.

I picked up three of the children from a nice Valentines Day dinner at their Uncle and Aunt's house (Thanks guys!), and then took them home to do homework and get them settled into bed. Miranda in particular missed her Dad, but I think we all wished Carl would have been home. Happy Valentines Day...

On Tuesday February 15, 2011 when I went to see Carl, he was mostly exhausted and tired. The nurse said he had rated his pain around 3 on a 10 point scale, where 4 was tolerable (to Carl). Just before I left Carl at around 2:00PM, Carl said he didn't really have pain, at the moment nothing "hurt" him, but he was drained of all energy. The procedures in previous weeks had drained his energy, and now what little energy he had remaining was gone. He didn't watch TV or anything, and when he talked he kept his eyes closed and didn't move or sit up. I brought him two pints of blueberries, and he ate one pint while I was there, mostly without opening his eyes. He didn't want any phone calls or any visitors, he just wanted to rest.

While I was there, I had 3 questions I was trying to ask him. 1. How do you feel? 2. How did he feel the surgery went? and 3. Did the surgeon come and talk to him? During the five minute time we were trying to talk about these three things, we were interrupted three times. The nurse came in, the pharmacist came in and 'interviewed' Carl, and someone else. (Maybe the nurse returning with something?) It was incredible. The pharmacist interview took probably 25 minutes alone. (Starting with the questions are you allergic...)

The surgeon came by and talked to us for a (very) brief time. He feels the surgery went well. We hope he is right. The surgeon did not see any sign of new tumor growth, which is really nice to know. The Jan 24 surgery was important (to me) for removing 90% of a not controlled tumor. In that alone, the first surgery was very successful.

I guess the important thing about today was that Carl's pain was under control, momentarily at least, and that he was already eating. After the last surgery he pretty much didn't eat for 2.5 days. So, Carl appears to me to be in significantly better shape after this surgery then after the one on January 24, 2011. Maybe he will recover faster.

Carl should be coming home tomorrow. Then he will be able to get rest. You don't get rest in the hospital.

Please keep Carl in your prayers, and hug your loved ones for Valentines Day.

Saturday, February 12, 2011

Neck Surgery Update - Try Again

Today is Saturday, February 12, 2011, and I am finally writing to bring this blog up to date. The last chaotic jumble of posts can be referred to or ignored, but I'll try to recap here.

Carl's Angiogram
with embolization procedure done at Froedtert on Friday, Jan 21, 2011. It was a long day and a long procedure that attempted to kill off blood supply to the tumor in his neck, and the Doctors felt it went well. Carl remained in the hospital through the weekend, and on Monday, Jan 24, 2011 Carl had a surgery to de-bulk the tumor in his neck and to stabilize his neck. Monday was a long day and a long procedure, and the Doctors felt it went well. Carl stayed in the hospital a few more days and came home from the hospital late Wednesday, January 26, 2010.

Carl has been mostly staying at home and trying to recover from the surgery. He has been in a lot of pain at times, and takes a lot of pain medication. Carl takes 60mg of Oxicontin, (a long acting pain pill) twice a day, and he takes 10 mg of Oxicodone between these doses for break through pain. He takes a version of Valium to relax the muscles, up to four times a day.

Carl didn't have to return to the Medical complex until Monday February 7, 2011, when he had three appointments: 9:00AM with the Oncologist, 10:20AM with the Radiation Doctor, and 11:30AM with the wound check people. The wound check lady removed the stitches in the back of Carl's neck. The meetings with the Doctors were surprisingly unenlightening. (A friend once told me that with cancer you have to remember that every Dr. meeting is not going to answer all your questions, or even tell you a whole lot. There is no great answer at the next appointment.)

On Tuesday,
February 8, 2011, Carl went to work for about four hours. He felt good about getting out of the house and going to work. (I drove him both ways. Carl won't be able to drive for weeks)

On Wednesday, February 9, 2011, Carl went to work in the morning, and then I drove him to a 1:10PM CT simulation appointment in radiation oncology.

On Thursday, February 10, 2011, Carl had a 9:00 AM MRI appointment in radiation oncology. Carl's pain, usually bad, was even worse today. It was wincingly bad, and so while Carl got his MRI I tried to get appointments to address the pain. The Oncologist could see him at 12:30 that day, but recommended we contact the surgeon. At around 10:00 AM I call the surgeon, and they made an appointment for Carl to see them at 12:00 noon the same day. We were in the surgeon's office at noon, and the surgeon reviewed the mornings MRI (which were taken from angles appropriate for Radiation planning, not the angle the surgeon was used to). The Surgeon then ordered an X-ray which Carl had 20 minutes later. At 12:40 we were back in the Surgeon's office. He studied the X-ray and indicated that the mechanical parts placed in Carl's neck were not in the right position, a plate had slipped and a screw was out of position. He said we should have that fixed in surgery on Monday, was that OK? Carl just kind of stared at the guy numbly. The surgeon was good. He said let's schedule the surgery time to hold the time slot and you can decide later whether or not to do the surgery. I said, Carl, your going to go along with this, right? (and probably some more things...) and Carl agreed he had no real choice. (We could edit that to "Carl agreed"... but I am not sure either edit defines the real moment)

So... Carl will once again undergo neck surgery, this time on Monday, February 14, 2011, Valentines Day. Sigh....

The rest of Thursday afternoon included a pre-op appointment and expediting a CAT scan through both insurance and the hospital, and we were home by 4:00PM. Carl went home in pain, (not really numb, was he?) and so both Carl and I will just keep going.

Carl is like a exotic sports car - He's finicky. He needs a custom tune-up.