Carl was wheeled in to surgery at 8:30 AM. at Froedtert Hospital, and there now as I am typing this.
I hope to update my blog with details later this week.
Wednesday, June 15, 2011
Monday, June 13, 2011
Tuesday, May 31, 2011
April 2011 update - one month late
I had felt bad that I didn't update the blog in April, and now May is nearly over. So now I really feel pressured to post something. It's been a busy 2011, so I will give a relatively non-medical update of April, at least.
April started well. Carl was feeling fairly good. Carl was actually able to drive to work again on Friday, April 1, 2011. (No fooling) . He had been counting the days until he could drive again, and it was now six weeks after Carl's second neck surgery. The Dr's. gave him the go ahead.
On Saturday April 2, 2011 Carl and I got to see our very talented niece be Carlotta in the musical "Phantom of the Opera" at Marquette High School.
The photo below is from Sunday, April 3rd, when Carl, Miranda, and I went to a show at the Art Museum.
The children's spring break vacation from school started on Saturday, April 2 to Sunday, April 10, 2011. Starting Monday, April 4, 2011, Carl was happy to drive off to work and leave me at home with the children.
As spring break progressed, Carl's left knee and the area just below the knee started to bother him. By Thursday, April 7, 2011, Carl's left knee was painful enough that he had to start using crutches to walk. The children's spring break vacation continued, though, with Carl escaping to his work when he wasn't at something medical or recovering from something medical.
On Saturday, April 9, 2011 we 'left town' for the baptism of Cooper Schmidt, my niece's 1st baby, and the first grandchild in my family. We took the family picture at the beginning of this post before Cooper's baptism in Green Lake, Wisconsin.
Here is Carl with Cooper. Carl is now a Great Uncle, but we already knew that before Cooper was born.
After the baptism (the very next day, even), we started celebrating Miranda's 12th birthday. We celebrated Miranda's birthday several times, actually. (Her actual birthday is April 11)
On Wednesday April 13, 2011 Carl had a small surgery for a hernia repair.
On Thursday, April 14, 2011 we celebrated Tom's 17th Birthday.
On Sunday April 17, 2011 we celebrated my niece's birthday, and Tom's and Miranda' birthday again!
On Monday April 18, 2011 we finished our taxes.
Sunday April 24, 2011, Easter came, and we decorated Easter eggs and more.
We saw both side of the family on Easter - lunch with my relatives, dinner with Carl's relatives.
On Monday April 25, 2011, Carl's neck was swelling up.
On Friday, April 29, 2011 we went and watched a play at Homestead High school that Anthony was very active in. Anthony was the lighting stage crew manager, and had been working on this play extensively through out April.
Many other things went on in April 2011. Almost every weekday in April, Carl got a dose of radiation to the neck.
So, as I said before, April was very busy.
Monday, March 28, 2011
Neck MRI and CT scan images
Figure A below is a MRI image of a sarcoma in Carl's neck as of Jan 5, 2011 with some added 'visual' information. In photo shop I added colors and labels, and drew a rough outline to help you orient the placement of the head, which hopefully helps you better understand the MRI.
In Figure A, the vertebrae (neck bones) are in green. The vertebrae part on the left in green (front of the neck) rings the spinal column and connects to the green part on the right (in the back of the neck).
The photo below shows a neck vertebrae bone as it would look if your were looking from the top of the head. You can see how the bone has a ring. The ring circles the spine.
The next visual labels different parts of the vertebrae.
In Figure A, the spinal column (in yellow) is protected by a fluid filled sack. Perhaps you can now see the bad news of Figure A.
The nasty sarcoma tumor (shown in red on Figure A) is impinging (almost touching) the spinal column. It is squishing the fluid filled spinal sack. Unfortunately, the sarcoma tumor has also eaten away and destroyed part of the bone in the back of the C2 vertebrae, and possibly others (C3?). Destroying parts of the bone of the vertebrae - Bad. Touching the spinal column (i.e. the spine) - Well, that would be way worse.
Below are images from a CT scan of Carl's head taken from the top of the head looking down. This CT scan is from January 5, 2011. CT scans show bone details clearly. You can see the vertebrae glowing in white. Instead of being shaped like the photo above, the white bone has been replaced on the right with ominous gray tumor material.
Below are three MRI images of the same cross section, again, from Jan 05, 2011. Above, CT scans, below MRI scans.
The three MRI images show different ways the MRI contrast can be adjusted to better see various types of tissues.
The final two images below are from a CT scan adjusted to show different structures. The views are a cross sections of Carl's neck from the back (image on the left), and a side view of the neck (on the right).
These images document why the sarcoma tumor in the neck had to be surgically removed. Carl had surgery to remove the tumor on January 24, 2011.
Click on any images to see it larger (and less blurry.)
In Figure A, the vertebrae (neck bones) are in green. The vertebrae part on the left in green (front of the neck) rings the spinal column and connects to the green part on the right (in the back of the neck).
The photo below shows a neck vertebrae bone as it would look if your were looking from the top of the head. You can see how the bone has a ring. The ring circles the spine.
The next visual labels different parts of the vertebrae.
In Figure A, the spinal column (in yellow) is protected by a fluid filled sack. Perhaps you can now see the bad news of Figure A.
The nasty sarcoma tumor (shown in red on Figure A) is impinging (almost touching) the spinal column. It is squishing the fluid filled spinal sack. Unfortunately, the sarcoma tumor has also eaten away and destroyed part of the bone in the back of the C2 vertebrae, and possibly others (C3?). Destroying parts of the bone of the vertebrae - Bad. Touching the spinal column (i.e. the spine) - Well, that would be way worse.
Below are images from a CT scan of Carl's head taken from the top of the head looking down. This CT scan is from January 5, 2011. CT scans show bone details clearly. You can see the vertebrae glowing in white. Instead of being shaped like the photo above, the white bone has been replaced on the right with ominous gray tumor material.
Below are three MRI images of the same cross section, again, from Jan 05, 2011. Above, CT scans, below MRI scans.
The three MRI images show different ways the MRI contrast can be adjusted to better see various types of tissues.
The final two images below are from a CT scan adjusted to show different structures. The views are a cross sections of Carl's neck from the back (image on the left), and a side view of the neck (on the right).
These images document why the sarcoma tumor in the neck had to be surgically removed. Carl had surgery to remove the tumor on January 24, 2011.
Click on any images to see it larger (and less blurry.)
Awesome Technology
When it comes to cancer care in 2011, in the United States, here in Wisconsin, the engineer and photographer in me is grateful and proud of the available digital diagnostic technology. The technology is improving exponentially.
Like the expansion of the Internet and the digital camera, diagnostic imaging is improving cancer detection, monitoring, and care. I don't like the fact that Carl has cancer, but if you have to get cancer, (and you can't delay getting cancer into the future), now is the time to get it over any other period in time, any other millennium, century or year. The 'technology', drugs, and care is improving. Teams of engineers, scientists, technicians and doctors have created the technology I am going attempt to show you below.
Don't let the fact that this technology is cool make you think I am in any way happy that my husband has cancer. The pep talk above does not make it any easier for me to use photo shop to try to document this tumor. I am doing this (originally) for my children; also my spouse, our relatives and friends; and others who may stumble across this post trying to understand cancer. I do not like spending time trying to make the images understandable. But I think I can use my time to help some people understand more about cancer, or Carl's cancer, where ever their interest might lie.
Below are some MRI images that show the tumor in Carl's neck as of Jan 5, 2011. MRI stands for Magnetic Resonance Imaging. See Wikipedia for technological information on MRI's. Basically, MRI's use a large machine, a lot of physics and a lot of engineering to take multiple cross section photos of a part of the body, in this case Carl's neck.
If you can't see how Figure 1 or Figure 2 are images of a view of a neck, see Figure 3 and 4 below for some added 'visual' information which may help you to be able to better understand the MRI's.
Figure 1 is a MRI of a sarcoma in Carl's neck as of Jan 5, 2011. This is a view as the doctor or technician can see it on their computer screen. On the computer, the doctor can manipulate settings like contrast.
Figure 2 is a MRI of a sarcoma in Carl's neck as of Jan 5, 2011 with different settings, as the doctor or technician can see it on their computer screen. Notice how the neck vertebrae (the bones) stand out differently then in Figure 1 above. In Figure 1 the vertebrae (bones) are gray, in Figure 2 the bones are dark and stand out more. The tumor is more visible in Figure 2 when the bones are dark.
Figure 3 is Figure 2 with some added 'visual' information. I took the Figure 2 above and in photoshop I added colors and labels, and drew a childish outline to help you orient the placement of the head, which hopefully helps you better understand the MRI. Figure 3 is NOT what the doctors see on their computer screens.
Figure 4 is Figure 2 with some added 'visual' information. It is my first attempt at showing what parts are what. I took the Figure 2 above and in photo shop I added labels, and drew a childish outline to help you orient the placement of the head. Figure 4 is NOT what the doctors see on their computer screens.
MRI's are good for showing tissues, and differences in tissues. Carl also gets CAT scans. CAT scans are good at showing bone and structures like veins. I hope to show you CAT scans on a different future post. Carl also gets some X-Rays, which are good for showing bones, although differently then in a CAT scan. The combination of MRI's and CAT scans give doctors knowledge (and a visual picture) of things inside the body that used to be able to only be seen once a surgeon cut the body open. Now, the doctors and surgeons learn much before any cuts are made.
My children find these photos interesting for several seconds, and then at some point the information creeps them out and they need to walk away. It is not just a screen shot, it is a tumor that once was in their dad. (Surgery removed almost all of the tumor in Carl's neck on Monday Jan 24, 2011.) I am telling you about my 11-16 year old children's responses so that you may be aware of and accept your own feelings. I find it easiest to view these images when I detach them from being my husband's neck images. (It is easier to view them 'clinically'.)
I waited months to post these images. Maybe you will understand why. Whatever.
The next blog post will talk about Carl's MRI more specifically.
Click on any images to see it larger (and less blurry.)
Like the expansion of the Internet and the digital camera, diagnostic imaging is improving cancer detection, monitoring, and care. I don't like the fact that Carl has cancer, but if you have to get cancer, (and you can't delay getting cancer into the future), now is the time to get it over any other period in time, any other millennium, century or year. The 'technology', drugs, and care is improving. Teams of engineers, scientists, technicians and doctors have created the technology I am going attempt to show you below.
Don't let the fact that this technology is cool make you think I am in any way happy that my husband has cancer. The pep talk above does not make it any easier for me to use photo shop to try to document this tumor. I am doing this (originally) for my children; also my spouse, our relatives and friends; and others who may stumble across this post trying to understand cancer. I do not like spending time trying to make the images understandable. But I think I can use my time to help some people understand more about cancer, or Carl's cancer, where ever their interest might lie.
Below are some MRI images that show the tumor in Carl's neck as of Jan 5, 2011. MRI stands for Magnetic Resonance Imaging. See Wikipedia for technological information on MRI's. Basically, MRI's use a large machine, a lot of physics and a lot of engineering to take multiple cross section photos of a part of the body, in this case Carl's neck.
If you can't see how Figure 1 or Figure 2 are images of a view of a neck, see Figure 3 and 4 below for some added 'visual' information which may help you to be able to better understand the MRI's.
Figure 1 is a MRI of a sarcoma in Carl's neck as of Jan 5, 2011. This is a view as the doctor or technician can see it on their computer screen. On the computer, the doctor can manipulate settings like contrast.
Figure 2 is a MRI of a sarcoma in Carl's neck as of Jan 5, 2011 with different settings, as the doctor or technician can see it on their computer screen. Notice how the neck vertebrae (the bones) stand out differently then in Figure 1 above. In Figure 1 the vertebrae (bones) are gray, in Figure 2 the bones are dark and stand out more. The tumor is more visible in Figure 2 when the bones are dark.
Figure 3 is Figure 2 with some added 'visual' information. I took the Figure 2 above and in photoshop I added colors and labels, and drew a childish outline to help you orient the placement of the head, which hopefully helps you better understand the MRI. Figure 3 is NOT what the doctors see on their computer screens.
Figure 4 is Figure 2 with some added 'visual' information. It is my first attempt at showing what parts are what. I took the Figure 2 above and in photo shop I added labels, and drew a childish outline to help you orient the placement of the head. Figure 4 is NOT what the doctors see on their computer screens.
MRI's are good for showing tissues, and differences in tissues. Carl also gets CAT scans. CAT scans are good at showing bone and structures like veins. I hope to show you CAT scans on a different future post. Carl also gets some X-Rays, which are good for showing bones, although differently then in a CAT scan. The combination of MRI's and CAT scans give doctors knowledge (and a visual picture) of things inside the body that used to be able to only be seen once a surgeon cut the body open. Now, the doctors and surgeons learn much before any cuts are made.
My children find these photos interesting for several seconds, and then at some point the information creeps them out and they need to walk away. It is not just a screen shot, it is a tumor that once was in their dad. (Surgery removed almost all of the tumor in Carl's neck on Monday Jan 24, 2011.) I am telling you about my 11-16 year old children's responses so that you may be aware of and accept your own feelings. I find it easiest to view these images when I detach them from being my husband's neck images. (It is easier to view them 'clinically'.)
I waited months to post these images. Maybe you will understand why. Whatever.
The next blog post will talk about Carl's MRI more specifically.
Click on any images to see it larger (and less blurry.)
Monday, March 14, 2011
2011 Summary (so far) and 2nd Surgery update
Wow, it has been a while since I have done an update. Perhaps no news is good news? It's been so long I'll do a brief summary of 2011 with regards to Carl's medical journey. I'll start with December, just 'cause.
Dec 27-Dec 30, 2011 Carl had inpatient Chemotherapy at Froedtert. They let him out one day early so that he could enjoy New Years Eve and Day with his family.
Carl had the hardest time recovering from this particular chemotherapy, and pain increased in his neck. The Doctors decided to operate on his neck to stabilize his neck and debulk the tumor, and the neck surgery was done on Jan 24, 2011. Carl was sent home from the hospital wearing a neck brace, which he wore for 23 plus hours a day, except in the shower, for weeks, and instructions not to drive.
After the surgery Carl was recovering (sort-of) but then the pain in his neck was getting worse. The surgeon saw Carl, took an X-ray, and determined that Carl's spinal fusion had failed, and included a screw pulling out. Carl had an emergency surgery on Feb 14, 2011 to repair the failed hardware. On this surgery they pulled out the screws and put in larger screws, used acrylic glue and more hardware, and fused Carl's neck from the base of his skull to C7.
Carl was released from the hospital on Wednesday, February 16, 2011. After a week or so, Carl felt good enough to start working again, although with reduced hours. Again, Carl was sent home from the hospital wearing a neck brace, which he wore for 23 plus hours a day, except in the shower, for weeks. He won't be able to drive a car for at least six weeks.
Life with the children, of course, continued, and the weekend of Feb 25-27, 2011 was particularily busy. Anthony (a freshman) was in a great musical for 4 days, Miranda (6th grade) was in forensics, and the three younger children had a piano recital, and poor weather made some things more difficult. We survived the activity, but Carl overdid it that weekend. The funny thing about overdoing things is that "hindsight is 20-20". After you overdo something, you know that hey - you overdid it, you shouldn't do that. But by then it is too late. Fortunately, Carl survived, with no ill effects.
The 2nd surgery's spinal fusion has lasted longer and worked better then the first surgery, so far. On Thursday, March 10, 2011 I took Carl to see the surgeon for a post-op appointment. Carl had an X-ray and the surgeon said things look great. He even said Carl could start wearing the neck brace less (an hour or two each day), and that Carl should start PT (Physical Therapy) next week.
This week, later today, in fact, Carl will meet with the radiation Doctor, and 'the doctors' will start planning the next link in the chain of treatment.
Dec 27-Dec 30, 2011 Carl had inpatient Chemotherapy at Froedtert. They let him out one day early so that he could enjoy New Years Eve and Day with his family.
Carl had the hardest time recovering from this particular chemotherapy, and pain increased in his neck. The Doctors decided to operate on his neck to stabilize his neck and debulk the tumor, and the neck surgery was done on Jan 24, 2011. Carl was sent home from the hospital wearing a neck brace, which he wore for 23 plus hours a day, except in the shower, for weeks, and instructions not to drive.
After the surgery Carl was recovering (sort-of) but then the pain in his neck was getting worse. The surgeon saw Carl, took an X-ray, and determined that Carl's spinal fusion had failed, and included a screw pulling out. Carl had an emergency surgery on Feb 14, 2011 to repair the failed hardware. On this surgery they pulled out the screws and put in larger screws, used acrylic glue and more hardware, and fused Carl's neck from the base of his skull to C7.
Carl was released from the hospital on Wednesday, February 16, 2011. After a week or so, Carl felt good enough to start working again, although with reduced hours. Again, Carl was sent home from the hospital wearing a neck brace, which he wore for 23 plus hours a day, except in the shower, for weeks. He won't be able to drive a car for at least six weeks.
Life with the children, of course, continued, and the weekend of Feb 25-27, 2011 was particularily busy. Anthony (a freshman) was in a great musical for 4 days, Miranda (6th grade) was in forensics, and the three younger children had a piano recital, and poor weather made some things more difficult. We survived the activity, but Carl overdid it that weekend. The funny thing about overdoing things is that "hindsight is 20-20". After you overdo something, you know that hey - you overdid it, you shouldn't do that. But by then it is too late. Fortunately, Carl survived, with no ill effects.
The 2nd surgery's spinal fusion has lasted longer and worked better then the first surgery, so far. On Thursday, March 10, 2011 I took Carl to see the surgeon for a post-op appointment. Carl had an X-ray and the surgeon said things look great. He even said Carl could start wearing the neck brace less (an hour or two each day), and that Carl should start PT (Physical Therapy) next week.
This week, later today, in fact, Carl will meet with the radiation Doctor, and 'the doctors' will start planning the next link in the chain of treatment.
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.
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