Our dad had his first post surgery visit with Dr. Krishnan today. Prior to his appointment, our dad has a Chest Xray, and then proceeeded to his scheduled visit. He met with Dr. Krishnan's Nurse Practitioner, Kristin, first to briefly discuss how he has been doing since his discharge. Kristin is warm and positive with our dad. She remarks that our dad looks good and reminds him to continue to challenge and strengthen himself with activity, including his physical therapy exercises. Kristin then removed our dad's sutures from the chest tube incision.
Dr. Krishnan enters soon after and launches into his perspective on our dad's Chest Xray. He comments that it has improved a lot, but is not perfect yet. Dr. Krishnan explains that our dad's lower left lobe had a significant amount of scar tissue from his heart surgery in 2000 and as a result, he likened the view of his lower lobe to a "tight knot." Our dad's continual and frequent exercises with the incentives spirometer and flutter valve, along with increased activity--walking, deep breathing, coughing, etc.--ought to help 'loosen the knot,' open up and clear that lobe for optimal function. Dr. Krishnan remarks that our dad's oxygenation seems quite good. He removes the oxygen and wants to 'test' his level without oxygen during activity. He sends our dad and Kristin for a walking test. Our dad's O2 remains in the mid-high 90s. As a result, Dr. Krishnan tells our dad he may use the oxygen "as needed" for the interim until he sees Dr. Nadeem on Friday for further instructions. This, definitely, was a positive development. Our dad was visibly pleased.
Dr. Krishnan also offered us the opportunity to see images of our dad's lung, tissue, ribs, and, of course, tumor, from photos taken post surgery. Our dad seemed very interested in seeing the photos. It was amazing to listen to Dr. Krishnan explain the contents of each slide and show us the tumor from different imaging perspectives. Dr. Krishnan obviously loves his profession. Fascinating to me was his eagerness to share and articulate as multidimensional a picture as possible for our dad his disease. The opportunity to see his tumor gave our dad and us an incredibly concrete visual of this insidious enemy and how it had invaded our dad.
Dr. Krishnan and Kristin wish our dad further strength in his recovery and schedule another visit in one month for another Chest Xray followup.
The next visit, with the oncologist, Dr. Treisman is scheduled for 3:30, though as we wait for our dad to be called, we learn that scheduled appointments rarely follow "schedule." Our dad, already nervous for this appointment, becomes increasingly anxious and frustrated that we are not seen. Finally, over an hour past his scheduled time, we are seated in a room. Dr. Treisman comes in and begins to talk about the chemotherapy recipes that are used with our dad's nonsmall cell lung cancer, naming each drug and talking about the combination "recipes" that can be chosen. It is overwhelming for us, as patients, to listen to these foreign names and follow as Dr. Treisman speaks of combining one drug with another, and offering perspectives on the merits of choosing drug B over drug C. He explains that this portion of chemotherapy followup is recommended for patients whose tumors have been completely resected as an added measure to prevent recurrence. He suggests that the research indicates more favorable outcomes for patients who undergo a short course of chemotherapy post surgery over those who do not have chemotherapy. It is unclear that precise difference, but it is clear that chemotherapy is strongly recommended. This "recipe," as it is called, will be followed in a course of 4 infusions, once every three weeks, beginning in approximately 3 weeks.
Dr. Treisman continues by adding that a national Reseach Evaluation Study "E1505" is currently underway and recommends to our dad to add this chemotherapy element to his course. This added component would extend his chemotherapy, as it would include a specific number of infusions for the next year. Dr. Treisman explains that he really likes this drug and believes it is tolerated well by patients. He suggests that our dad would benefit from participating in the study. He sends us home with a 28 page consent form packet that discusses the treatment drugs, their potential side effects, and other basic information to consider before proceeding the chemotherapy course.
Our dad seems emotionally drained by the day's end. Despite knowing that chemotherapy was an almost assured inevitability, he still remarks that he had "hoped he would not have to go through chemo." Chemotherapy seems ultimately scarier and more daunting than the excruciating pain of even his surgery. He is quiet and accepting during his appointment with Dr. Treisman, but (to me) seems upset over this next step. Dr. Treisman's professional style and personality are markedly different than Dr. Krishnan's. While we have the reminder of Dr. Treisman from our dad's sister, Rose's, experience (and her deep affection and adoration of him), he is nevertheless new to us. This relationship is new, scary, and will take time to develop, we agree. Everyone we talk to seems to love Dr. Treisman and think he is fabulous. We trust these testimonials. As we look ahead, we must begin to put our faith in the process and help our dad see this future with optimism and light.
Tuesday, March 31, 2009
Sunday, March 29, 2009
Preparing for Home
Well, I suppose I never realized how truly out of touch with time I have been until it dawned on me a couple of days ago that Easter is not next weekend. I am completely screwed up with time, it seems, and have been seriously operating under the assumption that Easter was sooner than its actual date on the calendar. And no one was kind enough to correct me either. Oops. So with Easter two weeks away, we will likely spend the next two weeks continuing to help our dad recover and regain strength, in preparation for chemotherapy that will presumably begin shortly after our Easter holiday.
This week has been a good one for our dad. He decided to spend the week with Gina, to continue his course with the visiting nurse and physical therapist, and to be surrounded by people and activity throughout each day. It is clear to us he feels safer when surrounded by others throughout the day. The days continued to be positive times for our dad. He seemed to enjoy his time with Gina and her little ones. His kinship and connection with Gianna seemed to grow and be a mutually adorable experience. Evenings still remained a struggle. Our dad experienced pain most intensely and palpably at night. Since last Tuesday, his evening "bedtime" routine began with one Advil PM and a prescribed pain med to help get him to sleep; though he still had trouble sleeping for an extended period and would inevitably wake in the middle of the night for the additional Advil PM to help carry him through the evening hours. His body now appears regulated to a 3 hour sleep cycle. He remains troubled to find a comfortable position in which to sleep and is restless. Gina wonders if our dad is generally restless, as she hears him moaning or making plaintive comments in Italian during the night. She wonders this especially because when she checks on him--worried for his restlessness--he is actually sleeping.
By Thursday, our dad had begun to spend daytime hours without dependence on his walker, a major step in the right direction. He is showering every day and seems to have a witty sense of humor, Gina reports. She says he is "hamming it up" with the visiting nurse and physical therapist and is cracking jokes, making hilarious and sarcastic one-liners with Gina as they hang out together. Carmelo visits on Thursday with his son Vincent to watch NCAA basketball. They spend the entire day and into the late hours of the evening together. Our dad was delighted. An added surprise guest on Thursday for March Madness visiting was our dad's nephew, Matt Regan. The guys all hung out together and watched the games and seemed to enjoy a laid-back, relaxing time. Our dad was truly touched by Matt's visit and was so happy to see Carmelo again as well as his grandson, Vinnie.
Our mom and Tony arrived for the weekend on Saturday morning. Our dad, of course, was happy to be with them again too. Saturday seemed busy and bustling at Gina's house. Our dad seemed to be in pretty good spirits on Saturday. He looked great. We had a low-key day, played 'reindeer games' with the kids while our dad watched basketball, and enjoyed a fantastic family dinner, compliments of Mr. and Mrs. Aiello. It was a good day with good energy shared by everyone there.
Today our dad prepared for the journey home--back to Milwaukee. He has his followup appointment with Dr. Krishnan tomorrow afternoon and his oncology appointment with Dr. Treisman immediately after Dr. Krishnan. Our dad seemed nervous about going home...not for anything except the change, it seemed. My guess, too, is the impending appointments tomorrow have him unsettled as well, especially the oncologist. Gina told our dad that he is welcome to return to her house for the week if he would like and assured him that he should do whatever makes him feel most comfortable. It is apparent, to all of us, that he does quite well and is good for his spirits when he has people around him throughout the day. Both he and our mom seem to be concerned about imposing too much on any of us, though. They are assured there is no imposition.
He is now home safely. Our mom seems glad for it and is, no doubt, looking forward to their physical closeness...saying goodnight at bedtime and greeting him with a kiss in the morning. She seems to miss not taking care of him herself. It is obvious they have missed each other. While there is some natural trepidation from both of them for this homecoming, we all hope his first night back home is restful and comfortable. Equally important, we hope he feels secure and proud of how he has evolved and strengthened these two weeks post-surgery, especially as he anticipates his big appointments tomorrow. His belief in himself is both essential and critical, and seems (true to him) the most difficult hurdle to overcome.
This week has been a good one for our dad. He decided to spend the week with Gina, to continue his course with the visiting nurse and physical therapist, and to be surrounded by people and activity throughout each day. It is clear to us he feels safer when surrounded by others throughout the day. The days continued to be positive times for our dad. He seemed to enjoy his time with Gina and her little ones. His kinship and connection with Gianna seemed to grow and be a mutually adorable experience. Evenings still remained a struggle. Our dad experienced pain most intensely and palpably at night. Since last Tuesday, his evening "bedtime" routine began with one Advil PM and a prescribed pain med to help get him to sleep; though he still had trouble sleeping for an extended period and would inevitably wake in the middle of the night for the additional Advil PM to help carry him through the evening hours. His body now appears regulated to a 3 hour sleep cycle. He remains troubled to find a comfortable position in which to sleep and is restless. Gina wonders if our dad is generally restless, as she hears him moaning or making plaintive comments in Italian during the night. She wonders this especially because when she checks on him--worried for his restlessness--he is actually sleeping.
By Thursday, our dad had begun to spend daytime hours without dependence on his walker, a major step in the right direction. He is showering every day and seems to have a witty sense of humor, Gina reports. She says he is "hamming it up" with the visiting nurse and physical therapist and is cracking jokes, making hilarious and sarcastic one-liners with Gina as they hang out together. Carmelo visits on Thursday with his son Vincent to watch NCAA basketball. They spend the entire day and into the late hours of the evening together. Our dad was delighted. An added surprise guest on Thursday for March Madness visiting was our dad's nephew, Matt Regan. The guys all hung out together and watched the games and seemed to enjoy a laid-back, relaxing time. Our dad was truly touched by Matt's visit and was so happy to see Carmelo again as well as his grandson, Vinnie.
Our mom and Tony arrived for the weekend on Saturday morning. Our dad, of course, was happy to be with them again too. Saturday seemed busy and bustling at Gina's house. Our dad seemed to be in pretty good spirits on Saturday. He looked great. We had a low-key day, played 'reindeer games' with the kids while our dad watched basketball, and enjoyed a fantastic family dinner, compliments of Mr. and Mrs. Aiello. It was a good day with good energy shared by everyone there.
Today our dad prepared for the journey home--back to Milwaukee. He has his followup appointment with Dr. Krishnan tomorrow afternoon and his oncology appointment with Dr. Treisman immediately after Dr. Krishnan. Our dad seemed nervous about going home...not for anything except the change, it seemed. My guess, too, is the impending appointments tomorrow have him unsettled as well, especially the oncologist. Gina told our dad that he is welcome to return to her house for the week if he would like and assured him that he should do whatever makes him feel most comfortable. It is apparent, to all of us, that he does quite well and is good for his spirits when he has people around him throughout the day. Both he and our mom seem to be concerned about imposing too much on any of us, though. They are assured there is no imposition.
He is now home safely. Our mom seems glad for it and is, no doubt, looking forward to their physical closeness...saying goodnight at bedtime and greeting him with a kiss in the morning. She seems to miss not taking care of him herself. It is obvious they have missed each other. While there is some natural trepidation from both of them for this homecoming, we all hope his first night back home is restful and comfortable. Equally important, we hope he feels secure and proud of how he has evolved and strengthened these two weeks post-surgery, especially as he anticipates his big appointments tomorrow. His belief in himself is both essential and critical, and seems (true to him) the most difficult hurdle to overcome.
Monday, March 23, 2009
Exactly One Month
Today marks one month after learning of our dad's tumor...a "large," rarely noncancerous mass in his upper left lobe. It is strange--still--to me that the night before this whole nightmare began, I did not sleep well and did not understand why. I remember tossing and turning that night before 'the news' and being awake while the whole house was asleep. When the 7am phone call came, I remember looking at the caller ID and wondering whether my mom was calling early to chastise me for not making a Sunday, "how is everyone?" pbone call to my parents' house. If only I could have been so lucky. Instead, I recall screaming--screaming, when my mom called with the news--hysterically asking her "why did you not call any of us during the night?!?" and not being able to stand while I tried to shower while sobbing. I wonder, with much pain in my heart, how our mom must have felt hearing the words from the ER doctors; and then, I cannot bear to imagine how she managed to bear the agony of repeating the words--four times--to each of us that day. True strength. Unimaginable.
I know I did not sleep well last night and believe it had a great deal to do with this one month marker. I had dreams that woke me in a start. I suspect none of us slept well, thinking of the reminder of last month's crude awakening. This month has gone by so quickly, and yet, so slowly, if that makes any sense. Our dad has been through the most intense and physically painful month of his existence. And we would each do anything for him to take this all away.
I heard from Gina that our dad, despite an active and happy day, did not sleep well Sunday night. She said when our mom and he parted with their tender kiss and loving goodbye, he saw tears in our dad's eyes. The two of them have this crazy connection--intense and fiesty, yet deeply committed. Gina said she could not handle our dad's stifled tears. I said I had to leave prior to seeing my mom weep in her goodbye. Gina again mentions how horribly she feels that our dad cannot sleep. Gina and I talk about how, even with a small, seemingly insignificant problem, sleeping can be difficult. We know, with our dad, the quiet of night must be agonizing. He is left alone with his thoughts and is tormented. Gina hears him sighing restlessly and in pain through the baby monitor. She does not know quite how to handle the pain. She wants him to sleep. She does not want to interrupt him by visiting his room. Yet, she does not want him to feel ignored. She just wants him to have rest. He remains restless until she, at last, distributes another pain pill. It was a difficult night, especially since he did well all day. The night, with its silence, seems to feed on the pain.
He is running out of pain meds and is getting frustrated. Gina called Dr. Krishnan's nurse today to ask them to reissue his pain meds. Kristin only offered one of the two for refill. Our dad felt noticeably upset when he learned his "round the clock, every 12 hour med" would not be refreshed. Gina, clinically, did not quite understand it either. Nor did any of us. It has not even been a week since he started these meds. "Too addictive," remarked NP Kristin. Yet, at the same time, Kristin informed Gina that our dad would feel a host of agonies, "numbness, dullness, pinching, prodding, and throbbing (to name a few) for weeks." But no more "biggie" pain meds. Gina expressed distraught for our dad. She said he was visibly annoyed, to say the least..."they never said it would feel this bad." We all feel miserable for him. He is moving; he is trying to be active, both physically, and while seated, with his Incentives Spirometer and his Flutter Valve. Yet his pain remains. Bone, cartilage, muscle, organ--all removed--just over a week ago. Pain. Real pain. Why can we not modify it a bit longer?
I keep thinking about last month--February 23rd. The phone call that literally has changed my life, and that of our entire family. I feel selfish sometimes when I think of us....every family has its problems. Every person has his or her Big issues. But I cannot help but feel deeply for our dad. I still do not understand all of this. Every health problem he has seems to be a "biggie:" prostate cancer=aggressive surgical removal; heart problem=double bypass surgery, not angioplasty; and now lung cancer. Even writing the words seem to stop me in disbelief. Why? And why? Not just a lobectomy, but a thoracotomy too. Why?? Maybe our strong and ever faithful dad will not ask. I will. I do not have his strength.
This all has begun for us on the eve of Lent. As I drove to Milwaukee to see my dad this very day last month, I thought about this shock to our family and this unfathomable diagnosis for him, presenting itself on the Eve of Lent. I wondered, and still do, why our dad is a constant sacrifice and symbol of pain, for our family. I am weeping thinking about this amazing man and his unbelievable gift of himself to all of us. I understand, but at the same time, do not.
Our mom told me, when we talked last week about our dad and Lent, that Carmelo's wife Michelle poignantly said it is interesting that this is all happening--for our dad and all of us who are closest to him--during the Lenten season: the Holiest time our our year. The Holiest. He was diagnosed the day before Ash Wednesday. The meaning for Catholics could not be greater. I still cannot get the symbolism out of my mind. I find Michelle's perspective full of so much Wisdom--wisdom I never would have seen. I see it only as Sacrifice and Pain. But I am holding on to Michelle's wisdom. She is right. Somehow, in spite of this unbearable pain, I do believe in the meaning of all of this, during the most Holy time for our Faith. And I would like to believe that his hospital discharge on the day that symbolizes our "Irish Luck" would bode well for our dad somewhere, somehow.
Optimism. It makes so much sense. Yet it can be such a difficult concept. I know I am trying my best. I do believe in our dad. I do. I desperately want to feel confident that he has optimism too. 12 more days until Easter. Hope. Hope. Hope....
I know I did not sleep well last night and believe it had a great deal to do with this one month marker. I had dreams that woke me in a start. I suspect none of us slept well, thinking of the reminder of last month's crude awakening. This month has gone by so quickly, and yet, so slowly, if that makes any sense. Our dad has been through the most intense and physically painful month of his existence. And we would each do anything for him to take this all away.
I heard from Gina that our dad, despite an active and happy day, did not sleep well Sunday night. She said when our mom and he parted with their tender kiss and loving goodbye, he saw tears in our dad's eyes. The two of them have this crazy connection--intense and fiesty, yet deeply committed. Gina said she could not handle our dad's stifled tears. I said I had to leave prior to seeing my mom weep in her goodbye. Gina again mentions how horribly she feels that our dad cannot sleep. Gina and I talk about how, even with a small, seemingly insignificant problem, sleeping can be difficult. We know, with our dad, the quiet of night must be agonizing. He is left alone with his thoughts and is tormented. Gina hears him sighing restlessly and in pain through the baby monitor. She does not know quite how to handle the pain. She wants him to sleep. She does not want to interrupt him by visiting his room. Yet, she does not want him to feel ignored. She just wants him to have rest. He remains restless until she, at last, distributes another pain pill. It was a difficult night, especially since he did well all day. The night, with its silence, seems to feed on the pain.
He is running out of pain meds and is getting frustrated. Gina called Dr. Krishnan's nurse today to ask them to reissue his pain meds. Kristin only offered one of the two for refill. Our dad felt noticeably upset when he learned his "round the clock, every 12 hour med" would not be refreshed. Gina, clinically, did not quite understand it either. Nor did any of us. It has not even been a week since he started these meds. "Too addictive," remarked NP Kristin. Yet, at the same time, Kristin informed Gina that our dad would feel a host of agonies, "numbness, dullness, pinching, prodding, and throbbing (to name a few) for weeks." But no more "biggie" pain meds. Gina expressed distraught for our dad. She said he was visibly annoyed, to say the least..."they never said it would feel this bad." We all feel miserable for him. He is moving; he is trying to be active, both physically, and while seated, with his Incentives Spirometer and his Flutter Valve. Yet his pain remains. Bone, cartilage, muscle, organ--all removed--just over a week ago. Pain. Real pain. Why can we not modify it a bit longer?
I keep thinking about last month--February 23rd. The phone call that literally has changed my life, and that of our entire family. I feel selfish sometimes when I think of us....every family has its problems. Every person has his or her Big issues. But I cannot help but feel deeply for our dad. I still do not understand all of this. Every health problem he has seems to be a "biggie:" prostate cancer=aggressive surgical removal; heart problem=double bypass surgery, not angioplasty; and now lung cancer. Even writing the words seem to stop me in disbelief. Why? And why? Not just a lobectomy, but a thoracotomy too. Why?? Maybe our strong and ever faithful dad will not ask. I will. I do not have his strength.
This all has begun for us on the eve of Lent. As I drove to Milwaukee to see my dad this very day last month, I thought about this shock to our family and this unfathomable diagnosis for him, presenting itself on the Eve of Lent. I wondered, and still do, why our dad is a constant sacrifice and symbol of pain, for our family. I am weeping thinking about this amazing man and his unbelievable gift of himself to all of us. I understand, but at the same time, do not.
Our mom told me, when we talked last week about our dad and Lent, that Carmelo's wife Michelle poignantly said it is interesting that this is all happening--for our dad and all of us who are closest to him--during the Lenten season: the Holiest time our our year. The Holiest. He was diagnosed the day before Ash Wednesday. The meaning for Catholics could not be greater. I still cannot get the symbolism out of my mind. I find Michelle's perspective full of so much Wisdom--wisdom I never would have seen. I see it only as Sacrifice and Pain. But I am holding on to Michelle's wisdom. She is right. Somehow, in spite of this unbearable pain, I do believe in the meaning of all of this, during the most Holy time for our Faith. And I would like to believe that his hospital discharge on the day that symbolizes our "Irish Luck" would bode well for our dad somewhere, somehow.
Optimism. It makes so much sense. Yet it can be such a difficult concept. I know I am trying my best. I do believe in our dad. I do. I desperately want to feel confident that he has optimism too. 12 more days until Easter. Hope. Hope. Hope....
Sunday, March 22, 2009
March 22, 2009
Our dad has had a front seat for March Madness this weekend. It started off with a delightful and welcome visit from Carmelo on Friday, who drove down to watch basketball with our dad Friday afternoon. Our dad was very excited to see Carmelo. He got up and seemed to eagerly await his arrival, as he hadn't seen either of his sons since Monday evening. Carmelo arrived with a few favorite treats from home, including our dad's beloved Stella Doro breakfast treats (a no-no, given his erratic post-surgery blood sugar). The two of them watched Marquette play, and our dad seemed a bit more himself. As soon as Carmelo arrived, our dad made efforts to ensure Carmelo was properly fed: "Gina, fix your brother a sandwich" (no comment on Gina's response to that :)). He seemed so happy to have the company. Gina said it made his day.
The visiting nurse and physical therapist also visited on Friday. The visiting nurse again checked our dad's incision and reported it looked very good. Later, the physical therapist consulted with our dad. She helped him with additional range-of-motion exercises to perform while seated, and also worked with him on stair climbing. The physical therapist encouraged and complimented our dad on his strength, which she felt was impressive. She recommended he (and we) work with him on endurance and confidence. Follow-up visits with our dad are scheduled for Monday, March 23. Overall, both Friday visits were quite positive and reassuring for our dad.
We are so pleased to see our dad becoming increasingly more independent. It is definitely a gradual, careful, and tepid process, but he is doing it and he is proud of himself in his ever-so-modest way. On Saturday, our dad began to complain of a "pinching" like pain around his incision, which necessitated additional pain meds; but by Sunday, our dad reported with some pride that he had skipped his (every 4 hours as needed) pain pills. He also privately expressed pride in the fact that he had used the stairs both Saturday and Sunday to shower. After he woke up on Sunday, he--to everyone's surprise--got out of bed on his own and moved to the kitchen for breakfast. Throughout the day, he got up without assistance to take his repeated walks around the first floor circuit of Gina's house on his own, without prompting. Additionally, since we were fortunate to have a beautiful, sunny, warm spring weekend, our dad spent some time outside both Saturday and Sunday.
During a quiet, private moment on Sunday, I mentioned to our dad that he seemed a bit restless. He did not seem at ease, no matter where he sat--outside wasn't satisfying, nor was his preferred chair indoors. I asked him whether he was okay and if I could do anything for him. He, really, looked contemplative. In response, he said he was a bit tired-that he may need to rest for an hour or so-but, yes, he was okay. I asked him how he had been sleeping, as he seemed to look very good and much improved from Tuesday. He said the pinching pain was interrupting his sleep, but he was managing okay. We looked at each other for a brief time and I again asked if everything was okay. He did not seem to want to share a lot, though I felt by looking into his eyes that anything he would say would mean a great deal. He, simply said, "this is hard." I felt my eyes begin to well-up instantly, but tried (not very successfully) to contain my emotion. I responded by telling him, again, that he is going through so much, but is getting better every day--visibly better, and that we are all here to help him both with the recovery and rehabilitation and with being here for him to share his feelings. He told me he did not want me to start crying, (which, thankfully, I did not) though I could see the (contained) tears in his own eyes. I told him we are all so proud of how much strength he has shown thus far, that we are taking one day at a time, that he is cancer-free today, and that we are all with him...all of us. I told him we just do not want him to give up on himself. He quickly responded that he has not, is not and does not intend to give up. We ended with an embrace, kisses, and more I love yous.
Soon after, our dad had a very restful pre-dinner nap. Carl then prepared a fabulous and enjoyed-by-all steak dinner. Our dad ate very well. He seemed to sincerely relish the family time, in his unspoken way. The babies, Gianna and Ava, have a keen affection for him, which is adorable and so endearing. He seems to know it too, but never draws attention to their special connections. After dinner, Tony, Carl, Kevin and our dad spent time chatting politics and watching the disappointing end to the Marquette game :(. Tony reminded our dad of his placement in their basketball "picks" and complimented him on his predictions thus far. Life, for a moment, again felt "normal."
This week, we hope, will be more promising for our dad. It surely will be different, as our mom will be back in Milwaukee at least through Friday. No doubt they will miss each other tremendously. He does seem to feel safe and content with Gina, which is really a special dynamic to witness. We continue our prayers for positive days ahead and hope each new day offers the promise of greater strength, endurance, and confidence for our forever faithful, quietly emotional dad.
The visiting nurse and physical therapist also visited on Friday. The visiting nurse again checked our dad's incision and reported it looked very good. Later, the physical therapist consulted with our dad. She helped him with additional range-of-motion exercises to perform while seated, and also worked with him on stair climbing. The physical therapist encouraged and complimented our dad on his strength, which she felt was impressive. She recommended he (and we) work with him on endurance and confidence. Follow-up visits with our dad are scheduled for Monday, March 23. Overall, both Friday visits were quite positive and reassuring for our dad.
We are so pleased to see our dad becoming increasingly more independent. It is definitely a gradual, careful, and tepid process, but he is doing it and he is proud of himself in his ever-so-modest way. On Saturday, our dad began to complain of a "pinching" like pain around his incision, which necessitated additional pain meds; but by Sunday, our dad reported with some pride that he had skipped his (every 4 hours as needed) pain pills. He also privately expressed pride in the fact that he had used the stairs both Saturday and Sunday to shower. After he woke up on Sunday, he--to everyone's surprise--got out of bed on his own and moved to the kitchen for breakfast. Throughout the day, he got up without assistance to take his repeated walks around the first floor circuit of Gina's house on his own, without prompting. Additionally, since we were fortunate to have a beautiful, sunny, warm spring weekend, our dad spent some time outside both Saturday and Sunday.
During a quiet, private moment on Sunday, I mentioned to our dad that he seemed a bit restless. He did not seem at ease, no matter where he sat--outside wasn't satisfying, nor was his preferred chair indoors. I asked him whether he was okay and if I could do anything for him. He, really, looked contemplative. In response, he said he was a bit tired-that he may need to rest for an hour or so-but, yes, he was okay. I asked him how he had been sleeping, as he seemed to look very good and much improved from Tuesday. He said the pinching pain was interrupting his sleep, but he was managing okay. We looked at each other for a brief time and I again asked if everything was okay. He did not seem to want to share a lot, though I felt by looking into his eyes that anything he would say would mean a great deal. He, simply said, "this is hard." I felt my eyes begin to well-up instantly, but tried (not very successfully) to contain my emotion. I responded by telling him, again, that he is going through so much, but is getting better every day--visibly better, and that we are all here to help him both with the recovery and rehabilitation and with being here for him to share his feelings. He told me he did not want me to start crying, (which, thankfully, I did not) though I could see the (contained) tears in his own eyes. I told him we are all so proud of how much strength he has shown thus far, that we are taking one day at a time, that he is cancer-free today, and that we are all with him...all of us. I told him we just do not want him to give up on himself. He quickly responded that he has not, is not and does not intend to give up. We ended with an embrace, kisses, and more I love yous.
Soon after, our dad had a very restful pre-dinner nap. Carl then prepared a fabulous and enjoyed-by-all steak dinner. Our dad ate very well. He seemed to sincerely relish the family time, in his unspoken way. The babies, Gianna and Ava, have a keen affection for him, which is adorable and so endearing. He seems to know it too, but never draws attention to their special connections. After dinner, Tony, Carl, Kevin and our dad spent time chatting politics and watching the disappointing end to the Marquette game :(. Tony reminded our dad of his placement in their basketball "picks" and complimented him on his predictions thus far. Life, for a moment, again felt "normal."
This week, we hope, will be more promising for our dad. It surely will be different, as our mom will be back in Milwaukee at least through Friday. No doubt they will miss each other tremendously. He does seem to feel safe and content with Gina, which is really a special dynamic to witness. We continue our prayers for positive days ahead and hope each new day offers the promise of greater strength, endurance, and confidence for our forever faithful, quietly emotional dad.
Thursday, March 19, 2009
March 19, 2009 1 Week Post Surgery
Our dad is accustoming himself to his temporary new home with Gina, Carl, Carl, Sophia and Gianna. The kids seem so happy to have him at their house and he seems to feel safe with both our mom and Gina helping him. Despite the bustle of family life, our dad has managed to finally catch up on much needed sleep at Gina's house. While his first night home was a bit uneasy, he was able to sleep uninterrupted for 5 straight hours. Last night was a bit better. Gina actually had to wake him to give him his pain pill in the middle of the night instead of hearing him call out first.
While he still has post-surgery nausea, he has been eating well. On both mornings, he has enjoyed good breakfasts, eating a little bit more each day. He has made dinner requests too, which is amusing and delightful to us all.
For activity, he is continually exercising his lungs with the Incentives Spirometer and his "flutter puffer" and is sitting upright for the entire time he is awake. He walks his laps around Gina's first floor numerous times throughout the day and is using the cardiac rehabilitation exercises to increase his range of motion, especially on the left side. His visiting nurse stopped in yesterday and is scheduled to see him three times per week. She checked his incision and reinforced the post op orders from Dr. Krishnan. No one can stress enough the need for him to push himself to stay upright and active...deep breathing, deep breathing.
Our mom is being so helpful, both in encouraging and nurturing our dad, and in sharing time with their grandchildren. It seems she is enjoying plenty of laughs with the kids, especially always amusing Sophia. Our mom took 4 year old Sophia and 2 year old Gianna for a wagon walk around the block yesterday when our damsel-in-distress little Sophia stopped her--serious as-can-be--and in her high-pitched, desperate voice said, "I just cannot walk anymore Grandma. I just cannot stop thinking about (the love of her life) Noah." It was easy to imagine her, stopped in her tracks, with her hand on her forehead: ah, woe is me! Our mom just looked at Sophia, dumb-founded. She said she cracked-up the whole way home, after telling her she needed to get a move on and could think and dream about Noah all night when they got back home. Everyone had a great laugh when our mom reported that news back at home. Hilarious Sophia.
And Gina, well Gina gets an A+ for effort and caring for our dad. Of course, she is doing it with her own usual sense of humor too. Her clinical experience coupled with her daughterly love are honestly a perfect combination for our dad. He, without a doubt, needs both. It is clear he trusts her fully. We hope, with each new day, he becomes a bit stronger and a bit more confident so that he may begin to again trust himself as well.
While he still has post-surgery nausea, he has been eating well. On both mornings, he has enjoyed good breakfasts, eating a little bit more each day. He has made dinner requests too, which is amusing and delightful to us all.
For activity, he is continually exercising his lungs with the Incentives Spirometer and his "flutter puffer" and is sitting upright for the entire time he is awake. He walks his laps around Gina's first floor numerous times throughout the day and is using the cardiac rehabilitation exercises to increase his range of motion, especially on the left side. His visiting nurse stopped in yesterday and is scheduled to see him three times per week. She checked his incision and reinforced the post op orders from Dr. Krishnan. No one can stress enough the need for him to push himself to stay upright and active...deep breathing, deep breathing.
Our mom is being so helpful, both in encouraging and nurturing our dad, and in sharing time with their grandchildren. It seems she is enjoying plenty of laughs with the kids, especially always amusing Sophia. Our mom took 4 year old Sophia and 2 year old Gianna for a wagon walk around the block yesterday when our damsel-in-distress little Sophia stopped her--serious as-can-be--and in her high-pitched, desperate voice said, "I just cannot walk anymore Grandma. I just cannot stop thinking about (the love of her life) Noah." It was easy to imagine her, stopped in her tracks, with her hand on her forehead: ah, woe is me! Our mom just looked at Sophia, dumb-founded. She said she cracked-up the whole way home, after telling her she needed to get a move on and could think and dream about Noah all night when they got back home. Everyone had a great laugh when our mom reported that news back at home. Hilarious Sophia.
And Gina, well Gina gets an A+ for effort and caring for our dad. Of course, she is doing it with her own usual sense of humor too. Her clinical experience coupled with her daughterly love are honestly a perfect combination for our dad. He, without a doubt, needs both. It is clear he trusts her fully. We hope, with each new day, he becomes a bit stronger and a bit more confident so that he may begin to again trust himself as well.
Tuesday, March 17, 2009
St. Patrick's Day Going Home
St. Patrick's Day was a beautiful, unseasonably warm day in Milwaukee. With blue skies, sunshine, and 70 degree temperatures, we could not help but feel so good that our dad would breathe fresh air on this particularly meaningful day for our family. We tell our dad God and our loved ones are shining and smiling down on him today, this gorgeous and special going home day for him.
The thought of going home seemingly so soon post surgery began to affect our dad a great deal last night. He began to worry about his weakened state and his limited mobility. His doubts and fears about settling back at home began to set in and he suggested to our mom, Carmelo, and
Tony that he leave the hospital and head to a rehabilitation center. He, with good reasons, just did not feel ready to try independence at home. As a result, for the remainder of the night and into the morning, the five of us debated the pros and cons of a rehabilitation center for our dad. We know he is weakened and scared, but we do not want him to give up on himself.
This morning however, he accepted the challenge to moving from the hospital to home. Dr. Krishnan encouraged him well and reassured him that he would do better recovering from home rather than a rehab center. Carmelo, Gina, Tony and I talked again about home recovery together. We agreed that the most important goal now is to help our dad get as close to his presurgery baseline as possible. He will need to regain as much strength and mobility as possible before we move to our next phase, chemotherapy. We want our mom to be able to provide support, comfort and love for our dad and we do not want her to have all of the physical care responsibilities herself. We talk about splitting the next two weeks for our dad's care: Gina offers to have him with her family for the first week home and I offer the second week. We know he will resist. We know he does not want to burden us. We insist though. The most important thing is getting better. He agrees.
Our dad trusts being in Gina's care, as she is a nurse. Carl is with us at the hospital and, with his usual lightheartedness and sense of humor, reminds our dad that "he hasn't been paying $65,000 for his wife's education for it to go to waste." We promise our dad we will help him every step of the way and reassure our mom that we do not want her to do this recovery with him alone. Our mom resists, but tells our dad it is his choice. Our dad, surprisingly and without much resistance, agrees to the proposed plan, but wants our mom with him, of course. At discharge, Carl drives our dad straight "home." Our mom and I go home to pack, fill prescriptions, and prepare for the days ahead. Gina prepares the house, coordinates the home care logistics for his O2, the visiting nurse, and physical therapy. Her little ones, Carl, Sophia, and special birthday girl Gianna, anticipate with happiness that Nonnu will be at their house and they will help him get better.
While waiting to be discharged, I sit next to our dad and lean into him as he shakes his head. He is still -- as we all are -- in disbelief that all of this is happening. In exasperation, he looks up and says, "it has been 22 short, 22 long days since this all began..." I say to him this is so, so overwhelming, that he has been so amazing through this short, short time. He jokes that we are all "killing him with kindness," but I again remark how in awe I am of his strength and faith. He is remarkable and inspiring. I tell him how much we all love him and how proud of him we all are. I hug him and tell him we will get through this, we will. He says he really hopes so.
The thought of going home seemingly so soon post surgery began to affect our dad a great deal last night. He began to worry about his weakened state and his limited mobility. His doubts and fears about settling back at home began to set in and he suggested to our mom, Carmelo, and
Tony that he leave the hospital and head to a rehabilitation center. He, with good reasons, just did not feel ready to try independence at home. As a result, for the remainder of the night and into the morning, the five of us debated the pros and cons of a rehabilitation center for our dad. We know he is weakened and scared, but we do not want him to give up on himself.
This morning however, he accepted the challenge to moving from the hospital to home. Dr. Krishnan encouraged him well and reassured him that he would do better recovering from home rather than a rehab center. Carmelo, Gina, Tony and I talked again about home recovery together. We agreed that the most important goal now is to help our dad get as close to his presurgery baseline as possible. He will need to regain as much strength and mobility as possible before we move to our next phase, chemotherapy. We want our mom to be able to provide support, comfort and love for our dad and we do not want her to have all of the physical care responsibilities herself. We talk about splitting the next two weeks for our dad's care: Gina offers to have him with her family for the first week home and I offer the second week. We know he will resist. We know he does not want to burden us. We insist though. The most important thing is getting better. He agrees.
Our dad trusts being in Gina's care, as she is a nurse. Carl is with us at the hospital and, with his usual lightheartedness and sense of humor, reminds our dad that "he hasn't been paying $65,000 for his wife's education for it to go to waste." We promise our dad we will help him every step of the way and reassure our mom that we do not want her to do this recovery with him alone. Our mom resists, but tells our dad it is his choice. Our dad, surprisingly and without much resistance, agrees to the proposed plan, but wants our mom with him, of course. At discharge, Carl drives our dad straight "home." Our mom and I go home to pack, fill prescriptions, and prepare for the days ahead. Gina prepares the house, coordinates the home care logistics for his O2, the visiting nurse, and physical therapy. Her little ones, Carl, Sophia, and special birthday girl Gianna, anticipate with happiness that Nonnu will be at their house and they will help him get better.
While waiting to be discharged, I sit next to our dad and lean into him as he shakes his head. He is still -- as we all are -- in disbelief that all of this is happening. In exasperation, he looks up and says, "it has been 22 short, 22 long days since this all began..." I say to him this is so, so overwhelming, that he has been so amazing through this short, short time. He jokes that we are all "killing him with kindness," but I again remark how in awe I am of his strength and faith. He is remarkable and inspiring. I tell him how much we all love him and how proud of him we all are. I hug him and tell him we will get through this, we will. He says he really hopes so.
Monday, March 16, 2009
March 16, 2009
We waited all day today.
When I arrived to be with our dad this morning, he explained that he had not slept last night...maybe it was the pain or maybe he was overstimulated from the previous day. He looked so tired, but had already had cardiac rehabilitation and physical therapy, as well as his daily chest Xray. He needed to rest, at least a little bit, before his next walk. In addition, we were anxious today; I am certain the fear of test result reports had impacted his restlessness.
He tried to sleep throughout the day, but the interruptions were endless: housekeeping, vitals, a visit from the surgical team, the nurses, nurse assistants, pulmonologist, and respiratory therapists all made their required visits with our dad. From the moment I saw him this morning, I knew he was drained. It was difficult to balance the need he had to rest with the necessity of activity for him. Clearly, he needs his rest to manifest the strength and endurance for activity. Without the activity, he slips physically--his lungs are weakened and his recovery period takes longer. He became frustrated with me pushing him to use his Incentives Barometer and his "Flutter Puffer" every 15 minutes. He just wanted me to give him a break--let him rest. He did not want to sit today. He did not have the energy for the walking. He was so tired. It was difficult to push him, as his pain is incomprehensible; but the consequences of not expanding and working the lungs, constantly, seem more dire.
Dr. Krishnan orders the removal of the chest tube, the epidural block, and the catheter. These tube removals are promised to be acts that will make him, ultimately, more comfortable and more willing to engage in activity. But the lack of sleep from the previous night has made him weakened physically and in spirit. His chest tube removal came first. The removal and sutures seemed to go smoothly. As our dad held my hand and my arm, I watched Dr. Krishnan's nurse remove the thick tube and stitch the area. This sight was bearable. What was unbearable was the sight of our dad's pain during this procedure. Equally painful was watching him in such excruciating pain as the nurses ripped the tape from his back and removed the epidural line. For both separate procedures, he was in agony. It took all of his energy to sit up, even bend forward toward me, and remain there as the procedures took place. I told him to clench my hand and arm as much as he needed to, and as he did so, I tried to lean into him to kiss his forehead and encourage him to hold on. These tasks left him completely exhausted.
He slept for a time following all of his tube removals and I waited for word of his surgical pathology reports. The lung cancer nurse coordinator came in and gave me a care binder for our dad. Seeing he was asleep, she offered to return again tomorrow to introduce herself to him. Dr. Krishnan's nurse returned later and I asked whether Dr. Krishnan would be back again today with any pathology report. Doubtful. She talked to me a bit more about the chest Xray and the hopes for more deep breathing, exercising, sitting, walking, and expanding the lungs to loosen the secretions and avoid infection.
As I waited for my brothers and mom to arrive to take the "night shift" with our dad, I watched him rest. This day was a struggle for us. I welled-up as I thought about how much loving someone so much really hurts. The more you love someone, the more painful it feels to watch him in so much pain. We all just want to be able to do something to take some of the pain away.
Minutes after I left, Dr. Krishnan arrived to see our dad. He had the surgical pathology report on the ribs. Free of cancer. In spite of our dad's exhaustion and pain, he sheds tears of joy.
When I arrived to be with our dad this morning, he explained that he had not slept last night...maybe it was the pain or maybe he was overstimulated from the previous day. He looked so tired, but had already had cardiac rehabilitation and physical therapy, as well as his daily chest Xray. He needed to rest, at least a little bit, before his next walk. In addition, we were anxious today; I am certain the fear of test result reports had impacted his restlessness.
He tried to sleep throughout the day, but the interruptions were endless: housekeeping, vitals, a visit from the surgical team, the nurses, nurse assistants, pulmonologist, and respiratory therapists all made their required visits with our dad. From the moment I saw him this morning, I knew he was drained. It was difficult to balance the need he had to rest with the necessity of activity for him. Clearly, he needs his rest to manifest the strength and endurance for activity. Without the activity, he slips physically--his lungs are weakened and his recovery period takes longer. He became frustrated with me pushing him to use his Incentives Barometer and his "Flutter Puffer" every 15 minutes. He just wanted me to give him a break--let him rest. He did not want to sit today. He did not have the energy for the walking. He was so tired. It was difficult to push him, as his pain is incomprehensible; but the consequences of not expanding and working the lungs, constantly, seem more dire.
Dr. Krishnan orders the removal of the chest tube, the epidural block, and the catheter. These tube removals are promised to be acts that will make him, ultimately, more comfortable and more willing to engage in activity. But the lack of sleep from the previous night has made him weakened physically and in spirit. His chest tube removal came first. The removal and sutures seemed to go smoothly. As our dad held my hand and my arm, I watched Dr. Krishnan's nurse remove the thick tube and stitch the area. This sight was bearable. What was unbearable was the sight of our dad's pain during this procedure. Equally painful was watching him in such excruciating pain as the nurses ripped the tape from his back and removed the epidural line. For both separate procedures, he was in agony. It took all of his energy to sit up, even bend forward toward me, and remain there as the procedures took place. I told him to clench my hand and arm as much as he needed to, and as he did so, I tried to lean into him to kiss his forehead and encourage him to hold on. These tasks left him completely exhausted.
He slept for a time following all of his tube removals and I waited for word of his surgical pathology reports. The lung cancer nurse coordinator came in and gave me a care binder for our dad. Seeing he was asleep, she offered to return again tomorrow to introduce herself to him. Dr. Krishnan's nurse returned later and I asked whether Dr. Krishnan would be back again today with any pathology report. Doubtful. She talked to me a bit more about the chest Xray and the hopes for more deep breathing, exercising, sitting, walking, and expanding the lungs to loosen the secretions and avoid infection.
As I waited for my brothers and mom to arrive to take the "night shift" with our dad, I watched him rest. This day was a struggle for us. I welled-up as I thought about how much loving someone so much really hurts. The more you love someone, the more painful it feels to watch him in so much pain. We all just want to be able to do something to take some of the pain away.
Minutes after I left, Dr. Krishnan arrived to see our dad. He had the surgical pathology report on the ribs. Free of cancer. In spite of our dad's exhaustion and pain, he sheds tears of joy.
Sunday, March 15, 2009
Sunday Thanks
Our dad shared his day today with his many supporters, Dick Cialdini, his sister Josephine and his nephew, Ben, our Aunt Mary and Uncle Tom Street, and his Rawlings nephews, Michael, with his wife Cindy, and Jimmy, as well as his niece, Gloria with her husband Tony. His nurse, Erik, today remarked that he loved "Italian patients because their families are always there" to comfort and support. Of course, our mom made certain to add that the Irish have that same closeness and spunk, too. We are so thankful to all of the people who have visited him, in person, through phone calls, and through this site. We share with him or read him every message we receive, and he is truly touched by the enormous outpouring of concern and love for him. Thank you, truly.
Today was an active day with our dad and we know, at day's end, he was quite tired. In addition to the breathing exercises, sitting, and walking requirements, he learned new range-of-motion tasks from his physical therapist and received much needed massage. Dr. Krishnan's nurse removed the bandage from his incision too today. Our hope is that his chest tube may be ready tomorrow for removal. Once his chest tube is removed, he will also be relieved of the epidural block as a pain modifier. His oxygen level was decreased to 2L, and his O2 seemed to remain steady in the mid-90s, While his chest Xray did not indicate a substantial change from the previous day, Dr. Nadeem remarked he was pleased with our dad's appearance and activity level for today.
We are hopeful our dad may rest better tonight and will feel stronger tomorrow. We know tomorrow brings more angst, as we wait and expect the return of the pathology report on the ribs that were removed during surgery. We continue to pray, and are ever-grateful for the prayers of our loved ones for our dad.
Today was an active day with our dad and we know, at day's end, he was quite tired. In addition to the breathing exercises, sitting, and walking requirements, he learned new range-of-motion tasks from his physical therapist and received much needed massage. Dr. Krishnan's nurse removed the bandage from his incision too today. Our hope is that his chest tube may be ready tomorrow for removal. Once his chest tube is removed, he will also be relieved of the epidural block as a pain modifier. His oxygen level was decreased to 2L, and his O2 seemed to remain steady in the mid-90s, While his chest Xray did not indicate a substantial change from the previous day, Dr. Nadeem remarked he was pleased with our dad's appearance and activity level for today.
We are hopeful our dad may rest better tonight and will feel stronger tomorrow. We know tomorrow brings more angst, as we wait and expect the return of the pathology report on the ribs that were removed during surgery. We continue to pray, and are ever-grateful for the prayers of our loved ones for our dad.
Broncoscopy, Post Day 2
We know this journey may resemble a roller coaster. Each of us will take turns, emotionally, up and down. I would like to think of today as an "up" day for our dad.
While our dad had more sleep last night that he has had since the surgery--close to 5 hours--he spent the remainder of the night with frequent visits from various staff. As the new day began, he was put to work immediately, with physical and occupational therapy and cardiac rehabilitation. He had his first walk of the day before 9am. The prep for the Bronsoscopy followed shortly thereafter.
We met our dad in the prep area for the Broncoscopy. A substantial team of nurses had him prepped for the procedure while his surgeon, Dr. Krishnan, watched and his pulmonologist, Dr. Nadeem, performed the procedure. Dr. Nadeem reported that our dad's left lung actually looked good during the procedure. He was happy about how it presented, but "washed" it as a good faith measure. He noticed a substantial amount of secretion in the right lung, likely a response from the right lung to take over due to trauma of the left side. Dr. Nadeem used the procedure to clean up the secretions, collect them as specimens, and culture them to rule out any infections. Results may take up to 48 hours. Again, we wait.
We see our dad post-procedure and he is quite groggy, but surprisingly talkative. He slurs his speech, yet seems happy to know we are close. As we remark to him about the positive news, he tries to speak, but says he "feels like he sounds like Donald Duck," which is funny to us because our oh-so-serious dad is making jokes. Carl, seeing our dad for the first time since his surgery, curiously states that he hasn't heard our dad talk so much in years. :)
Later, we try to let our dad get rest and regroup. We see him in the early afternoon and he seems remarkably different from yesterday. He is happy to have us in his company and spends the rest of the day willing to exhibit his ever-present work ethic with his breathing exercises. He uses his Incentives Spirometer and "flutter puffer" dilligently every 15 minutes, sits in his chair for several hours, takes his required walks, eats a "transitional" meal without nausea, and visits with us and our family visitors with conversation and enjoyment. We observe our dad interacting with humor and wit. We are charmed. We all share real smiles and have genuine laughs with him.
Our dad is surprised and moved by his visitors today. Aside from us--his regulars--he is also pleased to have the company of Aunt Margie, and, later, his sister Santa, his nephew Joe, his niece Mary and her husband Mike. Kevin is able to see our dad today for the first time since the surgery, too. His nephew Tom's daughter Keisha makes a pleasantly surprising visit later in the evening. And our dad is able to see Carmelo and Michelle's children, Carmelo, Madisen, Vincent, and Dominic. A busy day for certain, but one filled with intentions of support and love for our dearly loved dad.
We see today as a hopeful one. Our dad, while physically still quite debilitated, seemed markedly more motivated than yesterday. His Broncoscopy undoubtedly facilitated his physical need for breathing room. Equally important though, we saw a slice of his spirit alive again today.
He asks us to attend his regular mass tomorrow morning, to pray for him, and speak with his priest and longtime friend, Father Carl Last, following St. John's Cathedral 9:30am mass. We assure him we will be there praying with our mom, as he and our mom never miss a liturgy together. We kiss him goodnight with the hope that he will rest and the promise that we will never leave him feeling abandoned.
While our dad had more sleep last night that he has had since the surgery--close to 5 hours--he spent the remainder of the night with frequent visits from various staff. As the new day began, he was put to work immediately, with physical and occupational therapy and cardiac rehabilitation. He had his first walk of the day before 9am. The prep for the Bronsoscopy followed shortly thereafter.
We met our dad in the prep area for the Broncoscopy. A substantial team of nurses had him prepped for the procedure while his surgeon, Dr. Krishnan, watched and his pulmonologist, Dr. Nadeem, performed the procedure. Dr. Nadeem reported that our dad's left lung actually looked good during the procedure. He was happy about how it presented, but "washed" it as a good faith measure. He noticed a substantial amount of secretion in the right lung, likely a response from the right lung to take over due to trauma of the left side. Dr. Nadeem used the procedure to clean up the secretions, collect them as specimens, and culture them to rule out any infections. Results may take up to 48 hours. Again, we wait.
We see our dad post-procedure and he is quite groggy, but surprisingly talkative. He slurs his speech, yet seems happy to know we are close. As we remark to him about the positive news, he tries to speak, but says he "feels like he sounds like Donald Duck," which is funny to us because our oh-so-serious dad is making jokes. Carl, seeing our dad for the first time since his surgery, curiously states that he hasn't heard our dad talk so much in years. :)
Later, we try to let our dad get rest and regroup. We see him in the early afternoon and he seems remarkably different from yesterday. He is happy to have us in his company and spends the rest of the day willing to exhibit his ever-present work ethic with his breathing exercises. He uses his Incentives Spirometer and "flutter puffer" dilligently every 15 minutes, sits in his chair for several hours, takes his required walks, eats a "transitional" meal without nausea, and visits with us and our family visitors with conversation and enjoyment. We observe our dad interacting with humor and wit. We are charmed. We all share real smiles and have genuine laughs with him.
Our dad is surprised and moved by his visitors today. Aside from us--his regulars--he is also pleased to have the company of Aunt Margie, and, later, his sister Santa, his nephew Joe, his niece Mary and her husband Mike. Kevin is able to see our dad today for the first time since the surgery, too. His nephew Tom's daughter Keisha makes a pleasantly surprising visit later in the evening. And our dad is able to see Carmelo and Michelle's children, Carmelo, Madisen, Vincent, and Dominic. A busy day for certain, but one filled with intentions of support and love for our dearly loved dad.
We see today as a hopeful one. Our dad, while physically still quite debilitated, seemed markedly more motivated than yesterday. His Broncoscopy undoubtedly facilitated his physical need for breathing room. Equally important though, we saw a slice of his spirit alive again today.
He asks us to attend his regular mass tomorrow morning, to pray for him, and speak with his priest and longtime friend, Father Carl Last, following St. John's Cathedral 9:30am mass. We assure him we will be there praying with our mom, as he and our mom never miss a liturgy together. We kiss him goodnight with the hope that he will rest and the promise that we will never leave him feeling abandoned.
Saturday, March 14, 2009
Uncle Tommy
This post is for our Uncle Tommy, who is suffering greatly.
Since our dad's diagnosis, Uncle Tommy has been a champion for him, encouraging him to pray, advising him on practicalities of the future, and fostering an unparalleled optimism for him. He, literally, has been a cheerleader for our dad in this brief time knowing of our dad's condition. We are grateful to him for his spirit, his tenacity, and his love for our dad and for all of us.
I feel we may have been a bit selfish in our needs for our dad and desperately want our Uncle Tommy to know how much we love him, and how much we are praying for him. He, in spite of the devastating news of his own diagnosis last July, has shown amazing strength, will, and faith through his treatments and journey.
We all love him very much. We want him to know he is not alone, and we are praying for him. He, too, is a fighter. We know he is suffering; yet his determination, strength and spirit are so strong.
Uncle Tommy, we love you. Our prayers are with you always. xoxoxo
Since our dad's diagnosis, Uncle Tommy has been a champion for him, encouraging him to pray, advising him on practicalities of the future, and fostering an unparalleled optimism for him. He, literally, has been a cheerleader for our dad in this brief time knowing of our dad's condition. We are grateful to him for his spirit, his tenacity, and his love for our dad and for all of us.
I feel we may have been a bit selfish in our needs for our dad and desperately want our Uncle Tommy to know how much we love him, and how much we are praying for him. He, in spite of the devastating news of his own diagnosis last July, has shown amazing strength, will, and faith through his treatments and journey.
We all love him very much. We want him to know he is not alone, and we are praying for him. He, too, is a fighter. We know he is suffering; yet his determination, strength and spirit are so strong.
Uncle Tommy, we love you. Our prayers are with you always. xoxoxo
Friday, March 13, 2009
Friday, March 13, 2009
Today was an emotionally trying day. Our dad clearly had the weight of the world on his mind and heart. He appeared incredibly contemplative and sad, especially for the first part of the day. The physical pain from surgery and its emotional toll had begun to set in. The demands from the doctors were intense and challenging, and the expectations for his traumatized body, too much. Our dad expressed he felt exhausted from the night and complained he had not slept. The combination of the physical pain from the incision and the necessary interruptions from hospital staff throughout the night left him seemingly daunted and depressed.
Earlier in the morning, our dad had a chest Xray. Shortly after we arrived, Dr. Krishnan came in to talk to him about the findings from the chest Xray and stated he was not happy about how the Xray looked. Dr. Krishnan and the Pulmonary doctor decided to order a Broncoscopy to take place tomorrow, where a scope runs through the throat to the lung so the lung can be viewed from the inside-out. This procedure will allow the doctors to detemine what is happening with the secretions in the lower left lobe and how to deal with them. For the day, the doctors want our dad to work harder at breathing deeply, to exercise his lungs by forcing his air into his Incentives Spirometer, and to try coughing to loosen the secretions in his lungs. In addition, he must sit for extended periods of time and walk the corridor 4x today. Dr. Krishnan explained that the lower left lobe looked hazy, which indicated his breathing was not deep enough, and the secretions were building in his lower lobe. An excess of secretions could lead to problems that we would like to avoid. Dr. Krishnan wants to see his lungs expanding and moving air better.
After Dr. Krishnan left, our dad just wanted to get some sleep. We--our mom, Carmelo, Michelle, Dominic and I--let him be alone for the next two hours, hoping he would sleep. During that time, his sister Mary Grace arrived and visited with us, and later, him. At some point, I went in to check on him. When I asked him how he was holding up, he so vulnerably stated, "not good." I asked him if he was in more pain. He said no. When I asked him again to tell me what was happening, he said that he was upset that "My chest Xray was bad. Now they have to do something else to me tomorrow." He said that he was scared and upset and in pain. It hurt so much to breathe deeply. He was so tired.
I knew he felt so scared to go through another procedure--like he was failing in some way--that he had disappointed the doctors, us, even himself. I could see the tears in his eyes as he struggled even to tell me how he was feeling. This was agonizing. We had been telling him how well he was doing, how amazing he is, how successful the surgery was; but he hears what is now wrong.
We begin to encourage him more. This is only Day 1 Post Surgery. He is doing so well. This procedure will help the doctors understand how to help him more. We know he is upset. We know he is confused. We cannot even imagine the pain he is in. We will not let him give up. We will be with him every step of the way. We are so proud of him.
He had more visitors throughout the day: his bosses, Louis Black and Dave Lawrence, and his nephew, Tom, and his wife, Milta. He sincerely appreciates the outpouring of support from everyone. It is so clear to us that our dad's spirits are visibly lifted when he sees or hears something from our family or friends. It undoubtedly results in a marked improvement in his attitude, outlook, and spirit. During one particularly poignant moment with our mom, Tony and I tonight, we asked him if he felt like talking about anything that was on his mind. He sat quietly for a moment, looked up at us, and steadfastedly stated, "I feel like I want to, that I am going to, beat this thing."
Dr. Krishnan returns to the room late in the day to share preliminary pathology findings. The pathology from the rib area is not yet complete, though we know the tumor was pushing on the ribs that were removed. But the lymph node pathology comes back negative for metastasis. I think our dad took his deepest breath of the day from this relieving, wonderful, delightful news.
We now continue to be grateful toward and reach out to our loved ones for their generous outpouring of support and love. We hope our dad may sleep soundly tonight. And we pray...
Earlier in the morning, our dad had a chest Xray. Shortly after we arrived, Dr. Krishnan came in to talk to him about the findings from the chest Xray and stated he was not happy about how the Xray looked. Dr. Krishnan and the Pulmonary doctor decided to order a Broncoscopy to take place tomorrow, where a scope runs through the throat to the lung so the lung can be viewed from the inside-out. This procedure will allow the doctors to detemine what is happening with the secretions in the lower left lobe and how to deal with them. For the day, the doctors want our dad to work harder at breathing deeply, to exercise his lungs by forcing his air into his Incentives Spirometer, and to try coughing to loosen the secretions in his lungs. In addition, he must sit for extended periods of time and walk the corridor 4x today. Dr. Krishnan explained that the lower left lobe looked hazy, which indicated his breathing was not deep enough, and the secretions were building in his lower lobe. An excess of secretions could lead to problems that we would like to avoid. Dr. Krishnan wants to see his lungs expanding and moving air better.
After Dr. Krishnan left, our dad just wanted to get some sleep. We--our mom, Carmelo, Michelle, Dominic and I--let him be alone for the next two hours, hoping he would sleep. During that time, his sister Mary Grace arrived and visited with us, and later, him. At some point, I went in to check on him. When I asked him how he was holding up, he so vulnerably stated, "not good." I asked him if he was in more pain. He said no. When I asked him again to tell me what was happening, he said that he was upset that "My chest Xray was bad. Now they have to do something else to me tomorrow." He said that he was scared and upset and in pain. It hurt so much to breathe deeply. He was so tired.
I knew he felt so scared to go through another procedure--like he was failing in some way--that he had disappointed the doctors, us, even himself. I could see the tears in his eyes as he struggled even to tell me how he was feeling. This was agonizing. We had been telling him how well he was doing, how amazing he is, how successful the surgery was; but he hears what is now wrong.
We begin to encourage him more. This is only Day 1 Post Surgery. He is doing so well. This procedure will help the doctors understand how to help him more. We know he is upset. We know he is confused. We cannot even imagine the pain he is in. We will not let him give up. We will be with him every step of the way. We are so proud of him.
He had more visitors throughout the day: his bosses, Louis Black and Dave Lawrence, and his nephew, Tom, and his wife, Milta. He sincerely appreciates the outpouring of support from everyone. It is so clear to us that our dad's spirits are visibly lifted when he sees or hears something from our family or friends. It undoubtedly results in a marked improvement in his attitude, outlook, and spirit. During one particularly poignant moment with our mom, Tony and I tonight, we asked him if he felt like talking about anything that was on his mind. He sat quietly for a moment, looked up at us, and steadfastedly stated, "I feel like I want to, that I am going to, beat this thing."
Dr. Krishnan returns to the room late in the day to share preliminary pathology findings. The pathology from the rib area is not yet complete, though we know the tumor was pushing on the ribs that were removed. But the lymph node pathology comes back negative for metastasis. I think our dad took his deepest breath of the day from this relieving, wonderful, delightful news.
We now continue to be grateful toward and reach out to our loved ones for their generous outpouring of support and love. We hope our dad may sleep soundly tonight. And we pray...
Thursday, March 12, 2009
Post Surgery Day 1
Our Mom, Gina, Tony, Aunt Margie, and I waited in the ICU family waiting area during the surgery. Aunt Margie provided an enormous amount of comfort and cheer as we worried and waited and wondered. We wanted Carmelo to rest after his shift, so he would be able to see our dad post surgery. Our time passed slowly.
Dr. Krishnan finally arrived at 11am with the surgical report. Dr. Krishnan is an amazing surgeon with remarkable bedside manner. The surgery went very well, and our dad fared impressively during the procedure. He shared with us that the tumor had indeed invaded the chest wall and that, as a result, rib portions were removed. He believed that he was able to eliminate all cancerous and plausibly diseased tissue with the removal of the upper lobe and surrounding ribs. Surgical pathology results on lymph nodes and rib portions were not expected back until Monday. Because the ribs involved were positioned high on the back, the scapula will provide protection and anatomical structure for our dad. Therefore, reconstruction is not necessary. Though we were prepared for the possibility of this scenario, it was nonetheless difficult to hear. We know chemotherapy will follow and will begin in approximately 4 weeks.
Since our dad fared so well during surgery, Dr. Krishnan expresses confidence that he will remain in recovery for 1-1.5 hours and will be transported to a regular room, not the ICU for his remaining hospital stay. He wants our dad sitting up by day's end and feels confident that his pain will be managed well. We are so glad surgery was a success. We hope and pray that pathology will have the most favorable report as possible. More praying.
For the remainder of the afternoon, we struggle to understand why our dad is not moved to a regular room, as promised. What was assured to be 1.5 hours evolves into a 6 hour stay in the Recovery or Holding area. This is unacceptable. Three hours in, we are eventually allowed to see him in this busy, public zone. This was difficult and frustrating. Our dad is suffering, and we all are Mother Hens, trying at first to considerately inquire about room availability; but, feeling ignored, we become more and more upset. He is not resting. He is in pain. There is no privacy, no peace. We do our best to advocate for him. By the end, we "got our Irish up" with the staff. Gina spoke to the charge nurse, Carmelo spoke to the Recovery nurse, and I spoke to the surgical nurse. Our "never rock the boat" father, too, is visibly exasperated. Eventually, by 5:30, we have our private room. Finally, he may rest.
I am in awe of my dad. I honestly still am unable to fathom this whole experience. To see him after surgery was difficult, but beautiful too. He, again, looks amazing. Really. He is shaken to his core. Yet, his face is lovely. He has his same rosy cheeks, despite the trauma of surgery, and when asked about the pain, he still says, "just a little bit." He keeps saying, "pray, pray, pray." His (and our mom's) faith is, and alway has been, inspiring, to put it mildly. I really cannot believe this strength.
One of his first questions was about his ribs: "they didn't have to remove any ribs, did they?" We responded that Dr. Krishnan said he did so well and he got everything out. The cancer was out. Just a little bit of the ribs. But he was going to be okay. And he looked great. Later in the evening, after his Pulmonary doctor visited, we again told him how great he looked and how wonderfully he did through this whole day. Tired, confused and shaken, our dad mused, "Well they tell me I look good; but why doesn't inside of me look good. They told me I looked good before my heart surgery, and I had a heart problem (2000)...." We assure him the "bad" inside of him is gone. It's out and he will get through this. He will.
I am wrestling with all of this personally. I know my whole family is. In actuality, there is no "bad" inside of this man. His heart and soul are so good, so pure. It still makes no sense. It still feels so unfair. We know he is strong. We know his faith is solid. We know he is a fighter. He is a rock-without a doubt he is. It is so just difficult, so so painful to see him suffer again and again.
Dr. Krishnan finally arrived at 11am with the surgical report. Dr. Krishnan is an amazing surgeon with remarkable bedside manner. The surgery went very well, and our dad fared impressively during the procedure. He shared with us that the tumor had indeed invaded the chest wall and that, as a result, rib portions were removed. He believed that he was able to eliminate all cancerous and plausibly diseased tissue with the removal of the upper lobe and surrounding ribs. Surgical pathology results on lymph nodes and rib portions were not expected back until Monday. Because the ribs involved were positioned high on the back, the scapula will provide protection and anatomical structure for our dad. Therefore, reconstruction is not necessary. Though we were prepared for the possibility of this scenario, it was nonetheless difficult to hear. We know chemotherapy will follow and will begin in approximately 4 weeks.
Since our dad fared so well during surgery, Dr. Krishnan expresses confidence that he will remain in recovery for 1-1.5 hours and will be transported to a regular room, not the ICU for his remaining hospital stay. He wants our dad sitting up by day's end and feels confident that his pain will be managed well. We are so glad surgery was a success. We hope and pray that pathology will have the most favorable report as possible. More praying.
For the remainder of the afternoon, we struggle to understand why our dad is not moved to a regular room, as promised. What was assured to be 1.5 hours evolves into a 6 hour stay in the Recovery or Holding area. This is unacceptable. Three hours in, we are eventually allowed to see him in this busy, public zone. This was difficult and frustrating. Our dad is suffering, and we all are Mother Hens, trying at first to considerately inquire about room availability; but, feeling ignored, we become more and more upset. He is not resting. He is in pain. There is no privacy, no peace. We do our best to advocate for him. By the end, we "got our Irish up" with the staff. Gina spoke to the charge nurse, Carmelo spoke to the Recovery nurse, and I spoke to the surgical nurse. Our "never rock the boat" father, too, is visibly exasperated. Eventually, by 5:30, we have our private room. Finally, he may rest.
I am in awe of my dad. I honestly still am unable to fathom this whole experience. To see him after surgery was difficult, but beautiful too. He, again, looks amazing. Really. He is shaken to his core. Yet, his face is lovely. He has his same rosy cheeks, despite the trauma of surgery, and when asked about the pain, he still says, "just a little bit." He keeps saying, "pray, pray, pray." His (and our mom's) faith is, and alway has been, inspiring, to put it mildly. I really cannot believe this strength.
One of his first questions was about his ribs: "they didn't have to remove any ribs, did they?" We responded that Dr. Krishnan said he did so well and he got everything out. The cancer was out. Just a little bit of the ribs. But he was going to be okay. And he looked great. Later in the evening, after his Pulmonary doctor visited, we again told him how great he looked and how wonderfully he did through this whole day. Tired, confused and shaken, our dad mused, "Well they tell me I look good; but why doesn't inside of me look good. They told me I looked good before my heart surgery, and I had a heart problem (2000)...." We assure him the "bad" inside of him is gone. It's out and he will get through this. He will.
I am wrestling with all of this personally. I know my whole family is. In actuality, there is no "bad" inside of this man. His heart and soul are so good, so pure. It still makes no sense. It still feels so unfair. We know he is strong. We know his faith is solid. We know he is a fighter. He is a rock-without a doubt he is. It is so just difficult, so so painful to see him suffer again and again.
Surgery Prep
We arrived at St. Luke's at 5:30 this morning. The team prepped and took him to surgery around 7:30. The team again explained his surgery and the preparations to his body for surgery. We will anticipate a number of IVs and tubes, monitors, and machines post surgery. He was given an epidural to help manage the pain for the next several days. We are told it will be important for him to exercise his lungs from the base-deep breathing.
Again, it is difficult to put into words the feeling one has seeing someone who is loved so deeply suffer. I know we all just so desperately want to make this better, easier for him. We want to shield him from the pain of all of this and feel with him as we comfort him. To watch him lie on the table as he was prepped was heart wrenching. He said very little. His angst was clear. We took turns holding his hands, assuring him that he will be okay, and that everyone we know is praying for him, rooting for him. Still, we saw the water welling up in his eyes and watched him swallow the lumps in his throat. He is so strong, so protective, even now.
Anyone who knows us Pattis knows how hairy we all are. :)One moment of levity was when the male nurse had to shave our dad's chest (and back, of course). That electric razor ran out of juice before the nurse could finish! He needed a backup to complete the job. We told the nurse he'd likely need a garbage bag to contain all the hair from dad and that we should've taken him to the spa the day before to make that job a little easier. We all had a much needed laugh from that. Our dad even remarked he would now be beach ready.:)
Now we wait and hope and pray. He is in excellent hands. We know our loved ones and God are with him.
Again, it is difficult to put into words the feeling one has seeing someone who is loved so deeply suffer. I know we all just so desperately want to make this better, easier for him. We want to shield him from the pain of all of this and feel with him as we comfort him. To watch him lie on the table as he was prepped was heart wrenching. He said very little. His angst was clear. We took turns holding his hands, assuring him that he will be okay, and that everyone we know is praying for him, rooting for him. Still, we saw the water welling up in his eyes and watched him swallow the lumps in his throat. He is so strong, so protective, even now.
Anyone who knows us Pattis knows how hairy we all are. :)One moment of levity was when the male nurse had to shave our dad's chest (and back, of course). That electric razor ran out of juice before the nurse could finish! He needed a backup to complete the job. We told the nurse he'd likely need a garbage bag to contain all the hair from dad and that we should've taken him to the spa the day before to make that job a little easier. We all had a much needed laugh from that. Our dad even remarked he would now be beach ready.:)
Now we wait and hope and pray. He is in excellent hands. We know our loved ones and God are with him.
Wednesday, March 11, 2009
March 11, 2009
We are all anxious for tomorrow. Today, our dad has received so many heartfelt phone calls, cards, and well-wishes. It really means so much to him. It is clear that he is unbelievably touched by the outpouring of care, concern, and love for him. We cannot express how grateful we are to everyone who has called him or any of us, sent cards and messages as we have prepared mentally for tomorrow. Our dad is truly so blessed and so loved. As our Aunt Mary Street said, "We are all with him. We love him and we know he is a fighter." It is so true. He is such a quiet fighter.
Carmelo was here with him during the evening, and Gina, Tony, and I are here overnight to be with him when we go in for surgery tomorrow. Carmelo will join us after work tomorrow as we wait. We have faith that the surgery will go well. Our dad seems to be in good spirits. He looks amazing and he seems hopeful too...
While our dad seems optimistic, without a doubt, the thought of his surgery never escapes him. Our mom has been in a cookin' mood these past several days, and tried out a friend from work, Barb's, famous ribs recipe last night. So today, when he called our mom at work, Barb asked him "Hey, how were the ribs?" In response, our dad, with all of his seriousness, replied, "well, we won't know about that until after the surgery." Barb was a little stumped as to how to respond to that. She came back with, "I meant the ones you ate." Ooops. Of course, they were delicious. :)
We are so grateful to our family and friends for keeping our dad in their hearts and prayers. We need all of the positive energy and are very thankful for it. We are hopeful that tomorrow brings some relief, and more optimism for our sweet, sweet dad.
Carmelo was here with him during the evening, and Gina, Tony, and I are here overnight to be with him when we go in for surgery tomorrow. Carmelo will join us after work tomorrow as we wait. We have faith that the surgery will go well. Our dad seems to be in good spirits. He looks amazing and he seems hopeful too...
While our dad seems optimistic, without a doubt, the thought of his surgery never escapes him. Our mom has been in a cookin' mood these past several days, and tried out a friend from work, Barb's, famous ribs recipe last night. So today, when he called our mom at work, Barb asked him "Hey, how were the ribs?" In response, our dad, with all of his seriousness, replied, "well, we won't know about that until after the surgery." Barb was a little stumped as to how to respond to that. She came back with, "I meant the ones you ate." Ooops. Of course, they were delicious. :)
We are so grateful to our family and friends for keeping our dad in their hearts and prayers. We need all of the positive energy and are very thankful for it. We are hopeful that tomorrow brings some relief, and more optimism for our sweet, sweet dad.
Tuesday, March 10, 2009
March 5, 2009 Radiologist Consult
The Radiologist involved with our dad's case suggested, at this time, Radiation is not recommended. She shared the positive results that the bone scan was unremarkable and the tumor appeared mainly localized. She affirmed that chemotherapy would likely follow surgery, but that because of the localization of the tumor, radiation is not, at this time, necessary.
March 4, 2009 University of Chicago Dr. Hoffman
We visited the University of Chicago today to meet with Dr. Hoffman, a highly regarded oncologist specializing in malignancies of the chest. Dr. Hoffman echoed the sentiments of Dr. Krishnan and offered to refer our dad to a surgical team at the University of Chicago. His first available appointment for a surgical consult at U of C would be Wednesday, March 11th. We choose not to proceed with surgery at U of C, as his surgery at St. Luke's in Milwaukee is already scheduled for Thursday, March 12th.
Dr. Hoffman, too, is wonderful. He is straightforward and encouraging. He offers to review pathology reports from surgery and to serve in a consulting capacity for our dad post surgery, so as to make recommendations for his chemotherapy course in Milwaukee, or, if he were to choose, in Chicago.
We leave this appointment feeling a strong sense of confirmation that surgery is our best course and that all of our dad's medical team is in agreement for him.
Dr. Hoffman, too, is wonderful. He is straightforward and encouraging. He offers to review pathology reports from surgery and to serve in a consulting capacity for our dad post surgery, so as to make recommendations for his chemotherapy course in Milwaukee, or, if he were to choose, in Chicago.
We leave this appointment feeling a strong sense of confirmation that surgery is our best course and that all of our dad's medical team is in agreement for him.
March 2, 2009 Dr. Krishnan Surgical Consult
We met with Dr. Krishnan early in the morning. His Nurse Practitioner, Kristin, met with us first to discuss with us the tumor, its location, and the three modalities of treatment: surgery, chemotherapy, and radiation. After a throrough explanation of each, Kristin explained to us the surgical course.
Surgery would likely be a two-pronged process. She explained that for our dad, the entire upper left lobe would be removed--a lobectomy, which would be a removal of approximately 40% of the left lung. Because of the concern for chest wall invasion, Dr. Krishnan would determine, during surgery, whether to conduct a traditional thoracotomy, where rib area would also be removed. She explained that our dad is a good candidate for this surgery because (1) the tumor appears localized, (2) he is in otherwise good health.
In order to prepare and be approved for surgery, our dad would have to (1) have a clear bone scan, (2) pass a stress test to ensure his heart would be strong enough for the surgery, and (3) pass a Pulmonary Function Test (PST) to ensure his lungs are capable of this type of procedure and life adaptation. Both Kristin and Dr. Krishnan suggested their confidence that we would be able to move forward with the surgery.
Dr. Krishnan explained that because of the suspected involvement of the chest wall, following approximately 4 weeks recovery from surgery, a course of chemotherapy would be likely for our dad.
We left this appointment with the surgery scheduled for Thursday, March 12th at 8am. Our dad really, really liked both Dr. Krishnan and Kristin, his nurse practitioner. Both had an amazing capacity to articulate our dad's treatment course, as well as an ability to empathize with our dad and us as we prepare to move forward. They were truly wonderful to meet.
Surgery would likely be a two-pronged process. She explained that for our dad, the entire upper left lobe would be removed--a lobectomy, which would be a removal of approximately 40% of the left lung. Because of the concern for chest wall invasion, Dr. Krishnan would determine, during surgery, whether to conduct a traditional thoracotomy, where rib area would also be removed. She explained that our dad is a good candidate for this surgery because (1) the tumor appears localized, (2) he is in otherwise good health.
In order to prepare and be approved for surgery, our dad would have to (1) have a clear bone scan, (2) pass a stress test to ensure his heart would be strong enough for the surgery, and (3) pass a Pulmonary Function Test (PST) to ensure his lungs are capable of this type of procedure and life adaptation. Both Kristin and Dr. Krishnan suggested their confidence that we would be able to move forward with the surgery.
Dr. Krishnan explained that because of the suspected involvement of the chest wall, following approximately 4 weeks recovery from surgery, a course of chemotherapy would be likely for our dad.
We left this appointment with the surgery scheduled for Thursday, March 12th at 8am. Our dad really, really liked both Dr. Krishnan and Kristin, his nurse practitioner. Both had an amazing capacity to articulate our dad's treatment course, as well as an ability to empathize with our dad and us as we prepare to move forward. They were truly wonderful to meet.
February 27, 2009 FIrst Oncology Consult
The six of us were together for this appointment. We sat in the waiting room, waiting, waiting, waiting for our dad to be called. We made little small talk but all sat closely to one another. While our fear, our anxiety, and our pain were obvious, we were together and our unity gave us strength and courage for this visit.
We were called into an exam room, where again, the six of us crammed together, waiting for Dr. Treisman. While we waited, we talked about the strangeness of being in an exam room for our consult. The nurse had told us as many people as our dad wanted to be there could attend the appointment. Carmelo and Tony stood against the exam table, while Gina and I shared a chair. We joked that we were used to cramped quarters, to being A to E...Villard had prepared us for that.
Dr. Treisman came in and asked our dad "what's the word?" "You tell me," remarked our dad. Dr. Treisman then opened the file, seemingly as though he hadn't previously reviewed the results. Upon review, he remarked that the brain MRI was clear and the PET looked clear as well, but a small shadow was visible on one rib. He recommended a bone scan to rule out the presence of cancer on that rib, though he did suggest he was "not appreciating it" as ominous.
Dr. Treisman explained the size and location of the tumor. Dr. Treisman was concerned that our dad is experiencing some pain, which is suggestive of chest wall invasion, as lung cancer does not cause pain. He expressed concern that the tumor was very close to the chest wall, and as such, an imminent question for the medical team to discuss was whether the tumor could be removed immediately, or whether a 6 week course of chemo/radiation was necessary to shrink the tumor prior to surgery. He referred us to a surgical consult, Dr. Krishnan at St. Luke's for the following Monday.
It's funny how one's perspective changes from Monday to Friday with this worst of life-altering news. We left our appointment with Dr. Treisman feeling hopeful, really hopeful. His cancer had not spread. What a relief. Now, we looked forward to Monday and continued to pray that this tumor would be able to be removed by Dr. Krishnan.
We were called into an exam room, where again, the six of us crammed together, waiting for Dr. Treisman. While we waited, we talked about the strangeness of being in an exam room for our consult. The nurse had told us as many people as our dad wanted to be there could attend the appointment. Carmelo and Tony stood against the exam table, while Gina and I shared a chair. We joked that we were used to cramped quarters, to being A to E...Villard had prepared us for that.
Dr. Treisman came in and asked our dad "what's the word?" "You tell me," remarked our dad. Dr. Treisman then opened the file, seemingly as though he hadn't previously reviewed the results. Upon review, he remarked that the brain MRI was clear and the PET looked clear as well, but a small shadow was visible on one rib. He recommended a bone scan to rule out the presence of cancer on that rib, though he did suggest he was "not appreciating it" as ominous.
Dr. Treisman explained the size and location of the tumor. Dr. Treisman was concerned that our dad is experiencing some pain, which is suggestive of chest wall invasion, as lung cancer does not cause pain. He expressed concern that the tumor was very close to the chest wall, and as such, an imminent question for the medical team to discuss was whether the tumor could be removed immediately, or whether a 6 week course of chemo/radiation was necessary to shrink the tumor prior to surgery. He referred us to a surgical consult, Dr. Krishnan at St. Luke's for the following Monday.
It's funny how one's perspective changes from Monday to Friday with this worst of life-altering news. We left our appointment with Dr. Treisman feeling hopeful, really hopeful. His cancer had not spread. What a relief. Now, we looked forward to Monday and continued to pray that this tumor would be able to be removed by Dr. Krishnan.
February 24-26, 2009 Research, PET and MRI scans
We all begin the painful task of sharing the news with our family and friends. Shock and disbelief seem to continue to be the responses from loved ones. The support and love for our dad is encouraging and he, though in quiet acceptance of this new reality, seems determined, willful, and with resolve to find the best treatments out there.
He is scheduled for his PET scan and MRI of his brain for the following day. Results of both will help the teams of doctors determine disease staging. We pray, pray, pray that the tumor is localized.
Dad is scheduled to see his oncologist in Milwaukee on Friday. Dr. Jonathan Treisman is a familiar name. He treated and cared for our dad's sister Rose during her battle with cancer. In the meantime, we have scheduled a consultation in Chicago with Dr. Phillip Hoffman, an oncologist who specializes in malignancies of the chest. Dr. Hoffman's name was highly recommended by doctors known by Gina and me. We confirm our Dad's insurance would allow this visit. Dr. Hoffman wants to see our Dad after all initial scans. We schedule our visit with him on Wednesday, March 4th at the University of Chicago.
It is Ash Wednesday. Our mom and dad try to stay busy all day. They drive to mass, park in their usual spot, and attend Ash Wednesday services. Following mass, our dad shuffles for his car keys in his pockets. They are missing. Mom hands him her keys. When they reach the car, there is a parking ticket. Oh well...weekday parking prohibited. Then they realize that our dad had left the keys in the car...in the ignition...and that the car was still running! Everyone is a mess. Poor dad...his nerves are all over the place. We all get a good laugh out of the goof.
PET and MRI scans take place Thursday morning. The waiting and the praying continues...
He is scheduled for his PET scan and MRI of his brain for the following day. Results of both will help the teams of doctors determine disease staging. We pray, pray, pray that the tumor is localized.
Dad is scheduled to see his oncologist in Milwaukee on Friday. Dr. Jonathan Treisman is a familiar name. He treated and cared for our dad's sister Rose during her battle with cancer. In the meantime, we have scheduled a consultation in Chicago with Dr. Phillip Hoffman, an oncologist who specializes in malignancies of the chest. Dr. Hoffman's name was highly recommended by doctors known by Gina and me. We confirm our Dad's insurance would allow this visit. Dr. Hoffman wants to see our Dad after all initial scans. We schedule our visit with him on Wednesday, March 4th at the University of Chicago.
It is Ash Wednesday. Our mom and dad try to stay busy all day. They drive to mass, park in their usual spot, and attend Ash Wednesday services. Following mass, our dad shuffles for his car keys in his pockets. They are missing. Mom hands him her keys. When they reach the car, there is a parking ticket. Oh well...weekday parking prohibited. Then they realize that our dad had left the keys in the car...in the ignition...and that the car was still running! Everyone is a mess. Poor dad...his nerves are all over the place. We all get a good laugh out of the goof.
PET and MRI scans take place Thursday morning. The waiting and the praying continues...
February 24, 2009
We all wait for the results of the needle biopsy. Gina and our mom have been waiting with him at the hospital since very early in the morning. Dad has not slept well. He says little, but the fear on his face is palpable. He wonders what is happening..."I come in thinking I have a heart problem; now they tell me this." Still, he says "we have to pray. Keep praying."
The attending Internist, Dr. Husain, visits our dad and remarks on how well he looks. He offers words of hope and encouragement: "you do not look or sound sick; are you sure you did not strain yourself?" He discharges our dad and informs him to expect the biopsy results the following day.
Less than an hour later, Dr. Husain returns with the news we feared. Squamous cell carcinoma. Non-small cell lung cancer. Despite our fears, we all seemed to have held out hope that this just could not be true. The biopsy results made it so real. Uncontrollable tears. We are all scared. Our hearts are aching.
Gina leaves the room. Dad breaks down. He says he just wanted to be strong for our mom and Gina. Mom tells him it is okay. We will be strong for him now.
The attending Internist, Dr. Husain, visits our dad and remarks on how well he looks. He offers words of hope and encouragement: "you do not look or sound sick; are you sure you did not strain yourself?" He discharges our dad and informs him to expect the biopsy results the following day.
Less than an hour later, Dr. Husain returns with the news we feared. Squamous cell carcinoma. Non-small cell lung cancer. Despite our fears, we all seemed to have held out hope that this just could not be true. The biopsy results made it so real. Uncontrollable tears. We are all scared. Our hearts are aching.
Gina leaves the room. Dad breaks down. He says he just wanted to be strong for our mom and Gina. Mom tells him it is okay. We will be strong for him now.
February 23, 2009
Dad had been experiencing mild to moderate upper left back pain on and off for the past two weeks. During the night, the pain seemed to radiate to his chest. He feared this may be a sign of a heart attack, so he and our mom drove to the ER in the middle of the night.
ER staff at St. Luke's began a cardiac profile workup on him and sent him for a chest Xray. The chest Xray showed a mass on his upper left lobe. Dad was then sent to CT for a better look at the mass. Upon confirmation of this mass, he was admitted to St. Luke's so that a needle biopsy could be performed.
We (Carmelo, Gina, Tony, and I), were not aware of the situation until early morning. Our mom wanted to wait until everyone's day had begun to give us the news. I believe I speak for all of my siblings when I say our reaction was complete shock and disbelief. We did not even know he was in any pain whatsoever. Our mom had no idea either, until a couple of days before this news.
Our dad looks healthy. He looks as he always has: he has color in his face, his weight is unchanged, he has no cough, no shortness of breath, no wheezing. This all feels so wrong.
ER staff at St. Luke's began a cardiac profile workup on him and sent him for a chest Xray. The chest Xray showed a mass on his upper left lobe. Dad was then sent to CT for a better look at the mass. Upon confirmation of this mass, he was admitted to St. Luke's so that a needle biopsy could be performed.
We (Carmelo, Gina, Tony, and I), were not aware of the situation until early morning. Our mom wanted to wait until everyone's day had begun to give us the news. I believe I speak for all of my siblings when I say our reaction was complete shock and disbelief. We did not even know he was in any pain whatsoever. Our mom had no idea either, until a couple of days before this news.
Our dad looks healthy. He looks as he always has: he has color in his face, his weight is unchanged, he has no cough, no shortness of breath, no wheezing. This all feels so wrong.
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