As expected the chemo today took the full day: we arrived at 9 AM and left at 5:30 PM. The M. D. Anderson protocol that was used required a 1/1000 dilution for the first hour, 1/100 dilution for the second, 1/10 for the third, ½ for the fourth, ¾ for the fifth, and a full dose at the last two hours. Susan handled all this very well. She had no allergic reactions. This evening she ate a good dinner, and seems to be doing fine. She still has to take some nausea tablets as a precaution tonight, and of course the high steroid dose could mean a sleepless night. However she also has some sleeping tabs that should help her in this regard.
We also confirmed with Dr. Mirtsching that the protocol he is using is somewhat experimental, due to the synergistic nature of how carboplatin and topotecan interact. The good news is that the combo of drugs should be much more effective against the cancer; the bad news is that it also does a number on the bone marrow and hence on the white blood cell count. For that reason we will be escalating the topotecan on a monthly basis. Susan will receive topotecan on each of three weeks at a low dose, then next month the dose will be increased while the doctor observes how well her immune system handles the increased dose, etc.
All in all it was a good day, and we thank you our friends and family for your prayer support during this critical time.
Susan and I were greatly touched and encouraged this evening when Pastor Mark and the TNPC Acapella Singers (Jessica & Jason, Sue, Susan, Tricia, Bill and Mark) came to our house to hold their rehearsal. This is something akin to having a doctor make a house call: an unprecedented event in our day. Their voices, their faces, and their prayers lifted Susan on this evening prior to her big chemo tomorrow. We will remember their ministry in song to us all throughout Thursday. It was truly a spiritual tonic.
Earlier in the day, Pastor Dave, along with Gayle, stopped by and refreshed us with the Word and prayer. How thankful we are for the body of believers at Town North, and for the faithfulness of our pastors.
The third blessing was Susan’s improving strength. For most of the day she was much better, both in appetite and energy, than any day since Feb. 1. Around dinner time, however, she relapsed somewhat with a digestive challenge and pain. A call to Dr. Munoz’s office confirmed that her recent tests showed it was OK to take Imodium, and that fixed the problem in time for her to greet the singers. Even as I write this I hear her running the vacuum—a sure indication that she is feeling better! (Somehow, despite all my efforts, I can never pull an “A” on the vacuuming tests that she gives me. Sigh….)
Our trip to the allergist was uneventful. She went over the pre-medications that Susan will be taking prior to the cisplatin administration on Thursday (which will take all day because of the desensitization required). The allergist used the results of a paper on desensitization from M. D. Anderson (found on the Internet by yours truly) authored by Jubilee Robinson et. al. (How do you like that for a first name?) In the “it’s a small world category” Dr. Jubilee was the first physician to examine Susan when we visited MDA last July. In her usual gentle fashion Susan probed Jubilee about where her name came from. “What a wonderful name.” Jubilee in turn didn’t seem to produce any strong rationale (that she was willing to share) about why her parents chose that name for her. We were thinking: “maybe after the year of jubilee in the Old(er) Testament.” But I digress. The bottom line is that these pre-meds are MUCH heavier in steroids than anything she ever took for the previous chemos. Even those mild-in-comparison doses kept her up two nights. No telling what these will do, except Weds. night promises to be a long one. So, if you have insomnia on Weds, you can call Susan. She’ll be up!
We’re also up because Susan is doing better today with improving appetite and less digestive distress. Please check back here on Thursday night for an update on how chemo went. (We’ll be up then, too!)
Despite my claim of fewer updates yesterday, here I am back again. That's because we now have the chemotherapy schedule. Monday we go to see the allergist, Dr. Finnerty, who will go over over the cisplatin desensitization protocol and also provide prescriptions for the pre-meds. Then chemo will start the following Thursday (the 28th) during which both the oncologist Dr. Mirtsching and the allergist can be present. This chemo will begin with a short infusion of topotecan, followed by a full day of cisplatin given in escalating doses to protect against a reaction to this platinum-based agent. (You will recall she developed a hypersensitivity to carboplatin during her chemo in 2000.) If all goes well she will repeat the topotecan every seven days for two more weeks and then have a week off. On day 29 the entire cycle will repeat, and so on as long as Susan can tolerate it and as long as it seems to be effective as monitored by various diagnostic tests. We will appreciate your prayers, not only for the effectiveness of the chemo, but also for Susan's ability to tolerate it without an allergic reaction.
Susan continues to do well today. She's had a bit of a problem with her replumbed digestive system, but things seem to be quieting down today after some rambunctiousness last night.
Well, gentle readers, we appreciate your ongoing interest in this page. We've received so many emails from y'all saying that you check this page once or even twice a day. This has kind of put the pressure on to put a new report up each day. However, Susan has now reached the point where there's not much new to report. Praise the Lord! Just like yesterday she's laid off the vicodins in favor of ibuprofens. Like yesterday she moved around to challenge her body but without overdoing it. And just like yesterday, we're still waiting for the oncologist to give us a specific schedule for the chemo. So, we want to spare you from any obligation you might feel to check this page every day. We'll plan to go to an aperiodic schedule, only posting when there is new news to report. We're guessing this will be about 2 or 3 times a week. So you may want to come back here on Saturday or Sunday to see what the chemo schedule is, and then again on Tuesday to see how chemo went, etc. Once again we thank you for your prayers. The Lord has blessed Susan greatly in her recovery in answer to your prayers. And we continue to hope you'll be able to continue to stand with us as we enter this critical chemo period. Thank you once again!
For those of you who wanted to be able to read all of our postings to date, they are now all posted below. If you are looking for a specific day, check out the archive link to your left.
Susan has had a very good day today. No vicodins at all. Another good night's sleep. And a walk around the cul-de-sac. Dr. Mirtsching was out of the office today so we don't know yet the details of her chemo: whether it will be 5 days/week for 3 weeks or just once a week for 3 weeks. Should know tomorrow and will post accordingly.
Despite a 2 hour postponement in our appointment, we got through Dr. Munoz's office in record time today. As he and I stood in the hallway Susan came towards us from the examining room, stunning in her black slinky knits and her matching zebra hat. "She looks terrific," he said. "She always has," I agreed, but then made a mental note: should I worry about this guy? He did give her a big kiss on the cheek in the hospital.
"I want her to wait another week before starting chemo," he declared. That sounded good to me, too. Although she's made amazing progress (last night was the best sleep for her since surgery), she still has a ways to go to get back to her full strength. Tentative schedule: cisplatin & topotecan next Tuesday with Dr. Mirtsching. Then topotecan the next two Tuesdays, then a week off followed by a repeat. We'll confirm this tomorrow.
Today has been a bit of down day for Susan. More pain today than yesterday--but nothing serious. She's had to take more vicodins today. But she's still plugging away with more and more food, even though she's not too hungry. Our day was topped off by a good visit from Tori & Nate and their parents with a delicious angel food cake. Tomorrow we go see the surgeon for the first post-hospital visit. He typically runs late, so we're hoping the time in the waiting room won't exhaust Susan. This visit should give us insight as to when the chemo can start. We will appreciate your prayers.
Today while a neighbor visited, Susan told her: "What I have is incurable. We just keep trying to find things to knock it out for awhile and live a day at a time." It breaks my heart to hear this from her lips. Yet she says it matter-of-factly. She is truly an inspiration of faith, courage and perserverance to me.
Susan is forbidden from riding in a car for two weeks, so she didn’t make it to church today. But after church our two granddaughters, Susanna and Lydia, came over (along with their parents) to provide their usual cheer. Lydia at age 3 months is starting to smile now, and her eyes are taking in everything in her view. Susanna is over her ear infection and back to her normal self. As an almost two-year-old she was showing nothing of the “terrible twos”, but rather melted our hearts as she smiled, laughed at everything, climbed into our laps and generally entertained us in her own charming way. Even the Grand Canyon can’t generate the emotions like that of a granddaughter falling asleep in your arms while hugging your neck.
Susan continues to make steady progress. She cut her vicodins down by half in favor of ibuprofens. She still gets up in the night because of pain, but it’s manageable. Solid food consumption by her continues to increase also as we enjoy special meal treats from friends and neighbors.
Today was also the first time that my mom (Nelle, age 98) had visited Susan since the surgery. She has just upgraded her computer and Internet service (with a little help from yours truly), and is thrilled by the faster download speeds as she surfs the net in search of new genealogical materials. (You can email her at. nelldish@hotmail.com ) . She can also see these updates better and faster. (Hi mom!)
Tomorrow we hope to have a visit from our other “grandchildren”, Tori and Nate.
Just a quick update to say that Saturday saw Susan continuing to improve. She ate more solid food today, and moved out of her nest frequently (but not so much to get into trouble as we did on Tuesday). More significantly she substituted iboprofen for vicodin today as her pain has eased somewhat. She's saving the latter for nighttime when she tends to have more pain. All in all a good day.
It was an inauspicious start to the day. From a dead sleep I heard Susan—up and fully dressed for the day—calling to me: “the garbage truck is coming around the corner.” I bolted up in bed. Somehow finding my blue jeans on the floor I managed to get both legs in the right places, raced to the closet to put a jacket unzipped over my bare chest, then sprinted to the garage. As I opened the garage door I heard the pulsating diesel already roaring into the cul-de-sac. Luckily, the driver elected to go clockwise around the circle, giving me a full 10 seconds advantage over him. I scooped up the 4 trash bags and put on a burst of speed towards the end of the driveway. I arrived there to come face-to-face with the guy who loads the truck who appeared stunned to see a bare-chested creature in an unzipped jacket with uncombed hair standing straight up charging directly for him. That gave me a few more seconds. I casually laid the bags at his feet, nonchalantly picked up the Dallas Morning News, and sauntered back into the house. There I found Susan had already made the bed and fixed me a hot cup of tea. All told, it was a typical Friday morning. It looks like things are getting back to normal in the Dishman household….
Around 11 AM Bonnie and Judy stopped by with miscellaneous goodies including instant macaroni & cheese packets. Their visit and the M&C stimulated Susan to eat the best lunch she’s had in many days. Between lie downs in her nest, I keep catching her doing little cleaning chores (why am I not surprised) and sitting up to write thank you notes. She says she is really feeling better today and her activity shows it.
Each day we get several emails, cards, and voice mail messages. So far we haven’t been able to respond back to you individually. However, we want you to know how much these remembrances mean to us, and how much we value your prayers for Susan’s recovery. Thank you, thank you, very much!!
For the record, here is the input from our oncolgist, Dr. Mirtsching:
John--
Your timing is great. I was about to call you this afternoon. I completed my review of the various dosing programs for topotecan. I have the data on topotecan weekly dosing x 3 weeks on, one week off, as well as a dosing plan that will integrate cisplatin given on day one every 4 weeks. I just got off of the phone with Dr. Munoz. He will follow her up until he thinks the wound healing is ready, then will let me know. After that, chemo will commence right away. I have already spoke to Dr. Finnerty and we have the platinum desensitization regimen here in the office.
I feel she is on track to have a good remission.
Thanks,
BCM
Susan's reaction to the above. "Ugh!"
Well, at least we get one week off. Who knows. Maybe we'll pop over to Italy for a week and stay where David & Elizabeth did.
Mom slept through the night, except getting a pain pill at 2:30. She has been holding down liquids. Mom had a nice shower this morning and is now wearing her favorite purple pjs. She had most of her craberry jellow before bed last night and was looking forward to some popsicles this morning. Dad also slept well last night, so we are all thankful that tranquility.
Today I gave my true love….a bowl of cranberry jello. I tried to mold it in a heart shaped container, but we were fresh out of same. Nonetheless, she said she liked the cranberry flavor much better than those store-bought brands. I was very pleased. I was also pleased that she actually ate much of the jello, along with taking some Gatorade, after a much quieter night for us. I believe she’s over the worst of the nausea. She hasn’t needed a compazine for awhile, and she’s even spacing out the vicodins for pain to a longer interval. This, combined with her taking a shower and looking much more alert today indicate that our prayers (and yours) for improvement have been answered. PTL!
29 years ago on this date Susan spent the day giving birth to Mark. Today, she celebrated his birthday by…..sleeping most of the day. This was a good present after last night’s festivities. Mark was good enough to come over to our house this evening to celebrate by helping me prepare a dish of jello for his mom. [Directions: if using this packet for a cool drink, please ensure the recipient drinks quickly after mixing. You don’t say!]
The return call from the doctor’s office reaffirmed our current approach to Susan’s condition. Liquid diet, compazine for nausea and vicodin for pain. Everything seems to be under control tonight as we prepare for bed. We pray for a calm night.
Around 9 last night Susan’s nausea and pain got so severe that I conferred with Dr. Munoz by phone. He instructed me to give her an anti-nausea pill and two pain pills and put her on a liquid diet, and then give her two more pain pills at midnight. All went well until midnight when she became so violently ill that I was in the act of calling 911 before she stopped me. She could keep nothing down including the anti-nausea pill. For 5 hours she gutted it out, fighting both the pain and the nausea with no medication help. Then finally at 5 AM she was able to hold down the compazine, and by breaking the vicodins into halves she could take these as well. We both finally got to sleep at 6 and slept until 9:30. She was much improved and was able to take another vicodin. She’s resting comfortably now. We’ll she how she does for a while longer and then confer again with the doctor. We don’t want a repeat of last night!
John says that Susan is doing better this morning, although at midnight he almost called 911. Things got a little better from there, however, and at 5AM she was able to take and keep down her anti-nausea pill. Finally, at 6AM, she was able to sleep. John says that Susan woke up at 9:30, took another pain pill, and is dosing again. She is better for both nausea and pain, though John is watching her closely and plans to call the doctor around noon. My guess is that this was the worst night of "recovery" so far, with the exception of the night shortly after her surgery when her epidural pulled out. Please pray for a restful day and more importantly, a restful night!
I don't have specifics, but I called home and apparently Susan is experiencing significant pain right now, possibly continued "referrent pain," possibly something else. John has called the doctor and I believe they are giving her some more pain pills.
It was a cliffhanger. Susan began to have significant pain in her shoulder and one nurse suggested that it could be her lungs. But Dr. Munoz stopped by between surgeries and noted that the removed spleen caused "referrent pain" that appears not where the spleen was, but in the shoulder region. On that basis she decided to come home. In typical fashion, however, I was directed by her not to go directly home, but to stop by Kroger to make sure "we had treats for the kids when they come over." So there we were, me pushing a cart and Susan in one of those motorized vehicles usually reserved for senior citizens, zipping up and down the aisles. She seem right home behind the wheel, and only scared me once when she almost took out the checker while she scanned our order.
Tonight Melissa Anthony showered us with an incredible home-cooked meal that Susan really enjoyed (not to mention yours truly who pigged out on pork). Eating is an issue with Susan, since she has to force herself to test her replumbed digestive system. Melissa's meal was just perfect for her, and she cleaned her plate! Kathy Bowman also stopped by with enough food for our freezer that will last for many days. We're thankful for faithful friends who feed us when times are tough.
Right now Susan continues to struggle with her shoulder pain. We're hoping that the pain killers and a heating pad will help things in this department.
This morning was marked by a frank and sobering conference with Dr. Munoz. Susan, fully lucid, was in her “this is no ordinary person you’re dealing with” mode, and peppered the doctor with questions about the details of her surgery. “Is she always like this?” he asked me. I nodded affirmatively. As Susan probed, the full details of the surgery emerged: an hour and a half to clean the diaphragm, 3 hours to do the colon, delicate surgery around the ureters, etc. At one point, noting the extent of the cancer’s spread, he remarked: “you probably had only a few months left.” She almost certainly faced surgery no matter what, if only of a palliative nature, to deal with the impending bowel blockages. “Ovarian cancer is an insidious disease, and there is almost always more than you expect,” he said. The bottom line: Dr. Munoz saved Susan’s life. When we look back on how we were providentially led to him, through a glitch in our health insurance, we are once again reminded of Proverbs 3:5: “lean not on your own understanding.”
The remainder of the morning was spent readying Susan to go home tomorrow. The two drains in her sides were removed. The central IV line into her neck was taken out, so now she is totally independent of any poles or pumps. We’ll plan to dine together this evening in the romantic lobby of Medical City!
We still have a long road to tread. In addition to the at home convalescence, the new chemotherapy regime needs to start ASAP. Both doctors Munoz and Mirtsching believe we need to go after the remaining disease aggressively, including perhaps both cisplatin AND topotecan taken together. This will zap her immune system, big time, but she’s shown exceeding stamina in her past chemo treatments.
Once again we thank all of you who have prayed for Susan during these 11 days. The Lord has delivered us once again through His love and your prayers. To Him be the glory!
Once again Dr. Fine stopped by to examine Susan, and commented: “Dr. Munoz may well send you home tomorrow. You have made great progress.” We received these words with a mixture of joy and anxiety. Joy that she’s come so far so fast; but apprehension that it may be a bit too early, given that Susan still has significant bouts of pain when the pain pills wear off (about every 3 hours). As I write this Susan is dozing on her bed, letting her body recover from a full day of walking the corridors, receiving visitors, and having her body adapt to her new full scale diet. (OK, I admit I helped her just a bit by sharing part of her steak and cheesecake…..) So far so good on the latter item. However, we will likely petition the doctor to let her stay one extra day just for good measure. We sure don’t want to return here once we’re home.
Pastor Dave shared Psalm 118 with us today, which includes the following verses:
I was pushed back and about to fall, but the Lord helped me.
The Lord is my strength and my song; he has become my salvation.
Shouts of joy and victory resound in the tents of the righteous:
“The Lord’s right hand has done mighty things!
The Lord’s right hand is lifted high;
The Lord’s right hand has done mighty things!”
We’re grateful for the Lord’s right hand giving us this victory for this day he has made. Rejoice!
It’s been a quiet day in Medical City, which is quickly becoming to us “our home town.” Dr. Fine who is on call for Dr. Munoz this weekend came through and shifted Susan to a full liquid diet (includes puddings) for today, and to a full diet starting tomorrow. Susan says “I’m so excited when I think about it: oatmeal, grits, canned peaches….” This comment will help calibrate you on how far she’s come. She continues to walk the hallway loop, each time breaking her previous record and now without a walker. Various folks have cheered us with their visits and phone calls and emails. We’ve passed the day watching the Olympics and reading the paper. She continues to show improvement with pain, but still needs to take the pain pills. Tomorrow will be a major challenge to her re-sectioned colon. Please pray with us that it will be able to handle the new load.
Today marked a major accomplishment. All body systems are now fully functional, leaving a single IV line as Susan’s only constraint. In celebration she has donned her newly purchased purple PJs, and is resplendent in them with her matching hat. She is now ready to receive visitors, although she still tends to get sleepy so visits need to be relatively short. She’s in Room 558 in the north tower of Building A.
A number of years ago while still a student at Georgia Tech I read the book by that name authored by C. S. Lewis. At the outset Lewis was quick to acknowledge that he himself was unfamiliar with pain. The book centered on the theological and philosophical issues associated with the existence of pain, not with any practical help in dealing with real live pain. And even the brilliant Lewis could not fully explain the mystery of how a good and powerful God could create a universe in which evil (and pain) were present. My own understanding of pain is like that of Lewis (at least when he wrote the book): my experience of pain personally has been quite limited. In this I suppose I am like most 21st century American citizens. The common grace of medical treatment has insulated me from experiencing the pain that undoubtedly was quite common for our ancestors prior to the invention of chloroform. (For an insight, read Tolstoy’s short story The Death of Ivan Ilych.See: www.geocities.com/short_stories_page/tolstoydeath.html)
But the last week has suddenly put me in touch with pain in a way I’ve never experienced before. Despite all the medical technology, this major surgery has hurt the one I love most in the world. To hear her groan. To see her sparkling personality severely attenuated as she fights the pain as it assaults her wave after wave. To be helpless to do anything except press the nurse’s call button and hope the next dose of pain pills will give her relief. All these things have suddenly transformed my understanding from the theoretical to the real. I have just a bit more insight now than before as to the meaning of the Lord’s words on the cross: “My God, my God, why have you forsaken me?” It hurt! Physically, not just spiritually.
Having said all that, I am pleased to report that the medical technology seems now to be catching up with Susan’s pain. After a restless night last night and a zoned-out state this morning after I arrived, the Susie I know and love is coming back to life. They have tweaked the “recipe” and this seems to be working. She even bumped into her surgeon in the hall while taking a walk (with me pushing her IV pole) entirely on her own. He responded by commenting on how great she’s doing and forecasting her discharge in another 4-5 days. PTL!
It was exactly one week ago that we entrusted Susan’s body to the scalpel of Dr. Munoz. I was greatly encouraged on that day by those of you who came out to the hospital to sit with me during that very long wait. In addition to family members David, Mark and niece Kathy, there were TNPCers Terrie Jones, Wayne Bowman (who comes to every “Dishman event” since 1982), Judy & Jim Hewlett, Bonnie Wells and Martha Gessick; and neighbor Jack Reaves, who himself was recently released from the hospital. (I hope I haven’t forgotten anybody—I was a bit preoccupied.) Also thanks to Kathy Bowman for staying with granddaughter Susanna so that Mark, Angie & Lydia could visit during the week. And of course Pastor Dave has attended us faithfully with the ministry of the Word and prayer before, during and after the surgery.
Susan finished off the day by a triumphant 2nd walk around the 5th floor. The morphine continues to wear off, and the new pain pills seem to be doing their job. She's all tucked in for the night, and one of our favorite nurses is on duty 'til 5 AM, so I'm leaving a bit early knowing she is in good hands.
Pastor Dave's verse for the day was very appropriate:"He will not let your foot slip--he who watches over you will not slumber; indeed He who watches over Israel will neither slumber nor sleep." (Psalm 121). This has been a day of non-slip walking and slumber for Susan.
The morphine pump did its work well last night. Almost too well. Susan slept almost all night pain free, but when she got up this morning she thought she was in Denver! Most of the morning has been a sleepy one for her.
Today's big event was a walk (assisted by a walker and a physical therapist also named Susan) around the entire 5th floor. She went much further than we anticipated. We also went for an exciting trip to X-ray where they are investigating a small amount of fluid on her left lung. Dr. Munoz says "no big deal. She's doing super and way ahead of her recovery schedule."
As I write this, a student nurse Kelli and her professor are changing the dressing on Susan's central IV line in her neck. Kelli bears a strong resemblence to our niece Kathy. I keep calling her by that name instead of her own. It's almost like Kathy were here ministering to her Aunt Susie!
Family members will recall how Susan's mother Helen reacted to morphine during her illness. She said all those humerous things but was always clear about her wants and needs. In this regard Susan is very much her mother's child. As they transition her off the morphine to oral pain killers we will miss the humor, but be very glad to see her become her old self again! Perhaps by tomorrow this will equip her to have brief visits in her room.
I just talked to the family clan at the hospital. Today Susan ate red jello (she wasn't too excited about that), slept more because they gave her a morphine pump, and walked to the door and back. Tomorrow she is looking forward to moving from clear liquids to other liquids (presumably tastier ones). Everybody seemed to be in good spirits.
First the good news. When I asked the surgeon if Susan was on track with his expectations for her, he replied: "No, she's ahead of track given what I did to her." Then he clicked off a list of positives: white count back to normal--so no infection; lungs are clear; bowel sounds returning to normal. We are rejoicing in this answer to prayer.
Also on the good news front: she got the tube out that went in her nose down to her stomach. Now she looks and feels like a real person, instead of a baby elephant with a trunk! She can also begin taking liquids now by mouth.
The bad news is strictly regarding pain. Last night was a tough night for her. The epidural didn't seem to be controlling the pain like it had before. Even though I was asleep on the couch next to her, in her usual fashion she didn't want to disturb me to complain. Come to find out this morning from Dr. Blakely that the epidural had partially pulled out with all the jostling she got in getting out of and back into bed. Consequently, Dr. Blakely removed the epidural altogether and put her on pain pills. Unfortunately, these didn't seem to work very well. When the surgeon came in to see her, she was sitting in her chair with tears pouring down her face because of the "worst pain she's had." In response Dr. Munoz decided to give her a morphine pump for her IV, which should control the pain and help her sleep.
Several of you have sent emails, left voice mail asking about how I'm doing. I'd admit it's been a bit wearing. But because Susie didn't wake me last night, I actually got a reasonable night's sleep and am feeling pretty rested. The good news from the surgeon was also a hefty tonic in the positive sense. I'm home for a brief moment to shower, shave and get a fresh set of clothes before heading back to the hospital.
We've had a number of emails, etc. from many of you saying how much you appreciate the web site. Thanks to Peter for putting it together and allowing Mark & I to add updates. He reports that there have been 584 "sessions" for the web site, which suggests a lot of people are viewing it. Please feel free to share the web address with those who might be interested. And thanks for your encouraging notes. We hope to reply to you personally in due course. And most of all thanks for your continuing prayers! John
PS: we still think it's best to restrict visitors until she gets over the "pain thing." We'll post a big message on the site once she's feeling more herself again. Thanks for understanding.
"Mom' s new room is really nice with a great view of some trees and nice black sky scrapers. This will be enjoyable during the snow storm. Already 1.5" on the ground with another 1-4" through tonight. Big stuff for Dallas."
Blogger was down (or perhaps our ISP's FTP server) as of last night when I attempted to post, so that's why the updates were delayed until now. We are back up now, though, and here are the updates that were missed. PWD
Most of you will not be surprised that I found a way to log in from here in Susan's new room. Today has been a better day for Susan than yesterday. Both her surgeon and anesthesiologist came in today at the same time. They were encouraged with her progress. As I write this the nurse has just come in to clamp the tube in Susan's nose that empties her stomach acids. Dr. Munoz wants to try her out with this for today to see if her digestive system can kick back in successfully. If it works they will take out the tube entirely tomorrow: a huge advance in her progress if it happens.
Last night she had a slight fever, but it went away this morning. It was a challenging night for both of us as far as getting sleep was concerned. The energetic night nurse kept coming in to check her (much more than I had expected). I'm hoping we can both get a nap today to make for last night's deficit.
We had a detailed discussion with Dr. Katie Blakely (the anesthesiologist who looks like an aerobics instructor) about Susan's spaciness on the current epidural recipe. She is much improved today, and is no longer seeing things that aren't there. However, Dr.Katie indicated that a "sundown effect" is quite common in surgery patients wherein they experience disorientation after the sun sets. For now we're going to continue to use the same meds recipe which provides a good compromise between pain control and leg strength.
Last night after Peter hung up, Susan abandoned her attempt to sit up. She was just too worn out. However, this morning she was up in a chair for close to an hour and tolerated it much better than yesterday. For some reason that no one understands it's her left knee that is hurting today. (She may have to lay off those soccer kicks for awhile.) Otherwise she is resting comfortably. The major goal established by her medical team is for her to cough, and get rid of what appears to be some fluid in her lungs. They are sending the pulmonary team in to help in this regard.
For now, I think we would like to continue to restrict visitors until we are sure the sundown effect is no longer operative. Thanks!
I talked with John and Susan briefly at around 10:45pm. John says that Susan is feeling better, and she sounded like she was doing OK to me on the phone. Her pain has gone down, she has gotten a little bit of sleep, and she was even planning to try to sit in a chair for an hour when I hung up with John! A curious time to be trying to sit up, but I guess she wanted to be able to feel her toes again. John is still planning on staying the night in the new hospital room, which he and Susan agree is better than a Holiday Inn. It has a good view, a couch for John to sleep on, a footstool, various curtains, and a telephone that receives incoming calls until 10pm (I know, because I tried to call them back with my free cell phone minutes and couldn't get through).
Given Susan's agitated state, I think it's best we limit visitors to the immediate family for awhile. We'll let you know when she feels more like having guests. Thanks for understanding!
She was a bit spacy in the morning from the pain killers. Then they got her up in a chair at noon for over an hour. That totally wiped her out physically. This afternoon she was moved to a wonderful private room (a Holiday Inn on steroids) with even a couch for me. However, with the reduction in the pain meds she has become very agitated as she fights the increasing pain and nausea. Consequently, I'm home for a quick shower and back to spend the night with her since the nursing coverage is much less than in the ICU. Please pray for relief from the pain and agitation. Otherwise, except for a high white count, all her other vital signs are good.
Also, our medical oncologist came by. He is full of good, innovative ideas about further chemo. He practices his oncology like I do physics: a lot of research and attempt to think outside the box. I'm encouraged about this.
I just spoke with Dad (John), and he tells me that the doctor has ordered Mom to be transferred to a regular, private room between 2 and 3 pm this afternoon. She continues to make a strong recovery, but her white blood count remains elevated. As result she continues on antibiotics. They have turned down her epidural so that she will regain feeling in her feet to walk. She had been sitting up in a chair for 1hour when I talked with Dad. -MSD
Hi, it's me, John posting this, which will probably end up under Peter's name. I was encouraged to leave the hospital early tonight by Susan's nurse who wanted to give her a sponge bath. This is crucial at this time because Susan is experiencing intense itching over her body as a side effect of the epidural she is receiving for her pain. The bath will help relieve these symptoms. Otherwise I left her feeling reasonably well, but somewhat uncomfortable from the itching and muscular pain that is inevitiable with surgery of this magnitude.
First, let me say "thanks" for all the emails, phone calls, etc. that so many of you have sent. I'm not able to respond to each one just now, but we are reading each one and really taking strength and solace from your prayers and encouragements.
Today I became aware of the fact that Susan had a one-on-one conversation with her surgeon while I had stepped out of the room on Saturday. From her questions to me I realized she was now fully informed about the extent of the cancer spread. "Tell me about my diaphragm. Tell me about my pancreas," were her questions. In spite of the discouraging news, she continues to maintain her positive outlook and determination. This afternoon she drew particular strength from the words from John 10 that Pastor Dave shared with her:"My sheep listen to my voice; I know them, and they follow me. I give them eternal life, and they shall never perish; no one can snatch them out of my hand. My Father, who has given them to me, is greater than all; no one can snatch them out of my Father's hand". We continue to depend on this great truth even as we "drink the cup" the Father has given us.
I just talked to John, who was eating dinner at the Black Eyed Pea with Mark and Angie. He gave me a quick update on Susan just before their food arrived.
Susan had a good day today, and was able to rest much more comfortably on her new medications. Apparently, she was in significantly more pain yesterday than her facial expression indicated, and the change in the drug regimen brought her pain level down from a 7 (on a scale of 10) to a 2. Currently, there is only one issue of concern, which is that Susan's white blood count is above normal, which may indicate that she has some kind of infection. The doctors plan to watch her closely over the next 24 hours, but continue to note that she is making exceptional progress. They were ready to release her to a "regular" hospital room today, but she was able to bargain in her inimitable way to remain in the better care environment of the CCU for one more day.
Susan may be ready to receive a few visitors in her regular room on Monday evening, but since she will quickly become tired (and won't particularly show it) we need to start very slowly. Please call ahead if you want to visit after we have posted her room number on the website so that we can make sure they are of maximum benefit for everyone. Thank you for your continued prayers and encouraging emails, which John will read tonight when he gets home from the hospital around midnight or tomorrow morning when he gets up to go to the hospital at six; it is a blessing to suffer in community.
This evening [Saturday] John had a long talk with Susan's anesthesiologist, Dr. Blakely, a lady doctor who looked to be in her thirties. She was very enthusiastic about Susan's recovery, and how well she was doing this soon after major surgery. As they were talking, the intensive care doctor walked by and interjected: "your wife is doing extremely well." Dr. Blakely described some of the details of the surgery from her end, and then indicated that she was changing Susan's medications to reduce her discomfort even further. Sure enough, within the hour the new meds kicked in and Susan was practically pain free, and began to get some much needed sleep. Her swelling is down considerably, and her face is almost back to normal. Her only complaint is a dry throat, for which the nurses are giving her limited ice chips. At this progress it continues to look like Susan will be transferred from ICU/CCU to a regular room by Sunday.
Here are the updates:
This received from John this afternoon:
At 2 PM CST Susan was able to get up out of bed, stand briefly, and then sit in a chair for 15 minutes. After a brief spell of lightheadedness she maintained her equilibrium and good spirits. We are all greatly encouraged by her progress.
Her surgeon, Dr. Munoz, examined her this morning and said "you are doing fantastically. You may be able to leave the ICU tomorrow and go to your regular room." Nevertheless, we would encourage prospective visitors to visit the web site before venturing to Medical City. We will post the visiting hours and room number when they become available.
Janell Kapp summed up the way some of us feel right now...
"I get sad as I read the medical aspects of your mom's health, but her strength and spirit are so amazing through all of this that it makes something inside me smile a little too."
Whoops, lost the last post, so I'll try to give it to you again.
A few minutes ago I talked to John and David, who were getting back from breakfast and moving toward the CCU (Critial Care Unit). John says that Susan is doing "real well" this morning. She was finally able to get to sleep at about 2:30 AM when the medicine started to really make a difference, and she really came back to her "old self" this morning when the doctors removed the breathing tube at about 6 AM. Susan is lucid, not in pain, and able to talk, albeit faintly. She is asking "all the right questions," and although all she knows now is that the liver was clear and that they had to take her spleen out and do some work in the colon, she will soon know the full scope of the spread of the cancer and the operation. After she first woke up, she also noted that she had "pain in the diaphragm" (John notes that he was impressed that she could spell this word after so much surgery!), so she may know that something is going on there as well.
Everyone is "up" this morning at the progress that Susan has made since last night. The fact that the swelling in Susan's face has gone down, that she can talk, and that she continues to be classically herself has encouraged us all. David will probably head home to Atlanta today, given her good progress.
Susan continues to be in CCU, where she will be for a couple of more days. Right now, only family members can visit her, but she should be out of CCU and "visitable" by this coming Tuesday. If you want to visit, remember to try to call ahead and not to make Susan laugh. Thanks for your continued prayers!
Talked with my dad at about 11:45PM and he seemed to be in good spirits. Susan has awakened, and though she was initially in pain and the 15 liters of the fluid that were given to her while in surgery have caused her face to become somewhat bloated, she was able to ask for a pencil (she can't speak because she has so many tubes in place, particularly one attached through her windpipe to a respirator) and in perfect handwriting to inquire about her condition and direct the nurses in their care of her. Most people are completely out of it after such a major surgery, but Susan has once again proven that "this is no ordinary person that you are dealing with!" David is there for the night, and he and John are trying to get some sleep and praying that the lady who periodically cries out in the CCU will be comforted and that the five year old boy who is in the waiting room will also be able to make his way home. Mark, Angie, Kathy, and Terry should come in tomorrow as reinforcements.
I just talked to my dad who had talked to the doctor (at about 5:45). This is my summary of his report:
When the doctors went in, they found the liver clear, but found that the cancer had spread to the diaphragm, spleen, colon, and part of the pancreas. The doctors were able to remove most of the cancer except for a 1mm layer on the diaphragm, and it is hoped that the remaining cancer can be combatted through chemo which will begin in two to three weeks. During the surgery, Susan was given a substantial amount of blood and there is still a risk of bleeding, but the surgeon will be on duty during the first two to three days and an "intensivist" will be on duty after that. It should be seven to ten days before she can go home.
Please pray for Susan's quick healing and recovery of strength, that the bleeding risk will not materialize, and that God will give us all His strength to persevere as things turned out to be worse than originally expected.
PWD
Susan went in at about 10AM and the surgery started at 11AM. She is currently still in surgery. Vital signs are all stable, doing well under anesthesia. As soon as the doctor comes out, we'll update, probably around 5:30PM CST.
PWD
Just a quick note to thank you for all your emails, cards, letters, phone calls, etc. regarding your continual prayers for Susan as she enters surgery tomorrow. She is in good health and good spirits going into her preparations today. Because I will not have a chance to send out emails for awhile, we now have a web site: www.dishmans.net where Peter will be posting updates after the surgery and during her recovery. You can check there for the latest.
Once again, thanks for lifting up your hearts to our gracious Lord on our behalf.
In Him,
John