OK, it has been a while since my last post, but things have been really holding steady here.  Deb continues to slowly improve and I continue to try to take care of her and do some work around the house as well.  Deb's mom has been around for most of it, but she did drive up to Kingsport yesterday morning and spent the night (she had her own appointment with a doctor today) before driving back down today.  I guess I hadn't realized it, but Linda had been dealing with emptying Deb's drain ever since we first brought Deb home.  Last night was the first time I did it myself.  I guess I can check the final box on the nursemaid checklist now.

Deb also continues to get cards, calls, messages, and visits as well.  Four of her friends came into town on Saturday and ended up going to get dinner and bring it back.  Jeff and Gabe came by yesterday for a visit, and our next-door neighbors stopped in last night.  I'm happy that she's getting all the outside encouragement.  I think it really makes a difference.

OK, now for what's coming up.  As I stated before, I will be taking Linda to the airport tomorrow morning so she can fly out to Nevada for another month or two.  Then Deb and I will go back to the reconstructive surgeon for an early afternoon appointment.  We expect (and hope) that he will be removing the last drain tomorrow.  He may also put a little more saline in Deb's tissue expander (pre-implant), but that isn't certain, either.  I may not have reported it well, but Deb was really sore after the first drain was removed.  Not a pleasant sensation, I would imagine.  It's likely that this one will hurt more coming out, as I believe it is in deeper.

Deb's plan is to pre-medicate before the appointment with the heavy-duty painkiller (Tylenol just won't cut it).  I hope that's effective enough, but I recognize the possibility that I may have an especially uncomfortable patient on my hands for about 48 hours or so.  Maybe I should pre-medicate, too?  I am, of course, referring to a legal drug, which would be caffeine.  Espresso is my preferred delivery mechanism.  Enough to maintain vigilant attentiveness, but not be too jittery (a delicate balance, I assure you).

So keep those good wishes flowing her way.  

Three More Down

First of all, allow me to apologize for not posting yesterday, but after dinner and helping Deb with her first post-surgical shower (which pleased her mightily), I was feeling a bit ill and went straight to bed (most likely due to the pork BBQ I'd had for dinner).  That just means I have more to say tonight.

So yesterday's appointment was back with Deb's general surgeon.  He went over the pathology report in more detail with us (it's all good) and answered some of Deb's questions about long-term diligence.  About the pathology report; he said he doesn't like to use the word "cured", but that this is about as close as it gets to that (WooHoo!).  At the end of the appointment he told Deb that she should go ahead and schedule an appointment with the Oncologist to see if he wanted to put her on Tamoxifen, which is a long-term (i.e., five year) preventative drug.  His office made the appointment for us and it was today.  Wow.  I'm not used to getting appointments that fast.

Today's first appointment was with the Oncologist.  He and Deb talked it over for about ten minutes after going over the pathology report, and the final consensus was that Tamoxifen wasn't likely to do her enough good to be worth the likely side effects, especially given the increased detection protocol Deb will be using to screen for any future cancer risks.  I didn't contribute much to the conversation other than to support or explain some of the statistical jargon/data, but I agree with their conclusion.

Having said that, I suppose I should say that Deb probably thinks that I haven't had/don't have much of an opinion about most of her course of treatment.  Truth is, I do have opinions - usually definite opinions, about everything, but I decided long ago to keep my mouth shut and let her make most of the decisions for herself, only offering input if I was truly in opposition (but without trying to impose my will).  What I've found is that my opinions have matched Deb's at every step of the way (which just goes to show that we are somewhat compatible and that there's hope for us yet).

The last appointment was back with the reconstructive surgeon.  We had hoped he would be removing the drains today since he didn't remove them on Tuesday, but he only gave us half of what we wanted.  He removed one of the drains, which is at least some progress.  He wants to see Deb again on Tuesday, so he will likely remove the other one then.  Deb is a little uncomfortable this evening from where the drain was removed, but she took a painkiller a little while ago and that should knock the edges off of the pain.

Tuesday is also when Deb's mom leaves to return to Nevada, so I'm on my own again at that point.  I will likely have to take Tuesday off from work to drive Linda to the airport at mid-morning and take Deb to the doctor in the early afternoon.  That makes a very short work week for me with just Monday and Wednesday.  I'll just have to make do, I suppose.

Thanks again for all of the cards and calls and emails et al.  It's good to have friends.

Follow-Up #1

Today was Deb's first follow-up appointment with one of her surgeons. Today it was the plastic surgeon, and we had hopes that he would be removing at least one of Deb's drains, but it wasn't to be. Actually, I'm not sure he had ever intended to do it today in the first place.

The doctor had been in surgery and had called his office to let them know that the surgery had started late, so he would be running behind. He only ended up being about fifteen minutes late, but it gave me fifteen minutes to lightly doze off on the sofa in the waiting room (we were the only ones there). They took us back and he removed the dressing for the first time since the surgery. Everything looked OK to him, so he wrapped her back up, gave us directions on rewrapping her dressing in the future (and some ideas on what to use), and told us to call on Thursday morning for an appointment on Thursday. That doesn't leave me a whole lot of time to arrange for taking time off of work on Thursday, but you do what you gotta do, I guess.

The best news from Deb's point of view is that she's now allowed to take a shower (which is also good news for the sponge bath giver - me).

Tomorrow morning is Deb's appointment with the other surgeon. So what we're going to end up with is an appointment on three consecutive days this week. Good thing the people at my work are understanding about all this, but both Deb and I think that I should be there with her at these appointments. I just wish my work was closer to town (one-half hour each way).

On the over-all recovery front, Deb continues to show improvement. She's cut back a good bit on the painkillers, so her thinking is clearer and she's awake more. She decided to test the limits of her energy level today, and she found them. We stopped at the grocery store after her appointment, which included a lot of walking around. When we got home our landscaping guys wanted to ask her some veterinary advice questions, so she stayed out there talking with them for at least fifteen minutes (I was at least able to direct her to some shade while she was out there). She also got involved in fixing dinner and did some other things around the house, but now she's worn out and back in position on the sofa. I could have predicted that ... and did.

So a good day. Let's hope they continue to be good going forward.

Monday

Well, it's been two days since my last post, and there has been some notable improvement in Deb. I wish I could say the same about me.

Deb obviously has more energy today. She still sleeps a lot, but she's awake a lot more, too. She's trying to space out her painkillers a little more. She's also moving a little faster when she's up. The only thing not coming along as I'd wish it is the drainage. Drainage in both drains is slowing, but there's still more from #2 than the doctor said he'd want to see before he removes it.

The best news for Deb, though, is the pathology report, which she got today. Even though the total length of the affected region of the duct was longer than expected (at 4 cm), all of it was removed and no invasive cancerous cells remain. The surgeon did say that given the size, a lumpectomy would not have been sufficient, so Deb did make the right choice. Even though he said he was hesitant to use the word 'cured' in most cases, the surgeon said he would be willing to call this one 'cured'. WooHoo!

We go see the plastic surgeon tomorrow afternoon, so let's hope for more good news.

As for me, I somehow managed to pull the muscles in my lower back on Saturday afternoon. The spasms have continued through today and are just now beginning to abate..slowly. I am so happy to have Linda around right now. She's been a real trooper about picking up the slack, especially with laundry and dog-walking duties. So I'm singing her praises yet again.

Thanks go out to John B. for coming by today and bring us our dinner for tonight. To bad I had to go back to work, so I missed his visit. Still, I think Deb was happy he stopped by. Thanks, John.

Getting in Touch with Her Inner Potato

Deb and I had discussed yesterday afternoon the possibility of her actually sleeping upstairs in the bed last night (her idea), but when it came right down to it, she ended up spending another night in the succubus-like embrace of the sofa.  I have to say, it is the most comfortable sofa we've ever owned and I will be very sad when it finally wears out.  Linda again took up the other end of the 'L' since I was afraid I'd end up bumping Deb in the night (and Linda is shorter than I am).  This way Linda was able to take the night shift while I stumbled back upstairs into bed at about midnight or so.

Deb has made some notable progress today.  The amount of drainage has gone down (sorry if talking about that disgusts you, but I'm trying to give a reasonably accurate reporting for the medical-types checking in here).  Also, she's gone from taking two pills at painkiller time to taking one pill, which tells me that the pain is becoming more manageable for her.  And trust me, Deb doesn't tolerate pain all that happily (she will attest to that herself).  Still, most of her time is spent dozing, which is the best thing for her.  When she does have to get up she has been taking several laps around the first floor level just to get some movement going.  She's going farther each time (more laps), so I am definitely see improvement there as well.

Kelly came by for a visit today after she got off of work. Deb had just finished her lunch, so the timing was perfect.  Deb has also taken a couple of phone calls herself (though not many - just family).  She's also been feeling strong enough to pester me about sending out "Thank You" emails or text messages to several people who've sent stuff (especially coworkers), so if you sent something it is entirely my fault that you haven't gotten a "Thank You" yet.  You could say that I've been somewhat preoccupied of late.  I will get to it eventually.

Another day of progress, so I call it a good day.

And I hope you all have a good day as well, whatever you are doing (but especially Jennifer and Rick).

First Day Home

It's 12:30 pm as I begin this post. The night passed reasonably quietly. Deborah stayed snuggled into the sofa (which from personal post-surgical experience is one of the most comfortable spots in the house). Linda took the other leg of the sofa (it's 'L'-shaped) as her overnight post. I had gone into the front room to read for a little bit at about 9:30 pm, ended up drifting off soon after, and woke up at around 4:15 am! After checking on Deb, I headed up to put sheets on our bed only to find Linda had already done it for me previously.

I slept until maybe 9:00 am (I guess I was more tired than I thought), then got up and checked on Deb, got her some breakfast, and found that Linda had already taken care of Deb's surgical drains (I guess when she had gotten up to walk and feed the dogs - I'll tell you, everyone should have a Mother-in-law like Linda).

Since then I've been answering the door, answering the phone, making calls to doctor's offices, calling to check on our car that's in the shop, et cetera, while Deb has been doing the one thing that it is important for her to do - resting as comfortably as possible. Since breakfast she's been lightly dozing, mostly, which is good. She looks very peaceful, at least as long as we can keep the cat from trying to walk on her chest. Lindsay-kitty can't quite understand why we keep blocking her from trying to step any higher than Deb's lap, and she's very persistent in her attempts to snuggle up under Deb's chin, but Linda and I are just as persistent at denying her the opportunity. Lindsay is now curled up at Deb's feet.

Good. They can both get some sleep.
_________________________________________________

Deb's first re-check with the surgeons is on Tuesday afternoon. There won't be as many posts from me between now and then - maybe one each day, maybe less - unless something unexpected comes up, but I definitely will post after her visit to the doctor on Tuesday.

No Place Like Home

Deb is now happily snuggled in on the sofa. It took a while, and for a time I thought I might be seeing the night nurse again, but they finally wheeled her out the door at about 5:45pm. My time since getting her home has been spent picking up dinner and dropping off Deb's prescriptions at the pharmacy.

Her mom is now here with us. I had to go pick up Linda at the airport this afternoon, which happened to be right when the nastiest thunderstorm I've seen in years hit. I got absolutely soaked walking from the hospital to my car through sheets of rain blown so hard it was going sideways (I'm not kidding). There was hail and high water (18 to 20 inches in places - again, I am not kidding). I even saw a Ford Fiesta drive into a puddle and disappear (OK, I am kidding about that - a little). Anyway, it will be good to have Linda here to help out during Deb's initial recovery period over the next few weeks.

Deb reports that she is feeling 'fair'. I'm sure she will feel better once she takes her next painkiller in another hour-and-a-half. After I go pick it up, that is, here in a few minutes. She also says she's feeling more tired than she expected, but I don't know why she didn't expect it after being with me after each of my surgeries.

Finally, she wants me to say 'thanks' to everyone for their messages or calls wishing her well. I have been relaying them on to her during her waking moments, and she does appreciate them all.

So do I, so thanks from me, too.

Currently waiting to go home. Sometimes this process takes forever as they push paperwork through myriad departments. I am reminded of the Vogon bureaucracy at this point. They started the process at about 2:30pm. It's 4:20pm now and I haven't seen anyone for over an hour. Maybe they are collecting an anthology of poetry to read to us on our way out*.


* If you don't get this reference, you need to go read "The Hitchhiker's Guide to the Galaxy" or ask someone who has.

Consultation

Dr. Brown, the surgeon, just stopped by a few minutes ago. He went over the surgery report with Deb, reporting that everything did indeed go very well. He went into a lot of medical jargon with her that went over my head a little so I won't report on that, but the overall gist is that everything is going according to plan.

We discussed her release from the hospital as well. First, he wants to have her try just oral medication for pain control without the morphine pump. If that goes well, I think she'll be free to head home whenever she feels that she's up for it, but if it doesn't, he'll put her back on the pump and keep her around a bit longer. I personally think that she wants to head home not long after lunch, so we'll keep our fingers crossed that the oral meds work out well.

I wouldn't mind getting out of here either. I think we'll both be happier once she's home in her own bed or on her own sofa (her choice). With Deb's mom coming into town for the next two weeks I think we can handle the required nursing duties between the two of us.

Day Two

Well, I'd said that I wasn't going to post again until after we see the doctor, but as of 9:00am we haven't seen him yet. If he's in surgery this morning we may not see him for a while.

Deb made it through the night OK, but didn't get as much rest as she'd have liked. From my own experiences post-surgery, I can't say I'm at all surprised. I woke up most of the times that Nurse Sara came in to check on her, medicate her, help her into the bathroom, empty the surgical drains (which she showed me how to do since that will become my job...hurray), or silence one of the various alarms on one of the various monitors. Still, I must have slept through a couple.

The worst thing to happen was this morning when the magic button stopped working. I'm referring to the self-medicate button on the morphine pump, which allows the patient to portion a dose at will as necessary every so often, with a built-in timer to keep you from overdoing it (I think it's set on a fifteen or twenty minute delay between doses). Anyway, at around 7:30am the vial of morphine hit empty and the pump went into alarm. Due to shift-change it took us an hour to get a nurse to respond, go look for the pump key and another vial (apparently in the possession of someone who had left the floor for "just a few minutes"), change the vial, and re-set the machine. I had at least been able to figure out which button on the machine would silence the alarm for twenty minutes at a time, but that was a difficult hour for Deb. At least she's dozing now.

I've heard the analogy that pain management is similar to driving a car (though I like to think of running a nuclear reactor or even a business). It is far, far easier to maintain control than it is to regain control. Better to make a series of small inputs along the way than to have to make large , if not radical inputs just before it goes into the ditch. Worse yet is having to haul it back out of the ditch. The car may run, but more than likely some damage has been done.

But from the sounds of her breathing, it seems like Deb's engine is running fine right now.

The Potato Soup Caper

Question: When is a bowl of potato soup not a bowl of potato soup?
Answer #1: When it is a plate of chicken and dumplings.

Not long after my previous post the nurses asked Deb if she felt like eating something. Deb wasn't very hungry, but thought that maybe a bowl of soup would be good. Her aunt suggested the potato soup, which she had tried at lunch, so Deb ordered a bowl of that and some ice cream. Twenty minutes or so later, someone showed up with a covered dish on a tray that looked suspiciously not like a bowl of soup. Indeed not. I pulled the cover off to reveal a plate of chicken and dumplings with a side of apple sauce. The food deliverers had already beat a hasty retreat.

Deb said it would be fine and started picking at it unenthusiastically, but her aunt and I decided that she should actually have what she actually ordered and asked the nurse to reorder the soup et al. It wasn't long after that when I sent Deb's aunt away (more on that later), so I was waiting for Deb's soup alone (since Deb had drifted off about then).

Twenty five minutes later I went up to the nurses' station to check on the soup order, but they didn't know anything about it and said they could try reordering again. I decided that I could more easily go down to the cafeteria and get some myself, so I went back to the room to see if there was anything else she might want. Little did I know that the food delivery people had snuck in while I was down the hall. There was Deb, eating from a bowl.

Question: When is a bowl of potato soup not a bowl of potato soup?
Answer #2: When it's a bowl of chicken noodle soup.

At least they brought her the ice cream.
________________________

As for Deb's aunt, we sent her off when we started noticing the numerous flashes of light coming from outside. Since I didn't see any receptions going on that would require thirty or so photographers, and since we are on the fifth floor and not many photographers would climb that high anyway, we quickly surmised that there was a rather intense lightning storm brewing and that those headed one hundred miles east to get home should probably get to it before the storm hit with full force rather than after.

Todd did not end up coming back by tonight. I don't blame him. The lightning was pretty intense around here at 8:30pm when he'd planned to drop by. Maybe we'll see him tomorrow.

I'll hold off on posting again until after we see the surgeon in the morning. I suspect he'll decide to send Deb home then. Time will tell.

Good night.

At Last...

Deb is finally in a room. I had hoped to get up here before she did, but her aunt and I walked in to find that she was already here with two of the floor nurses hovering over her. That, at least, made me feel better. I just wanted to make sure Deb didn't get dropped off and left alone for any length of time.

The only problem I had was that the room temperature was set to "Ice-box" when we got here. Deb didn't think it was so bad, but then she's well bundled in several layers of hospital sheets and blankets, so go figure. Happily, the nurse told me I was free to reset the thermostat, so I am no longer having to plan a trip out to get parkas for her aunt and me.

Deb is in some pain, but the morphine pump is really taking that down a bunch of notches, so she isn't complaining. She's awake right now, but is still pretty groggy so I don't know how much longer that will last. Once her aunt leaves I will try to let her get some sleep for a bit until Todd shows up again to see her.

She looks good. Of course, she always looks good to me, but she does look like she's come through this rather well.

Maybe one more post tonight, maybe not.

Holding Pattern

Well, it has now been close to two hours since Deb went into the recovery room and I still haven't seen her. They are waiting for a room to open up, or be cleaned, or be repainted, or be built, or something before they'll move her out of recovery, but they won't let me back to see her. I really want to. Maybe I haven't made myself clear on that to them, but I am trying not to be the 'problem spouse' that I'm sure they tell stories about from time to time. Still, I'm getting to be as jittery as an acrophobe stranded alone on a rainforest canopy zip line. No, not really, but I've been wanting to try using that line and this seemed like as good an opportunity as any.

Duane had to go, but Deb's aunt is still here waiting with me. Still, it was very nice of Duane to come down and sit with me. I do appreciate that (and Todd, too, who told me he will be coming back by later this evening).

Now is also a good time to express my appreciation to everyone who has called, texted, emailed, commented, sent cards, smoke signaled, et cetera, with good wishes and all. I haven't been able to answer many of them, but we are happy to know that Deb and I have so many friends out there. Thank you.

But for now, the waiting game continues...

Phase 2 Complete

OK, I just got back a few minutes ago from the consultation room with Dr. Kleto. I didn't even have to go all the way down there to find out all I needed to know, because as soon as saw me coming down the hall he was shouting out "Everything went GREAT!!!" All that was left to talk about then was the care of her dressings and drains for the next week (until we see him again on Tuesday). So I'm happy. Everything is good. Deb's aunt is still here with me as is Duane, and one of our pastors just stopped by a few minutes ago to confirm that what she'd heard at the info desk jived with what I'd heard from Dr. Kleto. I also got a visit from Stewart, the CRNA who was in on the surgery (we discovered we have some mutual friends while he was in the pre-op room getting her ready earlier).

So now I just have to wait another hour to see her. She's in the recovery ward now, but I don't get to see her until she gets into a room.

Whew.

Phase 1 Complete

I just got back from the consultation room where I talked with Dr. Brown, the first surgeon. He let me know that his part went very well. He saw no problem areas in what he left behind. The removed tissue will now be sent to Pathology, and we will likely get the results back by Monday. Dr. Brown doesn't expect that the news at that point will be anything other than good. Let's all hope that the margins are clear.

Dr. Kleto, the plastic surgeon, had already gotten started with his part of the surgery (according to Dr. Brown). If things go as expected, she should be coming out into a recovery suite by 4:00pm if not a little earlier than that. I'm looking forward to that. Also, she should be really funny for a while since anesthesia always leaves her loopy. No telling what she'll be talking about for the first hour or so.

It Begins...

They've taken her back now. She should go under the knife in about 30 minutes or so. From there I expect the first doctor (surgeon) will take about an hour and then the second doctor (plastic surgeon) will take over and that will take about an hour and a half. I should know something by 2:45 that the first part is done.

I'm not here alone. Deb's aunt came down and was back in the pre-op rooms with us for a while. My friends Todd and Duane are out here with me in the waiting room right now. As soon as I hear that the surgery has started I will head down to the cafeteria and then be back here in the waiting room for the duration.

More to follow.

Waiting...

This is actually a test message. I'm not sure that I will be able to post through my phone, which is what I'm trying to do.

We are back in the pre-op ward now. No wi-fi back here. Just waiting now for the IV nurse to come in and hook Deb up. Deb's spirits are still high. I'm the one who is as nervous as a long-tailed cat in a room full of rocking chairs.

More when there is more...
Sent from my Verizon Wireless BlackBerry

Post 1 - Surgery Eve

It's the evening before Dr. Deb's surgery and I've decided that the best way to keep the large number of interested parties informed about the upcoming events is to blog about it.

I blog.  I don't tweet.  I blog.

A little information for those just coming "into-the-know".  Deb had a mammogram last Fall.  The results were, well, mixed.  They said that everything looked more or less OK, but that there was an 'area of interest' - something that they wanted to watch and reassess before the usual one year interval was up.  They asked her to come back in six months.

Fast forward to Spring.  Deb returned to have another mammogram done.  They looked at the results and said "Well, this area we wanted to look at looks fine.  Everything there is A-OK.  This other spot, however, ... we want to biopsy that."  Deb was able to have them schedule the biopsy immediately while she was still there.  We heard back from them on the next day.  The diagnosis was DCIS, or Ductal Carcinoma In Situ.  (Click the link for further information about DCIS).  It wasn't there six months ago.  Ladies, Deb is now a poster-child and strong advocate of getting your mammograms on a regular basis.

A lot more has occurred since that time as far as interactions with the medical community, but I can fill in those gaps later on.  The upshot is that she decided that single-side mastectomy followed by reconstruction is the way to go.  Having been privy to all of the discussions, I have to say that I agree.  If all goes well with this, she won't have to receive radiation or chemo, and that's a very good thing.

Anyway, her surgery is scheduled for tomorrow afternoon.  We'll be at the hospital sometime in the morning so they can begin the whole prep process.  I'm not sure just when they'll wheel her away from me to put her under anesthesia, but I'm not looking forward to that moment at all.  It's strange - I've been through seven surgeries since 1989 and I haven't really had any nervousness at all going into them.  This isn't me, though.  This is my wife of 18.5 years and object-of-my-affection of 26.5 years.  I suppose this is turn-about for all of the times she's watched them wheeling me off to pre-op.  I was always cracking jokes with the staff then.  I doubt I'll feel like that tomorrow.

I'll have the laptop with me tomorrow.  If I can get a wi-fi connection at the hospital I will post an update after they take her back.

Wish her luck.