Sunday, March 31, 2013

Sunrise with Hood

Several times a night I am gently woken for various nursing ministrations. Thanks to a shift from my PCA to oral pain meds - which, I admit I was a little resistant to - my pain management lasts longer, and these early morning activities, and trips to the bathroom, are more tolerable. This morning, while Tony (mostly) slept, I asked Katelyn, one of the very sweet, and very Portland CNAs, if we could go on the lam to one of the empty rooms next door. IV pole and multiple cords and tubes in hand, i got a lovely view, and this snap. Happy Easter!

Saturday, March 30, 2013

Day in the Life

Good Morning PDX!

Morning Walk

TKP Takes it Easy

Still Life with Daffodils and Peeps

...And Mt. Hood (and a Helicopter Pad)

Dr Ahmad Examines, Consults

JZ Annotates Ahmad's Figure

Missing Label: "Blowout" -- Lower Colon

We Miss Brandee Already
(Those with Excellent Screen Resolution May Note Mt. St. Helens in the Background)

"Dude. Tired of the Camera Thing."





Friday, March 29, 2013

What Makes it All OK

What would have been a droning hospital day...countless visits from the nursing staff, CNA's busting in to take Jen's vitals, arduous trips to the bathroom, pain and discomfort, a PT,  a nutritionist, a case manager, doctors, doctors, doctors and meds, meds, meds...was pleasantly broken up by the well-timed visit of friends, John and Nancy. Their arrival was well-timed because it coincided with Jen's one and only walk today, and they got to come along.

Remember way-back-when, when I wrote that Jen missed the warm halls of the seventh floor? And, upon reading that she demanded a correction ? Well--that correction still stands. She did not miss those halls; she did not want to return to them; it was nice out today, and she would have loved to go to work this morning, come home later to do some gardening under the Portland springtime sun, have a nice dinner, and then maybe watch a movie or be with friends on a Friday night.

So, this sucks. It sucks a lot. Yet, this day was certainly brightened by friends, as certainly every day is in a zillion different ways. And, Jen is indomitable, as we know: the Stubborn knob and the Effervescent knob--both cranked to 11.

Blurry! But, Sweet Shot of Jenny, John & Nancy.

Great Shot by John

Thursday, March 28, 2013

"People Die From This"

Sorry. Dramatic. This is actually a happy post. The above quote comes from our new hero, Dr. Ahmad (he with the Scottish lilt), who performed the agonizing and nerve-wracking surgical clean up, last night, on Jen's ravaged-by-infection abdomen. If you are squeamish, cover your ears for this one: He drained over a liter of green puss out of her last night; it had the viscosity of yogurt. The pressure was building up so much that it was literally about to burst out of her body.

People die from this. In this instance, though, Jen's youth and vitality perhaps saved her life. Regardless, immediate surgery was absolutely obligatory.

Luckily, Ahmad is happy both with his own work, and--moreover--with Jen's progress. A few possible problems remain that could result in anything from longer stays in the hospital (she's currently slated to be here for 7-10 days from now), to more surgery. But one of the big ones--which he terrified Jen's sister, Brandee, and me with last night--was the possibility of systemic swelling. This occurs in some people as a result of the jostling of the organs required by a procedure of this type, and can land them in the ICU on a ventilator and dialysis machine. The point: Jen seems to be well beyond this danger.

Most of us know how Jen relates to liquids--she likes them. She likes to drink them, especially water, a lot. Dr. Ahmad left her room after granting her the gift of progress from a mouth swab as the only liquid allowed, to ice chips. Tomorrow, however, she gets to graduate to "Clear Liquids." Jell-O here we come!

She loves her swab!

Dr. Ahmad's drawing of her infected abcess--the long, dark area.

Room 728, this time

She'll probably be here for another week, maybe longer.

For those who want to know:

Providence Medical Center
4805 NE Glisan Street
Portland, OR
97213

A walk with Sarah

Ended up doing the whole loop and coming back to her room from the other side. This is less than 24-hours, people. It's amazing what draining a huge infection out of your body will do, isn't it?







Awake. Cogent. Healing already.

This woman is a total warrior. Already had a walk. Well...a short hobble, but it's a start.

Much to be thankful for, much to be wary about as she progresses. Hard to convince ourselves and the medical professionals to look at beautiful young healthy Jen no differently than we do a 68-year old overweight man. But this is the mandate. We now assume the worst. That way we can feel thankful when we find out it's not so bad.

The point is: It feels like this was probably avoidable.

Exhausted. We are all sleeping now.

Out

This surgery was quite a bit more intense than her first one. She had a major infection going, the surgeon was amazed that she hadn't felt worse earlier. He felt that he was able to clean it all out pretty well. She has some significant short-term hurtles to get over in the form of swelling and possible reinfection, but we take it as a sign of her tenacity that the original infection didn'tknock her off her feet. He decided that she didn't need to spend the night in the ICU, so that also is a positive sign.

Mostly as a barometer of his outlook for her recovery, I asked when she might be able to return to work. If all goes well and comlications are limited, then he said she can be back in 6 to 8 weeks from today. That may seem like a long time, but it made me feel good to hear. We just need to get her well--nothing else matters before that.

Based on what he said, I think Jenny is going to be pretty uncomfortable for a little while. She will probably stay in hospital for 7 to 10 more days. My only goal will be to alleiviate her discomfort and keep her on a healing course.

Beyond the initial issues of swelling and infection, which her surgeon is pretty positive about regarding her capacities for fighting off, she has a great deal of healing to do in her intestines. There is a longish road ahead; please keep her in your hearts and minds (I know you will).

Wednesday, March 27, 2013

She'll be in surgery until 11:00PM

The doctor just sent someone out to inform us.

Jen is now going in for more surgery

The first thing to say is that she is going to be OK. But, her resection has leaked, which sometimes happens, and they need to go in and fix it. Her recovery will be extended for a while; we're not sure how long yet.

She is in surgery now. Your thoughts, prayers, or positive intentions of any type are greatly appreciated.

Re-admitted

Well, the doctor decided to re-admit her because she's been so sick today. He perceived a "mass" around the surgical site, which could have a number causes--the worst of which would be a leak in the bowel resection. But, we do not think that is what's going on. It's too late for a leak; they usually occur in the first three days after surgery, if at all. It's been over two weeks.

So, what if it is a leak? Although that would be a real let-down, because it would involve a surgical remedy, it would still be a relatively easy fix. So says Dr. Cho.

A more likely scenario is that she has an abscess at the site, which they can drain and then send her home. Even better than that is the just-as-possible scenario of it being a hematoma, which will resolve on its own through the amazing powers of the human body's capacities for self-healing.

Jen is presently getting a CT scan. We'll keep you posted.

Challenging Day

Jen's recovery has suffered some more regression today. We are glad to be visiting the docs for a follow-up at 2:00 PM. Her outlook remains positive; we feel this is all part of normal recovery, but she feels really crappy. We are hoping that the problems lie more with the constant battle for perfect meds dosing vs. a perfect process of uncoupling from the meds. Friends who know about these things assure us that this is all a part of the healing process. Indeed, overall she has been doing great.

We'll keep you posted.

Tuesday, March 26, 2013

Back to the Doctor

Jen is visiting her surgeon's office tomorrow to have a couple of things checked out. These are probably normal issues for someone in her shoes: a frequent low fever, ongoing pain, swelling; the doc left it up to her whether she wanted to come in to see him or wait it out some more. But she's going in, she decided, and we'll keep you posted on what the medical professionals have to say.

In the meantime, we are very happy to have Jen's sister, Brandee, visiting. Among other happy benefits of her presence is that she somewhat ameliorates the effects of Tony's persistent nagging and regimented views about Jen's meds/supplement/walking schedule.

Monday, March 25, 2013

It's only work and furious busyness...

...keeping me from posting. But, as most major-surgery patients can relate to, even when things go really right, a few things will go wrong. Thus, there have been some minor setbacks: a diagnosis of thrush and its attending new medication to work into the mix (swish and spit, nothing else in the mouth for an hour); an intermittent temperature; sore throat pain (left over, we think, from surgery's intubation), a few other issues, and the lasting discomforts of surgery. But these all occur against the happy backdrop of a generally progressing healing process. Jen's appetite increases every day, her guts are behaving as they should more and more, she sleeps less, and--as the 2.1 mile walk she took today a few hours after her 1.5 mile walk attests--she moves more.

Meantime, the help of friends doesn't let up, and--I can't say it too many times--exponentially hurries her healing process.

The pics are Tony-heavy today, as JZ was the main photographer.





Saturday, March 23, 2013

Not bad

Today was a banner day in the eating department and elsewhere. Jen began her morning with a protein smoothy; she consumed (count 'em!) two soft boiled eggs with a piece of toast at lunch, and she had a couple/few bowls of apple sauce (with added Slippery Elm bark powder for fiber) and ate several crackers throughout the day. Then, at dinner she ate a big bowl of--we may as well call it what it is--gruel (not good tasting, not bad, yet oh so satisfying) combined with Mama Griffis' Wonder-Broth. She also went for a one-mile walk (accompanied) and took a shower with her new hose-attached hand-held shower head. She only took one short nap today, which is also a record of sorts. Now, even at the late hour of 11:30 she is still awake and sort-of semi-active. Pain, nausea, and the discomforts of surgery and medication all persist (it's only been ten days), but all in all it's been a pretty good day.

This was despite the fact that Tony's every movement resulted in something crashing to the floor, and his every endeavor ended with his head cradled in his hands.

Good sleep for all tonight!



Thursday, March 21, 2013

Quick Post

The only thing more heart wrenching, energy demanding, and all-around exhausting than helping your ailing loved one get better after major surgery is being the one who has undergone major surgery. As a good friend, who is both a nurse and a former major-surgery patient herself, told us--after surgery you are caught inside a condition of chronic pain on the one hand, which is exhausting and depressing to your body and mind, and narcotic pain medications on the other, which are exhausting and depressing to your body and mind. It takes enormous vigilance and effort to crawl away from that situation and into full healing. Nevertheless, the Jen we all know and love has not gone anywhere (she just sleeps more). Her effort is apparent, her mind is strong, and her willpower inspiring. Her pain is receding, even if ever so incrementally, and her appetite--just as slow, but sure--is growing.

Jen asked me to issue a strong correction of a previous post which found her wistful, perhaps, about the warm halls of the 7th floor of the Providence Cancer Center. She misses "nothing" about the hospital, she told me, and least of all having to pass by the many rooms of her fellow patients who are undergoing more severe treatments than she had to experience. Her heart goes out to all of them, and to all victims of cancer.

So many, many thank-yous are in order, and I (we, soon) will get to them all. Suffice for the moment to say, however, that together you all have made a profound impact on Jen's healing process so far. Feel good! She will too, soon enough, thanks to you.

Yesterday: Jenny enjoys a tromp through a puddle outside the offices of the fabulous Dr. Dave--of whom you shall all hear a great deal more.


Yesterday after a rare sit-down (thanks, Courtney!) shower: A beauty, wearing her beautiful new semicolon pendant.

Tuesday, March 19, 2013

non-post

I am at my (cr*ppy) job, and I slept till 10:30, this morning---so I have few specifics to report today. Except that Jen is happy to be home, but no doubt found one thing to miss about the 7th floor of the Providence Cancer Center: it's warm hallways to walk through. Yesterday was a nice early-spring day with lots of sun in Portland, but today is decidedly late-winter---if you know what I mean.

Monday, March 18, 2013

Home and Doing Well

With the help of great friends.

Cats very happy.

More to come tomorrow. Presently, we are all somewhat totally exhausted.

Is Today Checkout Day?

We were awakened this morning by the exuberant Dr. Cho, who definitely seems comfortable with the idea of Jen going home today. The only thing holding her back from taking that permission and running out of the hospital (well, getting wheeled out of it - as per protocol) is her ongoing battles against nausea. Sadly, the overnight nurse accidentally doubled the dosage of Oxycodone that Jen had settled on in an effort to stave off the persistent nausea, and this morning finds the problem at its worst. Dr. Cho asked her to try going off the Oxy entirely, and he told her that he was going to set up all the paperwork for her to leave if she feels better later (!).

While he was here, Dr. Cho excitedly asked her if she had heard about her pathology report yet. "We took 66 lymph nodes out of you! You only need 12!" Jen asked how they got that many and he answered "Dr. Whiteford is a good surgeon!" That's how, yo.

In the meantime, she had  a little energy following Cho's visit, but now she's passed out again. I'm eating her sourdough pancakes for her, but, no worries, I'm leaving her all the rice cereal gruel.

Sunday, March 17, 2013

About That "Getting Home and Healing" Part...

Now that the scariest parts of this journey are behind us, Jen is letting her body tell her what to do next. And her body is saying "Don't mess around, here. We just had major surgery on Tuesday." The doctors concur with this, and have urged her to stay in the hospital until it feels reasonably certain that going home (where she wants to be, to be sure) is the smartest next indicated action.

Observers note that she is still exhausted, hooked up to an IV, and hardly partaking of solid foods. Indeed, the docs have backed her off the previously granted option of a full menu, which she never really partook of, to "full liquids" only. However, they also say that this pace of recovery is perfectly normal, and they are pleased with it, overall.

Saturday, March 16, 2013

Amazing and Truly Wonderful News!

Pathology Report = T2 - N0 - M0 !!

This means Jen's pathology report is Very Clean.

"T" is the depth of the tumor, "N" refers to nodes involved (zero), and "M" is about metastases--or the spread of the cancer (also zero!). As the doctor said, it is an "amazingly clean" path report. Her cancer, then, will be downgraded from the Stage II that her surgeon had originally diagnosed it as, to Stage I. Jenny will need no chemotherapy or radiation.

Now, it's just about getting her home, healing from the surgery, and living life as both science and instinct tell us all to live it: by eating wisely, exercising significantly, relaxing intentionally and practicing mindfulness conscientiously.

In the meantime, Jen remains uncomfortable from having major surgery. At first, she wanted  to be the one to write this most-important and celebratory blog post, but, although she's very relieved, at the moment she is feeling pretty crappy physically and is well on her way to a nap.

Nevertheless, we are anticipating that she'll be released some time tomorrow.

As ever---more than ever---thank you all, so very much.

-tkp

Friday, March 15, 2013

Better and Better

This afternoon-into-evening has been fairly positive for Jen's progress. She often tricks non-medical observers into believing that she's ready for anything, but then will suddenly grimace in pain—or just pass out. She's gone on quite a few walks, though, among the byways of the 7th floor, and she's engaged in much animated discussion (Nurse Ally--sadly now off shift--lives in New Hampshire, for instance, and is a "travelling nurse" who goes all over the country in her professional capacity). Earlier, she took a very satisfying shower, and she's now finishing her vegetarian vegetable soup and saltines.

It's unlikely that she'll be released tomorrow, but Sunday is a definite possibility. One intimate yet wholly unqualified observer is confidant that the worst of her pain is behind her.

As for Jen herself, she wants to communicate her gratitude for all the love and support she feels coming from near and far. It might not be surprising, but it is remarkable and so appreciated.



Afternoon Update

Jen has been resting---she has a hard time calling it "sleeping" when she's on the narcotics---but is now awake, alert, and discussing various haircut length options with the short-haired Nurse Alley. She just got another dose of Dilaudid, which she can have hourly if she chooses, but is only taking about every two or three hours, and she's planning on getting up and having a walk in the halls of Providence Cancer Center in a moment. This place has many nice common rooms and "Meditation" rooms with lovely views of this part of Portland.

She's OK Now, But...

If two nights ago was "rough," last night was--at least for a moment--downright scary, and pretty painful for Jen. To explain I will use the ever-quotable Dr. Cho, who said that her "honeymoon phase is over." She spent much of last night in considerable pain, and is now on stronger pain meds.

Basically, the gas---the CO2 that was pumped into her intestinal cavity in order to make room for the laparoscopic surgery, is making itself known. Or, even normal intestinal gas, like we all experience every day, could cause this level of pain for someone who just had surgery. Think of babies and their sensitive guts---that's Jen right now.

There remains an outside chance that the problem is something more to do with the surgery itself, E.G. a ruptured staple in the bowl resection. But all indications are gas: she has no fever, the pain comes and goes and it moves around, and she doesn't feel "sick," just uncomfortable.

Yesterday--oh so long ago, Dr. Whiteford and his team had come by and he continued to be impressed by her relatively low pain levels and her all-around general perkiness (well...we are not surprised there, are we). He said she could possibly even be released today. Well, that idea is now nixed---maybe tomorrow, but we have to be certain that no more gas events, or any other pain on that level, will occur. It's nice to have an attentive nursing staff around for those events, let me tell you.

She is presently finishing her first-ever solid food breakfast while discussing with Nurse Ally the pressing issue of what happens when a knitter runs out of the yarn she is presently utilizing in her knitting project, and is then forced to add a completely new yarn.

More to come.

Thursday, March 14, 2013

Making Comments on Posts

Howdy. Those of you who have wished to make comments, but were unable to, likely can now. You don't need to be logged in or anything, we don't believe. You do need the password, but you have that I think, or you wouldn't be reading this right now.

Day Watch

A lot happened last night and this AM! She had a fever, which was a bit scary, since that's what would happen if she was leaking internally. But, it was only from the moisture in her lungs. So they prescribed a big dose of Tylenol and Advil together and that knocked her out and brought down her fever nicely.

This morning, she completed a long walk down the hallway and back, and they are next going to take her off the PCA (Patient Controlled Anesthesia) and try oral meds only---but just the Tylenol and Advil mix!(Unless she needs something more). In the meantime...we've got poop, people! A real coup in this battle!

The awesome, funny, and humble Dr. Cho, I believe the assistant surgeon, came in and said she was healing at a "new record" pace.



Night Watch

A rougher time was bound to come, and this is what tonight has been. Jen's temperature spiked a bit--likely the result of moisture build-up in her lungs (very normal), her "spinal" anesthesia wore off, so some of the pain of surgery has started to set in, and when she successfully took a little walk out the door and back (doctors orders), that took a lot out of her. She was not feeling very well for a while.

But the docs prescribed a cocktail of Tylenol and Advil which knocked her out like we hadn't seen before. She slept very deeply and only woke up (soaked with sweat) when they came to check her vitals. She is now (yes, at 4AM) taking her first shower since surgery. I have a feeling more great sleep will follow.

Wednesday, March 13, 2013

FYI

I guess the flowers place I posted has, sadly, closed. Another great place---still a functioning business---is Sammy's Flowers (503) at 222-9759, or sammysflowers.com.

It goes without saying (but I'll say it anyway) that flowers and such are not necessary! Nice as they are (she has received some really beautiful bouquets), they don't compare to the love and positive energies you all have showered onto her---demonstrably healing help.

Thank you!

First broth--on the way to solids!

Still doing great.

Tried to walk with nurse...

...too woozy. They'll try again in the afternoon.

Jen's sleeping, Tony's eating and drinking coffee, Mama-Jane is en route from cats.

A good night. Still resting.

Room is 710 (sorry, forgot to post last night). MANY visits through night from nursing staff. They are really excellent caretakers here. Jen is still sleeping, and still doing great.

I'm guessing that she won't be allowed or taking any visitors this AM, maybe not all day. Not sure, tho, and will keep you posted on that matter.

For myself, I am going to get some more shut eye too. This cot is thin, plastic, and full of rocks, and I love it.

Tuesday, March 12, 2013

She's alert and doing great!

Flashed me a hang-loose sign as they rolled her into her room. Still hasn't needed pain-button. Very alert and doing great.

Off to sleep everybody. We'll update you tomorrow.

All below notions confirmed.

Went just as he hoped.

Still waiting to see her.

A Check-In from the Surgeon!

Great news!

We just received a call from the operating room. A nurse, speaking for Doctor Whiteford, told us that Jenny's surgery has gone "very well" and that he's just beginning to close her up and send her to post-op. I think all Jane and I heard were the words "very well," but we are taking it that she did not need an lliostomy, that the surgery remained laparoscopic and not open, and that they were able to get out everything they hoped to get out.

Fabulous !

Within the hour we will meet with the doc and get the details---at which point I will pass them on to y'all.

Pager

Our waiting-room pager just loudly activated, shocking us out of our peaceful wait. It was just a message from Jenny's team, telling us that they've begun and all looks well so far.

Jen just going in.

Doctor Whiteford, her surgeon, stopped by and seems super confident. The anesthesiologist is a real sweetheart, like your best friend's mom.

Good energy all around.

Thanks again, everybody, for all your good attentions.

Chillin' Out in the Pre-Op





Jen's Home Address

Great reminder from Errin R (Thanks,Errin!) for those who want it:

Jen Zarnoch
6406 NE 22nd Ave
Portland, OR
97211

For those who have asked about sending flowers:

Hi everybody,

Several people have asked me about sending flowers, which I think is a fine idea---keeping in mind her proclivities for the natural, native and whathaveyou... (She is out gardening as we speak).

So, I called the hospital to get the scoop. Apparently her room number won't be assigned until she's out of the surgical recovery room, which could be as late as 10:30 tonight. However, any flowers that arrive prior to that will be held for her, and voulnteers will bring them in once she's in her room. But, I suppose that the later flowers are ordered, the better...

The address is:
Providence Medical Center
4805 NE Glisan Street
Portland, OR
97213

I'll post this all to the blog as well; I'll post the room number there as soon as I get it.

Blog address: http://jzhealthupdate.blogspot.com/
Password (asked for ceaslessly): kalesalad
Only flower place I know of (really nice place):
Origin Flowers (503) 775-9599
1532 Alberta Street, PDX, OR

Meadowscaping Natives in the Morning...

...surgery in the afternoon!

Saturday, March 9, 2013

Surgery is Scheduled

Hi Everyone, 

I just wanted to let you all know that my surgery has been scheduled for this Tuesday, March 12, in the afternoon.  I'm scheduled to go in at 3 pm and surgery is expected to take 3-4 hours, but I'm guessing it won't start until 4 and I wont' be out of post-op until as late as 9 pm.  I have a great surgeon - Dr. Mark Whiteford - who has told us that I'll likely be in the hospital for 4-5 days; it will be less if I'm really motivated and all goes according to plan.  Unless things change in the operating room, the surgery will be laparoscopic, and I should be up and walking about the next day, and back to 80% in 6 weeks.  

Since the initial shock of diagnosis, a little over two weeks ago, I've had consistently positive news. The cancer does not appear to have spread, though we won't know for certain until we get the post-surgery pathology, which could take up to a week. I also got connected with a great naturopathic oncologist, Dr. Dave (thank you Heather P!!), who has me on a robust supplement protocol to help support my system pre- and post- surgery, and prevent metastasis. I was initially concerned that Dr. Whiteford wouldn't support my supplement regime up to surgery, since standard surgical protocol is to stop all supplements 5 days prior to surgery.  As Dr. Whiteford pointed out, most of his patients are getting their nutritional information from "the person in aisle 3 at the GNC," and he was happy that I was getting my information from someone who knows what he is talking about.  A great reminder to go to someone well trained in their field. I cannot recommend a good naturopath enough, if you want someone to treat you as a whole person and complement the Western approach.  

Tony and I have had many questions about what we could do to help fight cancer and help support my body to recover from surgery. We have consistently heard that I am better prepared for surgery than most because of our healthy lifestyle choices.  As my dear friend Leigh said - it's as if I have been training for this marathon my whole life since I have often considered my food as medicine.  Let's hope it pays off.    

We (meaning Tony or someone else) will post updates as they are available.  Mom is arriving Sunday to help out and offer maternal support, and a bevy of friends and neighbors have offered to lend a hand with all of the miscellany.  I'm sure we will be taking you up on your generosity.  

Feel free to share these posts with anyone who I might have missed - just a gentle reminder to keep it off Facebook, please.

Thanks for all of your well wishes and positive, healing thoughts. 

xo