Halfway Point

It has been 24 days since my first surgery, and my second surgery is scheduled 25 days from now. Candidly, I am dismayed by how weak I find myself. Yesterday, I had lunch at my apartment with my brother, Bill, who drove up from Virginia to see me, and I was so exhausted afterwards that I had to take a nap. Today, I went out to a local restaurant for lunch with a friend and got so tired that I developed an upper back spasm, which thwarted my plan to be driven out this afternoon to Belmont Park to see my two-year-old colt, Backslider. Backslider arrived from Kentucky two days ago to be prepared for his racing debut on July 23 at Belmont Park. 

It is amazing how fast, and to what extent, a sequence of cancer, chemotherapy, surgery, and an infection can debilitate one's body. Since the surgery, I have lost nine pounds, and I would not be surprised if all of the weight lost has been in the form of muscle. At least the post-surgical swelling of my abdomen has receded enough so that I was able to wear a pair of trousers when I went out to lunch today that I was wearing before the surgery.

I need to get much stronger over the next 25 days before undergoing the second surgery. In the meantime, I will try to husband my strength enough to enable me to go out to Belmont in the next couple of days to see Backslider. After I had to cancel my visit today, my trainer, Christophe Clement, very kindly sent me these two photographs of Backslider. Obviously, Backslider is still growing, as his hindquarters are higher than his withers. But he looks strong, and my guess is that he will mature into a grand-looking colt.

Update

Gradually, my energy and stamina seem to be improving. I am no longer taking medication for pain or antibiotics for the infection of the incision. Although the infected part of the incision is slowly healing, it still requires the services of a visiting nurse twice a day. The swelling of my abdomen has subsided enough to enable me to wear newly purchased khaki trousers only four inches larger in the waistline than I wore prior to the surgery. The skin below the incision was irritated from something during the surgery, and that skin irritation does not seem to have lessened. I will have to find out if the surgeon can safely modify the next surgical procedure to avoid a recurrence of that skin problem.  Next Tuesday, I will undergo a day of tests to ascertain that I am on track for the second surgery to take place on August 3.

Starting tomorrow, I am going to start seeing visitors again. I will not be able to do much on visits-- my longest walks since surgery have not exceeded 1.4 miles, and I more typically have been taking walks of a half mile or so. Most foods no longer taste good to me, apparently because of what is transpiring with my liver as its right lobe atrophies. But I am looking forward to being with friends again, if only to talk.

Status and Schedule

This morning, I had appointments with Dr. Jarnagin, the liver surgeon, and Dr. Saltz, the medical oncologist. Dr. Jarnagin removed the remaining 36 of the original 40 staples-- four had previously been removed to treat the post-surgical infection that developed. Dr. Jarnagin also scheduled the second surgery, to remove the right lobe of my liver, for August 3. Dr. Saltz indicated that he will probably re-start my chemotherapy a few weeks after the August 3 surgery.

Dr. Jarnagin indicated that the trauma and pain associated with the second surgery should be comparable with that of the first. Just a day or so ago, the pain from the surgery on June 15 began to subside. I am starting to sleep a bit better and hope soon to start getting through the nights without the assistance of a nurse's aide. Yesterday, I was able to walk for the first time with a fairly normal stride and posture. Today, I began to cut back on the pain pills. A visiting nurse service is coming twice a day to change the bandages on the infected wound, and I am scheduled to continue taking antibiotics for approximately another week. Although my belly is still distended-- I am wearing size double extra large sweat pants--  the swelling is starting to subside. As soon as I have reduced my ingestion of pain medication enough so that I am not groggy, I will post an update on this blog inviting visitors.

Returning Home

Charlie will be returning home about the middle of the afternoon. We may walk from the hospital, which is probably .7 miles away. Should they be needed, there are a number of benches along the route. Yesterday he did 48 laps of the hospital hallway, but only four at a time, so the challenge will be the sustained effort, not the total distance.

The infection is healing well, but the open portion of the incision will need to be dressed on an as-needed basis--in any event, twice a day. So I will be trained this afternoon for my new role as Nurse Susan. I must say that the patient has a decided lack of confidence in my capabilities, although the doctor and (real) nurse say it will be easy and that I really cannot hurt him.

"Not Even a Speed Bump"

Having no knowledge of the blog or my post, Dr. Jarnagin just told me that the infection is "not even a speed bump." He said it would have no effect on anything from here on out, noting that the infected place is very small and already responding well to the antibiotics. He said the area would be completely healed in about two weeks.

A Bump in the Road

I had intended to entitle this post "Setback", but after hearing this morning's medical report, I decided to change to the above. I am hopeful that the new title better fits the situation.

Last night, after two consultations with the doctor on call, Charlie and I returned to Urgent Care (MSKCC's emergency room). The area around the incision had become redder, and the redness was spreading. At 2:30 a.m., after blood tests, cultures, and opening of several stitches to clean the wound, a bed was located in the completely full, in-patient part of the hospital, and Charlie was readmitted. He is on intravenous antibiotics.

This morning, the doctor said the infection is already better, meaning that it is responding to the antibiotic. The plan is to keep Charlie in the hospital one more night. After he goes home, a visiting nurse will change the dressing daily so the area can be kept open for continued drainage. Dr. Jarnagin's fellow says this happens in about ten percent of cases, and he appears optimistic about the outcome. I will post again later today with an update.

Incremental Progress

Charlie wanted to wait for some sort of major news before posting again, but I thought some of you might be wanting an update before then. I would describe his progress as incremental, a little bit day by day, but with a startling contrast when comparing today with a week ago. This morning he ate and enjoyed a full breakfast--oatmeal and juice before I got up, and eggs, bacon and toast with me. Last Wednesday, he ate a little jello and some fruit ice. Today he spent an hour or two with the newspapers. He didn't touch the newspapers we delivered he whole time he was in the hospital. He's walking two or three times a day over to the East River and back. One or two laps at a time around the hospital hallway was last Wednesday's exercise.

Pain control and fatigue remain major issues. When he is feeling up to visits or phone calls, we will notify everyone here. He still loves e-mails!