Homecoming

Shane came home from the hospital today.  He is tired, but he was able to walk from the cab to the building, and he has been walking around the apartment a bit.  His first order of business when he came home was to fix himself a cup of tea.  (Thanks John, Jim, and Laura for the gourmet tea bags!)  The visiting nurse service is going to come see us tomorrow.

Rounding the corner

So much has happened in the 48 hours since Shane's last operation.  He is off of the IV pain medications and gets Vicadin only on request.  As he puts it, he's now on the "opiate-lite" plan.  He can walk without a walker and he is off of oxygen.  The doctors are saying Shane will be able to go home soon if his appetite continues to improve and the symptoms of infection don't come back. Shane has lost a lot of weight, so a nutritionist came to visit yesterday and suggested that Shane try a high-protein diet supplement.  They bring this drink every meal now, but Shane isn't too eager to drink the foul-tasting stuff.  I contribute to Shane's weight-gain plan by picking up a glazed doughnut every day on my way to the hospital.  On request, I brought his favorite potato-kale soup from home for lunch yesterday.  His mom brought spaghetti for dinner from one of the Italian restaurants near the hospital and Shane ate it right up!  In preparation for Shane's home coming, I will stock the kitchen with lots of calorie-dense foods: guacamole and corn chips, bacon and eggs, coconut sorbet, and peanut butter.  If only we could all be so lucky to have a doctor tell us to eat lots of these foods!  The doctors also suggested Shane go to rehab to regain some of the strength he's lost during the last 2 weeks of fasting and bed rest.  He will receive rehab on an out-patient basis.  

The operation went as planned

Shane's operation today was successful.  He received twilight sedation, so he was fully awake about an hour and a half after surgery.  He immediately asked what was for lunch!  His appetite was better today than it has been over the past week, which makes me think the surgery is helping him get better.  The doctor said everything went as expected during the procedure - he rinsed out the abscess and put in the drain.  He also said he didn't see any signs of ischemia, which is a reduction in blood flow to the tissue that can signal more problems in the future.  The doctor said we have to play it by ear now and see whether the infection clears.  I asked if Shane could come home from the hospital this week and the doctor said he can't make any promises.  So, we'll just take it day by day.  Thanks, everyone, for your words of support as we continue on this journey.

Another operation

Shane's test results indicate he continues to have an infection at the site of the surgery, even though he's been on antibiotics for two weeks.  He still has one of the two catheters that they gave him during the surgery last Sunday, but since the CT scan shows fluid building up again, they will do a simple procedure to put the second catheter back in.  The doctor said this infection will not resolve itself with antibiotics alone, and part of the reason Shane is having so much trouble healing is because of the radiation treatments he received before the surgery.  Luckily, tomorrow's procedure won't involve any incisions, can be done without full anesthesia, and will only take 10 minutes. 

Doing the dance again

Shane had a fever of 101.5 tonight, so he repeated the dance he knows so well by now: urine sample, blood culture, chest x-ray, CT scan.  Same routine, different day.  The on-call doctor hypothesized that Shane's fever was caused by a topical infection at the site of his IV needle.  We shall see.  Meanwhile, there were some successes.  Shane managed to eat a bit more today.  Using the walker he walked a loop around the oncology unit without his oxygen.  He sat up in a chair for three hours. A respiratory therapist came in the afternoon and said Shane's lungs sounded clear, so he managed to avoid having her thump on his back to make him cough up phlegm.  Shane received numerous calls from friends and was too tired to get back to all of you, but he asked me to tell you he'll call you back as soon as he can!

Breakfast for two

This morning I made homemade oatmeal and hard boiled eggs and toted them to the hospital so that Shane and I could share a quiet breakfast while we looked out the window at his view.  Shane still doesn't have his appetite back.  He says food just doesn't taste right, like when you have a cold.  Even so, he managed to eat a few spoonfuls of oatmeal and drink some orange juice.  He ate half of the egg, a few saltines, and a little bit of chicken soup at lunch.  I didn't mention this before, but Shane did have another 101 degree fever on Thursday night even though he is still on antibiotics.  Shane's doctors ordered a urine culture and another complete blood count.  He may also have another CAT scan on Monday to make sure that no abscesses have formed in his abdomen or pelvis.  His diuretics and albumin are working, so much of the swelling, edema, or "third spacing" he experienced in his body after the surgery has subsided.  Third spacing is when fluid collects in the spaces between your organs.  I don't fully understand the phenomenon, but if you are interested in the chemistry of it, you can checked out this nursing article on third spacing.  Shane also had a lot of visitors today.  I visited in the morning and his mom visited in the afternoon.  His friend Tom from Tuesday night dropped by.  We also met Dave, the son of Shane's aunt's best friend, and his wife Crystal, who happen to live in New York.  They brought Shane some delicious mint tea and we had a nice visit.  Seems like all the visitors wore Shane out, because he told me he didn't have the energy to watch The Wire tonight - that's our favorite TV show that we watch on DVD.

View of the Hudson

Shane moved back to his bed in the oncology unit last night around midnight.  They saved his room for him, which is excellent because it has a view of the Hudson and the George Washington Bridge.  It is lit up at night and the cars twinkle as they go by.  His contact information is:
     New York - Presbyterian/Columbia
     Milstein Hospital Building
     177 Ft. Washington Ave.
     6 Hudson South, Room 240 B
     New York, NY  10032
     (212) 543-7235
Shane has been getting a nebulizer, which is helping him breathe more easily.  (It's also better than the alternative treatment for fluid around the lungs, which involves a big needle.)  Shane's doctor promoted him to a regular food diet today.  Shane's stomach has mixed feelings about that.  He is having an easier time getting out of bed and sitting up in a chair.  He also has less pain.  He's going to hang out in his hospital room and enjoy the view for the weekend.  We'll see how next week goes...

Allowed to drink again

Shane was really tired and slept a lot today.  His physical therapist came by in the morning and Shane set a new record for walking.  Using the walker, he was able to make it out of his room and down the hall a bit.  He also got his nasal-gastric tube and urinary catheter out today.  Hooray!  Shane's surgeon came to visit twice and noted that Shane is having increasing difficulty breathing.  They said Shane does not have fluid in the lungs (according to his previous x-rays), but it looks like he does have fluid around the lungs, which is called pleural effusion.  This could be the result of having general anesthesia twice in eight days.  If that continues, they will do some diagnostic tests and they may have a thoracic surgeon come and drain some of the fluid out in a fairly low risk procedure that could give Shane a lot of relief.  We also visited with Shane's ostomy nurse who said Shane's ostomy looks like a rose.  She gave us a lesson on ostomy care and told us some eyebrow-raising stories about the things she's seen pop out of people's ostomies, like an entire intact green bean!  She said everyone should chew their food more.  The most exciting development is that after three and half days of eating and drinking nothing other than ice chips, Shane was finally permitted to start a liquid diet.  His first request was iced tea.  Yummmm... caffeine!

Baby steps

Shane is still in the step-down unit, still on oxygen, and still has the nasal-gastric tube and other drains tubes in.  He is also still receiving antibiotics.  He is in less pain, but he's tired because his heart is beating faster than normal and that takes a lot of energy.  Nevertheless, things are slowly improving.  He sat up in a regular chair and even did a little walking in his room with a walker.  His intestines even started turning back on little bit.  We talked to his surgeon today and he said Shane will be in the hospital for about another week.  He also said Shane's pathology report came back today and looks good.  As a result of the chemo-radiation treatement, he was "down-staged" to stage 1 (T2N0).  In other words, the lymph nodes they tested were all negative for cancer, which means the chance of re-occurance is low. 

A tough day in the step-down unit

Shane spent the night in recovery and moved to the step down unit this morning.  He was resting and sleeping a lot, which was good because his recovery nurse said he was awake much of the night.  He wasn't eating or drinking anything all day, but unfortunately he began vomiting bile in the afternoon.  The nurse said Shane's intestines had likely stopped working temporarily, which is quite common after surgery.  Peristalsis is the muscle contraction that keeps things moving through your digestive tract, if that stops then things can get backed up in your system.  In other words, bile can collect in your stomach and make you sick.  They put in a nasal-gastric tube to drain the bile and relieve the pressure in his stomach, and Shane looked a lot better afterward.  The doctor and nurse said they'll encourage him to sit up and walk a little bit tomorrow, which will help get his intestines moving again. 

Emergency surgery

After Shane's CT scan was finally performed early this evening, he was wheeled downstairs for emergency surgery.  The scan showed that he had pockets of fluid and air in his abdomen.  I asked him if he was scared before the surgery and he said no - he was mostly disappointed that he had to have another urinary catheter.  (Those things hurt!)  The surgeons reopened the surgical incision and found a small "leak" had formed, so bacteria from his intestinal tract had migrated into his abdomen and were causing an infection.  They've cleaned the area out and will keep drainage tubes in him for a little while.  He'll spend the night in the post anesthesia care unit (aka "recovery") for close monitoring.  Tomorrow he will go to a "step down unit" for further monitoring.  I saw him after the surgery and he looked good - way better than before.  His pain level was a 10/10 this morning, midday it was 5/10, and after the surgery it was 3/10.  Please send him your prayers and positive energy while he recovers from this second surgery.  

Sitting with the unknown

Shane is on antibiotics but he is still having high fevers on and off.  His doctors aren't sure what is going on since his white blood count is normal.  We are waiting for the results of another chest x-ray he had yesterday.  Oddly, Shane doesn't have any other signs of infection.  For example, he isn't coughing at all, so it isn't clear whether he has pneumonia or not.  Shane has also been having sharp abdominal pains.  He's going to have another CT scan on his chest and abdomen today, and they are doing more blood work.  I'll be sure to put up another post as soon as we have more information.  

Pneumonia

It looks as though Shane may have developed pneumonia.  He had a fever of about 102.4 last night which subsided but then came back this afternoon and hit 103.  He's had a series of tests on his blood, urine, etc., and based on a chest x-ray the doctor is recommending a course of antibiotics for a possible case of pneumonia.  The diagnosis isn't certain, but Shane's surgeon doesn't want to take any chances.  Shane has been on oxygen ever since the surgery because he had general anesthesia and that can affect your ability to breathe afterward.  So, he is staying on oxygen and should be starting his antibiotics as soon as the pharmacy sends his medication up to the oncology unit.  He is sleeping a lot and doesn't feel very good.  

Phone number

Shane is feeling better.  He had physical therapy today and was able to stand up and get into a chair.  Other than that the day was fairly uneventful.  Shane is ready for phone calls and he asked me to post the phone number for his room: (212) 543-7235.  Visiting hours in the oncology unit are noon to 8 p.m. Please call before coming.  He reports that the hospital food leaves something to be desired.  SOS.  SOS.  If you see matzo ball soup on your way here, please pick some up.

Room information

Shane has finally been transferred to a room in the oncology unit.  Hooray!  His new stretcher is much more comfortable than the hard stretcher he had in the recovery room.  He is not ready for visitors or calls yet, but I will post his phone number as soon as he is.  If you would like to send flowers, his room information is as follows:
     New York - Presbyterian/Columbia
     Milstein Hospital Building
     177 Ft. Washington Ave.
     6 Hudson South, Room 240 B
     New York, NY  10032

Still waiting for a bed

Hi everyone, Shane is doing better and better.  He's alert and smiling a lot, especially since he's got his magic pain button that he can press every 10 minutes to get a dose of pain killer.  Unfortunately, he is still in the recovery unit.  His surgeon wants him to go to the oncology unit and the beds there are full.  A bed was reserved for him this afternoon, but the patient who was supposed to be discharged has not left yet.  I'll post his room information as soon as he is transferred!  Alex

Fever be gone!

Shane's fever is gone but he is still in the recovery unit.  He had a bit of tachycardia last night and this morning, i.e. his heart was beating a bit faster than normal.  This can be a sign of a pulmonary embolism (a blood clot in the lungs) so the surgeon ordered a chest x-ray and CAT scan.  All of the tests came back normal and Shane should be transferred to a room sometime this afternoon.

Hospital Update

Hi people, It's Alex again.  In case you were planning to call or visit the hospital today, I suggest you wait a day or two.  The hospital called this morning to let me know that Shane developed a fever last night and they are keeping him in the post-surgical recovery unit so the nurses can monitor him more closely.  That means he isn't in the room they assigned to him last night and he can't have visitors, except for brief visits from family.  The surgeon said Shane would be in a lot of pain the first 36 hours, and he is mostly sleeping because of the pain medications.

Surgery report

Hi everyone, This is Alex reporting on Shane's surgery.  The surgeon was very pleased with the outcome of today's surgery: he said it was the best case scenario.   Shane received a temporary ileostomy rather than a permanent colostomy.  The surgery was done laparoscopically (with a small incision and cameras), which is less invasive and has a shorter recovery time than traditional open-abdomen surgery.  We saw Shane in the recovery room this evening and he was awake enough to talk and smile.

Hospital stay

I am scheduled to have my surgery next week on Tuesday January 12.   I will be recovering in the hospital for at least 5 days.  During that time if you'd like to visit or contact me please check my blog for information.  Alex will post my hospital room and the room phone number once I am able to receive calls and visitors.