No one gets much sleep at M.D. Anderson!
Here I am, at Version 5.0, hanging out with my night nurse, Yesinia (whose parents got the idea for her name from a Soap Opera! Parents sure come up with weird names for their poor kids!)
Yesinia has been working on cleaning up my chest area. I ended up having a tracheotomy as part of round four surgery, and when I cough, which happens a lot, I end up with "crud" (that is the technical term for it) on my chest. Yesinia is almost an artist at doing this cleanup. She wields a water-soaked sponge-tipped stick like a brush as she works off the goo from painful areas around incisions and other places the doctors have "modified" to build this new version. She is good, but it takes a while.
Good thing we have all night.
She also has to check out the Doppler pinger that proves there is good blood flow in the "flap" they put in to cover part of my new jawbone! That "flap" used to be part of my leg. Exactly what part I have not figured out yet. There are several possibilities from what I can feel! With the Doppler sensor, you can hear blood flow in both directions through the new tissue they grafted into place on the new jawbone they are growing in the area.
Dr. Yu has a world-wide reputation for doing this kind of magic work, and I am extremely lucky to be one of his patients!
Surgery Day
In my last post, we had settled into our favorite La Quinta off route 59 in Houston. We set the alarms(s) (you need more than one this time) for 3:45AM so we could get ready and drive over to the hospital by 5:15AM, when I was to report for surgery.
We were the first ones in the waiting area. Cheryl, Connie, Karen, and I all sat there while I filled out the requisite ton of paperwork needed to get ready for surgery. Soon, there were many other folks doing exactly the same thing, with varying numbers of folks waiting with them.
At around 5:30AM, an orderly came out and had us all line up to wander into the surgery prep area. Last time I had surgery here, we ended up in a curtained off cubical. This time we each had private rooms, with a bed, TV, and everything needed to get ready.
They had me strip down and put on the blue "BHO" gown (Butt Hanging Out, in case you do not know proper hospital acronyms!)
Once that was done, a constant stream of doctors, nurses, trash collectors, etc, started streaming into the room:
"Patient ID" "1234567" "Name" "me" "Did you?" "np" "Have you", "no" "Will you? "never, I promise!"
The questions were identical to those on forms I filled out back in the waiting area. It must be some kind of test!
Our PA came in and wrote YES on one leg, and NO on the other one, after asking me which side they would be operating on. Hope I answered her right! She also wrote on my face as well. I guess enough doctors have been burned by making a mistake in surgery that this is now common practice!
Finally, the evil person with the needle came in and they set up the IV. This one went very well. Either I was so preoccupied by things or he was very good. I never felt the needle going in!
Good!
Karen and Connie had to swap out while all of this was going on, since they only allow two family members in the room at any one time.
Time to Go!
I had some general ideas about what might happen but did not know exactly what would happen during this surgery. The doctors would figure things out as they worked on me.
All I remember next was being told they were going to start the IV. I kissed Cheryl goodbye, and we said we would meet up again in recovery. I have a vague memory of the bed starting to move, then it was lights out!
I do not remember anything until I woke up in a recovery area.
Eight Hours had gone by
The Surgery
Apparently, two teams worked on me at the same time. Dr. Lai's team was at my head, working on making the cancer go away, and Dr. Yu's team was working on my legs, trying to find parts he would need to rebuild things in my mouth when Dr. Lai got finished.
Once more, more of my leg was going to end up in my mouth. Fortunately not my foot, although that has happened a time or two in my past!
Dr. Lai would work a little, then wait for lab results to tell them how to proceed next.
In the end, they took my entire lower left jawbone out. I knew this might happen, and the doctors agreed that, based on my history, this was the best way to go. If they left any bone in that area that has microscopic cancer cells in it, going back in later would be much more difficult. So they went for the easier, and safer, alternative.
Dr Yu had to rebuild a jawbone out of pieces of my left leg bone and tissue he stole from the same leg!
Artificial Jaw
Look up Roger Ebert to see what I might have had to deal with. He was a movie critic back in the 1980s who lost his entire lower jawbone to the same kind of cancer I have. I saw an interview with him before he finally died from this cancer, so I was not happy with the thought that I might follow him down the same path.
But Dr. Yu is a master of this kid of work, and he had another idea.
Basically, he took three pieces of bone from the non-weight-bearing part of my left leg and built up a new jawbone structure out of that. He braced those bone fragments with a titanium plate and screws to hold everything together as the bone grows back into place, and covered everything up with tissue and blood vessels from my leg as well. It will all heal giving me a mouth that looks reasonable.
Except I have no teeth on that side now. Maybe we can fix that later,
The surgery was difficult, and took a long time to complete. Cheryl had to endure another painful waiting process. But the hospital staff is great about keeping family informed about the progress, and this time Cheryl had family with her, so that much was easier for her.
Me? I slept through the whole thing and woke up on the eleventh floor in a private recovery room.
Recovery Time
That is when I found out they had stuffed in so much new material into my mouth that I could not breathe normally. So they added a tracheotomy.
The expected time in recovery is about a week, during which time they work on getting you through the pain part of the process, and get you walking again. You have to learn how to eat again as well, much of that is going on through a feeding tube they put in my nose.
I have to deal with physical therapists (aka torturers) who make you put weight on the injured leg to help things heal properly!
And watch a bunch of weird TV shows. M.D. Anderson is a world-wide center, with patients from all over. They have TV stations from most regions of the world. Actually, it does not matter what language they are speaking on most of those channels. I am convinced there is no intelligent life anywhere in TV-Land!
Still, at 3AM is it nice to have something to watch, even if it is a station from Kuwait!
Feeding Time
I have been working on this long enough that there has been a shift change. My nurse now is Miranda (who probably cannot sing a country song, but she is a great nurse! She also has five kids, ranging from 4 to 14! Yikes, she does not look that old at all. Her husband is a doctor here, but his family was from Milan, Italy. Quite an International place, this M.D. Anderson!
I am sleepy enough to need a nap. Since Miranda just fed me, that probably is making me sleepy as well. I will add more to this version of the story in a few days!
In the meantime, thanks to all of you who are praying for us as we work through this adventure. We could not survive this battle without you.
BTW, the ward filled up last night with several emergencies and a few more surgeries contributing new patients. I loaned a few prayers to those new folks. We are all in this battle together. I hope none of you mind! God's hands are big enough for us all!
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