Friday, November 21, 2014

Hospital, Post-Op, Day 9

After several days of pain-filled nights, we finally got a decent nights sleep. Josh was able to manage his pain at a tolerable level so he could get a few hours rest. Sleep was still limited.
Doctor Katz, his surgeon, visited us this morning with pathology lab results from the tumor biopsy. There were 35 lymph nodes removed, but only 2 had cancer in them. Good news, but there is still the chance that the cancer was able to spread outside of his pancreas. He will continue to receive scans every 6 months to make sure the cancer has not spread anywhere else.

That seems a bit too long for my liking, so we will probably ask for another scan in a couple months, just to be on the safe side.

He is resting now, but he is now able to eat some soft foods like oatmeal and pudding. Before, he had a tube inserted into his nostril down to his stomach to extract any bile that might build up. He was unable to eat for almost 6 days. Then when the tube was finally removed, he started to vomit bile, a bad sign. If that continued, the tube would have to be reinserted.
Thankfully, he was able to get past the vomiting and move onto holding down clear liquids. Since then, he's been getting progressively better. Just still need to work on pain management. He's trying to be tough and hold off on using his pain meds, but it slowly makes the pain unbearable, until he needs a double dose of meds, which then knocks him out. It's a vicious cycle. But I feel we are close to finding a balance.

Here's why he is in so much pain. The procedure that we were trying to avoid was called a "Whipple" which means the surgeon has to remove the head of the pancreas. Because the pancreas is so integrated with other organs, the surgeon must also remove the first part of small intestine (duodenum), the gallbladder, the end of the common bile duct and sometimes a portion of the stomach in order to reach the pancreas. In the reconstruction phase of the operation, the intestine, bile duct and remaining portion of the pancreas are reconnected.

Josh ended up with a Whipple PLUS, which meant that the surgeon removed his entire pancreas plus a portion of the stomach, intestines, and bile duct that the pancreas was touching. He also had to reconstruct a vein leading to the liver that seemed to be affected.
This is not an accurate depiction of what was actually done for Josh, but it gives you a good idea. The white dashed line areas are removed, including the gallbladder.

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After the surgery is complete, it now looks like this.
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Here is Josh's actual incision scar. He said he felt "gutted." Well, he wasn't far off. I don't blame him at all for wanting to use pain meds!!
And to top it all off, Josh had an allergic reaction to the surgical tape they used on his back for his mid-section epidural. So he developed a large, oozing, itchy rash. Thankfully both the incision and the rash are healing well.

1 comment:

  1. Gnarly! Josh if you secretly wanted your stomach stapled you should have just said so....