Karen's doing better. Her body is slowly detoxing from Morphine which is translated into more sleep. Still not a full night but any improvement is still an improvement.
Her wound had opened about an inch which led to a visit to Overlook's Wound Center yesterday. They patched her up and we'll return on Friday to see how it's doing.
She is moving around, still quite weak. Picking up the kids is still out of the question. Coughing or laughing sends searing pain into her side. It's going to take some time to heal up completely. I think the addition of some sleep makes everything easier to deal with.
Thanks once again to all for the good-will, kind thoughts and sincere prayers that continue to flow our way this holiday season.
Wednesday, December 19, 2007
Tuesday, December 11, 2007
Post Operative Recovery
Karen's having a very tough time. On Saturday night she cut back on the morphine as the pain from the surgery had become more manageable. Soon after going to bed she began having uncontrollable muscle spasms in her legs and body, apparently a withdrawal symptom from the narcotics. This didn't quit and the thrashing kept her up until 3AM.
The following day her incision began opening up and "weeping". This resulted in a trip to the emergency room at Overlook. What a difference from LIJ!! The incision is otherwise healing well and this opening is nothing to worry about. Unfortunately each night since then has resulted in more and more jitters and less and less sleep. Last night she was up until 6AM.
The kids are sick too at the moment which isn't helping either of us get any sleep.
With some care Karen's wound should close up soon. Her mobility is slowly returning, still not very steady but able to get around. Picking up Ethan is way way out of the question.
Today we met with Dr Moriarty at Overlook. He was a sight for sore eyes and despite the circumstances, it was re-assuring to be back meeting with him.
He and Dr Ravikumar have spoken and essentially he agrees with everything that was done during the surgery. Unfortunately the detection of additional tumors in Karen's left lobe alters her prognosis for the worse. This is something we already knew but Moriarty confirmed. These have been ablated now so essentially Karen is in a better position today than she was before surgery.
We will have another consultation with Moriarty in two weeks. After that Karen'll have a repeat CT Scan to see where things are (hopefully clean scans) and we'll decide on a plan to move forward. Some potential options are more/new chemo or SIR Spheres which I'll discuss in another post.
We wish everyone a joyous and peaceful Christmas season.
P.S. Happy birthday to our amazing son Ethan who turned 2yrs old last Friday, Dec 7th.
The following day her incision began opening up and "weeping". This resulted in a trip to the emergency room at Overlook. What a difference from LIJ!! The incision is otherwise healing well and this opening is nothing to worry about. Unfortunately each night since then has resulted in more and more jitters and less and less sleep. Last night she was up until 6AM.
The kids are sick too at the moment which isn't helping either of us get any sleep.
With some care Karen's wound should close up soon. Her mobility is slowly returning, still not very steady but able to get around. Picking up Ethan is way way out of the question.
Today we met with Dr Moriarty at Overlook. He was a sight for sore eyes and despite the circumstances, it was re-assuring to be back meeting with him.
He and Dr Ravikumar have spoken and essentially he agrees with everything that was done during the surgery. Unfortunately the detection of additional tumors in Karen's left lobe alters her prognosis for the worse. This is something we already knew but Moriarty confirmed. These have been ablated now so essentially Karen is in a better position today than she was before surgery.
We will have another consultation with Moriarty in two weeks. After that Karen'll have a repeat CT Scan to see where things are (hopefully clean scans) and we'll decide on a plan to move forward. Some potential options are more/new chemo or SIR Spheres which I'll discuss in another post.
We wish everyone a joyous and peaceful Christmas season.
P.S. Happy birthday to our amazing son Ethan who turned 2yrs old last Friday, Dec 7th.
Tuesday, December 4, 2007
Home After Surgery
Karen's doing well. She came home late last night and is recuperating. The kids were visibly glad to see her and we spent a restful day at home today after what seems like the longest week of our lives.
Between one thing and another, running back and forth to the hospital and cajoling the kids back to sleep each night, I have had neither the time nor the inclination to update this blog but with Karen home it's time to give a little update.
Karen's stay in hospital was not without incident. The day after her surgery, her epidural stopped working. By the time I got to her room that morning she had already been an hour without pain medication and could barely speak. Another hour passed with me becoming more and more irate whilst the nurses frantically looked for an IV pump. I finally hit the right nerve (no pun intended) with the nurse manager and a pump was found. It took the rest of the day to get Karen's pain under control.
Mild fever, low blood counts, shallow breathing kept my nerves on edge.
There were a few other incidents which essentially all stemmed from in-experienced residents all waltzing into Karen's room, treating her like a science experiment without fully reading her chart.
I have to say we were very disappointed overall with the level of intelligence and care displayed by the nurses and residents at LIJ. Thank God for Dr Ravikumar who was diligent in his post-op follow up. He ended up over-riding or supplementing almost every instruction given for K's post-op care. I won't go into the details but it was Karen's determination that finally got her released last night.
An oral form of morphine is controlling her pain now and she's improving every day. We have scheduled a follow up with our oncologist, Dr. Moriarty, next week. The current plan which he'll likely confirm is to proceed with chemo for two months followed by hepatic artery infusion (chemo directly into K's liver) followed by more systemic chemo. A second surgery will be needed to remove the right lobe of the liver.
I will conclude with thanks to all for the loving support which somehow continues to flow into the Shanahan household.
Between one thing and another, running back and forth to the hospital and cajoling the kids back to sleep each night, I have had neither the time nor the inclination to update this blog but with Karen home it's time to give a little update.
Karen's stay in hospital was not without incident. The day after her surgery, her epidural stopped working. By the time I got to her room that morning she had already been an hour without pain medication and could barely speak. Another hour passed with me becoming more and more irate whilst the nurses frantically looked for an IV pump. I finally hit the right nerve (no pun intended) with the nurse manager and a pump was found. It took the rest of the day to get Karen's pain under control.
Mild fever, low blood counts, shallow breathing kept my nerves on edge.
There were a few other incidents which essentially all stemmed from in-experienced residents all waltzing into Karen's room, treating her like a science experiment without fully reading her chart.
I have to say we were very disappointed overall with the level of intelligence and care displayed by the nurses and residents at LIJ. Thank God for Dr Ravikumar who was diligent in his post-op follow up. He ended up over-riding or supplementing almost every instruction given for K's post-op care. I won't go into the details but it was Karen's determination that finally got her released last night.
An oral form of morphine is controlling her pain now and she's improving every day. We have scheduled a follow up with our oncologist, Dr. Moriarty, next week. The current plan which he'll likely confirm is to proceed with chemo for two months followed by hepatic artery infusion (chemo directly into K's liver) followed by more systemic chemo. A second surgery will be needed to remove the right lobe of the liver.
I will conclude with thanks to all for the loving support which somehow continues to flow into the Shanahan household.
Tuesday, November 27, 2007
Surgery Results
Yesterday was a difficult day. I only have a few minutes so will keep this brief. Karen's surgery did not go as expected. Additional tumors were found in her left lobe which meant the right could not be removed as planned. The surgeon burned all tumors but did not remove any of the liver. The surgeon believes the tumors in her right lobe may be resistant to the chemo. We will discuss options today, one of which may be a 2nd surgery in the future.
Karen developed a mild fever during surgery, her platlet count is low and she may need a transfusion in the coming days. Otherwise she is doing ok.
I know everyone is praying for us, thank you for that. Please keep up the prayers as we all really need them at this time.
Karen developed a mild fever during surgery, her platlet count is low and she may need a transfusion in the coming days. Otherwise she is doing ok.
I know everyone is praying for us, thank you for that. Please keep up the prayers as we all really need them at this time.
Thursday, November 22, 2007
Hurray For Surgery
Life is good. I have wanted to contribute to this blog for quite some time and now is a good time.
Well I am headed to surgery on the 26th and I am cautiously excited and just looking forward to the next few days with my family. I have been trying to get a lot of rest, and stay hydrated (one of my constant challenges) for my big day.
I cannot believe, and I am overwhelmed by how blessed I have been through this whole experience. God has sent to me the best medical people and treatments and I am so thankful for the response I have had to chemo. Yes, cancer/chemo is difficult and not fun but this is life and crappy things happen to people all the time. I really believe you have to extract the good out of all things and find out what it is you are supposed to learn in life whether it be good or bad. I know I am already healed. I know because so many amazing people are praying for us. I know Jesus always hears us and I may not always “feel” like He is there but I know He is. We don’t always have to feel things to know they are real. I have been saying in my mind since this whole thing started, I don’t believe in Jesus, I know in Jesus.
I want to thank everyone for their prayers, thoughts, emails, calls, gifts, etc. People who I don’t know, and have never met, have been kind enough to post comments, and send me emails and that blows me away. It truly does. People are good, and I am humbled.
My family has been awesome. Sarah, there are no words. But we couldn’t have gotten this far, this well without you. That is the truth. You have given up a lot, and we thank you for loving our kids and caring for them in the way you do. I love my brothers and sisters deeper than words can ever describe. You have all been awesome to me and supported me in such amazing ways.
I cannot even begin to speak of my husband because my love for him and gratitude cannot be expressed in words, and are too much to put on this blog.
Let’s all keep praying for each other and for great success on Monday and the weeks ahead. I love you all.
Karen.
Well I am headed to surgery on the 26th and I am cautiously excited and just looking forward to the next few days with my family. I have been trying to get a lot of rest, and stay hydrated (one of my constant challenges) for my big day.
I cannot believe, and I am overwhelmed by how blessed I have been through this whole experience. God has sent to me the best medical people and treatments and I am so thankful for the response I have had to chemo. Yes, cancer/chemo is difficult and not fun but this is life and crappy things happen to people all the time. I really believe you have to extract the good out of all things and find out what it is you are supposed to learn in life whether it be good or bad. I know I am already healed. I know because so many amazing people are praying for us. I know Jesus always hears us and I may not always “feel” like He is there but I know He is. We don’t always have to feel things to know they are real. I have been saying in my mind since this whole thing started, I don’t believe in Jesus, I know in Jesus.
I want to thank everyone for their prayers, thoughts, emails, calls, gifts, etc. People who I don’t know, and have never met, have been kind enough to post comments, and send me emails and that blows me away. It truly does. People are good, and I am humbled.
My family has been awesome. Sarah, there are no words. But we couldn’t have gotten this far, this well without you. That is the truth. You have given up a lot, and we thank you for loving our kids and caring for them in the way you do. I love my brothers and sisters deeper than words can ever describe. You have all been awesome to me and supported me in such amazing ways.
I cannot even begin to speak of my husband because my love for him and gratitude cannot be expressed in words, and are too much to put on this blog.
Let’s all keep praying for each other and for great success on Monday and the weeks ahead. I love you all.
Karen.
Wednesday, November 21, 2007
Pre-Admission Testing
Karen's doing great. Over the last few weeks her color has returned and she's regained a lot of the strength lost to chemo. Today we had pre-admission testing at Long Island Jewish.
The pre-admission testing consisted of a chest X-Ray, CT Scan, blood work (including CEA) as well as an EKG. A huge amount of information was collected through interview along the way. Allergies and pre-existing problem type questions. We'll get Karen's CEA result on Friday.
We also met with Dr Ravikumar this morning before pre-test. That was a good visit. Dr Ravikumar explained the process he'll go through as well as the various decisions he'll make during surgery. These decisions are rather complicated but essentially result in Karen leaving the theatre with varying degrees of weight loss.
The surgery will last 5 hours approximately and starts at 11:30 EST on Monday morning.
He also may look to use a new technique he's developing (with a handful of other surgeons worldwide) that involves PET scanning with a wand DURING surgery. This allows him to detect a negative margin in Karen's liver more accurately. That's surgery talk for "figure out if there's cancer left or not".
It's an innovative procedure that doesn't add risk to the operation so we're signed up. It involves nuclear medicine though and may not be feasible logistically given the holiday here in the US. We'll see. Only a couple of people have received this process so there's no data to backup whether it actually is of benefit or not but it makes sense to me.
My parents have flown in from Ireland and are a great comfort and support during this time. Ethan loves his "DanGrad" and Sydney likes "Nana's white hair".
Karen's in "game mode" and although she's nervous, overwhelmed and a small bit scared she's up for the challenge. Her nerve is steady and we're quietly confident in what's to come.
We are looking forward to a successful result on Monday.
The pre-admission testing consisted of a chest X-Ray, CT Scan, blood work (including CEA) as well as an EKG. A huge amount of information was collected through interview along the way. Allergies and pre-existing problem type questions. We'll get Karen's CEA result on Friday.
We also met with Dr Ravikumar this morning before pre-test. That was a good visit. Dr Ravikumar explained the process he'll go through as well as the various decisions he'll make during surgery. These decisions are rather complicated but essentially result in Karen leaving the theatre with varying degrees of weight loss.
The surgery will last 5 hours approximately and starts at 11:30 EST on Monday morning.
He also may look to use a new technique he's developing (with a handful of other surgeons worldwide) that involves PET scanning with a wand DURING surgery. This allows him to detect a negative margin in Karen's liver more accurately. That's surgery talk for "figure out if there's cancer left or not".
It's an innovative procedure that doesn't add risk to the operation so we're signed up. It involves nuclear medicine though and may not be feasible logistically given the holiday here in the US. We'll see. Only a couple of people have received this process so there's no data to backup whether it actually is of benefit or not but it makes sense to me.
My parents have flown in from Ireland and are a great comfort and support during this time. Ethan loves his "DanGrad" and Sydney likes "Nana's white hair".
Karen's in "game mode" and although she's nervous, overwhelmed and a small bit scared she's up for the challenge. Her nerve is steady and we're quietly confident in what's to come.
We are looking forward to a successful result on Monday.
Tuesday, November 6, 2007
Cleared for Surgery on the 26th, November
Karen's doing well. She has recovered from last chemo and working on building up her strength for surgery. The surgery itself has been scheduled for the 23rd 26th of November, Friday the Monday after Thanksgiving. This doesn't leave much time and the few weeks we have are literally flying by.
We had a consultation with Dr Moriarty last week. He had reviewed the results from Karen's colonoscopy biopsy and was very up beat. The colonoscopy on visual inspection revealed that Karen's primary tumor had disappeared. The biopsy results revealed even better news; that the cancer is not detectable at the cellular level in her colon. We asked if this was good, he said "yes, VERY good". In Dr Dan's words "she has had a 'complete response' to the chemo".
Surgery's job will be to remove the remaining tumors in her liver.
Dr Dan gave us the following tidbit; The percentage of people who's tumors disappear from chemo is small. Maybe less than 10%. Of those people, the percentage of who's tumors are no longer detectable through biopsy is less than 5%. So like I always knew; Karen is very special.
When Dr Moriarty started in 1985, the percentage of people who were chemo resistant was about 95%. Only about 5% of folks actually responded to chemo. These days, with Avastin and other drugs, things have improved substantially. These developments are so new (Avastin is only on the market since 2003-4) that the statistics have yet to be adjusted to reflect these improvements.
On the insurance front; after many phone calls and back and forth with the insurance company and our surgeon it has been determined that Dr Ravikumar is out of network. This would ordinarily leave us footing a 5 to 6 digit bill. By some miracle, Dr Ravikumar has agreed to accept the out-of-network payment offered by the insurance company and waive the remainder. God is sending us the help we need.
Between now and the surgery date Karen has a number of pre-admission tests to do, including various scans, X-Rays, blood tests, MRIs and so on. We also have to squeeze in some Christmas shopping. This year my list will be short, but I know exactly what I want.
Before we left we asked how Dr Dan felt about the surgery. He said "I'm excited".
We are too.
We had a consultation with Dr Moriarty last week. He had reviewed the results from Karen's colonoscopy biopsy and was very up beat. The colonoscopy on visual inspection revealed that Karen's primary tumor had disappeared. The biopsy results revealed even better news; that the cancer is not detectable at the cellular level in her colon. We asked if this was good, he said "yes, VERY good". In Dr Dan's words "she has had a 'complete response' to the chemo".
Surgery's job will be to remove the remaining tumors in her liver.
Dr Dan gave us the following tidbit; The percentage of people who's tumors disappear from chemo is small. Maybe less than 10%. Of those people, the percentage of who's tumors are no longer detectable through biopsy is less than 5%. So like I always knew; Karen is very special.
When Dr Moriarty started in 1985, the percentage of people who were chemo resistant was about 95%. Only about 5% of folks actually responded to chemo. These days, with Avastin and other drugs, things have improved substantially. These developments are so new (Avastin is only on the market since 2003-4) that the statistics have yet to be adjusted to reflect these improvements.
On the insurance front; after many phone calls and back and forth with the insurance company and our surgeon it has been determined that Dr Ravikumar is out of network. This would ordinarily leave us footing a 5 to 6 digit bill. By some miracle, Dr Ravikumar has agreed to accept the out-of-network payment offered by the insurance company and waive the remainder. God is sending us the help we need.
Between now and the surgery date Karen has a number of pre-admission tests to do, including various scans, X-Rays, blood tests, MRIs and so on. We also have to squeeze in some Christmas shopping. This year my list will be short, but I know exactly what I want.
Before we left we asked how Dr Dan felt about the surgery. He said "I'm excited".
We are too.
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