Surgery/Post-Surgery Updates

From Sam:

Hello all!  Thank you for your continued prayers, thoughts, support, kindness, and love.  Today marks Jerome's 3rd day in the hospital as he continues to recover from his surgeries.  The surgeries themselves went as well as we could hope.  Both for the liver and the colon were conducted laparoscopically using modern robotic technology (pretty cool!).  Although they were major surgeries, they were not as invasive and Jerome's healing process should be quicker.  It wasn't until the day of in the pre-op room, that we found out from the nurses that they were going to perform the surgeries this way.  They mentioned that there would be some possibility of open surgery if needed.  We initially expected it to be all open based on our consultations with the doctors previously, so it was a pleasant surprise to hear this.

If you're interested, here are a couple of links to animated simulation videos I found online that show how the surgeries were performed:  

Liver Surgery

Colon Surgery

The Surgery: On Thursday (9/25), we checked in at 5:15 AM and Jerome waited in the pre-operation area until around 7:45.  Since I had Caleb with me, they didn't allow us to go back to wait with him, but upon Jerome's request, they did let us see him to wish him off before going into the operating room.  The surgery started at around 8:00 AM and then I was called to meet with Dr. Fichera (the colon surgeon) at around 3:00 PM.  My mom, sister, Caleb and I went back to the conference room with him and he told us the colon surgery went well, and the cancer in that area is now all gone.  He also said he did not need to place a stoma and colostomy bag and the healing process should be relatively quick "because he's a young healthy guy" (in his words :) ).  

I also spoke with Dr. Yeung (the liver surgeon) over the phone and he shared that on the left side of the liver, they were able to see 3 tumors.  They removed 2 of them and burned 1.  On the right side, they were able to see 1 tumor and burned that one as well.  Dr. Yeung also said that he did not do full resections on the parts of his liver with the cancer because they would be taking out a lot of healthy liver that would not be necessary to remove, and if they see any tumors later on, treatment options would be more limited.  Since he still has basically all of his liver, which is mostly healthy, if they do see other tumors later, they can treat them more effectively with minimally invasive options (i.e. placing radiation beads in the liver to attack the tumors, ablation, etc.).  Overall, he mentioned that they saw less tumors than the previous CT scans showed (which could mean a number of things: The tumors are completely gone from the chemo, the tumors have shrunk and are too small to see, the tumors could not be detected via ultrasound because they blended in with the liver or are too deep, etc.).  They will be doing ongoing scans and tests to monitor his liver and will treat as necessary.  The next step for the liver treatment is to complete chemo after at least 6 weeks from surgery and another CT scan will be done.  

The Recovery Process: After about an hour and a half out of surgery, we were able to see Jerome in the post-surgery area.  He was a little groggy for about 1/2 an hour or so, but seemed mostly alert and cognizant not too long after.  He was experiencing some pain in his shoulder, but not anywhere else.  The nurses said this was likely due to the air/gas from the surgery, which is common for laparoscopic procedures.  They placed an epidural to keep his mid-section/abdomen area numb, so he did not feel anything there.  He was moved into his own recovery room at around 7:00PM and will be there until about next Tuesday or Wednesday (9/30 or 10/1).  His blood loss was minimal and all his vitals looked good, so overall, the surgery was a success.  

Later that night, Jerome's heart monitor kept beeping throughout the night because his heart rate was elevated (120-130+, normal is around 60) and he began experiencing sharp chest pains at around midnight.  He also came down with a low grade fever.  The doctors and nurses said that the fever and heart rate were pretty normal for post-surgery, but the chest pain was concerning.  They ran an EKG and some blood tests, but they were all negative for any major heart, lung, or blood-related issues.  His blood pressure also has been normal.  They also conducted a chest CT scan, but found that negative as well.  He is still experiencing the chest pain, but at this point, since they have ruled out any of the most concerning conditions, they think it is also probably from the gas/air from the surgery like the pain he had in his shoulder.  

Yesterday (Friday, 9/26), they tried to get Jerome to stand up and start walking a little (this will help open up his lungs, get his blood flowing, and get things in his system moving in general).  However, when he stood up, his blood pressure significantly decreased both times (the second time, it was as low as 77 over 46) and he felt extremely light headed and nauseous.  The doctors said this was due to the epidural, so they had to lower the dosage.  Unfortunately, he is now experiencing pain in his mid-section area because of this.  

Today (Saturday 9/27), Jerome was able to stand up and walk around and his blood pressure remained stable (YAY!).  He is still having the same chest pain and more mid-section pain, but he is tolerating it and resting when he can.  They said the more he gets up and moves around and takes at least 10 deep breaths every hour, the better things should get.  His heart rate is also starting to go down (at about 111 now as opposed to 120-130+)   We were just told by the nurse that some time today, he should be off of his IV fluids and will be slowly re-introducing ingesting fluids on his own, and solids some time after.  

Slowly but surely!

I think that about covers most of it!  Thanks for reading.  Please continue to send your positive thoughts, prayers, and vibes.   It really has made a huge impact and we truly appreciate all of you!