Cancer Never Sleeps

Dear Friends and Family,

First and foremost we wish our youngest son Ryker Thomas a happy third birthday today. We miss and love him on his special day.

Our fight with cancer has always been an ongoing battle. We have enjoyed the last 9 months essentially cancer free. Our lives in many ways have returned to normal, with Jeanel and I returning to full work duties, her hair and energy has come back to normal with the exception of being crazy curly. We have been to Wisconsin , Chicago , and Disneyland, and Jeanel has enjoyed all of her trips to Seattle with me, her parents, her sister Suzette and my sister-in law Brooke. We truly have been blessed with a wonderful season of health.

Thursday 1.21.10, Jeanel was due for her routine PET scan. This required her to be on bed rest the day before and limited activity the day of the procedure. She woke up at 3:00 am with right lower quadrant pain. Ever the martyr, she waited until morning for me to push on her abdomen, and immediately I suspected an appendicitis. Her mother brought her to my clinic in the morning, and while the white blood cellcount was normal, her doctor and I suspected appendicitis. The PET scan was followed by a CT scan, and the results were suspicious forovarian cancer with one aorto-caval 1 cm lymph node. Otherwise PET scan was normal. We consulted OB/GYN and were referred to Hustsman Cancer Center in SLC to GYN ONC (cancer surgeon that take care of female cancers). After a very rough night on Thursday (due to pain), we met with Dr Soision on Friday at 11 am. After reviewing the scans and chart, he stated he was fairly sure this was a benignovarian torsion, but was willing to admit her to the hospital and operate the same evening.

Jeanel was taken to the OR at 6:15 pm, and at 8:45 he came out and informed me of both good and bad news. Bad news: this was cancer of the ovary on the cryosection taken intraoperatively. The good news was that he didn’t see any other cancer. The tumor was 11 cm in diameter on the right ovary, and there was no torsion of the ovary. However, once the cancer was found, this meant looking through the entire abdomen for any other cancer seeding including checking the diaphragms, running the entire bowel, biopsying lymph nodes, and removing the greater omentum. He also removed the uterus, both ovaries and ovarian tubes and the appendix (our request). She has a long vertical midline incision from the bottom of the ribs to the pubis and 41 staples.

We have loved the Huntsman Cancer institute. The building is absolutely beautiful, and the room spacious, comfortable and ornate and the view is second to none of the entire Salt Lake Valley . The aides and nurses have been very attentive and kind as have been all of our doctors. This all being said, they did make a big mistake the first night after the surgery. Jeanel was supposed to have had an epidural placed in the operating room and a PCA pump (pain meds on demand). Instead she was left with a highly inadequate dose of dilaudid that she initially could only request every two hours. Her dilauded would only last for 20 minutes and then she would be in a lot of pain. I stayed up with her all night as she begged and pleaded for pain meds trying to talk her through this. The resident in the night did increase the dilaudid to every 1 hour, but still this was not adequate. When her resident/surgeon came in at 0530, I insisted that they should switch to morphine, or a PCA pump or something additional because of all the pain she was in. The resident/surgeon had no idea that she had not been on the PCA and epidural through the night and immediately apologized and ordered these. Several hours later she finally had some level of pain control with the PCA, but by that point was far too painful to position for an epidural. Needless to say, it was a very rough first night. I feel bad I didn’t insist on more sooner. It has been a long time since I have done a surgical rotation, but I should have known better. My deepest apologies to Jeanel.

Besides a mild scare the day after surgery for a possible blood clot to the lungs (acute desaturation of oxygen, chest pain, shortness of breath and tachycardia for 15 minutes—with a negative CT angio of the chest) we have had an uneventful hospital stay. She has weaned off the NG tube, and is tolerating jello, pudding, broth and water. Tomorrow we will wean off the pain pump, and the urine catheter, and hopefully the IV and oxygen. The current plan is to be discharged on Tuesday. Jeanel plans to go to her sister’s house until she is ready to be around the kids again.

So now we are left hoping for the pathology results to be a stage 1 A ovarian cancer, in which case the surgery is curable. Alternatives also include more advanced stages of ovarian cancer, or metastatic breast cancer that has taken over the ovary. We continue to pray for our miracles and are grateful for the miracles we have received.

Thanks for your love, prayer and support,

Bruce