So this quote is attributed to Vince Lombardi, but I thought it was fitting for Sara’s situation. Except that she hasn’t literally fallen down, don’t worry! There isn’t too much to update, but “boring” is a good update too 🙂 .

Sara’s recovery has continued to progress, slowly but surely. She is now able to do several laps around her floor, without holding on to anything for assistance (her IV pole is with her just in case). She is also spending more time sitting up in the chair in her room. Other signs of progress – the arterial IV in her neck has been removed (ick!) and her epidural is scheduled to be removed tomorrow. Her main complaint concerns the blood thinner shots that she has to receive twice a day, apparently the medicine itself stings a lot when it is applied. Yes, it is better than developing a blood clot, but still not very pleasant. Oh and she isn’t too thrilled about the hospital food, but then this seems to be a universal issue! She had to start on a very bland and mushy diet as well and is finally able to start eating a few more “regular” foods.

As to the $64,000 question – when is her release date – we don’t know yet. Hopefully it will be within a few days, but she still has to meet her doctor’s list of criteria first. As soon as she knows the date, I will update the information here. Thanks again for all of your support!

I heard from Sara early this morning (5:30 am West Coast time) – she said that the nurses wake her every 2 hours or so to check her vital signs and do other tasks. Her voice is a bit hoarse from having a breathing tube during the operation, but otherwise she seemed to be in very good form. It appears that her pain management is being controlled much better this time around, compared to the emergency blockage/colostomy surgery she underwent in October 2015. One factor is the epidural she received – similar to the type women can get during labor – but she is only numb in the stomach area, not her legs.

Despite having many lines and tubes attached (including an IV in her neck – Sara said it sounds worse than it is – yikes!), Sara was encouraged by the doctors to start walking already around her hospital wing, several times a day, and to start sitting up in a chair for short periods of time. In the attached pictures she sent me she is using a walker, but later in the day she was able to walk around a bit just holding Eric’s hand. Just in case you were curious, her incisions are closed by staples :).

        

Taking her first lap around                  Room with a view

 

 

 

6:30 am (East Coast time)
I just talked to Sara; she is in good spirits and she and Eric are on their way to the hospital. Eric’s mom will be there too. I will update the blog as soon as I hear *anything*, so please be patient with me.

2:45 pm (East Coast time)
Just talked to Jan, Sara’s mother-in-law – GREAT NEWS!! The surgeon removed 4 tumors and otherwise everything looks fine inside. Sara is in the recovery unit now and they will be able to visit her in a couple of hours. Thanks so much for all of your thoughts directed her way, I’m sure they helped!!

6:00 pm (East Coast time)
Jan reports that Sara is in a regular hospital room now, and has already shown her smile in defiance to her hospital confinement!

6:00 pm (East Coast time)
Eric wanted to make sure that I passed on a special “thank-you” message from him to express his gratitude to everyone for their support and help. He wishes that he could have been able to text every person who has helped along this journey, but for now a blanket appreciation will have to do. Although Sara has been a strong fighter throughout her ordeal, today’s surgery is a very positive step towards Sara’s recovery to health, and everyone has had a part in getting her here.

Great news regarding Sara’s PET scan – she is cleared for surgery on Monday! The news is scary and exciting at the same time, but at least it is a forward action. Today she had a pre-op appointment, had some blood taken and basically is getting ready. She has been taking advantage of the break from chemo by cooking and freezing some meals, spending quality time with the horses and kids, etc.

A few public service announcements:  the plan is that Eric will be in touch with me on Monday to relay the latest information on the surgery and Sara’s progress, and I will then update the blog right away. This way we can have one central source of information. They will have an early start – arrival at the hospital at 5:15 am and surgery is scheduled for 7:15 am.
The other announcement has to do with the Mealtrain schedule – as Sara has been prepping for the week that she will be in the hospital, she won’t need any meals delivered during this time period. If the schedule can start back up again on February 1, that would be great! Thank you to everyone who has been participating in the Mealtrain program, it has really been a big help.

Any updates will be posted as they come in! Please pray, think healing thoughts, meditate – whatever works for you – for Sara on Monday morning.

Sara and Rylan at the regional riding awards – Rylan cleaned up! But the best part was that Sara was able to go, when a few short months ago she thought she would be too sick to make it.

Sara’s surgery date has now been scheduled for January 25. It turns out that the surgeon, who is a liver surgery specialist, will only move forward with the surgery if Sara doesn’t have cancer anywhere else in her body (aside from the colon cancer). This means that if even 1 lymph node is found to be cancerous, the surgery is off for the time being. If this is the case, Sara would then resume chemo treatment and then undergo more tests (CT scan, PET scan, etc). As you can imagine, this is a very high bar to pass so Sara is anxious to find out the results.

A PET (positron emission tomography) scan was scheduled and took place yesterday. PET scans use a radioactive solution to look for signs of cancer in the body (so yes, for a little while Sara might be slightly radioactive – ha!). Sara reported that it went fine, just made for a long day of preparatory procedures, fasting, the IV placement, the scan itself, etc. The results of the PET scan will be ready on Monday, January 18 so please think good thoughts for her in the meantime!

Sara also did learn a bit more about the liver surgery itself – the plan is that a portion of the right lobe of the liver would be removed, which is called a “non-anatomical wedge resection”. She will probably be in the hospital for about one week, and then the recovery period at home is estimated to be 4 – 6 weeks. In some cases (not many though), the surgery can be done laparoscopically. In Sara’s case, this is not possible, and the surgeon informed her that she will have a scar across the front of her body, just under her diaphragm. So as you can imagine, this is a pretty major surgery. Sara is eager to move ahead though and is ready to be tough (remember, horse people are tough!)

Sara also had genetic testing done for known markers of colon cancer mutations, such as Lynch syndrome, familial adenomatous polyposis (FAP), Apparently up to 25% of colon cancer cases have a family history of colorectal cancer (CRC), though known mutations only include 5% of this group. The remaining 20% may have other contributing factors, such as undiscovered mutations or other unidentified genetic backgrounds. Even though the risk of a genetic form of CRC is not that high, it is obviously better to rule it out sooner than later, for Sara’s children’s’ sakes and that of other family members.

 

Sara met with her oncologist today and the verdict was “go for surgery!”. More details to come in the near future, but for the moment the plan is that she will have surgery on the right lobe of the liver in 2 weeks (!). It may sound strange to be “happy” about surgery, but in this case it is definitely a good sign. Way back when Sara was first diagnosed (ok not so far back, but it already feels like a long time) it didn’t even look like surgery on the liver mets would even be a possibility. Sara was very glad to prove the stats wrong 🙂 .

According to existing literature, a large share of the liver mets reduction can be attributed to a relatively new chemo drug she is taking, Erbitux. This drug has been found to be extremely effective in shrinking colon cancer mets to the liver, when administered in conjunction with other more standard CRC treatments (such as 5FU and Oxaliplatin). Unfortunately Erbitux is also responsible for giving her a painful rash on her face and body – kind of like having teenage acne all over again – but in view of the great response rates I think that she feels it is worth it.

So back to the surgery – there are different types of liver surgery, called a “resection” in the case of operating on liver mets. A surprisingly large amount of the liver can be hacked off, as long as there is a decent amount of healthy liver left behind. I came across some examples of good recovery rates after removal of even 80% of the liver! As you may remember from high school biology class, the liver does actually regenerate itself, and remarkably fast – 6 to 8 weeks, depending on the amount which was removed. For surgery purposes, the liver is divided into 8 “segments”, and the right lobe contains segments 5 – 8. We don’t know yet if just a few segments will be removed, or if all of the right lobe will be removed (in this case it is considered to be a “lobectomy”).

Despite the somewhat giddy tone of this update, liver surgery is a serious procedure. There are many blood vessels, veins, etc flowing through and around the liver. Recovery from a liver resection is often a bit of a long but generally smooth road, though complications can happen and everyone’s case is different. Sara will also need to have a PET (positron emission tomography) scan prior to the surgery, to make sure no little bits of undiscovered cancer are lurking. While we wait for more information, please keep Sara and her family in your thoughts!  

P.s. Just as a reassurance, I am using respected sources when I cite the information above, such as the efficacy of Erbitux and the odds of eligibility for liver resection, for example. But I am not going to turn this blog into a research paper with corresponding citations. If anyone is particularly interested in the sources, feel free to contact me directly and I’d be happy to provide the information.