Football and Stethoscopes

New hospital, same old story.

2011-07-19T15:02:00.000-07:00

After nearly 3 weeks with fevers post-ablation, Dan has landed in the hospital again. We went to the ER yesterday just to make sure nothing crazy was going on before his hip replacement surgery. The CT showed an abscess, though that finding is now being questioned. He spent the night battling fevers and some more pain, then went off to have the "abscess" drained. Unfortunately/fortunately, there wasn't much to drain off from his liver. Accordingly, the radiologist just took a sample to culture.

Though Dan feels fine and his fevers are coming down a bit, the hospitalist basically told us that he is stuck here until the culture grows bacteria (1-3 days). If nothing grows, the infectious disease doc will called on to the case to tell us what could be growing without showing up. After he decides on a treatment plan, Dan can go home. He'll likely be on antibiotics for quite a while, even at home. We're still not sure on whether it will be oral or IV antibiotics. Dan is certainly hoping for oral meds so he won't need another PICC line.

Overall plan: wait, wait and wait some more. The hospitalist wasn't very keen on setting any clear goals at this point, so we're hoping tomorrow is better.

Thankfully, my boss is letting me take leave of absence days while Dan is here in the hospital. That takes a lot of stress off of us, as I can be here to help him out and talk to the doctors.

We're trying to take it a day at a time, enjoying spending time together while we can. Dan is studying for his final, which he'll have to take late. Also, Dan is on the floor I work on, so everyone is being great.

Wait, wait, wait.

Prayer Requests:

* Knowledge and wisdom for the docs

* Effective antibiotics that Dan can take orally

* A discharge sooner than we are expecting

* Cooperative and helpful communication with doctors

* NO MORE FEVERS!

* Speedy and conclusive results

* Time for us to show God's love and grace through how we handle this situation

Fried tumors!

2011-06-29T14:05:00.000-07:00

I am happy to report that Dan is right now waking up from (possibly) his last necessary cancer treatment. The last of his visible tumors have been fried today...and hopefully, they'll never come back!

We got to the hospital about half an hour early, but they couldn't start the procedure until 3 hours later because Dan's platelets were a bit low. After finally deciding to give him a unit of platelets, they took him at 1030.

3 hours later, his fantastic doctor (our favorite over the past 4 years) came out to give us great news. The pre-procedure CT showed no new tumors and showed that the old tumors looked smaller than before. Then, they ablated a few areas ("microwave on a stick", as Dan says). The doctor admitted to us that he thinks the tumors were already dead, but he wanted to cook them anyway--for good measure. Biopsies from the site will tell us if there was any living cancer in them later. The doctor was overall very happy with the procedure. Little bleeding, no complications seen yet. Dan is waking up right now, so he's not even in the recovery area. In a couple hours or so, we'll be able to see him in his hospital room where he'll stay overnight for observation.

As long as Dan can eat, drink and have good pain control tonight, we should be able to leave in the morning. We'll be on the watch for signs of bleeding or infection for a little while. Then, we'll take a couple days to recuperate in NorCal, then drive home to La Habra.

As for future cancer treatments--there are NONE scheduled. After Dan's hip gets replaced, he can begin to work toward life without cancer. Check-up scans will happen every 3-6 months and the possibility will always remain that something could return. I will personally always be a little scared and worried. Yet, it feels like a new stage of life can begin. Please pray with us that Dan can officially and forever become a cancer survivor, instead of a cancer patient!

It's hard to believe that 4 years ago this time, Dan hadn't even started chemo. In fact, my mother-in-law and I were probably playing cards waiting for Dan to come out of a scan that would tell us fairly terrible news. Fast forward to now: Dan has his Bachelor's degree, has a wife, almost has his teacher's credential, has a cat and is planning for whatever God has in store for him and for us. God has certainly been faithful to His children.

I can say simply now, that the doctors did not think Dan had a fighting chance shortly after his diagnosis. Yet, after 10 rounds of chemo, SIRSpheres, a couple embolizations, a Whipple surgery, a bowel obstruction surgery, and 2 ablations...Dan is very close to being cancer-free.

We can obviously be thankful for the doctors and nurses. We can give some credit to Dan himself for being so incredibly, crazily courageous and strong. However, we would be completely wrong to not give all praise and glory and thankfulness to the One who orchestrated every good gift in the midst of this trial: our God and Savior, Jesus Christ. Without His provision and protection, I know that Dan would not be alive today. What a wonderful God we worship!

Thank you everyone for your prayers and support. Continue to give glory to God for all He has done.

Updates will continue...though, I hope they won't involve too many more stories from the hospital!

Almost done!

2011-05-24T18:05:00.000-07:00

One year ago, Dan and I were making some big changes in life. Dan was finally recovered from his surgeries and preparing for another one. I was graduating from nursing school, studying for the NCLEX and looking for a job. We were also looking for a place to live. As I hear about all the students graduating from Biola this weekend, I am glad that we aren't in such a topsy-turvy period of life. Yet, life has not slowed down yet!

Dan is now the one finishing up school, preparing to get his teacher's credential by the end of July. Actually, there will be a lot of changes by the end of July: one less liver tumor, one teacher's credential and one new hip. Good thing he has so much energy! Dan found out recently that he passed the TE (teaching event) and is nearly done with most of his assignments. Next step: finding a job. The search has already begun, so please be in prayer that God guides Dan toward the right job at the right time.

As for me, I am just working working working. Sometimes when I think about doing this until I'm 65, I get overwhelmed. Thank goodness nursing provides me with many options for refreshing my nursing spirit! I do like being a nurse, and I still feel that God has made me to take care of people. This thought is easier to remember at the end of a good shift with thankful patients...a rare combination! I am so very thankful that God is providing for Dan and I through this job and allowing me to learn so much every day.

This weekend will be the first whole weekend I have had off to spend with Dan without having work or family issues to deal with. We are thrilled! Time to sleep, clean, re-stock the fridge, snuggle, and maybe even take a day-trip. Yay!

Dan and I were slightly forced to take a trip home last weekend to attend my grandfather's funeral. It was obviously a very difficult week full of reliving memories and realizing that my papa won't be making new memories with us. As his death was very sudden, it still feels like a punch in the gut every time I think of the Dodgers or John Wayne or airplanes or old music. I can not even imagine how my grandma must feel right now and sincerely wish I could be home with her still. My prayer is that God is holding Papa tight now and that he is happy and right at home in Heaven.

We do apologize for the lapse in updates. As the title states, we feel like we are almost done with this phase of life called "School and beginning our careers". Hopefully, that means more time to focus on connecting with family and keeping in touch with everyone. Thank you for those of you who still keep us in your prayers.

Prayer Requests:
* Help on the job search for Dan--open doors and job offers soon
* Endurance for long hours at work and safety for me
* Successful tumor ablation (June 29th at Stanford) and hip replacement (July 28th in Whittier)
* Continued grace and peace as we seek God's will for our marriage and family

TE (Total Exhaustion)

2011-03-23T17:56:00.000-07:00

So, we knew this was coming when Dan started the credentialing program. The Teaching Event (or TE or the TPA or the Mistress) is the big project that stands between students and their teaching credential. Dan has already been working hard in school, but he has been buried up to the neck for the past month or so. We are realizing now that the year-long break Dan took to have surgery and heal has actually made his TE a little more difficult for him. Not impossible, just difficult.

We haven't been able to spend much time as a couple since I've been working a lot at the hospital and Dan's been stuck with the TE. Even for his birthday, he did homework when he came home from our "date night"! We're trying to make the time we do have count, but it will be a breath of fresh air to have my happy husband back. We're fairly used to challenges in our marriage, but this has been stretching us pretty thin.

We are beginning to see a light at the end of the tunnel, as the TE is due next Thursday. God willing, Dan will pass the first time and be done with this for good! Please pray for endurance for Dan and that he would finish well.

Though Toulouse is sleeping and quiet at the moment, he is showing us that he does not like being home alone so much. He knocks over all of his water dishes and our cups, eats anything he can grab (including my hair) and tries to get into every cabinet he can. Just a couple days ago I had to "cat-proof" our kitchen. Now, all our cupboards have baby locks on them. Good grief.

In health-related news, Dan has scheduled his hip replacement surgery for July 28th. It will be a rough bit of rehab, but then Dan should feel "young" again and not dependent on a cane. He's much more excited about this than I am! Yet, it will be nice to know all the nurses since the surgery will be at my hospital.

We cannot wait for a break. Even if our first day together with no work or homework consists of running errands or just sitting on a couch, we will be thrilled. The next couple weeks are going to be murderous for both of us, so any and all prayers would be appreciated greatly!

That's the news for now. We apologize if we have been non-communicative lately...you'll all begin to hear from us again soon :)

The New Year

2011-02-22T10:41:00.001-08:00

Yes, we do know that it is half way through February and we are just now blogging about the new year. That is just how life is right now.

Back up to Christmas: we were blessed to have our families come to Southern California to celebrate a few days after Christmas. Since Lise and I worked all of the holidays, it was so refreshing to make our own holiday celebrations. What a wonderful way to start the new year!

Dan has started back at UCI to finish his teaching credential. He is BUSILY doing his teaching event (TPA) and student teaching. He is training in a middle school in Garden Grove, teaching algebra and geometry. From what he says, he will like being a teacher but does not like the process of getting there. The next few months will be just as crazy as the last couple have been. The "light at the end of the tunnel" is June when he gets his credential, though Dan will have to take one more class in July to be officially done. Then, we hope and pray that God opens doors for Dan to find a job.

Ashley is now working days on the oncology unit. It is a fairly stressful and busy unit, though in a different way than her last unit was. The patients are more complex, which means Ash is learning a lot. God is also providing lots of opportunities for her to give spiritual care and take care of the whole patient and their whole families. The hospital is busy right now, so there have been quite a few long days and extra days...which makes for one tired Ash most of the time.

All that to say, the Howens are ready for a break soon, but are pushing through like always. We are praying that we will be able to make a trip up for Easter....hopefully.

On the cancer front, Dan had a CT this month that showed us good news. The tumors have not grown and his liver is healing from all of the abuse it has been through. At this point, we are waiting to schedule the 2nd ablation until after Dan graduates. The surgeon and oncologist feel it is safe to wait since the tumors are not doing anything scandalous.

That should about sum it up for now. Dan and Ashley are busy and tired, but learning and growing. God is good; He is in control.

Please pray with us that God will continue to protect us and give us the endurance to keep on the path He has set us on.

Bronchitis

2011-01-07T21:25:00.000-08:00

That's what the doctor says Dan has. Lungs sounding gunky+fever+clear chest x-ray=bronchitis. Hopefully, antibiotics and stronger cough syrup will do the trick.

A chest CT will be added to the abdominal CT in February just for good measure.

We thought a few people might want an update. Thanks for the prayers.

Goodbye 2010, Hello 2011

2011-01-07T10:55:00.000-08:00

2010 has come to a close. What a crazy year.

Dan and I haven't blogged since his last ablation, so I suppose we should start there.

We went back for the second round of ablation in November. We were a little hesitant about whether or not it would happen since Dan had developed fevers for a couple weeks. None of the doctors could really figure out why he was running fevers, but decided to at least look at the CT.

We spent Thanksgiving with the families and then drove to Stanford.

Dan went into the procedure room and the moms and I wa

ited in the waiting room. In about a quarter of the time the procedure was supposed to take, the doctor came out to the waiting room. At first, I dreaded what he was going to say, but he was smiling. He said that the last ablation had covered more area than he had anticipated. So, good news: 3 tumors look to have been cooked instead of 2. Bad news: the last ablation had cooked one of Dan's liver blood vessels and part of his liver had lost blood supply. Accordingly, doing the second ablation would mean inserting a needle through sick liver tissue and opening Dan up for infection and problems. So, the doctor opted to wait on the ablation. He told us to take a couple months, get a CT in February and then make more decisions. If the tumors had grown, ablation in March. If no tumor growth, ablation after Dan's graduation.

So, we got away with some IV antibiotics and a CT

and no hospital stay!

The holidays came and went quickly, as Dan was preparing to go back to UCI and I was working a lot. I ended up working almost every major holiday, but that was not a shocker for a new grad nurse. Both of our families made the drive down here after Christmas to celebrate with us and Lisa (who also worked the holidays). It was a wonderful time with everybody...and I think Toulouse loved all the company the best.

New Year's Eve was nice and quiet with just Lisa and Andrew and the cat.

Finally, 2010 ended. Dan had surgery. Dan recovered. Dan had more surgery. Dan recovered more. Dan came home. I graduated from nursing school, passed the boards, got a job and started it. We moved into a new apartment. Dan's second liver surgery got cancelled. We got a cat. Dan had an ablation. The second ablation got postponed. We celebrated out 3rd married Christmas.

Now 2011 is here, bringing changes already. Dan started back at UCI to finish his teaching credential and will begin student teaching soon. I started a posi

tion at the hospital, working oncology on day shift. We're both trying to get used to to waking up early again, but it is certainly nice to be able to sleep at the same time!

Now we are gearing up for a busy semester. Dan is a little under the weather again, so we're checking in with doctor today. A month's worth of coughing is a little much, but add some fevers and off to the doctor we go. Please pray with us that this is just a little bug and some antibiotics kick it away. Also, he'll be having his CT a little earlier than expected, though we're waiting on authorization still. Prayers that nothing surprising shows up would be appreciated.

There's our lengthy update for the end of the year. Thank you for your prayers and support!

Microwaved

2010-10-15T21:11:00.000-07:00

Today, some of Dan's tumors got cooked.

We drove to the hospital early today and were greeted by amazing fog rolling over the Golden Gate. Despite the reasoning for the trip, it's so nice to be back home in Northern California.

Anyway, Dan got checked in, prepped, and was ready to go on time...too bad the anesthesiologist was not ready to go until 2 hours later. (I hope she had an emergency!) Finally, Dan got taken down to the procedure room and I was allowed to follow him until it came time for the anesthesia. He was already on the table when the docs let us know his blood levels were low (platelets 79, H&H 8.9-9.5). They were worried about needing to transfuse, but felt confident about proceeding.

After about 3 hours waiting, Dr. Sze came out to let us know everything went well. The 2 biggest tumors were fried/melted leaving some dead tissue to be resorbed by the liver eventually. His liver still hasn't grown much, so it seems like going with radio-frequency ablation (RFA) was a much better idea than surgery. Also, the last 2 tumors are very small (watermelon seed sized) and not growing. This means that Dan can wait a few months before another RFA cycle. To Dan's delight, he can probably get his hip replaced before he starts school. We'll have to scramble to find a surgeon, but it could happen.

Tonight, Dan will stay in the hospital for observation. His new wound is only a couple centimeters and covered with a big band aid, but there is still a chance for bleeding. The chance is low, but it's safer for him to be here tonight. Also, he can get the "good" pain meds. Though, he says it just feels like he got punched in the ribs. He has already talked the nurse into removing one of his IVs by mentioning that they could leave the bigger gauge in his hand so that the one is AC wouldn't beep at night. Good grief, he's a pro. He ate dinner fine and hopefully, it will stay down because he is already asking for more food!

Please be praying that Dan's liver heals fine and that there is no internal bleeding resulting from the procedure. Also, pray his good eating continues (he's halfway to his pre-Whipple weight!) and that his pain can be easily controlled. Finally, pray we can get some sleep tonight and get out of here safely tomorrow morning. We're hoping to drive to our apartment on Sunday with a healthy Dan :)

Exhaustion

2010-10-10T17:04:00.000-07:00

So, I just woke up...at 4:45 pm. This is becoming normal. I've been working night shift (6:45p to 7:45a) for about 6 weeks (about 3 weeks without a preceptor), and I like it. Except, I don't have much of a life. I'm always sleeping when others are awake. Usually, my days off makeup for it, but the last couple weeks have been the exception. Due to Dan's procedure coming up, I've had to pack in all my shifts into a tight time-frame. Also, since I work nights, I sleep a little before the shift and then go to bed after. Dan says it wastes 2 days for each shift. He isn't a fan.

Anyway, I'm saying all this to just explain if I'm a bit of a grump lately. I like my job and am very thankful for it. I am just exhausted. Here's my schedule since last Friday:

Fri: work

Sat: work

Sun: sleep

Mon: work

Tues: sleep

Wed: work

Thurs: work

Fri: get ready for Dan's procedure, do housework, sleep

Sat: housework, sleep

Sun: church, work (Today)

Mon: work

Tues: pack, sleep

Wed: work

Thurs: get home at 8am, shower, drive to SR

Fri: wake up early, drive to Stanford, Dan's procedure, overnight stay (hopefully)

Sat: drive back to SR (Hopefully), sleep

Sun: drive back to La Habra

I also say all of this to remind you all that Dan is honestly the man. He takes care of the cat, makes sure I eat occasionally, cleans the house (kinda :)), pays the bills, cooks me dinner before work, encourages me to do what I love and to lean on the Lord when I hate what I am doing. He is wonderful and the perfect calm to my constant busyness. I hope I can be this supportive when he starts working.

Dan's procedure is this coming Friday at 8am. It should be an overnight hospital stay as long as there are no complications. Please pray for an easy procedure and recovery. And pray that it is successful! He'll need to have this same procedure one more time, so also pray that my boss will be understanding when I need to ask for a special schedule again next month.

One last thing: pray for energy and endurance for me. I am tired.

Well, I'm going to go eat my hubby's yummy dinner, drink my Diet Dr. Pepper (DDP) and put on my scrubs. It's time for work.

Breakfast

2010-08-30T08:36:00.000-07:00

So apparently we've been sleeping for a month and a half and we're just now waking up. Ok, that's not really true. But there hasn't been a lot going on. Well there has. But we just haven't blogged about it. I will try and catch everyone up.

Ashley passed her boards and got a job at Whittier Presbyterian. She is now working 12 hour shifts after going through orientation, which was arduous. The 12 hour shifts are long, but it's nice to work only 3 days a week. She will soon be switching to night shifts, which will be interesting. We'll see how it goes. The extra $8 an hour will be nice.

We celebrated 2 years of marriage by going out to some nice restaurants and Ashley going to work. 2 down, 58 to go.

I had a CT to see how well the embolization worked (and if the liver was big enough to handle surgery). Long story short, the liver did not grow as much as expected. I still have pretty good liver function, but it would not be good at this time to further insult it with a surgery. So the plan as of a few days ago is to do Radio Frequency Ablation, which is colloquially called 'Microwave on a Stick'. The radiologist will insert probes into my liver with the tips in the middle of the tumors. The tips will get really hot and melt/burn the tumors. It's a lot less invasive than surgery and still holds a good success rate. The procedure will happen in two parts a month apart (hospital stay is likely minimal- just overnight for observation). I'll let you all know when it is scheduled. Hopefully I can also get my hip done before UCI starts in January.

We got a kitten from Ashley's friend Katie. He is gray, tiny, precocious, ferocious, and his name is Toulouse. He likes naps, meowing when we're not around, going into the refrigerator, and climbing.

While Ashley is at work, I watch movies on Netflix Instant Watch, do chores and errands, read the Bible, read the Book of Mormon (I am almost finished!), keep an eye on Toulouse, eat, and play PS3.

Football is coming up. I am very excited. Predictions are in: I think the 49ers will win the division, but the Super Bowl will be San Diego over New Orleans. Disclaimer: it is very very difficult to predict the Super Bowl before the season starts.

Our new apartment is awesome. If you google IL Pompeii La Habra, you can take a look around.

This last one is not new: God is good. Also, I am hungry.

Double Take II

2010-07-12T21:40:00.000-07:00

I'm getting more and more into puns these days. So this title is a pun on the last title (Take II) but now it's Double Take, meaning a second look. So my radiologist (who performed SIRSpheres back in 08 and the embolization back in early June) was looking at my recent CT to check the liver volume, just to be sure that this surgery is a good idea. Well, he thinks the liver is actually a little smaller than it was (which makes sense, since the embolized side was supposed to shrink), so the idea of cutting off more of it didn't seem like a good idea right now, especially since my tumors are slow-growing, if growing at all. So tonight, like 45 minutes ago, the Greek called to tell me that

the surgery is postponed until further noticed.

Basically, since this surgery isn't exactly chopped liver (pun!), it would be safer and smarter to wait a while for further hypertrophy (growing) of the liver. So in early August/late September, I'll get another scan and see how it's going. Another option that we'd discussed in the past was to burn the tumors instead of cutting them out (which was the idea for the 4th tumor of the now-postponed surgery). Theoretically, if September's scan looks the same as this one, the burning option could be the #1 option. I mean, you can't really not use your liver. That's why it's a 'live'-r. I can here your groaning from hear. OK, I'll stop.

I think we're both ok with this. Now I can be in our awesome new apartment for more than a week to start with. Now I can be here as Ashley starts her new work. Now I can definitely be here for our anniversary. I can still recover in time for school, which won't start up until January. My hip surgery will be a little further away, but again, that's not the highest priority right now. So... I'm excited.

Please continue to pray for liver growth. And praise God for a wise choice by the doctors to not rush into a serious surgery without a definitely safe amount of healthy liver.

Surgery: Part II

2010-07-11T18:32:00.000-07:00

Nearly six months later, the second half of Dan's cancer resection has been scheduled and set in stone for this Friday, July 16th. The CT Dan had last week showed that his liver grew back some, but not the extend the surgeon had hoped/expected. Accordingly, the surgery plan has been modified to leave Dan with more healthy liver tissue. We have a meeting with the surgeon on Wednesday at which time we can explain the details.

This week will obviously be a busy one: we leave on Tuesday for Lodi, meeting with the surgeon and pre-anesthesia appointment on Wednesday, and then surgery on Friday. It will be nice to see our families before spending more time in the hospital.

As I am starting my new job on the 26th, I have to be back to SoCal the Wednesday following the surgery for a couple days of pre-hire appointments. I'll drive back up to Stanford with a friend for the weekend, and then start orientation on Monday. All that to say, I won't be able to stay with Dan throughout the recovery. I'll try to drive or fly when I can on the weekends, but it will be rough.

God-willing, this recovery will be much faster and smoother than Dan's previous surgeries. The liver is prone to bleeding and becoming quite angry when "attacked". Thus, there are quite a few complications that can arise after surgery. Yes, it is true that this surgery could leave Dan cancer-free. Yet, we are focusing on Dan's recovery before we glory in the possibility of remission.

Dan is doing fine: not worried, confident and encouraging. I am fine for now, though I'll get more nervous by the day. To be frank, I'd rather have a healthy/happy husband with a small of tumor than a sick/suffering husband without cancer. I do understand that it is possible to have a health AND cancer-free Dan. It's just the surgeries and hospitalizations and complications that keep me from believing it's possible any time soon.

Anyway, time for prayer requests. People often ask what they can do for us in times like this. Eventually, there may be material needs, but for now, our needs are spiritual. Please go before God on our behalf in preparation for Friday.

* Ask God to guide the surgeons' hands and minds, giving them wisdom and assurance.

* A safe and successful surgery

* No complications, especially bleeding and infection

* Pain management (it's going to be tricky with Dan's modified liver)

* Quick recovery

* Cooperative digestive system: no bowel obstructions!

* Peace for me and the rest of the family

* Endurance for me

Transition. No fade, more like a wipe.

2010-07-01T21:56:00.000-07:00

In case you don't understand the title, it's in reference to film transitions. A fade is, as it sounds, a slow mixing of two shots that's nice and smooth. A wipe is what you see in Star Wars a lot where the new shot sort of rolls abruptly across the screen.

There, I used my degree.

So in the last 3 weeks, much has happened. The bowel obstruction scare came and went, though Ashley is still concerned I might wake up one morning with that same intense pain. God willing, I never will again. Ashley took the NCLEX (the national certification process for RNs) on June 21st. It is said that the devil works at the NCLEX. It's true, or at least it feels like it. It is by far the most intense, draining, ulcer-inducing test I have ever heard of, and that's just studying for it. Taking the actual test must be like facing a firing squad. But the absolute worst part is after you take the test. Everyone leaves the testing center feeling like they failed, and California is one of the states that does NOT participate in a 48-hours-later-pay-10-bucks-and-find-out-if-you-passed program (and they need the money, why not?). So you're left waiting and agonizing for 1-4 weeks, praying to have passed but dreading that you failed.

Anyway, we found out on Wednesday that Ashley PASSED! (thanks Monique for waking us up at 5am) It was an answer to fervent prayer and a huge relief. Once the official license comes in the mail, she'll be all set. Also, Ashley got a job at Whittier PIH on an observation floor (where you end up if you go to the ER and the doctor doesn't quite want you to go home yet, but you can't stay in the ER). Hopefully, after some time on that floor she can transfer to the adjacent oncology floor (which is Ashley's desired specialty). So... that's AWESOME.

That also means that we are sure (for the first time) where we will live this coming year(s). We found a nice apartment to move into, and we're moving from Biola housing to.......morrow. Yeah. It's been crazy packing up our lives. I wish I had two good hips instead of one, because it has relegated me to non-heavy lifting only, which doesn't sit well with my exceeding manliness. (Ashley laughs... but she knows it's true) However, we have some awesome friends helping us out. We're both excited for our new place.

So, up next is this: I have a CT on July 6th to see how much my liver has grown after the portal vein embolization. If it has grown a sufficient amount to sustain liver function, then Surgery: The Sequel will be premiering on July 16th to lop off the bad section of liver. Hopefully, there will be a quick recovery, because Ashley has orientation at the hospital starting July 26th. I can resume my schooling at UCI in January (where I left off last year), so until then I will apply to sub and/or seek a short-term job to keep myself occupied and start attacking student loans. Also, there will soon be an addition to the Howen family....

No, not a baby. A kitten! It is yet to be named. But you can bet there will be pictures eventually.

Anyway, this is getting really long, especially for me. Keep praying for us, especially for no more obstructions, good liver growth and a complication-free surgery. And make sure to praise and thank God profusely for the blessings we have received.

Dan

Praying to stay put

2010-06-10T10:39:00.000-07:00

So, since last week, Dan has recovered well from his liver procedure. No complications, not much pain. We went to a wedding on Sunday and drove home on Monday morning. I've been finishing my NCLEX review to prepare for later in the month and applying to jobs. Dan's been playing lots of Madden football and eating :) Accordingly, I'd say things have been going well.

Until this morning.

Now, we aren't in any emergency or crisis as of yet, just preparing for one. Dan woke up with a bit of belly pain on his left side. Though it isn't nearly as bad as in March, the symptoms are pointing toward a possible bowel obstruction. Thankfully, he isn't feeling really sick, just a little pain and crampy. Rather than freak out, we talked to his surgeon who agreed that the symptoms sound like a very early, mild obstruction. So, Dan will be on clears at home today and tomorrow to see if it can resolve on its own. If it doesn't get completely better, we have an appointment on Monday at Stanford. If it gets worse, Dan needs to be admitted again.

Our biggest concern now is determining where to do the waiting. If it resolves, it'd be nice not to drive all the way back up. Yet, if Dan needs to be admitted, we want him to be at Stanford. So, by tomorrow, we'll decided whether or not to drive up north again. I don't want to wait too long and have Dan feeling miserable all the way up, but Dan doesn't want to jump the gun.

The timing of another bowel obstruction is not great. This is crunch time for me to study for NCLEX (nursing boards), so I can pass the first time. (Yes, I got great grades in college and am a good test taker. That does not imply that I will pass the boards. It is a different beast. Please, do not comment on my odds of "doing fine" right now). Having Dan in the hospital would be a rather large distraction from my focus. Additionally, we need to be preparing to move into another apartment. Once I know where I'm working, we can put a lease on an apartment and move. Yet, with Dan admitted, I'd be doing the looking, leasing and moving without a hubby.

All this to say, Dan needs prayer--a lot of it. God has been with us throughout Dan's suffering and trials. Our prayer is that God would intercede before everything turns bad this time. Pray that whatever obstruction there is would be able to clear on its own. Pray that Dan would be able to recover completely at home. Pray that there would be no need for another trip to Stanford. Pray that if (IF) Dan gets admitted, this hospital stay would be very very short. Better yet, pray that Dan doesn't even have an obstruction at all!
A prayer or two for me to be able to study intently and pass the boards the first time would also be appreciated.

I will obviously keep you all updated, though there may not be any news for a while.

Pray pray pray.

Rough day? A bit.

2010-06-02T21:44:00.001-07:00

So, Dan's procedure went well and ended at about 7pm. He had to stay in recovery for a while to wake up, and the doctor decided to keep him overnight to watch for possible complications. Dan's still really tired, though he woke up long enough to eat some jello and crackers. He's not in a lot of pain, but his stomach is wobbly. He won't go so far as to say it's sick feeling, but he's not feeling great. Stupid anesthesia.
Tonight we watch for his ability to keep fluids and food down and make sure his liver isn't bleeding through the wound it got today. As long as Dan can eat breakfast well and isn't actively bleeding tonight, he'll be discharged in the morning.

Amazingly, Dan was given a private room AND I got a cot! What? The first day? Awesome.
I've been sitting here applying for nursing jobs, while he's asleep. The nursing job market is horrible to say the least. Several polite rejections after making it through the last interview process is getting old. You'd think graduating top of the class, having CNA experience and good communication skills would get you somewhere...not quite.

Dan and I are really beginning to feel the strain of the unknown. We need to know where I'm working before we can move, and we have to be out of our apt on June 19th. Prayers for guidance and a job are coveted. I know that God is guiding me to where He wants me, but this time period kinda sucks.

Prayer Requests:
* No bleeding or complications
* Dan's ability to eat and a hearty appetite
* Safe discharge tomorrow
* Continued health of bowels (no obstructions ever)
* Great re-growth of liver tissue
* A job for me...soon!
* Peace in yet another period of unknown

Another Procedure

2010-06-02T14:14:00.000-07:00

I have to type this very quickly because the hospital has decided that they don't like people blogging on their wireless...thus, I am only allotted 10 minutes on our blog. Weird? Yes.
Anyway, we're back in Palo Alto (SHC) for Dan's embolization procedure. Things are running late, so Dan just got taken back to the preop phase. We have even spoken to the doctor yet. They will blocking off the right portal vein (blood supply to the right lobe of the liver) to allow for quicker regrowth of his liver. We have been told that this should be just an overnight stay, so we're really hoping and praying for no complications and a fast recovery.
I'll keep you posted when I can, but just be in prayer as the procedure should be starting in about an hour.

Prayer Requests:
* Successful procedure
* No complication
* Open and happy bowels without obstructions
* Safe discharge tomorrow as planned
* NO SURPRISES!!!
* Keeping Dan at home with me in SoCal for a lot longer :)

Steady Freddy

2010-05-20T22:38:00.000-07:00

Since I've had a few people mention that they haven't read anything new on the blog for a while, I thought we should probably blog again.

Since the last blog, we have gone to Stanford twice for meetings with the surgeon and the oncologist. Dan's wound is healing, but being difficult. He still has a hole the size of a dime, which has to be packed a couple times a day. Luckily, his second surgical wound looks good...and will hopefully stay that way.

Aside from advising us on the wound situation, the docs also met with us to make a decision regarding the next step. Due to the several complications and setbacks, Dan hadn't truly been able to recover from any of his surgeries and was being a bit pressured to "hurry up" with the next one. Dan and I set about intelligently gathering information and advice from his doctors to assure we were making the right decisions. Honestly, his docs agreed that he needed more time to heal, but still advised surgery as the next step. Accordingly, we are looking at the second half of the surgery late in the summer.

Another good part to the doctors wanting to let Dan heal is that the embolization procedure (cutting off the blood supply to the right side of the liver to test regrowth of the left side) is going to be after graduation. Yay! One less thing to stress about for now.

Did I mention I'm graduating next week? Yes, you read that correctly. Next week! My clinical hours are finished, my research hours are finished, my classes are finished, and I have very little left to do. This is a strange season. My friends are beginning to move away, we are competing against each other for jobs, and we're saying goodbye after 5 years of constant together-ness. Weird and sad, but necessary.

Next week's schedule:
Monday-Class party
Tuesday-Senior Baccalaureate (reflection?)
Wednesday-Epsilon Kappa Epsilon Honor Society Ceremony
Thursday-Pinning Ceremony (Traditional nursing graduation)...a BIG DEAL
Friday-Fun with family!!!
Saturday-Graduation!!!

We have a busy week ahead of us, but it is so exciting. We're looking forward to beginning a new chapter of our lives soon...new apartment, new jobs, no school, no more cancer...God willing.

Prayer Requests:
* No complications or new problems
* No hospitalizations or illnesses until after graduation
* A job! (I've had 4 interviews)
* Safe travels for family coming down
* A safe and uncomplicated embolization procedure

The Latest

2010-05-01T16:31:00.000-07:00

We're headed back to Stanford for Dan's first appointment since being released a few weeks ago. It has been nice to have a break from doctor appointments and tests and such. Hopefully, this will be an easy appointment with no need for tests and no need for any hospital admissions. Basically, we're praying for good news and no surprises.

I've still been doing dressing changes 3 times a day, which is getting tiring for both Dan and I. Yet, I'd rather do it at home than have a nurse do it in the hospital. Dan's new incision is healing nicely (finally), while we were within a week of his old wound healing and it opened up a bit again. A blister formed over the scar tissue, the blister popped a couple nights ago, and gave us a bit of a scare since it bled quite a bit. We thought it was healing back up, but today the new tissue split a little again revealing an open hole under his scar. Ugh. Hopefully, it's just a hole in the scar tissue under the scar, and it will heal up completely.

I'm thankful it happened right before a doctor appointment, so I can get the surgeon's advice. Please pray this is just a little hole from the blister and not anything serious at all. Dan's not worried; his dad isn't worried, but of course, I am worried. I've gotten used to Dan actually being home. I really don't want to have him leave again. :(

Anyway, time is speeding by. I have 12 hours (out of 188) of clinical time left. Graduation is in 28 days. Wow. Please be in prayer that Dan and I can share in this next month living together and celebrating the end of nursing school without any complications or hospitalizations. Having my husband with me for senior banquet, Pinning and graduation would be the greatest graduation present imaginable. So, ask God for this good gift with me :)

Contact

2010-04-28T09:20:00.000-07:00

Well, it's been 9 days since the last blog... Ashley is still busy and I am still not a good blogger. At least you can surmise that I have not had any surgeries or infections, which is totally awesome! It's been good to be up and about, going out to places like the grocery store, friends' houses, and church. We even went on our first real date since January (Chili's and the new Steve Carrell/Tina Fey movie, Date Night). I'm still trying to get some weight on me and get my legs working better. Other than that, not much to report. I am pretty excited about the 49ers' draft; we should make a serious playoff push this year. Boston is sucking less than last post, but my NHL team (Colorado Avalanche) got eliminated by the hometown heroes, the Sharks. I guess I don't have to root against them now.

The days go by and so does my food. :)

Still Cruisin

2010-04-19T17:37:00.000-07:00

Quick blog: it's great to be doing great.

Excited about playoff hockey, not really excited about playoff basketball, the Sox are sucking, and the draft is nigh.

I drove yesterday, and am driving again today to the store and bank.

Went to church yesterday; I had really missed it.

I'm not a real wordy fellow. And my wife knows this, yet she makes me blog anyway!

En Casa

2010-04-15T18:42:00.000-07:00

For the third time this year, I'm back home. This time I have a good feeling that there won't be a fourth time until after surgery numero dos. It feels so right to be here. I've been eating a lot more than I was in the hospital; I think I could be up to normal rations relatively soon. Ash cut my hair today, and I preceded that with the shaving of my massive hospital beard. I had considered keeping it for the Colorado Avalanche playoff run, but I've never liked a beard that could catch food. My wound from the bowel obstruction surgery is still a little painful, but not as much as it was in the hospital.

So basically things are going great. We'd really love for them to keep going that way. It's been nice being able to have our prayer times not be all about things we need, but about the things that God has done, or even to get to pray for other people. The one lasting prayer request we have (aside from loads of thanks that I'm out of the hospital) is for no more complications. For now, take a minute to sit down, relax, and enjoy your home too.

Done (hopefully)

2010-04-12T21:16:00.000-07:00

I am not in Palo Alto, but I am not home yet. I'm in Lodi for a brief waiting period to make sure I'm ok before I move 6 hours away. It was thrilling today to leave the hospital, to have my PICC line and staples removed, and to eat some steak at my parents' house with my two foreign exchange sisters. If everything goes fine tonight (sleeping) and tomorrow morning (eating and such), I will complete the journey home to my wife, who is going bonkers right now with homework and trying to get the apartment clean. I love her a lot.

This one will be short because I procrastinated until the end of the day to write this (to be fair, the first part was spent waiting for discharge and the second was spent in an internet-less car ride). But I figured this was blog-worthy, so here you go. The fruition of a boatload of prayer. But we're not out of the harbor yet. After all, I have been known to eat and suddenly become unable to eat. The doctors removed all the obstructions in my bowels, but if they can appear suddenly, they can come back suddenly. Please pray that they stay away so I can stay home. :)

Also pray for:

Safe drive to LA

No other complications (like fever)

Ability to ingest enough food and drink to sustain myself

Quick healing of my incision, which still hurts when I walk

My facebook friend Mary, whose cancer has resurfaced in her liver and the doctors don't have a clear idea where it's coming from

My real life friend Paul, who's recovering from pretty nasty pancreatic cancer

Peace in the Middle East while you're at it

Not a bad day at all

2010-04-11T18:35:00.000-07:00

Dan here, taking on blogging duties.

Today was pretty good. I found out that discharge is possible by the end of tomorrow at earliest; it's contingent on my ability to eat an amount large enough to keep me hydrated (which could be soon) and my wound's inability to develop an infection. So... awesome!

I also got to watch a great hockey game between Boston and Washington; it's unfortunately rare these days to see the great game televised.

Ash and I filed our taxes, which was done with considerable difficulty with things scattered between Stanford and LA. A refund from our nation's deficit will be nice.

A couple of friends from church surprised me today by stopping in; they had come up from LA to a wedding in Stockton and impulsively decided to see me in the hospital.

My mom came by also and brought some matzoh ball soup for me. I had asked earlier for some, since I missed Passover, but yesterday asked her not to bring it, because Stanford's soups had been both plentiful and banal. However, she brought it anyway, and I thought I'd try a little bit. Turns out, it was really good. Lots of flavoring. I had a whole bowl. I might have another in a little while.

I'm really hoping that I can get out soon. It's been too long that I've been away from home. It feels so right when I'm there. Plus, it means more clinical hours for Ashley when she dresses my wounds.

Thanks for praying for us. Keep praying; I'm not out of the woods yet. I have to get out of the hospital, have an embolization procedure, and then a second surgery--- then I will be cancer free!

Prayer Requests:

Continuous increase of appetite

No fevers/infections

Discharge soon

No coming back to the hospital with complications

Tut tut

2010-04-10T22:08:00.001-07:00

This blog will be short and to the point because Dan has such an aversion to blogging that he makes his sad and tired wife blog right after driving 6 hours away from him. Tut tut.

Appetite: Better but not good enough to get off of TPN, which is the goal. Dan got a hamburger on his lunch tray, was delighted, ate half and has had no room for much else. Dinner was nibbled at most. So far, food is staying down and going through without causing much of a problem. This needs to continue so Dan can go home.

Infection: Fever returned a bit today, but not high enough to be considered a "spike" (38.5 C). Incision is still oozing, but the docs wants to give it time to drain before opening any more. All of the staples will most likely be removed Tuesday or Wednesday. One of the labs drawn Thursday came back "suspicious" (they take 2 days to grow), so another test was done today. No antibiotics until another fever spike or a sudden change in the wound or labs.

Spirits: Doing well, though getting restless and sad to be in the hospital for so long again. Also, we are no longer in the same place. It's getting harder to keep driving away and leaving Dan in the hospital. I won't be able to return until next Monday at the earliest, so we're hoping and praying Dan will be released this week without any complications, so he can get his butt home.

Prayer Requests:
* More appetite and ability to eat and snack throughout the day
* Cooperative digestive system...no vomiting, no distention, no premature full feeling
* Resolution of infection (where ever it is)...no fever, no discharge from wound
* Pain control...continued improvement of pain
* Increase in mobility and energy
* Wisdom for the docs to know what and when things should happen
* Discharge from the hospital within this upcoming week
* Comfort for hearts sad to be apart :(

No Bon Appetit

2010-04-09T18:06:00.000-07:00

As an update to yesterday, the most obvious source of infection is the incision. Dan no longer has a fever, but the incision is still oozing. The surgeons are being cautious and slow with removing staples, as they do not want Dan to have an entirely new open wound. They are still holding off on antibiotics unless Dan has another fever spike.

Today has been somewhat better. We got a little more sleep and Dan woke up early enough for the docs to see him out of bed for once. He said walking is a easier, and he is definitely taking longer strides. He finally got tired of the hospital gown, which is a good sign to me.

The problem of the day is a lack of appetite. We aren't sure if the cause is the extremely nutritious TPN telling his brain he is satisfied or that his stomach his tiny or that things are going through or a combination of all of these. After dealing with an intern who doesn't always think things through well (we just got the chief resident to give him the "what-for"), I think we've convinced the docs to decrease the TPN calories. Hopefully, this will let Dan be a little more hungry. Dan is glad he is eating other things besides clears though...sunchips, bread, crackers, etc.

We're bummed because I have to leave for school tomorrow. There have been too many good-byes said at the front of the hospital. I won't be able to return for at least a week, so we are still praying that Dan will get out of the hospital sometime next week. I hate being away as so many things are going on. Hopefully, I receive only good news over the phone.

Now, I need to get him up to walk. The Simpsons is seriously distracting him from moving around. Doh.

Prayer Requests:
* A big(ger) appetite
* No more vomiting
* Continued decrease in pain
* No more fever
* Wound healing...no need to open the wound
* Safe travels for me tomorrow
* Dan getting discharged next week...and coming home

Hunt for the Infection

2010-04-08T08:50:00.000-07:00

Last night was a teeny bit better than the last, though Dan continued to vomit and have bloody noses. We're hoping that the nausea and throwing up is from swallowing blood and not from the food. As Dan threw up again this morning, he is weary of trying to eat for fear of throwing up again. With a 3-4 incision in the belly, throwing up is quite painful.

McGreeky came in this morning with an agenda: find what is causing Dan's fever and illness. About time. Despite the wound being slightly infected, the surgeon is concerned infection could be elsewhere being allowed to run rampant. So, Dan will be getting blood cultures, urine samples, and an abdominal x-ray. The x-ray is also to see what is causing Dan so much pain in his left side, as the docs aren't sure what it could be. Another issue emerged when McGreeky changed the new incision packing: Dan bled, quite a bit. Due to a couple of blood thinning medications, Dan isn't able to clot very quickly...this is contributing to Dan's very frequent bloody noses. The doc is taking away one med and decreasing the dose of another med, which should help things.

Today should reveal some things. Reasons for pain, reasons for fever, reasons for vomiting. God willing, today should also find Dan able to eat more and keep it down. We really don't understand why all of this is happening, but it needs to change soon. Very soon.

Selfishly, I need the docs to get things settled this week because I am leaving for school again on Saturday. I would simply hate to have still this sick while I'm hundreds of miles away.
Unfortunately, I have to go back if I have any hope of graduating (which I do). Due to my clinical schedule, I won't be able to come back to see Dan for almost a couple of weeks. Accordingly, Dan and I are asking for prayer that Dan would be released from the hospital sometime next week. I wouldn't be able to be here for the release, but at least I would know he was doing well enough to get out.

This is truly a miserable situation that is just being prolonged. Pray that God moves now. That's what Dan needs more than labs or meds or doctors: he needs God to save him from this mess.

Wound Infection #2

2010-04-07T19:43:00.000-07:00

As if Dan didn't have enough to deal with, his wound has become infected. It has looked a little red and angry today, but we were just watching it. Then, he spiked a fever of 101.1 this afternoon. Finally, we got the team to pay more attention to the incision. The intern thought they would take out a staple or two tomorrow to let any pus drain out. The nurse and I helped to convince the resident (his superior) that maybe that should happen today. So, 3 staples got removed and a good deal of drainage came out of the wound. It was deja vu as this happened with Dan's last incision--which is now a wound that we are still dealing with.

The plan is to let the incision drain and to recheck it tomorrow. If it doesn't look markedly better, Dan will be started on antibiotics. Hopefully, the wound will be able to heal better this way and not need to be opened all the way.

Dan really isn't feeling well right now. His immune system is pretty low (WBCs=2.5) after being in the hospital for so long (TPN is causing some problems with immunity also), so it is taking a lot out of him to fight this infection. He's been tired and sleepy all day. He's fighting some nausea here and there. He's still in pain. I just convinced him to give in and go to sleep, though I don't know how much that will help him.

I'm really not sure what tomorrow will look like. The doctors were anticipating advancing his diet, but Dan didn't really eat enough to be sure he can tolerate the clears. As I blogged earlier, his GI system is sending mixed messages, so that isn't helping the docs make decisions. Yet, the resident commented tonight that it might take real food to get Dan's bowel working again...though he cannot give a regular diet yet. A catch-22 of sorts.

I wish we had chosen to do Cyberknife. It may not have worked, and Dan might have needed more treatment later on. Yet, it would have been a week of out-patient visits. I might still have a job. Dan might have been able to finish his credential. I would have had Dan around to celebrate my final semester of nursing school. Yes, I understand that those are all potential outcomes and that complications could have arisen there, too. Yet, I cannot bring myself to see this surgery as a success.

I haven't the faintest idea what to pray for now. A wound infection, nausea, vomiting, non-improving pain...all of these things have been prayed against, yet they have happened. Yes, God has a plan for Dan. It just hurts to see Dan continue to suffer more and more set-backs as he tries to be in God's will. Of course, Dan has more faith than me. Always has. I know we're not supposed to test the Lord, but sometimes I just yearn for proof that He actually loves Dan and is caring for him.

So many people declared that 2010 would be a year of victory for Dan. No more cancer, a new hip, a teaching credential, a new job, etc. Instead, Dan is stuck in a hospital bed with half as much cancer, losing his strength, losing his immune system, losing so many things.

We need a turn-around. Dan needs to feel better in the morning. Dan needs to be able to eat and not be nausea. Dan needs his pain to abate. Dan needs his infection to resolve. Dan needs his immune system to bounce back. Dan needs a miracle.

Mixed Messages

2010-04-07T11:36:00.000-07:00

Question of the day: is Dan's GI system awake, asleep or obstructed?

Since Dan passed a little bit of gas yesterday, he was allowed to have sip on some clear liquid last night. Things went down fine, but around 3 or 4 in the morning, he got a bloody nose. He proceeded to swallow some blood which made him throw up quite a bit. The nurse got nervous as it was mostly bile (too much bile in vomit means the GI system is not absorbing and passing the bile through quickly enough), called the on-call resident who put Dan back on NPO.

This morning, when Dan's team rounded, he explained about the bloody nose and that he wasn't nauseous at all otherwise. The docs agreed Dan could be back on a clear diet today, especially since his bowels were making lots of noise and letting free lots of gas. About the time the tray of clears came, Dan got another bloody nose (heparin and toradol and a dry nose is making this happen a lot). Dan also received a rather large dose of dilaudid. Between swallowing blood and his head swimming from too much med too fast, he threw up again. Great. His day nurse also felt that his vomit had too much bile in it, so she asked Dan not to eat any more until the team makes a decision. Dan insists that he is not nauseous anymore and wasn't until he received the pain med and really doesn't think the episode had anything to do with eating.

Dan's body is once again sending mixed messages. Good messages: passing lots of gas, active bowel sounds earlier, no nausea when eating. Bad messages: vomiting bile, quiet bowel sounds now, no BMs. Though we know the vomiting could be from multiple things (food, drugs, bloody nose, gag reflex), it is often assumed that food is the problem. Unfortunately, the longer it takes to find out if Dan can handle solid food, the longer he has to be here. As his stay will hit the 4-week mark on Sunday, he'd really appreciate no more hang-ups. Of course, we also want the docs to make the appropriate decisions.

Thanks to the dilaudid, Dan is sleeping like a baby. This is a nice thing as no one let us sleep last night. We have a lot of walking to do today to catch up on our slowness this morning. Hopefully, Dan will also have eating to do....without throwing up.

Prayer Requests:
* No more throwing up and no need for another NG tube
* Dan's ability to eat and tolerate the clears well today
* Wisdom for the doctors making the decisions (hopefully, quickly)
* Control and improvement of pain
* Continued healing of incision and wound
* No complications or infections (he had a fever again last night)
* Ability for Dan to come home with me very soon
* A period of peace, health and rest for both of us...very very soon
* Encouraging news and events today

Not better

2010-04-06T09:59:00.000-07:00

We're already having a hard day.

There's no point in trying to make up points of encouragement or happy anecdotes. Dan's not really progressing much. He's still in pain, he's still exhausted, he's not motivated to get up and no matter what anyone says, he never feels like things are getting better. Sure, he could barely walk around the unit on Sunday but now he can--he's still not better. Sure his pain was 8/10 after surgery, and now only gets up to 4/10--that's not any better either.

To be frank, I sometimes don't want to get up in the morning. All that is ahead of me is forcing Dan to do things he doesn't want to do, trying to determine whether or not his pain is better/worse/new so as to tell the doctor, hoping for progress that doesn't ever happen how doctors expect, changing the linens, trying to talk Dan into getting cleaned up, trying to do the homework I have no motivation for and then putting on a happy, encouraging face for everyone else. It's exhausting and rather unchanging.

I apologize for the lack of cheerfulness or good news. This is a blog to update on how Dan is doing, and today, he's not doing great. His heart rate is back up, his energy is lower and he barely talked to McGreeky when he came in this morning. As far as the surgeon can tell, Dan isn't doing any better than yesterday and that doesn't make sense. Labs are good, incision is healing, etc. Dan should be feeling better. Alas, if you have been following this blog, you know Dan seldom feels like he is supposed to. It's frustrating to watch elderly patients cruising the halls, but see Dan just lay there. Yet, there's nothing we can do but "wait and see".

Though, he got out of bed and walked once around the unit, he just got too tired and went back to bed. So, we're back at square one for the day: wake up. Sometimes, that truly is the worst part of the day.

Prayer Requests:
* Sudden and long-lasting energy and endurance for Dan
* Resolution of pain (muscular and intestinal)
* Passing of gas--lots of it, today
* No infection or complications
* Motivation for Dan to move and want to get better
* Motivation for me to keep encouraging him and to keep doing my schoolwork
* Unmistakable improvement today
* Good news and encouragement
* Wisdom for me to know when to go home again
* Ability for Dan to be able to come home with me soon
* Our marriage
* Hope

Nursing Student

2010-04-05T22:12:00.000-07:00

I must make a confession: though I am a nursing student, I am not always fond of Dan being cared for by nursing students. I know, I know...hypocritical. However, some SNs just aren't on their game and let mistakes happen. Accordingly, I have become a wee bit more watchful tonight, as Dan has a SN again. This one is graduating in May like me, but has fought with this IV pump multiple times tonight and if I chewed gum like her, I think one of my preceptors would have smacked me. Oh well. We all have to learn. Dan is her easy patient, so I'm pulling for no mistakes this time around.

By the way, Dan is doing alright. (He was supposed to blog in exchange for taking the computer away from me, but he thought checking sports stats would take priority.) The NG tube came out this morning, freeing him from one more tube. His heart rate stayed up for most of the day until McGreeky came in. After he left, Dan and I went for a walk. When I hooked him back up to the pulse ox (measures oxygen and heart rate), his pulse was barely high. Now, it's back to the normal range. Yay! He still has a teeny fever, but that's better, too. His new wound looks good--like a football, Dan says. The staples will probably come out sometime next week, so long as everything goes well. His pain is under control, and he is much less sleepy since they changed the medication today. He still has a pain that the doctor cannot explain, but Dan said it is getting better.

Tomorrow, we're hoping for gas! That would mean a clear diet finally, and some progression toward the true test: solid food. Accordingly, we'll keep walking around the unit and staying out of bed as much as possible.

Keep praying. We're both tired of this hospital business. Dan wants to eat and go home. Seems pretty simple, right? Oy.

I'm off to sleep, too. I need to be alert when the nursing student comes in...maybe I should crawl in bed with Dan and freak her out again! Ha. Don't worry, we'll be nice.

Prayer Requests:
* Passing of gas tomorrow!
* No infections or other complications
* Ability for Dan to eat normal food without any pain or recurrence of obstruction
* Resolution of weird pain...and all pain very soon
* Energy and endurance
* Ability for Dan to come home with me soon...this is getting very old :(
* NO MORE COMPLICATIONS EVER EVER EVER AGAIN
* Encouraging news and events tomorrow

Easter in the Hospital

2010-04-04T13:40:00.000-07:00

Unless you are a little kid, holidays in the hospital can be pretty boring. People feel sorry for children missing Santa Claus or the Easter bunny, but adults get to fend for themselves. Accordingly, if we didn't have a calendar in the room, we wouldn't know it's Easter today! Though it is a bummer to not be with our families or finding hidden eggs (yes, we still do that), we hope that this is one of the last holidays spent in here. Well, we hope it's one of the last days spent in here period!

Dan is doing alright today. He's still having considerable pain, but it's better than last night. Oddly, his pain is on the opposite side of where the biggest band was, but the surgeon isn't concerned about it as of yet. The NG tube has to stay until tomorrow since it was still draining quite a bit. Though, the foley got to come out this morning. Dan has some post-anesthesia affects still (low fever, high heart rate), but they will be considered normal as long they resolve by tomorrow.

The goal for the day is to get Dan out of bed, get walking, and wean off the oxygen. So far we have been successful. Dan got out of bed by himself (for the most part), went for a teeny walk and sat in a chair for a couple of hours. He is now as clean as is possible without the possibility of a shower. Apparently, that wore him out, as he is now asleep again.

Long term goals are similar to before surgery: bowel sounds, pass gas and be able to eat. Dan will be NPO (no food or drink) until he can pass gas, which could be anywhere from 2-5 days from surgery. At that point, he'll start with clears and work his way up to solid food. God willing, Dan could squeeze out of this joint by next weekend eating happily again. (McGreeky does NOT think that's going to happen, but you can't blame us for hoping).

Enjoy Resurrection Day, as that is what today should be about...Jesus and the price He paid for us to receive salvation. Dan and I certainly missed going to church to celebrate, so if anyone knows of a good webcast of an Easter sermon, let us know. For now, here is one of my favorite musical reminders of God's grace and mercy for us. (The Power of the Cross by Keith Getty)

Oh, to see the dawn
Of the darkest day:
Christ on the road to Calvary.
Tried by sinful men,
Torn and beaten, then
Nailed to a cross of wood.

This, the pow'r of the cross:
Christ became sin for us;
Took the blame, bore the wrath—
We stand forgiven at the cross.

Oh, to see the pain
Written on Your face,
Bearing the awesome weight of sin.
Ev'ry bitter thought,
Ev'ry evil deed
Crowning Your bloodstained brow.

Now the daylight flees;
Now the ground beneath
Quakes as its Maker bows His head.
Curtain torn in two,
Dead are raised to life;
"Finished!" the vict'ry cry.

Oh, to see my name
Written in the wounds,
For through Your suffering I am free.
Death is crushed to death;
Life is mine to live,
Won through Your selfless love.

This, the pow'r of the cross:
Son of God—slain for us.
What a love! What a cost!
We stand forgiven at the cross.

Prayer Requests:
* Safe, complete, uncomplicated recovery
* No infections, no internal bleeding, no bowel damage, etc.
* "Awakening" of bowels (bowel sounds, gas, etc.)
* Control and continued improvement of pain
* Ability for Dan to get moving, get eating and get out within a week (that's the normal recovery time for this type of surgery)
* Ability for Dan to come home with me soon
* Good health and endurance for me (I don't want to get Dan sick)

Night One

2010-04-03T22:48:00.000-07:00

Dan made it back to his room accompanied by lots of tubing, though not as many as after his last surgery. After the nurses got everything situated, I could finally say hello to my hubby after a few hours of waiting. He is still in a good deal of pain, though the PCA (pain button) has helped considerably. I have yet to see the incision, as Dan is tucked in and cozy for now. The NG tube is still in, but draining only a small amount.

Dan wanted to know how the surgery went, so I told him, but I bet I'll have to remind him tomorrow. He wants the surgeon to explain it, too. Hopefully, morning will find him feeling better and more alert. Of course, there is probably a long road of healing up ahead. Our prayer is that the recovery goes as smoothly as the surgery did.

Pray for no complications (no infection, no internal bleeding, etc.) and a cooperative digestive system. Also, pray for easing of the pain so Dan can sleep and regain strength.

Recovery Room

2010-04-03T19:52:00.000-07:00

Dan got out of surgery after only a couple of hours.

McGreeky said they found 3 thick bands of scar tissue wrapped around his bowel, which were causing Dan the pain when he ate. The surgeons had to make a large incision to check all of Dan's bowels for adhesions. Luckily, he didn't have many adhesions elsewhere in his bowels, but these bands were causing some serious problems. McGreeky said they took care of those bands, checked everything out and closed him up. There was very little blood loss and the open surgery time was very short.

So, the surgery was definitely necessary, though there was no way to see this for sure on the CTs. Tomorrow, they should be able to remove the NG again (which will thrill Dan). They will wait until there are bowel sounds and passing of gas before letting Dan try eating again. Hopefully, eating will go much better, though this is still a concern.

For now, we are waiting for Dan to get out of the recovery room and go back to his room. As McGreeky said, "we aren't victorious until Dan is out of the hospital." Keep praying.

Prayer Requests:
* Quick and uncomplicated recovery
* No infection, no problems
* Successful eating trial...completely successful!
* Ability to get out of the hospital and go home within the week
* NO COMPLICATIONS AND NO MORE OBSTRUCTIONS

Waiting Rooms

2010-04-03T15:38:00.000-07:00

The doctor officially decided to do surgery to get rid of the bowel obstruction. He will be doing a lysis of adhesions (cutting the scar tissue that is holding the bowel up). McGreeky said he would try to do this through a scope (laparoscopically) first, though there is a high chance he will need to make a larger incision. If they simply find adhesions, they can take care of them and close Dan up. If they find that his bowels are "very sticky" (lots of adhesions), the surgery could take quite a while longer. Additionally, they are hoping to not find a need to resect any of Dan's bowel. That would potentially create more problems and longer healing.

Basically, McGreeky doesn't know what he is going to find when he takes Dan into surgery. He gave us a time estimate only because I asked: 2-6 hours. Lovely.

Currently, Dan and I are waiting in his room for transport to pick him up for surgery. He was supposed to go at 2, but a trauma surgery took precedence. So, we wait. Unfortunately, Dan has to wait with another NG tube until surgery. Bummer.

His parents, my parents and his aunt and uncle are waiting in the surgical waiting room. I'll join them as soon as Dan is actually taken back to the OR. Hopefully, we won't be waiting more than a few hours this time.

I will update as I can. Keep praying.

Prayer Requests:
* Successful, short, simple surgery
* No complications whatsoever (no infection, extra bowel obstructions)
* No bad surprises
* Peace for those of us in the waiting room
* Quick and unremarkable recovery for Dan
* Ability for Dan to eat comfortably and go home within the week :)

Good Friday?

2010-04-02T23:04:00.000-07:00

As a kid, I never really understood why Good Friday is called Good Friday. I mean, Jesus was beaten, betrayed and killed. What is so good about that? Now, with a little more Biblical and theological understanding, I know that what happened on Good Friday was the best thing to happen to humanity since...ever. Still, meditating on the events of the Crucifixion does not leave one in a joyous mood. Our sins put Christ on the Cross. He was innocent, yet paid the price on our behalf. It wasn't fair, but it saved our souls. Wow.

In a much much much less severe way, Dan's Good Friday wasn't all that good either. His diet was moved up to solids, but that didn't work very well. By noon time, he was in pain and vomiting. McGreeky got finished with his surgery early and told Dan he'd have a CT to make sure there was an obstruction and then be scheduled for surgery tomorrow.

By the time I arrived from LA (a nice, easy drive for once), Dan was headed to CT. Results showed...nothing. The CT was normal except for a very small amount of dilation of the same bowel that has been problematic. McGreeky called and said this was definitely not something to operate on. In fact, he said this CT looks even better than the one done last week. The other surgeon who came in agreed, put Dan on a clear liquid diet again and apologized repeatedly for how frustrating this must be for Dan. After banking on surgery tomorrow, we just had to take this change in stride. McGreeky told us that if Dan's symptoms persisted through the weekend, he'd have surgery on Monday. Sound familiar?

About half an hour later, McGreeky called back (he and Dan are on cell phone basis now). He had spent some time thinking about the situation and wasn't comfortable leaving Dan in pain all weekend. So, he was actually leaning more toward surgery tomorrow after all. He wanted Dan to keep drinking tonight to see how he felt and they would discuss things in the morning. He also put Dan on the surgery schedule for tomorrow just in case. The interesting thing is that McGreeky feels Dan is now a better candidate for a laparoscopic surgery, meaning he would not need to make a large incision to open Dan all the way up. Thanks to the improvement shown on the CT, it is possible for this type of surgery to be successful with less risk of missing something. (Of course, there is always the possibility that they will not find what they need to find and Dan will be opened up a little bit into the surgery.)

We tried to take this turn of events in stride, discussing what to say to McGreeky in the morning to get something done. Dan's pain seemed to go away, he was in good spirits, and he ate most of the clear liquid on the tray. It began to look like Dan wouldn't be in enough pain to convince the doc he needed surgery! Of course, another hour told a different story. Even the clears caused Dan pain and cramping. As he is now drugged and sleepy, we're pretty sure Dan will have a date in the OR tomorrow.

As the disciples must have felt scared and disappointed and doubtful in the day between the Crucifixion and the Resurrection, Dan and I (and family) are having a hard time grasping what God is doing here. Yet, the pain and sorrow for the disciples and believers of Jesus was replaced with rejoicing in that glorious morning when Christ conquered death. Wouldn't it be spectacular for Dan to have a glorious morning of healing and renewal on Resurrection Sunday?

Prayer Requests:
* Wisdom for the doctors in making the 'final' decision
* Safe, effective, simple surgery done laparoscopically
* Swift and uncomplicated recovery time (this has to be possible for Dan)
* Peace and comfort for those in the waiting room
* Resolution of this bowel obstruction once and for all
* Rest and comfort for Dan as he sleeps tonight
* A 'glorious morning' for Dan very soon

Eating

2010-04-01T20:26:00.000-07:00

So it's update time; sorry for not blogging yesterday. I tend to forget when Ash isn't around; she's more motivated than I am.

Yesterday and today were very similar. My mom came both days, we did the cryptoquip and crossword, I walked, watched TV and movies, and perused facebook more than the average day. The main difference was that yesterday I ate broth and jello, and today I had more milky products like cream of wheat and what may become a dietary staple in the coming weeks, Ensure (or other protein supplement to gain weight). Once again, they're working me up to solid food and seeing how my bowels respond. So far, everything's moving through. (yayyyyyy)

But here's the rub: this exact thing happened last time, and at the end of the solid food day, I was in some nasty pain and eventually threw up, restarting this process. I really want this food trial to work, but at this point, I can't say what I think will happen.

Ashley has been working her gluteus maximus off back at school these past two days, and for that I am really proud of her. She's going to make an excellent nurse one day. But for now, nursing school still makes her life pretty stressful. Tomorrow, she'll drive up and actually be on a break! Praise the Lord.

Insurance has been really weird. They kept trying to shirk payment of my bills by claiming I had an accident I didn't report. Yes, I had an accident that meant I needed a Whipple surgery. April Fools! If Obamacare makes health insurance worse, I'll really need God's healing! (not that I don't need it now...)

Anyway, please pray for one thing: that this works and we can go home together (and maybe even go to Easter with our extended family!).

Thanks friends. More to come later.

Dan

Passing

2010-03-30T10:42:00.000-07:00

Today's theme is Passing.

Passover is today (I think?), when God spared the children of Israel right before His mighty deliverance from Egypt.

This morning, I caught the end of To Kill a Mockingbird on TV, including the immortal moment when everyone stands and the old black man says to Scout, "Miss Jean Louise, stand up. Your father's passing."

I am passing gas.

I am also passing through the contrast from yesterday's test.

Therefore, this morning, the doctor passed on the surgery option.

You read right. No surgery today. Hopefully no surgery at all.

The doctor said that my study looked normal. He even showed us the images. Neither he nor the radiologist nor I could see any dilation. Combined with me passing gas and contrast out of my system, he felt like surgery was not necessary for fear of opening me up, running his hands all over my intestines, and finding zilch. We're kind of relieved, since the surgery is a big deal, but also a little nervous that the food trial will yield the same result as last time. We'll take it slow, though, and pray that everything works fine.

Is this what we've been waiting and begging for? After months of prayer coming back seemingly answered with a 'no' or 'not yet', is God saying yes? The only thing that could have stopped the surgery was a clean study, and that's what I got. Will this last, or will it be only a moment of triumph? I don't know, but I'm going to flood God's inbox with e-mails asking that this be the end of my complications. So to speak. I hope you will do the same.

This, too, shall pass.

Pray for:

Successful food trial (no more need for hospitalizations or surgery)

Safe travels for Ashley (who is going back to school for a few days to pick up some much-needed clinical hours)

My release from the hospital by Easter

and thank God that I won't be in surgery in 4 hours as was thought.

The Surgical Option

2010-03-29T20:20:00.000-07:00

After 2 weeks of trying to get rid of the bowel obstruction with NPO and an NG tube, it looks like this obstruction won't move without some surgical help. McGreeky ordered a test to be done today, but the resident who put the order in the system put the wrong order in. So, Dan had a GI test that showed part of his bowels, but not the part that is obstructed! I tried to convince the radiologist that McGreeky wanted something else, but he wouldn't budge. Of course, when McGreeky paid them a visit in radiology he changed his tune.

So, we're now waiting for the real test he wanted to be finished. The surgeon really wanted to make sure Dan needs this surgery before doing it, but he is fairly positive that he'll be operating tomorrow. The surgery is scheduled for 3pm tomorrow...but it could go earlier or later depending on the other cases in the OR. Basically, all we know is that sometime tomorrow Dan is having surgery. Considering his last operation took 15 hours, we're thinking this one should be shorter. :)

Prayer is certainly necessary. It is not a complicated surgery, but there are all sorts of things that they could find or that could happen. Obviously, we have no control over that at this point, but we can pray to the One who does have control.

Look for updates tomorrow.

Prayer Requests:
* A safe and successful short surgery...with no complications
* Rapid recovery...with no complications
* Wisdom and skill for the surgeons
* Ability for Dan to eat normal food from here on out without pain or problems
* Peace for the family and me
* Ability for Dan to come home with me very soon
* A night of rest
* NO COMPLICATIONS

Tentative Tuesday

2010-03-28T14:06:00.000-07:00

Not much has changed since yesterday. NG is still draining, bowel sounds are still present but quiet, and not much is passing through. On a good note, Dan's belly pain is gone (unless an unruly resident presses too hard).

McGreeky came in and told us he has put Dan on the tentative surgery schedule for Tuesday. He still doesn't want to do surgery, but feels like it's nearly inevitable. The final decision will be made after the results of Dan's GI study (he'll drink some contrast and they'll take x-rays every hour or so to see how far the contrast goes in the small bowel) are seen. The GI study i scheduled to start ASAP today or tomorrow morning, but radiology is pretty slow on Sundays.

We've been told the surgery isn't complicated, but will still involve a new incision in Dan's belly and risk of infection and more adhesions. To date, Dan hasn't had a surgery without complications before, so we're hoping this surgery will be the first quick-healing-no-complication-fix-the-problem-without-making-more-problems surgery.

Obviously, our prayer is that Dan wouldn't need surgery at all, but the requirement for that is for Dan's GI study to be "stone cold normal." Accordingly, that would only be in God's domain of healing. God is powerful and can heal Dan in a second, it's just a matter of whether or not that is in His will to do. We cannot coerce God to do anything, but we can plead and plead until He gets tired of hearing us and grants our request. As there are probably hundreds of people praying everywhere, I'm hoping God is getting close!

Today we wait. My parents are visiting after church to bring me some more food for my "hospital pantry" and just to say hello for a while. Otherwise, we just wait.

Prayer Request:
* Completely normal GI study showing complete resolution of obstruction
* No need for surgery...miraculously
* If surgery: no complications, no infection, no muscle problems, no digestion problems
* A week of healing and successful recovery
* Ability for Dan to go home with me very soon...and not return to the hospital for A LONG TIME
*Lots of encouraging and excellent news to report this week

Alrighty then

2010-03-27T14:59:00.000-07:00

After discussing it between ourselves, Ashley and I thought that surgery was a better option than trying to wait out my obstruction only to be obstructed again and need surgery. So we were going to wait for the doctor to come in and let him know how we felt. The only game-changer would be if my morning x-ray looked impeccable.

I did not get a lot of sleep last night. NG tubes do not let you get really comfortable. Just to let you know.

Well the doctor finally came in, fairly late since it was a weekend, and told us that the x-ray looked better, and that he didn't want to operate on someone who was passing gas and other things (that would be me). Well, so much for our opinion. After a long talk with him and him showing us the scans, we decided to give it 'til Monday like we had said last night. The biggest factor was his strong hesitation to do surgery. It is a big deal, and doesn't guarantee no complications. And especially for me in my condition, since I'm not in an ideal state for surgery, he wants to avoid it if possible, and he feels like there is objective data to go with his plan rather than a hunch, which is what our plan was based on. Hopefully this time, it will resolve with no surgery and will STAY that way. The interesting thing is, last night Ashley prayed that the doctor would be strongly opinionated one way or the other; though she was expecting him to be strongly for surgery. We'll see. We'll pray.

Please join us in praying for:

resolution of the obstruction with no surgery (quickly!)

NG out soon and eating soon (as is safe)

wisdom for the doctors

out of the hospital soon, at least by Easter

no more complications EVER

What next?

2010-03-26T20:31:00.000-07:00

McGreeky and the team came in a little while ago with CT results. The obstruction is definitely back and not resolving well. Though the doctor doesn't want to have to do surgery, but he feels that the odds of the obstruction healing on its own are getting much smaller. His gut feeling (pun?) is that surgery will be necessary. He's going to do an x-ray in the morning to see how things compare to today, but he is willing to wait until early next week to make a decision.

After they left, Dan and I talked about what he wants. It seems as though we are simply postponing the inevitable. Dan could start to feel better and look better, but the last time that happened, we were surprised by a re-obstruction. Our fear is that that will happen again or that we will always be on the look-out for a recurrence of the obstruction. Dan's life has been put on hold for quite a while now, and he (we) would really like to work toward healing finally.

The surgery is not without lots of risk, especially considering Dan's state of health. It would be a separate incision to reach the distal part of the small bowel. It could be a simple surgery (removal of adhesions or whatever is blocking the bowel) or it could be complicated (resection of any part of the bowel that has become injured or has died). Those things will not be known until surgery has already begun. Additionally, surgeries involving the bowel could cause more adhesions and obstructions. Then, there are the normal surgery risks: infection, pain, malnutrition, etc.

Dan and I need a lot of prayer tonight to help us make a good decision. If surgery has to be done, we would rather it be done tomorrow rather than next week. Yet, there is no way to know whether or not surgery is absolutely necessary. Dan made the point that God could heal him and end this situation, but how long do we wait on God for a miracle? Perhaps, the healing we are seeking from God is coming through the hands of a surgeon. We really don't know.

Please pray that God will be very clear with us. Pray that the surgeon will stew on the situation tonight and make a firm recommendation in the morning. Pray that if surgery is required, it will be successful and the recovery would be smooth this time. Pray that we stay in the safest place in the world: God's will.

Stay tuned. The next few days may be more exciting than we would like.

Second opinion

2010-03-26T11:07:00.000-07:00

The gastroenterologist walked in while we were watching Grey's Anatomy (Dan's uncle was on it again last night!). He and the team did a brief history and exam and then gave their opinion...the agree with what McGreeky is doing. It's nice to know that the second opinion is the exact same as the doctor we've been trusting so far.

Basically, the GI doc said it is completely the surgery team's decision regarding surgery. Some people heal and get passed obstructions without surgery, some do not. Looking at Dan's last CT, this doc was almost certain that this is not a medical issue (not paralysis of the stomach or bowels) and could not be fixed with any medications they could prescribe. Accordingly, he feels Dan is best taken care of by the surgical team. He will join McGreeky in looking at today's CT, but feels confident they will concur.

Dan's still working on the CT contrast. Pretty much a champ. After he finishes, he will wait for 90 minutes or so before getting the CT. This will allow the contrast to work its way through his intestines to give the docs the best picture.

Perhaps, this is a 3 update day.

Keep praying!

Out of control

2010-03-26T09:23:00.000-07:00

The night went smoothly. We both slept, though I had to get the NG running every now and again. It hasn't put out much since last night, which is encouraging. Some of the belly pain has persisted, but it's gotten better.

McGreeky came in and said he had been expecting to operate on Dan today. Then, he looked at the x-ray from last night and was pleasantly surprised. The bowels are slightly distended, but there is air in the colon, which means things are still getting through. My favorite part of the conversation: McGreeky asked if Dan was passing gas, and Dan answered by doing so in his presence. Ha. (Hospital humor). At this point, the surgeon still doesn't think surgery is necessary. Though, he has warned us that if another trial of NG suction doesn't resolve the obstruction, surgery will be warranted.

Dan is currently giving himself contrast through the NG in preparation for the CT. So long as the CT shows improvement, we wait. Otherwise, this may be a bigger weekend than we would like. Also, the gastroenterologist is coming in eventually (possibly after the CT) to throw his advice in. We're not expecting anything different from the new doctor, but I suppose it won't hurt matters.

This will be another two-update day, though I am hoping the next update is nothing more than "things are looking better." We are definitely not in control of the situation, though God is.

Prayer Requests:
* Complete resolution of bowel obstruction without the need for surgery
* Encouraging news on the CT scan
* Wisdom for the doctors (McGreeky and GI guy)
* Bowel movements and passing of gas (such a weird thing to pray for, I know)
* Disappearance of belly pain
* Ability for Dan and I to celebrate Easter at home
* Peace and confidence in God's control

NG 2

2010-03-25T23:09:00.000-07:00

Two updates in one day? That hasn't happened in a while. Today it is necessary.

Last night was awful. Thanks to exhaustion and 4mg of morphine, Dan slept until almost 1pm this afternoon. He obviously needed the rest. When he finally got up and moving, his pain kept him from walking around much. The belly pain got better as the day went on, but never really went away. The two meds he got put on ended up making him sick...so, we got the doctor to ditch those. We also convinced the doctor to order an x-ray for tonight instead of waiting for the morning. As we explained to McGreeky how Dan's symptoms had progressed throughout the day, he agreed with our thought that this was his obstruction returning. Accordingly, he wanted to get a jump-start on taking care of the problem.

While we waited, Jamie made a surprise visit since she was taking the exchange students to San Francisco. She brought us fruit and gifts from Israel. Very fun!

Unfortunately, the x-ray did warrant some concern. As the on-call resident is quite busy tonight, the only detail we got on the results was that his abdomen looks a little distended and the team wants to decompress the bowels before any obstruction gets worse. So, Dan got his 2nd NG tube inserted about an hour ago. The nurse was awesome and made the experience much less traumatic than the previous NG placement by the resident. We're awaiting x-ray confirmation of proper placement before Dan gets hooked up to suction again. Hopefully, this NG won't need to be in place as long as the last.

Luckily, Dan isn't feeling too bad tonight. Before the NG got placed, his nausea and pain were very minimal and sometimes, not even there. Perhaps, this will mean a quicker resolution of the obstruction, as the doctors caught it early. On the other hand, McGreeky is going to be even more cautious regarding advancing Dan's diet. Surgery is what we want to avoid.

Tomorrow, the plan is for a gastroenterologist to take a look at Dan's case (at McGreeky's request) to make sure nothing is being missed in his care. Also, Dan will have a CT to see the extent of this obstruction. Hopefully, by tomorrow evening we will have a more solid plan for Dan.

Let it be known, I have never seen a patient endure so much, have so many setbacks and still find the resolve to laugh and smile. Dan is honestly the most amazing man I have ever met, and no, I am not biased.

Prayer Requests:
* Complete resolution of obstruction without need for surgery
* Wisdom for the doctors
* Encouraging news from the CT
* Passing of gas very soon
* Short period of NG necessity
* Comfort and rest for Dan (despite NG)
* Wisdom for me to know when to go to school
* Ability for Dan and I to celebrate Easter at HOME

Back up

2010-03-25T08:46:00.000-07:00

Approximately an hour after Dan blogged last night, we figured out something was going wrong.

His belly pain was coming back, his stomach felt full and he just couldn't comfortable. Over the course of a couple hours, Dan was vomiting and having terrible back and abdominal pain. The on-call doc got paged, she ordered an x-ray and checked him out. The x-ray came back mostly normal, though all his intestines looked a tiny bit distressed (mild ileus). The pain got worse and since the resident had ordered oral pain meds, he threw up any relief he might get. We called the nurse again, she saw how sweaty and miserable he was and came back with a large dose of morphine. Since then, Dan has been mainly sleeping. It was a terrible night.

This morning, McGreeky came in looking pretty disappointed, but not as much as Dan. He said it looked like the solid foods were a little much for his intestines and pushing it anymore could result in another obstruction. He wants to give the bowels a break today...thus, back to NPO and TPN. Dan was relieved that an NG isn't necessary today, though it's always a possibility if this continues. McGreeky and the team are pretty sure this isn't another obstruction but just distress on the bowels. He'll be starting Dan on a couple new meds (Reglan and erythromycin) to help the GI system get moving again, but we have to monitor him carefully. If he does have an obstruction, these meds would make it worse. If no obstruction, they help the situation. We're always walking a fine line here.

Dan will be watched today and if the pain continues, will have a CT tomorrow to make sure nothing is out of place. Additionally, the pain he is having in his back could be related to his pancreas, so he'll be having some extra labs to rule out pancreatitis.

This time yesterday, McGreeky said Dan could have his PICC removed and go home today as long as food stayed settled all day. Now, we're back to having no clue when discharge will be. As frustrating and disappointing as this is, I'm just glad it happened before we left the hospital. McGreeky told us that most obstruction patients go home when they can tolerate liquids, but with Dan, he wanted to be extra cautious and watch him progress through solids. Thank goodness, he decided to keep him a little longer than normal.

So, now we back up and wait a while. This could be only a set back of a day or two, or this could keep Dan here a lot longer. Only God knows what is in store for us.

After one of the best days we've had since January, that was one of the worst nights on record.

Prayer Requests:
* Dan's bowels calm down and do not become obstructed again
* That this is simply a matter of eating too much too soon
* That the meds help
* No more pain
* No need for more invasive procedures (NG, surgery, etc)
* Ability for Dan to be able to progress through a diet again soon
* Home for Easter (only a week or so away!)
* Creative clinical hours for me to make up this week
* Total healing for good!
* NO MORE COMPLICATIONS

More good news!

2010-03-24T19:21:00.000-07:00

So two days ago I gave some good news: that I ditched my NG tube and was starting to eat. Well... things went well sipping, so I thought I would get upgraded to clear liquids (not just sipping). Wrong.

I got upgraded to full liquids, which is one step above. Hot dog. That's not what I ate; I had creamy soups and ice cream. Anyway, that went well, so today I went on regular diet. I mean... !

So that was nice to eat real foods. That has been going pretty well. I still have to remind myself not to eat too much. It's also been nice because they're holding off on the TPN tonight (to let me get more hungry) and they've also canceled my IV fluids, so I am currently wireless. Oh yeah.

If things keep going well while I'm eating, then I have no more reason to be here. Which means I get to go home. Oh yeah! So hopefully that will be soon.

Ashley got back last night and it was really good to be with her again. I got to kiss her for the first time in a while now that my NG tube was out, and it's really nice to cuddle with her on my bed. But it'd be nicer to cuddle with her on our couch. Soon. For now though, she's dealing with some belly pain that's just annoying.

Please pray for the following:

Food to go down well

Reduction/Elimination of Ashley's belly pain

Soon discharge from the hospital

Wisdom for doctors

Good news is good, you betcha

2010-03-22T15:21:00.000-07:00

I like good news. Get ready for some.

There was zero drainage in my gravity-induced bag and my x-ray looked good, so this morning the doctor pulled out my NG tube! At first, my nose was extremely confused. My throat hurt a little bit, but that only lasted a while. I feel SO much better now. As of now, my new diet is sipping on clear liquids. If that goes well (which it is so far), I can drop the 'sipping' part. And advance as possible after that. It feels good to taste things again, and also to not be confined by my nose. Pray that things continue to go well!

Ashley is back at school. It's sad that she wasn't here for the gloriousness of the NG being removed, but there will be plenty more good times for us to share in the future. Unfortunately, tonight she is headed to the ER to check out some belly pain that has been off and on in the past months. Pray that nothing is wrong with her so she can make her scheduled flight on Tuesday night.

Well, I need to go because the battery's dying and I'm due for a walk around the unit. Keep praying-- I am encouraged by all of your prayers. Hopefully tomorrow I can give some more good news.

:) /\ |\|

Patience

2010-03-21T09:24:00.000-07:00

So, we didn't blog yesterday. I was busy writing a paper all day, and Dan didn't really feel like it. However, don't feel like you missed a lot.

Dan had an x-ray yesterday and it looked a little better than the previous one. McGreeky came in and told us that a few loops of the bowel are still distended, but that the distention is decreasing (Thurs: 6cm diameter, Sat: 4 cm, Normal: less than 3cm). The obstruction is still there, but hopefully it is beginning to resolve. When we asked about what the obstruction is, McGreeky said there is really no way to tell just from a CT. However, the main options are still surgical adhesions or an internal hernia. Regardless, the plan of care remains the same: wait patiently for as long as possible. Though the obstruction could be fixed through surgery, Dan is not a good surgical candidate right now. Accordingly, McGreeky (and the other surgeons consulted) do not want to be hasty about making this a surgical issue.

(My blogging was interrupted by a victorious Dan announcing the passing of gas! Normally, we wouldn't post this, but it has been a prayer request. So, that means this is a praise!)

The NG drainage is still a lot, but is thin and light which encourages the doctors.

(My blogging is again interrupted by the doctors coming in.)

Between the NG output being light and the passing of gas, McGreeky has decided to put the NG to gravity with a drainage bag for a day to see how Dan does. If he can stay the day without being nauseous or vomiting, they'll start giving him fluids tomorrow. If not, they'll put the NG back to suction for a couple days. Once the diet keeps advancing, it will be the true test to make sure Dan can tolerate the food and that the food goes all the way through the system. An x-ray tomorrow will determine whether or not the NG gets pulled all the way out. So, it's a big day tomorrow.

I am unfortunately leaving for school today and won't be back until Tuesday night. Hopefully, I will be missing some exciting events so that when I get back, Dan will be eating a bit. It will be nice to get some school work done and to gather more clean clothes from home. It will be even nicer to get back to a happier, healthier Dan!

Luckily, Dan is able to talk better with the NG tube, so he can communicate to the nurses without me around. Also, he knows the signs to alert the nurses to quickly. He's a smart guy, so I trust he will be intelligent about his care. He wants himself to get better even more than I want him to get better! Though, somethings will be more difficult without me here--washing up, motivation to walk around, asking questions of the doctors, and remembering what the doctor says. It really isn't a matter of preference for Dan to want me here, it is actually very helpful for both the doctors and my husband. Sure, we can be apart when necessary, but when my professors are working with me so patiently and ensuring my graduation, why wouldn't I want to be with Dan?

Anyway, this has the potential to be a very exciting day or a very disappointing day depending upon what happens with Dan's GI system. We are hoping and praying this is indeed the turning point for Dan's recovery.

Prayer Requests:
* Complete resolution of the obstruction without the need for surgery
* Continuation of passing gas, bowel sounds, etc.
* No further complications!
* No nausea or vomiting or increased belly pain
* Safe travels for me (and the girls driving me down to school
* Peace and confidence in the doctors for Bob and Jamie
* Wisdom for the doctors to watch the progression
* Successful food trial this week
* Ability for Dan to come home with me very soon!
* Good news and encouragement for the rest of this hospital stay...may it be short!

Stuck

2010-03-19T18:55:00.000-07:00

Things that prompted this title:

The NG tube stuck up my nose

The fact that I am stuck to the wall when the NG suction is on

Sometimes my NG tube gets stuck because of all the mucus

The fact that I am stuck in the hospital, with little progress

ESPN is stuck on March Madness right now

My bowels are stuck

I am really not a fan of this time. Not counting follow-up appointments, I have spent 41 days in a hospital this year, or 52.6%. And still, I wait. With a tube up my nose.

Granted, there is so much to be thankful for. I have made a lot of progress on other areas physically, but it's so easily masked by another setback that puts me in the hospital and not even able to eat the little cups of jello and drink the plain chicken broth. At least I get ice.

Before Ashley and I got a private room, I was in a shared room, and had 3 different roommates. The first was a guy with no legs who got transferred to a different floor and was later discharged. The second was a younger post-op who went home like the next day. Both complained about the food (because it is popular to complain about airplane and hospital food--I will never complain about either ever again). At least I have legs, right? My third roommate was an old Indian chap who was able to eat, but slowly. His wife and family were extremely nice and I felt really bad that I had to transfer out while rooming with him, for fear of seeming like we didn't like them. Whenever I walk by my old room, if I see them, I wave, and they wave back like I was part of their family too. They remind me of my Indian neighbors back at Biola. How I wish to see them again and eat their yummy chicken.

But really, I'm not obsessed with food. I think. The point is, 52.6% is too much. 41 days is too much. I'm done. I want to get on with my life and be normal again. I haven't taken a regular shower since January. I want to eat a home-cooked meal by my wife and gain weight and muscle mass back. I want to be at home for more than 2 weeks at a time and be with my friends and church family. And hopefully, I will soon. I'm hopeful that this will pass (and praying for it to not be surgically-induced). I'm praying that this will be the last complication, even for the upcoming second surgery in June. I've been on this ride too long, and it's time to get off. But wouldn't you know it, I'm stuck. Which is why I need God's help getting out. May He have mercy on my body.

Patient's Progress

2010-03-18T11:11:00.000-07:00

Drum roll please...not much going on.

Dan is feeling a little better with more energy from the TPN. The morning has included getting cleaned up and an abdominal x-ray, which took forever because of radiology students.
Somehow, when Dan was here for a month, he only had one nursing student for part of a day. In just these past few days, he has had 2 nursing students (SN), a med student and radiology students. Good grief. Being a nursing student, I know we need to be nice and understanding since they are learning. Yet, I am also more aware of mistakes...(like dumping the NG canister down the toilet and never recording the output, causing the doc to think great strides were being made when nothing has happened). Today's SN is much better than last night's and has been very accommodating. What's more, she's not nervous and performs her tasks efficiently and well. Phew.

McGreeky came in twice this morning: once he was very excited because the intake/output record showed a very low NG output from yesterday and again with the x-ray results. After I explained the SN's mistake last night, he seemed a little disappointed. The x-ray showed not a lot of progress since Tuesday--maybe 20% more open. At this rate, Dan will be here for a LONG time. McGreeky told us we had to have patience and added a note of encouragement when he saw the look on my face that told him we have more patience than he does (patients, ha). He also reminded us that the possibility of surgery remains in the back of his mind.

Anyway, we're going to be up and walking a lot today to encourage his bowel to get past this obstruction. At this point, it looks as though Dan will have the NG for more than 3 days, which is not making him happy. The overarching goal: bowel sounds and passing gas. Seriously, without those...he's stuck here.

On the note of being stuck, I'm beginning to feel a little stuck myself. School is on break this week, but will resume next week. Dan feels pretty helpless since he is attached to the wall with the NG and has asked me to stay even if it means missing school. He hasn't asked that of me before, so I know he is serious. I have a lot of school work I can get done here (papers, readings, research, etc.), but there are some things I cannot make up while here. I'm becoming concerned that the grace my professors have given me is stretching a little thin. In the end, I know I need to choose Dan over school (and will), I just hope that doesn't prevent me from finishing school.

Speaking of school, I better start writing some papers!

Prayer Requests:
* Complete resolution of bowel obstruction with the need for surgery
* Quicker rate of progress (10% a day is too slow!)
* BOWEL SOUNDS AND GAS!!!
* Decreased NG output (less than a liter/day)
* No complications or further problems
* Wisdom for the doctors
* Wisdom for my decisions regarding school
* Ability for Dan to come home with me very very soon

Third time's the (Lucky) charm?

2010-03-17T11:29:00.000-07:00

For the third time in 2 years, Dan got a PICC line placed today. Somehow, he got to the top of the PICC nurse's list, which means he'll be able to get TPN tonight. After a week of not eating (and losing 10 more pounds), some solid nutrition will do his body well. He has no energy and is pretty apathetic about getting out of bed. Such a bummer.

McGreeky came by this morning and reminded us that this is a "waiting game." Yes, we know, sir. The NG tube drained about 2 liters yesterday, which is still a lot. Additionally, Dan's belly pain has returned here and there. The surgeon says that is his bowels trying to overcome the obstruction. He doubts the blockage has changed much in the past day -- for good or worse. McGreeky might rethink the x-ray tomorrow if the NG keeps putting out so much fluid. So, now we just wait.

In other news, today is one of my favorite holidays...St. Patrick's Day! Of course, as a good (mainly) Irish lass, I enjoy the celebration of my heritage. Yet, I also find excitement in this day because it is celebrating a missionary! St. Patrick spread the Gospel using culturally relevant object lessons and stories--allowing the good news of Christ to permeat Ireland. Makes one wonder how many pubs full of people slamming pints tonight actually know what they are celebrating!

Usually, I make Irish soda bread on St. Patty's Day and watch The Quiet Man (classic John Wayne film that takes place in Ireland) to celebrate. As we are stuck in the hospital again, no soda bread will get baked today. Also, my movie is 500 miles away from me, so we had to switch to another great Irish movie: Waking Ned Devine (hilarious). I even forgot something green to wear, so I'm making due with a lime-green head band I found in my backpack. It'll have to do.

I hope everyone has a wonderful St. Patrick's Day and remembers what the day really is about...God working through a man to reach people for Christ. Though celebrating Irishness with a Guiness, corned beef and cabbage or wearing shamrocks is quite fun, too!

“Before I was humiliated I was like a stone that lies in deep mud, and He who is mighty came and in His compassion raised me up and exalted me very high and placed me on the top of the wall. What is more, let anyone laugh and taunt if he so wishes. I am not keeping silent, nor am I hiding the signs and wonders that were shown to me by the Lord many years before they happened, [he] who knew everything, even before the beginning of time.” ~ St. Patrick

Prayer Requests:
* Complete resolution of bowel obstruction without the need for surgery
* Miraculously quick healing of the obstruction
* Positive signs by today or tomorrow: bowel sounds, gas, etc.
* Improved nutrition status with TPN
* Quality rest for both of us
* Wisdom for the doctors
* My ability to get school work done in such a distracting situation
* Dan's ability to come home with me very soon
* Normalcy and a long period of good health in the near future!

And, here we go again.

2010-03-16T19:33:00.000-07:00

McGreeky came in around 7pm to let us know the results of the CT. It definitely showed a bowel obstruction in the distal small bowel. Fortunately, is a partial obstruction meaning some fluid is still getting past the blockage. However, it is a very small amount. The doctor could only give a well-educated guess about how long it would take to resolve and threw out the number 3-4 days (at least). Dan will have the NG tube at least 3 days, which he is thoroughly unhappy about. He will have an x-ray on Thursday to see if there is any change in the blockage. We will also be watching for warning signs indicating worsening of the situation: increase in white blood cell count (WBC), fever, low urine output, abdominal pain, no bowel sounds or movements in the next few days. If these things happen, this problem may need to be surgically fixed. McGreeky said he is dragging his heels to avoid another surgery, but it is still a possibility. Surgery carries many risks, especially when Dan is already sick.

Unfortunately, we are embarking upon another "wait and see" type of journey. There really is no way to tell how long this will take to resolve. It's quite a bummer for all of us, but especially Dan.

Dan will be getting a PICC tomorrow (hopefully) or the next day for TPN. We asked the doctor to start him off with lots of calories to make sure he gets some heavy duty nutrition after so many days of nothing. We're hoping this PICC is definitely not needed for too long, as Dan should be able to eat normally after this resolves. We don't really know if he'll go home with TPN again, but I won't mind mixing to keep him "fat and happy".

Our lives have been seemingly put on hold since January 8th, and we are so ready to move past this. Dan misses how he used to be and I do, too. We need a little "us" time that doesn't involve meds and tubes and nurses and doctors and fevers and hospitals. We'll get through this, but we are weary and in need of joy and encouragement and normalcy.

Please be in prayer that something McGreeky said will be accidentally prophetic: "You'll have that NG for at least 3 days and be here a while unless something miraculous happens and the bowel opens up very quickly." So, pray for something miraculous! Pray that Dan's bowel opens up and the obstruction resolves very quickly...bowel sounds appear, gas gets passed, etc. Let 3-4 days be more than enough time for Dan to heal. Wouldn't it be great to point out to McGreeky that something miraculous did happen due to the prayers of the saints?

Prayer Requests:
* Complete resolution of bowel obstruction without surgery
* Miraculous speed of healing...which can only be attributed to God's hand
* PICC placement tomorrow
* Bowel sounds, movements, etc. in the next day or two
* None of the "warning signs"
* Comfort and rest for Dan
* Wisdom for the doctors
* Ability for me to stay with Dan throughout his healing
* Encouraging and joyous news in the next couple days
* Ability for me to get all of my school work and clinical hours completed for graduation (it's getting pretty tight)

Yucky stuff

2010-03-16T11:19:00.000-07:00

Last night was pretty miserable. The NG did its job and drained nearly a liter from Dan's belly...that's a lot considering he threw up 1.5 liters already! Yet, as effective as it was, it also kept Dan awake because it kept triggering his gag reflex. A couple doses of Benadryl were in order just to keep him comfortable and sleepy. Then, we had a little scare when his pulse was running in the 150-160s. An EKG proved it was just the NG physiologically and psychologically speeding up his heart rate. After a bolus of fluid and some sleep, it's running in a normal range now.

At the moment, we are awaiting the CT. Dan has to have the contrast fluid pushed through his NG. Might be easier than drinking it, but it still fills up his belly too much. The CT will show how severe the obstruction is and what is needed to fix it.

When McGreeky came in this morning, he said he was putting in the orders for a PICC tomorrow due to how much fluid the NG was emptying. He believes this might take a while to resolve and doesn't want to Dan to keep going without nutrition. So, hopefully, by tomorrow night, Dan will have some TPN to get him going again. As this is another waiting game, none of us are sure how long he'll be on TPN this time. I guess it's nice to already know how to administer it at home, though.

I'm pretty nervous about the CT as it could mean more surgery. I just wish this would have been caught at one of the trips to the ER or at the follow-up appointment with McGreeky. (Oh, if wishes and wants were candies and nuts...I actually don't remember the end of that saying.) Honestly, I think McGreeky is a little nervous, too.

Alright, back to spending time with Dan. He has to keep this contrast down so the CT will show what it needs to. We cannot wait until he can eat and drink like normal again. Oh, and no more hospital stays. Good grief.

I will update this after we hear CT results.

Prayer Requests:
* CT that shows only a simple bowel obstruction (no twisted or strangulated bowel)
* No need for surgery to resolve the obstruction
* Quick and complete healing
* Smooth PICC placement tomorrow and starting of TPN by tomorrow night
* Understanding doctors and nurses
* Wisdom for the doctors
* Encouraging news today
* Comfort for Dan--he hates the NG tube

The Culprit

2010-03-15T22:12:00.000-07:00

About 3 hours ago, I saw McGreeky walk in the room with the resident. Let's just say he has a terrible poker face.

Apparently the GI study Dan had today showed that he has a bowel obstruction (blockage). At this point, they aren't sure whether it is from surgical scarring (99% chance) or some other cause. A CT will be done tomorrow to get a better view of exactly how severe the obstruction is and exactly where it is. If it is from adhesions (scarring), it will most likely resolve on its own. There is a small possibility, however, that Dan will need another surgery to get rid of the obstruction.

The resident came in about 2 hours ago and placed an NG tube (through the nose to the belly) to help rid his GI tract of fluids and such. This will alleviate pressure on the bowels and help the obstruction to resolve. The NG placement was horrible, but very necessary. Over a liter of fluid has been emptied from his belly so far. Additionally, the pain that woke him up last Wednesday...gone.

So, we now know what the culprit is behind the nausea, vomiting and pain. Hopefully, it will resolve quickly without surgery. Dan will be NPO (nothing to eat or drink) with the NG until he can pass gas and bowel sounds return. That could take anywhere from 1 day to several. The CT tomorrow will be compared with the GI study x-rays from today to see how much improvement the NG tube has made. As the obstruction hasn't been visualized yet, the surgeon is hoping for the best but preparing us for whatever needs to be done.

Along with all of this, McGreeky has decided that we are done with the wound vac...for good. The wound is healing nicely, and is too small to need the vac. This would be very exciting news, but it is overshadowed with the terrible NG tube and the unknown concerns of the obstruction.

I have hidden myself away under the window ledge on a fold-out chair to update everyone. Dan seems to finally be asleep with the help of some Benadryl. Due to the nature of an NG tube, his gag reflex is triggered almost constantly until it gets used to the foreign tube. It will make Dan feel better in the long run, but he is positively miserable right now. I hope the next nurse lets him sleep. And leaves me alone, too.

All we ask right now is pray pray pray.

Prayer Requests:
* Complete resolution of the bowel obstruction without surgery
* Calming of Dan's gag reflex so he can be more comfortable
* Rest for both of us tonight
* Encouraging news from the CT tomorrow
* Grace for the doctors...they missed this at two hospitals and must feel crummy
* Peace and hope for Dan and I (and Bob and Jamie in Israel)
* Ability for me to stay with Dan throughout this ordeal (still no private room and no car)

Back on E3

2010-03-15T09:15:00.000-07:00

The decision was made on Saturday night to transfer Dan up here because he just wasn't keeping anything down. Dan felt so weak and tired that he called and asked about going back on TPN. McGreeky said no for now, but told us to get Dan up to Stanford for more testing. It was getting too difficult to be around doctors who weren't sure about Dan's history (and new anatomy).

So, Dan got out of PIH...and got admitted to Stanford again. Our wonderful friends (Lise and Andrew) drove us up yesterday afternoon, and Dan got admitted to the floor he was on after his surgery. It's nice to know all the nurses and the staff. We don't have to play phone tag with McGreeky anymore--he just comes to visit in the mornings.

Dan is feeling a little better today. He had more energy yesterday and only threw up twice. He actually made it the whole car ride feeling fine! Since he threw up at midnight, he's NPO for more testing. He'll be having a GI study (he'll drink a contrast fluid while a radiologist takes x-rays to make sure his GI system is working appropriately--that food is going from his mouth through his stomach through his intestines and out) later this afternoon. If that comes out clear, he'll have another CT to make sure nothing is going on there.

McGreeky really does think this is just a bump in the road and that it will resolve itself. It doesn't make sense to him that he could be eating fine for 10 days and then his GI system would stop working. Luckily, though, he's willing to do all the testing necessary to ensure Dan's health. Hopefully, Dan will be able to hold more food down today or tomorrow. That will be the true test and will help avoid Dan getting another PICC for TPN.

Of note, also, Dan is supposed to be undergoing an embolization procedure this week. It will shunt blood to the left lobe of his liver to help it regenerate faster and to help the right side to atrophy before the next surgery. This was supposed to be an outpatient procedure scheduled for Friday, but I guess since Dan is here they might do it sooner. We'll see.

For now, I'm doing homework and trying to stay caught up on school. My professors came to visit on Saturday night at PIH and were very encouraging. I might have to scramble a bit at the end of the semester, but I'm caught up for now.

Please be praying for during this time. Also, pray for Jamie and Bob who are in Israel right now. I'm sure they are having a difficult time watching from afar, but hopefully they know we have a lot of help and support of here in the States.

Prayer Requests:
* Clear CT and GI study--proof that everything is working appropriately
* Dan's ability to hold down food and drink
* Wisdom for the doctors
* No more vomiting!
* Successful and safe embolization procedure
* Ability for us to go home to La Mirada very soon...this week :)
* Ability for me to be able to stay with Dan here at Stanford the whole time (It's not a private room, but we're on the list. Dan just feels a lot better when I'm here through the night. Also, I don't have a car to drive myself anywhere this time!)

Turning a corner?

2010-03-12T11:28:00.000-08:00

So, the last blog was happy. This blog is crappy. Just so you don't get caught unaware.

Dan was feeling great up until early Wednesday morning when he woke up with abdominal pain. After waiting for a bit for it to recede, he began throwing up. So, we went to the ER where they did a CT and labs. The CT looked great, showing no obstructions, no fluid collections...nothing to be causing the pain. After the ER doc called McGreeky, they decided to just make sure he could drink something and then send us on our way up to Stanford as planned.

By 10am Wednesday, we were back at the apartment and Dan was starting to realize that he couldn't really eat much. I went to clinical for a few hours, came home, packed and then we headed up north.

We stayed Wednesday night with the Sizeloves and it was a miserable night. Dan threw up at least 6 or 7 times and could keep nothing down. The pain had also come back, so he couldn't sleep. We got up early and headed to see McGreeky. The appointment actually went well. The doc looked at the CT we brought with us and was very pleased. He could see nothing to be alarmed as far as the pain went. He pulled out Dan's last drain (yay!) and changed the wound vac, which will only be on for a couple more weeks. He told us to just wait out the pain and vomiting before getting too concerned. He gave Dan a prescription for anti-nausea meds and told us to call if anything happened.

We met my parents in SF for a little bit because Dan was feeling better. He drank some and looked better. By the time we left, though, he wasn't feeling good anymore. The drive down was miserable, with Dan throwing up pretty much everything he had drank all day. We called McGreeky again, who was confident that Dan's body is just readjusting to "new anatomy". He said to wait it out over the night and he'd call in the morning. I drove us home, we showered and went to bed.

The night was a little better with Dan only throwing up once this morning, though it was everything he had ingested. When the doc called, he said to wait until this afternoon to make a hospital decision. If Dan can keep some fluids down, he can wait this stomach thing out at home. If he cannot keep fluids down, we need to go to the ER for dehydration and another CT to make sure fluids are making it past the stomach and that there are no obstructions building up.
For now, Dan is playing video games and trying to stay distracted. He's had a half glass of water so far, and is feeling ok. I'm trying to straighten up the apartment and get my homework done without worrying too much.

It is good that the CT didn't show anything and that the drain is out. Those are very great things.

Yet, we are so tired. Dan especially needs to be able to eat and drink to build up the strength he has lost over the last couple months. After finally being able to live together again, this is such a discouraging event. We really need Dan to "turn a corner" for the better (as McGreeky would say).

For a week or so, good news was finding us. Now, it feels like good news is far off.

Please pray loudly that Dan will be able to avoid another hospital admission and just get better at home. Please.

Prayer Requests:
* No more vomiting
* Dan's ability to digest fluid and food today
* Disappearance of pain
* Another good CT (if he needs one)
* Rest for both of us
* Good news that sticks with us
* NO MORE COMPLICATIONS
* That Dan can continue to live down here with me in our home

Drain drain

2010-03-09T21:33:00.000-08:00

Hi everybody. It really has been a while, comparatively (because if you compare January on with everything before, it really hasn't been that long). Just wanted to give you an update since there is news.

Ash and I are leaving tomorrow to go to Stanford again. This Thursday could be my last appointment in a while (we're talking multiple weeks). It's really early, but the Sizelove family continues to be awesome and let us stay at their place. What will happen are a few things: the doctor will remove my last drain because it is not giving out much fluid at all, even though I'm eating full-time (YES), he will look at my wound, and we will discuss future options. I'm really excited to be done with drains. Like, really excited. It's starting to smell really bad and it's always been a pain to lug around and sleep next to and it's just time for it to go. My wound is healing, but still has a way to go. There's a little problem because the wound is a little small for the wound vac, which means that sometimes the sponge inside spills over onto my skin and really irritates it, so we go back to dressing it with gauze until it gets better and there's just a long cycle. Right now, we're being cautious with the skin and dressing it with gauze. As for future options, there is some kind of procedure planned for maybe a couple weeks. It's outpatient, so not too big. They want to cut off the blood supply to one side of my liver, so the tumor-less side has to work harder and therefore grow more, while the tumor-filled side will shrink. It was supposed to be done in the first surgery, but if you remember from the beginning, the surgery took 15 hours and there was no time.

Otherwise, things have been really good. We went to the store today and got some food that I'm excited about, and I ran into a teacher at the high school where I did my observation during the fall. I've been trying to get back into the swing of things around the apartment, like doing dishes and little things to help Ashley as she digs herself out of her homework mountain. I have also been playing a lot of football on my PS3, which is fun. And my parents have just gone to Israel for a couple weeks. Anyway, life is good. I'm eating. God is good. There's a lot of journey left for us, and we're going to be leaning on Him for the rest of it. Peace to you all.

Dan

Birthday fun

2010-03-05T09:19:00.001-08:00

So it's been a couple days since we've blogged--Ashley's been busy and I've been having too much fun doing other things. But don't worry, you didn't miss anything dramatic.

Things are really good. Wednesday was my 23rd birthday, and it was a good day. Lunch with my parents before they drove back up to Norcal, time alone with my wife, and a really fun game night with good friends. Yesterday, Ash was gone for a while at homeless clinic, so I played a lot of video games. When she got home, we got to spend some good alone time together and watch Jim and Pam from The Office have their baby.

I've been feeling better and better each day as I keep giving my body real food. My only real hindrance is my wound, which still interferes with my movement. But my wound looks better every time I see it, and it won't be too long before I'll be done with the wound vac. Right now, compared to weeks ago, it feels like drinking cold lemonade after being in the hot sun for hours. I'm so thankful that God has led me out of the sun, and I'm looking forward to healing even more.

Warning: blogs may become less frequent because there is less news. Maybe Ash will want to blog about things. We'll see.

Dan

Good news fills my stomach again

2010-03-02T13:34:00.000-08:00

Right now, I am sitting at a table in my parents' house in Lodi. I was discharged from the hospital today--tonight I will be at my apartment. God has once again turned mourning into dancing- well, except I still can't dance THAT much.

Last night, after watching The Express and finding out that it is one of my new favorite football movies (and if it's accurate, Ernie Davis and I had the same number in high school), I slept pretty well as far as hospitals go. I just got woken up by people who felt like they needed to check my levels or whatnot. Interestingly, my nurse was an E3 nurse (I stayed my month on E3) that I had had before. Anyway, eventually the doctor came in and said that things looked good, so I could go home. Also, since the last two aides who had come in to empty my drain did not do so because it was EMPTY (aka, the drains... are... stopping?), the doctor did not do the painful procedure of pulling my drain another inch, but instead said he'd like to remove it altogether in about a week! I am all for that.

Not so long ago, I was not eating, I had two drains that were pumping out much too much fluid, I had a PICC line, and I had a painful wound. Now, I am eating, I only have one drain and it's barely doing anything, the PICC is gone (freeing up my arms), and my wound is less painful. I thank God for finally turning this around.

So yeah, my parents and I are headed down to LA tonight. There was an issue with the antibiotics prescribed; they are apparently really expensive, so most insurances, including mine, don't cover it. So we're waiting on the doctor to either write up an approval statement or prescribe something else. We'll figure it out.

Anyway, I'm just very glad I can spend my birthday tomorrow with my wife. :)

Pray for:

my body to keep accepting food and be able to recover weight

insurance issues to pan out

safe travel

no more setbacks

thankfulness for all the good news

Flowers

2010-03-01T13:36:00.000-08:00

Looking out of Dan's window we can see the Garden Entrance to the hospital. As Spring is drawing near, the flowers are blooming beautifully. The colors are so cheerful that one cannot look at them without drawing some joy from the sight. Dan and I walked outside and the fragrance was amazing. (I'm wearing a little white flower on my shirt that smells so good, but I have no clue what kind it is!) I suppose the garden reminds me of God's goodness and beauty. Granted, He has allowed Dan (and lots of humanity) to suffer for His purposes. Yet, He is still good and working out good things in our lives.

I very much like the view out of this window, however, I will much prefer the view outside my apartment window when Dan is home with me. Which, by the looks of things today, will be on Wednesday :)

Dan began feeling dramatically better after a fluid bolus and antibiotics were started, not to mention eating. The night was alright, though neither of us got much sleep. Dan was able to keep his dinner down, which is a great thing.

The residents came in early and haphazardly redressed Dan's wound. (Dan stated that a boyscout could have done a better job). They gave us little news as it seemed we knew more of the plan than they did.

A couple hours later, Dan got some dilaudid and prepared for wound and drain care. The wound looked pretty good, but McGreeky decided the pull the sutures out to allow for less complicated healing. Dan said the wound vac doesn't hurt much at all today. Also, McGreeky pulled one drain completely out...OUT! Dan prepared for the worst as pulling on the drains usually hurts a tremendous amount, but he said pulling it all the way out wasn't bad at all. Strange, but good. The surgeon will pull the other one out a little more tomorrow morning, though it will be kept in as Dan continues to eat.

McGreeky told us that Dan's WBC count was 5.3--completely normal. We're still waiting on blood cultures to come back, but he's pretty sure the infection was in the PICC. He said Dan will likely get discharged tomorrow. Yay!

The plan is for Dan to spend the night Tuesday in Lodi and then to come home on Wednesday. Jamie will drive him halfway down and I'll drive up to meet her there. I really hope that plan works so Dan can celebrate his birthday at home with me!

I'm flying out this afternoon to Los Angeles to celebrate Lise's birthday and be back for a busy busy school day tomorrow. As my original flight got cancelled (such a bummer), I'm leaving a little earlier than planned. Hopefully, Dan has a good night without me around. Maybe some time to himself will be nice :)

Prayer Requests:
* Ability for Dan to be discharged tomorrow (no fevers, no complications, no scary labs, no suprises, etc.)
* Ability to keep eating and keep the food down.
* Resolution of infection and fever
* Continued healing of the wound
* Safe travels for me
* Birthday reunion in La Mirada on Wednesday!
* NO MORE COMPLICATIONS

Whoosh

2010-02-28T21:57:00.000-08:00

I'm in the hospital. How did I get here? I'll tell you.

The night I blogged last, I developed a fever in the 101 range. The next day, I called the doctor, and he said he wanted me to go to Stanford a day early for tests...

(Dan's hand hurts from the IV in it, so he passed the 'torch' to his wife)

The doctor basically laid out 3 options:

1. A CT shows a fluid collection or abscess and he would be admitted for that to be drained

2. A CT is clean, but the WBC count is high and he would be admitted for IV antibiotics

3. The CT is clean and the WBC count is in the normal range, so the culprit is the PICC. Pull

the PICC, send him home on antibiotics.

Since 2 of the 3 options resulted in Dan being hospitalized again, we decided to drive up north a day early, go to the Stanford ER and go from there. That way we could get the hospitalization started with earlier and hopefully ended earlier.

Jamie was wonderful and drove Dan and I from LA to Stanford last night. Dan slept in the front seat and I wrote a Bible paper in the backseat. I slept some, too, which proved a good thing as nights aren't always full of sleeping for us.

We arrived at the ER around 10am, right before the Sunday rush. McGreeky arrived fairly shortly after I got through the stringent security process (worse than the airport) to gain entrance into the ER. Because Dan was tachycardic (high heart rate), the doc said Dan would most certainly need to be hospitalized. All the labs got drawn, Dan started drinking the contrast, and we waited for his turn in the CT. By 2pm, Dan was back from CT and we had to just wait for results.

Amazingly, Dan got a phone call from McGreeky saying that the CT was "dry as a bone"--no fluid collection! So, that meant the PICC would be pulled, Dan would need to eat real food for nutrition and one drain will get pulled tomorrow. Unfortunately, the high WBC count and heart rate meant Dan would be admitted for IV antibiotics. McGreeky said Dan would probably be in the hospital for 48 hours. Only the Lord knows if he will stick by that time estimate. He might be a good surgeon, but he's a terrible estimator!

Dan got transferred to a new unit in the very old part of the hospital. It was a teeny semi-private room, but we figured we could make it work. Though I mentioned to a nurse that Dan has a really hard time at night and would be so much more comfortable with me in the room. I was merely hoping to be allowed to sit in a chair by his bed all night, instead she moved Dan to a recently vacated private room. Awesome!

So, here we sit watching the end of the Olympics in our little room. Dan looks a lot better after getting IV fluids, 3 doses of heavy duty antibiotics and being able to eat. He no longer has a PICC, so we just have to hope the eating can pick up soon and be successful. His fever was much lower this afternoon, but we don't know about now. Hopefully, we can both get some sleep tonight.

The plan for tomorrow is to pull out one drain completely, put the wound vac back on and keep pumping the meds. As long as things hold tight, hopefully Dan can get out of here very shortly after the 48 hour mark!

I will sleep here tonight and then fly back to LA tomorrow evening. My Tuesday classes and clinicals were just too crucial to miss this time. Then, depending on when Dan gets released, I will probably drive up on Wednesday after clinicals to help Dan celebrate his birthday. We would really love to celebrate by driving back to LA together!

Thank you for the prayers and support. Keep it up troops!

Prayer Requests:

* Resolution of the fever

* Continued healing of the wound

* Dan's ability to eat...and eat well without losing too much more weight

* Discharge in 48 hours!

* Dan being able to go home for his birthday on Wednesday

* No more complications

Expanding my Stomach

2010-02-26T14:13:00.000-08:00

Needless to say, I was pleasantly surprised when I received an e-mail from my doctor saying, 'start eating solid foods.' I'm still on TPN, and my stomach is really really small, so I can only nibble as of yet. But it is exciting to think 'I wish I could eat something' and then... eat something. I have to take it slow, but I'm hoping to expand my stomach (and hoping that my drains don't go crazy in the process). Also, I don't want to be overambitious with my eating and not be able to hold things down.

My fever's still hanging around, but at least it's still a low fever. The antibiotics should help. There's still a decent amount of pain in my life, but I'm starting to sleep a little better. I'm very tired of this. I'm ready to be done with it. I'm ready to be normal again. I'm ready to help my wife do things rather than her help me all the time.

I got a visit from the home health nurse today. She was very nice, though she probably won't be the one seeing me regularly. She was supposed to put the wound vac on, but since it's a very complicated wound, it needs a complicated dressing, which only a few nurses know. Anyway, someone is coming by later to put it on. It should help keep my wound from getting infected while it heals.

My friend Daniel is driving over from Riverside tomorrow to hang out and give me some 'man time'. It should be fun. We'll probably play Madden 10 on my PS3, which will be good since Daniel knows more about it and quite frankly, I'm losing faith in all the reviews that say it's the 'best Madden ever'. Graphics-wise, sure, it's very realistic (except for the weird running motion). But it seems like some of the better elements from previous games were taken out and replaced with worse things. Whatever.

Pray for:

Good eating and holding it down

Drain stoppage

Pain control

Good sleep

Less stress for Ashley

No more fever

Home at last ... hoping to stay

2010-02-24T21:51:00.000-08:00

Today, I drove down with my mom to LA so that I could finally live at my real home with my wife. It was a long drive, and it was a little uncomfortable at times, but we made it. I was surprised by our friends Sam and Titus blowing up balloons. Titus is 3. He picked out the balloons. There was way too much crap in the car, and it took a while to get everything put away, but we finally did it. Well, Ashley did it. She's hardcore like that. It was really good to see her again. I hope I can stay.

One of the things the doctor cautioned against as a possible deterrent to me going home was a fever. As luck would have it, last night I was putting up a high of 100.7. Ashley thought I wouldn't be able to come at all, but I called the doctor in the morning to make sure. He said it was ok, so long as my fever didn't break 101, where I might have to go to the hospital or back up north. He also put me on some antibiotics to try and combat whatever infection I might have. Hopefully, my fever will go away and I can stay here. As I type this, I'm at 99.5--still a fever but better than 100.

Some good news: the doctor wants to get me eating. I think he'd rather me not have a fever when that happens, so I'm not eating yet, but hopefully soon. I'm not sure how this will affect the drains; they are still putting out a lot. Who knows, maybe eating will stop the drains! Wishful thinking, but we're waiting and seeing. As usual.

It's really nice to just sit on the couch, just me and Ash. I've missed that. I can't wait until this is all over and we can just sit on the couch together.

Pray for:

drain stoppage

NO FEVER

staying home with Ash long-term

wound healing

being able to eat well

Sleep!

2010-02-23T16:05:00.000-08:00

Last night, I got to sleep extremely fast and only woke up once before 6 (when I had to take my blood sugar, which I am starting to hate. I'm not diabetic. It doesn't really surprise me what it is. Ugh). I woke up again at 8ish and fell back asleep and finally got up just before 11. Que bueno! I really needed that sleep. I might even get a little bit more. Except today, I'm going to try and start packing. Because I'm leaving tomorrow for LA. Booyah and Hallelujah!

I'm sitting here wearing my bags around my thigh. It's ok. They look a little like old-time ghetto leg pads like old football players or samurai would wear. One of them, the problem child, is being a problem child. After two emptyings, the problem child has given 275 ml. The good child in that same span: 37. So. We'll see whether I can eat or not tomorrow. I'm almost positive the doctor wants to see that number drop.

My wound is coming together, but it's a little messy. We can deal with it, but hopefully there won't be any big problems.

But good news: the home health agency we're using has everything all set up for us down in SoCal. It should be easier because they are close enough to my apartment to do the home health themselves (whereas this one was based in Hayward, too far from Lodi, forcing outsourcing) (rhyme time). And the woman I talked to on the phone was so energetic and happy! I will enjoy dealing with them, I think.

Keep praying for:

Drain stoppage

Wound healing

Safe drive to LA

Wise medical decisions

Continued sleep, thank you Lord!

Getting close

2010-02-22T16:34:00.000-08:00

Today my mom and I went to Stanford (Ash is back in LA for school). It was nice to have the doctor give some good news.

I had a CT scan to check for fluid buildup (you remember from last time that that is a bad thing). It was a long wait, and I felt like cacapupu because my wound was hurting and I had gotten very little sleep. Then I had to drink contrast (which tastes nasty) [sidenote: in the hospital I had drank it mixed in gatorade and it was not great, but they mixed it with water and it wasn't too bad. weird] ANYWAY the CT turned out great! I went back to the doctor right after the scan and he told me so. Then he switched my ugly gross grenades to sleek and sexy drainage bags I can strap to my thigh like a secret agent, and then he pulled on my drains for the second to last time (apparently they are right by the skin- hence 'getting close'). It hurt like crazy. I could barely take a step with my right leg. So I'm taking it easy right now.

So here's the plan: watch the drains to make sure they don't go crazy, and if they don't by Wednesday... EAT! I'm excited. I have an appointment next week, where he'll pull out (like, all the way out) one of my drains if everything goes well. The next week, he'll pull the other one out (if all goes well). Oh, did I mention I am free to go home? To La Mirada? Because I am! I just have to make sure the home health people have their ducks in a row (which they should), then my mom will drive me down, probably on Wednesday, and I'll be home and my mom will take care of some business at my grandma's house. So... yeah.

There are a couple hitches: my wound, which has been stitched up by my dad so it's almost all together, has some problems. a) it hurts more because the sutures are pulling on me, b) it's not coming together in exactly the right way, and c) it is more of an infection risk than the wound vac. So sometime, some or all of the sutures have to come out and the wound vac will be put in again, because the two (sutures and vacs) don't coexist well. Some of the progress made will be retained, so it's not a total loss. But wound vacs are more annoying, and still painful.

Hitch 2 is that we're trying to get an appointment on a non-Monday so Ash can go. It's really hard because Monday is his only official clinic day but it's also Ashley's biggest class day. However, he had said that he could squeeze us in on a different day if we needed to, so we're pushing for Tuesday. Other than those and my pain (which has lessened but still really hurts), things are good. God is good. Mysterious, but good. He is not a vending machine or Santa Claus. I don't know what he's up to, letting me suffer when he could have healed me, but there are so many horrible things in life that turn around for the good. One day, I will know. Until then, I am his, because he is God, and I .... am not.

Pray for:

drains to continue being low so I can eat! (and to stay low if I do start eating)

home health agency to work efficiently to allow me to get back to LA

fast-working and well-working wound vac

pain to die down

tuesday appointment rather than monday

The drains stopped? But hold on...

2010-02-20T17:12:00.000-08:00

The drains stopped. Basically. But put away the champagne for now. Here's the qualifier.

Yesterday, the drains put out over 500 mL. That's a record for me. I e-mailed my doctor yesterday, showing some concern. His new plan was to change the bulbs from sucking to catching. To give you an idea, the fluid is collected in bulbs (actually referred to as 'grenades' because they look like... grenades). Normally, the bulbs are squeezed when they are emptied to provide some suction. Now, the doctor wants to leave them unsqueezed so they just accept whatever fluid comes.

No drainage could be a good thing or a bad thing.

It could mean the pancreas was ok this whole time and was just being picked on by the overbearing drains, sucking its soul into a grenade.

It could also mean the fluid is going somewhere else. It is likely going into the bowel, because according to radiology, the track left by my drain (after being pulled out a few inches) is walled off, like concrete. However, it could also be forming a fluid collection in my abdominal cavity, which is not a good thing. So if I develop a fever or abdominal pain, that's probably what it is, and that would be a complication I do not want. A CT on my Monday appointment will bring the verdict.

Also on my Monday appointment, the doctor will be switching my grenades for bags, which are more suitable for catching fluid than the grenades (and they will be clean, too- mine have not been changed, and they are pretty grody). I may or may not have my drains pulled on; it will depend on the CT results. He will also change my wound vac, which is complicated right now:

The vertical part has the wound vac in it, because it is still big (though not as big since my dad placed some sutures in it). The horizontal part doesn't have a wound vac on it because of the sutures which are closing it up, and it should heal openly rather than under a seal of the vacuum. But since they're connected, it's hard to get a seal. So... some problems, but none too big.

I'm having a good day today. I like being with Ashley. She makes life more colorful. I will be sad when she drives the Big Drive back to school tomorrow. I really hope I can go home next week.

Please pray:

That the drains are stopped for the right reason

That there are no complications that mean I can't go home

For travel safety for Ash

That my wound heals up nicely

That I won't get a collection in my abdominal cavity

That, if I go on a food trial soon, my pancreas can handle it and I can go off of TPN

Prayer needed badly

2010-02-19T21:26:00.001-08:00

So, I'm back in Nor Cal until Sunday when I drive back to La Mirada. At least that is the plan.

Unfortunately, the only new thing here is that Dan's drain output has increased massively. For those who like numbers: the past few days have been in the 300s (bad) and today will end up close to 500ml (terrible). As Dan is still not eating, it is difficult to know what is causing this increase. Though the doctor thought that pulling on the drains would decrease the output, it seems to have done the opposite. Our concern is that the pulling of the drains has opened the hole in the anastomosis more or has caused damage to the tissues. Honestly, we do not have any idea what is going on.

We emailed the doctor and haven't heard anything yet. It is frightening for us as another surgery may be necessary to fix the anastomosis. While this has always been a small possibility (and still is), it is the possibility that scares us the most. Dan's body isn't as strong as it was for the last surgery, so another one to fix the last would be difficult.

Also, my schooling would be in jeopardy. I've been given a deadline of March 1st to be settled into school without missing days. Up until today we figured that was possible since the surgeon wanted to get Dan home early next week. Now, we really don't know. Obviously, I wouldn't want to go to school while Dan's being operated on. Yet, I do not want to have to choose between graduating from nursing school and being with my husband.

We really do know that God is in control of this entire situation. He knows when Dan's drains will dry up, when he'll come home with me, when he'll eat again, when his next surgery will be, whether or not I graduate and when/if Dan will be cancer-free. It's just becoming difficult to pray and pray and pray (and know others are interceding for Dan) and see very little progress and even worsening. It is so difficult to force our hearts to hope and to force our minds to be still.

Honestly, we are running out of reserves. Dan hasn't eaten for a month (except for 2 days of food trials) and the TPN just isn't keeping his hunger away. He hasn't been home in 2 months now. I haven't been home for more than 3 days at a time and am getting worn down from frequent flying. Trying to wrestle between wife-nurse and student-nurse is getting harder--I even forgot to turn in an assignment (if you know me, this is huge). The constant barage of set-backs has made joy and hope infrequent emotions. We were so excited about Dan coming home next week, and now, that seems nearly impossible.

I've heard that God does not give us more than we can handle. He already knows our breaking points, and apparently, He is pushing us to them. I'm about ready to crack.

Please be in prayer with us now. We're so tired. We need to taste victory. Soon.

Prayer Requests:
* Decrease in the drain output immediately
* Healing of the anastomoses
* Continued healing of the wound
* Wisdom for the surgeons
* Dan's ability to come home to La Mirada
* Endurance and comfort for Dan
* Safe drive for me on Sunday (I haven't driven by myself since sophomore year)
* Progress in the right direction
* My ability to graduate with my class on May 29, 2010
* Hope

Nothing new

2010-02-18T13:45:00.000-08:00

Alright fan club, everyone return to your home pages. Nothing new to see here. Go do something productive. Have a good day. Keep praying for me.

Dan

Ugh

2010-02-17T19:56:00.000-08:00

I have watched almost all of the old Office seasons in the past few weeks. I am currently watching the season in which Jim and Pam are separated while she is at school. They are miserable and argue and get upset about weird things and have doubts and count down the days until the schooling is over. I can commiserate. Though I truly wish Dan and I had a date to countdown to!

Dan seemed really good this morning on the phone, but as the day went on things failed to get better. Instead, they got worse. Dan's drains are still high and possibly more than before the 2nd pulling. Also, he's been running a fever since early afternoon. It's just so hard to be down here trying to be excited about Dan finally coming home and then WHAM! Another setback to the plan.

The doctor was pretty clear about the one thing that would halt the plan: a fever or Dan getting sick. Ugh. I am just hoping that McGreeky surprises us and sends Dan to LA anyway. Hoping a lot.

In other news, Dan was able to go without the wound vac for a day as his dad gained the permission of Dan's surgeon to add a couple sutures to the wound. They are thinking that it will make the wound heal more quickly. Dan will get a few more sutures every day for the next 4 days. Dan is really hoping it will work out, though if the wound gets infected again the wound vac has to go back on. As badly as I want Dan's wound to heal quickly, I would love anymore for him to heal without new problems. I suppose we'll just wait and see.

Forgive me for sounding like a broken record, but we are so very tired of no progress, of being apart, of flying back and forth, and for feeling downright rotten (well, Dan).
And now, I have reached the episode in which Jim and Pam are reunited in Scranton. The episode in which Dan and Ash reunite at home is hopefully sooner than I think.

Prayer Requests:
* No more fever ever and no hint of infection
* Endurance and encouragement for both of us
* Safe travels for me (flying tomorrow night and driving Sunday)
* Good health (I think I might be getting sick)
* Ability to get work done
* Peace and faith that God is still working
* Ability for Dan to come home to La Mirada next week
* Strength for our relationship...this is a 'for worse' situation

Maybe next week?

2010-02-16T13:50:00.000-08:00

Another day of doctor's appointments is finished. The visit with McGreeky seemed optimistic, though it was very painful for Dan. As the last "let's pull on the drains a bit and watch them go down" failed, the surgeon decided to try again today. He pulled a couple more inches out on each drains hoping that the suction would be removed from the anastomoses (holes in the connections of the pancreas and intestine). The drains had been pumping out so much over the weekend, that we can only hope the output goes down.

Also, we pressed McGreeky about getting Dan home to La Mirada. Maybe my argument with him last week did something (or maybe everyone's prayers), but he's thinking Dan can go home next week. Basically, he's uncomfortable with Dan being far away on TPN (not sure why, but whatever), so wants the drain to go down more over this week, let Dan eat real food for a few days and watch the drains. Sounds familiar, right? Dan was awesome about asking for clarifications--what will keep him from going home early next week? Dan getting sick.
So, the big prayer for now: keep Dan from getting sick! No fever, no infection, no pus from the drains (sorry, gross).

All of us want Dan to go home to La Mirada, especially him and me. It's really about time, right? Please press in with prayer that things go on schedule and on-target this week.

I'm flying back to LA this afternoon and then back up on Thursday night. Dan and I will spend the weekend getting things together and making plans as to how to make life work out in LA. I'll drive my car down to LA on Sunday afternoon and wait patiently (ha) to hear how the appointment goes on Monday morning. I have a sneaky suspicion that McGreeky will try some stall maneuvers on to keep Dan up here, but hopefully Dan and Jamie can hand back the heat. I hate not being there for the appointment, but school beckons.
Keep praying, friends.

Prayer Requests:
* Decrease in drain output
* NO INFECTION
* Pain control for pulling on the drains
* Ability to tolerate food this weekend
* Dan going home early next week!
* Endurance and energy for all my travelling this week
* Safe travels for everyone

V-Day? How about VD-Day

2010-02-15T10:53:00.000-08:00

So Valentine's Day has come and gone; making plans for 2-14 is a little more difficult when eating is not on the menu and going somewhere takes more effort than usual. But we managed to have a little date night on the couch and wrote each other sappy love notes, and it will be logged in Valentine's history as a decent run. So we're looking forward to next year.

VD-Day is what we're really looking forward to. For those of you who have forgotten about World War II, VE-Day was Victory in Europe, VJ-Day was Victory in Japan, and VD-Day is Victory over Drains. As of right now, they're still pumping out way too much. They are being bad drains. Bad drains! It's really frustrating, because they were down to around 40 total mL per day, and now they're running at over 200 total per day. Maybe that would have happened anytime the drains were moved- which would be bad if I was leaking and didn't have the drains in. Speculation. The point is, we're sick of this war. Sometimes I wish I had been Switzerland and just stayed home. But, I am where I am, and now I have to get better. Tomorrow, we're going to Stanford and maybe figuring out just what that entails. Will I need another scan? Another surgery? Or more waiting?

Well, my wound is healing. Still a long way out, but at this point, slow and steady wins the race. When it gets to the point where the wound vac comes off and there's just gauze covering it, I will consider that a huge victory. My drains had BETTER be done by then. Or else. Grrr.

I know I have many blessings to count, so it's not the worst thing in the world, but it is entirely frustrating. Please pray for VD-Day. To come soon. Like now. Which you have been doing. And I thank you all.

Dan

Mighty

2010-02-13T22:22:00.000-08:00

I spent the last hour reading a friend's blog about going to Rwanda and then following her link to the blog of a family who just adopted their second daughter from Taiwan. As I read both blogs, a jumble of emotions welled up within me.

Sadness: millions of children around the world need parents to love them, genocide has left a deep and seemingly impenetrable scar in the heart of Africa (among other countries), tragedy exists everywhere.
Jealousy: I long to open my home and heart to little ones in need of a family, but Dan's medical history disqualifies us from nearly all types of adoption.
Joy: God worked through the Biola girls in Rwanda to love His children; another child has a home.
Frustration: Why isn't God doing more for His children? Why allow genocide? Why allow cancer?
Hope: God is working in the lives of those who are hurting--from orphans to nursing students to Dan.
Excitement: What is God doing in my life to make me better suited to His purposes?
Fear: What is God doing in my life to make me better suited to His purposes?
Peace: No matter what goes on in my life (or around the world), God is in control. I may struggle against so many circumstances and beg for them to change, but there is peace in knowing that God already knows what is happening and what will happen. What's more, He knows why everything happens.

Reading those blogs also reminded me that I have a blog to update, though this won't be much of an update. Today has simply been another day of pressing onward. Dan hasn't vomited in 2 whole days, but is still frustrated with some GI stuff. His drains seem to have decreased a bit today, but they are still 4 times as high as before the surgeon pulled them out a bit. It is so discouraging to see those drains fill up each day, as it pushes Dan's eventual eating further and further away. Additionally, the drains have begun to let out a new odor from being in so long. Pain has been more of an issue the last couple of days, but Dan just pushes through. We even took a trip to Target today--it seemed short to me, but completely wiped Dan out.

My parents and grandpa made a trip to Lodi to deliver some goodies left over from Christmas and just to visit. We loved seeing them and having more friendly faces around. Yet, my heart hurts when we all sit down to dinner and Dan can't eat. He read at the table while we ate, but it must be miserable to watch everyone do something that he has been longing to do for almost a month now.

I find myself getting more and more frustrated lately. It seems like this will never end: the drains will drain forever, the wound will stay open for a long time, Dan will be on TPN indefinitely, Dan will have to stay in Lodi forever, etc. I know these things aren't true, but it sure does feel like it. What's more, the nervous questions are plaguing my mind more and more: the doctor said pulling on the drains would help--why has it made it worse? Is there something wrong with the placement? Did the drains pull open another hole? Why isn't Dan healing? Will Dan need extra surgery to fix the leak? Will Dan miss my graduation? Will we live apart until then? The questions go on and on without answers. Hopefully, most of them are of the paranoid nurse/wife type.

We so very badly need progress right now. We need to know that Dan is moving toward healing. We need to know that things are getting better soon.
We are discouraged, to say the least.

Yet, God is mighty on His throne. He knows all the answers, and He knows why Dan is going through all of this. Somehow, all of this is molding us to be more like Christ, so to shine His light more clearly. God is mighty whether or not things go our way or not. Yet, He also calls on us to cry out to Him in our times of need.

Lord God, hear our prayers for healing tonight. Draw us close to You. Touch Dan's body with Your power and mercy. Give us rest, oh God. We are weary and scared.

Prayer Requests:
* Drain stoppage (sudden and immediate and exciting and miraculous)
* Wound healing
* Endurance
* Incredible progress in the next few days
* Wisdom for scheduling matters
* Good news and encouragement
* The ability for Dan to be in La Mirada very soon (confidence for the surgeon)

Too cool for a title

2010-02-12T10:45:00.000-08:00

So-- you may have noticed that I didn't blog on Wednesday OR Thursday. That's because not much happened on Wednesday. And Thursday, I was just not in the mood. Thursday morning, we went to get Ash from the airport, then scooted over to Stanford for an appointment. What they did was injected some contrast through my drains and took X-rays to see if they were draining from my pancreas or a collection of fluid elsewhere in my body (we were rooting for pancreas). Turns out it was indeed coming from my pancreas. Surprisingly, my doctor decided to pull my drains out a couple inches right then and there. This was a surprise because he had told both Ash and I on separate occasions that he would wait until he saw me on Tuesday. Oh well, I thought--better sooner than later.

Turns out it hurt a significant amount. Also turns out I didn't bring my pain meds with me because I didn't think he'd do the drains. Stupid.

I made it home ok, then took some pain meds. I still felt crummy though, so blogging wasn't first on my mind. I did have a nice ending to my day though. Ash and I had our weekly TV date upstairs all by ourselves (Bones, The Office, Grey's Anatomy, and Private Practice). It was so refreshing to have time alone with my wife- that's how we normally live, and I think that's how it's supposed to be done. We even fell asleep together during Private Practice (which I don't mind at all- I only watch Grey's and Private Practice because Ash likes them). Finally, we went to bed and -- miracle of miracles -- we both slept through the night! We've been praying for that for a while and it felt really good. Hallelujah.

One thing that dampened our day was the doctor's estimation of how long I would be in Lodi. He didn't talk to me, so I don't remember the details, but it's longer than we wanted. He is cautious. But he also changes his mind based on circumstances; if the drains really dip down (like they should eventually- though right now they are pumping out extra because of the pulling), maybe the date will be moved up. But we'll have to see what happens and I'll have to push for it.

My wound looks better today. It's noticeably smaller than before. I hope it heals faster than expected. That would be awesome.

Today, Ash is trying to get me to be more active; going on more walks, going upstairs, and my first shower in a loooooong time. Please continue to pray for healing of the wound and stoppage of the drains. You guys are awesome.

Dan

I love my wife

2010-02-09T20:16:00.000-08:00

One year, six months--feels like so much longer. In a good way. I love my wife.

On the Dan front, not much news. The drains are pretty low, which is good, so maybe (by the end of the week?) I can eat. That's being really optimistic. But you know what? I am really tired of TPN, drains, and all that comes with it. Once I can eat properly, all I will have left to worry about is my wound vac. That brings my list of healthcare items from 29873 to 1. It feels like that anyway. The next real news will come on Thursday. Or Friday. Eh, it'll come when it comes. I may not blog tomorrow. You guys will understand, right? Good. Anyway... still here. Still waiting. Still praying.

Dan

Happy 18-monthiversary!

2010-02-09T17:34:00.000-08:00

Yes, I do realize that the above is not a real word. Yet, today is a year and a half since Dan and I got married, and I feel somewhat proud of that. Though, there are many things that have happened in the past 18 months that neither of us would have liked to happen, we have made it through those things together. Even now, when we are apart, we are pressing onward as one. Sometimes, I wish I could take some of the pain or vomiting or something so that Dan could feel better (sometimes, I think he would let me have it!). Yet, all I can do is support him in whatever way I can.

In a way, finishing nursing school is something I can do to support our little family of two. The sooner I am a nurse, the sooner we can move out of LA. Additionally, having a steady income will help Dan finish school in a timely manner, so that we can have two incomes. Though neither of us are under the impression that we will be rich, we cannot wait to be able to settle down wherever God wants us. Someday, we'd like to worry about normal marriage stuff: a house, children, traveling, investments, missions, the drapes, etc. (Maybe not about the drapes).

So, in the next year and a half of marriage, we have a couple goals: get rid of this cancer crap and get Dan whole AND be finished with school to be doing what God has called us to do. Of course, we have learned to remain very flexible in our "plans" because God decides to change them here and there.

Here's to many more monthi/anniversaries! I love you, Dan.

(For those of you concerned with lack of mention of Dan's health, I'm letting him update on another blog later because I'm not there to know all of what is going on. This parenthetical addition will irritate my hubby because he isn't too fond of blogging, but I'll just bat my eyelashes and pretend he can see them over the phone tonight.)

How did I start blogging this frequently?

2010-02-08T18:17:00.000-08:00

I'm going to blame the wife. She started this blog, knowing full-well that I didn't want to blog every day. Then she used it as a way for people to follow me through my epic journey through the hospital, and then she bats her eyes at me and says, 'can you blog tonight?' and I say 'fine.'

So today started pretty poorly. I threw up a couple times because my stomach is weaker and my gag reflex goes off more than I'd like. And the horrid part is, the first time I actually hit Ashley with some of it. She's a trooper, though. She cleaned up in spite of her being really tired from nights that don't contain 100% sleep. She's amazing. Anyway, my mom, Ashley, and I went to Stanford for a follow-up with McGreeky (she also made this silly name based on *gag* Grey's Anatomy) (I'm ok, by the way--not throwing up). Not much news there, except he said that he wants me to go to radiology on Friday so they can inject some contrast into my drains, take an X-ray, and see from where the drains are receiving their fluid (the pancreas itself or a separate fluid collection). Then my next appointment (next Tuesday), he wants to pull out the drains about an inch (I believe depending on the results of the radiology thing).

Speaking of the drains, one had been spouting out way too much fluid, while the other was quite tame. This morning when we emptied them, the spouter had dropped down almost to the level of the tame one! As of right now, they are still both pretty quiet. This is a good sign. I like good signs.

It's weird to be cold more than I am used to. We took Ashley to the airport today so she could attend some more classes (another reason I am blogging--probably the most significant one). When I got out, I forgot to have my sweatshirt on (I was not cold in the car and it wasn't that cold when we left), and all of a sudden, I felt like a shivering chihuahua. Ridiculous. I want my drains to dry up so I can eat again so I can put on weight so I won't be a shivering chihuahua. Also to help my skin not be so dry because I am slightly dehydrated.

I press on. We press on. This will not be forever. It sucks right now. But we're walking with God through it, and He won't abandon us.

Pray for

DRAIN STOPPAGE

ability to not throw up

rest for Ash

rest for me

wisdom of the doctors

physical stability so I can return to SoCal

Super Sunday

2010-02-07T19:18:00.000-08:00

Not as high-scoring as everyone thought, but I do remember that the Colts' last Super Bowl win was won on defense, not offense. This time, the game was won by New Orleans by not their offense, not their defense, not their special teams, but by the coaching staff. If you're going to beat the Colts, here's what you do: don't give Peyton Manning the ball. In the 2nd quarter, the Colts ran only 6 plays, and 3 of them were conservative runs to avoid a safety or turnover deep in their own end. Then, at the beginning of the half, the Saints surprisingly onside kicked it and got it, once again, not giving Manning the ball. Sure, it really helped that they picked off a pass in the 4th quarter and ran it back for a TD, but that was not a game-ender. Yes, I wanted the Colts, but I'm not too disappointed with the results; the Saints earned it and deserved it. Anyway, it was a good game, in spite of mostly disappointing commercials and a really annoying Saints fan who felt it necessary to bring a tambourine to the game and bang it before every Colts play. Oh, and I hate CBS. Stands for Creativity's Been Sapped. And the Who put on a show that was awesome at some parts and sloppy at others. It may be time to put some youth back on stage for the halftime show.

So- my drains might be going back down? It's hard to tell. They're more than I'd like, to be sure. I'd love so much to be able to eat. This was the first time in a while where I didn't go to a proper Super Bowl party, but I don't think I would have really liked being around all that food without being able to eat it. I'm getting really tired of being hooked up to things all the time. I'm glad to be out of the hospital, but I'm still frustrated being tied down to my wound vac and my TPN. I have an appointment with the doctor tomorrow at Stanford; he had mentioned before that he might pull out the drains, which might be helpful to slow them down (because they may be sucking more than catching). Ashley unfortunately leaves tomorrow evening to return Thursday morning. I will miss her. She's been super helpful and she's a little piece of real home. But nursing school calls. She's going to be an amazing nurse. She already is; just missing her license. I'm a little tired. Sleep comes easier here but it still doesn't come easy.

Pray for:

Drain Stoppage! Now!

Good doctor visit

Safe travels to LA for Ash

Wound healing

Life Beyond

2010-02-06T15:50:00.000-08:00

The past 24 hours have been exhausting, yet the end result is that Dan is resting and recovering outside of the hospital. Finally.

The doctors did their part yesterday by changing the wound vac early in the morning and writing up all of the discharge orders before noon. The nurses did their part by gathering up extra supplies and teaching us what we need to know. The case manager did her part by setting up home health and ordering Dan's IV meds for home use. I did my part by packing up the room and getting our stuff ready. Jamie did her part by driving to the hospital and getting our stuff in the car. Dan did his part by simply being ready to go.

With everyone doing their part, how did we get home so late? The meds we had to take to Lodi got delivered an hour late and the transporter found other things to occupy his time. Then, when finally in the car and driving, we got caught in terrible traffic. I mean terrible.

So, around 8 o'clock, we finally pulled onto Vienna Drive. It must have felt weird for Dan to be somewhere new for the first time in a month. Good weird.

We then proceeded to unload all of our supplies while waiting for Dan's home health nurse to arrive. Toni arrived at 10pm to begin the TPN and teach us how to use the new pump. The pump then proceeded not to work. Dan finally got TPN started at 11pm.

What next? We went to bed--together for the first time in a month! Expecting to have a lovely night of sleep compared to the hospital, we quickly discovered that medical equipment often refuses to cooperate and things do not go as planned. Dan's wound vac detected a leak in the suction seal, so it alarmed every 5 minutes or so unless we were holding the suction portion down. The "tug-boat" sound also proceeded to get louder.

Our night looked like this: bed at midnight, blood sugar check at 2 (he needed insulin but we didn't have a sliding scale), wound vac alarm at 3 (we tried repositioning first), wound vac alarm at 4 (the next hour was spent on the phone with the home health agency as I tried to fix the seal), wound vac alarm at 5:30, blood sugar check at 7, wound vac alarm at 7:30, medication at 8, dozing until 9:30 when home health agency called, new nurse showed up at 11 to fix wound vac...quiet for the first time in 12 hours. With all this waking up, we should have a baby around!

All that being said, it is nice to be home. We could sleep at least close together, lounge in our pjs, visit with friends and set our own schedule. As of now, I have gotten half of my homework done while Dan is catching up on some sleep. Though, it's med time, so I better wake him up soon.

Being a home health "nurse" will be interesting, as I'm doing things I'm used to just in different ways. TPN at night will be the biggest production, so I hope I do that appropriately tonight (first time without the nurse). Octreotide IVP every eight hours, blood sugar checks every 6 hours (Dan does these), empty JPs 2-3 times a day, etc. Thankfully, Dan's mom will step in to help Dan out when I go back to school. We can obviously handle being nurses, but it sure will be nice to go back to being "mom" and "wife"!

We are so thankful for all the support we have and that God has brought Dan this far. Please continue to pray for good news and confidence at Monday's doctor appointment.

Prayer Requests:
* Drying up of the drains (they've been changing colors a lot lately and not decreasing much, so this is a huge prayer)
* Continued wound healing
* No more problems with the IV pump or wound vac
* Sleep-filled nights
* Ability for Dan to go home to La Mirada very soon
* God's glory to be visible in this trial
* Focus so I can be a "nurse" and a student

Praise:
* Dan's out of the hospital!
* Great home health nurses
* Insurance coverage
* Flexible teachers at Biola
* God's grace is new every morning

Out

2010-02-05T21:35:00.000-08:00

Dan is out of the hospital. Got out about 5:08p and drove through horrific traffic. Made it to Lodi around 8p. Now, we're waiting for the home health nurse to arrive.

It has been a long day, but a good day.

We are surrounded by home health supplies and are pretty wiped out.
Check back tomorrow for the extended version of today.

We have work to do...then sleep to sleep...together!

Prayer Requests:
* Drying up of the drains
* Quick learning for all of us doing home health
* Expedited wound healing
* Only needing home health for a short period of time
* Dan being able to go home to La Mirada with me...soon!

failblog- but not entirely

2010-02-04T09:59:00.000-08:00

The food trial failed. My drains collected a lot more than usual, even when my eating was minimal. Perspective: last night, one drain put out 75mL in 8 hours; before the food trial, I was getting 40-50 combined for the whole day. Darn pancreas.

Now I'm back to NPO except water when I'm thirsty. I will have to go home on TPN; but the hidden gem of that sentence is that I'm going home. Tomorrow. That is sweet.

A few weeks ago, I had joked with Ashley that I had better go home before one extremely pregnant resident had her baby. She had her baby today. Fail.

So here's basically what life will look like at home (not my 'home' home, but my parents' home in Lodi--it's different once you're married):

TPN at night

Blood sugar checks about 4x/day

Wound vac changes 3x/week

PICC line dressing change once a week

NPO (no food)

Thankfully, no more IV meds

Weekly visits with the surgeon at Stanford (at least at first- frequency will probably go down after a while)

While I'm not really happy to be back on TPN, I know my pancreas isn't quite ready for food yet. Hopefully, the drains will dry up quickly like they did before when I was on TPN, and I won't have to be on it for too long. I'm not afraid of TPN really; I just want everything that is wrong to be righted, and I think the best way to do that is with TPN. Though it is far less fun.

This drain failure is a step back, but I am taking steps forward. It has been a long ordeal; it will be a little longer. Many of you have prayed for me; I would appreciate a continuation of that. I look forward to the day when I don't have to worry about my pancreas anymore. Until then...

Prayer requests:

Quick drying of the drains

Good healing of the wound

No return to the hospital (except for planned visits with the surgeon)

Ability to go home to La Mirada with Ashley

Aggravation

2010-02-03T16:46:00.000-08:00

When I was little, my mom and grandma used to play Aggravation with my brother and I. It's that marble game that you must go around and get your marbles home without getting knocked off by other players. Just when you think you're about to win, someone comes up and kicks you back to the beginning. The only word to describe the game: aggravating.

That is how this hospital stay is beginning to feel.

After such great news yesterday, Dan and I felt as though maybe we were really getting to the end of this long haul. Dan has been eating very small amounts since last night and the drains looked great...until 2 o'clock. While the last shift's 8-hr total was 12 cc, one drain put out 30 cc in two and a half hours. Shoot. The nurse is paging the doctor to see what he wants to do. Does this increase mean the end of the food trial? Could this be just a short spike before things get better? Will this delay going home? After finally being able to eat (due to very low drain output), Dan is frustrated to be faced with NPO status again.

We are waiting for the doctor's opinion before getting too gloomy, but we're pretty bummed.
As far as we know, if Dan fails this food trial, he will be sent home on Friday on TPN. Dan has come to terms with that and just wants to get home. I suppose we just don't want the disappointment of not being able to eat to be compounded by the disappointment of not going home on Friday. Going home with TPN is not the end of the world, but it will get old pretty fast. I'm just unsure how long Dan would have to be on TPN before doing another food trial. In fact, we are just unsure of a lot.

On a good note, I'm back with Dan. I fly out of Sacramento of Sunday night, so please pray he is home by then! I'll be back again on Tuesday night. I'll be an airport pro in no time. It's wonderful to be back in the same place, I just that same place could be not the hospital!

Prayer requests:
* Drain stoppage...no more increase!
* Wisdom for the doctors
* Continued wound healing
* Surprise "passing grade" in the food trial
* Home on Friday! (one month is enough)
* Joy through the frustration
* My ability to get my homework done while away from school
* Good news....great news...soon

Praises:
* Dan's eating
* Safe travels
* Wound healing (the wound vac change showed great improvement today!)
* The last six M&Ms in my bag were blue, green, yellow, orange, red, brown...on accident :)

He sets the prisoners free

2010-02-02T14:44:00.000-08:00

I do feel a little bit like I'm in prison. The doctor even used the same metaphor this morning. However, he seemed to indicate that I'll be released soon. Read on for some good news.

I'm having a CT today. I had to drink the nasty contrast stuff again. The first time was torture, the second time was easy, this one was also hard. But I got enough to get me down to the CT, for which I am waiting now by blogging these words.

My drains went down again! This time to 40 (and just think: I used to be in the 200's!). There are a few factors involved, such as the CT results (is there excess fluid in my body where it's not supposed to be?) and the drain output (will it go up now that I have downed so much liquid?), but so far... it's looking like I'm eating tomorrow. Doc had said before that 30-40 was a good place to try food, while the other, meaner, more experienced doc had said he wanted the drains dry first. So I guess we're going with the earlier plan. Should the drains maintain their low output (which would be SO excellent), I can go home with no TPN (which is SO excellent). Also, the team will pull back on the drains about an inch (did I mention this last time? I feel like I did), which could help even more with the drains. Maybe they'll do that anyway. On the other hand, if the drain output goes up, I'll go back on TPN for a little while.

But I'll be able to go home.

Basically, unless there is a new complication that is severely unstable, there won't be any deviation from the plan, and I can go home! Before the Super Bowl! I am excited.

Ashley comes back tonight. I'll need to take a nap later so I can be more than semi-awake when she arrives. Her teachers are being really nice to her and letting her use my eventual home-health care as part of a hodge-podge clinical. It sounds like things are really looking up.

Pray for:

NO DRAIN INCREASE!

No excess fluid on the CT

Going home on time

No drain increase :)

Safe plane trips for Ash

February-- seriously?

2010-02-01T16:13:00.000-08:00

February has come upon us already. I only had a week of 2010 outside of the hospital, so it feels like I not only had my liver resected, but also my January.

Still not getting great sleep in the hospital. I was proud of myself for being able to get myself in bed with everything in reach without any assistance. Usually, I climb into bed, and Ashley sets everything up (making sure things are plugged in and that I have necessary items on my tray). Without my wonderful helper, I still managed to do it. But that doesn't mean I don't miss her.

Drains are back down to a low rate (the drain increase from yesterday turned out to be an anomaly). Tomorrow, I'm having a CT to make sure there's no fluid floating freely where it ought not. Some time after that, the doctors want to pull back on my drains (pull them out an inch or two and monitor the drain situation). Sometimes, the drains can suck more than catch leaks when they're in deep, so pulling them out a little might actually help the pancreas to heal a little better.

After being in here so long, I have made getting home my top priority instead of eating. The upcoming food trial the doctor had mentioned excited me before, because eating is just fantastic. But-- I've been here too long. I'd rather go home with TPN and wait until the pancreas is healed nicely than fail a food trial and add a couple days to my stay. After so many extensions of my stay, I am determined to be out by the newest estimation: the end of this week. I do NOT want to watch the Super Bowl from the hospital. Imagine: close game, 4th quarter, and someone walks in to take vitals. No. No. A thousand times, no.

My mom's here today; we walked outside again to the fountains. I have found that using my cane as well as the IV pole (well, I could even do without the pole) works very nicely to keep me from wobbling back and forth when I walk. I miss my wife. I've talked to her a few times today, which is nice, but-- well, you married people know what I'm talking about. It's not the same.

Pray for the usuals:

drain stoppage

rest

wisdom for the doctors

Ash and I as we're separated for a few days

FREEDOM

Quiet on the Western Front

2010-01-31T15:31:00.000-08:00

Tonight, for the first time since October, Ashley will be sleeping 7 hours away from me. School starts tomorrow for her, and she had to go for a few important days before coming back up here (Biola is allowing her to miss some time). That time in October was the only other time in our marriage of almost 1.5 years where we didn't sleep together. It's going to suck, but things already suck. At least she can come back by Tuesday night. My mom will be around on Monday and Tuesday to help me while Ashley's away, but she won't be spending the night here. That's a right I reserve for my wife. :)

So it's kind of quiet today. One of my drains is acting up- it gave up a good amount of bile-y fluid this morning, but is quieting down. However, I think when the nurse emptied them, they equaled the combined total of yesterday. So if nothing else comes out of the drains today, it'll be the same as yesterday. We'll just have to watch it to see if it's a new trend or an anomaly.

When the doctor finally came in around 12, I told him how much I wanted to go home; if I'm waiting for my drains to dry, may as well wait at home where I can actually get some sleep, you know? He said he wants to see at least two more wound vac changes, so on Wednesday, he can think about it, but of course other factors are involved, and it's all so very tricky, an art really, so we'll just have to wait and see. Unpopular answer, but probably the best. So. Not much new to report.

Pray for the usuals:

drain stoppage

accelerated wound healing

rest

absolutely no new complications rearing their ugly heads

We've already discussed this.

2010-01-30T10:52:00.000-08:00

Well, it took me 3 weeks but I got a mild scolding from McGreeky. With everyone wanting to know a solid plan, it falls to me to do the questioning. Apparently, he is getting tired of it. He has been very patient, though, so his firm "we have already discussed this several times" didn't sting as much. To my credit, we have heard 2 different plans for the past couple weeks and we just want to know which one he's working with today!

Anyway, Dan's doing well today. The residents are all taking a huge test today, so doctors didn't bother us until 0930. Whoa. McGreeky and the nurse changed the wound vac again, and he was very pleased with the progress. He's making some modifications to the suction and sponges to help Dan's wound begin to contract. This is certainly a large step in the right direction.
The drains have decreased dramatically. The past few days totals: 250, 140, 120, 110, 85-ish. They MUST continue to decrease in this fashion for Dan to be able to eat. Labs have been ordered for every other day now and antibiotics might be discontinued tomorrow or Monday.

As for the "plan" I got in trouble for asking about, McGreeky really wants to do a feeding trial before Dan goes home. Accordingly, he wants to see the drains continue to decrease in output, let Dan eat a couple of days (Monday, maybe), then see what happens. Just like before, if the output stays the same, Dan is free to go home and eat. If the output increases, he has to spend a couple days "in-house" waiting for the TPN to start again. Either way, the surgeon says he should be home by end of next week.

For McGreeky's safety, I hope he lets Dan out before the Superbowl. Dan might get violent :)

Today will be spent with our sisters, Lise and Laura. They drove all the way up from SoCal yesterday to see Dan and I. So fun to spend time with people who don't live or work in the hospital. I'll be driving back with them tomorrow afternoon (I'm happy and sad about this, of course).

Prayer Requests:
* Release from the hospital earlier than the docs think (before Feb 7th)
* Decrease in drain output to nothing!
* Continued healing of the wound
* Feeding trial to begin on Monday and be very successful (no increase in output)
* Safe travels for me tomorrow and Tuesday night
* Comfort when we're apart
* Patience for McGreeky (too bad, buddy, we're asking questions)
* Confidence for Dan to go home to La Mirada soon :)

Praises:
* Wound healing
* Progress and improvement
* Good friends visiting (Lise and Laura!)
* A mighty God

Another week?

2010-01-29T11:56:00.000-08:00

The doctors must be getting tired. They arrive later and later every day. Today, McGreeky didn't arrive until nearly 11am, when Dan very kindly told him that he had hat head. The doc was in-between cases, so it was nice of him to come by and check things out.

Amazingly, he says that Dan is looking at one more week. Honestly, that is the 3rd or 4th time we've heard that, so who knows. Yesterday, it was 5 days. Today, it's a week. Tomorrow? Maybe he'll go backwards and decide on 3 days. Ha.

Anyway, he wants to change the wound vac tomorrow and Monday, while watching the drain output. He wants to "reassess" on Monday and probably try feeding Dan for a couple days. If the drain output stays the same, Dan gets to go home and eat! If the output goes up again, Dan will be have to re-cycle the TPN before going home. So, Dan could be home by Wednesday or Friday...but we have certainly heard that before.

To make matters worse, McGreeky is consulting a surgeon (McChief) who changes his mind a lot and could develop a new plan. (I'm not being impertinent or disrespectful; McGreeky actually told us that the other surgeon "changes his mind every day, so we don't really know, but I'll go with his advice.") We plan on asking McGreeky if "the plan" is changing or not, because it gets pretty old hearing his plans and then hearing them change due to another opinion. Of course, he keeps reminding us that dealing with this problem is stylistic...so, I'm hoping McGreeky sticks to his guns this time.

I think something has clicked in our minds that we can do absolutely nothing about getting Dan out of here. The nurses really don't think he needs to be here (nor some of the doctors), but I'm not sure we'll ever hear, "You can go home today" from McGreeky. Even when goals are met, new goals are made to delay discharge. Dan feels good, but it must be discouraging to not be able to get out of here even after great improvement.

So, I'm driving to LA on Sunday, then flying up north again Tuesday night. It's my last semester of nursing school, so I have to actually go (Dan's doctor seemed glad that I was coming back, so maybe I haven't bugged him too badly yet). I'm hoping, I'll be able to drive Dan out of Stanford before I go back to school again.

Let's just pray that Dan is home for the Superbowl...9 days.

Prayer Requests:
* The surgeon feels confident to trust his decision-making and actually commit to a "plan"
* Dan's release from the hospital...4 weeks is a LOT different than 10 days
* Complete drying up of drains (I mean NOTHING)
* Improvement of wound
* Successful feeding trial--no increase in drain output at all while eating
* Cooperative/flexible professors to allow me to keep spending time up north
* Dan going home to La Mirada SOON (before I begin clinicals on Feb 17)

Praises:
* Dan feels fine
* Families being helpful and coming to visit
* Financial security
* Ability to fly back and forth

A little sunshine

2010-01-28T17:04:00.000-08:00

If you've been keeping up with the blogs (or have been in Northern California for a few weeks), you may remember that it had been raining and storming pretty nastily. Well, I think we're on day 3 of sunny days. Today, I ventured the furthest I have gone since surgery (the reader is now aware of the author). I went out to the hospital front door and out by some nice fountains with a few ducks lounging in the corner. Despite my new low weight (165 down to 145 and now up to 148), I wasn't too cold in the January air. It was nice to see the outside and feel real air.

Earlier this morning, the doctors changed my wound vac. My skin did NOT appreciate the removal of the adhesive covering, and the whole of the procedure hurt pretty badly, even after taking some pain meds beforehand. But the doctors said it looked better than it did before. It is 'granulating', which is a step towards healing, I have been told. I am getting tired of having an open wound, so this wound vac that is speeding things up is my friend right now. I mean, had it not been for an infection, the wound would have never been reopened and my only concern would be the drains. Too bad. Speaking of the drains, I think they're still at their low pace (about 140/day combined), so that's good.

My surgeon thinks I'll be out of the hospital in 5 days. That is not the greatest news, because that also means Ashley will have to go to school while I'm in the hospital. But at least it's better than 'we'll wait and see.' Here's some sunshine breaking through the clouds: after 3 or 4 days, they're going to put me on a food trial and see what happens with my drains (as was the plan before- if the output goes up, I go back on TPN, but if the output stays the same, I can go home and eat!) Either way, I get to eat soon. You may or may not know how elated I am by that thought.

We've been loved on by some special women today. First, my mom came (and is still here) to spend the day with us. Then, we got a care package and some letters in the mail (I get more mail here than at home!) The package was from one of Ashley's nursing instructors, and had stuff for Ashley and me, including a 5-year-old's rendition of a football game between the Jets and the Angels (he has some learning to do). The cards were from a friend of my mom's; she and the people in her office pitched in and gave us some money to pay for Ashley's flights to and from LA. Then my Aunts Patty and Debbie wandered in and talked for a while, then took my mom and wife out to lunch.

Today was a good day (all things considering). We needed a good day. There have been a lot of mediocre to bad days. There might be some more coming, too. But today--- today was a good day. It was a nice gift from God. I'm open for more of it.

pray for
drain stoppage
wound vac efficacy
wise decisions from the doctors
sleep-filled nights in the hospital
more good days
:)

Word Choice

2010-01-27T11:04:00.000-08:00

We have heard nothing new today. McGreeky hasn't actually stopped by yet. The team of residents simply looked at the wound vac and the drains and left. Not a good enough reason to flip on the exam light at 0630, in my opinion.

While we wait for any news, I'm going to take the opportunity to improve semantically. In the spirit of fairness, Dan wants to clarify that he does not HAVE to go to Lodi. He has chosen to go. The surgeon wants him to stay in northern California for a little while after discharge, and since I will not be able to be here, it makes more logistical sense to stay at his parents' house. The plan was originally to stay in Santa Rosa, but without me there, it won't really work.

Just so we're clear, Lodi is not the unfortunate middle ground on the way home. And when I said "Lodi isn't home for him," all I meant was that it wasn't our apartment in La Mirada with me. Dan will be taken care of very well by his parents, and I am grateful for that. Our first choice would be being together, but he will have anything he needs in Lodi. Honestly, what surgeon would choose a nursing student caretaker versus a surgeon and a licensed nurse as caretakers?
If Dan is sad about anything, it is not that he will be in Lodi indefinitely, but that we will be separated.

Anyway, Dan is feeling more comfortable with the wound vac, though he isn't thrilled with it. He received blood products last night, so he has more energy. The docs also increased the calories in the TPN, so he isn't even hungry. Unfortunately, the decrease we saw in the drain output has increased again, so maybe the leak isn't getting better after all. The "2nd opinion" surgeon was quite clear that Dan will not taste food until the drains are dry, while McGreeky just wants to see a solid and steady decrease. Who knows which opinion will be followed?

It sure is getting frustrating to get excited about an improvement and watch it get worse again. Something positive that lasts would really help us out.

Prayer Requests:
* Drying up of the drains (no more increase in output)
* Efficacy of the wound vac
* Surgeon's confidence in letting Dan out of the hospital
* Good news today
* Good communication between Dan and I and others

Praises:
* Less pain with wound vac
* More energy from the blood and TPN
* Free coffee all the time

Sucker

2010-01-26T15:48:00.000-08:00

Not a whole lot has changed today, but things are finally starting to make some progress.

The day began with an ambush by the residents at 0620 wanting to change the wound dressing, followed by the charge nurse telling us that we had to pack up our stuff and be moved to another room by 0730. Fun. We had been warned that we were moving to a new room eventually because all of the rooms are getting new TVs and Dan's room was one of the last to be modified. So, I packed up our stuff and my sleepy husband and moved to a new address down the hall. Everyone was busy at shift change, so I had move it all by myself--even the bed! But, I got to keep my sleeper couch, which makes up for the work.

The doctors finally decided to put the wound vac (the sucker for the wound) on Dan's wound today. Everything went fine, though Dan said it hurt quite a bit from the intense suction. He is slowly getting used to it. McGreeky was very confident that the wound vac would greatly speed healing. We certainly hope so.

Also, Dan's hematocrit dropped a teensy bit more today. The doctors believe that his marrow is having a hard time recuperating from the stress of surgery and blood loss. Accordingly, McGreeky has agreed to give Dan a blood transfusion (RBCs and fresh frozen plasma) to give his system a boost. Dan's been pretty tired today, but after some blood and a higher calorie TPN mix, he should feel almost great tonight.

We are getting used to our new room, which has a good view of the helicopter landing pad. A few friends even came to visit to help break it in. Thanks, Grant and Lise!

Now, we just have to keep ourselves occupied until things really turn around and Dan can get out of here. Dan's drains have decreased today, but we need to keep them decreasing permanently! At discharge (which seems like another week away), Dan has to go to his parents' house in Lodi for at least a week. We're both bummed about this because it means I will be living alone in our apartment for a while until Dan can come home. My professors are only making me do a couple days a week for the next two weeks so I can be up north with Dan. Lodi isn't home for him, but it will be better than the hospital!

Prayer Requests:
* Continued decrease of drain output...permanently!
* Efficacy of the wound vac
* Safe tranfusions today
* Confidence for the surgeon so Dan can leave the hospital earlier than expected
* Drastic improvement (we're talking huge enough that the surgeons are surprised)
* Release before I have to go to Biola, so I can help him get settled :)

Praise:
* New TV?
* Wound vac!
* Drain decrease (at least a little)
* Understanding professors
* God's power and love
* Transfusion

Just a little PO'd

2010-01-25T09:39:00.000-08:00

If you read the last blog, you read that

1) another surgeon was going to consult on my case so that I could be assured a well-rounded decision

and

2) the plan was two days NPO, two days eating, decide from there TPN or not and go home.

Well, this morning the surgeon came in (who reminded me of my US History prof at Biola) and consulted. I kinda wish he hadn't.

He said that I needed to be NPO longer, though he was going to up my TPN so I wouldn't be as hungry. He wants to put a wound vac in tomorrow (which I think is a fine idea- I'm ready for the wound to close). He wasn't too concerned about the underlying hole- there's something they can cover it with and it won't be a problem. However, instead of a set timeline like McG gave me, now, I'll have to be evaluated at the end of the week. I suppose that could still mean a release date of Friday, but it could also mean I'll be stuck here longer. And even when I do get home, I'll be on TPN for sure, to be renegotiated by weekly meetings with the doctor.

So I mean, there's good news mixed with bad; I think the good news is marred by the fact that I'm still here. I even think the drain output went down. Maybe if it keeps going down, today's decision can get overridden and I can go home sooner. Maybe that's just wishful thinking.

Also, Ash just spoke with her nursing professor and needs to be down there a couple days a week to be able to graduate. So, pray for cheap flights and safe drives. This will be a long month.

What we do now is wait and see (surprise, surprise). Keep walking. Keep breathing. Keep doing something to pass the time. Pray for drains to stop. Pray to go home. Pray just because that's what you do in all situations.

Right now my goal is to be out by the Pro Bowl, of which I could write another entire blog, because of the timing and location change this year which the NFL will likely regret and hopefully reverse. But that's not what this blog is about.

Keep praying for us.

Dan & Ash

A tardy update

2010-01-24T20:50:00.000-08:00

As the night got later, I suddenly realized that neither of us had updated the blog. I apologize for the lateness. Our day was full of visitors.

This morning was basically the same as the past few have been. Early rising for a dressing change, rounds by the residents and waiting for McGreeky to come by. The wound is looking better, though there is a small hole in the fascia that will result in a hernia. Fortunately, the surgeons will be able to fix it during the next surgery very easily. The surgeon is going to consult another attending on the unit to ensure that it is safe for Dan to have the little hole for a few months. We're just hoping whatever they decide will not interfere with Dan's discharge. McGreeky mentioned another week, and I became uneasy with the repetitiousness of his time intervals. After he left, Dan and I talked about what was going on and decided that the issue of length of stay needed to be discussed.

I went out and caught the surgeon before he left, and he graciously came back into the room. Dan explained that it feels as though all he has been doing is waiting, and waiting is something he could be doing at home. He told the doc that being NPO for a week and being in the hospital was harming his strength and spirits. Dan told him that he wanted to do what was safe, but was tired of waiting for something that wasn't working. Accordingly, McGreeky decided that Dan will be NPO today and tomorrow. Tuesday and Wednesday, they will let him eat. If the drainage increases substantially, Dan will need to go home on TPN (which will need to be re-cycled through his body a couple days before d/c). If the drainage stays the same, Dan will go home on a diet and just wait out the drainage. The surgeon even conceded that there really isn't much being done for Dan in the hospital right now.

Having the doctor give specific days and plans and admit that Dan really doesn't need the hospital, gives Dan and I some leverage for negotiation. At the end of the day, Dan is the one in control of what's going on--it's his body. The doctor is here for Dan, not the other way around. I was so proud of Dan as he expressed how he was honestly feeling and only hope that he can continue to press the doctor to stick to his word. Being in the hospital is not helping Dan get better. He needs to go home.

After the doctor left, we got cleaned up and prepared for an onslaught of visitors. Lise finally made it to Stanford for the first time after arriving home from Rwanda on Thursday. She is our sister in all the ways that matter. Oh, it was so good to have her around.

Then, Katal arrived. She found someone (well, her husband found time) to watch her little rug rat, so she came to see us. It was so lovely to be able to hear about someone else's adventures and ongoings.

Finally, my parents, brother and grandpa showed up to keep us company, too. Mom brought clean laundry and a refill of food. Dad brought some homework, Nick brought some hunger and Papa C just brought himself as a buddy to watch football with. Amazingly, Dan didn't get too tired out with all the company. I loved having my family and my closest friends around me. Sometimes, a hospital gets a little lonely.

Now, the day is coming to a close, and I am perched on the edge of the hospital bed as Dan sleeps. His arm around my waist keeps me warm and reminds me of something very important: 'home' can mean very many things. As much as we want to be back in our little apartment in La Mirada, we are home as long as we have each other. It seems so strange that we have only been married a year and a half. Feels like a decade at least. We have surely seen some good times and bad times in our relationship. Yet, standing upon the Solid Rock, we are safe.

Prayer Requests:
* Healing of the wound without any new infection or complication (no additional surgery necessary)
* Healing of the pancreas leak
* Approval for Dan to be able to go home on a real food diet THIS WEEK
* Wisdom for the doctors and an understanding of the benefits of home
* Discharge home BEFORE SUNDAY (so I can go to my first day of classes)
* No need for Dan and I to be separated during recovery (he wants to go to LA after d/c)
* Supernatural intervention and healing

Praises:
* Wonderful friends and family
* Patient doctors
* Resolution of infection
* Energy from the TPN

Extended Edition

2010-01-23T10:31:00.000-08:00

Today is day 15 that I have been in the hospital (16 if you count surgery day, but I was unconscious for most of that day). According to the doctor today, they want to add another six to make it a full 21. Four days they want to watch me and my drain output while I'm NPO (not eating), then the next two days see what happens when I eat. So the good news of me being able to eat is masked by the fact that it is preceded by four more days of NPO. I've lost about a pound a day since they've been weighing me (came into surgery at about 170, fell to 150, and have since fallen to 145), and I'm eager to start eating again and regain some weight.

Ideally, the output from the two drains should go below 200 combined mL/day; right now, hovering at about 250. The two-day eating test is to see what happens to the output when I eat; if it rises substantially, they'll send me home with TPN (not ideal); if it doesn't rise too much, then I can go home and eat.

This six-day idea kinda tweaks plans. Before, there would be plenty of time to stay in NorCal for a little while so I could be close enough to Stanford in case I needed a little extra doctoring, but the plan ultimately being to go back home to La Mirada while I recoup. Now, we're cutting it close to the beginning of Ashley's school. A lot depends on my exit status (can I eat, what will my wound care look like, what do I do with my drains), so it's hard to make plans.

It's just really frustrating because of how many times it's looked like I could go home but just never happened. We have plenty of things to occupy our time in here, but hospital rooms are no place to live. We need to get back to something real. It's also frustrating because other factors are improving, like my fevers going down. In other words, while there is progress, it is not the progress we need.

Pray that:

my drains stop up. period.

my wound heals more quickly than is medically expected.

we would not be discouraged at the extension of time.

that the timeframe would not be extended any longer.

Pleasant People

2010-01-22T16:57:00.001-08:00

You know, I bet it takes a lot to still be willing to answer a bunch of questions right after you've performed a 5-6 hour surgery and spent the day in clinic. McGreeky is just a pleasant guy. Dan had a CT today and rather than making us wait until tomorrow to hear the results, the surgeon came on over and listened to us. Patiently. Listening might do more for calming a person that having all the right answers at that moment.

The CT provided comforting results that the excess fluid floating around has lessened by half and there appear to be no signs of additional infection. Good news.

Dan and I asked about his hematocrit that has dropped rather than increased and about the leaky pancreas. The hematocrit levels are blamed upon Dan's chemo a couple years back and on the toll of hospitalization. The pancreas drainage is still chugging along, though it might be losing some steam. McGreeky was humble enough to admit that things are not going as quickly as he would have expected, but also told us he was being as aggressive as possible (without opening him back up). Yet, he thinks the rate will decrease and the worst of the dangers are behind us. He said to cross our fingers, but we'll stick to praying.

McGreeky also mentioned that he wants Dan to fully heal before going ahead with the next step of the surgery. Instead of 2-3 months, he's thinking more 4 months.
My nervous mind makes me worried...I graduate in 4 months. So, hopefully, we can talk the doc into doing the surgery at least a month before May 29 or waiting until after. I don't think I could walk without Dan there...he's how I got through nursing school! Before anyone starts telling me "Slow down, stop worrying, my goodness, blah blah blah." I know! At least if I vocalize this concern, I can be joined in prayer for it right?

Another group of pleasant people also visited: the Sizeloves! They brought all the kids and sat at the front lobby of the hospital so they could see Dan (kids aren't allowed in the hospital due to H1N1). Mark and Rachel were thrilled to finally see Dan, since they've only seen me these past few weeks. The kids even packed us a present bag: play-do, hot wheels, bubbles, a puzzle and a book. They drew us pictures, which now decorate our wall. I'm not sure we can ever express how thankful we are for Laura and Jon. They have never failed to open their home to us while at Stanford. Such a blessing. I hope someday, Dan and I can be just as hospitable as they.

Anyway, this is the 3rd blog in one day. Phew. Unless something major happens, I'll update more tomorrow.

Prayer Requests:
* Healing of pancreas and wound
* Recuperation of Dan's bone marrow (for hematocrit)
* Wisdom for planning the next surgery
* Rest for the surgeons (they look tired!)
* God to be glorified through us and this situation
* School scheduling, etc.

Praises:
* Good news from CT
* Patient doctors
* Encouraging friends

Path Report

2010-01-22T13:36:00.000-08:00

We forgot to share the the pathology report came back from Dan's tumors!

The lab is still having a difficult time determining the exact kind of cancer Dan has and has sent some samples to Johns Hopkins for a consult. The pancreatic tumor was fairly active, though encapsulated to make it behave a little better.

2 liver tumor samples showed just scar tissue and DEAD tumor tissue. The other 2 liver tumor samples showed mostly scar tissue with a small amount of necrotic cancer. That means his liver had a nearly complete response to the chemo and radiation.

The surgeons saw some swollen lymph nodes beneath the pancreas and believed that the cancer may have spread to the lymph system (very bad). They removed 22 nodes...and NONE had any trace of cancer. Yay!

The doctor is very pleased with the report and pointed out that the most active cancer is gone along with its margins.

That being said, one more small procedure and one more large surgery could make Dan a cancer-free man. Whoa!

Today is yesterday's tomorrow.

2010-01-22T13:08:00.000-08:00

I tried to get Dan to write this since he wrote such a great blog yesterday, but...no luck. You're stuck with me.

Today is much like yesterday and the day before yesterday and the day before that.

Dressing changes show a wound that is healing, just very slowly. The skin and adipose tissue looks very healthy but the fascia (tough under-layer) is healing with some holes. Thus, Dan will have a hernia when the wound closes up. Luckily, he's having another surgery in the near future (the other half of the liver resection) in which they will fix the hernia and shrink some of the scar. The docs still want to put a wound vac on him, but are waiting for the slow-like-molasses-in-snow wound to clean up and look nice. No point trapping infection inside under a sponge and suction!

The drains may have slowed a touch last night. One of them went for 8 hours with nothing! And then drained faster to catch up with its twin. Dan is on a medication called octreotide to lessen the secretions, which has been increased in dosage 3 times already. Between that and the NPO status, his pancreas should stop throwing a hissy fit soon.

McGreeky announced that discharge will not be until midweek next week. Dan will most likely go home on TPN at nights and clear liquids in the day time. He's thrilled (note sarcasm), but wants to go home regardless. So, we will have two addtions to our little family: Mr. Wound Vac and Mr. TPN.

Right now, I am discussing with case management where home health needs to be. We thought we would be going to Santa Rosa for a week to recuperate before going to La Mirada, but as this hospitalization has grown longer--the beginning of school for me has grown closer. I may need to miss a couple of the first days (if you know me, you know I'm bummed), but we hope to get to our apartment as soon as is safe. Luckily, Biola's nursing program has surrounded Dan and me with prayer and support and is doing everything possible to help me graduate on time.

For those of you concerned that we are going to be in SoCal alone, we will not be alone. We live in a complex filled with wonderful families who have offered to help us in anyway possible. Additionally, I work at a hospital on a surgical floor where I believe I can find answers to questions that arise. Also, I'm in nursing school surrounded with wonderful and skilled nurses. Finally, Stanford is always a phone call away (and a quick airplane ride if necessary). Psychologically, Dan feels he wound heal better in our apartment. He needs some normalcy. If for some reason, something comes up that would necessitate staying in Northern California, however, we have enough wisdom to do what is best for Dan's health.

Today will hopefully provide some good news as to the collection of fluid in Dan's abdomen. He is currently drinking more contrast fluid for another CT. This one will be before 1 am! McGreeky is specifically checking to see of the small abcess has resolved or if there is anything else to "go after" in his abdomen. We are praying for only good results. No more setbacks!

Thank you for all the prayers and support you have given us. From cards to games to food (for me) to flowers (thanks, Mama!), your love is very apparent.

You will note that I am now including praises to the Lord. Many prayers have been answered. To God be the glory.

Prayer Requests:
* Clear, good results on the CT today
* Drying up of the pancreatic drains!!!
* Continued wound healing and start of wound vac
* Flexibility and understanding of the case managers and doctors in d/c planning
* Encouraging news
* Release from the hospital in time for me to begin school on February 1st
(We can be surrendered to God's timing and still hope and ask for expeditiousness)

Praises:
* Safe surgery despite its length
* Very excellent pathology report
* No VRE/MRSA in wound
* No increase in drainage last night
* Encouragement from family/friends
* A private room for me to stay with Dan (and a shower!)
* Compassionate nurses and excellent doctors
* The Great Physician is in control

An apt word

2010-01-21T19:50:00.000-08:00

I think one thing I've learned through this whole ordeal is how to deal with bad situations. Not something like patience or perseverance, which I think I have developed quite substantially over my lifetime, but how to both be in a bad situation and trust God in it. What I mean is, before, because of my unusually optimistic outlook, when a bad situation arose, my mind would tell me, 'Don't worry. Everything will be ok. Time to be happy.' Now, I think, 'Don't worry. Everything will be ok. But it still really really bites.'

There are a lot of sunny-faced Christians out there that love to be happy and don't know how to be sad. I'm pretty sure I used to be one of them. I'll tell you what, the term 'the joy of the Lord' means a whole lot different to someone who's stuck in the hospital and can't eat.

One of my verses that I have recently adopted as one of my go-tos is from 2 Corinthians, verse 9, where Paul asked God to take away the thorn in his flesh: "But He said to me, 'My grace is sufficient for you, for my power is made perfect in weakness.'" Note that God doesn't take away the thorn. He denies Paul's request. Does the thorn, then, all of a sudden, become so easy to deal with? Paul says that from then on, he delights in weaknesses. But the thorn never changes. The thorn still sucks. It's still a bad situation. God's grace is sufficient for me. He is here with me and has been working wonders throughout this ordeal, thanks to a multitude of prayers that have been pouring in. So many good things have happened-- I have a lot to be thankful for. And that helps. But you know what? It still sucks right now.

Dan

Discouraged

2010-01-21T08:33:00.000-08:00

Neither of us feel like blogging, so this will be short or not very exciting.

Dan is basically the same as yesterday. His wound looks about the same--not getting worse, but not clean enough for the wound-vac idea the docs had. It would speed healing, but his wound isn't ready yet.

His drains have shown no decrease whatsoever. Even without food for 3-4 days, his pancreatic leak persists. Dan would prefer to have a leak because of food. The TPN keeps him from being too hungry, but knowing his GI system can handle food makes it difficult to still be allowed to eat. As the leak persists, there is no reason for the docs to let him eat again.

His infection seems to be mostly gone. WBC count better (10.7) and no fevers.

McGreeky says he'll be here at least through the weekend. Personally, I've lost my confidence in his estimation skills (a couple hours=7 hours?), so I'm not getting too excited when Monday rolls around.

Basically, room 339 is getting restless, discouraged and sad. We aren't getting any reasons to believe we'll be living any where but here in the near future. I'm beginning to feel the pressure of school being a week away. I need to write essays, order books, pay rent, organize my schedule, etc. Biola is being very flexible with me, but I was hoping to be able to make it to the first day of school (February 1st). That is very unlikely.

Dan's day revolves around 4 dressing changes, antibiotics, getting cleaned up, walking around the unit and sleeping. For someone who doesn't feel that bad, days in the hospital go by slowly.

I apologize if this is not the tone everyone is used to from us. We're tired. We're hoping God will intervene, but having a hard time expecting Him to.

Prayer Requests:
* Continued healing of pancreas and wound
* Increased speed with which Dan's body heals
* Dry pancreatic drains
* Multiply the hours of sleep we are getting
* Some form of encouragment from the doctors
* Something good to happen--more than just a day of waiting
* Release from the hospital by next Monday (can't hurt to ask)
* Dan and I can make it home (La Mirada) in time for the first week of school
* Good spirits

drip drip drip

2010-01-20T09:03:00.000-08:00

It's really coming down out there. There are likely going to be floods in some places. And I am stuck inside hooked to a pole where my food and antibiotics drip, drip, drip. Such is my recovery: drip, drip, drip. The wound looks a little better. The drains are leaving about the same amount of liquid, but it looks like it's slowing. But still: drip, drip, drip. I'm really tired of being here, and I'd really like to be eating food, but I must keep dripping until I get to go home. At least things are improving. The TPN (food) in my new PICC line keeps my energy up to a fairly normal level, but I still miss eating for real.

I'm really glad that Ashley is here with me. She has been an amazing help and encouragement to me. I promised her I'd do this blog so she could watch a baby show on TLC, so... I don't really have much else to say. Keep praying, keep loving each other, and I'll see you when I get out.

Dan

Hurry up and wait

2010-01-19T18:26:00.000-08:00

I looked at the clock and just realized that I haven't updated everyone today! Oops. My folks came to visit, I went to the Sizeloves to take a shower, went for lunch, and just hung out with Mom and Dad. Felt so nice to have them around. (Thanks for doing my laundry, Mom!)

Today is another day of waiting, which is something we are going to be doing a lot of in the near future.

We were told to wait patiently for the PICC nurse...and she showed up early! The line insertion went by the textbook, and Dan said it barely hurt this time. Luckily, his PICC nurse has been doing it for 19 years and teaches all the other PICC nurses. She had lots of stories, explained the newer technology they're using now, and gave me tips on getting into oncology nursing as that was her old field. She loves to teach, so she had an eager student for a while.

We were also told to wait for Dan to feel better after starting PPN (partial parenteral nutrition) last night...instead, he woke up feeling somewhat better. He even woke me up this morning with all of his energy. Though he still wants real food, he feels as though he is getting much better nutrition to keep him running on more than fumes. He'll be starting TPN (total parenteral nutrition) tonight through his PICC.

The biggest things we are waiting for are his drains to dry up and his wound to heal. These will keep us waiting for quite a while. The docs are hoping his pancreas (and now biliary anastomosis) will heal quickly while Dan is resting his bowels. One of the drains began putting out a new color of drainage: bile green. So, that means another anastomosis is leaking a bit. It is low output (by the doc's estimate), so they are simply watching it for now. The pancreas is slowing a little, but only a little.

Dan's wound got some special cleaning attention this morning from McGreeky. He spent a little time cleaning out the "nooks and crannies" before packing it. He feels that it is improving, albeit slowly. He is contemplating using a wound-vac to speed the healing, but the wound has to be very clean before that can happen. Perhaps a couple more days. Another doc just stopped by to see Dan's most recent dressing change and was surprised how good it looked this evening..."improving by leaps and bounds," she said.

So, now, we wait. It really does feel like we're rushing to get things done to get out of here, but it really won't be soon. Dan's really hoping for discharge this weekend, but we both know that he is safe here. Better to have most of the surprises occur at the hospital rather than at home!
Dan is getting restless and a little bored, so I'm trying to be creative. Any ideas for "fun" things to do in the hospital?

Prayer Requests:
* Continued healing of the wound by "leaps and bounds"
* Drying up of the pancreatic/biliary leaks (quickly!)
* Lack of hunger for Dan while NPO on TPN
* Safety for PICC line--no placement probs, infections or mix-ups
* Endurance and encouragement
* NO MORE COMPLICATIONS
* God's glory to be shown throughout this situation

A blog I do not want to post

2010-01-18T10:35:00.000-08:00

As much as I had wanted to blog today about going home, this update will be much different.

Dan finally got his CT around 1245 am! Luckily, the results showed that there are no large abscesses to "go after" surgically. There is some fluid rolling around in his belly, but they think it will begin to go away.

The bad news, though, came after the good. Dan's pancreas is leaking too much for the comfort of the docs. If Dan were not having more surgery in the near future, McGreeky said he would send him home with the drains and let the pancreas heal on it's own. However, with more surgery on the horizon, the surgeons want to be aggressive with forcing his pancreas to heal. Thus, Dan is again NPO. He'll be getting another PICC (peripherally inserted central catheter) line tomorrow to start TPN (total parenteral nutrition). He's lost about 20 pounds the past 10 days, so he's very behind on nutrition.

The plan now is to let Dan's bowels and pancreas rest long enough for it to heal. He will not be allowed to eat more than sips of clears until his drains dry up. The earliest this could happen in Thursday--the very earliest. Dan could go home on TPN if his body tolerates it well. It is becoming more and more convenient that I am in nursing school (and almost done), as I can do the dressing changes for his wound, his PICC and take care of the TPN.

McGreeky wants to be aggressive and cautious, making sure Dan recovers completely. He sees this as a definite setback, but one that can be repaired.

Dan and I are obviously disappointed that we are looking at least 5 more days of hospital life when we were first told we could go home today. Yet, he is in really good hands here and it is comforting to know that the docs are keeping such a close eye on him.

As for me, I am basically living here. I have a comfortable couch to sleep on and a kitchen to make soup and such. I'm going to try to canoodle my way into the shower room on the floor...washing my hair in the sink might get old after a while!

Dan needs some cheering up--that's for sure. He is feeling fine and will feel even better once his nutrition picks back up. That being said, please call or email or visit. As long as you aren't sick and call first, Dan likes a little company to distract him.

What will help most, though, are your prayers. Dan needs a lot of healing.

Prayer Requests:
* Healing of the pancreas--quickly and finally (drying up of the drains)
* Resolution of infection(s)
* Endurance and encouragement for Dan (and maybe me)
* Understanding of the nurses (they've been very accomodating thus far)
* God's kind of healing--the massive kind that shows that only He could have healed Dan
* Good news!
* God's glory through our actions