Goodbye 2010, Hello 2011

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

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

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

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

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

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.

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