Day 5...Can't Keep A Good Man Down

First, I updated yesterday's post with a bunch of pictures that wouldn't load last night. I guess my devices were fighting. Take a look!

Nate finally got moved up to 6 East, the Oncology Floor, where he will hopefully stay until he gets discharged. The move didn't happen until 10:45 last night but we finally got him settled and cozy in his own private room. He had a "pretty good" night, but his epidural dressing came loose so it had to be removed. It can only stay in for 5 to 6 days, so they would've taken it away tomorrow anyway. Unfortunately, Nate's pain is up without the epidural so he has to use the pain button more often. It's controlling his pain so we're grateful.

New view....rained all day long. Better than snow I guess!

We got to have Family "Home" Evening with the kids tonight. A sweet friend brought a cute lesson today and we got to make a Blessing Mix with them. Thank you to all of our dear friends who are loving my kids for me!

Face Time chat for FHE!

Spoke too soon, Nate just got moved again! Same floor, different room. Still private! Thanks Dr. Lambert!

Lazy Sundays

After that last post, I realized that I never actually updated anyone on how Nate's actually doing after the surgery! Another indication of my lapse in brain power. Thursday morning was a little wild. Since he came out of surgery in the middle of the night, the anesthesiologists wanted to wait until morning to extubate Nate so he could rest. When he woke up, he was confused and agitated about having the breathing tube in. He had to concentrate hard to resist fighting the ventilator. He also needed some fluids and electrolyte replacement, so he had to wait until 1:45 in the afternoon to finally get the tube out and breath on his own. That was a huge relief!

3ICU - Day 0-4

The rest of the day went pretty smoothly until he realized that he couldn't move his left leg, so the pain team came in and turned his epidural down. He soon began to regain control of his leg, but he also started to feel a lot of pain, at a level of 7 or 8, which is really high for Nate. He finally ended up with a PCA (pain button), and a smaller dose in the epidural. I've mention before that Nate's a bit of a light weight when it comes to pain meds (which actually works to his advantage), and he hasn't disappointed! I'll just say that Friday was a pretty entertaining day in 3ICU! Thankfully, they got his pain under control and he slept his way to Saturday morning. Well, maybe 'slept' isn't the right term....

He had a rough night listening to the nurses 'chit chat' at the station just outside his room, and also had to endure several (as in 8 or 9) needle pokes as they tried to find a good vein after all of his IV's went bad. His right forearm and hand looked like he'd been working out with Popeye after about a liter of fluid was pumped into it through a bad IV site. Yesterday was a long day for Nate, but he remained his ever cheerful self. He is, once again, a staff favorite.

Nice view of the Nurse's Station...a lively place at 3 a.m!

Today was a pretty eventful day (as eventful days go in the ICU), and Nate made some great progress! This morning he got the great news that his NG tube could come out. Hallelujah and Amen! Nate's nurse pulled the dreaded thing at 11:45 and Nate was a happy man! He got all cleaned up and sat in the chair for a while. He was upgraded on his diet to "sips and chips" and even got to use a spoon to get to the ice chips! He also took his maiden voyage around the nurse's station!
 

We got to listen in during the Primary Program via Seth's phone at church which was a great boost! Sam and Sydney got a little surprise when the Bishop asked them to come to the podium and say a few words. So awesome to know what great hands they are in.

Love these crazy kids! 

I left for a few hours to go to church where I saw some old friends from our last visit and met (get ready for this) Nate's cousin's wife's brother and his wife! They live right here in Worcester! Crazy! The missionaries came by tonight to bring Nate the sacrament. I'm grateful that wherever we go, we can find access to the priesthood and its blessings.

The fun continued as we learned that Nate's ICU bed is needed, so he's getting transferred out of the unit and onto the Oncology floor! This means a few things. First, he gets a room with a door, which means quiet. Second, he doesn't have to be hooked to all of the monitors so they took off the sticky leads. Third, I don't have to call from the waiting room and get buzzed in anymore! Fourth, he's well enough to be out of the ICU!!!

Movin' on up to 6 East - Oncology
Nice legs, huh?

Quoting a wise friend, "We know not what tomorrow will bring and so we bask in the good news of today!"

Looking forward to losing some of that equipment in the background!

Pictures tomorrow...my devices won't sync. Argh. Pictures added! Enjoy!

Somebody Pinch Me

Can somebody please pinch me? After arriving at the hospital at 7:15 a.m., saying goodbye to Nate at 8:25 a.m., and waiting for almost 19 hours until I could see him again, I'm a little tired! The actual procedure started at 9:03 a.m. and ended at 2:30 a.m. It lasted for 17 hours and 42 minutes to be exact. It always takes time to get him settled up in the ICU, so I didn't get to see him until 4:00 a.m, 19 hours and 12 minutes after we got here.                          

 
I spent an hour with Nate before I nearly fell out of my chair, and was kindly escorted to a couch in some distant waiting room where I woke up four hours later.

Forgive me for such a late update. My brain feels pretty mushy, and I haven't had many coherent thoughts over the past two days. Thank you for letting me know that you're all still waiting and watching for news. Once again, Nate and I are overwhelmed with all the support we feel. Hopefully, I'll be able to write something here that makes sense!

At 10:45 pm, after 16 hours waiting in the same spot in the OR waiting room, we were thrilled to see Dr. Lambert walk into the room. This is always an anxious time as I try to assess the situation/news by watching the body language of the messenger. We've learned a lot by watching Nate's doctors over the years, and find that they usually give a lot away through their body language. As I watched Dr. Lambert, I could clearly see that she had a lightness to her step. Amazing in and of itself since she'd been on her feet since at least 8:15 when we first saw her! I'll admit that I allowed a spark, maybe even a flame, of hope well up in my chest. She sat down on the couch and flashed a smile that I won't soon forget.

She reported that they had just started the HIPEC perfusion, and since the treatment takes 90 minutes, she was taking a break to update us and to grab herself a drink. She said she was very happy with the surgical team and she felt like they all made really good decisions and took their time. She felt that Nate had the best possible outcome from the procedure. Music to my ears!

She explained that both of the other surgeons had a tough job to do because of the location of the larger tumors. They were very tricky to get to, which lengthened the procedure time. Dr. Movahedi (liver) had a challenge "taking the liver down" from the abdominal wall as it was "stuck" from all of the adhesions and scar tissue from prior procedures. It took extra time to carve the tissue away so they could get the liver free enough to remove the tumors. Dr. Lambert said Dr. Movahedi did a "great job" and was very careful as he proceeded.

Dr. Maykel spent a lot of extra time trying to preserve any and all tissue possible in the lower pelvis. The tumor was rather large, and sat next to some major mechanics and blood supply. They spent a lot of time trying to carefully dissect what they could to free up the vital tissue around the tumor, and also trying to prevent nerve damage to the major nerve centers in the pelvis. They spent an extra long time around the colon trying to free it up from the tumor, but ultimately decided to remove more colon because the blood supply was so compromised. Both Dr. Maykel and Dr. Lambert agreed that it was "the right decision to take it out", as the ultimate goal was to remove the tumor. Dr. Maykel said that Nate still has a very good amount of small intestine and colon left. I'm sure he sees some pretty crazy stuff in his line of work! I guess it's all about perspective!

After both surgeons were done, Dr. Lambert stayed behind to finish up. She examined every inch of colon and small intestine, freed them up from adhesions and scar tissue, and removed other smaller tumor nodules all around the abdomen. She noted that these tumors peeled off the tissue verily easily. When she was satisfied that all the tumors were out, she looked at the latest CT scan again, and noticed an area below the liver that she wanted to look at and work on a little more. She did find tumor there, and was able to remove it. At this point, she felt confident that they'd been able to remove all visible tumor. Miracle! By this time it was about 8:30 pm, and we were hopeful that she'd be done soon. They say that patience is a virtue...we didn't see her until 10:45!


It was great to listen to Dr. Lambert describe the operation. As with any surgery, especially abdominal surgery, scar tissue and adhesion are a major concern when there have been prior procedures. Although she didn't come out and say it, she was very worried about the possibility that when she opened him up that there would be too much disease and/or scar tissue and adhesion that may have prevented her from accomplishing anything. She said this was a major concern for her coming in to the day, but that she was "very encouraged and impressed by Nate's amazing attitude about everything in pre-op". She said his demeanor and ability to joke around and be so cheerful helped her feel better about the day.

There were more than a few remarkable things about the day, here are the highlights:

Nate got to talk to the kids on Thursday!

*When they made the first incision, Dr. Lambert was expecting to spend "hours" chiseling away at scar tissue and adhesion before she'd be able to even see into the abdomen. In her words, "I've really never seen anything like it. After making the incision, I just slid my hand inside and we got right in". Now she's done A LOT of these surgeries, so when she says she's "never seen anything like it", it's a celebration! I know this was a very direct answer to some very specific prayers, and I'm grateful beyond my ability to express.

*She mentioned twice that Nate's small intestine looked "really good", and much healthier than the last time she saw him.

*There was also a positive difference in the tumor in the lower pelvis. During the last HIPEC in June 2012, there was also a large tumor in Nate's lower pelvis. They had to leave a "postage stamp size" piece of the tumor behind which they hoped the HIPEC would take care of. In subsequent surgeries, there was no sign of it. After we saw tumor growing in the same area, we assumed that it was the same tumor. However, this tumor was a bit lower, or deeper, in the pelvis and it looked like more of a low grade tumor than the other one. She suspects, and will be interested to see what the pathology says. This would be good news because low grade tumor cells have a better prognosis than mid to high grade cells. She said the liver tumor looked similar as well.

Because the tumors, and tumor nodules looked more low grade, it makes us think that Nate has responded really well to all of the chemo he's endured. It seems that the treatments have kept the mid/high grade cells at bay. It's nice to know that some big benefits may have come from all of the chemotherapy and suffering Nate's been through. Since the low grade cells don't respond well to iv chemo, these low grade tumors grew.

*During the last 14 hour surgery Nate was given 23 liters of fluid to keep him stable. This time he only required 8 liters so he isn't nearly as puffy! This also gives the kidneys a bit of a break. He did really well and was very stable throughout the entire procedure. Isn't it amazing how "otherwise really healthy he is"? (Still one of my favorite lines!)

*Dr. Lambert was so pleased with the outcome. She said that she's more encouraged than after the last HIPEC, and is very happy. She was glad we chose to do the surgery now, rather than waiting. She said he had far less disease than before, but it was much harder to get to this time. Hence the almost 18 hour procedure.

Nate is settled in the ICU and we are so proud of him!
He looks amazing!

So grateful that Nancy and my sister, Genn could be here with us. 

I'm so grateful for all of the blessings Nate and our family received on Wednesday. Both Nate and I have had a very peaceful feeling about the surgery and decision to have it now. I think that feeling came less from feeling like it would go our way, and more from the knowledge that we are all in God's hands, he has a plan for us, and he will always take care of us. We're very humbled by this knowledge, and by the miracles we've witnessed.


Thank you for the prayers, thoughts, good vibes, faith, friendship, acknowledgement and love you've sent our way. Nate is undoubtedly one tough cookie, but we have no doubt that these efforts result in continued blessings and strength for Nate and his family. Love to all!

17:42

17:42...yep, that's seventeen hours, 42 minutes

Nate is finally out of the OR and is getting settled in the Surgical ICU. Dr. Lambert is heading home to get some sleep, and I'll get to see Nate within the hour. He tolerated the HIPEC well. Dr. Lambert proclaimed, "This was a great day in the O.R.!" I'll take it.

It's 3:34 a.m. and I'm a little fried. I'll post a coherent update after a few hours of sleep! Thanks for hanging in there with us!

Time Time and More Time

Ahh time. We are now 14 hours into this, and have at least 2 1/2 hours more to go before we will get to see Nate. I can't even imagine how tired Dr. Lambert must be feeling. She is one amazing woman! 

Dr. Maykel, the colo-rectal surgeon, started his part at 4:00 and finished up at 7:15. I continue to be impressed with this team that Dr. Lambert put together. Dr. Maykel was able to remove all of the big tumor in Nate's lower pelvis that we were so worried about. It was tricky because the tumor had grown so large that it had compromised the vasculature around it. He had to dissect the tumor away from the colon, the rectum, from around the ureters, and a number of necessary blood vessels. This tumor also came out in one piece!

He said that the procedure went as he expected it to, and in his own words, "This is really the best case scenario". I'm starting to feel like things are too good to be true! Knock on wood! They did have to take some colon, but they connected it back together, leak tested it, and everything looked good. He left Dr. Lambert in the O.R. to finish cleaning some other small spots out of Nate's belly, and thought she might be another hour. That was 3 hours ago....

I just received a call from the circulating nurse who informed me that Nate is still doing well, is stable, and that Dr. Lambert was finishing up the de-bulking. Now for the crazy news...Dr. Lambert decided that the procedure went well enough that she felt comfortable administering the HIPEC! What?! They were just getting ready to begin the perfusion. Crazy. I'm so happy that the procedure went so well! I'm a little nervous about this HIPEC thing though. It's scary because I know how hard it was the last time, and all I can do is hope and pray that Nate will heal better this time around so he doesn't have any complications. It also caught me completely off guard because I was not expecting this!

I know he's had angels surrounding him today and that Dr. Lambert must have had heavenly help as well. I'm so grateful that so many of our prayers are being answered! I'll update as soon as I have an update!

Loving the Liver

Dr. Movahedi, the liver transplant surgeon, started his procedure at 10:30 this morning and finished up at 3:45. He was "very pleased" with the results, and when I asked if it was what he was expecting, he said, "It went better than he expected". Don't worry, I made him pinkie swear that he wasn't lying.

He said the tumor was completely wrapped around the caudate lobe, followed the portal vein down by the stomach and duodenum (beginning of small intestine connected to the stomach), and was pushing (not growing into) the right lobe (like a finger poking into a water balloon). They worked slowly, mm by mm chiseling the tumor away, and separating the tissue. Once they separated the tissue, he said he could pull the tumors out in one piece, and with some ease. He said there was less mucin than he expected, and that it looked localized around the tumors. He said it was a good thing he could get the tumor out now because it would have eventually squeezed off the duodenum and prevented Nate's stomach from emptying.

The Dr. drew the picture, I just labelled it. 

Now for the miracle of it.....yes, I said MIRACLE!!!

Nate has an anatomical abnormality (from birth), that about 5% of the population has. The liver is normally fed oxygen-rich blood through the hepatic artery, which has a right and a left branch. It lies right next to the portal vein (where the tumor had grown along), then splits into the left and right branch. These two branches bring oxygen to the different lobes of the liver. Instead of having both branches, Nate was born with only the left branch, and a gastric artery compensated to supply the upper part of the liver with oxygen-rich blood. In other words, an artery from his stomach feeds the liver with oxygen. I asked if it was consequential, and he said, "It was actually ideal". Because he was missing the right branch of the artery, it made it less complex because they didn't have to work around a major artery as they removed the tumor. The tumor could have also compromised the artery. 

"Ideal", "very pleased", and "better than expected" aren't words that we hear very often. Nate still has a long way to go in this procedure, but I'm grateful that this part is done and that the outcome is good. The colo-rectal surgeon, Dr. Maykel,  started on the lower pelvis as soon as the upper abdomen was complete. It could be 5 or 6 more hours before they close him up. Dr. Lambert also let me know that she's still undecided whether she will administer the HIPEC. This isn't surprising because at that point, she hadn't started exploring the lower abdomen.

my stopwatch....plus 90 minutes

Stay tuned! Grateful for anatomical abnormalities and an ever watchful Father in Heaven.

The Wait Begins

Good morning! Just a quick update...

We arrived at the Surgical Registration Desk at 7:15 this morning. Nate was his usual cheerful self as he joked around with the nurses and anesthesiology team. Dr. Lambert sent two LDS Resident med students to pre-op to offer Nate a priesthood blessing which Nate gladly accepted. One of them was from Pocatello, ID, and the other was from South Jordan, UT. We're so grateful that we can find access to priesthood blessings wherever we are! Dr. Lambert joined us at 8 and went over the consent forms. Nate will get an epidural for pain control, as well as general anesthesia. This will allow him to recover without narcotics for the next week if all goes smoothly. When it was time for us to leave, we prayed together with Dr. Lambert for a successful procedure, stamina and guidance for the surgeons, and of course for extra strength and wellness for Nate.

We left at 8:25. The circulating nurse called at 10:30 to update us. The procedure began at 9:03, and Dr. Movaheti (liver transplant surgeon) was there working on Nate's liver to remove the tumor there. She said everything was going well....whatever that means! Grateful for an update. Last time we never had an update until 12 hours into the procedure when the circulating nurse went off shift. This will help to pass the time!

Here We Go Again

We're on the count down. Nate and I said goodbye to our kids on Saturday night, and left early Sunday morning for Boston. We arrived in Worcester on Sunday afternoon and checked into the Hope Lodge. Yesterday was a busy day full of pre-op appointments. We met with all three surgeons on the surgical team, anesthesiology, had a two hour pre-op consult, chest x ray, and a visit to the pharmacy. We started at 8 a.m. and finished at 4:20. I guess it's good practice for all the sitting and waiting we'll be doing over the next month or so. We were very happy with the two surgeons Dr. Lambert asked to be on her team, and are so grateful that she would consider asking specialists to assist her on the surgery. We know we're in very good hands. One of the Dr.'s is a liver transplant surgeon, and the other is a colo-rectal surgeon. 

Boston, MA LDS Temple

We had a great day today! After a good night's sleep, we traveled about an hour to the Boston, MA LDS Temple, where we spent a couple of hours before we headed to the airport to pick up Nate's mom and my sister. They'll be here until Saturday night and are staying here at the Hope Lodge with us. I'm so grateful to have them here with us. I'm glad to have their company as we sit and wait during the surgery. 

Nate has to check into the hospital at 7:15 tomorrow morning. Dr. Lambert has him scheduled for the entire day in the O.R. We knew this was going to be another long procedure, but we weren't expecting another 14 hour day. Dr. Lambert said this procedure will be very much the same as the June 2012 surgery. The team will start in the upper abdomen at the liver. There's a large tumor up behind the liver that may require a resection of the liver to remove. This is where the liver transplant surgeon will help out. Dr. Lambert will then move down through the abdomen until she reaches the lower pelvis. At that point, the colo-rectal surgeon will come in to assist to remove a large tumor by the colon. If Dr. Lambert feels that Nate can handle it, and if she can get all visible tumor out, she will administer the HIPEC again. She seemed more hopeful that this was a possibility than the last time we spoke with her. Nate left the appointments feeling more at ease, and I left feeling more anxious. Go figure. We balance each other out so nicely. 

Always ready with a smile!

Nate is doing really well. He's cheerful, energetic, and always optimistic. I admire him in so many ways and I recognize the blessing he is in my life. I know that he would do anything for me and our kids, and this surgery is just one more evidence of that. I'm grateful that he's willing to receive more treatment in order to extend his time with us. I love him more than ever, and I pray that he will receive a complete healing. Tomorrow is another big day in this more than 2 1/2 year long journey, and we're hoping that this one will do the trick. Thanks again for all of your thoughts, prayers, and combined faith on his behalf. We're so grateful for the support we feel and hope you all know of our gratitude. 

Wish us luck!!!

Off To See The Wizard

Once again, time and life got the better of me and I've neglected to update our blog for almost two months! Today marks Nate's 11th treatment, and his 6th treatment of Vectibix (biological agent). He had a CT scan on October 16 to see if the Vectibix was making a difference, and to help us decide on timing for surgery in Boston. Thankfully, all of the tumors showed no growth since the last scan in late August. Ideally, we would've liked to see the tumors shrinking, but we will take "no growth" anyday! This is the first time that there's been no growth in visible tumors on the scans since late 2012, so we consider this good news! Since the tumors were still the same size, Nate's oncologist and Dr. Lambert recommended surgery as soon as possible to take advantage of the "no growth" window.

It took a few weeks to get surgery scheduled because we had to work with three different surgeons' schedules. Along with Dr. Lambert, there will be a colo-rectal surgeon, and a liver transplant surgeon (in case they need to resect some of Nate's liver). We both appreciate Dr. Lambert consulting with these other surgeons, and we absolutely trust her judgment. We're always glad to have any specialist on the case, so having three specialists in on the surgery is great! The goal of the surgery is to remove as much tumor and mucin as possible from the peritoneal cavity, which could include removing more bowel and portions of other organs. If they're able to remove all visible disease, Dr. Lambert will consider doing the HIPEC (shake-n-bake) treatment again, and will have it on stand-by in the O.R. While she doesn't think this is very probable, we know that miracles happen!

Nate is scheduled for surgery on November 12, with pre-op appointments on the 10th. We fly to Boston this Sunday, November 9, and have been told to expect to be there for a month. They estimate 10-14 days in the hospital and about two weeks before they'll give travel clearance. You all know what an optimist Nate is, and he's shooting for three weeks. I'm planning on a month because I'd rather be pleasantly surprised, but this is one bet I'd be happy to lose!

It's hard to believe we're doing this again, and it's killing us to leave our kids. We're not looking forward to spending Thanksgiving away from them! Fortunately, my parents are able to come from Idaho to stay with them at our house. Last time, we left during the summer and the kids didn't really have anything going on so they went up to Idaho for the 6 weeks we were gone. Now that they're in school, two years older, and they're running in every direction, having my parents come here to stay is a huge blessing. We don't want to disrupt their lives any more than we have to so we're very grateful that they can stay home and get spoiled by their grandparents. They can't wait for Grammy and Papa to get here!

Nate and I will stay at the Hope Lodge in Worcester, Massachusetts. This is another huge blessing. The Hope Lodge provides lodging, free of charge, to cancer patients and their caregiver. We stayed there during Nate's 2012 surgeries. It's a beautiful old Victorian mansion and it's only three miles from UMASS Hospital. It's nice to know we're going back to a familiar place and we don't have to figure things out all over again!

Nate's mom and my sister are once again flying out to be with us during the surgery and for a few days following. I'm hoping this surgery won't be 14 hours long like the other one was, but I'm so thankful that I'll have such good company again in the waiting room. Those waiting hours seem to tick by in a Twilight Zone fashion.

Since surgery was booked, Nate stopped receiving the chemical agents (the actual chemo) after his 9th round to prepare for surgery. This allows his body to get rid of the chemicals that can hinder tissue recovery, gain strength, and just have a break. He's still receiving the Vectibix infusion every two weeks (the biological agent doesn't compromise tissue), and the side effects have been pretty nasty. It causes a pretty severe skin rash, like teenage acne, that's supposed to peak at 6 weeks after treatment begins, level off, then become pretty mild for the remainder of the treatment. Unfortunately, Nate's peaked after 10 days, hasn't really leveled off, and certainly hasn't gotten any better. He received his 6th treatment today, and if it proves effective, he could stay on it forever. I'm praying that Nate gets some relief from the skin rash soon because I don't want him to have to deal with his recovery AND the rash. Grateful that it seems to be keeping the tumors from growing, but a little reprieve would be so nice!

Since I'll have some down time in Massachusetts, I'm planning to update the blog often for those of you that want to check on Nate. Please don't hesitate to call, text, email, FB, whatever, if you have any questions, a good joke, or any words of encouragement! We get a little stir crazy staring at hospital walls for weeks on end. Thanks again for the love we feel from so many of you! We are BLESSED!

Pray Big

                                  "True love is not so much a matter of romance
                                      as it is a matter of anxious concern for the 
                                                well being of one's companion."                                                   
                                                                                Gordon B Hinckley


I've been stalling on a new blog post for a month, and now I'm staring at this screen and my mind is blank. Hmm....Let's start with an update:

After four rounds (eight weeks) of the Folfiri treatment, Nate had another CT scan. Once again, we didn't get the results we were hoping for. The tumors looked bigger than they did in the last scans, which means that the chemotherapy hasn't been as effective as we'd hoped it would be. We also have to consider the fact that Nate didn't start chemo for a month after the initial scans, so the growth could have occurred during that time. We are so good at grasping at straws! Since we needed time to make some decisions, and since he only had four treatments, we decided to continue the chemo with the hope that it may be holding at least some cells at bay. 

We finally spoke with Nate's surgeon in Massachusetts about the scans, and she agreed that some of the tumors did look bigger. We discussed treatment options, and she wanted to consider surgery. She spent the next couple of weeks consulting three other surgeons about the case, and they all agreed that he could benefit from another surgery. Especially since he's "young, strong, and otherwise healthy". That's become one of my favorite phrases.


The surgery will be another long and involved procedure. Our surgeon will have two other surgeons assist her to debulk as much tumor as possible. The tumors are in some hard to reach places so she will have a liver guy and a bladder guy help her in those respective areas. She said that by agreeing to do another procedure we are "pushing the envelope", but that she really feels like Nate can handle it, and that it can help. There's risk involved because every time they go in, they have to deal with scar tissue and adhesion from prior procedures. The question most people ask is if Nate will have the HIPEC (Heated Inter Peritoneal Chemotherapy), or "Shake 'n Bake" as Nate affectionately calls it. The only way that will be considered is if all visible tumor and mucin can be removed during the procedure. They'll have it on stand-by in the O.R. in case this little miracle comes to fruition. We still aren't sure about the exact timing, but it looks like we'll be heading East sometime in November. 

Since the chemo doesn't seem all that effective, they've changed it up a bit. Nate will still get the Irinotecan (part of the Folfiri chemo), but will no longer receive the 5-FU, which is the chemo agent he carries around in the fanny pack for 46 hours. Nate's really going to miss that fanny pack. He also won't get the Avastin, which is the drug that interferes with tumor blood supply. In place of these he receives something called Vectibix, which is a biologic agent and not a chemotherapy in the traditional sense. It's an antibody therapy which targets and attaches to the proteins used to produce and maintain cancer cells. This treatment works for patients who don't have a KRAS mutation, which Nate does not, so he could very well benefit from the treatment (see how good we are at grasping?). The plan is to continue this concoction through 8 or 9 treatments (he has to be off of it for 4 weeks prior to surgery), and he will continue with the Vectibix every two weeks right up until surgery. More scans will be scheduled for late October. If the Vectibix works to shrink the tumors, there's a chance that they may want Nate to hold off on surgery and continue that therapy longer until he has reached a maximum benefit, meaning that the tumors will shrink to a point and then level off. 

 I hope that brings everyone up to date. Nate is currently receiving his 7th treatment (2nd of Vectibix), and will have at least one more just like this. The Vectibix has a nasty side effect of a severe acne rash, which started this past week. It's really the first time he's had an obvious side effect to his appearance, so you might be able to tell that he really is on chemotherapy! I don't know how this husband of mine does it, but he still isn't complaining. I'm grateful for his courage and easy going nature. I'm grateful for the perspective he has and how he takes advantage of the time we have together as a family. 

We are currently praying for an increased measure of strength for Nate, that the Vectibix will obliterate the cancer cells which will shrink the tumors, and in turn make them easier to remove in surgery, and that we will continue to be guided through this trial. Like I've said before, we believe in the power of prayer and combined faith, so we invite all who would like to join us in our petition on Nate's behalf. I saw a sign at the store the other day that I've seen before, but this time it really made me think about how grateful I am to have a Father in Heaven who loves me and my family. The sign had just two words, "Pray Big". So that's what the Hardy Family is going to do. Miracles happen! 

Love to all.