Now and Then

What a contrast this visit has been for us from our first trip to Worcester in June/July of 2012. In many ways it was exactly the same, and in many ways it was totally different. As I've pondered why this trip has had such a different 'feel' to it, I realize that it stems from how the similarities and the differences stacked up against each other this time around. I'm about to explain all of that, so if you're in a hurry you might want to skip down to the last paragraph for my update on Nate!

Same, and different...
For starters, last time I was the one who got the lobster! Nate got smart this time around, and thoroughly enjoyed his meal! 

2014
Nate enjoyed his first whole lobster, and
really rocked the bib!

2012
Feeling a little spoiled for such a treat!

Different...
Last trip we had a weekend in between pre-op and HIPEC, so we got to tour around Boston and Vermont.

2012
This time we didn't get to
visit Mike's Pastries...

...or get sick on Mike's Pastries.

2012 
Freedom Trail

2014
This time we only had time to explore from the car

Same...
We were fortunate enough to snag a room at the ACS Hope Lodge of Worcester. So grateful for this amazing service!

2012

Different...

Summer/Fall
shave/no shave
a little skinny/good, healthy weight

2014

Different...
We were lucky to get the "family bedroom" this time so Genn and Nancy could stay with us. There's two twins and a queen bed in this one with a lot more space to move around! Made a BIG difference!

2012

2014

Same...

HIPEC Procedure

2014

2012

            
          Different...
              bangs/no bangs haha
              cute hat/no cute hat



Same...
Surgical Waiting Room

2014

2012

2014

Different...
14 hour surgery in 2012 vs. 17 hour 42 minute surgery in 2014

2014

Same...

2014

Fat Hand Syndrome

2012

Although, last time Nate was given 23 liters of fluid, this time only 8. Not so fat in 2014!

Same...

Great company from Genn (my sister) and Nancy (Nate's mom). Not sure how I would've survived these trips without these two angels. So grateful!

2014
Yes he's a little drugged...talking to the kids

2012

2014

Same...

ICU stay then to Oncology Floor

Different...

2012 FOUR surgeries/TWO ICU stays/GAZILLION Oncology stays in 6 different rooms, 27 day hospital stay

2014 ONE surgery/ ONE ICU stay/ONE Oncology stay in 2 different rooms, 9 day hospital stay

2012 ICU

2014 ICU

2014 Oncology

Same...

Pesky new friends.

2012

2014

Same...
Dreaded NG Tube

2014
hates it now

2012
hated it then...

Different...

Sleeping arrangement for Nat

2012
Had a hard time leaving Nate in the hospital...
my own kind of therapy

2014
actually slept at the
Hope Lodge...every night!

Different...

TWO ambulance rides in 2012

NO ambulance rides in 2014

2012 Wheels

2014 Wheels

Same...

Determined Nate! He is AMAZING!

2014

2012

Different...

Notice any difference? In 2012, I had a constant view of the old State Insane Asylum (building on right with clock tower), and the current State Mental Hospital (red brick on left). I was pretty sure I'd end up there before the end of that visit! One of the first things I noticed when we got to the hospital is that the old Asylum is being torn down! Hopefully they aren't expanding the current hospital?!

2012

2014

Same...

Happy, hopeful, optimistic, friendly, positive, mind-over-matter, strong, generous, cheerful Nate! Still a crowd favorite among the nurses and OR staff.

2012

2014

Did I mention that he's always very patient and cooperative with my photos?

Different...
THREE hospital discharges/ONE hospital discharge

2012

2012

2012

2012

2014

2014

Same...
Nate recovered at the Hope Lodge in his favorite spot in the basement family room.

2012

2014

Same...

We miss our cute kids!

2012 our perfect children

2014our "perfect" children

2014did I mention they're perfect?

Different...

In 2012 we relied on Skype to talk to the kids...blek

In 2014 we got to FaceTime which was so much better!

2014

Different...

This time Nate had a whole team of surgeons. Dr. Movahedi and Dr. Maykel assisted Dr. Lambert for a "better than expected result". 

Dr. Movahedi, Liver Transplant Surgeon
Missed out on a picture with Dr. Maykel

Same...

Appendix Cancer and HIPEC procedure

Different...

2012 Dr. Lambert couldn't remove all the tumors and was disappointed about the outcome of the procedure

2014 Dr. Lambert and her team were able to remove all visible tumor and agreed that Nate had the best possible outcome

Same...

Surgeon...The Amazing Dr. Laura Lambert!

2014

2012

We truly love this woman. Not only because she has literally saved Nate's life, but because she's such a kind and compassionate woman, full of faith and charity. She's dedicated herself to being an amazing surgeon, and to helping people with this rare cancer. We owe her so much! We're grateful for the professional relationship we have, but also for her friendship. 

Different...

2012 43 days away from home

2014 17 days away from home.....

That's right! We are coming home! We were blessed to squeeze onto a flight leaving Boston at 7:15 tomorrow morning! Just ahead of the first nor' easter snow storm expected to dump 6 to 12 inches of snow on the busiest travel day of the year! We land in Salt Lake City at 2:15. We are so grateful that this is working out, and we cannot doubt that we've had heavenly help from the beginning. Heavenly Father is so aware of his children! 

Same...

HOPE! Gratitude! LOVE! Determination! STRENGTH!

Finally, an update on Nate. As you know, Nate is amazing. He's been blessed with a strong, resilient body. He's had a very quick recovery after this surgery, and continues to improve. After he was discharged, we've been trying to lay low. We rented movies, watched way too much TV, and took naps. On Sunday Nate felt well enough to go to church for two hours! Dr. Lambert gave her stamp of approval, and we even got to sit with her! 

We were at a stoplight! I swear!

We had an appointment with Dr. Movahedi yesterday. He was very pleased with Nate's recovery and since his surgical drain is draining such a small amount, he agreed to let Nate go home with the drain in place. He let Dr. Lambert know what he thought, and she called me last night to tell us that she agreed with his assessment, and that she would get in touch with our doctors in Salt Lake to make sure our surgeon there can follow Nate and the drain when we return. We immediately got on the phone with Delta, where we spoke to what I'm pretty sure was an angel, and we quickly had our flight arranged, complete with a wheelchair at every gate! She even waived our change fee! 

We had our post-op appointment with Dr. Lambert this morning. She removed Nate's staples (all 69 of them), went over a few details about recovery, and gave him a 'once over' before giving us the green light to go home! We're so excited! We didn't come into this trip with the same expectations we had before. It's not that we weren't hopeful, but the reality of cancer tends to settle on a person, and the more you fight the more tired you get. Dr. Lambert wasn't very hopeful that she'd be able to remove all the visible tumor which made the HIPEC a distant hope, and we came into this just feeling grateful that she'd be able to take what she could and hopefully add more "healthy" time to Nate's life. 

The good news started coming the day of surgery, and it really never stopped (knock, knock, knock on wood). We're amazed, humbled, and thankful beyond words. We've been so blessed, and acknowledge God's hand in our lives. He tests us and He tries us, but above all He loves us. 

We're so excited to spend Thanksgiving Day with our family! We hope you all have a wonderful holiday! Thanks again for sticking with us and cheering us on! Love to all!  

We broke the good news today while
FaceTiming with the kids after school...
SO HAPPY!!!

Hanging Around

We don't have any "new" news to share, thank goodness, but I'm happy to report that Nate is still recovering  well at the Hope Lodge. We did have to go see Dr. Lambert and Dr. Movahedi for an unexpected visit yesterday when Nate's surgical drain changed color overnight. Dr. Lambert checked on Nate through a text to me, and when I looked at the drain to tell her how much was there, I  noticed the color change. I sent her a picture and she asked if we could come in. Those old familiar emotions came out in me and I secretly packed an overnight bag for the hospital. Old habits die hard!

After seeing Nate, and the drain, Dr. Lambert and Dr. Movahedi weren't as concerned. They said that anytime surgical drains are placed, and left in, bacteria starts to form and can change the color of what's draining out. Even though the bile changed color, it was still clear, watery, and had no odor. Nate also showed no new symptoms and all his vitals were good, so they sent us on our way. There's nothing like having a surgeon's personal cell number for questions and concerns. She is one amazing woman! 

We love the balloons Mike! We'll get him on the course ASAP! 

Nate had a good night's sleep and is currently napping on the couch. I'm so thankful to be able to stay in the Hope Lodge where we have so many comforts of home. The fact that it's free is also a huge comfort! Thanks American Cancer Society for providing these facilities around the country!

This may or may not have been a posed photo for Nate's mom.
I'll never confirm or deny.

Nap time

Sam had his end of season football banquet last night. We were sad to miss it, but he had a large fan club there to support him. So proud of all he accomplished this year! He learned a lot from his great coaches and made some great little friends. I think we may have discovered Sam's passion. 

Good job Sam!

The plan from here is just to rest and recover. We are still praying for the surgical drain to stop draining, and that Nate's pain can be controlled. He has appointments on Monday and Tuesday with his surgeons. Hoping for a very uncomplicated recovery! We hope to be able to come home sooner than our scheduled flight on December 5th! We miss our kids! Here's to hoping!

One Flew Out Of The Cuckoo's Nest

That's it folks! He's out. When I arrived at the hospital this morning, Nate's discharge process was well on its way. I, of course, threw a major fit and asked for a few more days of surveillance but was immediately shut down and offered a Valium, which I politely declined. Nate met all of the discharge goals; his pain is in control, he's off IV meds, he's eating and walking, and apparently sweet talking all of the doctors into letting him go. After a very reassuring discussion with Dr. Lambert, we got to leave the hospital around 1:00! I'm so glad to have him staying at the Hope Lodge with me! I've missed him so much!

Taken this morning  just before we got the good news!
Seriously, he looks too good to be in the hospital, right?!

Today is Day 8 post-op, and Nate and I are both pretty surprised at his relatively short hospital stay. Last HIPEC he stayed for 10 days post-op and we thought that was amazing! Nate was definitely not as "healthy" the last time around, he had a lot more disease, and was about 40 pounds lighter. He's done so well this time around that I keep waiting for some ball to drop. I'm so grateful for Nate's strength and resilience. I know that we've been so very, very blessed. Thank you for all of the prayers!

Behind that patient smile Nate
 was screaming "Get me out of here!"

Goodbye Elevator C! Hope to never see you again!

Looks ready for a jog!

On to better days!

                   

After our big escape, we headed to the Hope Lodge where Nate will rest and recover under my watchful eye. The plan is to take it easy over the weekend, pray hard that his liver will heal and stop draining, and that everything else will heal up well! He has an appointment with the liver surgeon on Monday and an appointment with Dr. Lambert on Tuesday, where he'll get his 69 staples removed (we miscounted)!  He's been a very good patient thus far, and I promise not to let him lift more than a gallon of milk, eat popcorn, or go for a jog. 

The kids were pretty excited when we told them the news! So was Nate....haha!

Love to All!

Day 7...Man On The Run

Every year, UMASS hosts a PMP Symposium, MC'd by our very own Dr. Laura Lambert. As luck would have it, our visit coincided with it perfectly! Dr. Lambert invited us to attend, and even busted Nate off the floor in a wheelchair! It was all pretty exciting, what with Nate getting to put his shoes on and all. So the day began with a trip over to the Medical School Building. With the winds whipping, we chose the indoor route over the "pathway", and Nate never had to go outside. He did, however, enjoy basking in the sunlight out in hallway during a break.    

The presenters included a pathologist from Mass. General in Boston, who is an expert on peritoneal cancers, a Medical Oncologist from UMASS, Dr. Lambert, and an Appendiceal Adenocarcinoma SURVIVOR of 13 years. It was nice to exercise the old brain cells for a minute as we learned more about the latest research and awareness progress. There were also about 20 other survivors in the audience! Good company! Dr. Lambert pointed Nate out to a few of her colleagues as, "the guy I operated on for over 17 hours last Wednesday". There were more than a few, "Are you serious?", "And he's here?", "What?!", and "I bet he has his SuperMan disguise on under that track suit" comments. I was feeling pretty proud to be on his arm today.



We stayed for about two hours before Nate's pain started to kick in so we headed back to his room. BUT, not before we took a photo op with the famous MOAS HIPEC machine! That is the same perfusion machine used on Nate last Wednesday. The tech who started the perfusion was also present, so he explained how it works and showed us the temperature settings, catheters, and tubing. He also showed Nate exactly what he had sticking out of his belly during the procedure. It was 4  rather large rigid tubes about the exact same size as one of those giant Pixie Stix! I have to say, it was pretty cool.

After I maneuvered Nate back to his room, he had a nice lunch and we watched a little daytime t.v. What is with daytime t.v.? Dr. Lambert came for a visit and answered a few questions we had about the symposium, and she changed a few orders around so Nate is now on all meds by mouth. Apparently she wants to get him ready for discharge at some point. I know Nate's ready for that, but I don't know if I am! I do not want him exploding on me again! It's so much pressure!

We really aren't too sure when he'll get the boot, but I for one appreciate all the eyes that watch over him day and night. Maybe it's PTSD playing out? Nate's actually been a very compliant patient and is taking everything pretty slow. He's been very cautious on his diet, he takes his walks per Dr.'s orders, and he's staying on top of his pain meds and his naps. I appreciate his optimism! I also know that Dr. Lambert won't let him go until she knows he's ready. I hope this paragraph satisfies the 147 of you who sent texts, emails, and FB comments to encouraged Nate not to rush his recovery too fast! Believe me, I'm as freaked out and as cautious as you are! I just can't hold him back when he's behaving like a model patient!!!

On a more serious note, Nate's pathology came back today. Dr. Lambert was correct on her assumptions after seeing the tumors in surgery that they looked more like low grade cells. All tumors came back as low grade except one nasty little area up behind the liver which had a "focal" area of moderate grade cells. She's going to present the pathology at Friday's tumor board for clarification of what "focal" means, and to discuss recommendations from here. She described the report as "very positive" and she seemed genuinely happy with the results. This really is good news!

And what would a "Natalie" post be without a medical equipment update? Doesn't our old friend look sad and lonely? I feel bad saying it, but I really don't feel like that's any of our concern. In fact, I'm really hoping not to see "her" around again anytime soon.

Cheers to another day of good labs, good pain control, good pathology, and solid food! 

I was also reminded of one of my favorite "get me through the day" quotes so I thought I'd share it here. 

So, so grateful as I know that this applies to ALL aspects of our lives. Jesus Christ paid the ultimate price for each of us as we struggle through this life. I know that NOTHING will EVER, EVER, EVER go permanently wrong. Love to All!

Day 6...I Really CAN"T Keep Him Down!

Nate had another eventful day. On Sunday, his food orders went from "sips and chips" to a clear liquid diet. Yesterday he was advanced to a full liquid diet which he tolerated very well. Before the surgery, he swore that he wouldn't drink any chicken broth while here. Well, it's amazing what a man will eat/drink when he gets hungry! At lunch he even ate cream of wheat! Just before dinner, he was upgraded again to a regular diet! He does have to make good choices, like no meat, veggies, fresh fruit. No matter! He was pretty happy with a grilled cheese sandwich and a baked potato. He is completely on board with being cautious
and advancing slowly. We don't want to have any "incidents" this time around!

Goodbye Baby!

Nate's been up walking a lot today. He cruises around the Nurse's Station every couple of hours, and is feeling stronger with each trip. He started the day with 3 surgical drains and an IV for replacement fluids, electrolytes and pain control. Because two of the drains had decreased output, Dr. Lambert was able to remove them late in the afternoon! The third drain, by his liver, continues to drain bile, so will remain in until it stops.

That's not all! Because Nate is tolerating his diet, he was started on oral pain meds, which means that the IV was unplugged! His port is still accessed so he can still get IV meds if needed, but he doesn't have to drag that lovely pole around anymore! I was getting a little weary of the competition anyway! Like I said, no IV means no pain button, which means more pain for Nate and it's harder to control. This is where a good nurse can help out. Right now he has a great nurse, who grew up in Utah (crazy), that helps him stay on top of it really well. Praying the night nurse won't be too shy about waking him up for meds! Sorry Nate!

As you can see, losing the IV has its pros and cons. One more pro is something that makes a huge difference to Nate.....he got to have a real shower! Yay! Don't worry, there's no pictures.

We don't know when Nate will be discharged to the Hope Lodge, but the goals are controlling Nate's pain, tolerating his diet, removing his staples (there's 64 of them!), and removing the third surgical drain. If there are no other complications (praying!), that drain is what could keep us here. They say it could take up to four weeks to stop, but we like to believe it'll stop way before then! Hey, a girl can hope, and pray, and pray some more!

Thanks friends! Made our day!

We received a great surprise today when Nate's nurse delivered this cute little bundle! It's from Nate's co-workers at UAMPS. Thanks UAMPS! We love you, and appreciate everything you do to help lighten our burdens.

Here's to a good night with restful sleeping and pain free dreams!

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!