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Re: Possibly unnecessary open liver surgery

Posted: Wed Jan 31, 2018 11:46 am
by mpbser
Thanks for all the positive vibes!

I just saw the surgeon. Everything went great. It was a small open incision, not laparoscopically. But that's OK, it's not much different in the end. The reason it could not be laparoacopic was his girth as he has put on weight in the past few weeks. The entry into his abdomen to get there to "drill down" into the liver was at an angle that just had to be done in open surgery. He did not have to remove the whole lobe because it was far away enough from the blood vessel. He made sure there was clean margins so there's no cancer left. There were some small micro spots that we already knew about on the right side that are likely little cysts but he burned them just to be safe. He will probably be discharged on Saturday assuming all goes well.

The doctor does not think that he can go back to work in a week like he hopes to be able to.

Re: Possibly unnecessary open liver surgery

Posted: Wed Jan 31, 2018 12:05 pm
by Robino1
Congrats on the successful surgery!! Good news indeed! :)

Re: Possibly unnecessary open liver surgery

Posted: Wed Jan 31, 2018 10:50 pm
by Shana
Good news! Hope he's home soon :)

Re: Possibly unnecessary open liver surgery

Posted: Thu Feb 01, 2018 12:08 pm
by LPL
Hi mbpser,
Surgery is over - that is good news! :)
The doctor does not think that he can go back to work in a week like he hopes to be able to.

Please take it easy - to heal both inside and outside. And remember NO lifting!

Re: Possibly unnecessary open liver surgery

Posted: Fri Feb 02, 2018 9:42 am
by mpbser
Sodium level is low. They haven't been testing his blood glucose as often as they did at our local hospital for his first colectomy. They were giving him insulin to keep his glucose at a steady 100 or so. Here, it is about an average of 150. This bothers me as normal blood glucose is so critical to proper tissue healing. I nearly flipped when the nurse came to give him a full sugar Gatorade. I brought him a Clearfast which has 8% RDV of sodium so when I showed it to her, she was satisfied with him having that.

His catheter is bothering him and making it too uncomfortable to sit for a bowel movement. That stinks because he really could use a poo! The catheter can't come out until the epidural comes out. That hopefully will happen soon.

The nurse just came in and said she was going to give him oral oxycodone now that the epidural IV dilaudid drip had finished. He was getting 10 ml every hour. It's going to be very interesting to see what his pain is like after this runs its course and is out of his system.

This is a huge factor in how well enough he will be to 1) be discharged tomorrow morning like they are talking about and 2) travel the 4 or so hours home. We will see.

Re: Possibly unnecessary open liver surgery

Posted: Fri Feb 02, 2018 5:06 pm
by mpbser
Husband refused to take oxycodone, as it doesn't ever help him much with pain and blocks up his digestive system. He is now on tylenol and tramadol. Pain hasn't been too bad and he has had sufficient bowel movements so that ileus is not a concern, for the time being. He will definitely be discharged tomorrow, but the decision whether to stay at the hotel or go home will be made in the morning.

We saw his surgeon today. The excision via burning (RFA and argon was used after manual knife excision to ensure negative margins) brought him within 3 millimeters of the blood vessel. Wow.

Re: Possibly unnecessary open liver surgery

Posted: Sat Feb 03, 2018 9:09 am
by mpbser
Husband will be discharged today at lunchtime but he and I are going to stay at least tonight in the hotel where I have been since Tuesday night. He doesn't want to risk the long, arduous drive home today and would rather play it safe. The forecast for tomorrow calls for snow, so we will likely head out as early as possible in the morning.

Husband's roommate at the hospital has had the same two surgeries by the same two surgeons, only in reverse: liver first then colon. His colon surgery went extremely well. So far, my husband's surgery has gone phenomenally well. Fingers crossed he keeps recovering speedily. We are very thankful husband is to have been in such wonderfully skilled hands.

Re: Possibly unnecessary open liver surgery

Posted: Sat Feb 03, 2018 1:34 pm
by LPL
Mpbser,
That sounds like a good plan!
Hoping this trip home will be different then last time..
Good recovery wishes.

Re: Possibly unnecessary open liver surgery

Posted: Mon Feb 05, 2018 5:39 pm
by AnonSurvivor
Was this a Dr. Ryan / Dr. Berger (aka the "two Daves") production? Those guys (+ Dr. Hochster at Yale (now at Rutgers)) cured me.

AnonSurvivor

Re: Possibly unnecessary open liver surgery

Posted: Sun Feb 11, 2018 7:09 am
by mpbser
I don't know those doctors, anonsurvivor. They were Dr. Qadan and Dr. Cusack.

I am so glad to be home. I've been so swamped with work for the past week to post an update.

The ride from Boston is so much better on Sunday mornings. Without traffic, we made it back in 3 hours. The surgery did not involve any maneuvering of the liver and his gall bladder was not removed. Originally, he was facing losing 60-70 percent of his liver, but thanks to a great team, that didn't have to happen. Only a couple centimeters from one segment were removed. The experience at Mass General this time around was so much better than the last. What a relief!

Apparently, you can request the floor that you get admitted to. Husband's nursing team on White 7 was so awesome that we have taken note of this in case he ever has to go back. Praying that doesn't happen but I think it will take a miracle. Given the diet he's gradually returning to (yesterday it was chocolate chip muffins, ice cream, fried chicken), I won't be surprised if he has future mets.

Very depressing and, to be totally frank, I've just about had enough.

Re: Possibly unnecessary open liver surgery

Posted: Sun Feb 11, 2018 8:36 am
by NHMike
mpbser wrote:I don't know those doctors, anonsurvivor. They were Dr. Qadan and Dr. Cusack.

I am so glad to be home. I've been so swamped with work for the past week to post an update.

The ride from Boston is so much better on Sunday mornings. Without traffic, we made it back in 3 hours. The surgery did not involve any maneuvering of the liver and his gall bladder was not removed. Originally, he was facing losing 60-70 percent of his liver, but thanks to a great team, that didn't have to happen. Only a couple centimeters from one segment were removed. The experience at Mass General this time around was so much better than the last. What a relief!

Apparently, you can request the floor that you get admitted to. Husband's nursing team on White 7 was so awesome that we have taken note of this in case he ever has to go back. Praying that doesn't happen but I think it will take a miracle. Given the diet he's gradually returning to (yesterday it was chocolate chip muffins, ice cream, fried chicken), I won't be surprised if he has future mets.

Very depressing and, to be totally frank, I've just about had enough.


I'm glad you have some good news. I drive into Boston at 4:00 AM if I need to go there during the week as I hate the traffic. Yes, Sundays are hugely better. I think that we all wish that the cancer marathon was over.

Re: Possibly unnecessary open liver surgery

Posted: Sun Feb 11, 2018 9:22 am
by Atoq
mpbser wrote:Given the diet he's gradually returning to (yesterday it was chocolate chip muffins, ice cream, fried chicken), I won't be surprised if he has future mets.


Sounds like then he can only blame himself. Of course life style has something to say, but not that much...

Best

Claudia

Re: Possibly unnecessary open liver surgery

Posted: Sun Feb 11, 2018 10:30 am
by Utwo
mpbser wrote:Given the diet he's gradually returning to (yesterday it was chocolate chip muffins, ice cream, fried chicken), I won't be surprised if he has future mets.
There is no scientific data linking after-surgery diet and a risk of metastasis.

However, considering diminished liver capacity, it probably still makes sense to adjust his diet.

Bon appetit!

Re: Possibly unnecessary open liver surgery

Posted: Sun Feb 11, 2018 12:32 pm
by mpbser
My point related to any additional cancer. As there is plenty of scientific data supporting the role of diet in cancer, it stands to reason that the same applies to post cancer diagnosis recurrence. Sure, might not share origins with the same tumor. Even NCCN guidelines recommend a plant based diet as part of treatment milieu.

Re: Possibly unnecessary open liver surgery

Posted: Sun Feb 11, 2018 1:40 pm
by Utwo
mpbser wrote:Even NCCN guidelines recommend a plant based diet ...
Could you please provide a link?