Author: althea

8:40 am: Louise just came to tell us that the laparoscopy has begun.  Dr. Farnell’s nurse came down a couple minutes ago to say hello, so say that they were completing her pre-surgery prep., and to let us know that after they started the laparoscopy, we would have news in one to two hours.  And so we wait…

8:25 am: We just got news from Louise, our surgical communicator, that Mom entered the operating room at 7:40.  They have her set up…the anesthesia has been applied…but they haven’t yet started surgery.  That means Mom is getting some good sleep.  I’m sure she didn’t sleep a lot last night!  Louise said she would tell us as soon as they know the results of the laparoscopy, which she estimated at two hours from now (10:30 am).

Jan 11
7:00 am:  I’m writing from the Mayo St. Mary’s Hospital patient waiting room.  We got here at 5:45 this morning, and by 6:45 they had Mom in her gown and checked in.  Dad said he was really impressed at how the professionalism and quality of the service we’ve received here translates right down to the patient check-in procedures.  They’re really efficient and courteous, and I think they’re taking good care of my mommy.
A few minutes ago, she walked down the hall with her fuzzy patient socks and nifty hospital gown.  They said they will start the surgical event at 7:45.  Our gang has dispersed for breakfast and coffee for now!  For some fun, early morning photos of Mom pre-surgery, see the gallery!

Jan. 9:  We just got done meeting with Dr. Farnell.  I’m doing this update from Mayo’s swanky, stylish waiting room.  Her surgery is tentatively scheduled for 6:45 am on Wednesday morning.  She’s supposed to report in at 5:30 am (which, for Mom, is really early).  Good thing our hotel is across the street.
Dr. Farnell said he expected the surgery will last six to seven hours, but it depends a lot on the complexity.  He stressed several times that it isn’t yet clear that he’ll be able to do the entire surgery.  They’ll start with a laproscopy, move on to a physical and then visual examination of the site of the tumor, and then if it still looks do-able, they’ll begin the Whipple.

Dr. Farnell said the average hospital stay is 10 days.  He quoted risk to life at about 1% and risk of complication at about 40%.  However, Mom told him that she doesn’t plan on doing complications, so that should make things much simpler.  Risks during the surgery are related to blood loss.  For 24 hours post-surgery, risks are bleeding and potential clotting of the Superior Mesenteric Vein.  Then for about one week, there’s a risk of the new seams between the pancreas and the intestine leaking.  Fortunately, most of those complications they can address without needing to do further surgery.
If they do the full surgery, they said that most patients (90%) do not need to be in the ICU.  The average hosptial stay is 10 days, and they said they will try to get her up and moving the day after surgery.
Dr. Farnell has emphasized the complexity and number of uncertenties of this surgery.  He said he can’t guarantee that he can do the surgery, but he said that he’d like to give it a shot.  He also stressed that it isn’t clear that this is cancer.  That’s what Mom is aiming for!  We should know about 24 hours after the full surgery if it is.
So now we go and Mom gets her blood drawn and takes care of some paperwork, and the rest of our gang should arrive this evening.  So far, thumbs up!

Jan. 9: Mom’s surgery is scheduled for Wednesday, January 11.  Tomorrow morning a bunch of us are heading up for her preoperative appointment.  That’s when she’ll sign lots and lots of forms, and I’ll get to meet her surgeon, Doctor Michael Farnell.

We don’t yet know what time on Wednesday she’ll be scheduled for surgery (I think we find that out on Tuesday night after 8 pm).  I checked with St. Mary’s hospital in Rochester, and they said that I should be able to get internet access in the building.  So my plan is to update this website over the course of the day on the 11th as we have information. However, knowing how quirky technology can be and knowing how things always take longer that you expect at hospitals, don’t assume that there’s a problem if you don’t see a post.

We’re going to have quite a gang at the hospital on Wednesday.  Mom, Dad, Michael, Maretta, Joey, Bryan, Andrew, Maretta’s boyfriend Kyle, Terry, Tom, and perhaps my mom’s cousin Paula.  I want to wish Dr. Farnell a good night’s sleep, a sharp mind, steady hands, and lots of stamina.

Thanks so much for everyone who is thinking of her, and if you want to reach me or would like to request an email when there’s an update, you can email me at adotzour@gmail.com.

Jan 3: One week from today, on Tuesday, January 10, Mom will be at Rochester having her pre-operative appointment with Dr. Michael Farnell.

For so many months, the chance was dim of Mom being able to have surgery to remove her pancreatic tumor.  But now, seemingly quite suddenly, the day of her surgery approaches.  So I’ve been trying to learn more about the Whipple Procedure in order to know what to expect.

During the Whipple Procedure, also called a pancreaticoduodenectomy Mom will have many pieces of her lower digestive tract removed: the head of the pancreas, possibly the spleen, her gall bladder, bile ducts, part of her upper intestine including the duodenum, and a portion of the lower stomach. Here’s a diagram of the pre- and post- operative anatomy.  I also found some historical information on the Whipple Procedure on the Wikipedia.

Once she is in surgery, the first thing Dr. Farnell will do is to do a laparoscopy to see if the cancer has spread.  If it has, she won’t have the surgery.  If Dr. Farnell doesn’t see any signs of spreading, he will begin the Whipple procedure.  As he moves forward with the Whipple procedure, there are several points at which he can stop if he determines that he won’t be able to remove 100% of the tumor.  So Mom won’t know until she wakes up whether the surgeons are able to do the complete Whipple.  It still seems so weird to be hoping that they can do the most complete, aggressive version of this operation.

Mom is expecting to be at Mayo for about 14 days after surgery (at least, that’s the average post-operative hospital stay).  She’ll probably have a good couple months of general recovery time.  Here’s a nice website that describes the surgery for patients.

Dec. 30:  Wonderful news!  Mom’s surgery is scheduled for Wednesday, January 11 at the Mayo clinic in Rochester.  Dr. Farnell will be performing the surgery.  Not only is it scheduled, but she also got approval that her health insurance will cover it.  Thank heavens!  Mom will have her entourage (I think there will be about nine of us) on the 11th at Mayo.  The time for the Whipple Procedure has come!

Dec. 19:  We just got some amazing news…Mom is scheduled for surgery with Dr. Farnell at Mayo the week of January 9.  They’re going to try to get that tumor out of there!

Mom talked to the doctor who reviewed her endoscopic ultrasound today, and he had two major points to convey: 1) the test didn’t show anything that made them think that surgery was out of the question and 2) although they ran a set of biopsies on the tumor and on lymph nodes and  they didn’t find any cancer cells.
This means that she gets to have the Whipple Procedure (the surgery they do to remove the tumor) and there is a 4-5% chance that what she has is not cancer at all.  Here’s Mayo’s website discussing the alternative types of tumors it could be.  She was diagnosed with mucinous adenocarcinoma. Apparently it is very hard to prove a negative bioposy, and what she has is acting like cancer, but it’s kind of amazing news.
The doctor ended the conversation telling her to have an optimistic Christmas:)

As far as I can tell at this point, the surgery Mom will have in January can be broken down into several steps.  At each point, Dr. Farnell has the option of stopping the procedure and sewing her back up if they find conditions that they don’t like.  The first thing they are going to do is a laparoscopy.  She had one of these on June 9 to see if the tumor had spread, and before they go in to remove the tumor on the pancreas, they are going to do another laparoscopy to make sure it hasn’t spread to other parts of the abdomen.  If they see evidence that it has spread, they won’t even start the Whipple Procedure.  However, if the laparoscopy doesn’t see any metastatic spread, they’ll do the Whipple.  The re-plumbing of Mom’s digestive system.  Here’s a good diagram showing “before” and “after”  from Mayo’s website.

Here’s some information on the Whipple Procedure

• From USC
• A really detailed 9-page PDF describing the procedure
• http://www.treatments-for-pancreatic-cancer.com/html/surgical-options.php3
• A 16-page scientific document from Gastroentorology

We still have quite a few bridges to cross before we can say we’ve had a successful surgery, but this is so much better than the news we were getting throughout November.  What a Christmas gift!
Enjoy the holidays:)
~Althea