Category: Mom’s health chronicles

3:00 pm: Jacquie, Dr. Farnell’s nurse just came in to tell us that the surgeons are done with the Whipple Procedure, and they are moving on to closing her up.  So the really complicated part is done, and the next phase, that of closing her up, is expected to take about an hour and a half.  If that is how long it takes, she should be out of surgery at about 4:30 pm.  Then she’ll be in the recovery area for about two hours.  So we may see her here in her patient room around 7 pm.

Jacquie said that they are not expecting to have to admit Mom into Intensive Care, and they said that they didn’t have to mess too much with the Superior Mesenteric Vein.  Good news, as that was going to increase her chance of the SMV clotting, plus it would have increased surgery time significantly.

Jacquie also had some updates on the report from pathology.  They said that when they looked at the outer-most covering of the removed tumor (the margins) under a microscope, they did find some cancer cells.
That means that a) the tumor probably was cancerous despite our fervent hope that it wasn’t cancer at all and b) there may be some microscopic cancer cells that they left behind. Jacquie said that this is usually the case with pancreatic tumor removal, and she said that Dr. Farnell would be able to tell us more.

So mostly really good news today. I will post again when we hear that the surgery is  complete.  Mom sounds like she’s doing well so far.
I’m so glad that they have been able to get the tumor out!

1:30 pm: We just got a phone call from Anne, our current Patient Communicator.  She said that they were working on the last anistomosis (connection between organs).  Anne didn’t have any information about what the report from pathology was, but it sounds like they are nearing completion of the Whipple Procedure.  And at this point, it’s sounding like they didn’t have to reconstruct the SMV.
Mom has been in surgery for about five hours, and she’s doing well.  Mom, we’re so proud of you!

11:35 am: Dr. Farnell’s nurse, Jacquie, just stopped in our waiting room and delivered wonderful news.

The tumor has been removed and is being reviewed by pathology.  They’re looking to determine whether there are any cancer cells at the edges (margins) of the tumor.  If so, Dr. Farnell will try to remove more tissues near where the tumor was located in order to try not to leave any stray cancer cells behind.

Jacquie said she was doing pretty well, although she has had a two transfusion units.  Two to four transfusions are average for this surgery.  Jacquie didn’t have details about whether the Superior Mesenteric Vein was involved with the tumor.  At this point, it doesn’t sound like they needed to reconstruct the vein, but then again, they haven’t received the report back from pathology yet.  So far, this is a wonderful day.

11:20 am: We just got a call in our little personal waiting area from our surgery communicator. GREAT news right now.  Mom is in surgery and doing well.  They didn’t find any spread of the disease, and they are in the process of removing the tumor.  I’m a little trembly as I’ve been pretty nervous (and I had some coffee this morning, which doesn’t help with calming my nerves).  Mom’s doing so well.  I’m really hopeful.  They’ve begun the heart of the surgery!
11:50: Despite the protests of some of our group, I continue to take photos.  You can see us as we wait in the gallery.

9:25: We’ve been moved from the general family waiting area to Mom’s patient room.  So we’ve re-settled in Patient Care Unit 2C at the Mayo Clinic Saint Marys Hospital.  People are knitting, cross-stitching, reading, drooling, and typing to pass the time.

And the sun is shining again today.

9:00 am: Louise just came to tell us that they have completed the laparoscopy, and they did NOT see any spread of the cancer.  Thank heavens!  Step one complete.  They are now going to make a small incision on her right side and feel the tumor area.  If it feels the way it looked in the CT scan, they make a bigger incision and take a look.
Louise said we’d be moved from the group waiting room to her room soon, and she thought we’d get our next update at 11 am.   I am SO relieved!

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!