Thursday, April 26, 2012

Centrally Lined!

The last couple of days have been really busy, kind of stressful but ultimately good.
Yesterday Owen went to Newport with the 8th grade band (they did well and got to go to the aquarium!  LUCKIES!).  David and I spent the day at the hospital so he could get his central line.  Rose came by to hang out and have lunch with me during the procedure and Tim stopped by after he got out of "surgery".  They gave Dave some mild sedation as well as a local anesthesia so he doesn't remember anything and he came out of it pretty quickly.  

Now he's got half a shaved chest, a catheter coming out of the right side of his chest near his armpit with a dangly end and two small puncture wounds where they apparently poke the catheter out and then back in when they are weaving it through the vena cava or something along those lines.  Yuck! I'm glad he wasn't fully awake for that!  His neck was so sore last night that I had to give him a couple extra doses of morphine and some advil just to stay ahead of it but today it was much better.  

Today for chemo and the blood draw the CL worked like a charm.  It probably cut a half hour off the chemo time! They drew blood then gave him chemo and all went well and they hooked him up quickly and changed the bandages and ultimately we're all glad he had it done.  All being him, me and the chemo nurses!  They're important to keep happy! 

We also met with Dr Hauck, the neurologist, today.  He showed us the MRI results and said that yes, while the radiologist saw advancement (which I posted about) he doesn't think the actual tumor has grown much.  The rest of what we saw is likely swelling.  He really signaled in on the cervical spine (neck) and showed the greatest amount of swelling at C3-C6 and then showed us what he thinks is going on.  There was a "normal" looking section on the MRI down the middle of his spinal cord which indicates a build up of spinal fluid.  That's bad.  He said sometimes when there is damage further down it restricts the flow of spinal fluid and it can build up somewhere else and cause pressure.  Right now it doesn't seem to be doing any additional damage but it could.  If it does there are 2 surgical options that we're not sure about but thankfully don't have to decide about right now.  They can do the laminectomy or they can use a catheter to drain off some of the fluid.  Neither one sounds all that fun.  More on that option in a minute. 

Basically Dr Hauck is always super optimistic, always... as we found out when Ransom was in the ICU.  We like that he's optimistic but we have to realistic at the same time.  He said the "swelling" in his neck COULD have tumor cells but for now he's just calling it swelling because he sees the fluid build up which would cause swelling.  He also pointed out some enhancements then danced around it a little bit.  It's really not important to pin him down on EXACTLY what he thinks is tumor and what isn't because it would all be speculation but we're happy enough to know that David still has movement in his arms/hands.  That's actually how they will be monitoring how he's doing. Dr Hauck also felt it was important to get David all the way off the steroids because the longer he's on them the more side effects he'll get.  So... 10 more days and he'll be off them.  YAY!  If the swelling gets worse he can always go back on them but for now off them is good. 

So when we talked to Dr Sharman after meeting with Dr Hauck he said that Dr Hauck may not realize the implications of offering surgical options since David would have go off the Avastin for a "significant amount of time" to be able to do surgery.  They told us before that he needed to heal  28 days after surgery for Avastin and I don't know how long they'd want him off before.  If that's one of the only things keeping the tumor at bay... yeah... not ideal.  I think the two of them should actually have discussions but it's hard to coordinate care between busy doctors. I guess that's what we're here for.

Oh speaking of coordinating card... apparently hospice thought the dr was keeping track of David's blood thinner levels and dr thought hospice was doing it or something.  He even said to me "we do that test every time you come in"  Um... no you don't!  He didn't know.  He seemed a little irritated and added that blood work in with the stuff they normally do.  Finally.  Add that to the list of things I didn't realize I had to ask about.  "Are you testing his blood for _____"  So now hospice is tasked with checking his blood every week until the levels get right.  At least I hope that's what they said.  I'm gonna have to double check.  These drs... they must hate to see me coming! I ask so may questions. ;)

Tomorrow I have a meeting at the funeral home just to get that planning out of the way.  We're hoping we won't have to use those plans for a long time to come but it will ease his mind knowing that it's taken care of and ease mine to know that I won't have to make decisions when I'm mourning.  I'm not looking forward to it but I am looking forward to not thinking about it anymore.

We're planning to make Owen watch JAWS this weekend.  He's so jaded and wants to watch scary movies but we won't let him watch anything too... mature?  Jaws seems 13 year old appropriate.  David says he remembers watching it when he was little little little.  He used to run and jump onto his bed so the sharks wouldn't get him.  That's funny to me because I used to do the same thing but it's because my mean cat, College, used to hide under the bed and swipe at us when we walked by the bed.  I guess we all have our "jaws" 

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