Thursday, July 5, 2012

Five weeks post surgery

It is hard to think that five short weeks ago, I was going in for my second day of surgery.  I have been home for about three weeks now and, this week, I have finally felt like my recovery is moving forward significantly.

When I got back to Colorado Springs, I immediately went to my local oncologist to get my Sandostatin LAR shot and he weighed me in at 171 pounds.  Four months previous, that same scale weighed me in at 203 which gives me a 15% weight loss in just four months.  Two weeks later, that same scale marked me at 165 which is not a good sign.

I believe I have now turned the corner for two reasons.  I am now tracking my calories and targeting at least 2600 calories a day which should yield approximately a 1 pound/week weight gain.  Additionally, Dr. Young has prescribed me some appetite increasing medicine (not THC, gotta keep that security clearance) which I have been taking daily.  I have noticed a real improvement in my overall energy and am hoping to get good news from the Doctor's scale at my followup next week.

My body has taken a few hits as well over the last two weeks which could also be part of the weight loss.  One of my drains indicated an infection and I was running a low grade fever (100-101).  Dr. Young started me on an antibiotic which seems to have solved that issue.

Then, the weekend of 6/23, we went to a local lake with some friends for some fun water skiing, tubing, and wakeboarding.  Stephanie got up for the first time on skis and all our kids did well on skis or wakeboards.

On Friday of that weekend, the T-drain that goes into the bile duct stopped draining completely while the JP drain increased correspondingly in volume.  Over the weekend, the JP drain started reducing in volume but was still excessive while the T-drain only increased a small amount.  I called my surgeon and he suggested we get a cholangiogram the following week.

The cholangiogram (dye inserted through the t-drain) revealed that the bile duct was indeed draining into the intestine as desired but there was a large blob at one point that looked confusing and so we went for a CT scan.  The CT revealed that the left lobe of my liver had absolutely no venous activity.  This means there was no blood flow through the left lobe of my liver which means that the repair of the artery to that lobe almost certainly had failed.

So now, rather than having 80% of a liver, I am now down to about 60% of a liver.  Hopefully, the right lobe will now start to increase in size to compensate for the loss of the left lobe.  Tumors will certainly invade the new liver growth but I hope we will be able to stay ahead of it.

My surgeon also suggested conservative treatment of the necrotic liver for the time being.  This means no new surgical drains or active removal of the liver.  For me, that is good since it means I can avoid another trip to the operating room, at least for now.  We certainly will re-evaluate again when I am in New Orleans but I hope things are looking good then for the removal of the surgical drains.

Return to work?  Well, my happy path would have me return to work the Monday following my New Orleans trip which is 7/30.  I don't know for sure if I will make it but if my improvement of the last week continues, I think I can.  April 2nd was my last day at work and I know things have both changed and stayed the same but returning to that will help restore my feelings of normalcy for my recovery.

And sports?  Well, I hope to go to some open skate sessions over the next few weeks to just get my feet underneath myself but won't try any skating with pads until I get the surgical drains removed.  Bike riding has also been sidelined as I am not supposed to lift more than 20 pounds right now and I know I pull harder than that on some climbs (there are no flat rides in Colorado Springs).  That will start again after the removal of my surgical drains.

My hopes to do the toughest century in the US also have to be pushed off till next year.  Fortunately, the ride allows one to roll one's registration over to the next year for exceptional circumstances and have granted me an exception.  August 2013 is when I will be making the ride.

So, overall, things are looking up right now for my recovery.  There is still a ways to go but I am on track finally!

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