Reconstructive Roller Coaster

Have you ever had one of those days that didn't feel right?  I think we did today (May 23rd). 

We met with the Reconstructive Center plastic surgeons today.  The lead surgeon is one of the best in the world.  The other is the resident surgeon on his staff.  Again, as with the rest of the staff, they were both personable people.  However, our meeting with them was like "BAM!!!"  A slap in the face.  A wake-up call.  This is how it is.

Just like the initial surgical consult a couple of weeks ago, the resident surgeon came in, asked some questions, seemed very upbeat about the procedure possibilities, then left to consult with the lead.  And again, the lead came in and told us what he was going to do....   "Going to DO?!?"  Yet, he was describing the worst-case scenario.  It sounded like this piece of the procedure was set in stone.  OUR EYES ARE OPEN.  The roller coaster is going up.

Our initial takeaway a couple of weeks ago was that plastic surgery (skin graft) may be necessary if our primary surgeon has to go wide in cutting out the cancer.  Of course, we talked the spectrum of possibilities from a simple "alo-derm" (sp?) or synthetic skin application, on to the skin graft, then on to the skin flap as a worst case surgical scenario (Skin graft which include arteries from the arm).

Today --- the talk focused on the skin flap, as if it were a done deal.  The roller coaster is about to crest that first big drop.

Let's talk a little about the flap procedure (as I understand it). 
IF it's necessary for the primary surgeon to cut into the floor of the mouth in the effort to remove the cancerous tissue, then the flap will most likely be necessary.  Apparently it's very hollow underneath the floor of the mouth and you have to cover up the holes (who'd a thunk it).  I could be wrong, but that's how I envision it.

• To make the flap, tissue is removed from the forearm.  An artery is "borrowed" from the arm -- The tissue and artery are then grafted into the oral cavity where it's needed.
• The forearm has two arteries going into it.  The doctor chose the Ulna-side artery because the physical scar can be better hidden by the natural way a person holds their arms.
• Then, skin is "shaved" from another area of the body, usually the thigh or the stomach, and grafted to the forearm to cover the hole left from the "borrowed" material.

Scientifically, a very neat procedure.  As a patient, scary as heck*, but that's not the hard part to swallow (pardon the non-intended pun).  I'll get that the harder stuff a little later.

*I would use a different choice of words, but am trying to watch the language as I don't know who is in this audience.

I offered a suggestion to the resident when he first went into the details around grafting.  I mentioned that, instead of using skin from the forearm, they should pull it from the gluteal area.  That way Jennifer can stay true to her word when she tells me to kiss her........but I digress.

We did have a lighter moment (really the only one in this meeting) when the doctor was manipulating the stomach skin to test for viability....He said he'd take what was necessary to graft on the forearm, Jennifer said to take it all.  I think he mentioned he'd take out the extra for free (tummy tuck?)  Do you mean I really get to get Jennifer plastic surgery for our anniversary?  Sweet!  Scratch that off my list of to-do's.

Now, some of the shocker.  The surgery and recovery as the plastic surgeons were describing, will be more intense than we originally believed.  Again, the primary plastic surgeon approached us as if the flap was the procedure he would use (worst-case).  Jennifer and I are both HOPING AND PRAYING that he was only approaching us with the "worst-case" scenario so we will not be surprised if that is indeed the case.

They gave us handouts on after-surgery wound care, which involves the cleaning of drainage tubes, emptying drainage reservoirs, and all kinds of other gross cool stuff.  However, he mentioned a couple of things we didn't hear in our earlier consults -- a Trachiostomy and the feeding tube (for 2 weeks or so)-- There's our slap in the face.  My recollection from the initial meetings was that a trach wasn't necessary.  But then again, I'm not sure it was every mentioned during our initial consults.  Aaaaarrrrrggghhhh.  A question we should have asked.  The trach is typically necessary if there will be swelling or obstruction that would lend difficulty to breathing.  I wonder if they can feed an oxygen tube down her nasal passage?  Is that an option?  I haven't heard.  Another question to ask.  Here comes the double-loop, twist part of the ride.

During the initial consult, we were told that Jennifer would most likely be on soft foods shortly after the surgery -- like a day or two.  However, as described today, she may be on a feeding tube for a couple of weeks. This falls in line with the new fad diet that the celebrities are doing.  Again, I hope this is for worst-case scenario informational purposes only.

Right now, I have the "So You Had a Bad Day" song going through my head.  Really, because it's a catchy tune and I've always liked the song.  But it somehow fit into today.

Okay.  Our day has been rough.  We have more precise information that doesn't appear to favor our initial assessment.  It's upset us a bit, but it's part of the roller coaster ride.  As I stated in earlier posts (I think), it's the not knowing that scares us.  Now we know more.  It's still a bit daunting.  Is it right to know more?  Does it help us?  I can't say.  However, we have to face the situation whether we know it or not.  And we will.

Of everything presented today, the only choice Jennifer had to make was "from which arm do we take the graft."  And that was decided by the arm in which Jennifer does NOT hold a pen when she writes.  So she didn't even get to make that choice.  Dang.  The rest of the decisions will be made on the operating table by the surgeons:  Alo-derm (sp?), skin graft, skin flap, trachiostomy, tummy tuck. 

Oh.  As we left the Reconstructive Surgery consult, another person in a white lab coat came chasing after us to ask if Jennifer would participate in a study they were conducting where he would take 2D and 3D images of Jennifer:  before, right after, 2 months, 3 months, 6 months, and 12 months, etc.  Supposedly very non-invasive.  We both felt like we were at a time-share pitch....oh well.

I'm sure your tired of reading this long-winded synopsis.  Thank you for humoring me till the end.  The roller coaster ride is continuing.  Let's get to the end.

Finally, I received an email from the Knights of Columbus to pray for a fellow night stricken with cancer and not doing well.  Our prayers go out to him.  At the end of the email was the Prayer to Saint Peregrine, the Patron Saint of Cancer.  Why didn't I think of this earlier?

I've copied the prayer below and asked that you pray to Saint Peregrine for his intervention.  This really does help us.

O Saint Peregrine, you who have been called "The Wonder-Worker" because of the numerous miracles which you have obtained from God for those who have had recourse to you, who for so many years bore in your own flesh this cancerous disease that destroys the very fiber of our being, and who had recourse to the source of all grace when the power of man could do no more: you who were favored with the vision of Jesus coming down from His Cross to heal your affliction, ask of God and Our Lady the cure of these sick persons whom we entrust to you Jennifer. Aided in this way by your powerful intercession, we shall sing praise to God for His great goodness and mercy. Amen.

c-7 days and counting

Jennifer, I Love You.

God Bless.