Surgery Scheduled for October 1st

Here are the notes taken from my appointment at Lahey Clinic. This just gives a brief outline of the facts from my appointment. I will be receiving an email soon re guarding my arrival date and time of surgery. For now, I am eating all the organic protein I can and will be walking walking walking~wish it were skating skating skating because I had some serious muscle mass when I was doing that. Although, as much as I miss hockey and as good as I felt when doing it, I am enjoying my time doing other things and not being too consumed with one thing. So before this turns into another entry other than the notes I promised, I will end with this for now~KEEPIN ON!

Meeting with Dr. Roger Jenkins 9/16/2010, Lahey Clinic
What is it?
Same cancer as the prior cells – this is a growth from the original cancer that is now also in the small left lobe of the liver and has potentially affected the lymph nodes behind the liver.
Pain
Pain that has been occurring is most likely caused by the tumor and its growth. The nerves of the shoulder and the chest are all associated with the area of the liver so “referred pain” from the shoulder to the diaphragm is common.
The tumor stretches things within the body – this hurts.
The tumor is right no top of Kylee’s stomach. That’s why she feels hungry but when she eats she fills up quickly. She could keep eating frequently like she has been to combat this.
The liver and secondary occurrence of the primary cancer
The liver is the most common place for other primary cancer to spread due to blood flow. The left lateral segment, where the tumor is at, is a better location for surgery because it is the easiest to remove. The liver contains blood vessels all over it so the surgery is primarily around the blood vessels, not the issue of the liver itself.
Kylee’s liver is functioning normally at this point.
Dr. has learned that if you remove the liver you should also remove the gall bladder. Otherwise there’s a high chance of inflammation and a secondary issue, post surgery. They’ve also learned to remove lymph node. Each one of us has hundreds of lymph nodes
They will look around while they are in surgery to identify all impacted lymph nodes but he only thinks there is one.
Since the prior cancer responded extremely well and rapidly to the chemo – we can presume that there is only a small spread and this may have occurred prior to Kylee’s last chemo and radiation – aka its not really new. It was there all along. If the piece is removed there is a good chance of a cure and that it won’t show up somewhere else.

The Surgery
The surgery is a 2-3 hour surgery and Kylee will have general anesthesia . She will also have an epidural for pain, post surgery, so that she doesn’t have to take morphine.
Due to Kylee’s age, weight, she will have an up and down incision which will make it quicker and easier for her to recover afterwards.
As for the surgery, its mostly around the blood vessels and its not a difficult surgery for a doctor which does these so often.
Kylee will remain in the hospital for 5-6 days and will have the epidural for approx.. 3 of those days. She will have a tube inserted to drain the excess blood from the surface of the liver.
Recovery
Kylee should expect to be very tired after the surgery. She should bounce back well. She should expect to resume to normal activities 6 weeks after the surgery without much pain after she leaves the hospital. She will have pain medication in the event she needs it.
The liver is “greedy” and takes all the nutrients to grow in size to recover from what was removed. It will take all her calories first so she’ll need to be sure to have enough protein and calories in order to meet the liver growth need and her personal need. Otherwise she will lose muscle mass which she will lose some anyways. You don’t lose fat (which she doesn’t have!), you lose good muscle.
There are no other drugs or post surgery treatments which will require medical treatment. There is not a need for a nurse to visit when she comes home. Her family should be able to take care of her.
Complications
There have been some people who have had a hard time eating for a couple weeks after the surgery due to nerve damage from many lymph nodes being removed, but he doesn’t expect this with Kylee. There were no other complications from liver resection identified.
Will she have to have Chemo or Radiation?
Surgery is first. Then after that there may be a protocol that says she is best served by other treatment but for now there is no impending associated chemo or radiation planned. That will be up to Kylee’s oncologist.
Kylee will need to be followed up for a long time so she should expect to continue to have visits to check on her body for a long time.
Preparing for Surgery
Kylee needs to bulk up now as much as she can, eating frequent meals. She needs to eat protein and get a lot of calories. It would be good for her to continue with her supplements because they are all healthy additives but she shouldn't take anything not mainstream before the surgery. She needs to stop ibuprofen and aspirin 5 days before the surgery.
Kylee should also exercise and build up her endurance with walks and light exercise to strengthen herself prior to surgery. This will help her recovery. She should get a lot of rest and be in the best condition that she can.
Waiting for surgery
The Dr. would have recommended that Kylee wait for surgery. This is because they are able to see that it hasn’t spread any where else now besides the liver and the lymph nodes behind it. Therefore, removing the liver resection and the lymph nodes are more assured to remove all cancer. If they had removed the liver before – they might not have seen that it spread to the lymph nodes. Waiting was good and there should be no regrets.
What we are exposed to and its impact on our bodies
The Dr. believes that the cancer in the US is caused by what we are exposed to. He believes this because the cancers in our country are different than all other countries. He even went on to say he was upset with himself because he ate an apple he hadn’t washed today. He said we wash antibiotics down the drain and we grow things with artificial hormones. He doesn’t think this is a good thing.
Schedule
The doctor said a couple of weeks out is OK but no longer. Kylee has the birthday party for September 25th so Julie will call Kylee to schedule the surgery after that. She will come down the day before to get pre-surgery testing and to get a new MRI which will show the blood vessels to guide the Dr. through the surgery.