Falling into place

Tom met with the Radiation Oncologist Tuesday, October 23. They did a Sim's (simulation). They made a mask for his face and gave him three tattoos. They went over how the procedure was going to work everyday. Tom will go back Tuesday for a practice run and the treatment will start Wednesday, October 31st. Happy Halloween! He will go Monday through Friday at 1:00 pm.

Tom is still struggling with a sore throat. I was hoping this would improve before it became sore again. His energy level and movement range is getting better, but not as fast as he would like. He is doing things around the house while he can, before he starts feeling tired again. The kids are enjoying having him home at night. Thanks to Tom's cousin, we now have 3 computers to "game" on and the boys are having a blast! Tom is having a hard time keeping up with them, as the boys have more experience with the computerized games and faster reflexes. Cody's football is done for the year and Kyle has one more game. I have to say, as I do every year, that by the time the last game is played I'm ready for it to be done. Once again, thank you for all the cards, e-mails, meals, and help that we are getting right now. I know that many people are saying that we continue to be in their prayers; maybe that's why we are handling each step/each day so well. A special thank you to friends Tim and Linda for the beautiful Michigan blanket that Linda made for Tom. This must have been the hardest blanket that she ever made (MSU alumnus).

Radiation Oncology

We are so happy that we can see Dr.s in the West side! I forget how beautiful Grand Rapids truly is. This morning as we were driving US131 and the sun was coming up, the buildings seem to have their own character. It was nice for me, as I was not the one weaving in and out of the early morning rush hour traffic.

Dr. Buth received all the paperwork from U of M and had a clear idea of Tom's surgery and recovery needs. He stated that the issue after the surgery is that there still could be microscopic disease still on both side of the neck and his upper medium Steinem. To get this will require 30 to 35 treatments of radiation. Dr. Buth's concern was that radiation would attack his Salivary glands - permanently diminish his saliva during treatments. He is considering giving Tom an injection of Nythenal before each treatment could begin. This would have to be done 1/2 hour prior to radiation and carries the risk of causing high blood pressure and nausea. So, a simple 20 minute treatment regiment has more than likely become complicated. Such has been the whole progress with Tom's treatments!

Before radiation can begin, Tom will have to go through a "simulation" which is set for next Tuesday, October 23. They will create a plastic mold and will run a computerized treatment. Tom will need another CAT scan which will be simulated with the pre-op PET scan to make sure all effected areas are covered. Tom may have beams from the front and back which will also need to be determined. Then it's onto a "DRY RUN" before actually starting. Once the treatments are started Tom will have the risk of becoming tired and have a sore throat. Dr. Buth said that the skin will feel sun burnt and the same feeling with his esophagus, in which your skins get the tightening feeling when burned.

Thanks to so many people who have been so generous. The meals that we received were awesome! It really helped as we were concentrating on Tom's recovery, as I was the "taxi cab" for all the kids, and as we have the continual paperwork shuffle for each new step that takes more and more time to fill out and double check. The kids even learned to like new things that they would not have even tried if I had put it on the table. Please continue to pray for Tom's recovery and that his steps with all his Dr.'s have a clear, smooth path. Help Tom and myself as life has been different around the house. We seem to notice the small things we had taken for granted.

Post-Op

Tom was glad to go back to Ann Arbor. He was very concerned about the swelling in his neck and face. He has not been sleeping very well the past two nights. Dr. Teknos talked to us in great detail again about the surgery itself. They removed the sutures and were very pleased about the way the incision was healing. They explained that the swelling could be persistent for up to 4 more weeks. Dr. also talked to us about the signs of depression which are normal with patients who've had major surgeries.

We also went over the Pathology report with Dr. Teknos. There were no major surprises other than the amount of cancer they found. The tumor they removed was 5 cm. On the right side on his neck cancer was found in 50 lymph nodes, the medullary carcinoma was outside of the lymph nodes, and had aggressive features. Because of this, Dr. Teknos has decided to be a little more aggressive in the Radiology treatment. He plans on covering a larger area than previously discussed. The treatments will be done in Grand Rapids lasting 6 to 7 weeks. Tom will have a total of 35 radiation treatments. Calcitonin and thyroid levels will be monitored during and after radiation to make sure the treatments are effective.

Tom's consultation is scheduled for Wednesday, October 17 @ 8:00 am with Dr. Buth. The treatments will most likely begin within 2-3 weeks after the consultation. With 5 treatments a week, I am glad that we can have them performed close to our home. Thanks again for the cards and encouraging words that you have shared with us. We could not have made it through this time without your support. Please continue to pray for Tom's healing & pain.

Home!

It has been another crazy day at the Andrews household. I called Tom about 12:30 to see if the Dr.'s had been in to see him during their afternoon rounds. No show was the reply. I checked again at 1:30 and was told to "Come and get me. I'm ready to come home." It was like sweet music to my ears. We finally hit home turf about 8:00 pm. Kyle was the first to see his dad, and did that kid smile big! The kids and Grandma had welcome home signs and posters everywhere. Parents walked in the doors and carefully hugged him.

We will not get a chance to miss the U of M Hospital as we have to head back Thursday am. Tom will have his stitches removed. Kids have a running joke on the total count of stitches he has in his neck. We will also cover post op surgery items and the oncology report. Tonight the chiefs of all the departments at the U of M Hospital will get together for their bi-weekly meeting. Once again Tom's case has been chosen as the case that they will study this month.

Stopped in at the pharmacy on the way home. Tom will continue taking all his different drugs and pain killers. After just a few hours of being out of the hospital and being home I can tell that Tom is beginning to struggle. Just one more small step to take. Tom just smiles and says, "Tonight I get to sleep with my nurse."

Monday

I just wanted to let everyone know that Tom had 3 more drains taken out Monday morning. The Dr.'s are going to look at the last drain this afternoon. They like the output of this last drain, but want to monitor this last one a little longer. If the level remains the same, they will be pulling it. I might be able to pick him up yet today! He slept better last night and didn't require as much pain medicine. I was able to let Kyle and Katie know that he might be coming home. They both had the biggest smiles and said, "I can't wait to see Dad." I'm thinking, me too!

Progress

Saturday evening was a great day in Ann Arbor, Michigan won and I was able to spend a great deal of time with Tom. I slept great in the recliner chair, but Tom did not sleep so well. His pain is worse at night. Breathing and swallowing are both a chore. Sunday was better. He talked with Dr. Old mid morning who took out one drain and was pleased with the other three. These drains may be coming out Monday am!? He also had the Respiratory Therapist stop in to have Tom start Breathing Treatments. The first hour of trying to do these treatments really wore him out. He must do 10 treatments each hour he is awake. When I got home, Tom called to say he had been moved to a private room. His new room number is 4411. His new phone number is 734.936.4411.

Please continue to pray that Tom's pain decreases each day. Pray that he is patient during his stay. Thanks to all who were able to come and see Tom. It is such a long drive and he really appreciated those who were able to make it.

Hospital Stay

Tom is resting comfortably tonight. I drove home today, but have talked to him a few times. His pain is under control and his appetite has increased. Dr. Teknos wanted him up and moving even more today so he took quite a few trips around the block (he even passed a lady in the hall, he was really cruising!) I kept telling him to take it easy and he said that he had to keep moving, he wasn't going to just sit around once he got home. I told him in that case..the house needed vacuuming, dusting and mopping. I don't think he appreciated my sense of humor. He had a couple of visitors today and I think it really lifted his spirits.

The Physical Therapist also talked with him today. She gave him a sheet with his exercises and told him to try and do them twice a day. It is important in his recovery so that the scar tissues do not swell up and cause him to have limited movement in his neck. Dr. Teknos came by after I had left U of M and told Tom that he probably would not be coming home until mid week, Tom's goal was Sunday. The drains are still filling more than he had expected, which could extend his stay. I'm not sure who talked with Tom, but early in the day Tom was told that maybe one or two drains could be removed tomorrow.

I'm sorry if I confused anyone; Tom's nerves were not cut nor damaged. His nerves are stressed from the surgery. When I blogged at the hospital, some of their computers were not working and people were constantly waiting to get on. I really didn't even check what I wrote, especially when I hurriedly sat down to update. Another question people have asked is whether they went into Tom's sternum. They did go into the chest cavity, below his clavicle bone, but they did not have to open his chest. I hope that I did not give the wrong impression. He was cut almost from ear to ear only for his surgery. We call it his smiley face, but I was thinking on my drive home that it's a symbol of his loyalty of this University. Where did they engrave the M? Well, I've made this posting long enough. Thanks again and again for all they kind words and generosity. God bless.

Correction

Just wanted to give a quick correction. Tom's room number is 4415-2. His phone number is 734.936.4416. Sorry if there was confusion, but the wrong number was posted on the board in Tom's room and the phone number was not posted elsewhere.

Tom is doing well. He has been up twice to walk around the block and ate most of his dinner :)

The Day After

Wednesday was a long day here at the U of M. Tom was in surgery from 7:45 am to 6:15 pm. Cathy and I were able to see him a little after 8:00. Then between 9 and 10 he was assigned to the room he will stay in until his leave. We stayed with him until 11:30 when he was finally sleeping for longer periods of time we called it a night. His room number is 4415-2 and his room phone number is 734-936-6416. This morning when I saw him, his swelling was still down and as of now, he does not have a trache. They are monitoring his blood levels today as he lost a lot of blood during surgery yesterday.



This morning we saw both of the surgeons Dr. Teknos and Dr. Old. They said that they had to cut the Coratic artery, but were able to save most of the nerves. They also had to do an extensive amount of scrapping around his swallowing passage muscles. They said that he had a huge amount of tumor and that his thyroid was quite enlarged, especially on the right side. They said it was a stressful surgery yesterday. They confirmed that he would have physical therapy. Also that his radiation will start in about 4 weeks.



Tom is in good spirits and not complaining about much other than a little naseau and of course the sore throat. He has a window view from his room. It is a nice view and he loves the fact that he can see Aeromed coming and going. You can see the landing pad. Thanks again for the notes, I have been sharing them with Tom. The prayers have also been greatly appreciated and I know that we are not done yet. God is good and has been with all of us during this difficult time.

Post Surgery

I was able to get online before my assigned time. Cathy and I just finished talking with the Dr. Tom is doing fine and will be in recovery for 2 hours before we can see him. They have removed much of the muscles on both side of his neck. His tumor was a large size and the paralymph nodes were well into his chest. The surgery was tricky, but they feel they have successfully gotten the tumorous area. Dr. Teknos was able to save the nerves on both sides of his neck and his vocal cords. Dr. also feels that he cleaned all the lymph nodes successfully. However, the tumor was pressed on the vocal cords which may cause breathing issues and Tom will be monitored closely. I was also told that he may have massive swelling in his face. The swelling may not show for a couple of days and Dr. wanted me prepared for this. In all, this was a tough surgery and I am antsy to see Tom.

Going forward, Dr. Teknos feels that Tom will have Radiation in his future. It will be concentrated not only on the neck, but the upper chest as well. I'm not sure where or when that will be, but we will worry about that in the future. Thank you all who woke up early to pray and continued throughout the day. Please continue to pray for Tom to get better as we are now in a new phase of this disease.

Surgery

As of 7:30 am, Tom is now in the hands of the surgeons. He did not sleep well last night, but he should have no problems today. He has a slew of people that are taking good care of him. I have signed up for 7:30 pm to get back onto the computer to let you know how he is doing. It's nice to be able to have the computer right in the Family Surgery waiting room.

Tuesday was a 2 1/2 hour consultation with all his pre-op question/answer and signing another bunch of papers. During the surgery, we are told that they will start with the left side of his neck with what they call a "Selective Dissection". The right side of the neck will have a "Modified Radical Neck Dissection"... Which means that they will examine and take what they need to in his neck. The right side will be more extensive. He will have a Paralymphnode Dissection - also called the Calcium Glands- they will try to save at least one if they can, and of course the Total Thyroidectomy. Once he is out of surgery he will be in recovery for 2 hours before getting his room. He will have 3 to 5 drains which will need to come out before he his sent home. The other factor they will consider before sending him home is that he has stable calcium levels. At this point his Calcitonin level is through the roof. It should be a zero and at pre-op is 11,000. This will be taken again after surgery and will be the key to monitoring him for several month/years to see if they have gotten all of the cancer.

Tom seemed to be pretty up-beat or was that the "Tough guy" act for me? Either way we were both trying to joke before he was wheeled away. Thanks for all your prayers as I feel somewhat calm this morning. Please pray that Dr. Teknos and Dr. Old have a successful day!

Out the Door

This will be my last entry before Tom's surgery. We are heading out to Ann Arbor. Tom has his Dr. appointment @ 2:00. From there we will be checking into the Med Inn hotel on campus at the U of M. We will be joining Tom's cousin later Tuesday night for dinner. Wednesday, it's up early. Check in is at 6:00 am. Tom's surgery is scheduled for 7:30 am. They are planning on a eight hour surgery. He should be out by 3:30 or 4:00 pm. We finally received the approval for surgery. Nothing like waiting for the last minute. Tom's sister will be keeping me company during the surgery on Wednesday. I will try to find a computer Wednesday night to update you on the surgery, room number, phone number, etc.