Monthly Archives: July 2014

Monday, May 12th…the surgery

Monday, May 12th…the surgery

psalm-91_1

“Father, I dwell in Your secret place. I say of you that You are my refuge and my fortress, my God, in whom I trust. Surely, You will deliver me from the fowler’s snare and from the deadly pestilence. You will cover me with Your feathers, and under Your wings I will find refuge. Your faithfulness will be my shield and rampart. I will not fear the terror of the night, nor the arrow that flies by day, nor the pestilence that stalks in the darkness, nor the plague that destroys at midday. A thousand may fall at my side, ten thousand at my right hand, but it will not come near me. I will only observe with my eyes and see the punishment of the wicked. As I make the Most High my dwelling – even the LORD, who is my refuge – then no harm will befall me; no disaster, plague, calamity will come near my home for You have given Your angels charge over me to keep, defend and preserve me in all of my ways; they will lift me up in their hands, so that I will not strike my foot against a stone. I will tread upon the lion and the cobra; I will trample the great lion and the serpent. Father, You said that because I love You, You will rescue me; You will protect me, for I acknowledge Your name. I call upon You, and You answer me; You are with me in trouble, You deliver me and honor me. With long life will You satisfy me and show me Your salvation.” Psalm 91

A friend visited me the day before I entered the hospital and shared this powerful Psalm with me. She is a cancer survivor and told me she personally read this comforting Psalm as she battled breast cancer surgery and treatment. I will be forever thankful for this gift.

As they were preparing me for surgery early Monday morning, Tom prayed with me beside my bed. We had both read the Psalm together at home. I told him I would ask God to cover me with His feathers and under His wings I would stay until the surgery was over. He kissed me and I was taken back to the OR.

The surgery lasted 9 and 1/2 hours. While I do not know what it was like to sit in the waiting room or even all of the family and friends who sat there in support of my immediate family, I am so very thankful for each and every one of them.

As I was coming out of the anesthesia, I felt as if I were wrapped in some sort of cocoon. I could not see immediately, but I asked aloud, “Am I in heaven?” Tom replied..”No, you are right here with me!” My answer…..”PRAISE GOD!” as I extended my hand to the Lord.

It seemed a short time before our surgical team surrounded my bed. “We have great news”. Said Dr. Asbun. “You are the reason I do what I do.” “You made the correct decision to proceed with surgery. We have removed the cancer and you are at this moment….cancer free.” ” I have done my part…now the next step is up to you.”

God had been faithful…He had heard the prayers offered on my behalf. God is my refuge and my comfort and my protector, just as He promises.

He is YOURS too!

The surgical consult….

The surgical consult….

The week before surgery was surreal. Our new little “Jude” came home from the hospital, The 2014 Players Championship was literally being held in our backyard, my Father in law – Lugi was visiting as he always did for the tournament and of course for the birth of his fifth Great-Grandchild, and our neighbors and friends were curious to see the completed backyard renovation that had caused the dumpster and porta-potty to be displayed in our front yard since October 2013. Add to that the sudden announcement that I had a very serious diagnosis..people were curious.

The effects of the cancer were beginning to zap my energy. I began to jaundice. The rapid 20 pound weight loss was clearly evident. I wanted to make this last week before surgery a celebration. Late in the week the surgeon had scheduled the placement of a JP drain to relieve me of some of the bile that was blocked from the bile duct and streaming into my system causing the jaundice, the itching and scratching. But by the weekend, I developed a fever and late Saturday night we made a trip to Mayo’s ER. I was very weak and nauseated. They decided to admit me and keep me on an IV until the surgery Monday. In retrospect, this was the best decision as I doubt I would have been strong enough for surgery without the fluids. I needed to build my strength for the huge surgery that lied ahead.

Dr. Horacio Asbun, my hero!

Dr. Horacio Asbun, my hero!


Thursday we had a pre-op visit with the surgical team. My team and several other surgeons had been meeting to discuss my case. They had read over 1500 images from my MRI and were diligently planning their attack on the tumor and surrounding cells. Some of the lymph nodes were lit up in the pancreas and kidneys. They would remove any suspect lymph nodes during surgery. All of the tumor and surrounding tissue would be removed until the margins surrounding the tissues showed cancer free. The tumor in the pancreas head measured roughly 3.5cm. They were confident the Whipple surgery would be a success. They also informed us of the most dangerous effects the surgery could have on me; excessive loss of blood requiring transfusion, infection, etc.etc. We left the appointment prepared to take the next and most important step in our battle against this demon.

Shortly after we left the hospital, we received a phone call asking us to return to the hospital. The surgical team wanted to discuss something further.

When we arrived they told us one of the surgeons had viewed an image from the MRI that showed something disturbing. Part of the tumor appeared attached to the biliary artery. Removal of the tumor would be very risky. Dr. Asbun said he had an obligation to tell us about this find and to offer some options. One would be to undergo adjunct chemo therapy to possibly reduce the size of the tumor. This would of course delay the surgery and really did not have any guarantees. If he went ahead with surgery he could excise the tumor and place a stint in the artery replacing the effected section. It was difficult, but he assured me he was not afraid and he could do it.

He told me I was the only one who could make the decision. Tom and I looked at each other, another punch in the gut. But, we had our faith. We were going to make it thru this. We were going to be one of the 20 percent that the cancer did not return. We believed this and we had prayer warriors who believed this too. I felt God was telling me to proceed, to remove the cancer from my body. I asked Dr. Asbun what he would do if I were his sister. He told me he would go with the surgery now. That was what I felt too. “Let’s get the cancer out as soon as possible.” I said. We were on for Monday.

Unknown

Whipple surgery is basically the removal of the portion of the pancreas effected by the tumor,(in my case, the head of the pancreas), the gall bladder and the small intestine. The diagram illustrates the resections.Since my cancer was located in the head only, I would not be required to live on insulin. I am blessed to have a surgeon who performs this procedure laparoscopically. Normally an incision would begin below the breastbone and down the entire stomach. Recovery for my surgery would be much more speedy than open surgery. I was confident I was in good hands. Plus, I had an army of friends, bible study Sisters-In-Christ, CHRP Sisters from our church and family who were praying for me constantly. God would surely hear those prayers and I knew He would bring me through.

The birth…….

The birth…….

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“Our baby is having a baby! Lindsay, our youngest and only daughter is due to deliver our angel baby on May 5th.”

We shared this fact with our surgical team who told us “….this is perfect….go home, take a week and enjoy this miraculous life changing event with your family.” Dr. Asbun explained the tumor had been there growing for probably 15 years. Delaying the surgery one week more would not be a problem. So, we scheduled the surgery for May 12th and began to pray our little angel would arrive during TPC week on schedule…or close to it.

When Lindsay shared our great news last October, we could not have been happier. Louis had moved out so I immediately went to work on transforming his room into a nursery. Both Grandma’s would share daycare for the angel so Lindsay could go back to work. It was so much fun picking the baby furniture and painting a day bed and putting it all together in anticipation of May 5th, the due date.

Both Lindsay’s and our nursery were completed by April. We were all set.

When the news of my diagnosis on April 29th was shared with the family everything changed. It was a very difficult time for everyone, but especially for Lindsay. She was already hormonal and uncomfortable and anxious about giving birth for the first time. She amazed us with her strength. On her next weekly doctor visit she explained the situation. Her doctor agreed she should deliver by the due date and assured her the baby was completely ready to face the outside world. They made plans for inducement and we knew we would have a baby by May 5th.

Grandpa Lugi had arrived a few days before ready to relax and enjoy the golf tournament. This week was our 21st Player Championship week in our home. While I must say this week eclipsed all years prior…it was a roller coaster of emotions. Grandpa handled all of this extremely well.

We had begun a backyard project in October that felt similar to what Lindsay was experiencing in knitting the baby in her womb. The project seemed to go on and on and of course, the deadline was TPC week. The back yard was filled with carpenters, plumbers, stone workers and more. The street in front of the house was lined with trucks and trailers. It was coming together, but we were not really positive it would all come together in time.

So much going on…..

Matt told us they were at the hospital early in the morning hours of May 5th. The inducement was not necessary…little guy was ready and God was in control!

Tom and I rested alongside one another praying for a smooth birth for Lindsay and a perfect little baby boy. We got up early and prepared to spend the day at the hospital. When we arrived at the hospital, we sat in the waiting room. The Garrity’s were there, all of Matt’s sisters, and of course the Zitiello’s. It was a full house!

Lindsay and Matt requested to be alone in the delivery room …..their own family unit. We all honored the decision but waited in anticipation to hear that the baby was delivered and healthy.

Suddenly over the loud speaker was a doorbell sort of sound playing “lullaby and goodnight“. We asked the nurse if that meant a baby had been born…. Could it have been the Garrity baby? “Yes”, she confirmed. Within a few minutes, Matt emerged from the double doors to announce the baby was very healthy in fact almost 9 pounds!

He asked Phyllis and I, the Grandma’s to come in to see him first. We quickly followed Matt to the room and instantly fell in love with our perfect angel. God had blessed us, He had brought us a symbol of life, of hope and of His love. He blessed us all with this perfect child on this day, amidst this uncertain trial, to show us that life is precious and perfectly timed.

Then Lindsay announced…….”Come and meet Jude“…..It might have been the happiest day of my life.

The Diagnosis…..

The Diagnosis…..

Tomm & Judi at Kylies WEddingTom was seated on the sofa as I sat perched on the paper-covered table. The 30 something, very sweet, Sports Medicine Doctor shared my report displayed on the large computer screen. “There is a mass in your pancreas,” she said very cautiously not wanting our eyes to meet. Tom leapt from the sofa to my side on the table as we both tried to absorb the words. My first reaction…”Can you live without a pancreas?, recalling Pancreatic Cancer to be the most deadly form of cancer. “Yes, you can today, with the proper medication.” She continued to relay the medical facts that had been compiled in the short 24 hours since I had met with her. She read the blood test results showing elevated pancreatic enzymes, “…..Lipase, Serum 661, desired level should be between 7 and 60.” “I have scheduled an appointment for tomorrow with a general surgeon who specializes in this area,” she said. We clung in disbelief holding each other as the doctor wept with us. We prayed to God on the way home that He would give us the strength to weather this storm. We gathered our immediate family and told them everything we knew.

I loved to work out. Well, I longed to be in shape. Menopause and gravity had added about 30 pounds to my medium frame over the years. It seemed like each decade added 10 pounds. So, this kept me walking in the mornings, biking and being active. When my best friend’s daughter was planning her wedding we even went to a personal trainer. However, the impact on my 60 year old bones was too much. I began to suffer extreme knee pain. After a visit to an orthopedic surgeon he recommended he repair a meniscal tear. The surgery was performed January 15th. He kept me off my knee for 6 weeks. Once the knee was healed he released me to normal physical activities. Excited to be back in the gym, the pain returned. I was popping 800 mg ibuprofen twice a day to control the pain. Never having taken any type of pain control, I was reluctant to continue, but the pain was significant. I had read the side effects and wondered about the effect on my liver and kidneys. A few months later I stopped the meds.

The pain continued and I felt sick to my stomach most of the time. I suppressed the urge to throw up. All of a sudden I noticed I had lost weight without really trying. I was avoiding eating and when I did eat it was a small portion. I couldn’t even drink wine! Something must be wrong.

One day I noticed my urine seemed extremely dark. I had started to itch. My body was covered with small red scabs where I had scratched my skin raw. In my mind I felt it was related to the medications and the nausea was caused by the pain. It was time to go to the doctor to find out was was going on.

Mayo Clinic, Jacksonville is located 15 minutes from our home. A dear friend suggested I make an appointment at the Primary Care facility. Mayo is approved by our insurance and they certainly have a wonderful reputation. Monday morning I called for an appointment. After explaining my symptoms, the nurse suggested I see the sports medicine doctor and she happened to be available that afternoon. God was once again behind all of this!

When I arrived for the appointment I explained everything to the doctor. She decided to have blood work and a stool and urine sample. I was escorted into the lab where the samples were drawn. The next morning the nurse called to tell me I needed to come in for a sonogram that afternoon. What could be happening?

As the tech lathered my stomach with gel and guided the probe while watching the monitor intently, I noticed her focusing on one area. She was marking the spot with a red arrow drawing a line from one end to the other. A measurement? I asked her what that was. She began to probe different areas and showed me my kidneys, liver and pancreas. I asked her about the arrows. She said the Radiologist would review the scan and report to my doctor the results. I knew that would be her canned response, but I wanted her to say something more definitive. I sensed something was not right.

We were very familiar with this disease. When Tom and I first met, he lived with his aunt and uncle directly across the street from me. Shortly after we were married, Frank was diagnosed with pancreatic cancer. He was 36 when he died just 18 months after receiving the report. We had read the statistics and knew what we were facing.

The next few days were a flurry of consults with the surgical team, blood tests, CT scans and MRIs. The doctors held nothing back. While they shared the worst case scenario, they also encouraged us with the positives. I had no previous serious medical issues. They marveled how at 64 I was not on any prescription medications. With the exception of exercise related problems with knees and ankles, I was in very good physical condition.

We quickly realized God had provided the perfect medical team at a world renowned hospital. Our Mayo Clinic surgeon, Dr. Horatio Asbun, specializes in pancreatic surgery. He is the best in the country. His team was equally impressive. He would perform whipple surgery laparoscopically, removing my small intestine, gallbladder and the head of my pancreas where the tumor had taken hold. He told me he could do his job and remove the tumor from my pancreas. And, he believed I had the ability to do my part. He said I had a strong faith in God and a positive attitude.That was 90% of what was needed to make the surgery successful. We were all a team and we would don our armor and enter this battle together. Most importantly, he asked his surgical team to pray for me between the meeting and the surgery date. We were confident God had placed us in good hands.

We are blessed with a strong faith in God. Tom and I knew we would get thru this and there was a reason why this was happening. Tom began to attend morning mass daily. I attended with him and we advised our Church family about the diagnosis. They immediately called to action. Fr. Frank administered the anointing of the sick. We could face the outcome no matter what it was.My CHRP Sisters and my Bible Study group organized prayer vigils for the surgery date. Our amazingly close family would also use their faith to pull through and we would do it together.