Visit

 Ma had a visit from Ross the physical therapist today. He was fun and really nice.

He taught Ma how to do a bunch of chair exercises and then they went for a stroll; but this was no ordinary stroll.  They started a regular lap around the nurses station but then to start working on her balance Ross had Ma take a few step backwards. 

Then they turned around in a circle, like a dance.

But Ma got dizzy and Ross had to grab on to her.

Overall though it was a good session.

Progress

The doctors have been making their rounds very early in the morning and every morning I have been missing them.  This morning though I made it in time to be in Ma's room for their early morning visit thanks to a wake up call (at dawn!) from the hotel front desk.

So here is the latest:

The doctors have decided to discharge Ma on Monday.  They say she is doing "just fine" and the pain is to be expected given the major surgery that was done.

They also recommend that she transition through a rehabilitation facility to help her to get used to moving around again, and to build up her stamina and strength. These are called transitional care facilities for people recovering from surgery but not quite ready to live at home yet.  Thankfully the facility is only a couple blocks from Mave's house and so it'll be easy to visit.

In other news the doctors have upgraded her diet again and so now she can order solid foods from the hospital menu.

And finally the best news of all this morning: when getting up out of the bed for breakfast it was not as painful.  So we are making progress over here.

Healing

Today was Ma's third day of recovery and it was not that great.

Let's start with the good news. 

These flowers arrived today and they are lovely. 

The intravenous tubes have been removed by the nurses.  Ma has been able to drink plenty of fluids so the IV was no longer necessary.  

The doctors have moved up her diet from a clear liquids to a "full liquids" diet.  This means that she can have creamy and tomato soups instead of just broths, she can have some oatmeal, and the hospital even offers milkshakes and pudding on the full liquids diet.   

Her vitals are all good.

The doctors orders are for her to take 6 to 8 laps around the nurses station and she has been able to walk the laps, though today she was pretty tired out after each walk. She usually goes two laps per walk. 

Now for the not so good news: the excruciating pain. 

Getting up from bed and lying back down and turning on her side is hard for her to endure. It is bad. When she is sitting, walking, or lying flat in bed though she is better. Thank god.

They gave her a new pain medication that doesn't disorient or confuse her.  The nurses are supplementing it with plain old extra strength tylenol.  She's been very drowsy today and I asked if it was due to the pain medication, but no.  The nurse says it is because Ma has "a lot of healing to do."

Laps

This morning the doctors stopped by and the message was this: walk, walk, walk.

Here is Ma getting ready to head out the door.

Getting help from the therapist. The monitors and everything else came along on the walk.

Strolling around the nurses station.  The belt around her top is for safety.

She did three entire laps around the nurses station this morning.

First Day

"The first day of recovery is always the hardest," said the nurse today.

And it was. 

Sitting up, getting out of bed, moving from her back to her side are all painful.  The doctors and nurses are regularly asking Ma to rate her pain on a scale of 1 to 10 and they have her hooked up to an intravenous pain medication drip where she can hit a button and the medicine comes through the IV.  She has been using it sparingly though as she doesn't "want to turn into a dope addict."

The doctors insisted today that she get up on her feet and so the nurses took her for a stroll down the hall.  It was not a long walk - about 10 yards total.  She was assisted by the nurse and a walker, and she said the walk "wasn't too bad."

For tomorrow the goals are to go for two walks and to sit up for a while in a chair.

Recovery

The surgery finished at about 6:30 and shortly thereafter Dr. Wilson stopped by the waiting room to tell us about it.

First of all Dr. Wilson said that there were no major bleeding or cardiac or other type of problems during the surgery.  The doctors removed an ovarian tumor about the size of a large grapefruit or small cantaloupe.  They also found that her uterus was cancerous and this was totally unexpected.  They did plan to do a complete hysterectomy though so the whole works was going to come out anyway.

Following surgery she went to the recovery room and was there for several hours before being moved over to her own room.  She is in room 5-403.

2:30

The surgery started at 2:30 central time.

We've been told that the surgery will take about four hours.

Communicators

The Mayo Clinic has special nurses that serve as "communicators" between the surgical teams and family members. They come in every couple of hours with updates.

Our communicator's name is Suzanne.  Like all Mayo nurses, she is very nice and totally professional.

Here is what she just told us:

Ma went into the operating room at 1:31 pm.  It then takes about an hour to set up before the actual surgery begins.

Holding Area

At about 11:30 a.m. (central time), the nurses brought Ma upstairs to a "holding area."  This is where they get her all set to go into the operating room and where they administer the anesthesia.

We were told that she should be in the holding area for about two hours.  By the time Ma goes into the operating room she will have already been under anesthesia for about an hour.

We will remain here in the admissions waiting room on the second floor of the hospital until we're told where to wait next.

Pre-Op Prep

The surgery is being done at Rochester Methodist Hospital, which is affiliated with the Mayo Clinic.  We reported to admissions at 9 am. 

The nurses are doing the pre-op blood and other tests, taking down Ma's health and medical history, and the nurses are teaching her how to use a breathing tube once the surgery is done.  It's called an incentive spirometer and will help Ma to take deeper breaths and will help keep her lungs clear of excess fluid to prevent problems such as pneumonia.

Dr. Wilson

The doctor doing the surgery tomorrow will be Dr. Timothy Wilson.  I know you would agree that given the nature of the surgery (major) a full-scale reconnaisance on him is in order - or at least a google search.

Here is a link to his profile at the Mayo Clinic:  http://www.mayoclinic.org/bio/10014187.html

Here is an interesting short article about his work with ovarian cancer patients:  http://www.mayoclinic.org/news2006-rst/3215.html

Here is his academic profile:  http://mayoresearch.mayo.edu/staff/wilson_to.cfm

And a few random comments at a website that rates doctors:  http://www.suggestadoctor.com/doctor_245_timothyosborne_wilson.htm

He generally gets positive reviews from his patients.  When meeting him, Ma really liked him - and hers is the review that matters most.

Pre-Op

The doctors gave us a list of pre-op instructions for Ma:

(1) Have a good breakfast the day before. 

Check. 

We all had an awesome breakfast of pancakes, eggs, and ham - all courtesy of Sylvia's superb culinary skills.  We also had delicious muffins from Stephanie (thanks Stephanie!) and fresh strawberries (thanks Super Target!).

(2)  Clear liquids only.

From now until the surgery Ma can only have clear liquids - water, gingerale, tea. She can also have popsicles - sugar free of course. 

(3)  Early night to sleep.

The nurses instructed Ma to be in relaxation mode with pajamas on and in bed no later than 6 pm.  So we are making the drive from Minneapolis to Rochester this afternoon so that we are all settled into the hotel for an early night.  We are staying at the Kahler Grand Hotel at the Mayo Clinic.

(4) Call Mayo.

We've also been instructed to call the Mayo Clinic tonight to find out what time we are supposed to arrive for the surgery tomorrow.  We're guessing it will be early.

Developments

We have some fast moving developments.

At yesterday's appointment, Dr. Hartmann found that those critters she saw trying to grow back a few months ago are back in full force.  Following the blood tests and exam, Dr. Hartmann ordered a CT scan to see the extent of the growth.  The news is that the tumor is large; about the length of a football.

So Dr. Hartmann is taking the treatment plan in a different direction since the Doxil is not doing the trick.  She is pulling in reinforcements: the surgeons.

Dr. Hartmann arranged a surgical consult for Ma this morning at 8 am.  After a battery of tests and exams, the doctors there recommended surgery.  To cover all the bases, the surgeons brought in a cardiologist to check out Ma's heart.  The cardiologists gave the green light and the surgery is now scheduled for this coming Wednesday.  We do not yet have a time.

All of us will be traveling to the Mayo Clinic for the 4-5 hour surgery and we'll all be there to help out on the recovery side.

So get ready Minnesota. We're on our way.

Kahler

On Thursday, Ma has three appointments at the Mayo Clinic, with the first one starting at 7:30 a.m. for a blood draw.  In the afternoon there are appointments with Dr. Hartmann and chemo.  Sylvia and Tim are in Baraga now and tomorrow they are all making the 410-mile trip to Rochester.

The long drive on Wednesday followed by the day of appointments on Thursday at Mayo means a hotel stay is in order.  They will stay at the Kahler Inn.  

The best part about staying at the Kahler ( no. 9 on the map) is that it is directly connected to the underground subway level that links all of the Mayo Clinic buildings.  It is also very close to the Gonda Building, which houses the Oncology Department.

Safe travels to Sylv, Tim, and Ma!