For those of you who recognized the Saturday Night Live reference in the title, don't expect any Tina Fey-like humor...I only wish I could be that funny.
We met with both the cardio-thoracic team and the oncology team this morning. And, I just can't say enough about the doctors--and the nurses--here at UAB. Truly an unbelievable team of caregivers!
Parrish's surgery is still set for tomorrow (Monday). He is the third surgery, so he likely won't be rolled back for pre-op until noon. Surgery will be early afternoon at best. The procedures should take about an hour. They will make 4 to 5 incisions in his right side/chest, each about an inch long. They will take a large chunk (technical medical term, huh) of the tumor in Parrish's chest for biopsy. In addition, they will drain the pleural fluid (around his lung) and do a pleural fluid study. This will tell them if there are any cancer cells in the fluid and if so, what kind. While the pathology from the chest tumor won't be back until Wednesday or Thursday of this week, the fluid study will come back sooner. In addition to the above, the surgeon will do a bronchoscopy to take a look at Parrish's airways and lungs more closely. The surgeons will leave a chest tube in post-surgery to continue to let any remaining fluid drain.
The oncology team has increased Parrish's fluids because his creatinine went up just a bit--it is just some stress on his kidneys due to all of the dye he had to ingest for his tests on Friday. He is still on zosyn (a broad spectrum antibiotic) since he came here with a fever. They would also have him on this anyway to prevent post-surgical infections. The oncologist said that Parrish's abdominal and pelvic scan showed nothing more than what they already knew about the mass on the spleen. And, the doctor isn't sure whether the mass on the spleen is more residual (leftover from Parrish's previous cancer) or part of what is currently going on. He will look at Parrish's scans from St. Jude to see how the spleen looked post-treatment.
Parrish's brain scan showed some "white matter abnormalities" or "enhancement." This could likely be the result of the chemotherapy that Parrish received at St. Jude. However, if the chest tumor is non-Hodgkin's lymphoma, then the doctors will want to do a spinal tap to make sure the brain enhancement is not cancerous. As a side note, Hodgkin's lymphoma does not spread to the brain, while non-Hodgkin's lymphoma can spread to the brain. So, if Parrish's tumor is a Hodgkin's recurrence, a spinal tap won't be necessary. But, given the look of the enhancement and Parrish's treatment regimen at St. Jude, it is likely just a result of chemotherapy treatments and nothing to worry about. Again, the oncologists here are going to look at the historical scans from St. Jude to see if/when this first appeared. You will all love to know that when Parrish first learned that his brain was "enhanced," he jumped at the chance to tell me that he always knew he had above-average intelligence.
So, what happens post-surgery? Based on what the surgeons see tomorrow and some initial impressions from the OR (as well as the pleural fluid study), they could start treatment before getting the complete pathology back later in the week. While most of his treatments will be outpatient, the doctors might do the first round of treatments inpatient. Given that Parrish has had chemotherapy before, they want to be able to monitor his reaction to the initial treatment, just to make sure of side effects and such.
Whew...so if you are still with me after all of that....thank you for the bottom of our hearts for all of the thoughts and prayers, phone calls, texts, emails and more. I can't even respond to them all--but don't think that I am not getting them. They are such bright spots and I am sharing them all with Parrish.
Thank you for your prayers. We are such believers in the power of prayer and we can feel your love and your words showering us. I am someone who tends to pray constantly throughout the day--my words aren't fancy or formal, just a running dialogue (think me at a stop light mumbling and you'll get the picture). But now, at the most important time, I can't seem to find the words...I am having a hard time quieting my heart enough, I guess. But I am using all of your words and all of your prayers, so thank you for giving me your words.
I will keep everyone updated tomorrow.
Much love,
Molly
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