Angioplasty

I mentioned in my last post that I found out that the stent in my iliac artery had collapsed and another surgery was needed to fix it.  Anything more than a casual walk caused my left leg to go numb because not enough blood could get through to deliver oxygen to the muscles.  The procedure would be an angioplasty, where they would insert a wire with a small deflated balloon on the end of it into my femoral artery and feed it up to the scene of the crime.  Once it was in place at the collapsed part of the stent, they would inflate the balloon, which would open the stent, hopefully permanently.  The surgery was initially scheduled for last Tuesday, but was delayed until Thursday 8/21 because the surgeon had an emergency case that came up.  I was anxious to get this over with and a little disappointed to have to delay my recovery another few weeks.  Compared to everything else that has happened this year, this is not a big deal, but when I found out I needed surgery I thought "seriously? Another thing?"  Even though I didn't feel particularly filled with faith, I forced myself to revisit the verses that have encouraged me over the past year, including Psalm 16:8, "I have set the Lord always before me.  Because He is at my right hand, I will not be shaken."

When the day finally came, Tiffany and I arrived at the hospital around 8:15 and got checked in.  They brought us back into the surgical prep area and I got dressed into the familiar purple paper gown.  I filled out some paperwork and the anesthesiologist gave me some pre-meds while I waited to get wheeled into the operating room.  I remember getting into the OR and saying hi to a few people in there and then waking up about 30 minutes later in the recovery room.  The first thing I looked for was the clock, and the fact that the procedure only took 30 minutes made me happy.  I realized I couldn't move as they had attached a clamp to my hip in order to keep pressure on the incision, so I just dosed in and out of consciousness until they brought me to a room.  I was initially told that I would have to stay overnight, but Dr. Hoepp said that if I was feeling well and could walk by 4:00 that afternoon, then I could go home.  After eating lunch, I pretty much slept most of the afternoon.  Right about 4:00, one of the physician assistants came to see me and I was discharged.

Pre op selfie

Since then I've felt pretty good.  I have to delay my physical therapy for another couple of weeks, but I'll be able to return to work tomorrow and start my real recovery.  Baby Boy is due in about a week and a half, so I'll be ready when he gets here. 

But wait...there's more!

This post is coming from about 20 feet from the Atlantic ocean while we are on a short getaway at a resort in Maine (just Tiffany and I.)  After two unsuccessful attempts at a 10 year anniversary vacation, we finally made it.  Despite everything that has happened this year, life is good and we are incredibly blessed.  I had actually planned for this post to be about what I've learned and how my outlook has changed for the better after going through this, but that will have to wait a little longer as life continues to be interesting.

Room with a view

If you've ever seen an infomercial, you're familiar with the phrase in the title.  The host will excitedly talk about the benefits of his or her revolutionary new product that you can not live without and the ridiculously low price that you can have it for.  And just when you think it can not possibly get any better, he or she drops the phrase "but wait...there's more!" and reveals that if you call in the next hour, you will get double the amount/ a Snuggie/ etc. for free.

As I've been sharing my story over the last five months, I feel like any one of the things that has happened is pretty unusual and/ or unlucky standing alone.  Getting blood cancer at 34.  With two toddlers at home.  While my wife is pregnant.  Losing half of my blood and almost dying during the biopsy surgery. Going back in the hospital for blood transfusions.  Going back in the hospital a third time with an infection and high fever toward the end of chemo.  When combined together it's pretty incredible although I still haven't taken the time to sit down and fully reflect on everything.

After my last chemo treatment on July 22nd, I was eager to close this chapter of hardship and start the longer term recovery process.  Unfortunately that will have to wait a little bit longer as I found out this week that I'll need to go back for another surgery.  It turns out that the stent that was inserted into my iliac artery to repair it when it was damaged during the biopsy surgery has collapsed.  So instead of keeping the artery open, it is creating a bottleneck and slowing down blood flow to my left leg.  In order to fix it, I'll need to have a procedure called angioplasty where the surgeon inserts a wire into the artery and inflates a balloon that will open the stent (hopefully permanently.)  If everything goes well it should only require one night in the hospital.

I first noticed there was a problem a few weeks ago when my left leg would start getting numb after about 2 minutes of running.  I've mentioned before that after I was healed up from my initial surgery, I tried to run as often as I could during chemo in order to keep my energy and strength up.  I assumed the numbness was due to loss of muscle or possibly some other damage from the surgery and would heal with time.  When it didn't, I made an appointment with my surgeon after I was finished with chemo.  They had me run on a treadmill for 5 minutes and then tested the blood pressure in both ankles.  The blood pressure in my left leg was less than half of what it was in my right leg, so the next step was to do an ultrasound of the area where the stent is placed.  The ultrasound clearly showed that it was collapsed and obstructing the blood flow, so here we are.

My surgery is scheduled for Tuesday, August 19th.  It will be my third surgery and fourth hospitalization in the past 6 months, and hopefully the last of both for a very long time. The clock is ticking for me to get better before Baby Boy is due on 9/4, so I'm praying for a smooth operation and appreciate your prayers as well.  I continue to be optimistic about the future and I'm still very eager for things to get back to normal.  Until then, I'm working on being patient.

Last Chemo

Landing in the hospital only ended up pushing my last chemo treatment by 8 days, so I was recovered enough to go in for it on July 22nd.  I started the day with a quick run/ walk before getting ready, which I always do on treatment days.  I do it at the recommendation of Dr. D'Silva from early on as a way to increase oxygen intake and prepare my body for the chemo drugs.  Apart from the other obvious benefits of exercise, it also gives me a mental boost to be able to do it and show myself that this can't break me.

Tiffany and I arrived at the clinic around 8:15am and were brought back for the familiar routine.  I always show up with a positive attitude on treatment days as there's nothing really pleasant about it in and of itself.  It's another aspect that's within my control in the midst of so much that isn't, so I choose to be happy on these days.  The staff and nurses also do a great job of maintaining a positive environment at the clinic, which makes a huge difference.  My nurse this time was Shelley, who was also assigned for my very first treatment, so it seemed fitting that she would be with us for the last one.  My blood counts were good, which was expected after all of the medication the week before to stimulate white blood cell production, so I had the green light to start my last chemo.   

Ready for the last one

Above everything else, I would say I felt relieved.  Knowing that the cancer is in remission and that this was the last treatment, I just wanted to get it over with and start the recovery process.  The day itself was pretty uneventful until the end.  Once everything was finished and I was unhooked from the IV, a few of the nurses who were still there came over to celebrate with confetti and a cake.  It was a special moment to culminate all of the events of the last 5 months.  I even received a certificate for "graduating."  After a few hugs and some pictures, we were off to start the recovery process.  I spent the next week or so dealing with the now predicable side effects but have started to feel much better over the past 2-3 days.

With Tracy, Katie, and Shelley after finishing

With Dr. D'Silva

My "diploma"

The big question is "now what?"  That's what I've been asked the most and the same question I asked Dr. D'Silva.  Physically, I'll regain my energy and strength over the next several weeks as the good cells that were killed off by the chemo regenerate.  I'll have to return to the clinic every two months for the next two years starting in September for my "maintenance regimen."  This involves getting a dose of the Rituxan only and will take about 4-5 hours each time.  Rituxan is one of the drugs I've been getting, but it is not one of the toxic ones and doesn't come with the side effects of the other drugs.  It's a monoclonal antibody that identifies certain cells that contain a specific protein that the lymphoma cells contain and marks them for the body's own immune system to destroy.  Getting this every two months for two years after chemo has proven to extend the remission period significantly.  I'll have to get scanned once a year for the rest of my life, but I expect to not have to deal with this for quite a long time based on how everything has gone and the research I've done.  Plus Dr. D'Silva told me that we'll be getting together for a drink in ten years.

So my focus going forward is on recovery, healing, and rebuilding my strength and fitness level.  I've tried to keep myself from deteriorating too far, but my body has been through a lot this year, especially considering the damage from the surgery in March, so I know the road is going to be slower than I want.  I'll still continue to post here from time to time, even though the dramatic part is over.  I have some thoughts about how this experience has changed my outlook among other things, so I'll keep the blog up and running.  I'm also anxious to recover so that I can use my experience to help other people. As those opportunities come up I'll also use this space to share.  For now, thank you again for your support and sharing this journey with us. 

Isaiah 43: 1-2 "But now, thus says the Lord, who created you, O Jacob, and He who formed you, O Israel:

“Fear not, for I have redeemed you; I have called you by your name;  You are Mine.  When you pass through the waters, I will be with you; and through the rivers, they shall not overflow you.  When you walk through the fire, you shall not be burned, nor shall the flame scorch you."

Relevant message in this song below (although it is hard, so you probably won't like it unless you like awesome metal.)  The only line I don't agree with is "pure strength through solitude" because I've drawn so much strength from others and God during this trial.