Flurry of activity . . .

Bob's surgery is officially on the schedule. Next Tuesday, June 1st. That was decided for sure yesterday, and as such, Bob's room became the site of a whirlwind of visits, consults, tests, etc. to be done prior to surgery.

He had cardiology consult yesterday; said from a cardiac standpoint, his heart looks strong and healthy, so they gave their "go-ahead" with the surgery. They ceased the Plavix yesterday, will also cease the aspirin upon the surgeon's request a few days before the surgery . . .

Met with someone from vascular surgery, and learned something new: that tumors, particularly bigger ones, actually create their own blood supply by which to feed itself, like some creepy, freaky sci-fi creature . . . so, they're discussing the possibility of doing a minimally invasive procedure to cut off the blood supply to the tumor, which would be done prior to surgery. The goal is that by cutting off the blood to the tumor, it'll lessen the amount of bleeding during surgery.

Anesthesiology also paid a visit and said Bob's good to go, in their eyes. Not sure what the point of that visit was, as they showed up after I'd left; maybe will ask someone today, if I remember. Sounds like anyone and everyone who has anything to do with the surgery needs to give their "thumbs up," or to address any concerns from their perspective prior to surgery. So, it was another good reason to have Bob in the hospital this time, to get a lot of stuff done in a timely fashion. I'm imagining trying to get all of these things done on an out-patient basis, and am pretty sure it would have taken forever, if at all. . .

Bob had an MRI last night, one more pre-op image, to get a current, detailed view of the tumor and surrounding areas. And he had a PICC (long-term IV) line inserted into his arm, and will be going home with a portable PCA (Patient Controlled Analgesia) pump, for his pain meds. I got to go to a class to learn about the PICC (already knew about that) and the PCA pump (new stuff); how to operate it, change the medication, battery, etc. The PCA pump is a device that delivers Bob's meds via the PICC line. It delivers a "baseline" amount of medication continuously, along with a button that Bob can push to control an extra boost of the drug as needed (the "boost" is set to a specific amount allowed in intervals, and only so many "pushes" can be delivered in a set time frame, so he can't OD).

He had one on an IV pole in the hospital, but they have a portable version for home use. Bob'll carry the PCA in a little pack about the size of an old-skool Walkman. The IV delivery of meds is more effective than pills at this point and the theory is that it'll manage his pain better for this next week, while waiting for surgery. His pain has gotten to the point where he's maxed out on the amount of medication he can take via pills, hence, the IV version; uses less of the drug but gets into the blood system faster and more effectively. The trade-off is that the meds make him so groggy and zombie-like. He has a difficult time recalling words, and his memory is also being affected; a frustrating situation for this normally very coherent, in-control guy. He's very tired, but can't actually sleep well . . . it's a delicate balance, getting the pain managed to a tolerable level while still being coherent enough that he feels he can function. His Palliative care doctor assured me that this will be just a temporary set-back, as they'll start weaning him from all these drugs after the surgery.

That's the quick, down-n-dirty update. I know you're disappointed not to get a full chapter today, but got a busy day—head to the hospital for a few hours, then to work the rest of the day. Penny and Jim will be up later, to be with Bob in the afternoon, and to bring him home. Let's all toss up a few prayers that this will be a boring, uneventful week . . .