Today's tests

Dale had a Brain MRI today. Apparently it went well, since he slept through it! Advantage to having your hearing aids removed for the procedure. Next was a pulmonary function test.

Several of Dale's appointments next week have been shuffled around.

Tuesday: Xenon ventilation test and then an echocardiogram
Wednesday: Meet with thoracic surgeon, then if necessary, meet with radiation oncologist and have PET scan.

Dale seems to be doing well today as usual. He's using the valium whenever he feels anxious or pain and it seems to work well. It's a very small dose and perhaps the suggestion of relief from the pill is more helpful than the real medication. Either way, he's good and we're all happy!

Surgeon

We have a surgeon!

http://www.mdanderson.org/care_centers/thoracic/display.cfm?id=085bb8b6-09ed-415f-8cb0734c910f83ee&method=displayfull&pn=fa662779-7556-11d4-aec300508bdcce3a

Dad's appointment with him is Wednesday, Dec. 5 at 7:30am. Hopefully then we can this surgery scheduled!

Dale is having some periodic pains in the left chest area. He's taking medication and they are helping.

Anxiety and frustration abound!

Playing the waiting game

We all enjoyed our Thanksgiving weekend in Victoria. All, except well maybe Shelley! She took a nasty fall chasing her wiener dog puppy and now finds herself on crutches with a nasty sprain!

Missy is headed to Houston tomorrow evening and she will join Jackie and Dale on their trip to MD Anderson this week for more testing.

Dale is anxious to get the surgery scheduled. MD Anderson runs on their own time and that's frustrating. I spoke with Dale's doctor's nurse today and she assures me that the surgery will happen in due time. The doctor's at MD Anderson know what they are dealing with and know what tests need to be done. I reminded the nurse that this was my father they were dealing with! I reminded her too that we were new to the world of MD Anderson and wanted to make sure that we were dotting our i's and crossing our t's so as to not slow down any steps.

Dale is back off his Plavix again. His primary doctor pulled that medication in anticipation of surgery in the near future.

Dale and Jackie will head to Pearland on Wednesday in anticipation of Thursday's appointments.

Dale has really been handling all the frustrations remarkably well. I'm not sure I would be in half as good as shape as he is. Frustration and anxiety seem to be his only real symptoms. He thinks that sometimes he's looking for symptoms when there really aren't any there. The mind is very powerful! Long days to dwell don't help!

First list of appointments received!

Brain MRI on Thursday, Nov. 29 at 12:30pm.
Pulmonary Function Test on Thursday, Nov. 29 at 3pm.
Echocardiograph on Tuesday, Dec. 4 at 1pm.
Pet Scan on Tuesday, Dec. 4 at 2pm
Radiation Oncologist on Wednesday, Dec. 5 at 1pm.

These appointments are being made and he is being notified via internet. As more are posted - I'll post them here.

Dale is in super great spirits tonight. We do have much to thankful for!

MD Anderson visit #1

We just arrived home at 2:15 from our 8am appointment at MD Anderson. In addition to a lot of waiting, we met Dr. Ann Tsao. She was a very beautiful, articulate and personable Thoracic Oncologist.

She agreed with the Victoria doctors that this early stage cancer should be treated with surgery as a first line treatment. She ordered additional tests for Dale. (today he had bloodwork and a chest xray) These will be completed on Monday and Tuesday next week. Dale will be scheduled to see a surgeon next week also. Exact schedule times won't be available until Monday afternoon.

Dale and Jackie both enjoyed visiting with Dr. Tsao and her personality gave all of us a sense of strength and encouragement. She prescribed some medications for Dale to help with the continued muscle spasm in his neck and also a sleep aid for the restless nights.

Dale and Jackie will spend Wednesday night here in Pearland (traffic is too bad now) and then drive with Emily home to Victoria to get our Friday Thanksgiving Dinner started! The rest of us will follow Friday morning.

All in all, we all felt a sense of relief, that the news from this doctor was the same as what we had been expecting and gave us encouragement that this tumor could be removed successfully.

Procedures that may occur next week, pending approval by surgeon, are:

Mediastinoscopy
Xenon pulmonary lung function test?
Brain MRI (standard for all lung cancer patients)
Repeat PET scan
Echocardiogram
New CT

Dr. Tsao was very encouraging about her ability to coordinate any chemotherapy with Dale's doctors in Victoria. She was adamant that the surgery should be performed at MD Anderson. Their surgeons are fair superior at lung cancer!

Headed to MD Anderson

Dale's first appointment with MD Anderson is on Wednesday, Nov. 21st at 8am.

His appointment will be with Dr. Anne Tsao (see page 3 of http://www.mdanderson.org/pdf/thnmo_protocolreview0405.pdf)

Dr. Tsao is a Thoracic Medical Oncologist.

Dale's appointment is in the Clark Clinic at MD Anderson.

We are thankful to get a quick appointment. His scheduler had a cancellation and offered us the quick time slot!

Jackie and Dale will drive back to Pearland on Tuesday afternoon.

Side note: I contacted Dr. Pickett's office in Victoria today. Dr. Pickett will be back from vacation on Nov. 28th. (Dale has his rescheduled appointment that day) His office is currently scheduling surgeries for the first week in December.

Our plan is to still have Thanksgiving in Victoria on Friday!

Still waiting

We are still waiting to hear from MD Anderson with an appointment time.

Jackie and Dale are in Pearland for Dennis' birthday. Dale appears to be feeling pretty good. Aches and pains from the previous weeks tests seem to have resolved themselves.

I'll post again, when we have new news!

Contact with MD Anderson

I have spoken with Alyssa at MD Anderson's Thorasic Center business office. She has received all of dad's medical records required and will call to make an appointment as soon as she has reviewed them. (24-48 hours). Appointments are being scheduled for 7-10 days out.

Marcy and I left Victoria this morning for Pearland. Mom and Dad will drive up tomorrow to join us for a fun weekend celebrating Dennis' 50th birthday!

Pray for a fast appointment time and promising news from the doctor's at MD Anderson!

Apparently Not!

Dr. Pickett canceled our 2pm appointment and rescheduled us on Nov. 28th! %&*$##*(@#*

Dr. Adams will be setting us up with someone at MD Anderson to hopefully get in with before Nov. 28th.

Dr. Adams is now questioning whether or not Dale is a reasonable candidate for a lobectomy.

In the words of my mother, "I'm about ready to run off!"

Until later.....

Queen Frazzled!

Is today the day we get a definite plan presented?

We're up and ready for several appointments today. Dale slept better last night, actually in his bed and not the recliner. Chest is still sore but he's only taking Tylenol for that pain.

Idealistically, we would like to schedule the resection/surgery for Monday or Tuesday, Nov. 19 or 20. Dad's really wants to stay in Victoria and he doesn't want to delay the surgery waiting on MD Anderson to get us in. Not my "best option", but he is the patient and so I'll comply.

As has been the rule for the last week and a half, our current "plan" will hit multiple more glitches and change about 2-3 times per day! Confusion and frustration..two new states I live in!

I'll update again this evening after we meet with both doctors.

Biopsy Results

Poorly differentiated Non Small Cell Lung Cancer.

Dr. Taylor Pickett (thorasic surgeon) 2pm appointment 11/14
Dr. Robin Adams (pulmonary) 3:30pm appointment 11/14

Waiting, waiting, waiting!

3:45 - Still waiting! Having one Bacardi 8 with Diet coke or 30! Looks like we won't know anything until tomorrow morning
1pm - Still waiting! Nauseous!
Noon- Still waiting! Dammit!
11am - Still waiting!

Results haven't come in on yesterday's biopsies.

Dale had an uneasy night, he slept in recliner because lying down in his bed was too painful.

Dammit, why can't pathology be faster!

Biopsy Complete

Dale arrived at Detar Hospital this morning at 9am for an 11am needle biopsy of the tumor in his left lung. At 11:15am he was taken to radiology where Dr. Marriquin (diagnostic radiologists) took 3 core samples of the tumor. Those samples were taken to pathology where they will be tested. Testing will take 24 - 48 hours. Dale was pretty uncomfortable until a couple of pain pills worked their magic. We had hoped to talk with Dr. Pickett (thorasic surgeon) but Dale wanted to head home before Pickett could make it to the room.

We expect to hear from Dr. Henry (Dale's primary doctor) tomorrow morning with the results.
Assuming surgery is on the horizon, we will visit with the thorasic surgery on Wednesday at 2pm.

It's 5pm and Dad is sitting at the kitchen table and appears to be relatively comfortable. We are all disappointed in the delay in receiving the pathology report.

It's been really great having Marcy here to help out. She had plans to fly home Wednesday after our last appointment.

The Power of Family

If one ever underestimated the power of family, today was a day to realize the importance of family! I've had time to visit with family members here this weekend and chat on the phone with others far away and I think we are all on the same page as far as Dale's wishes for treatment.

Fun conversations, laughter and good food have helped erase the "C" word from the week's events. Hallelujah!

Dale's neck pain is manageable today. Lots of tylenol and heating pad treatments! This must be from the bronchoscopy procedure on Wednesday and the manipulations during that procedure.

Ribs and brisket with all the trimmings are heating on the pit. Texas Tech football on the TV and the quiet realization that times like these are invaluable!

Our eyes on on curing this disease by removing it from his body. We're all expecting the surgeon to report back on surgery day with clean margins on the tumor and a speedy recovery! ( My new mantra!)

Go Tech!

Neck issues

Dale's in bed early tonight. He's been nursing a stiff neck that has become increasing worse all day. He's very excited about being in Marble Falls this weekend. We all need the change of location, hopefully we can clear the air and get off the topic of "cancer" for a little while.

Dale is really pushing to go ahead with the lobectomy in Victoria. I've spoken with two doctors on this subject of hurrying to the operating table and both don't feel that a couple of weeks of second opinions makes his prognosis any worse. But, the patient's mental well-being is a concern. Dale hasn't slept a full night since I arrived in Victoria on Monday.

So far I think I've had every range of emotions I've ever had - in the past 3 days!

Hopefully we can have a fun weekend and be ready for the needle biopsy on Monday morning at 11AM!

Astounded!

Amazed and astounded! I just received a phone call from Dr. Pickett, the Thorasic Surgeon who may be performing dad's lobectomy. Did I mention is was 10:10 pm and the conversation lasted 32 minutes? Holy cow! Mother and I were on both extension phones and I referred to my "Spiral" to the page where we had been keeping questions for the surgeon. Dr. Pickett was very kind and jovial about the questioning session.

For those of you who have found yourself in my situation, can you tell me how does your head handle all the millions of facts, opinions, observations, comments and questions that constantly play in you head? I feel like a hamster on a wheel with the inability to just jump off.

Most of the time, getting more information just leads to more confusion.

It's like I'm "living the dream"! maybe nightmare is a better word!

First dip on the roller coaster

Dale had a bronchoscopy at 7am this morning. The 30 minute procedure was uneventful and his recovery was over by 9am. After Dr. Adams performed this procedure, he met with Mother and I to discuss Dad's treatment.

Dr. Adams explained that although dad's lung function test taken yesterday was not perfect, it was sufficient to move forward on a lobectomy (removing the upper portion) of his left lung. He felt that after surgery, Dale's lung function would be sufficient for a normal lifestyle. When questioned about Dale's reliance on oxygen after the surgery, Dr. Adams felt that Dale would be on oxygen for some time and weaning himself off of it would be up to Dale. Dr. Adams has consulted with Dr. Pickett (Thorasic Surgeon) and they believe the resection of the tumor via lobectomy can remove all cancer from that lung.

Dr. Adams does not feel that the needle biopsy is necessary. He feels that the cancer is a non-small cell lung cancer that should be removed. He doesn't need an actual biopsy to make the recommendation for surgery. He also stated that he would have to cancel the biopsy scheduled already for tomorrow morning, since he hadn't taken dad off his Plavik (blood thinner). Dr. Adams "forgot" that dad was on Plaviks and no needle biopsy can be performed until Dale is off the Plaviks for 5 days.

Dr. Adams feels that surgery should be done quickly.

Without a biopsy, Dale can not be seen at MD Anderson for a second opinion.

Dale was an excellent patient and had all the nurses laughing! He is upright and reading the paper - with little to no after effects of the anesthesia. Dale's vitals were all great and his appetite is robust!

After a long conversation with my cousin Dr. Matt, he explains that sometimes getting a good needle biopsy is difficult. When unable to get a good biopsy, the option is to open up the chest for the biopsy. In light of this, most dr's opt to go ahead with the lobectomy and get the pathology after the surgery. Matt feels this is what Dr. Adams is doing. If a good biopsy is not attained, then there would be no choice but to have the surgery here and find out after the fact what it was. Matt hopes a good biopsy could be attained and then a trip to MD Anderson for treatment!

Dr. Henry (primary care) called and agrees with biopsy and surgery option. He knows Dr. Pickett and thinks he's a great surgeon.

I have contacted MD Anderson and started the process of getting Dale in for a second opinion.

I will be bringing Jackie and Dale to Marble Falls tomorrow for the long weekend. I hope to spend a fun weekend with family and get their input on the upcoming days and weeks of treatment!

The beginning

Today Dale had a full body Pulmonary Function test (PFT). This was a one hour fifteen minute test performed in Dr. Adam's office (pulmonologist). Larry Gebheart (Respiratory Therapist) performed the test. Dale had 5 tests performed with 2-3 repeats for each test to verify the validity of the results. These tests measured capacity, flow and level of oxygen uptake. Halfway through the testing, Dale received an "Albuterol" breathing treatment and the results will be reviewed to see what impact that treatment had on tests. This treatment was tiring for Dale.
Hopefully he will sleep well tonight. The last few days have been anxious and sleep has been difficult. Dale received high marks for being a "good" patient during his PFT!

His spirits are high and he remains without symptoms.

Dale also pre-registered for a Bronchoscopy tomorrow morning at Citizen's Hospital in Victoria. Dr. Adams will perform this standard procedure and hopes to be able to biopsy the tumor. The procedure begins at 7am. Dale will be anesthetized and will come home later in the day.