The following section of this post is courtesy of Art Usher, Lisa Marie's lawyer brother:

Lisa Marie is out of surgery. After the surgery was over the surgeon (Dr. Paul Sugarbaker) met with Sean and Art and discussed and wrote up aspects of the surgery. Dr. Sugarbaker reported that Lisa Marie’s color was good and that she was being transferred up to the 3G Surgical ICU while we were speaking.

We attempted to go see Lisa Marie immediately but she was just being admitted to the surgical ICU at the same time as the nurse shift change was occurring. Thus we were informed that it would probably be at least 45 minutes before we could schedule a visit with Lisa Marie.

Overall the surgery went well and the focus is on Lisa Marie surviving and recovering from the lengthy (7+ hour) procedure that she just underwent. Lisa Marie lost an estimated 1200 cc of blood and received three (3) units of blood and six (6) units of platelets. Lisa Marie’s platelet count was not good. Her incoming platelet count was low (90K) as a result of the 10 rounds of chemotherapy that she has already undergone. This number sank to 50K during the surgery, but went back up to 60K with the infusion of platelets. However, with respect to any complications related to embolisms and the like, Lisa Marie’s low platelet count makes the use of any blood thinner such as heparin problematic if not outright prohibited.

In no particular order Lisa Marie’s procedures today included the following:
1) Excision of tissue and walls;
2) Repair of incisional hernia;
3) Lysis and resection of adhesions (scar tissue apparently being a common place for cancer cells to reside);
4) Extensive exploratory for evidence of visible cancer cells;
5) Greater omentectomy;
6) Lesser omentectomy;
7) Oopherectomy;
8) Hysterectomy and bilateral ovaries and tubes;
9) Pelvic peritenectomy
10) Recto-sigmoid colon resectomy and anastomosis;
11) Intraoperative chemotherapy.

Dr. Sugarbaker was guardedly optimistic about Lisa Marie’s long term prospects, but made it clear that this post operative recovery time in the next week is the critical period upon which we need to be focused. Dr. Sugarbaker saw little macroscopic evidence of cancer. While he found (and removed) various nodules in the cul de sac region, such nodules did not appear to be viable cancer cells. Similarly, the tumor in Lisa Marie’s pelvic region appeared to be lifeless. All such tissue, however, was part of that removed. Similarly, the evidence of cancerous tissue on her left ovary was not sent to a pathologist as the ovaries were being removed.

More may be written later but Sean is anxious to go back and schedule a visit in the surgical ICU to see Lisa Marie for himself. We feel blessed by God that Lisa Marie is out of surgery and stable and that there was so little evidence of macroscopic cancer cells during the procedures.

Latest update as of 11:30 pm EDT:
I spent the last 3 hours or so with Lisa Marie in the ICU. Her breathing tube was removed around 10:30 pm which made communicating much easier. The lip reading and scribble on a clipboard was getting frustrating. She is in very good spirits considering everything. She received some Benadryl for itching from the pain medicine and was resting peacefully when I left. This was some day. May none of you or I ever have to go through it again.

Thanks again to all for the prayers, thoughts, well wishes, and general support through this whole ordeal. It has meant a lot to us, more than any of you could ever realize.

Special thanks to Art for being here with me for the whole thing.

And to Sally for the unexpected quick pop-in to the waiting room bearing hamburgers, fries, drinks, chips, double chunk chocolate chip cookies (yes!), and assorted candies. Who was that masked woman?

And also to Renee for the laptop that let me avoid having to do all this blogging on the Blackberry like the first time we did all this colon cancer surgery thing. My eyes thank you.

And now to bed. I've already had my sweet dream. I love you, honey.

Lisa Marie remains stable. The nurse has reported the successful removal of the ovaries, uterus, gall bladder, and omentum (the last being a fatty apron of tissue within the peritoneal cavity for those of you unfamiliar with the word). The doctor is pleased with what he has seen so far and expects to begin intraperitoneal chemotherapy in 20-30 minutes. The intraperitoneal chemotherapy is expected to take about 90 minutes (like a cook book, pour heated liquid into cavity, carefully insert blender and stir for 1.5 hours). The nurse also reported that the doctor currently is hopeful that an ileostomy will not be necessary, but he will not know for sure until ready for reconnection. Still about 3-4 hours to go.

She's doing well so far. The doctor said she had responded well to her previous chemo treatments as evidenced by limited spread of disease outside the known peritoneal implants. The small bowel looks good. Some disease on the left ovary. The uterus and ovaries are coming out as planned. Too early to tell if she will be getting an ileostomy yet. She is receiving some blood because her platelet count was borderline going in. Nothing unusual yet so she will be getting the chemotherapy bath (HIPEC) as planned. She will be going to ICU on completion of the procedure. More in a couple hours.

The nurse just came out and said that all the prep work was complete (central line, breathing tube, etc.) and the actual procedure began about 20 minutes ago. They expect to provide an update on what the doctor saw inside in about another hour.

Godspeed, My Love...

And thank you for your undeniable courage and unbelievable will to survive and be there for your family. We love you, we need you, and we will be forever grateful and in your debt for saying that the statistics quoted to us were unacceptable and instead taking this more difficult path toward an attempt to be cured.

She went into the OR at 9:05 am EDT looking at digital frame slide show pictures of her "three little birds" (a family favorite Bob Marley song reference). The first update from the OR is expected about 10:30 or 11. Stay tuned.

300

Apparently this is my 300th blog post. Ideally, I would post something meaningful, but I'm on the blackberry in a car going 70 mph (Sean is driving) so the setting isn't conducive to inspirational thoughts.

We're on the way to the airport for our trip to DC. I check into the hospital tomorrow for some pre-op tests and such. I think the surgery is scheduled to start at 9 am Eastern on Tuesday and should last 9-11 hours. I assume Sean will be getting periodic updates on the progress and I've instructed him to post them here.

So keep us in your prayers. Sean and my brother Art will be with me at the hospital. We're hoping for what's called an R0 resection, which means no visible disease remaining. That pushes our stats up to 50% 5yr survival. Oh, and if you want to ask for some icing on the cake, I'm hoping not to end up with a temporary ileostomy. That's a 60-40 according to the surgeon, but really, we could live with that. Anything less than R0, not so much.

Hope to be back blogging for you soon.

LM

Oh I wish I were an...
Oscar Mayer Weiner, that is what I truly want to be. Because if I were an Oscar Mayer Weiner, everyone would be in love with me.

Some people take their kids on vacations to fancy exotic places. We take our kids to the Strawberry Festival and to the Kroger parking lot to see a hot-dog shaped vehicle. Now that's a family memory you don't want to forget.
Smile big for the camera kids. This is a definite scrapbook moment. "Remember the day we hung out in a parking lot in the 100 degree heat and mom made us pose by the giant hot dog? "
Now that's classy.

Cleared for takeoff

I have a million things in my head to post but am just so very, very tired these days. But I know that some of you are checking regularly for news, so I wanted to post something.

We met with the surgeon in DC on Monday and are now gearing up for surgery on July 21. We liked the surgeon and have confidence in him. But it's still just so scary at the end of the day. I know it's what I wanted and really represents my best/only potential for long term survival, but it's just hard to say you're happy or excited about a 12 hour surgery where they remove more organs than I can name. But onward we march nonetheless, making plans, getting ready. We're in good hands both physically and spiritually.

One of the hardest things to imagine is being away from the littles for so long. At least I can count on Hayden to tell me every detail of his day on the phone. If you've ever been on the phone with him, you know what I mean. How does a father who barely says 2 words on the phone end up with a son who never stops talking? Life's little ironies.

Quotes from a 4-yr old...

From Trevor this morning:

"Mommy, can I pick out your clothes for work today. I promise I'll do a good job."

Looking at himself in mirror: "I'm very concerned...and very curious."

Curled up next to me in the big bed: "Mommy, I just love you."

Me...

So people ask about the medical stuff, and I guess I haven't said much lately. It has seemed like more of the same. Work, home, chemo, repeat as necessary. I've been managing to work full time except for my chemo days. I finished my 8th chemo cycle last week. The side effects are somewhat cumulative, so it has been a little harder as we go along. The fatigue is a little worse, the neuropathy in my hands and feet is more significant. But overall, it's still all really manageable.

I guess I've been hesitant to write because I've been working on a plan and I still don't know if it will work out. I'm flying to Washington, DC at the end of the month to meet with a surgeon about the HIPEC surgery I mentioned a few times before. I've been on again and off again, but I know feel that it offers my best/only chance at some type of curative result. The best chance still only has a 25% success rate (in terms of 5-yr survival), but that's better than 8%.

So I'm on the schedule for surgery July 21st, tentatively. A bad scan between now and then could derail everything, but I can't go there. The surgery is rough, probably 12 hours in the OR and then 30 days recovery in the hospital in DC. You can read about the surgery and recovery here, on the surgeon's website. It's a little scary, lots of tubes. One of my internet friends refers to it as the MOAS - Mother Of All Surgeries. I'm guessing it will make my 3 c-sections look like a walk in the park.

That's it, the new plan. I'm probably in for a few more rounds of chemo before the surgery, but they have to stop about a month before the actual operation. Chemo inhibits your body's ability to heal and you need to be able to heal after the surgery. Then post-surgery, I'll probably have about 8 weeks recovery before resuming chemo for another 6 rounds.

Sean will likely stay with me in DC for a few weeks post-surgery. Then I think I'll send him home and some friends can come sit by my bedside and cater to my every whim.

Thanks as always for the kind notes, cards, packages, food, prayers that continue to bless us every day. Having you all here to support us through this journey means the world.

Superfriends...

Trevor and Logan are the best of friends. They were born 13 days apart and Michele and I have a tendency to dress them like twins sometimes...
Can you guess how old they'll be this month?

They're having a little party with their preschool crew this weekend. Can you tell if they're excited or not? Logan's hair tells most of the story...

Yes Y'all, We Live in Texas...

My chemo cycle is every other week, Wed - Fri infusion. So I usually lay pretty low on the Sat-Sun after my infusion. The fatigue isn't unbearable, but I try not to make any plans to leave the house for a few days. But there are exceptions to every rule. Like when the annual Pasadena Strawberry Festival falls on a chemo weekend. Times like that, you gotta suck it up and go.

The kids seriously look forward to this outing every year. This year Hayden's Sunday School teacher asked him if he went to the Rodeo Carnival and Hayden told him "No, we're saving up for the Strawberry Festival.". Anna came in from Budapest just for the Festival this year (not really, but we dragged her along). Michele just got her leg brace off and we conned her into going too. Needless to say, a splendid time was had by all. Did I mention the torrential downpour? We were not deterred.

There were scary roller coasters operated by even scarier traveling carnival workers:
1= Trevor (No Fear), 2= Logan (Perhaps a Little Fear), 3= Hayden (Pretending to be thrilled, but really ready for bigger adventures)

But as any East Texan knows, the real highlight of the Festival is the Pig Races. I took this picture of the boys waiting for the pigs to run, but when I downloaded it, I really enjoyed the guy/gal on the left side of the frame. Is that a sleeveless "Slayer" jean jacket? Seriously? We run with the best crowds.

Juliette is beyond delighted to be watching her second annual trip to the pig races. She really wasn't old enough to appreciate them last year.

And here they come spinning around the turn...those are some darn fast future slabs of bacon.

I know you're jealous. Don't worry, there's always room at the inn if you want to make a journey to Texas for next year's festival.

Catching up...

I've been delinquent in posting, clearly I know. Occasionally, Sean asks what's going on in my life since he doesn't get updates on the internet anymore. So that's the message my friends, stop posting your life on the internet and you may have actual conversations in your house.

OK, back to your regularly scheduled program. We took the kids to Seaworld in San Antonio for Mother's Day. As you can see, we had a fun ride in the car.
We arrived early the first day for "Breakfast with Shamu". Unfortunately, Mom's clicking skills aren't what they used to be and I apparently paid for Breakfast with Shamu for sometime in late June. So we stood outside for a while until the park opened.

When the park opened, the first order of business was the Shamu coaster. Hayden rode it about 10 times in a row when he was 2 1/2. This was Trevor's first time. I think he liked it.

Feeding the dolphins is one of the best parts. They come right up to the kids. So if you can stomach holding the slimy fish, it's pretty cool.

Trevor wasn't so much for holding the slimy fish, but he's cute, so the dolphins came to visit him despite the lack of food.

Our second day, we visited the Seaworld water park. I would say a good time was had by all, but Juliette had a massive ear infection the whole trip and was running a high fever. She didn't eat the whole time and Day 2 was not her best moment. Poor thing. She's all better now.

Oh, and the nice folks at Seaworld fixed us up with a backstage tour of the beluga whales and dolphins to replace my mixed up attempt to reserve breakfast with Shamu. Ever been kissed by a Beluga whale? Super sweet animal, but nasty fish breath.

Hayden also finished another season of Little League. I remember his first season, I took pictures at every single practice and every single game. I think this season I didn't bust out the camera till the very last game. But check out the batting stance on my little Rattler. Is he ready to go pro? We are so glad to be done with t-ball and onto machine pitching.

17 Months...

Sigh...precious age...goes by too fast...



Pictures here if the slideshow above doesn't work for you.

The Pied Piper...

I frequently say that Trevor is the Pied Piper of Juliette. Last night he got sent to time out for just ridiculous unnecessary roughness. He just tackles her and jumps on her for no reason except that he can (yes, obviously it's a cry for attention my amateur child psych friends). Anyways, he's out of the room for all of 5 seconds before she's wandering the house looking for him. And she squeals with delight when she finds him, immediately taking a seat next to him in time out, waiting patiently for him to be able to come out and play again.

Not a real post...

But I know I've been out of touch so I should post something, anything...

I've been thinking about getting a wig. My hair is thinning, not to the point where other people notice, but there are handfuls every day and I think at some point it will be unmanageable.

So do you think I could pull off this look?
OK, that's all I can muster for now. Real post forthcoming within a few days.

I wonder...

If the people who make the Superman pajamas with the capes get a lot of product safety-related lawsuits...
Because if you give a kid a Superman logo and a cape, he's gonna think he can fly. There's gotta be a correlation between wearing these pajamas and trips to the ER.

Sweet 16...

...and never been kissed? Hardly. This one gets lots of kisses.
Even occasionally getting a kiss from these rowdy boys...

Does Hayden look like he'd rather be throwing a ball or sitting for pictures with Mom?

And Trevalicous? Well, his news at school usually ends with "...and I love mommy." So he still has a little soft spot for me (and I for him).

Miss J. is quite the walker these days. You can't turn your back on her anymore or she's gone.

Here is Hayden and Trevor's attempt to cooperate for a picture together. Hayden is about half a second from rolling over onto Trevor. Boys!

Last, but not least, an attempt to get all three in a picture together. This picture is so worth a thousand words. They're wrestling over a ball, paying no attention to me, Juliette is looking at them as if to say "Can you please just cooperate so we can get this over with?" You're in trouble if your 16 month old is your best listener.

Traditions...

Every year, we visit the Easter Bunny at the mall (see 2008, 2007 ). It's hit or miss, really. Because honestly, when you're a tot, a 6 foot bunny rabbit is a pretty freaky sight. But still, we persevere. Juliette got dressed up in her best dress...
What's that, you can't see the shoes? Here we are wandering over to the Godiva kiosk...

The boys waited patiently for their chance to tell the Easter Bunny what they'd like to find in their baskets. Trevor was really hoping for the movie Bolt and Hayden wanted two movies and two books...

Could they love the bunny just a little more? Could this be any more perfect? Is something missing?

Oh yes, we're missing Juliette. The angel in the pink dress...

In case it needs interpretation, Juliette is screaming at the the sight of the big scary bunny and Trevor is covering his ears because the screaming is SO LOUD. Hayden is just posing away because when you're the oldest, your job is to keep posing on the off chance that the little ones might behave for a second so the picture can be taken.

This last shot is from the mall people. The best they could do under the circumstances. Juliette is still red faced and miserable, but not actually screaming or trying to climb off the bench. Oh well, better luck next year. I'm not holding my breath for the Santa pics this year.

Hope your Easter was a happy one.

Mad Skills...




Here is Miss J, in all her wobbly glory, stepping around the living room. Hopefully we can finally give those dirty knees a rest and start getting some use out of our adorable shoes. Note to self...stop buying baby shoes, really, just stop, enough already.

In other news, I made it through chemo round #4. We added a new drug this time, Avastin, which is one of the newer monoclonal antibodies which is supposed to target the cancer cells and turn off their ability to build new blood supplies. The side effects aren't too bad, my blood pressure is up a little. I did have a reaction to the oxaliplatin this time, just a little itching, but they jacked me up with benadryl and steroids. I don't know what it means yet in terms of my ability to continue taking the drug. I'm hoping we can stick with it a little longer at least.

We met with a surgeon last Monday and came up with a new plan. We're going to do 2 more rounds of chemo and then switch over to chemo/radiation. The chemo will be weekly infusions and daily pills. The radiation will be 5 days/week for 5 weeks. Then I'll get a 4-week break before they'll do surgery to remove the peritoneal implant. Then another 6-weeks recovery before we start back up with the chemo infusions every two weeks for another 6 cycles.

Then we see what happens...the surgeon wasn't overly optimistic...said that in cases like this they rarely see surgery as curative. He said the peritoneal implant won't kill me, but it's an indication of the spread of disease and that's the problem. So we'll do chemo for a while first to try to knock back the microscopic disease and then go after the tumor. He talked us out of pursuing the hot chemo surgery (HIPEC) for now. He said with just a single known implant instead of widespread peritoneal disease, the mortality rate from the HIPEC surgery itself isn't worth the risk.

So I'm excited to have a plan. Chemo, chemo/radiation, surgery, recovery, chemo...then a break. So maybe in November and December we can have some nice time with no treatments. I'm feeling a little worn these days with the cumulative effects of the chemo and working and everything else. But really, more good days than bad.