In the hands of God (and the surgeons!)...

Jan and I went to bed last night hoping that today would be a comfortable day for Jen...and the eve of her surgery definitely was.  She slept fairly well last night, but woke this morning needing some more rest.  Following our pre-surgery conference with Dr. Foster, she was able to take a good 4 hour nap.  The NG tube has been fairly effective and the pain medications have also helped.  She woke late in the afternoon looking and feeling much better.  Dennis and Tina made good time from Cape Girardeau (under 8 hours) and spent the afternoon and evening at the hospital visiting.  Monday night television was actually pretty entertaining, so all in all it was a good day.

I left Jen just before midnight when I was sure she was sound asleep.  As the night wound down she started to feel the nerves and emotions that she has stoically held back through all of this.  Following a good cry with her mother and I, she put herself back into the positive mindset and looked toward the cancer-free near future.

Here's the game plan as laid out by Dr. Foster:

At 6:30 AM they'll wheel her down to pre-op and by 7:30 or so she'll be in the operating room.  She'll get a general anesthesia and a spinal (shot of morphine in the spine).  Plan A will be the full fledged cancer debulking surgery.  The intention will be to remove all traces of tumor throughout her abdomen.  Stints will be placed in her ureters to prevent damage during the procedure.  The tumor has involved itself with some organs and those areas will have to be addressed.  This will entail the removal of a section of small intestine - which will include the area that has been creating the recent blockages.  A portion of the colon wall and her appendix will be removed.  They will do their best to not remove the gall bladder and spleen, but removal is a possibility.  There is also tumor on the exterior of her liver that looks easily operable.  It will be "sliced off" - for lack of a better term.  Following the debulking, they will do an Intraperitoneal Hyperthermic (heated) Chemotherapy (IPHC) wash.  Which in layman's terms is a "belly wash" with chemo drugs.  This procedure was developed by Dr. Loggie and was one of the factors that lead us to Creighton.  Dr. Foster estimated that the entire surgery could take upwards of 12+ hours.

Plan B will be in effect if they determine through their initial exploration that the "spots" on liver seen in the CT scans are cancerous (not the mass on the exterior of the liver).  Through a direct ultrasound of the liver, they will assess these spots.  If they look cancerous, they will biopsy them immediately and send for a quick test.  Within 30 minutes of the biopsy, they will know.  Should they be cancerous, they will proceed with a less complicated surgery which will include a bowel diversion and maybe some tumor removal.  The goal of Plan B would be to provide a temporary solution to her current bowel obstruction problem.  She will then heal up quickly and get back on chemo as soon as they determine it possible. Chemotherapy would be the best way to treat a diseased liver.

Of course, we are hoping for Plan A.  This would allow peace of mind that the cancer has been visibly removed and she would be leaving Omaha effectively cancer-free.  She will have to endure some more rounds of chemo several months down the road as insurance that the cancer is gone.

Thanks to everyone for their support, prayers, and encouragement over the past several days, weeks, and months.  She will take all of that love, faith, and positivity into the OR with her tomorrow.

Comments

[Dustin Ireland]

Chris and Jen~

Jen it's right at 7:30AM and i'm sure you're beginning your long day in the OR; I just wanted to let you know that I love you and will be thinking of you continuously throughout the day. As Chris described you are in the great hands of Dr. Foster and the Lord Himself! Chris, you are an inspiration to us all...

D

[Shelby Twenter]

Thank you so much for explaining what exactly is happening as my stupidity leads to fear. I hold you all in my thoughts today.

[Melanie Wiggins]

Jen-
I will be thinking and praying for you all day. Let God do his work and then we can focus on the road ahead. Chris and Jan thanks for being Jen's support, stay strong. I love you all and will see you this weekend.
Love, Mel

[Kristin Smith]

Jen, I will be thinking of you today and continually praying for your healing. Thank you Chris for all the updates, you are doing an amazing job of explaining everything.

[Dee]

Jen,Chris, and Jan: It is 8:30 here in B.S. and I have just read your latest report. Every ounce of my strength will be directed in prayer for all of you on this most important day. I pray that the Lord will show Jen's doctor the way to heal her and give her a full and happy life. God be with all of you and know that hundreds of people are with you in their thoughts.

Dee

[Sarah Hunter]

What an amazing woman you are Jen, to have to endure all of this pain. I will be praying for you all day. I hope everything in the OR goes well as planned. Come on PLAN A!!!
Wishing you a fast recovery and a cancer free life :)

[Shelly Heggs]

Just want you all to know that I am praying for you throughout today and am inspired by your faith, courage and positive outlook! God bless you and may Plan A be His plan for you today! In Christian Love, Shelly

[Julie Marriott]

Jen,
You're long day has just begun, butknow that so many of us will be praying you through. God is holding you in the palm of His hand right now. He is going to show Himself MIGHTY to you today.
Love you!
Julie

[MaryKay Jones]

Jen, I am a relative of Shelly Heggs and we too are praying for you. You seem to be surrounded by so many wonderful people and I believe in the power of prayer. God Bless you now and always.

MKJ

[Emily Mahurin]

In the months that I have been reading and praying for you both and your family I feel like I have gotten to know you through this. Never have I seen such love and strength as I have seen in the two of you- and I have seen it only through this blog. I can only imagine how much love and strength you truly have. I am praying and believing for a successful Plan A today. God's plan is greater than ours and I believe his plan is to bring you through this triumphantly so that you may share your story with others. My love and prayers are with you and your entire family all day long as they have been ever since I first heard of your battle.

Emily (Courtney's sister in law)

[Libby]

Jen-
My family and I will be praying for you all day. I know that God has a plan for you, greater than any of us can imagine! My heart goes out to you and your family today and in the days to come!!

[ginger]

Chris and Jen: Rollie and I are praying non stop. Thanks Chris for the informational update, it helps to lift up specific requests in our prayers. "Plan A" is certainly at the top of our list today. Ginger

[Mickey Ebert]

Back here in Blue Springs there's a lot of prayer, thoughts, and well-wishes aimed for Omaha. Plan A sounds like what we're hoping you'll get. I want to pray for those surgeons' hands also. Hang in there! Neighbor Mick

[Ken Ostendorf]

Jen, I have had all my students at Notre Dame High School praying for you this morning and will continue until you you have recovered. Thanks Chris for all the information. Uncle Ken

[Jeanne Peve]

My thoughts and prayers are with everyone. You all are such couragous fighters. Keep the positive thoughts flowing.You are doing great!

[Kathy Ducharme]

I am a co-teacher of Gail Jones and I've been wearing your bracelet and praying for you everyday. I read your blog daily and feel I know you all. You are so courageous and strong. I know God will take care of you and your family.