Today was radiation treatment 5 of 10. So far the radiation treatments have been uneventful. The effects of radiation are cumulative and lagging, however. So any side effects are only likely to arise near the end of the treatments -- or even after treatment is over.
After a remarkably good day last Saturday, the last few days have been less good, but not terrible.
The major event today was a consultation with interventional radiology to discuss the possible placement of a gastronomy tube. The main purpose of this would be to relieve pressure when blockages occur, ideally avoiding the need to spend (as much) time in the hospital, and to avoid the use of a nasogastric tube inserted through the nose to do the same thing. It is possible the tube could also be used for nutrition, although that will depend on just how the procedure goes and what sort of tube they are able to place.
Based on previous conversations (with other doctors), we were under the impression that this might be an outpatient procedure done under mild sedation, but Penny's situation brings with it some additional challenges caused by the cancer and her previous surgeries. Today we were told to expect at least an overnight stay, and possibly up to 5 or 6 days in the hospital, depending on how things go. It's also possible that the procedure will need to be aborted. We did learn one interesting advantage to her previous surgeries: any adhesion due to scar tissue (or to the cancer) actually can make the procedure easier because things don't "move around" as much. The tricky part is finding a route that doesn't require going through tumors that would pose a risk for bleeding. (We also heard the story of boxer whose procedure had to be aborted because his abdominal muscles were too tough to feed the tube through. Penny seems unconcerned that she will have complications of that sort.)
The procedure will begin with a CT scan to determine the best route and will require the use of real-time X-Ray in the latter stages to monitor the placement of the tube. That requires two different operating rooms, some additional personnel, and insurance authorization. The surgery will happen as soon as the authorization and scheduling allow -- hopefully in the next "week or two".
In the meantime, we will continue with daily radiation treatment, periodic visits to the START clinic for hydration, and attempts to find food Penny can eat. In between all the appointments and my attempts to get her to eat, we hope to enjoy some time together before the second semester gets started (two weeks from today for my classes.)
Comments
Andrea Turner: Thank you for updating us. If they can manage to place the g-tube, I can see there would be hope for some ease of problematic events and hope for a good pathway for some added nutrition. I hope the remaining days of radiation go uneventfully! I will pray for continued patience.
Mary Hulst: Praying for more good or not-bad days, good interventions that really help, and time with each other.
George Monsma, Jr.: Thanks for the update. I'm praying that the radiation does not cause bad side effects, and that the tube can be inserted and be effective in reducing the problems with the blockages.
Jim Ludema: Thanks for the update, Randy. We will continue to hold you and Penny in our prayers. I don’t know about her abdominal muscles, but Penny is tougher than any boxer I’ve ever met. Much love.
Alisa Tigchelaar: Praying for continued uneventful radiation, guidance as you choose on continued courses of treatment, successful nutrition and Penny's energy as you anticipate further vacation days as a family, Penny and Randy. Thank you for continuing updates that help us know how to pray for you. 💗
Tony Holmes Curran: We love you both and continue to pray.