Friday, August 25, 2017

posted in: 2017, CaringBridge, Surgery | 0

9:00AM

Dr. Green, a general surgeon with years of gynecology experience, will be removing Teresa’s 30lb mass around noon today. The surgery should take about 1 – 1 1/2 hours.

He won’t know until he is in there how much of a hysterectomy and oopherectomy needs to happen. We won’t know until after if it is benign or not. He said at her age, it’s not likely to be benign, but not impossible.

He thinks it’s better to operate now, rather than continuing to wait for a referral to Kramer. I asked about a referral to Sloan Kettering. He has done it for other patients, but it can take 2-3 weeks. Would be smarter for follow-up care so she can get this out.

12:19PM

Teresa was taken down to surgery right on schedule. The nurse who came to get her said what everyone else is saying, that Green is amazing, so trying hard to stay hopeful and positive.

After surgery, she goes to PACU (post anesthesia care unit) to recover and wake up. Then she should go back to her room, and is probably staying for the weekend at least.

Probably at least 6 weeks recovery.

1:35PM

Pager message received:

Dr. Green has started. Teresa doing well.

5:45PM

Teresa is out of surgery and stable.

She is in recovery, waiting to go to ICU, as soon as a bed is available. Once that happens, I can go see her.

The mass was about the size of 1-2 watermelons. It weighed 32 pounds. She also had a gallon of fluid, so they removed a total of 40lbs.

My understanding is the incision is rib cage to pelvis.

It took three surgeons to pull it out.

Her protein is very low, which contributed to the fluid build-up. She is malnourished.

Pathology is gone for the day, so Monday is the earliest they can start, but Dr. Green thinks it is malignant. He said there’s a chance it is benign, but it is very small.

The right ovary looked normal, but our understanding is he took it out. They never saw the left one; it was lost in the mass. He doesn’t know if it started in the uterus or the ovary.

There is a possibility it has been growing for at least a year, but he will know more once pathology examines the cells.

He took 90% of the uterus and 95% of the tumor. She has 46 staples.

He left parts of the uterus so she wouldn’t bleed out, because of how large the blood vessels to the tumor were, and the 5% of the tumor so as to not damage the other nearby organs.

He believes the last 5% can be fully treated with chemo or radiation, and that would be followed with a pelvic clean out in a follow-up surgery.

She lost 2500cc of blood in surgery. They gave her two units, and I believe they are giving more as her hemoglobin dropped to 6. (It should be above 12.)

She has a breathing tube, and I think one for food. 

She is in ICU because of a remote chance of bleeding. The ICU nurses are better equipped to respond if that happens.

She will be discharged when she is eating well, has good urine output, and they know her bowels are working properly.

They expect that to be Monday or Tuesday.

Dr. Green said follow-up at MSK is a good idea. He is very good,  but that MSK has so many more options and technology.

She is awake, and very tender. Very large incision. She is on a PCA pump of dilaudid. She did have some morphine before surgery, which she said helped.

I will post more as soon as I can.

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