Zach's first Halloween

Here are a couple photos from Zach's first Halloween. He was supposed to be a skunk but it was too hot out and so he went door to door as a scary skeleton!

Halloween Day... Radiation Day 1

Well, today is the first day of Pop's radiation. I think I am more nervous than he is! He is so positive and brave about the whole thing. Here are a couple new photos of Pop's radiation.

Here is what Pop's had to say about his first day of radiation... (taken from his caring bridge webpage)

"Day 1 – October 31st 2007 – Sunny and 70 degrees – weight 266 lbs
Appointment time 1:30pm. Found out the purpose of the mask is only for keeping my head in a certain position while radiation is applied. I need to purchase an electric razor; do not apply any cream or other liquids to my neck 4 hours prior to radiation; the amount of radiation applied is 2.13 Grays (gy)… I need to look up the description of amount of radiation. The same amount of radiation is applied each treatment for 35 days. The Radiation Therapist said it’s like an X-ray on steroids! In the later stages it was recommended that I may not even want to shave at all because my skin will be so sensitive."

GA v FL

Well, the good guys finally won! :) Go Dawgs!

Hannibal Lector... 35 Day Marathon

Here is the update from Pops regarding his upcoming radiation treatments... (taken from his caring bridge webpage)

"As Richard, my son, said "you look like Hannibal Lector" The truth hurts as they say. The photos are a bit interesting. What you are seeing is the Simulation process where they fit the Mask to my head in preparation for Radiation. This process took about an hour. I start my Radiation on October 31st. Appropriately Halloween!!
35 Day "Marathon"
The radiation process will take 7 weeks, 5 days a week to complete. There are several changes that will take place during this process. When I asked the Dr if there was anything I could do to make a difference in how good/bad it would affect me he said "expect the worst and hope for the best." So these are some of the side affects that I will experience
Skin reactions - could develop severe blistering in radiation area and may cause the outer and inner ear to become swollen.
Weight Loss - This could be good for me but if I have major problems eating then its possible a feeding tube will be inserted. Will devinitely loose weight they say. Many patients loose all sense of taste which will return in several months after radiation. Hoarseness is an expected side effect. Decreased Saliva becausse the radiation will eliminate the saliva in my good gland but this will return several months after radiaiton.
Now the good NEWS...
Because of the expected weight loss they have recommended several areas I should give attention to...this is what I call the opposite of Weight Watchers...
Increased calories - add butter to everything; use whipped cream as much as possible; substitute table cream for milk in everything; spread cream cheese on breads; add sour cream to soups, baked potatos; Increase protein - Melt cheese on anything possible; add ice cream to soft drinks and every evening; add peanut butter to sandwiches, crackers, etc.
Thank you all for being with me during this process. Your thoughts and prayers have been comforting and thank you for your notes of encouragement along the way. I probably will update you weekly when radiation starts next Wednesday. Thank you all again."

Radiology Simulation

Pops had his simulation appointment to set up his radiology sessions that will start next Wednesday. Here are some photos from his visit. Pretty crazy!

Radiologist Apt

Pops met with his Radiology Oncologist today. On Wednesday, he has his simulation appointment to set up his radiology sessions. They will make a custom form fitting mask that will make sure he gets his radiation in the proper spot. His radiation starts next Wednesday, October 31, 2007.

Here is a photo from that Dr. visit.

Pop's Follow-up Apt

Pops had his first follow up visit with his surgeon today. Dr. Griest was very happy with how dad is healing from his surgery. To read more details about dad's visit, please visit his Caring Bridge site.

Here is a photo from the Dr. Visit.

A Mango a Day...

Check out this article Andres found about how eating certain fruits like mangoes, grapes and strawberries can help stop the spread of cancer cells in the head and neck... According to Yahoo!News:

"Lupeol, a compound in fruits like mangoes, grapes and strawberries, appears to be effective in killing and curbing the spread of cancer cells in the head and neck, a study in Hong Kong has found."

"An experiment with mice showed lupeol worked most effectively with chemotherapy drugs and had almost no side effects, scientists at the University of Hong Kong said in a report published in the September issue of the journal Cancer Research."

"'It can suppress the movement of cancer cells and suppress their growth and it is found to be even more effective than conventional drugs (eg. cisplatin),' said Anthony Yuen, a professor at the University of Hong Kong's surgery department."

1 Week Post-Op Photos

Here are a couple photos of Pops one week after surgery. He looks great! It looks like the stitches are disolving and he is healing very nicely.

Update from Pops

Here is the latest update from Pops. This is taken from his Caring Bridge webpage...

"Dr Grist informed Margaret and I that the tumor removed was an 'Aggressive' fast growing tumor. 98% of the Parotid tumor was removed. In addition 22 lymph nodes were removed and 2 of the lymph nodes were malignant. According to Dr Grist all malignancy was removed but will do a PET scan to make sure. Great news in the process of recovery."

"Dr said he will provide Margaret and I with full details in writing when I see him on October 22nd. Dr Grist will also set the appointment with Radiology and start that process."

"Other than its difficult to shave around the stitches, all still very numb but I slept very poorly last evening. Must try some sleep aids. Very tired this morning."

Leaving Atlanta

We left Atlanta today. It was sad to say goodbye to Pops and Grandma, but with Pops feeling better each day I feel confident that he will be back to his usual active self in no time. Zach and I had an uneventful flight home. It was great to see Andres. It seems like we have not been home in a month or so because we were out of the country for a couple weeks and then up in Atlanta. It will be nice to get settled back in at home. However, we already have a flight back up to Atlanta on October 22. It will be time to check back in on Pops and Grandma again before the radiation starts. Pops has his big post-op appointment with his surgeon, Dr. Greist on October 22 also so we'll see what he has to say about the surgery.

Dad at Home

Here is Pops 3 days post-op. He is resting and eating soup!

Homecoming

Dad came home today! What a great day. Mom went to the hospital today and brought dad home. He walked in the door like he was coming home from work. He looked great. Although he didn't think so. He called in the morning a little bit upset because he had seen himself in the mirror when he was brushing his teeth. He was shocked at the indention caused by removing everything in the surgery. He also was a bit shocked by the 10 inches or so of stitches. We tried to assure him that he looked great, but he was still upset.

Linda, Frank, Carol and Joe stopped by the house tonight to see dad again. It was great to have everyone at the house again. Just like the old days. Dad commented that we needed to get together more often, not just for difficult times like these. I agree. We used to spend every holiday with the Blews and the Rowes and things have changed since all of us kids have grown up and we have had our own kids. I guess that happens, but we sure had some great times.

We spent most of the day watching football with dad. He was in and out as he took some naps. I am still amazed at how well he is healing and how great he is. If he only knew. We are just continuing our prayers for healthy healing and good results of the PET scan.

Homecoming Photos

The Day After

Spent the day in the hospital with dad today. He was incredible! He was in such a good mood and so positive. It was hard to believe that he had just had surgery to remove cancer the day before. He was so brave and courageous. He spend the morning calling his friends who were so worried about him.

Later in the day Linda, Frank, Carol and Joe came to the hospital to visit him. They spend a few hours hanging out with us and making dad laugh. The support was amazing. I know it was a little bit tiring for dad, but he loved having his good friends there to support him. Carol looked amazing. Her struggle with cancer has been so inspiring for dad and all of us. As she left, she warned dad not to overdo it. We are so blessed to have such great adopted family.

Zach was his usual happy self. He entertained everyone and was such a good boy. As I mentioned before, I am sure he was the best medicine for Pops.

Day After Photos

Hospital Info

Big Day

We woke up early to get ready for the big day. Dad was up early making sure he was organized for his hospital stay. He packed his bag and got his important papers together. Dad, obviously, could not have breakfast or have anything to drink because of the surgery. I decided not to eat breakfast in front of him today.

We arrived at Emory and meet Frank. He is such a good friend. He stayed all day and hung out with mom while dad was in surgery, and stayed until dad was settled into his room. It meant so much that he was here with us today, he probably will never know. Linda came to be with us in the afternoon. She and Zach had so much fun playing together.

Dad went into surgery a little bit ahead of schedule. He got dressed up into his hospital gown, socks and hat. He was so brave. He continued to crack jokes which made us all feel more comfortable. He is just that way.

Then we waited. Mom and Frank waited at the hospital. Zach and I went to visit Susan and George. We had some lunch and spent time catching up. It was a great distraction while dad was in surgery.

At 2:30pm, mom called saying that dad was out of surgery and in the recovery room. Mom met with the doctor who gave her the report on how the surgery went. Dr. Grist reported that the surgery went well. He took out part of the parotid gland and the tumor (which involved sacrificing the lower facial nerve). He also took out the cancerous lymph nodes. The cancer was labeled stage 3. They indicated that dad's paralysis would probably not be any worse than it has already been and that because he was in such good shape, his recovery from the surgery looked good. Dad will have a PET scan in a couple weeks and then follow up with daily radiation for at least a couple months.

So, I rushed back to Emory so I would be there when dad could have visitors. We made it in plenty of time. Mom and I went in to see dad at about 4:30pm. He was pretty uncomfortable. He was in some pain and had to go to the bathroom. I stepped out and mom helped him since he did not have a catheter. Dad was in and out of it, but for the most part he looked much better than I expected. He was talking, which I wasn't sure he would be able to do. He was also pretty fiesty, which is always a good sign.

Mom spent some more time with him while he was in recovery. Then he moved to a temporary room while he waited for his room. Mom, Zach, Linda, Frank and I spent time with dad. He was in and out due to the pain meds. He was most alert and responsive when Zach was in visiting him. He talked to him and touched his foot. Zach responded by laughing and babbling. It was probably the best medicine.

A Few Hours Post Surgery

Pops Getting Ready!

Waiting for Surgery

Day Before

Today, we spent the day hanging out with Pops before the big day tomorrow. We relaxed in the morning and let Zach take a nap at home. For lunch, Dad, Zach and I went to an Asian buffet with sushi that dad really likes so he could get a good meal in before his surgery. Everyone at the restaurant fell in love with Zach and the waitresses wouldn't leave him alone. He makes everyone so happy.

We had dinner, then Linda and Frank came over for dessert. They are such amazing friends. Really, they have become our family here.

We went to bed early in hopes of getting a good night sleep before the big day of surgery tomorrow. We'll see how well we sleep!

Pops Pre-Surgery

Atlanta

We arrived in Atlanta tonight. Great to see Pops and Grandma. Zach slept in the car on the way home from the airport, but was wide awake when we got home. He played and entertained us until we went to sleep. It was so good to see mom and dad. Since all of this has happened, I have a new appreciation for the strength and courage of both of them.

Tonight talking to dad on the way home from the airport, we discussed his biggest fears for the surgery. He said he had two major fears. His biggest concern is that he wakes up after his surgery. His second fear is that he can go back to work after some time of healing. I also shared my fears with him. My greatest concern is that he is not in pain and that he can get rid of the cancer and move on with his active lifestyle.

It's great to see dad so positive about things. I know mom is worried, but she also remains calm and positive about the surgery.

It will be so great to spend the day together with Pops tomorrow before the surgery on Friday.

Zach & Pops pre surgery

Layman's Terms

Susan just sent me the link to the American Cancer Society's webpage. There they do a great job of explaining things in layman's terms so I can understand them.

Here is what the ACS says about the surgery...

"In most cases, the cancer and some of the surrounding salivary gland or soft tissue will be surgically removed. If the cancer is high grade (more likely to grow and spread quickly) or if it has already spread to lymph nodes, the head and neck surgeon will usually remove lymph nodes from the same side of the neck in an operation called a neck dissection. Before surgery, ask your surgeon exactly what will be done during the operation, whether there are other options, and what side effects you can expect. Make sure that your surgeon has experience in the technique.
Salivary gland surgery: Since salivary gland tumors occur in the parotid gland about 80% of the time, we will first describe surgery of the parotid gland. Surgery is complicated by the fact that the facial nerve, which controls movement on the same side of the face, passes through the gland."

"Most parotid gland cancers start in the outside part of the gland, called the superficial lobe. These can be treated by removing only the superficial lobe. This usually spares the facial nerve and does not interfere with facial movement."

"If your cancer has spread into deeper tissues, the surgeon will remove the entire gland and might also remove your facial nerve. If your surgeon has mentioned this surgery as a possibility, ask about operations to repair the nerve and ways to treat side effects caused by removing the nerve. If the cancer has invaded other tissues near your parotid gland, these tissues might also need to be removed."

I also had some questions about what causes parotid gland cancer and the ACS says they still don't know a lot about what causes it...

"We know very little about the actual causes of most salivary gland cancers. Researchers have found that some salivary gland cancers have DNA abnormalities in certain genes. Abnormalities of some genes may change the way a cell grows or multiplies, or how the cell is recognized by the immune system. Exposure to radiation or certain carcinogens (cancer-causing chemicals) may result in these DNA changes but in most cases their cause is not known."

3 days to go

Well, 3 days and counting until the surgery. I spoke to dad today and he seems optimistic, as usual. I am glad he has such a positive attitude about his surgery. I think his attitude can only help the outcome of his surgery and rubs off on all of us. He is always so positive!

Today, dad told me that they are going to perform a surgery called a "neck dissection". I found a couple good sites that explained what is going to happen. Here is one of them.

HealthAtoZ.com reported, "Cancers of the head and neck (sometimes inaccurately called throat cancer) often spread to nearby tissues and into the lymph nodes. Removing these structures is one way of controlling the cancer."

"Of the 600 hundred lymph nodes in the body, about 200 are in the neck. Only a small number of these are removed during a neck dissection. In addition, other structures such as muscles, veins, and nerves may be removed during a radical neck dissection. These include the sternocleidomastoid muscle (one of the muscles that functions to flex the head), internal jugular (neck) vein, submandibular gland (one of the salivary glands), and the spinal accessory nerve (a nerve that helps control speech, swallowing and certain movements of the head and neck). The goal is always to remove all the cancer but to save as many components surrounding the nodes as possible."

"Radical neck dissections are done in a hospital under general anesthesia by a head and neck surgeon. An incision is made in the neck, and the skin is pulled back to reveal the muscles and lymph nodes. The surgeon is guided in what to remove by tests done prior to surgery and by examination of the size and texture of the lymph nodes."

Living Will

I spoke to mom today about a living will. We had an intellictual conversation about it because it would be silly to go into surgery without it. Actually, it is stupid for any one of us to drive down the road without having one. I sent her a link to a place that does them quick and apparently accurately . They have a 2 day turn around, so just in time for surgery.

Legalzoom.com says, "A Living Will is a document which lets you decide whether or not to be kept on artificial life support. Often, these documents also appoint someone to make important health care decisions on your behalf in case you are unable to do so. LegalZoom can help you quickly and easily take control of your health care decisions by preparing a customized living will online."

"As competent adults, we have the right to make decisions in advance as to whether or not we would like to decline life support when it is clear that death is imminent or a state of coma becomes permanent. Today, life support systems can keep an individual's body alive for years, even if the brain is no longer functioning or the person is in constant pain."

Pre-op appointment

Today dad went in for his pre-op appointment. I was waiting anxiously for his call all morning. He called at about 2pm with some updated news regarding the stage of his cancer of the Parotid Gland. He said they graded it at least a stage 2, possible stage 3. They will know more when they go in for surgery on Friday.

Stage 0—precancer
Stage 1 —small cancer found only in the organ where it started
Stage 2 —larger cancer that may or may not have spread to the lymph nodes
Stage 3 —larger cancer that is also in the lymph nodes
Stage 4 —cancer in a different organ from where it started

I was in shock that it had spread into his lymph nodes. I guess I just thought that they would go in and take out the tumor and the cancer would be gone. I guess this is more serious than I let myself believe. I guess denial can have its place. On the phone with dad, I acted strong like things would be just fine, but I had a pit in my stomach. Dad sounded almost relieved. Not sure why, but he mentioned that he felt better knowing that his doctors were the best in the country and that he would be in good hands at Emory. I feel good about his doctor and hospital also, but that didn't take away from the dreadful fact that this cancerous tumor was spreading into his lymph nodes.

I did some more reading online about this surgery and came across some information that scared me. I talked to Susan today who's father is struggling with multiple myeloma. She always makes me feel better. She has been through so much with her dad. I am so blessed to have her to talk to.

Well, Zach and I are flying up to Atlanta on Wednesday to be there for the surgery. I know having Zach there will be good for dad and mom. He is such a good boy. I know that he will be a great distraction during this time.