Office visit 11/4 and visit with the surgeon

11/4 11:25
ANC 1076

After getting up at the crack of dawn to get back to Radiology when they opened, we got Alan set up with Doc B. Since Alan's port wasn't accessed we went for anesthesia instead of sedation. Since the CAT scan could be done very quickly, they could do this without intubating him so this was the least invasive method.

This was the first time Daddy had seen Alan going under with gas, so he was surprised how quickly Alan went from kicking and crying to sleeping. By the time we made our way up to the 2nd floor waiting room by the PACU and made a trip to the rest room, he was already done and arriving in Recovery. Since it was a very small dose of gas he was soon up and alert. Like yesterday, he was not interested in water or juice. We waited a little to be sure he was recovered from the gas and then offered him chocolate milk and a cereal bar. Since he wasn't NPO for that long, he wasn't quite as piggy this time.

Since we had a little time before our appointment with Doc R, we dropped by Starbucks for some breakfast for Mommy and Daddy. It was a beautiful morning so we enjoyed the sunshine and fresh air on the patio. We offered Alan some of the fried egg, muffin and turkey bacon and he was gobbling it up! He hasn't eaten a solid form of protein in weeks, so this was very encouraging.

We headed to Doc R's office where he showed us the MRI and CAT scan images. There is continuing shrinkage (3.3 x 2.2 cm from 3.7 x 2.3 cm in October) and it looks like the tumor is no longer in his spinal column. Doc R told us about what he wanted to accomplish with Alan's surgery - he plans to remove as much of the soft tissue tumor as possible without cutting into anything else. He was very specific that this was not a debulking procedure, which confused us since that seemed like what he was describing. Apparently, the specific medical term debulking may involve removing tissues connected to the tumor in order to remove as much of it as possible, whereas in Alan's case the goal is to retrieve as much of the tumor as possible so we can send a representative sample to the pathologists.

The doctors who will be looking at the tumor are the pathologist at our hospital, Doc H at Texas Children's Hopsital in Houston (who examined Alan's slides back in April when we were determining exacatly what he had), and Doc H-H (Doc W's pathologist who had examined Alan's slides in October). We are quite interested to hear what Doc H-H has to say, since she seems to have a slightly different opinion of how agressive this cancer is than the other pathologists.

In any case, we will be seing Doc W, the orthopedic surgeon, on Friday to go over the scans and hear his opinion. We're not ready to move ahead with the hemipelvectomy yet, but it's good to hear what everyone has to say.

After we left Doc R, Daddy had to head off to work, and Mommy and Alan went to see Doc A at the office and tell him the date we had set for surgery - in two weeks on November 17. Good counts so far, but we will probably have to have one more transfusion before the surgery because Alan's HGB level is under 10. Otherwise, Doc A was very happy with how Alan looked and we won't be back here until Monday!