Andrew, unlike Carly at this age, is not scared of anything. Carly listened to her parents attentively and showed an appropriate level of timidity towards potentially dangerous objects and situations. Andrew is the opposite - he loves to do the things he shouldn't, particularly if they're dangerous. He goes straight for the cat food if we leave it on the floor (I didn't tell Penny but I caught Andrew drinking out of the cat's water dish the other day!), if we leave the lid up on the toilet he is the first to put his hand in there and swish it around, and he likes to try and stuff his fingers in the electrical sockets. One of his more worrisome habits is going down stairs (or any incline for that matter) head first. Usually this results in a bump on the head and a bit of a cry. Tonight we were outside and playing on the slide when I literally caught Andrew going down head first. On his first attempt I wasn't within arm's reach (shoddy dadmanship I know) and he landed flat on his face on the grass with a smile! It was no feeble impact either. It was a good nose crusher of a landing. But he seemed to like it so I got him to do it again. This time on camera with a little encouragement from his big sister and a more attentive dad waiting at the bottom.
Wednesday, April 29, 2009
Thursday, April 23, 2009
Go Canucks Go!
On Tuesday night the Canucks completed a sweep on the Blues and made it through to the second round of the Playoffs. As you can see Carly is a fan (thanks for the jersey Dave). I let her stay up late a couple of weeks ago to watch a game and she was thrilled. I think she was just excited to be awake at 10 at night but I took it as an excited Canucks fan in training. Go Canucks!
Timing?
The nurse also told me that I will be scheduled to see an anaesthetist as part of my pre-surgery consultation. I think it will be good to talk to him about post surgery pain control. For my colon surgery I had an epidural which worked well to control the pain but it limited my mobility and increased the number of tubes I had to live with. Penny thinks it also slowed my recovery. I'm sure it did but I was also pretty happy to have zero pain. The alternative to an epidural is IV administered medications (like morphine) which have more of a whole body effect. I had morphine before in the hospital and it to was good at controlling the pain but it made me super hot, increased my heart rate and made me feel high (not a good high). I think there are non-morphine alternatives for pain control so it will be interesting to discuss those with the anaesthetist and see what he recommends.
Wednesday, April 22, 2009
Spring?
This picture was taken yesterday afternoon. Today if the same picture were to be taken it would be white. We have about 5cm of snow here now with more expected overnight. Welcome to "spring" in Calgary.
We spent the day at the hospital today. I managed to schedule 2 appointments on the same day and also found my way into the oncology day care unit for some maintenance on my port-a-cath (a port-a-cath is a type of semi-permanent central line that is used for delivery of medications like chemotherapy).
My first appointment was with the ET nurses to discuss issues with my ileostomy. We did a bag change there so I was able to ask questions about some minor skin irritation I'm having. They were able to give me a slightly smaller bag size which hopefully will help with the issue.
My second appointment was with my colorectal surgeon to discuss the surgery, recovery and future plans and to answer any questions I had. We discussed the surgery (it went well), the pathology (very good) and we breached the subject of the timing of reversing my ileostomy. He said that they would only reverse the ileostomy during my liver surgery if the liver portion of the surgery went perfectly. So I'm preparing myself to have the ileostomy until sometime after my surgery and chemotherapy (January or February?) but I'm hoping that it gets reversed during my liver surgery in May, fingers crossed! Dr Buie also said I would need to have another colonoscopy in about a year to follow up. I hope things are going as well in a year as they are now.
My last appointment of the day was with the nurse of my medical oncologist (chemo doctor). We discussed plans for surgery and the insuing chemotherapy and then she asked me if I had been having my port-a-cath flushed every four weeks. I said huh? No one ever told me I needed to have it flushed every month. (by chance mine was used 2+ months ago when I was in the hospital for my colon surgery) I guess they need to do it so that clots don't form in it, blocking it and making it useless. So she sent me into the oncology day care unit to have one of the nurses flush it out. She was able to flush it moderately well but she got no blood back when she pulled back on the syringe meaning that there was a one way occlusion. The treatment for that is go for a chest x-ray first to make sure the port is placed properly and hasn't moved around and then they flush it with a powerfull anti-clotting agent and leave it for 2 hours. When I went back after 2 hours the nurse was able to get blood return which was good. It means my port is still working well and can be used after my liver surgery for chemo delivery. Yahoo!
Saturday, April 18, 2009
Living with "The Bag" (no, that's not my pet name for Penny)
My ileostomy is about an inch in diameter and is located two inches to the left of my belly button. The centre of it is about an inch below the centre of my belly button which puts it above the waistline of most of my pants. It is a loop ileostomy which means my entire intestinal tract is intact from beginning to end except the doctors cut a hole in my abs and skin and brought a loop of the small intestine through to the surface. The loop is sewn to the skin and then a small incision is made in it so that the effluent can pass to the outside. My loop ileostomy can be reversed in the future, possibly during my liver surgery. The ileostomy itself looks like a pile of ketchup. It's red and protrudes a quarter of an inch above the skin. The small intestine itself has no nerves so the ileostomy has no feeling.
The bag is a relatively simple (yet expensive - $11 per bag) contraption that is held in place by some very effective adhesives. The actual bag is about 10 inches long and 4 inches wide (fully inflated it would be about the size of a 1 litre milk container). There is a 1 inch diameter hole near one end on the back side that is surrounded by a peel-and-stick style adhesive. The other end is open but is sealed by a clip which can be removed to empty the bag. In order to fit the bag over the ileostomy so that no skin is exposed a secondary adhesive ring and some adhesive paste is used (the skin is very sensitive to the acids in the effluent - think diaper rash). Once in place it can be left for about 4 days before the adhesives wear out and the bag needs to be replaced.
One of the main differences as I understand it between an ileostomy and a colostomy (besides which part of the intestine is used) is the frequency with which the bag needs emptying. The colon's main job is to consolidate, dehydrate and package waste for once or twice daily evacuation. This means someone with a colostomy that has most of their colon intact has to empty their bag only a couple of times a day. I've heard also that people with colostomies can even train their bodies to "go" only once or twice a day so that the rest of the day they live with an empty bag. But for people with ileostomies life is a little less predictable. Without the colon to do its packaging job, an ileostomy has a nearly constant output. This means that I need to empty my bag 6-9 times a day. Which actually turns out to not be a big deal since I usually find myself in the washroom with a similar frequency to empty my bladder. Also, I was surprised by how quickly food passed through. It only takes about 3-6 hours!
Overall life with an ileostomy is great. As a guy, I can hide the bag easily under my clothes although frequent readjustment of the bag's position is needed as it fills. There is no smell at all when the bag is sealed so don't fart and try and blame it on me! I can shower, bath, swim and exercise just like normal. The only real limitations would be contact sports (no rugby for me) and some minor diet restrictions (I have to limit high fiber foods like potato skins, apple peels and popcorn and stringy foods like pineapple). There is a body image issue (no one wants an arsehole on the front of their body) but I think it would be much harder to be young woman with an ileostomy than a guy. My least favourite part is changing the bag and only because I'm lazy. It takes about 20 minutes to do it properly, (mostly it's the removal of the old one that takes time) it requires help from Penny and it must be done every fourth morning. Mornings are best because that's when the ileostomy is the least active since I haven't eaten through the night.
There. Now you know more than you probably wanted to know about my poops. Hope you're not eating your lunch...
Friday, April 10, 2009
Next step: Liver surgery
Penny and I met with the hepatobilliary (liver) surgeon on Thursday to discuss my upcoming surgery. He was actually there for my colon surgery and had a feel of my liver when I was splayed (I can't think of a better word) out on the table. He said the two lumps in my liver felt like cancer but he said there is about a 5% chance that its not cancer and is something benign. I'm not holding my breath on that one.
My hope for the meeting was to sign the consent for surgery and start the process of booking a date. In the back of my mind I was aware that he might send me for an MRI or CT scan or some other test to verify my candidacy for surgery. Luckily his attitude was 'lets not waste any more time' so we discussed the surgery and signed the consent. His assistant will call me in the next week or two with my surgery date which, according to him, will be in about a month. So between now and then I have my work cut out for me. I have to put on a bunch of weight (I'm up to 176lbs now) and get myself back in some semblance of shape (As of today I can't do a sit up, touch my toes, or run more than 1 block!).
Monday, April 6, 2009
Andrew - first steps
Andrew - first steps, originally uploaded by DPC Tutt.
At a year and a week old Andrew took his first steps. He's showing off in this video since he's actually drinking and walking at the same time (something I have yet to perfect myself). In the few days since this was taken he has become much more bold. He can walk for longer distances between Penny and I and he will actually try and walk by himself for short distances (from the red table to the couch for instance). Yesterday he had his first bad fall. He was trying to walk by himself and took a header and now has a nice red bruise on his forehead to prove it. His timing with starting to walk couldn't have been better given that spring appears to be here. It will be great to have him out running around this summer in the park chasing balls and playing on the slide. Let the fun begin!