No news is good news?

Not sure who came up with the old adage 'no news is good news,' but it's not really true in this case. I haven't been home much this week to update. So, we'll get you all caught up now...

To sum it up...Dad's still stuck at the same spot. Eating ice chips with the NG tube. The stomach has not kicked in and decided to work yet and pump the bile and fluid to his intestine. The surgeon is confident this will happen and he keeps saying the stomach only knows how to do 1 thing - it will remember. But, while it's inflamed after surgery it doesn't always want to pump and may take some time. How long you ask??? Up to 2 weeks.

So, they did a contrast test today and verified that the surgery did work and the stomach is open to the intestine so now we just have to wait for his stomach to decide to do its job. It's been 4 days since surgery, so yes, it could be up to another 10 days before it kicks in. Until it kicks in....ice chips only and NG tube. UGH!!

Mom and Dad are definitely hoping for some good news at the hospital. Got any good news? Add it to the comment spot below. We'll live vicariously through all of you for awhile...I'll go first...the biggest news in our house this week is I purchased a Swiffer vacuum for Tyler (the 8-year old) who now says I'm the greatest Mom in the world and he is vacuuming my floors everyday. The good news is: I am released from vacuuming duty and apparently, Denny and I are raising a sucker!!

Stuck in neutral....

So, we were apparently jumping the gun a bit by expecting clear fluids. He hit the brakes yesterday. Apparently Dad loves the roller coaster, because each day that looks great and is a high, is followed by a stomach dropping day of downs. The down day was yesterday. Still stuck with the NG tube...stomach hasn't started 'pumping' yet...still only on ice chips.

When Denver wakes up in a bit, I'll check in and update again. If he's on schedule, it should be an up day, but again he isn't sticking with a normal pattern. Gosh he's stubborn! :)

Door # 3 is a Winner!!

I am very happy to report that Dad is doing great today!!! The surgery was a success. I spoke with him this afternoon and he sounded great. His days of toughness training in the Navy have paid off and he hasn't needed any pain meds. The NG tube is now bringing up nothing. Sue laughed and said no wonder the surgeon thought we were all insane when we kept saying the NG tube was bringing up less fluid last week. It was still bringing up tons compared to what was 'normal.' As we've said from the beginning, they'll have to rewrite normal after Dad.

So, huge leaps forward today, and hopefully more this week. Today he resumed the ice chip diet. Tomorrow the NG tube comes out. Dad begged the surgeon to be his first stop in the morning so he can get the tube out early. Tomorrow has the possibility of clear fluids. Who would have thought some apple juice and broth would be so darn exciting?!?

The surgeon also emphasized today that Dad needs to take longer walks and spend more time up in the chair. I figure he is used to that exercise routine - wake up from a nap...take a walk down the hall...take another nap...sit in the chair...take another nap...you get the picture! He should be a seasoned pro at this routine. He'll hopefully be released from the hospital no later than next Monday.

Thanks again for all the prayers and support. They are definitely working.

Not the best day...

Well, the prize behind door #2 was a dud. Kind of like when people used to win a goat on Let's Make a Deal. The second option given to Dad to correct the stricture was another go at the endoscopy. So, the surgeon tried that approach this afternoon and was not able to open the stricture that way. They brought Dad back to his room for a couple of hours. He had to trade the goat for what was behind operating room curtain #3 (anybody following my 70's game show humor?). The surgeon reopened his incision from the Whipple procedure and had to surgically fix the stricture.

This is where the 'what they actually did' gets foggy. No offense to my mom, but she wasn't real clear on giving me the details. I know how much you all live for these great medical novels that I've been writing, but today you're going to have to be satisfied with a bit simpler version. We know this...they disconnected something and reconnected it somewhere else on his stomach...the surgeon drew a picture and it showed stitches (we don't really know where they were or what was stitched together), but he stitched something that in the picture looks like tubing. So, instead of a descriptive analysis of his treatment that could win me an amateur's award in the medical field, I've had to fall back on being the kid that's relaying you the story similar to a game of telephone.

The good news is, and Mom was very clear on this, the new connection was wide open and looked good. The bad news? The NG tube got put back in for at least 48 hours. Feel free to insert your own Hankism using the 'f' word here, because you know he had some choice things to say about that tube going back in!!!! So, we wait again...back to not even ice chips. That Schlafly beer is going to taste even better when he finally gets to drink it!!!

The waiting game continues. Hopefully, the NG tube will come out in 2 days and he'll be released from the hospital in about another week. By then he will have crossed the 1-month residency mark at Parker Adventist. We're keeping our heads up and trying not to view today as 2 steps backward. If it is, hopefully tomorrow will have 3 going in the other direction. You all know Dad's determination, which is what will pull him through this last week in the hospital, because basically at this point...he's pissed!

The Waiting Game Continues...

First some good news! Celeste came home yesterday and is doing very well. Thank you for all of the prayers.

Dad's progress continues to be much slower. They did the endoscopy on Friday and found that the blockage at the point where the stomach attaches to the intestine is due to a stricture. Basically just swelling and some tissue, nothing serious, but it's still not functioning properly. During the procedure they removed the NG tube, which was the tube through his nose to his stomach that was pumping out the bile. They did not replace the tube. So, on the good side, the tube is finally gone. On the bad side, he's now dealing with nausea and has gotten sick a few times since then.

So, what now??? The first option provided by the surgeon, is apparently not going to happen. This option was that the stricture, which they expanded during the endoscopy, would stay open and it would start to drain. Since he's still getting sick, that didn't work. So, on Monday the surgeon will do the second option, which is to perform another endoscopy and be more aggressive in expanding the stricture (the last endoscopy was done by the GI doctor). If this doesn't work, they'll have to go in and surgically remove some of the tissue blocking the drainage. That would be option 3. Obviously we are all hoping that what's behind door #2 will be the winner.

Still nothing besides ice chips. Hopefully, Monday will bring better news. We'll keep you posted.

Kathy

Third Update on Dad (Henry Herbst)

Our first 2 updates made it sound like Dad would be in the hospital a maximum of 10 days. Here it is Day 14 Post-op and he's still in the hospital. While the man can be a freight train when he sets his mind to things, he also tends to want to set his own pace. So, I guess he's decided to not listen to the doctors after all. He's making progress, but it's slow.

The main problem at the moment is he is still producing too much bile from his stomach. He had a couple of tests yesterday that show an enlarged area at the top of his intestine where it comes from his stomach. This blockage won't let the goop leave his stomach, so they are having to pump it out. Basically, the train isn't leaving the station in the right direction. They will be doing an endoscopy this afternoon to see what the problem is. They think it just may be inflammation from surgery, but it could be something more serious like a kink.

All of this means he still has the tube through his nose, down his throat, and into his stomach. While he's tolerated it all pretty well, he's losing his good humor about that tube. (Fill in your own 'Hankism' here about what he's saying to the nurses). He is making other progress. He hasn't been on any pain meds since last Thursday...he is taking longer walks each day...and more and more tubes are being removed. But, at the moment, he is still only allowed ice chips to eat. He gets 1/2 cup of ice chips over a 24 hour period. When I think of the volume of food I've eaten over the last 2 weeks and compare it to his 2 cups of ice chips, I'm feeling kind of bad for the guy.

I will update this site again this weekend when we know more. In the mean time, he's hanging in there and still hanging out at Parker Adventist Hospital.

For those of you asking about my niece Celeste's surgery, her post is listed below.

Celeste...

For the past few weeks, my 9-year old niece Celeste has been struggling with her blood disorder. Her blood has been breaking down quickly and she has needed a few transfusions. The doctors were planning on taking out her spleen (which is the 'cure' for this disorder) in a few weeks when she was on break from school and after a few immunizations that are ideal to get while the spleen is still in. She got the immunizations, but they weren't able to wait any longer to take out the spleen. In the past few days her blood was breaking down too quickly. So, surgery was scheduled for this Thursday (yesterday).

There was some discussion that they would remove her gall bladder as well, since gall stones can be common with this disorder. But, they were not convinced she has any gall stones, although the ultrasound showed a little ‘stuff.’ The doctor believed that to be more fluid-like than stone-like. So, Thursday they did the surgery laprascopically and only removed her spleen.

During the procedure her spleen was VERY enlarged and difficult to remove. There was a scary moment during the procedure when an artery was nicked and she bled for about 10 minutes losing at least a ¼ of her blood. But, the surgeon was giving her blood during the procedure to compensate and there are no ill effects. She’ll be in the hospital until tomorrow, but in typical kid fashion they say she’s bouncing back already. She’ll be back home in Castle Rock by Sunday.

Thanks for all of the extra prayers for Celeste!

Dad (Henry Herbst) - Second Update

This post is the second update on Dad that we sent out, via e-mail, on Thursday, July 16, 2009

Dear Family and Friends,

Again, thank you to each of you for the prayers, kind thoughts, well wishes, cards, and flowers. We are milking up all of it! The delivery man at the hospital brought a stack of cards today and said ‘Hi Henry. See you tomorrow.’ You know Dad was loving that! He doesn’t care where he’s the most popular, as long as he retains the title. So, for the moment, he is the Parker Adventist Resident Comedian…which is a good sign that he is in good spirits.

Since Sunday, much has happened, while at the same time some things are slow. It has kind of been a 2 steps forward, 1 step back sort of week, but the good thing is we’re making progress. More tubes have been removed, although he’s still on a feeding tube. Tomorrow’s goal is ice chips!!! Like I said, baby steps.

Hospital Stay
He had some issues with his blood pressure this week and passed out 3 of the 4 times he got out of bed in a 24 hour period. He figured out very quickly how to get about 20 nurses and doctors in his room. Again, he won the popularity contest on the second floor. Although his nurse told him if he wanted more attention to just ask. Those incidents were a step backward, but today the blood pressure was spot-on and he took a very long walk down the hall…2 steps forward. We are still unsure when he will be released from the hospital. He has a number of goals that have to be achieved before they will let him out. Things like eating and drinking. We are guessing he’ll be released sometime next week.

Prognosis
The pathology report was not quite what we expected after the surgery. While the ‘margins’ around the tumor were clean, including the tail of the pancreas, 7 of the 14 lymph nodes that were removed did have cancer. The cancer type was pancreatic ductal carcinoma. It is the adeno form of cancer that can move quickly (hence the spread to the lymph nodes). It is called ductal because it started in the ducts. So, what does all this mean?

He will definitely be undergoing chemotherapy, since they have to treat the system. They are not recommending radiation. They are optimistic that they removed all of the cancer, but you never know if any sneaky cells got elsewhere in his system and are moving to a different part of the body. The bad news of the day was he has an 80% chance of the cancer recurring someday, 70% chance if he does chemo. But, in typical Dad fashion, he said, “Not a problem, we’ll be in the 20%.”

Next Steps
Mom and Dad will be heading back to St. Louis probably near the end of the month. He has a few weeks before he needs to start chemo and he needs to heal some more from the Whipple Procedure. He will start with an oncologist in St. Louis and probably begin with a PET Scan to determine if the cancer is in any other organs. If that test is negative, he’ll start about 6 months of chemo. If that test shows cancer somewhere else he’ll start a whole new treatment and a whole new series of these ridiculously long updates! Pray like hell that the PET Scan shows good results!

At this point, we are still playing a bit of the waiting game…waiting for ice chips, food, and more tubes to be removed. Then we’ll move on to waiting for a trip home, a new oncologist, and chemo. Shortly after that we’ll finally be at the point that we’re waiting in the drive-thru at McDonald’s for an egg mcmuffin and at the bar at Schlafly’s for an APA.

Much thanks and love to each of you for your prayers and concern. He is truly lucky to have so many good friends in his life. Come visit when he gets home, Mom will surely be driving him crazy by then!

Love,
Kathy (Daughter #3)

DISCLAIMER…I have no medical training and don’t even know if some of this stuff is spelled correctly. Be careful if you google any of the medical terms listed above. It will probably bring back results for things like breast augmentation and plumbing.

Dad (Henry Herbst) - First Update

This is the first update we sent, via e-mail, on Sunday, July 12, 2009...

Dear Family & Friends,

First of all, a heartfelt thanks to each of you for your concern and prayers. Sorry to send out a mass e-mail to update each of you, but this is the best way to get all of the information to everyone. Feel free to forward this message to anyone who may be interested and just respond if you have any questions. I’ll be spending the week in the hospital room and can relay all messages. But a word of warning, he’s returning to his spunky self and you will probably get a sarcastic response.

History
Mom & Dad came out to Denver on Sunday, June 28th to visit Amy, Sue and the grandkids (son-in-laws too) and Dad was feeling a little under the weather. Tired, a little lethargic, and his coloring wasn’t great. By Thursday, he was unbelievably jaundiced and really feeling bad. He went to the emergency room swearing he had altitude sickness. We kept telling him that didn’t make you turn yellow, but he wouldn’t listen to us :) So, they ran a series of tests with the assumption it was Hepatitis A, as his symptoms were leaning to that diagnosis. The blood tests were negative for hepatitis, and an ultrasound showed a mass on the head of his pancreas.

The mass was blocking the bile duct that connects the liver to the small intestine. With the bile duct blocked, his body wasn’t able to get the waste to the intestines and it was backing up, hence the jaundiced skin. By this time his bilirubin counts (what makes your skin look jaundice) was 12 times the normal amount. They admitted him to the hospital until they could study the mass and drain the bile.

The next day, they performed an endoscopy (camera down the throat to the intestines/pancreas area) to determine what the mass/blockage was. They found a number of areas of concern where the intestines were inflamed and they could see the mass, but not reach it for a biopsy. Because of Dad’s strokes in 1996, he is on blood thinners and they were unable to push the scope past the inflamed areas to get a biopsy on the mass or even to put a stint in the bile duct and open it up. So the waiting game began…4 days of waiting before they would do a more invasive procedure while they waited for the blood thinners to leave his system.

Monday they went in to Dad’s liver through his stomach and were able to drain the liver (we’ll definitely skip the details here, it was NOT pretty). During this procedure they were able to get a brush biopsy of the mass….more waiting.

Thursday brought the diagnosis we were most fearful of. Dad has pancreatic cancer. There are rare cases when pancreatic cancer is resectable (operable). It has to be caught before it has spread, be contained in the head of the pancreas, and not surround a specific blood vessel to the intestines. From the tests they ran it appeared that his cancer was resectable. So, in typical Hank fashion, he bribed the surgeon with Schlafly beer and front row Cardinals tickets and got an appointment to do the surgery the next morning.

Surgery
On Friday morning they called his name for surgery. He told them he was not Henry Herbst, but Tom Sullivan and he was here for his breast implants. They weren’t fooled and we are happy to report that they proceeded with the operation and his breasts are the same size. The surgery is called the Whipple Procedure. The waiting game began again. The hope this time was that they would complete the procedure and not open him up and decide the cancer was not resectable and zip him back up. The good news came an hour and a half into surgery when the nurse came out to tell Mom they were proceeding with the Whipple. The tumor was contained in the head of the pancreas and they were able to remove the entire tumor, along with 40% of his pancreas, 1 foot of his small intestine, his gall bladder, the bottom half of his stomach, etc. The cancer had not spread outside of the tumor, including no lymph node involvement. The tissue around the tumor was tested and found to be cancer free!!!!! The surgery was a grueling 7 hours, although Dad obviously got to sleep through it all – talk about your power naps!

He was moved to ICU on Friday afternoon and expected to be there for 3 days. Since the man doesn’t slow down for much, in typical fashion, he was moved out of ICU in 24 hours and put in a regular room on Saturday afternoon. He was very glad to get out of there. The machines kept him up all night and as he has repeatedly said, “That place sucks, people are dying in there.”

So, it’s Sunday afternoon….Each day more drains, wires, monitors are removed. Thankfully the epidural giving him pain medicine will be in for a few more days. He is slowly returning to normal…whatever that is and keeping the nursing staff on their toes.

Next Steps
The pathology reports on the tumor should come the first half of this week. At that point they’ll know what type of cancer it was and what follow up treatment will be necessary. He may need chemo, but it does not look like any radiation will be necessary. Dad will be in the hospital for about a week. As his system begins to learn its new route they will slowly introduce food and water. Right now all his nourishment is through a feeding tube. The man is dying for an egg mcmuffin and a cup of coffee, but that will have to wait. He and Mom will be staying in Denver another week or so after he is released for follow ups with the surgeon before returning to St. Louis. He still has a long road to recovery, but has made huge steps in a short amount of time.

Looks like he dodged another bullet and as he said, “I’m the luckiest unlucky bastard around.”

Dad is bunking in Parker Adventist Hospital.

Thanks again for all your love and prayers. We appreciate them and all of you more than words can say.

Here’s to drinks of water, egg mcmuffins, and the return to Schlafly’s for an APA in the near future.

Love,
Kathy (Daughter #3)