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)