Down the Tubes (in a Good Way!)

I'm home again!

The second tube attempt at inserting a feeding tube was a success. This tube is a jejunostomy tube or J-tube. It is longer than the G-tube and goes through my stomach into my jejunum (small intestine). This type of tube is much more common, which no doubt helps account for this attempt's success... that and the fact that my stomach wasn't doing the cha-cha from chemo.

This morning I successfully took in nutrients via the J-tube and so they let me go home. Although the pain still isn't too bad in mouth and I'm still eating solids, I'll nevertheless be ingesting a can of this stuff a day from now on. The does will increase to six cans daily once I can no longer eat orally.

Meanwhile, my taste buds are now fully gone. I'm already compiling a list of foods I plan to gorge on when my taste returns in a few months' time. Mmmm. Cheeseburgers...

As always, thank you to all for your comments, calls, and cards of support. You sure know how to make a guy with a tube in his stomach feel better!

Take Tube

David checked back in to PMH this morning to prepare for another go at inserting the feeding tube. He'll be testing it out tomorrow. Let's hope it goes better than last time. We'll keep you posted.

Two Weeks Down, Four and a Half To Go

It has been a good week.

The nausea lessened day by day until it disappeared altogether and then my energy level steadily increased as I managed to eat more and more. Meanwhile, the side effects of the radiation are still only annoying (dry mouth, loss of taste) and not yet painful. This is one case where it's better to be tasteless than have a sharp tongue, I suppose.

Next Tuesday I check back into the hospital for another go at inserting a feeding tube. Fingers and eyes crossed that this attempt will go more smoothly.

Home for the Week!

I'm home again! After this morning's radiation appointment, I dutifully returned to floor 17-B to check back in. Imagine my delight when Dr. Thompson said I could go home. He's booked the next G-tube insertion attempt for next Monday, Oct. 29.

I couldn't be happier to be recovering at home. Before we left the hospital I collected some items I'd left in the hospital room and found a meal waiting for me. The sight of it almost set me spewing anew.

Have I mentioned I'm happy to be home?

Home for the Weekend

There's no place like home... even if just for 48 hours.

After an eventful six-day stay at PMH, Dr. O'Sullivan was kind enough to give me a weekend pass. Never has fresh air tasted so sweet as when Aunt Linda wheeled me out the hospital yesterday afternoon. I swear, after this week's ordeal, it has become hard not associate every sensation of being on floor 17-B -- the smell of the soap, the sound of the IV pump -- with discomfort and nausea. The car ride back and the familiar comforts of home immediately made me feel better. Not to mention eating for the first time since Monday.

Unfortunately, my stomach is still not 100% at peace, but it is nevertheless a treat to be worshipping at the home bowl. I'm taking it as easy as possible before checking back in to PMH Monday morning to prep for tube insertion part II. Hopefully they'll have more success in a week when my stomach isn't doing the cha-cha from chemo.

Thanks to all for your outpouring of calls, comments, and cards. You sure know how to make a sickly fella feel supported.

Thanks also to my lovely and talented wife for keeping the blog updated during my hospital stay.

Not So Tubular

Well, they removed the tube today. Another attempt of flushing the tube with water caused more pain and vomiting. We don't know if the tube was placed incorrectly from the get go, or if normal stomach contractions pushed it out. Regardless, it's been taken out for now. Once David's stomach has had time to heal they will put in another tube.
The good news is that David's nausea has passed. Now, he just feels very weak. A day of vomiting, no food and chemo will do that. David had a slight fever when he returned to PMH after his procedure. They started him on antibiotics right away. As I said before he is susceptible to infection and they don't want to take any risks.
We thought this was going to be the easy week. There's no turning back now. The good news is that David has almost completed one week of treatment. Only 5 1/2 weeks left.

Side Effects

The chemo is making it's way through David's body killing off any cancer cells. Unfortunately, it is making him vomit like clock work every 3 hours. This is a common side effect and will pass. His temperature, blood pressure and oxygen level remains good. His spirits remain positive.
He has not tried the feeding tube again as he's really not up to it. They will try in the morning and if it is a success send him home with a baggie full of anti-nausea medication. Hopefully, he'll be coming home tomorrow.

Feed the Tube

Just a quick update to let you know that David is doing okay. He has completed his first round of chemo and radiation treatment. So far, he hasn't experienced any nausea.
The G-tube on the other hand is causing some pain. Hopefully, it will subside as his tummy heals.
Thank you to everyone for all your well wishes. Keep them coming. They are much needed and appreciated.
One final note regarding the chemo (which I'm sure David will outline in his post) is that David will be extremely susceptible to infection 10-14 days after treatment. This means, please don't visit if you have a cold or think you are coming down with something. We'd love to see you, but keep your germs to yourself.
David will be home blogging in no time.

Game On!

Tomorrow I check in to Princess Margaret Hospital. By the time I return home on Wednesday, I'll have my G-tube in place and I'll have undergone my first dose of chemo and my first two sessions of radiation therapy. As much fun as this all sounds, I decided I needed something a little more enjoyable to look forward to while recovering at home.

And so, I've traded in a bunch of old PS2 games and gotten a deal on a shiny new Xbox 360. My folks have been kind enough to throw in an early Christmas gift: a 19" LCD-HDTV (thanks, Mom & Dad!). Our second bedroom, soon to be my recovery room, now has a sweet little set-up for virtual distraction.

Alfredo was kind enough to help me break it in this afternoon. The time flew by as he thoroughly trounced me in a car racing game.


I've kept Alfredo up to date about my cancer treatments and we both knew today was likely our last visit for a few months. Even though I've promised to phone and e-mail often, it was a pretty sad good-bye when I dropped him back home. No worries, little buddy. I'll be back in the driver's seat before you know it.

Let the games begin.

Tubular!

A quick update: I'll be checking into the hospital this Sunday, October 14 for a few days. Monday they'll be putting in my gastric feeding tube (or "G-tube"). Having this procedure now, while I'm still feeling fine, is actually much better than dealing with it in three weeks when I'll be a wreck. The G-tube will look something like this (no, that's not me in the photo):


Don't you wish you could have one?

Tuesday, my chemo and radiation treatments will begin as planned.

Treatment Begins Tuesday, October 16

Before I get to the medical stuff, let me wish everyone a belated Happy Thanksgiving. Jeanette and I spent the weekend up in Harriston and joined her parents, Uncle Henry, and Aunt Dorothy for a feast of turkey with all the fixings. We also fit in more visiting time with Mike, Krystal, and baby MacKenzie. Here, at last, is a picture of the little cutie:


Despite the freakishly hot weather it felt like a good ol' fashioned Thanksgiving. I was particularly thankful for being able to taste turkey, 'cause who knows when I'll experience that again...

...which leads me to today's cancer treatment news. Jeanette and I met with medical oncologist Dr. Eric Chen to discuss my upcoming chemotherapy. Dr. Chen confirmed the treatment that Dr. O'Sullivan had predicted: three doses of chemo administered at the beginning, the middle, and the end of the 6 1/2 weeks of radiation.


The chemo drug, called Cisplatin (SIS-pla-tin), is a clear liquid that will be administered to my bloodstream via an intravenous line. These sessions will take between 30 minutes and 2 hours and they'll keep me overnight each time to deal with the nausea, to do each other's hair, and to talk about boys.

At today's appointment, they didn't yet know the start date of my radiation treatment. By the time we arrived home from work,however, there was a message on the machine from Dr. O'Sullivan's office confirming that treatment will begin at 9:15 AM on Tuesday, October 16. The countdown is on!

We go back to PMH tomorrow afternoon for another appointment with Dr. O'Sullivan to further review the details of what's a-coming.

Tongue To Be Treated

It's official: I have agreed to undergo radiation therapy on my tongue. I spoke with Dr. O'Sullivan late this afternoon. On Tuesday he reviewed my case with the panel of UHN doctors, including Dr. Irish, and they came out supporting Dr. O'Sullivan's recommendation to zap the tongue. I was considering taking my friend Chad's advice and holding an American Idol style phone-in vote to decide the course of my treatment, but I suppose listening to a panel of doctors works too.

Aware of my concerns about risks to my jawbone, Dr. O'Sullivan offered two points that offer some comfort: 1) my tongue will be treated with a low dose of radiation to minimize side effects; and 2) I've never broken my jawbone, nor have I had any surgery on it before, which lessen the chances that it will be damaged by the radiation.

Nevertheless, having my tongue zapped will still be an ordeal. I'll need to be on liquid codeine to deal with the pain, and by the third week of treatment, eating will be nearly impossible. At that time I'll be admitted to the hospital for a few days to have a feeding tube inserted in my side that will provide food directly to my stomach. The tube will remain until I can handle solids again orally some time after treatment ends. Unless of course I get hooked on such an efficient means of administering nutrition. Maybe chewing is overrated?

Bad to the Bone

Well, today I was all set to give Dr. O'Sullivan the thumbs up for zapping my tongue when he hit us with a new piece of information: there is a "5% to 10% chance" that radiating the tongue will cause damage to the jawbone. Repairing that damage can require surgery. Keep in mind that radiation is so hard on the mouth, that doctors worry about even extracting a tooth even years after treatment. So jaw surgery? Yikes!

My decision to go for it had basically resulted from weighing the risks of cancer recurrence in the tongue against the long-term side effects of radiating the tongue. Until today, I'd thought those long-term effects were the same as those for radiating the neck, which I'll experience regardless. But this jaw thing has thrown me for a loop. I'm back to not knowing what to do.

Seeing my renewed hesitance, Dr. O'Sullivan offered to review my case with a panel of University Health Network doctors who are meeting this week to discuss cancer patients and their treatments. He expects that they'll agree with Dr. Irish that radiating the tongue is unnecessary. Even so, Dr. O'Sullivan is worried enough by the initial spread of my cancer that he doesn't want to take any chances and so he still recommends treating the tongue. I'm to call him this Thursday to discuss the panel's thoughts. I can make my decision then. In the meantime, preparation will continue for the neck treatment.

And so, today was also my CT planning appointment, which was a replay of the mask-making appointment I had last November 15. They made me a spiffy new mask, but were able to use the same pinpoint tattoo, which means no playing connect the dots on my chest. I don't have a start-date yet for treatment, but they tell me it's usually 7 to 10 days after the planning appointment.

As for chemotherapy, we have our first meeting with the medical oncologist, Dr. Eric Chen, next Tuesday, October 9. Let's hope that appointment is less of a jaw-dropper.