On Tuesday, March 20, we finally had a date . . . TWO DAYS LATER! I packed quickly and we left for Salt Lake the next day, after Phil's morning talk show. Phil was on clear liquids and we made sure to be at our daughter Liz's in Heber City in time for him to take four Dulcolax tablets at 4:00 p.m., and a concoction of Miralax and Gatorade at 6:00 p.m. After that, Phil stayed close to the bathroom!
The next morning Phil took the last of the Miralax and Gatorade, as directed, then no more fluids for four hours till his 11:00 a.m. appointment at Huntsman Cancer Institute. Phil was placed in an exam room to change into a hospital gown so the procedure could get started, and I was told he would be in recovery in about 30-60 minutes. I rushed to University of Utah Hospital to see three patients while I waited for Phil: my nephew, Willie; my Cousin Tasha's husband, Dustin; and a friend and colleague, Nedra. I visited each one briefly, and I was excited that I also saw my son Adam and my sister Wendy in the hallway. They both work in different departments at the hospital.
After Phil’s colonoscopy (which lasted much longer than expected), Dr. Samadder explained his findings:
(1) No new tumors!!! (This is significant when you recall that Phil’s CT scan last month hinted of two possible new sites.) The normal adult scope wouldn’t pass beyond the tumor, but a pediatric scope allowed Dr. Samadder to observe the entire colon.
(2) The tumor is located in the middle of the transverse colon, instead of the hepatic flexure, like we were first told. Not a game-changer—just nice to know.
(3) The tumor is completely circling the inside of the colon where it's located, leaving an opening of only 11 millimeters (about one-half inch); the width of a normal colon is several centimeters.
(4) The danger of a complete blockage is imminent. Dr. Samadder recommended placing a stent to broaden the opening.
With Phil already prepped, Dr. Samadder was able to schedule the procedure for 12:30 p.m. the next day, and the stent would be placed by scope, similar to the colonoscopy. Of course Dr. Samadder was concerned about the length of time since Phil’s last dose of Avastin. . . . had it been long enough to reduce the risk of accidental perforation?
Throughout this journey with cancer, we’ve learned to weigh the risks and this time was no exception. Should we risk perforation or occlusion? Perforation is life-threatening, but so is a blockage, which is also exquisitely painful. And if it happened in Grand or San Juan County, Phil would definitely be flown out to be treated. Plus, as Dr. Samadder explained, a successful stent placement after a blockage is much more challenging.
All these considerations lent themselves to our decision and we decided to go forward with the stent. Phil was put back on clear liquids, with another delightful elixir of Miralax and Gatorade that evening, and fasting after midnight. For the guy who was supposed to gain weight all month, Phil had not been able to eat anything solid since Tuesday.
But Phil never complains. He always looks at the bright side . . . and I mean, always! He believes in success. Failure is not in his lexicon, and that’s why he’s still here. Phil has the strongest faith of anyone I know. He places his trust completely in the Lord, where he derives his strength.
So it didn't phase Phil in the slightest when Dr. Samadder called late Thursday to postpone the stent for two weeks. That had all kinds of frightening implications, but Phil was still optimistic. Dr. Weis, Phil's oncologist, felt the risk of perforation was too great. After more back and forth exchanges between Dr. Weis' office and Dr. Samadder the next morning, we got a call from Judy, Dr. Weis' nurse, informing us that everyone now agreed that the stent placement should go forward and at 12:30 p.m., we reported to University of Utah Hospital. Here's Phil at check-in.
The team in the endoscopy lab was upbeat and supportive, and Phil was totally calm and positive. I was allowed to go to the surgery room with Phil and stay while they hooked him to multiple monitors and inserted his IV. Michelle, Phil’s surgery nurse, turned out to be related to some good friends who used to live in Blanding, and she was so fun.
I know that sounds like an oxymoron . . . fun in surgery?
Being in the radio business, Phil is used to being "wired." Here you can see him all hooked up with his IV plugged into the port-a-catheter in his chest. The yellow spot under the tape is called a butterfly needle. You can't see it but it has little yellow wings that are pinched while the nurse inserts the slightly curved and hooked needle that resembles a hummingbird's beak.
Michelle demonstrates an esophageal stent, just to give us an idea (although this one is much larger than a colon stent). The wire mesh is titanium and if all goes well, it will gradually expand to about 2.5 centimeters and significantly increase the passageway through Phil's tumor.
Ricardo came in to assist and he was fun, too! As it turns out, Dr. Samadder was also pretty jovial and he told us about multiple guest appearances on radio and television talk shows this month--National Colon Cancer Awareness Month. Before going under light sedation, Phil (always the consummate broadcaster) made arrangements to interview Dr. Samadder on his morning talk show this week.
P L E A S E . . . FOLLOW THE RECOMMENDED GUIDELINES AND GET A COLONOSCOPY! You don't have to experience what Phil's going through!!! Colorectal cancer is slow growing and 90% curable if it's caught early. You should have a colonoscopy when you turn 50, and then every ten years after that. If you have any pre-cancerous polyps removed, the current recommendation is to follow-up every three to five years. If there's a history of colorectal cancer in your family, your first scope should be before the age of 50. Talk to your doctor, and then don't get too busy to follow his advice--like Phil!
When I left surgery, everyone was in a pretty festive mood, including the patient!
Ricardo, Michelle, and Dr. Samadder (wearing another doctor's apron). Ricardo and Dr. Samadder have their fingers in the esophageal stent, which acts like one of those finger puzzles--when you pull, it only tightens and you can't get your fingers out.
After waiting and waiting and waiting, the news out of surgery was great. Despite swelling from the previous day’s procedure, which necessitated a whole lot of incremental dilating, the stent was placed and Dr. Samadder felt it was a good placement. Phil was pretty miserable in recovery, but within the hour we left the hospital behind us and were on our way, and he has (according to his own account) felt good ever since. But what else would you expect. It's Phil!
Phil was told to stay on a clear liquid diet for another 24 hours! Imagine that, Phil went four whole days without eating anything solid. He has to be careful for a few days--no corn, celery, etc. (in other words, foods that don’t break down in digestion), while the stent continues to expand.
We feel that we have been the recipients of multiple miracles over the past week!!! And we're very grateful . . .
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