Surgery number three on Lulu's breast

Today I'm thankful for...
seeing the great qualities in everyone
being there for my family
good, caring, and responsible kids
my health

The third surgery on the Lulu's right breast happened on the afternoon of Friday Oct. 29th. After spending the week in the hospital on the IV antibiotics the surgeon made time in his schedule to operate on Lulu Friday at 11 AM. There was a lot of discussion about what needed to be done during this surgery. The implant was to be removed and the tissue cleaned and re-sutured together so it can heal properly. The tension on the tissue was thought to be too much for the radiated tissue to stay sutured together, and the best treatment for Lulu was to just remove the implant and start again with either a new tissue expander or nothing at this point? After waiting for Lulu to finish in the operating room, I was told that she had preformed beautifully during the 2 hour surgery, and she was our of the recovery area at 2:15 PM. I walked her to the same room that she had been in for the week, so she could continue her recovery.

Lulu is so tired of the routine of trips to SF, hospital stays, feeling sick, not being able to hold her little girl, and the time away from her kids (not to mention the time out of the office and not being able to care for the patients). I even caught her in a "feeling sorry for herself" moment the morning of her surgery (these moments are becoming more frequent with the continued struggles with the poor heal that she's enduring). It's hard to second guess someone who's about to go through their third surgery in the last 60 days. Not only that fact, but also Lulu will need at least one more surgery (and probably two) in 4 to 6 months to replace the implant that is causing her so much grief? I can see that with each complication, surgery, and recovery that Lulu is wearing down both physically and emotionally. I have been thinking of how to build up her strength emotionally, because this lady only has a sliver of the strength that she once possessed. I feel as if I have let her down? I have been saying with each surgery (or other medical event) that she's beat this and everything from now on will be better, but it seems that there's always more that creeps into our life's? I truly know that one day soon everything will past us by and the days will be filled with positive feeling and a new revitalized wife; however, until then we just have to have faith in God that he will give us the strength to make it through.

Before Friday's surgery I returned to Reno to spend a overnight with the kids. Lulu and I felt it best for me to return and spend a evening with the kids and take them to school in the morning. Both of their parents being away for this length of time can really emotionally effect the kids? (not to stay the effect that it has on us too). I found the drive home by myself was very lonely, and it seemed to take forever? I did manage to make it in time to pick up the older kids from school, and then pick up Lourdes and Hamilton for a evening of piano lessons, fast food dinner, and then an evening at home playing together.

The night flew by and before I knew it the kids were in bed, fast asleep, and I was trying to catch up a past due tasks before heading off to bed so I could turn around and drive back to be with my wife. After taking the boys to school and finishing some errands, I found myself making the 4 hour drive back. During the whole drive I had the old familiar feelings of losing my wife to this terrible disease return to my mind. My mind was racing with the what ifs. What if the cancer returned? What if Lulu couldn't came back to the office and work? What if she could never again live without the pain? What if I was left to raise four little kids alone? As I passed through Sacramento and on to Davis I soaked the steering wheel of the Prius with my salty tears. I felt guilty for crying, but could hold back the emotions that I was feeling. I just all seems so unreal. Like I'm caught in someone else's nightmare? I had no choice but to pull it all together and continue my drive ever closer the hospital. With only hours before another surgery for my battling wife, I pulled into the parking garage at the clinic, and said a little prayer as I got out of the car to face another seemingly insurmountable challenge with my wife. Walking in the the hospital I found myself thinking of only impending demise for all of us on this planet. That the most precious thing that all of us have is time (and following close behind is our health). I renewed a promise to myself to spend as much time with my love ones as humanly possible?

I walked into room 421 (her room for the week) with a mission on my mind; be strong, love all those around you, and take the time to be there for your family. No day is more important then today, and don't take tomorrow for granted. I saw Lulu in the bed with IVs hanging next to her bed and I knew that I needed to live those commandments from this day forward. I gave her the biggest hug and kiss that I could muster, while the whole time thinking of how my life has been changed forever!

Back to UCSF, what would the doctors want to do?

Today I'm grateful for...
Being able to express my emotions
Great medical care for my wife
Antibiotics
The love of the people surrounding my family

What a long week it has been. I have made the drive from Reno to San Francisco three times this last week and I'm not done yet. After saying goodbye the the kids on Tuesday AM, Lulu and made the journey down to the UCSF clinic so her breast swelling and wound healing could be assessed. We talked about a variety of things as we drove the scenic highway 80 down the mountain, but we were just avoiding the real issues of "what's next"? I know that the reality of the situation is that Lulu will be at the very least admitted to the hospital for IV antibiotics, and more likely a hospital stay and a surgery to repair the infected breast. The drive seemed to be taking much longer then normal this trip?

The Prius knows this trip well, and the familiar scenery passed by while we spoke about what we were going to do if the scenario means Lulu will be sending the week in SF? We both agreed as the car pulled into the 6th floor of the parking garage that she was going to be here for the next four to five days.

During the appointment with the plastic surgeon and the nurse was a tense 30 minutes. As he arrived to see Lulu I could tell the surgeon was felling horrible that Lulu was having the issues that she was with her breasts. He was extremely caring in his presentation of options to Lulu's new infection. We were soon all in agreement that the only options is just we had expected, four days of aggressive IV antibiotics, and then breast surgery to remove the infected implant and to leave the area without expansion to heal for 6 months. Once the tissues have healed appropriately then Lulu could have a new implant placed during another surgery. If all goes well that she might be done with the process in May of 2011? Both my wife and had been prepared for this as the answer to her recurrent infection issues. After the orders were written up, Lulu was admitted to the 4th floor of the Mt. Zions UCSF clinic.

Lulu was in remarkably good spirits for having to spend the next four days hooked to a IV pole, and mostly restricted to a hospital bed. The nurses have been close to fantastic every time we have been here, and the trends continue when we were assigned to Roshone. She was so caring, helpful, and skillful. I was happy ghat she would be the first nurse of many so Lulu would have the best experience (at least to start off with). Before we knew it she was hooked up and started on the vancomycin, and we both just hoped the rest of the week would be a success?

What's going on?

Today I'm grateful for...
Being healthy and fit
Strength from those around me
Love that I share with my wife
Freedom to choose my days

I hate to start off my blogs with the negative news of the day, but I'm going to make the concession this one time. Lulu is having right breast infection issues again. Last night as we were returning from a rainy weekend in Sacramento with the kids, I later found out was having pain with her incision area of her breast. When we had arrived home after 8 PM I heard hear crying on the phone to my mother about needing her help with the kids early the next day, because she needed to be seen by the doctors at UCSF and needed to leave quite early. This was news to me, and I immediately went into panic mode. I encouraged Lulu to give me the details and she indulged me that the 5 or 6 sutures in her right breast had released and that the area was painful and swollen. I ask her how long she had noticed this because this is the first time I knew anything about it? She said that she had noticed an issue on Saturday afternoon, but didn't want to cry wolf, and figured that it was just part of the healing process or maybe she had sleep wrong? But today when the incision opened up, and the implant was visible through the wound and painful. She got concerned.

Lulu had apparently spoken with the resident surgeon at the clinic about the new development, and after he had a chance to see the photo Lulu sent to him, he insisted that she be seen tomorrow (Monday). After my panic attack and getting the kids into bed, I wanted to talk to Lulu about the "next steps"? She told me that they would like her at the UCSF cancer clinic by 2 PM Monday, and that she could drive herself to the appointment? I have to admit that I was torn about what her needs were from me? I have been present in all but two appointments with her in this last 18 months, and even those I was saddened to not be there for support. So even though she thought I should stay in Reno to see the patients at the office (my scheduled patient days were Monday and Tuesday this week), I really want to be with her, supporting her, and caring for her during this most stressful time. (I think that we both know the gravity of the situation?) We came to a mutual decision that I should be with her for the evaluation and whatever treatment that she was going to need next? (we're both sure that the next steps will at the very least involve another surgery, and possibly a three or four day hospital stay for IV antibiotics?) I spent the evening comforting her that everything will be OK, but honestly what do I know? I thought after the original implant exchange surgery that everything would be OK, and now she's looking at a second hospital stay for treatment of the infection, and a third surgery to repair the non healing breast. How comforting can one be when you're questioning the what and why all this is happening to your loved one?

So far everytime we thy to put the complications of Lulu's cancer and it's aftermath behind us; it jumps back out to bite us? Why can't she get a break? I also know that doubt has crept into Lulu's mind about the treatment she's receiving for her reconstructive breasts? Have the doctors done all they can to prevent the infections, was the radiation treatment too close to the implant surgery, could she have been too active during her healing phase? I think that everyone would agree that when things just aren't falling your way, you start to analyze the small details, and you begin to wonder what else could have been done? I feel so sorry for my wife, and I can see how all this unsureness, infections, and surgeries have been taking a toll on her mentally. I just need to stay strong for her until she makes it through this most difficult time. That's easy to stay, but much more difficult to do.

I'm going to be praying for a little extra help tonight. We both need strength to pull us through this, dare I say, a set back again? Please send your thoughts and prayers our way, this just might be shaping up to be our neediest hour?

Rose's cafe with friends

Today I'm grateful for...
My wife sharing her experiences
Spending quality time together
My health
Getting to opportunity to exercise

These two days have been busy with medical appointments at the cancer clinic. Lulu and I made the trip down for follow up checks to the surgery a week or so ago, and we decided to stay over night (it wouldn't work to have all the doctors appointments in the same day, to make it easier we decided to do a over night instead of two separate trips down). We will try our best to have a marriage encounter while here, but all the stress of the medical appointments the marital bonding wasn't ideal (turns out it wasn't even that enjoyable).

We did find enjoyment in sharing a dinner with Lulu's friends that have been sharing similar experiences with this disease. Lulu's had the opportunity to befriend a couple of similarly aged women that were diagnosed very near the time Lulu was. It turns out that each of the two women have been moving through the challenges of breast cancer treatment, surgeries, and the hardest part of having cancer; the disruptions to your life. I think that it's important for her to share her feelings with women that know what it's like to go through these mental taxing times?

At dinner (a placed called Rose's on Union Street) I felt the bond between the survivors. They talked about their feelings, how their bodies feel now, and what is in store for them in the future? Three people brought together by the unfortunate circumstances of having breast cancer. Throughout the evening (Rose's was quite good food by the way) I noticed the emotional boost to my wife's mood, and she was more passionate than I had seen her in a while. I think the sharing of cancer related experiences and the I'm not the only one going through this was allowing her to open up? I learned things about what she's been dealing with these last 18 months that I hadn't even known before. I was slowly learning that even the husband isn't privy to all the facts of the battle with this monster.

Sunday night before another UCSF trip

Today I'm grateful for...
My wife getting better and stronger
The kids being healthy and well adjusted
Relatively warm weather to enjoy
The little princess growing so much more cute everyday

As I write in the journal I can't help but think about what's going to happen tomorrow at Lulu's post surgical appointment? It's been 12 days since the last surgery and Lulu is to have a couple of follow up appointments tomorrow and Tuesday at UCSF. The next two days will be packed with medical appointments like, the surgical follow up, the estrogen shot, blood tests, consult with the oncologist for the Sutent drug treatment (that Lulu is back on after the second surgery), and seeing the director of the trial study. I'm hopeful that all will go well? The positives are even though Lulu's feet are bothering her again because of the trial drug, she id feeling much better the last 7 days after the second breast surgery to clean up the infection and place more Allograph tissue. I know that Lulu has some of that Molina spark back, and everyday I see a little more of the wife I once knew. It's amazing that I have forgotten just how alive and fun loving my wife was before these last few surgeries. I think the stress and the healing have taken a toll on her both physically and mentally? It's great to hear that infectious, inspiring tone back in her voice and feel that energy she is starting to possess again.

I spent much of the day with Lourdes today. She has been growing up so quickly. I just can't imagine that a short 14 moths ago we got to bring her home from the hospital intensive care unit? I think that Lourdes is weighing about 35 pounds now? Hard to remember when she was the size of my hand and 2 pounds. Lourdes' personally is just beginning to shine, and she showing us the maternal (by maternal; I mean from Lulu's side) stubbornness much like her older bother Hamilton. We're working on the walking part, but haven't mastered it yet. No hurry from her parents though. I love this little princess's dimples. None of the boys have them, and Lourdes stand out on her cute face when she laughs or smiles. We are so very blessed to have her here with us, and so honored to be her mother and father.

I again want everyone to know just how much all the thoughts and prayers have lifted our spirits. As the husband of a breast cancer patient, I'm so very grateful that we have such loving, supportive friends and family. I journey we have been this last year and a half would have been so much more difficult without you all. We love each and everyone one of you!

Triathalon Day

Today I'm grateful for...
This wonderful day
Super weather, and lots of sun
Spending the night and having dinner with the family
having a place to live and food to eat

Lulu has been doing well since Thursday's surgery; however she been complaining that the swelling around her right breast and arm is hurting. The two or three days immediately after the surgery she was fine, but last night she started to feel like the pressure was increasing. I'm wondering whether the relief of the pain she experienced immediately post surgery was related to the anesthesia and post surgery oral pain relievers? Now that the anesthesia is totally out of her system she feels the discomfort that was always there? I told her that she needed to call the UCSF clinic first thing Monday morning to see if this is normal (we don't want any infections getting out of hand again and spending three days in the hospital). She promised that she would give them a call. Hopefully, we won't have to make another unscheduled trip down to the clinic to check on the healing? But of course we will do whatever is needed to assure she heals properly.

We have also had to adjust Lulu's schedule at the office, again. She was scheduled to work this Tuesday through Thursday, and now I will be taking her schedule for the remainder of the week. I felt that the the surgeon wanted Lulu to take at least three weeks off (recovery, rest, and rejuvenation), but after we talked (well mostly Lulu talked and I listened) the decision was final; Lulu was to see patients starting on October 21. I really tired to convince my wife to take more time for recovery, but she really misses the patients, parents, and the staff. I'm here to support her in whatever way she needs me.

The above picture is at Discovery Park in Sacramento at the Golden State Triathlon that I participated in Today (Sunday). I'm loving this stuff, and can't wait to better my times in the next one (which will most likely be next March, but I'm doing a 50 mile Mountain biking race in two weeks?). Funny thing happened just before the swimming portion of the race. As I stood in wait deep water awaiting the start of the race, I looked over to my right and recognized a person that I knew from 25 years ago. I lived in the dorms my first two years while at UC Davis, and this guy I was sure was a dorm mate that I shared second floor Tercero dorm with in 1984. I said to him, "I know you (original I know), your name is Tom", well his name wasn't Tom, but that's what 25 years will do to your memory. He said his name was Paul, and he knew may name instantly (this really made me feel stupid). I guess that I had made quite the impression on not just Paul, but most of the other dorm mates, because he started naming off all these things that I had done that year, and he seemed kind of impressed by them all? (I couldn't remember most of the half dozen or so escapades, another memory thing I suppose?). Unfortunately, the race was just ready to begin so we need to go swimming, but we promised to meet after the race to exchange contact information. However, after the race, I could not find him again (maybe I was bump into him at the next event?). I have never ran a crossed anyone from my college days until now (even though I have spent many hours wondering what might have become of many of the friends I made those 4.5 years at Davis?).

As for the race. I about drowned in the .5 mile swimming portion of the event. I haven't much experience in "open water" swimming (I don't think that the last race in Lake Tahoe with 2 or 3 foot waves count?), so I was struggling with the mass of swimmers around me. The effects of 15 or 20 guys both ahead and behind you can be described as the feeling you get immediately after you hit the water falling down while water skiing behind a fast jet boat. I got kicked in the face, and I'm sure that I delivered a kick or two? The second sensation that I dealt with was not swimming in a straight line. A couple of times I swam into other swimmers to both my right and my left (I don't think that they were too happy with me taking their space?). After the first few hundred feet I had to begin swimming side stroke instead of freestyle, because I was struggling so much with the chaos. I ended up liking this new stroke so much that I continued for 3/4 of the .5 mile (I did finish strong passing two or three swimmers in the last quarter mile). Once I got on shore and my legs under me, comparatively the rest of the triathlon was a piece of cake.

Biking and running were fun and I rode and ran strong, I finished with more in the tank, but was unsure this being my first road race triathlon (and the drowning part kind of freaked me out and made me hesitant). I drove back from Sacramento thinking about how I could improve at my next race, and I vowed to train harder in the swimming).

I have happy that I found something that is enjoyable and at the same time motivational. I guess this is another thing I should have put at the top of this journal entry as something to be grateful for?

Tune into the saga later this week, because I have an idea that Lulu's post surgery healing might not be totally without more complications? One day at a time, what more can you do?

Another surgery at UCSF

Today I'm loving the fact that...
I get to spend a lot of time with my wife
My wife is through another step in betting cancer
I get to eat a hot Pastrami sandwich
Had a safe trip from Reno to San Francisco

I'm spending another night at the bedside of the strong, lovely woman that I've been sharing my life with for 13 years. I'm not totally thrilled with the fact that we are back at the UCSF cancer hospital for another surgery on the non healing right breast, but at the same time I'm thinking that we (she) should be closer to getting past this cancer thing, and back to a "normal" life? (whatever normal is anymore?) She flew through this 1.5 hour surgery, and is recovering well. The doctors were very happy with the results of the reconstruction of the infected right breast, and I was excited to hear that they could save the implant. The procedure today was explained as a "clean up" the tissue, and get a better closure of the incision. The internal breast tissue was cleaned out, and new Allograph tissue placed, then sutured in to the healing breast tissue. Post operatively, the doctors said that Lulu should heal uneventfully, and needs to return in 10 days for a wound check and bandage removal. I'm so, so happy that her recovery (so far) is much better then a last months surgery (where Lulu had a difficult time flushing out all of the anesthesia medications). She seems much more perky, less nauseated, and much more alert. One hour after being wheeled out of the recovery area, she was talking on the phone to her kids and mother in Reno.

We have been told that Lulu can return to Reno tomorrow (Friday), after the surgeon comes to follow up with her recovery. I know that both of us will be quite happy to be leaving this hospital after spending much of this last week as guests. I can't believe all that this person has
experienced with this disease? Could we be getting close to the end of the unknowing? I think that is the hardest part of the cancer and it's side effect is the unknown that come along with it? When I had my back surgeries a few short years ago, I knew what the results should be and what to expect, but Lulu doesn't know what is next. And maybe worse, when it might happen? I'm thinking that tomorrow will be the new start for a cancer free, healthy life for this beautiful girl? Lord knows she deserves it.

We've had enough of hospitals

Today I'm grateful for...
Knowing the difference between needs and wants
Best health care in the world
Supportive extended family
My Toyota Pruis

Lulu told me before I left the UCSF hospital that she feels as if she's spent more time in the hospital then at home lately. Between the Radiation, Chemotherapy, two surgeries, numerous test, trial drug treatment, and all the doctor consults; I think that she's right? I just smiled and gave her my best "I love you" look. I can say that I know that I'm tired of all the appointments, the drugs, and the wondering what's next. How couldn't Lulu be getting to the end of her patience with all that has come with the cancer? But you move forward looking and praying that tomorrow brings better news.

The logistics of the "weekend of antibiotics" was crazy to say the least. Lulu and I brain stormed on how to get Lulu back to Reno on Monday after she finishes the antibiotics? Together after looking for one way flights to Reno, we decided on asking my sister Lori, which was in Reno at our request to celebrate her 50th birthday (so much for that), to drive down to San Francisco with our Toyota minivan, and then I would turn around and drive her back up to Reno. Of course, this would mean she would be in the car for 8 or 9 hours, now that's brother-sisterly love. We left for the return drive for Reno sometime around 7 PM, and for a Saturday night, I'm not sure that there could be more traffic trying to get over the bridge? I was worried for Lulu, and didn't want to leave her there alone, but I knew that I planning on returning on Sunday to be with her. What could go wrong in one day?

My sister and I returned home to Reno around 12 midnight, after almost running out of gas on the way into town. After, dropping my sister off at the Sands hotel to her husband and friends, I zoomed home, because I was so excited to get to sleep so I could be awaken by the kids in the morning. Sunday didn't go as planned. I had planned on leaving the house by 9 AM to get back to Lulu, but unfortunately the doctors didn't get to Lulu until 11 AM, and Lulu had thought that she might be released today? By the time I found out that Lulu indeed had to say until Monday, it was too late in the day for me to drive the 4 plus hours and stay with my wife for the day, so I had the pleasure of spending the day with my beautiful children. I was feeling sad for Lulu, but excited to be there sharing the day with my kids.

On the personal side, I have been working hard on my fitness, diet, and attitude. This next Sunday I'm participating in my second triathlon of the year . This one will be taking place in Sacramento (the first one was in Tahoe), and I'm hoping that it will be better then the first one last month? (in my first one my bicycle chain broke halfway through the 22 mile biking portion of the race). It's hard to explain the enjoyment of swimming a half mile, riding a bicycle for 15 miles, and then run a 5K before your legs give out. I love training daily, weekly, and monthly for the big day. I look forward to the training as a way to both relieve my stress, but also to concentrate on something different then my wife's cancer. Whether I'm swimming in the pool, riding the mountains around Reno, or running through the woods I really have found something that I'm very motivated by. I don't think that I've ever worked as hard on my health and fitness as I have these last 3 months? I'm in the best shape of my life, and getting better. I really can't wait until I get to put all the training to the test this weekend. I'll keep you posted on this one!

I have a new book on my reading list, and have already downloaded it to the Kindle App on my iPhone. The title is "Leadership and Self Deception". I have ordered multiple copies so the team at the office can partake in the learning that is contained within this book. I have read this years ago, and took away some very helpful tools for improving myself, but I feel that there is more within these pages for me? To improve my being, to build better relationships around me, and to most importantly help me be a improved person. This is a short, wonderfully helpful book, and I really think a must read for all.

Another unscheduled trip to San Francisco

Today I'm thinking about...
The limited time we all have in this life
How great my first 44 years have been
Lucky to be married to this woman
How great my health is

Well what can I say? Here I sit next to my lovely, strong wife in a hospital room wondering what is next? There's an IV sticking out of Lulu's arm where she is getting strong antibiotics to combat the infection that recently started in her breast and seems to be trying to escape to other places. The doctors were concerned enough about the extent of the infection to recommend that Lulu gets admitted for two or three days for intravenous antibiotic drug treatment. When we drove down to UCSF this Friday morning after the surgeon examined a recent iPhone photo of Lulu's breast, we didn't expect her to be spending the first three days of October in a hospital bed.

I have seen my wife go through more in this last 14 months then most people live through in an entire lifetime. I've seen her strong, determined, and confident dealing with the daily life of a Stage III breast cancer patient, but today the foundation is cracking and the tower is falling. It's heartbreaking to see her struggle with these new circumstances. This is truly the first time I've really seen Lulu battered by the disease. How can anybody know what she's internally dealing with?

After sitting for what seemed like hours waiting for the surgeon (which we were notified he was in surgery since 7 in the morning), we conferred with the nurse and then the plastic surgeon about Lulu's breast infection, her feeling sick, and the discharge from her healing incision. After a week taking two oral antibiotics the cellulitis in her right breast (and arm now); it isn't improving, and if the infection persists much longer the implant that was just placed three ago could be lost? That's all Lulu and I needed to hear, we wanted to tackle this with he most aggressive therapy possible. The next thing we knew Lulu was assigned a room on the fourth floor of the hospital, getting an IV by a newbie nurse and some unpronounceable antibiotics names pumping through the tubes.

We'll make the best of the situation, and Lulu will fight the infection with all her faith and determination she can.