The Decision

I was hoping to report on the quiet day.  I was hoping to explain that J's blood counts have all improved and that he is no longer neutropenic.  I had hoped to explain that they lifted the silly restriction requiring everyone to wear a gown, mask (with eye protection), and gloves because J tested positive for rhinovirus, or the common cold.  I was hoping to explain what TPN was and how it looks like they pump milk straight into the veins.  While all those things are true, the surgeons came.  Surgery is recommended.  It's happening today.


Right now Mom and I are sitting on the couch in J's room.  She's reading a book.  I'm typing on my computer.  We are waiting for the report from the surgeon.  It's almost 2:00 and I just ate for the first time today.

What are the possibilities from this surgery?  They may go in and find the abscess and clean it out as best they can and not find the suspected bowel injury.  That would be great news (keep reading).  They may find that the bowel is inflamed by being so close to the abscess, and possibly find the leak related to that.  They may find one of the serious complications of being neutropenic, called typhlitis.  This is an inflammatory process in the cecum, which is the first part of the large intestines, and the part that the appendix arises from.  This would need to be cut out.  If they had to cut out a section of bowel, they would not reconnect the ends, but rather they would bring one end to the skin surface and he would poop into a bag (sorry for the description, but that's quite tame, really). We would have to let things calm down for a while before they would reconnect him.  I personally don't think he's sick enough to have typhlitis and his CT scan looked fine.  Hoping he doesn't need bowel resected.

The oncologist made a statement that was reassuring, as I'm not super excited to send him to surgery today.  He said that J will become neutropenic again with every cycle of chemotherapy and it is better to do something more definitive now (surgery) than to hope for the best with conservative management because he is at such a high risk of having additional problems in the future if we don't take care of it now.

I"ll update later to give the results.