The Meetings

Our beautiful boy, watching TV, waiting for surgery.

Nate was taken back for surgery at 11:30am.  He was not able to have anything to eat or drink from midnight last night on...so, none of us had breakfast this morning.  Needless to say, we were all getting a little cranky as the time was wearing on.  We just got our first update at 2pm and they said that Nate is doing well.  The resection is under way and the doctor got started at 12:35pm.

On Wednesday, we had our meeting with the surgeon and one of the doctors from the Neuroblastoma team here at MSKCC.  Nate was being a crazy goof while we met with both doctors, but we wouldn't want it any other way.  They surgeon sat down and looked at Nate's CT scans and reviewed his history with us.  He said on a 1-10 scale of difficulty for the Neuroblastoma that he sees here (he sees some of the most challenging cases in the country), Nate is about a 2.  He said he gave it this difficulty rating only because he has to shave off part of Nate's liver and there is a risk of bleeding.  He also talked about making sure there is no part of his adrenal gland (where the tumor originated) left.  If there is, he will remove it.  The surgeon also said that he will look at all of Nate's lymph nodes in the area and if any of them look diseased (apparently, they look different), he will remove those also.

We were given the low down on what to expect after surgery.  Most of which we already knew, because Nate has been through this once before.  Basically, he may come out of the OR on a breathing tube and ventilator.  If this is the case he will have to go the the PICU (pediatric ICU), which is across the street at New York Presbyterian Hospital.  If he is able to come out of the OR breathing on his own (which he was, after his first surgery), he will stay here at MSKCC.  We are REALLY hoping and praying for him to come off the ventilator in the OR.  It's very normal and expected if he still needs the breathing tube, but I am not looking forward to seeing my baby sedated on a breathing machine.  Nate is our champ and we think he can do it!  He will have a chest tube to drain fluids, another (temporary) central line and an arterial line (which he pulled out the last time!).  We really don't know how soon Nate will get to come home.  It all depends on him and his ability to heal.  He did really well last time, so we are hoping for the best.  Most likely it will be anywhere from 5 to 10 days (we were told 7 to 10 by the surgeon, but have been told as short as 5 by the oncologists).  We just have to wait and see.

Chris and I both came out of the meeting with the surgeon with the impression that he didn't understand why we were here...why we had traveled across the country to have this "2 difficulty" tumor removed.  Strangely, this makes me feel good.  We know exactly why we are here.  We are here because Nate is our son and we would do anything for him.  Nate was lucky enough to have most of this tumor removed already in Phoenix, but the key word is MOST.  We want to make sure that ALL of the tumor is removed this time and who better to do that than the best Neuroblastoma surgeon in the nation (maybe the world).  No one in Phoenix ever said anything about Nate's lymph nodes.  The surgeon here is very thorough and that is what Nate needs.  Studies have shown that surgically removing the tumor, all of the tumor, is an important component to curing Neuroblastoma patients.  We have worked hard and are fortunate enough, with the help of so many awesome people and great organizations, to be able to bring Nate here...that is why we are here.

One other bit of information we got from the surgeon, was about the "spillage" that Nate experienced when his tumor ruptured as he jumped on our ottoman.  I off-handedly mentioned this to the surgeon as we were talking about Nate's history and he said that they have found in Neuroblastoma that "spillage" does not matter.  In some tumors, it is an issue, but not in Neuroblastoma.  This was awesome news to me.  Not that it makes a ton of difference, but when they kept talking about spillage at the beginning, my mom brain was running wild with mind pictures of nasty little cancer cells running wild on his insides.  I kept wishing we could have some how found this tumor, fairly early like we did, without the rupture.  All coulda, shoulda, woulda...but still puts my mind at ease a bit, and I'll take all I can get at this point.

We then met with one of the oncologists on the Neuroblastoma team to discuss Nate's 6th round of chemo and the antibody therapy they do here, versus the one they do at PCH.  It is still up in the air as to if Nate will receive his 6th round of chemo here in NY or at home.  It will all depend on how long it takes him to recover from surgery.  We will make the decision as the days go on.  If he is able to come home quickly, he will do the 6th round at home.  If his recovery here in NY is extended, he will probably receive the 6th round here.  Chris and I will make the decision in the next few days.  I drilled the oncologist pretty good about the antibody treatment and we got all of our questions answered.  I will explain more about it, once we have made some decisions as it gets closer.  It was just nice to talk to a doctor here, face to face, and get the information we need to make decisions for Nate's care.  We will drill the oncologists in Phoenix and make some decisions...we know which way we are leaning right now, so that feels good.

I'm typing this as we wait for Nate to get out of surgery.  We went to lunch with some great friends and have had some good distractions.  Chris is mastering Angry Birds.  I think I'm going to make a game called Angry Moms (and Dads), where we can launch bombs at cancer...in real life.  Well, I guess that's what we are all doing every day.  Surgery, chemo, radiation, etc.  These are the only bombs we have right now.  I just wish our babies weren't standing in the way.