Cancer Survivors Network

Hi Kim,

This is really GREAT NEWS!!! It sounds like your Dad is on his way to surgery, as far as
the old lung surgery if he can pass the breathing test pre op and its not mets then it should be no problem. Al had some scaring on one of his lungs from an old pneumonia that he had and it wasn't a problem.

His meeting with the surgeon should go just fine.

Good Luck & God Bless
Kath

Shelly, Donna, Lori and Kath,

thanks so much for your support & comments! Tomorrow is the day I leave to go back to Duke and 11/11 (Wed) is the day we meet with the surgeon to see if/when my dad is a candidate for surgery (& what kind--Minimally invasive vs open). thanks for the prayers---it seems we on this site could always use more....something always coming up.

I need to make sure I have my Big Girl Panties on -- it will be a challenging day..any tips?
Kim

Hi Kim -

Remember the first rule for wearing the "Big Girl Panties"--is one "hole" at a time. You can't jump in with both feet and remain "standing". And it goes without saying the best way to "stand" is "on your knees". God can make a way when there seems to be no way. As we both know, the hardest prayer to pray is, "Not my will, but thine, be done". We're almost afraid to pray that prayer because it could result in an answer we had not wanted to consider. An answer may come up that is not on our "wish list". Like I said, we know ultimately our destination is Heaven, but we don't necessarily want to catch the next busload!

Now, we could send your Dad a pair of Big Boy Underwear but we aren't supposed to know he's in there, are we? Well, we can pray silently and only God will hear us. There's no extra charge for "long distance" and He's online 24/7.

As for tips, based on hindsight, I would consider the following:

• Some tips would be--if the surgeon would allow a tape recorder, I would take one. You would be able to concentrate on what he's saying without bothering to write it down. But there may be a problem. My first local Thoracic surgeon preferred I "not" tape him. When we were having a consultation, Loretta asked if she could tape the conversation. He said, "I'd rather not. Have you ever heard one of those things in "COURT"? I had to respect that, but I never thought about suing. He was so generous with his explanations that we couldn't have sued him for "lack of information" because he laid it all on the line. We told him we wanted to hear "the good, the bad and the ugly". We didn't like what we were hearing, but so often the "truth does hurt". He told us so much that a lot of it didn't sink in until I had already had the operation!

I just know that sometimes I would think he said one thing, and Loretta would say, "No, he said....." So we thought the best thing to do was just tape it. It is always a good idea to have someone along, and you will be that "someone", to ask questions that your Dad may not remember to ask. And you will, of course, write down the answer too. Then after the doctor leaves the room, the three of you will be on the same page because you will have the answers written down.

If surgery becomes a possibility, and it may well be, by the sounds of the results, you will naturally ask questions such as these, but not necessarily in the order that they come to me. Now we're "assuming" that your Dad absolutely has "ruled out a second opinion" and prefers only DUKE.

Naturally, the first thing I would want to know is the doctor's opinion of the correct Stage of your Dad's cancer. Was your Dad a Stage IV inoperable to begin with? If so, has the chemo done its work to the point that Dad's cancer has been "restaged to a lower number"? If so, what is the number?

• The time to ask about types of surgery if it is in the realm of possibility, would best be discussed at the very first of the consultations. That way, if you wanted to explore the possibility of another surgeon that performed a different way of operating, you could get a second opinion. Naturally, you would have had scans by that time also, so you could take that info to the next surgeon, if your Dad were seeking a second opinion.

• However, your Dad and Mom are quite independent and have not asked for your advice, so much so that you were really on the "outside looking in", instead of the other way around, if I understand correctly. There's a delicate balance regarding privacy when it comes to family members. You're really close to your Dad, but even when you know that he would benefit by your advice, you're not always free to give it. I know "you're not in charge", but if you were, you might have more of a natural opening when you meet with the doctor.

• But remember this, you should prayerfully consider what the doctor is recommending. Your Dad has the final say on whether or not he wants to go along with the "planned treatments or surgery". Some people never open their mouths, and take the doctor's advice as gospel. Ronald Reagan's advice would come in handy here, "TRUST BUT VERIFY".

• I would ask if it would be possible for you to speak with some of his former patients and see how they fared after this or that type of surgery. Dr. Luketich's office called me last Thursday and asked if I would be willing to talk with one of their upcoming patients. We said, "Most assuredly". So at the request of the patient, we called her. After our conversation, we received a lovely e-mail from her, thanking us for being so open and willing to answer them in a meaningful way. She said she would sleep a lot better that night. Kim, I know you would feel better if you knew this doctor had a long list of "satisfied customers" with great stories of recovery. So if your Dad doesn't want to go elsewhere, I would think he would benefit by talking to some others who know of this doctor and his level of expertise.

• What complications, if any, do most of his patients have after surgery?

• After surgery, during the "swallow test", if there should be a leak, what could you do to remedy that?

• I would "always" have a second opinion, if my insurance or personal finances would allow it, even if you decided to go with the first surgeon that discovered the cancer.

• Then of course, if the operation is a "go", there will be an optimum time for it to take place, probably not more than 3 weeks since the last treatments.

• Depending on the type of surgery, and remember we're assuming, an operation would be a possibility, you will want to know the approximate length of operating time. (That's assuming all goes without a hitch!"

• How long in ICU?

• Is a feeding tube insertion during the operation "standard operating procedure"?

• Length of days in ICU, length of days in the hospital.

• How soon does he conduct a swallow test? What does he do about leaks into the chest cavity if and when they occur?

• And by now you've learned that "dilations" OR "Dilatations" are normal to keep the opening pliable where sutures have been placed. So ask the doctor how often your Dad should need one. Also who would be performing that outpatient procedure and where, if needed.

• How often will he be needing to return for checkups and at what intervals?

• Will there be a home health nurse assigned to your Dad should he return home and not stay around the hospital for at least a couple of weeks? If anything is going to go wrong, Dr. Luketich said, it usually occurred within that time frame.

• You will, of course, ask about other health conditions that you know your Dad has and how they will figure into his operation and recovery.

• If the scans show no lymph nodes affected, will Dad still be having any type of post-op maintenance chemo administered? If so, what will it be and on what time schedule?

• Where will your Dad's follow-up Oncology checkups be scheduled and when?

I went to my local oncologist every month in the beginning, then gradually visits were spaced out until now I go twice yearly. I will be going to him as long as I live or until Congress passes the "Government-Run-National One-Size Fits All" and "One multi-purpose pill dispensary" comes on line. Then by means of their "Comparative Effective Research" analysis, my age will have "cancelled out the effectiveness of any drug that might have helped me specifically". At a certain point, the type of treatment that fits most people, will be mandated for me, whether or not it is tailored specifically for me. And then my age will play into it. And like I have said in other postings, I am fast approaching the "average age of death here in the Commonwealth of Virginia".

The government "research" will mandate how much treatment I can receive according to my age! The doctor will "not" have the final choice, it will be on a "list" of approved treatments. The cost of the treatment and/or drug based on the number of days I will have left to live to "contribute something of worth to society" will figure into the equation. And remember, President Obama said, when we are older, he would think that we would consider opting for a pain pill as opposed to having an operation.

• Lastly, there will be another list of questions if an operation is not feasible. BUT WAIT, REMEMBER WE'RE NOT THERE. BUT JUST IN CASE THAT IS A POSSIBILITY--In that case, what level of care does he provide his patients? What "palliative" procedures does he follow when an operation is not possible? But cross that bridge when you get there. Today, you're "here". Continue to think positive and keep hope alive!

Kim, I'm sure more things will come to mind, once I post this. Just know that we have been praying for you and your Dad and Mom. God has been "gifting" us with a lot of "survivors" recently. And God knows, all of us want to survive with quality of life.

William W. Marshall
AKA "William66"
Virginia Beach, VA 23464

P.S. Regarding the Government-run Health Care Plan --

Here's an interest Investors' Business Daily Report dated Sep. 16, '09, in which it states " 45% Of Doctors Would Consider Quitting If Congress Passes Health Care Overhaul ."

This article states, " Two of every three practicing physicians oppose the medical overhaul plan under consideration in Washington, and hundreds of thousands would think about shutting down their practices or retiring early if it were adopted, a new IBD/TIPP Poll has found. The poll contradicts the claims of not only the White House, but also doctors’ own lobby — the powerful American Medical Association — both of which suggest the medical profession is behind the proposed overhaul. It also calls into question whether an overhaul is even doable; 72% of the doctors polled disagree with the administration’s claim that the government can cover 47 million more people with better-quality care at lower cost...."

The link is here if you want to read more Kim. --

http://www.investors.com/NewsAndAnalysis/Article.aspx?id=506199

Hi Kim,

I'm so glad you all got the great news!!! I'm so happy for and your parents. What a relief to hear things are working!! I'll be thinking and praying for you all while meeting with the surgeon!!

Erika