Author: Dan Tran

The Waiting Game #goheavy

by Dan Tran

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The days following the surgery consisted of getting fit for my back brace, physical and occupational therapy, and a barrage of doctors and nurses constantly in and out of my room to check on recovery, administer medication, and start planning for next steps. Not only was I recovering from major spine surgery, but I also needed to get started with oncology.

The radiation oncologist arrived the day after the surgery to discuss the plan to take care of the lesions in my spine that the neurosurgeon wasn’t able to get out during surgery. Although the wound needed to heal from the surgery, we wanted to get started with radiation right away to prevent any further growth in the spine. We planned to start the radiation treatments 2 weeks after surgery, however, preparations would be done while I was still in the hospital for recovery.

The medical oncologist also came by to check on me. We knew the tumor was metastatic, but we still were not sure of the source. We could only assume lung because that was where the only other mass was found, but preliminary results were not expected until 2-3 days after surgery. When we finally received the results, they were very vague and actually caused more confusion than clarity. The preliminary results still were unable to confirm the cancer source, but also indicated that a possible gastric source could not be ruled out. Even though the CT scans showed no growths in the GI tract, the medical oncologist ordered a colonoscopy and endoscopy just to be sure everything was clear. I was thrilled. I expected to be discharged on Friday and hoped these new tests didn’t extend my stay in the hospital.

The scopes were scheduled for Friday morning at 11am, which I wasn’t told until 5:50pm Thursday night. I had to be NPO (i.e. nothing by mouth – no food) starting at 6pm and I had not planned accordingly. I was looking forward to warm cookies from Insomnia that evening, but those would have to be put on the back burner in exchange for a lovely clear liquid diet and a 2 gallon container of golytely that I needed to consume by the next morning to clear out my GI tract. They should call it goheavy rather than golytely. If you have not had the pleasure of trying golytely, it tastes like seawater. I finished half the container Thursday night and woke up Friday morning to complete the torture. I finished at 9:20am, proud of myself for getting through it without vomiting and ready for the procedure.

The nurse came in to tell me that my procedure was pushed back to 1:30pm because I did not finish the golytely 2 hours prior to the scheduled start time. I was never told about the 2 hour protocol and I was not happy. Hungry and ready to go home, I was frustrated that I had to wait for an extra 2.5 hours. The scopes came and went, confirming what the CT scan had previously shown; the GI tract was clear.

I was finally discharged Friday evening (see picture above), just in time to spend Christmas at home. Final results for pathology were not expected for at least another week.

In Patient’s Clothing #spinesurgery

by Dan Tran

The day after I was admitted to the hospital, they took MRIs on the rest of my spine to see if there was anything else we should be worried about.  I hadn’t been able to lay down flat for the past month without having excruciating pain.  Unfortunately for me, MRIs require you to lay down flat and not move for about a couple of hours depending on how many pictures they needed.  They had administered some IV pain mediations for me, which I thought would make the experience better. I think they overdid it a little bit because I started to feel nauseous during the whole procedure.  I had to request Zofran in between the scans, which helped a little, but imagine being hot, nauseous, and in pain stuck in a metal tube.  After two grueling hours of being in and out of the MRI, I was finally done. The scans on the rest of the spine and brain came back clear; the first good news we’d received since entering the hospital.

I was on a cocktail of various medications of steroids to help with the swelling and opioids to manage the pain, but for the first time in over 6 weeks I was starting to feel a little better physically. With the swelling and my pain under control, the neurosurgeon and I decided to have the surgery Monday to ensure the best team was in to perform the operation. The neurosurgeon pushed his other cases scheduled for that day so that I could be the first of the day at 7:30am.

The procedure took nearly 4 hours to complete and I lost 1.2 liters of blood, but the neurosurgeon was able to remove the tumor that was compressing T11. He fused together my spine from T10 to T12 to replace the support that was previously being provided by the tumor. I was sent back up to my room for recovery while the tumor had been sent off to pathology for testing. A frozen section confirmed the tumor was metastatic. All we could do now was wait for the final pathology results to confirm the source of the cancer.