I apologize to all of you for not writing sooner - I have some very bad news. The cancer has returned, and it has spread. I needed a couple of days to be able to handle telling all of you, as this has been a mighty blow to us, and, also, Butch has been very ill, fighting an infection. We arrived Tuesday night, for our Wednesday post surgery appointment. At that appointment, his blood work seemed OK - white count normal, liver and kidney readings in pretty good shape. BUT, before we left - starting on Sunday, I noticed a bad odor coming from the area where the wound vac, and the j-pouch was. I asked the home health nurse about it, and she said she didn't think it was infected, but the odor got worse. I kept an eye on his temperature, and it went up a couple of times, but for the most part stayed around 98.1 (normal for Butch). The liver doctor who we saw in town refused to see us to check on the j-pouch (what we hired him on for, and discussed in great detail - would he attend to aftercare!), so we came to Pittsburgh. He got noticeably weaker by Wednesday, confused and hallucinating a bit. When I called, Dr. Gamblin scheduled him for a CT scan and blood work before his appointment. At the appointment, He thought the wound looked good, and took him off the wound vac. The blood work came back normal at that time, as I mentioned earlier. He cleaned out the j-pouch, and scheduled him for a procedure to aspirate a pocket of fluid he saw in the abdomen near the j-pouch, but not being drained by it. He said it was their intention to put a permanent catheter in Butch, in addition to the j-pouch. It turns out that when they drained the area, it was small, and they got it all, so they didn't need the catheter (Thank the Lord). He thought maybe the confusion, odor, etc. was caused by an infection, even though the blood work didn't show it at that time. In addition, he told us (on Wednesday) that the scan showed 3 "shadows" on the portion of the liver that remained after the resection. He showed us the scan, and the liver which has rejuvenated nicely, but those shadows were there. he said that the radiologist's report would be back Thursday and we would discuss it then. When the procedure was done - on Friday - that Doctor found some ascites (fluid in the abdomen), and his white count was up (means an infection) and he is on a course of antibiotics - one of those "broad-spectrum" types (ampicillan) - by IV drip, and has been admitted to the hospital (the procedure that he had Friday was as an outpatient) since Friday. They have run many tests, and this morning his blood work is back to normal. Dr. Gamblin wants to keep him another day, then they will give me a prescription for pills to continue the antibiotic at home, and we will return to Endicott. I am not sure which day - tomorrow or Tuesday. I need to evaluate the situation tomorrow. As for the scan, the Doctor said the cancer has spread beyond the liver to many places.
In spite of all the bad news, we have not given up hope. Butch was scheduled to begin chemo on Friday, and that will not be possible - he is too weak. So, we will have to talk to our Doctor's there, and they will consult with the Pittsburgh Doctors, to develop a plan for Butch's future treatment. He is not in a lot of pain, and is resting comfortable right now. He has lost so much weight, the Doctor discussed TNP (Total Perinatal (??) Nutrition) with us - a feeding tube, but - Butch said no. For the moment, my goal is to get him home safely, to Endicott, Beyond that, we can decide once we are home, and he has a chance to regroup. I would ask all of you to pray for Butch. My prayer is that God perform a miracle for his faithful servant. If that is not God's will, however, for whatever reasons we humans cannot fathom, I pray that he protect him from further suffering.