Hello and thanks for checking in and caring about Lee.
THE START Lee had been not feeling well for awhile, with a greatly diminished appetite and severe weight loss. On Wednesday, 04.21, she started having intense abdominal pain, nausea, and vomiting. On Thursday, 04.22, she went to the ER at Eastside Medical in Snellville. After a 10 hour wait, she was seen and admitted to room 441. Over the next few days, she had a CT scan, an MRI, a full bone scan, and an abdominal X-ray.
Owing largely to the very pleasant staff and accommodations at Eastside Medical Center, and to the constant presence of loved ones afforded by Eastside's unusually generous visitation policy (one-at-a-time, but 24/7), Lee has been in generally good spirits. Various pain and nausea meds, as well as IV nutrition (since she can't eat nor drink properly), have also kept her fairly comfortable for much of the stay.
Superhero Radiation Oncologist and dear family friend, Dr. Adam Nowlan, upon hearing of these troubles, stepped in and has been a tremendous help as a liaison between the family and the doctors. (He has done this while on his anniversary vacation, which means we're also grateful to his wife.)
THE INITIAL FINDINGS • Lee has a 10 cm, almost certainly malignant mass on her left kidney. The mass is putting pressure on the stomach. It's also very near, but not IN, the vena cava (a major vein) — being near increases surgical difficulty and danger, but being in would be much worse. This mass appears to be rather advanced and may have involvement with nearby lymph nodes. It needs to come out, and the kidney with it. • She also has a 2.5 cm mass in the small intestine. This was originally thought to be an almost certainly malignant tumor, but it has since been decided that it's probably a benign growth called a Meckel's Diverticulum. Still, this is causing problems in her bowels, and needs to come out. • Her overall kidney function is good, and the other kidney appears to be clear, so she should be okay with just her right kidney. • For a variety of reasons, biopsies cannot be done until they are removed. Endoscopy is also prohibited, because of how far down the small intestines the bowel mass is. • No initial indication that the kidney cancer is metastatic (spreading). That's very good, as metastasis decreases odds of survival.
THE EARLY PLAN Build up her strength via the IV nutrition for about 3 weeks, at which time she would be transferred to Northside in Gwinnett, where both issues would be handled in a single surgery. The surgery requires 4 surgeons, and a facility with trauma capabilities.
THE CURVEBALLS After almost a week in the hospital, Lee's abdominal pain, nausea, and vomiting returned, more brutal than before. For about 2 days and nights, no relief could be found. This caused the surgeons to consider switching to a less-than-ideal 2 surgery plan: an immediate bowel surgery, and a later kidney surgery. However, it was finally determined that the growth in her small intestine was causing an almost total bowel obstruction, and that this was the cause of her symptoms. A tube was installed through her nose, to continuously pump out the fluids that accumulate above the blockage, and this brought instant relief!
On Thursday, 04.29, during further review of her scans by the tumor board, something new was noticed: an unknown 15 mm hyper-density on the pancreas.
THE NEW PLAN UPDATE: Surgery is planned for Monday morning, May 3rd at Eastside Medical Center for the bowel obstruction, which is the most pressing issue. Then Lee will have time to recover from surgery and build up her strength eating real food while the doctors figure out the best way to address the other issues.
After a recovery period, she will likey have the other surgery at Northside in Gwinnett, ASAP. A biopsy of the pancreatic abnormality will be done by a gastroenterologist, there. What the abnormality turns out to be, and whether or not it represents a spreading of the kidney cancer, will inform the way forward. Unless the biopsy causes a course change, the surgery for the kidney will then happen at Northside.
And that's where we are, at the moment. As you'd imagine, this has all been very rough for Lee. But, though her body's been battered and weakened, her spirit has shown great strength. Your concern for her means a lot to her, and to the rest of us, and your prayers for her are solicited.
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