Journal

Journal entry by Joan Stromberg

Hey Everyone! 

First of all, thank you all for your prayers for Bob and for our family. It has been quite a roller coaster ride the last two weeks. Bob had his first colonoscopy June 26 and was found to have a large tumor in his rectum. Biopsy showed that the tumor was cancerous. Further tests showed that the tumor was most likely stage one or two, so that if it was removed, chemo, at this point, is not indicated. 

Bob goes into surgery at 12:30 tomorrow, July 17th, which is also our youngest son, Tommy's 10th birthday and the 8th anniversary of my mother's death. He will be at Baptist East and Dr. Allen is his surgeon. She is very highly regarded in this field, so we are very hopeful of a good outcome.

One of the reasons this came as such a surprise is that Bob has no risk factors for cancer...colon or otherwise. There is no family history, we eat well, grow many of our own vegetables, eat homecooked meals from locally raised meat. He exercises regularly, is not at all overweight, and is moderate in all ways. 

Still, the ways of the Lord are not our ways and his plans are not our plans. We are all very grateful that the cancer was caught in time to hopefully cure through surgery, as painful and uncomfortable it may be. 

Please continue to keep us in your prayers. I can feel the grace they have brought us every moment of every day. They lift our spirits and draw us together as family in the Body of Christ. 

I have to say a word of absolute gratitude to the children God has blessed us with. From Joe and Elise who have put their moving plans on hold to little Tommy who was unfazed that his birthday celebration would have to wait. The generous actions of Mary who made dinners for the week to Maggie and Theresa filling in the gaps of running kids around and making sure they get where they need to be. All the girls, including Elizabeth, now in Atlanta, stepping up to fulfill my obligations with Little Flowers Camps, is also such a blessing and relief.

Surgery is scheduled at 12:30 tomorrow, July 17 at Baptist East. It is expected to last 5 hours. It will be done in three phases: removal of the tumor and surrounding section, a resection, an a temporary ileostomy until the resection heals. After 6 weeks or so, the ileostomy will be reversed in another surgery. 

Thank you again for your prayers! God bless you all.
Joan
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Journal entry by Mary Stromberg

Dad just finished surgery and it went really well. They were able to do the procedure laproscopically so recovery should be easier. The doctor said the fact that he's thin worked to their advantage. He's in recovery now and we won't be able to see him for two or three hours but the doctor will check back with him tomorrow.

Thank you for all your prayers and continued support.

Journal entry by Mary Stromberg

I was able to visit with my dad for a little while after his surgery. He was still groggy from anaesthesia and really just wanted to go back to sleep, but the doctor is hoping he can get up and walk around tonight sometime. 

Dad says it's hard to talk because they had to cut through his abs and it feels like he did a whole lot of sit ups. But the goal is to restrengthen his core so he can get back to normal activities in a few weeks. 

My mom will be staying with him most of the time and will post updates here as they become available.

Thanks again for your prayers and support.

Journal entry by Joan Stromberg

Thank you so much for all your prayers! 
Bob is doing very well today. He was up walking even before I got there at 9 this morning. He was sitting up in a chair and talking to a volunteer named Joan! His color was good and he was very communicative and his pain level was low. They actually only have him on extra strength tylenol for the pain. 

All the nurses and doctors agree that he is an "over-achiever" when it comes to recovery, and he is doing very well. He walked around quite a bit today. We'll practice changing the temporary ileostomy tomorrow. He will most likely come home and have home health care for a couple of weeks on Friday.

The kids were able to visit today. Mary brought Mark, Cecelia and Thomas for a couple of hours this afternoon and we played Apples to Apples for a bit and then the younger kids left and Bob napped until Maggie, Theresa visited with Joe and Mick expecting to visit later this evening.

Our battles for the future include keeping infection at bay, resting and recovering and dealing with the temporary ileostomy. Thanks for your continued prayers!

Journal entry by Joan Stromberg

So, Dr. Allen, Bob's surgeon, came in about 1:45 pm this afternoon and said, "So, you ready to go home?"

Bob had been doing so well, thanks to your prayers and sacrifices, that he was able to come home 48 hours after surgery. He did so well during the hospital stay that all the nurses, aids, specialists, doctors, etc., thought that he would do fine at home.

He will have Home Health services for several weeks to help us change his ostomy sack and monitor his incisions, but overall, we are very confident that his recovery will be swift. Since Bob really had no risk factors and was in such great general health before this cancer diagnosis, this worked so much in his favor. 

Yet, I believe, more importantly, it was the prayers of the faithful, as well as the intercessory prayers of the saints, that made the largest contribution to Bob's recovery. His faith and his acceptance to the Will of God was such an inspiration to everyone who came in contact with him.

In addition, the children have been so absolutely outstanding. Mary making dinners for us, driving kids around, Joe and Maggie picking up the slack at the office, Theresa driving in the kids to visit their dad, and all of them going to Mass, adoration or just extra prayers and sacrifices for their dad. 

There will still be obstacles in front of us, but I know that through your prayers, they will be moments filled with grace. 

God bless,
Joan

Journal entry by Joan Stromberg

Bob's ileostomy got clogged yesterday, making him feel bloated and uncomfortable. He was able to clear it, but then spent a very uncomfortable night with stomach spasms, frequent emptying of the ileostomy and general discomfort. He looked very pale and fatigued this morning and the surgeon recommended immodium to slow down his system and avoid dehydration. He napped and seemed a bit better. He's walked a lot today and looks good, but he is keeping a journal of his foods in order to see if some are more likely to cause the stomach spasms and liquid discharge than others.

Fortunately, the ileostomy is temporary. They tell us that just as he is getting adjusted to it, it will be time to reverse it. I don't think Bob will be sad to see it go! Home health comes in today to help change the ostomy and evaluate Bob's recovery. Again, thanks for the prayers!

Journal entry by Joan Stromberg

Bob is the contributor for this update:

The initial surgery (July 17) went extremely well as the doctor was able to do everything laparoscopically.  I was out of hospital in 2 days and recovering quickly.  I have been doing a lot of walking and feeling great.
 
Then I got my pathology report from biopsy of the section removed and it is not so good.  I have a rare (for colon/rectum) fast growing type cancer called a neuroendocrine tumor (NET).  They found traces in 3/14 lymph nodes so I will need to go through chemo and possibly radiation.  Because it is fast growing, they rarely find it before Stage 4.  The good new is that mine is only Stage 3.  They cannot start treatment until my initial surgery heals (possibly another 5 weeks).  Rather than remove the ileostomy and wait another 3 weeks for recovery, they will likely start treatment first and remove the ostomy after treatment ends (maybe 6 months long).
 
Locally, there are only two doctors who have treated NET cancers but are not specialist.  Joan did some research and found that there is well regarded cancer research institute at the U of Ky about 80 miles away.  The Markley Cancer Center has twelve doctors that specialize and work only on NET cancer.  Today, I requested my doctor to submit a referral for me and hope to hear back from them early next week.
 
So keep praying.  The road to recovery is there, but will take a while.

Journal entry by Joan Stromberg

Bob currently has a busy doctor schedule.  This week he met with the Radiation and Hematology doctors.  Their proposal is six months of chemo with two days of continuous infusion every other week.  They also recommend six weeks of radiation 5-days per week concurrent with the chemo to treat the immediate area around where the tumor was removed.  The biopsy report listed the tumor as MIXED ADENONEUROENDOCRINE CARCINOMA (MANEC). We asked the doctor today if that was a hybrid or two distinct cancers. He said they are distinct - one is the very common Adeno Carcinoma and the other is a rare neuroendocrine tumor (NET).  The proposed treatment is intended to eliminate both types of cancer.  He has a 3-week follow up visit with the Rectal Surgen tomorrow to review his recovery.  Next week, he goes in for a PET scan on Wednesday, August 8 and an initial consultation with the University of Kentucky Markey Cancer Center on Friday, August 10 to review his case.  They are a premier Cancer Research Institute that have 12 specialist in NET cancer.  After meeting with them, we will decide how to proceed.  The local doctor was pleased that we are getting a second opinion from the Markey center and would like to work with them in the administration of treatment or as a minimum, learn from their recommendation.  The following week, he is scheduled to have a port implanted for the chemo administration and follow up visits with the Radiation and Hematology doctors to finalize treatment plans.

Bob continues to heal very well from the surgery. He walks 3-5 miles a day and is dealing with the ostomy well. It looks like the ostomy won't be able to be reversed until after all his treatments...in 6-7 months. He has found, though, that as the chemo and radiology allows, he can do pretty much anything with the ostomy, including swim, which he hopes to begin again soon. The home health nurse, all the nurses and doctors we have visited are so amazed at how healthy he is and what a low, strong heartbeat he has (47-55 bpm is typical). They all say that his healthy habits will help him beat this cancer. He's always been an overachiever, so I'm sure that is so.

We are all doing well. I've handed over most of my commitments to younger moms and others willing and able to take over those programs so I can be there for Bob during his treatments. The adult kids and the younger kids are all stepping up and picking up slack and helping to make sure things run smoothly. It was such a blessing to have both Elizabeth and Bob's sister, Lisa, to come and help last weekend. They were both such help and such a joy!

Your prayers are most especially helpful in lifting us up and carrying us through this trial. Thank you all so much!!

Journal entry by Bob Stromberg

I met with my rectal surgeon on Friday.  She allowed me to return to normal activities but cautioned me to not over do it.  I spent most of yesterday working outside in 90 degree weather and yea, I probably over did it.  I plan to return to work tomorrow (Monday) but as mentioned in the last posting, I have a lot of doctor appointments over the next couple weeks so will still be limited to 24 - 32 hours.

Journal entry by Joan Stromberg

Just wanted to give you all an update on Bob's treatments, PET scans and doctor's visits last week. He went to Lexington to get the PET scan on Thursday afternoon, Nov. 21st and we went back to get the results and meet with his NET specialist, Dr. Anthony on Friday and has an infusion scheduled following the doctors visit.

The PET scan was not good. It showed, "disease progression in multiple new, enlarging and more hypermetabolic lesions (tumors) in the left lower neck, chest, abdomen and pelvis." It also showed new tumors on his bone and upper back. 

Obviously, this latest treatment was not working, either. Bob and I were both hoping that with the severe reaction that he had to the treatment and indicates that the treatment is working, would be enough to at least slow down the rapid spread of the disease. There was one tumor on his lung that actually showed shrinkage, other than that, they all grew and spread.

So we move on to another treatment. We will be using a combination immunotherapy that has been showed to be effective in this type of cancer in ongoing clinical trials: Opdivo and Yervoy. He is scheduled to have his first infusion of those drugs December 13. They also have side effects, of course, but it will give Bob about three weeks to recover from the effects of the last treatment before starting a new one. Both this treatment and the last one are still experimental and in clinical trial, so getting the approval from the insurance company is always a bit of a struggle. Hopefully, since UK, where we go to see the specialist, is a teaching hospital, the data they collect from Bob will help in treating this rare form of aggressive cancer in the future.

Bob still works most days even through the fatigue and discomfort. He is having issues with the rash and his ostomy bag sticking and hope that issue clears up soon. He is also very grateful that a rash is not one of the common side effects of the new treatments!

All the family is home this week, or at least part of the week, for Thanksgiving. We plan on celebrating wholeheartedly! Theresa is also making plans to take a semester off college to be with the family for the next six months. I'm sure the adjustment will be hard for her since she loves Benedictine College very much. 

We are lifted by your prayers on a daily basis and continue to thank you for them and know how much they are appreciated. May you and your families have a blessed Thanksgiving and Advent and Christmas seasons!

God bless, Joan
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Bob’s Story

Site created on July 16, 2018

Bob was diagnosed with colorectal cancer June 27, 2018.  Surgery to remove the tumor is July 17, 2018 at Baptist Hospital in Louisville. Although the tumor is quite large, the surgeon is hopeful that the surgery is all that will be needed to rid the cancer from Bob's body, since there is no indication that it has spread further. Please keep us in your prayers. God bless you all!

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