Journal

Journal entry by Bob Stromberg

I have one more chemo treatment (tomorrow).  As usual, it have the infusion (~2 hours) and then wear a slow infusion pump for two days.  They will remove that Wednesday.  Then they begin monitoring my condition.  I have a PET scan on Feb. 19.  As far as success, there is no way to tell.  All they can do is monitor.  But prognosis is very good.

I have an appointment with my Rectal Surgeon on Feb. 1 to discuss when I can get the ileostomy reversed.  Most likely they will have to wait a few months for my blood counts to recover. My white blood cell count is very low but not to the point that they need to suspend treatments.  I look forward with great anxiety to getting rid of the ostomy bag.  I hate having it but when it is removed, I will have to deal with not having a rectum which will make it difficult to control the urge to go. The on-line discussions say I will learn to control over the first few months.  But it still scares me.
 
Thanks for your prayers and concerns.

Journal entry by Bob Stromberg

I just completed my third week of radiation treatment.  I have three more weeks to go.  So far, everything is going very well.  The primary effect of radiation is having to urinate more frequently, which I am feeling.  The other effect is diarrhea.  Since I am on an ostomy bag, it is not much of an issue for me.  But my output is more fluid so I have to take an anti-diarrhea pill more often.  The reduced radiation primary risk is dried, cracking hands which can be painful.  I did not have much issue with this until this weekend when I worked outside all day Saturday in the cold.  My hands got very cold and chapped.  I have been putting hand lotion on my hands frequently starting that evening.  They are getting better but much more slowly than normal.  Hopefully they will fully recover.

The other inconvenience is having to go in for treatment every morning.  Work is very accommodating in allowing me to miss time and make it as I can.  But missing 1.5 hours every morning is a little stressful since I miss multiple meetings and feel like I can't get caught up.  I used to make an effort to swim at lunch time a couple days a week.  But now I use that time to make up for missed hours.  So instead of swimming 3 x per week, I am swimming about once every other week.  Combined with the chemo and radiation which reduce my energy level, my swims are much slower.  Muscle wise, I don't feel too bad.  But I tire quickly and need to stop often to catch my breath.  I used to swim a mile in under 30 minutes.  Now it is taking closer to 45 minutes.  I guess it is still better to swim slowly then not at all.

Thanks to everyone for your prayers and generosity.  I am convinced it is making a difference.

Journal entry by Bob Stromberg

Sorry for the lack of updates.  I completed the first phase of my treatment - chemo with a concoction of three drugs called Folfox which is a combination of leucovorin, 5-FU, and oxaliplatin.  I now have a three week break and start a combination of radiation and reduced chemo (5-FU only) on October 22.  The 5-FU will be a daily pill (lower dosage) vs. initial infusion plus a 2-day continuous infusion with a pump which I carried in a fanny pack.  The pill has some different side effects, mostly severe drying and cracking of skin on hands.  They recommend the pump for higher dosage but pill OK for lower dosage and lower risk of drying/cracking of skin.

Some of the side effects of first phase (Folfox) were inconvenient but not horrible.  I did not like the pump because it is bulky to carry and difficult to sleep with.  Looking forward to not having that.  The oxaliplatin has two side effects.  First, it gives everything a metallic taste.  I love spicy food which turned out to be a very good thing because it overpowers any metallic taste.  I normally love coffee (drink way too much) but only drink one cup a day now because it tastes bad.  The second side effect is cold sensitivity.  If I hold anything cold in my hand, it begins to burn within a few seconds.  I also cannot eat or drink anything cold for about 10 - 12 days after each treatment.  It is almost like being allergic to cold, my throat feels like I am being choked.  They say as it turns colder, I will need to wear a scarf over my mouth to breath (filter/warm up the cold air) and wear gloves when outside.

Thanks to everyone for keeping me in your prayers. I am 100% convinced it has made a huge difference.  As I said above, the treatment is an inconvenience which is blessing compared to the alternative.  Prognosis is still very good for complete recovery.  God is good.

I will try to post an update after a week or so of combined treatment to let you know how it is going.

Journal entry by Bob Stromberg

I met with the Radiologist and Oncologist last week and have finalized my treatment plan.  I had a port (a long term type of IV that is in the chest under the skin and connected directly to one of the veins of the heart) inserted today.  Tomorrow I meet with an Oncology nurse to discuss all the side effects of chemo.  My chemo treatments begin on Wednesday.  They will connect a pump and the drugs will be continuously infused for two days.  At the end of two days, they disconnect and remove the pump.  I will wear the pump in something like a fanny pack with tubes connected to the port taped to my chest under my shirt.  This process is repeated every two weeks and continues for six months.  They anticipate nausea the first infusion and will treat with anti-nausea medication.  Approximately two months into the chemo treatment, they will start radiation treatment concurrent with chemo.  This will be every day for six weeks.  After that, they will complete the treatments with chemo only.

Journal entry by Bob Stromberg

On Wednesday, Aug 8, I had a PET scan.  The results were "unremarkable". It is a good thing it was not a performance review.  Unremarkable sounds terrible.  But when looking for potential cancer, it is a good thing. The report said there is no metabolic evidence of metastatic disease within the neck, chest, abdomen or pelvis. Yea!

On Friday, Aug 10, Joan and I went to see a specialist at the Markey Cancer Center.  All good news.  He said that proposed treatment at Baptist Hospital (BH) in Louisville is the best recommended treatment.  He also explained to us that the NET cancer is not the same as NET cancer found in the Lung and Liver.  They are small cell cancers, spread very rapidly and must treated aggressively.  My cancer is a large cell cancer, spreads more slowly and is partially dependent on the Adenocarcinoma (common colon cancer).  There is a treatment specifically for the NET but he said if they treated me for both, it would kill me (lethal combo).  And since the Adeno is the more aggressive and primary cancer, they treat that.  And, as previously stated, one of the  components of the Adeno treatment is effective on the NET cancer.  It sounds funny, but as we were leaving the doctor said he hopes to never see me again.  If all goes well and I don't have any recurrences, that should be true.  So I also hope to never see him again.

I meet with the BH doctors again this coming week to finalize treatment plan and have a port inserted into my chest for the chemo and blood tests.  Based on previous conversations, it will involve about six months of treatment.  Ten weeks of chemo followed by six weeks of radiation and chemo followed by ten more weeks of chemo.  Based on my current health, the doctors say I should have minimal side effects.

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

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 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'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

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

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
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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