The human kidney. The tumors on both of Pablo's kidneys have grown over the fleshy-colored core of the kidney. In layman's terms, I call that area the 'central drain.' Read on to learn how this fits into Pablo's scenario.
Surgery is set for NOON WEDNESDAY.
We need everyone to send light and love directly to Childrens Hospital Los Angeles at that time. Pass the word to everyone you can. We ask that you stop what you are doing, and bring Pablo into your consciousness. That is all we can ask of you. And it's a big thing to us. We believe–and have seen–the power of intention work in our lives time and time again.
Wednesday at noon is game time, and we need you on our team.
Everyone wants to know the details. What's going to happen when they open up his little tummy tomorrow? The answer is, there are so many variables, it's hard to get into it all. This isn't a Hollywood war movie moment where "we're gonna go in and knock back the Hun." We wish it were. I'd have rented Robert Duvall's costume from 'Apocalypse Now!' for the occasion.
In broad strokes, Dr. Stein's options range from doing a quick biopsy on the right side, tossing the specimens to the pathologist on his team, and, based on what he sees, proceed from there. This is the ultimate audible play. Wilms' Tumors fall into two buckets: good and bad. Just like Coke and Pepsi. Darth and Luke. Metallica and Megadeth. If the biopsy proves 'favorable histology,' Dr. Stein will take one course. If it is the bad guys, there's a totally different protocol altogether.
The long and short of it is that there are a few concrete facts the docs can see in Pablo's CT scan:
• The tumors on both sides have grown into the kidney's "central drain" area. This complicates things, cos that is how pee pee gets to the urological tract. Dr. Stein can deal with this with a standard surgical practice, but it makes it different than simply removing a tumor that has grown on a non-essential part of the kidney.
• The left tumor has stagnant growth. Great news.
• The right tumor (Big Boyee) appears to be in a state of necrosis, which means cells are dying, and are hanging around in the sac that is attached to the kidney. Technically, Mr Righty has grown about 5%, but the docs say that this is considered 'flat' in their view.
• They see no effect on Pablo's lungs or lymph nodes. More great news.
• Overall, the docs feel the chemo has done some work. The greatest news.
This will all make more sense when I can lay out a report of what DID happen sometime late Wednesday.
Please be with us tomorrow.
Here are the key times:
• Check in at surgery pre-op desk at 9 or 9:30 a.m.
• Pablo goes under at noon
• We wait in the surgery waiting room, and can take a restaurant-style beeper if we want to take a walk
• After Pablo wakes up, he will be admitted
• Length of our stay is dependent on the procedure Dr. Stein pulls off in the operating theater.
HERE'S A PLAY-BY-PLAY OF OUR DAY TODAY
We spent all day at CHLA Oncology Clinic. 7:45 a.m. to about 4 p.m. Pablo, Jo Ann and I met with Dr. Stein, our surgeon. Then Dr. Mascarenhas, our oncologist, joined the meeting. Each of them popped into our room at least one other time later in the day to check in on Pablo, and us. Jo Ann and I feel secure and sorted when we have a second or third opportunity to chat with the docs. Some other visitors joined us in the room today as well: Polly, of course, AND Nana and Boo arrived yesterday from Houston, and Uncle Dean came in from Milwaukee today.
Throughout the day, Pablo had all kinds of pre-op observations, vitals, and a blood transfusion. He now has a pint of his Papa's blood coursing through his veins. I joked with him at dinner that now he can read me a book tonight.
Just before the blood bag was connected to his port, Pablo's temp shot up, and the blood had to be put on hold. It's not ideal to do a transfusion with a fever in the recipient. With a four-hour clock running on the blood he was about to receive, the medical team drew a blood sample from him (fever can indicate infection), and knocked back the heat with an oral dose of Tylenol.
After an hour or so, the fever went down a bit, and the blood line was connected to Pablo, and for the first time in his life, he took someone else's blood into his body.