Tuesday, May 3, 2016

More training stuff

I ended up skipping CrossFit last Monday night.  After being very active all weekend and the week before, I was tired.  I walked for just over an hour while my wife did the CrossFit class.

On Tuesday, I felt a lot better, but for strength work, I opted for the squats I'd missed on Monday instead of Olympic lifting.  I did sets of 2 reps from 95 pounds to 155 pounds, and then singles from 165 to 225.  That last lift was my heaviest back squat since last May and it didn't feel too bad.  I could have gone higher if I hadn't done so many reps by then.  My lifetime max is 375, and I'm guessing I could do 245-255 right now.  After the squats, I did a scaled version of the "Hero WOD" DT:

"DT"

Five rounds for time of:
155 pound Deadlift, 12 reps
155 pound Hang power clean, 9 reps
155 pound Push jerk, 6 reps

I used only 73 pounds.  My time and barbell weight were nearly identical to the last time I did this workout.

On Wednesday, we started off with push presses and I started at 75 pounds and increased until 120 pounds.  My best here is 188, so I was far from that number.  After that, we did a variety of things - ring rows, dumbbell floor presses, sit-ups, box jump-overs (I did step-overs), and wall balls.

By Thursday, my wife was exhausted, and I'd worked out at some level for 10 straight days, so we took a rest day.

On Friday, we started with deadlifts.  I did 5x5 at 235 pounds - more than I expected I could do.  I'm sure I could pull 315 for a single rep right now, but I was happy with this weight for 5x5.  Then, some superman holds, rope jumping, goblet squats and sit-ups.  The sit-ups were my first since surgery and they were a bit uncomfortable.

On Saturday, I had an early walk to breakfast with my wife and a friend.  Then, a 4 mile walk with the dog later in the day.  And finally, fishing in the evening.  I registered 18,000 steps on my FitBit, but nothing was super-strenuous.

On Sunday, it was raining and chilly, but I really needed to do something.  So, I put on my running shoes and went for a very slow 4 mile run.  It had been close to 2 years since I'd run that far, and I was really slow, but felt OK.  My HR was really high for the slow pace, but I felt pretty good out there.

Yesterday, we did a new class at CrossFit aimed at mobility and aerobic training, rather than the anaerobic work we do so often.  We were supposed to keep our heart rates at or below 180 minus age for a combination of running, agility movements, and walking with kettlebells overhead.  I had to really go slow on the runs to keep my heart rate anywhere close to the goal.  To be honest, the workout wasn't too tough, and I wish I'd had time to do some strength work afterward.  But, with an hour commute home after CrossFit, I simply can't stay in the gym until 8:00 at night.

Tonight, I'll do squats rather than Olympic lifting, just like last Tuesday.

I'm still dealing with some pain and general discomfort from the surgery, but it gets better all the time.  I think I'm at the point where I'm now willing to train at my limits, rather than forcing myself to go easy.  The main problem is that my limits aren't that good right now.  I've got a lot of work to do to get back to where I was 14-18 months ago, before I started to get noticeably sick.

Monday, April 25, 2016

Seven straight training days - and still going

I mentioned last week that I'd done CrossFit on Monday and Tuesday, leaving me really sore.  My wife was sore as well, so we walked Wednesday evening.  That was my second walk for the day.

On Thursday, I returned to CrossFit, although my wife walked again that day.  Her back was a little bit sore from some Oly lifting earlier in the week.  I got to choose my own movements on Thursday, and I did rowing, box step ups, farmers carries and bench presses.

Friday night, we had limited time (dinner with my wife's parents), but we walked for 70 minutes before dinner, in between rainstorms.

My plans for the weekend were a bit ambitious - bike ride, fishing, walking the dog and skiing.  But, I pulled it off.  Saturday morning, we went to Montpelier and I got my mountain bike back from the shop, where it had been getting a tune-up.  I got home and rode for about an hour - nothing too tough.

Later that day, I got out for a couple hours of fishing.  I had a few strikes, but I didn't manage to hook anything.

Sunday morning, we went for a 75 minute walk with our younger dog.  And, about noon, we headed to Sugarbush.  It has been my goal since before my surgery to ski at least one more time this season.  Luckily, despite the crappy snow year, the mountain was still open when I decided (with my doctor's approval) that I could give it a shot.  I told my wife that I wanted to do maybe half a dozen runs - just enough to call it a skiing day, without overdoing it.

We warmed up on Spring Fling, a blue trail.  I felt pretty good there.  Then, we went to Downspout, another blue trail that was in good shape.  From there, we headed to the summit and skied a black diamond run - Organ Grinder - twice.  The top was a bit challenging, but it wasn't too bad.  After the second run down Grinder, we headed for the base and caught a different lift up to Stein's.  Luckily for her, my wife opted for an easier trail down.  It was a good choice because the top of Stein's was big bumps - not very soft - separated by nasty chopped up ice.  We had three of us there - one PSIA level 3 instructor and 2 Level 2 instructors.  I think we have close to 60 years of experience between us, and we needed to rest and regroup a couple times on the way down.  It was challenging, but not really dangerous in any way.

After one more run on Spring Fling, my wife and I called it a day and headed to the boot room to change.  My two friends, meanwhile, decided that the bottom of Stein's was so much fun that they would brave the top again for one final run.

After they were done with that run, we all met for a few beers.  The mountain might still be open next weekend, but I probably won't ski.  I have some plans with friends and I'll probably fish, but my ski season is probably over.  I'm very glad I got that final day in for this year though.

Tonight, it's back to CrossFit.  My goal this week is 4 classes, after 3 last week.  Hopefully, I can do the classes without getting so sore this week.  We start tonight with more front squats and lunges, and those two lifts put the hurt on me last week.

Wednesday, April 20, 2016

Back to CrossFit and Paying the Price

I'm so sore I can barely walk.  No, let's be honest, I can barely move.  But, believe it or not, it's a good thing.  Over the weekend, I was moving a lot.  My daughter and I walked around the Syracuse campus a fair amount on Friday.  She accepted her admission that day, which puts that whole selection process behind us.  I think everyone is glad that it's over.  Anyway, we also spent 5 hours in the car on both Thursday and Friday, which is never a good thing.

On Saturday, I walked 4 miles with my wife and one of our dogs.  The other dog has gotten so old and her hips so weak that she is fine not going on walks these days.  But, the younger dog needs to drop a few pounds, so he gets to go along every time.

Sunday, I fished most of the day, and my FitBit recorded over 10,000 steps, but it wasn't really exercise of any sort.  On Monday though, I returned to doing CrossFit workouts.

I'm scaling the workouts.  A lot.  Even though I went into this latest surgery in better shape than my surgery last September, I've still lost a lot.  After the surgery in September, I resumed CrossFit 7 weeks after surgery.  This time, I started CF only 5.5 weeks after surgery.  It's not a huge difference, and I know I'm in better shape than when I re-started in November, but my strength is poor right now.  I'm also still slightly anemic.  I talked to my doctor about the hemoglobin levels last week, and she wasn't concerned at all.  But, despite very good blood work overall, I'm still not quite right.  And, the pain in my abdomen reminds me that I'm not fully healed.  The "typical" minimum recovery from major abdominal surgery is 6 weeks, so I'm certainly pushing the envelope a bit.

Monday, the workout started with front squats.  Just before I started feeling sick a year ago, I'd set a new front squat PR at 305#.  We had done a focused training cycle on front squats at the gym, and this was a big PR for me.  On Monday, I did 8 sets of 3 reps at 63#.  Yep, that's it.  And, it was plenty.  Then, some lunges with an empty 33# barbell on my back.  After that, I did 30-20-10 of air squats, with a 400 meter run after each set of squats.  It took me just over 10 minutes and I was surprised that running (really a slow jog for now) felt OK.  Not great, but better than expected.

Last night, we started with Olympic lifting.  Again, I kept things light.  I did 10x2 power snatches at 53#.  Then, 10x2 clean and jerks (power clean, push jerk) at 73#.  Both of those numbers are about 40% of my one rep max, but those one rep max values were set in December of 2014, before liposarcoma became part of my life.  After the Oly lifts, I did as many reps as possible in 10 minutes of 10 ball slams and 10 ring rows.  I did 6 rounds plus 11 reps.

Which brings us to today.  As I said, I can barely move.  My wife is sore as well.  I think we will skip CF tonight and just go for a walk.  Tomorrow night, we can choose our own movements at CF, so we will be able to pick things that don't hurt too much.

So, I've been out traveling with my daughter.  Out fishing with a friend.  Going for walks with my wife and dog.  Things are returning to normal in many ways.  I even hope to ski this coming weekend - one last day on the slopes for the season.  But, in the back of my mind, I feel some level of desperation.  I'm going on vacation in mid-June.  The whole family is going to Lake Tahoe for a week right after my daughter's high school graduation.  But, the day after we get back, I'll be going to NYC for my first post-op CT scan.  The odds are good that the scan will be clean, but there are no guarantees.

So, the desperation I feel is the need to get myself back into shape quickly.  If I need more treatment, I want to be strong going in.  If I don't need more treatment, I want to be in good shape to enjoy the summer anyway.  I feel like I've just lost so much fitness in the past year, and even over the last 2.5 years, if I include my prostate cancer surgery.  But, I can only regain strength and fitness at a fixed rate.  I'm old enough that I know I'll get hurt if I push too hard.  I hope I'm experienced enough to not do that.  So, I need to find that fine line, to regain fitness as fast as possible, while not getting hurt.

And, I'd like to go a day now and then without worrying about cancer and the risk for recurrences in the future.  But, I'm guessing that's just not going to happen.  Maybe ever.  But, that doesn't mean it will rule my life.  As long as I'm clear of cancer, I'm going to dictate how I live my life, not the doctors.

Tuesday, April 12, 2016

Mixing it up a bit

Last Wednesday, I hopped on the Concept 2 rower and rowed a slow 5K - 25:20.  I followed that up with a mile on the treadmill.  The next day, I was a bit sore, so I walked 3.5 miles on the treadmill.

After that, the opening of trout season took over.  My wife and I saw a fly fishing film Friday night, so there was no workout.  I fished a decent amount of time over the weekend, and despite being on my feet all day, it wasn't really a workout.  And, just like in prior years, I caught zero fish in the Otter Creek Classic.  Someday, maybe...

Yesterday, I was looking at the CrossFit workout, and I found myself tempted.  Not by the strength training, which was front squats and barbell lunges.  But, the metabolic workout was 30 box jump-overs, 50 Russian Kettlebell swings, 100 air squats (just bodyweight - no additional weight), 50 more swings and 30 more box jumps.

I thought about it, but hopped on the rower instead.  While I was on the rower, one of our coaches, a regular competitor at the CF Games, asked me how I was doing with my recovery.  I mentioned that I'd thought about doing the workout.  She encouraged me to give it a shot, but to scale it properly.

So, I finished my 5K row in 23:36, much better than last week, and then set up for the workout.  I decided I would do 30 box step-up-and-overs, 30 kettlebell high pulls, 50 air squats, more high pulls and more box step-ups.  And, that was plenty for me.  It took me 7:31, about the amount of time it took the better athletes to do the prescribed workout.  It wasn't too bad, but I'm sore today.

The workout tonight is Olympic lifting followed by Fran - a combo of thrusters and pull-ups.  I think I'll walk for the first part of the workout, and then do a modified version of Fran - light thrusters and ring rows instead of pull-ups.

I see my medical oncologist tomorrow, mostly so she can see how I'm doing post-surgery.  I have to set up periodic appointments to get my chemo port flushed.  I may request a bit more pain medicine for the next week or so.  I'm using less all the time, although car rides are uncomfortable, anytime I sneeze it hurts a lot, and I'd like to taper a bit with less strong medications than I'm using now.  Anytime I'm not moving at all, such as at work or overnight, I'm fairly comfortable at present.  But, I still have more pain at times than Tylenol alone will handle.

But, things are better every day.  This weekend, I'm taking my daughter on her final 2 college visits before her looming decision day.  I think the decision is pretty much done, and she will end up at Syracuse.  We are going to Syracuse on Friday and then URI on Saturday.  Saturday is also her 18th birthday, so I want to stop somewhere nice, maybe in Boston, on the way home from URI to take her out to a nice dinner.

The next day, she is planning to celebrate her "adulthood" with a tattoo.  I'm not going to participate in that event (she knows I'd prefer she not do it, but at age 18, I'm not going to stand in her way), so I might sneak out fishing for the day.


Tuesday, April 5, 2016

Walking, walking, walking

Other than work and sleep, all I seem to be doing these days is going for walks.  I'm just shy of four weeks since my surgery.  My incision is still not completely healed, and I'm still wearing some sort of "gut girdle" over my shirts to support the incision and perhaps some internal organs as well.

Later this week, I should be able to do some rowing on the Concept 2, but so far, all I've done for exercise is walk.

When my wife goes to CF, I either walk on the treadmill if it's cold, or I walk outside if it's nicer.  Last night was the treadmill.

On the weekends, I'm going for walks every day.  Sunday, I walked for 90+ minutes in a mini-blizzard and I swear I walked into the wind the entire time.  Even my dog was smart enough to skip Sunday's walk.  He was all excited to go until he saw the snow and felt the cold air.  Then, he retreated to his crate and I walked by myself.

He had walked with me the day before though, so he's getting in some walking.

Last week, I walked 4 evenings while my wife did CF.  I walked at lunch for a while on the day she skipped CF.  So, it's pretty much every day.  And, I'm itching for more.

I do plan to row, at a very low intensity level, later this week.  For the next two weeks, I'll probably mix rowing and walking.  After that, I'll start some bodyweight exercises - air squats, push-ups, pull-ups, etc.  Maybe some light dumbbells.  And, 2 weeks after that, I should be using barbells again, maybe a bit sooner if I start to feel better soon.

I'm still taking some pain medication, to be honest.  I had a major incision and major abdominal surgery.  It typically takes at least six weeks for a complete recovery from surgery like that.  I will see my local medical oncologist next week and see what she thinks about my progress and activities.  I'm hoping I won't feel the need to ask her for any more pain medication.  I'm trying to taper off of those meds, but the pain is still there and my body isn't ready for me to quit the meds just yet.

So, hopefully, I'll be doing CrossFit classes again by early May.  I leave for a vacation on 6/18, so maybe I'll have six weeks to get myself fit again before that trip.  As soon as I return home from that vacation, it's time for another CT scan to see if the cancer has returned.  If I'm in the clear, I'll have 4 more months to focus on training (and fishing).

If the cancer does return that quickly, I have no idea what the treatment will be.  To be honest, I'm just trying to not worry about that right now.  But, for the past year, I've had very little good news related to this liposarcoma and I don't want to be unrealistic with my expectations.

But, it would certainly be nice to have a clear scan and be allowed to just continue on with my life.

Thursday, March 24, 2016

A few highlights from a trip I wish I hadn't had to make

My 16 days in NYC are over.  I got my pathology report Tuesday morning and it was fairly positive.  The lesion on my liver wasn't cancer at the time it was removed.  It might have been cancer earlier, but if so, the chemo killed it.  The lesions on the bowel were well differentiated liposarcoma - the less aggressive form of the disease.  The only part that bothered me a bit was the section removed from the psoas muscle.  During chemo, that lesion had not seemed to shrink in size.  In fact, when it was removed, it was a long, thin lesion that measured 13 cm at its longest.  It was almost all well differentiated cells, but there was a small tumor of dedifferentiated cells  - about 1.5 cm at its largest dimension.  Those cells showed a "spindle cell morphology", but I don't think that's really any different than my previous operation and its pathology report.

So, the chemo, whose job was to attack the aggressive dedifferentiated cells, worked very well.  But, some dedifferentiated cells remained.  Luckily, the margins on the psoas were good, and the only close margin was close to the less aggressive cells.  The dedifferentiated segment did not extend to the edge of the removed tissue.

So, for now, I appear to be clear of disease.  None of the other fat cells removed showed any signs of liposarcoma.  I will return to NYC in late June for another CT scan, but there are no treatments planned between now and then.  If the chemo and surgery were successful in changing the nature of this disease from the dedifferentiated subtype to the well differentiated subtype, the future is a lot less scary.  For the most part, well differentiated tumors do not metastasize.  They grow more slowly.  They recur less frequently, in general, than dedifferentiated disease.  If I do have a recurrence of dedifferentiated cells, especially in the short term, well, we will worry about that if and when it happens.  But for now, things look pretty good.

In general, I am healing well.  On Tuesday morning, after my appointment, I easily walked from the hospital to Penn Station to catch my train home.  I didn't need to use a cab for a walk that spanned close to 30 city blocks, despite carrying a computer bag and dragging a suitcase.

All in all, I would have preferred to never make the trip.  I would have preferred to never have the surgery.  I'm still on pain medication, and I have some new numb spots on my skin that will remain permanently numb.  This includes nearly all of the front of my right quad.  I suppose I'll adapt to that over time, but it feels pretty weird right now.

So, what were the highlights of my trip?  Amazingly, there were quite a few.

My wife and I got into town on a Monday night.  That first night, despite some medical appointments in the morning, we got out for a couple cocktails at a fun little bar near our room.  From there, we used Yelp and found a nearby Szechuan restaurant that turned out to be very good.

The next day, we went for a long walk in Central Park after my morning appointments.  The weather was just beautiful.  That night, we met some of our ultrarunning friends for dinner and a show.  We started at a wonderful Italian restaurant called Masseria Dei Vini.  We all ended up sharing a number of plates, including a great grilled calamari salad, an amazing rabbit dish, a milk fed pork dish, and some Brussels sprouts and a polenta cake.  We even shared 2 desserts, although everyone was getting full by then.  After that, we ambled a few blocks to the theater to see Jersey Boys.  It was my first ever Broadway show, and I enjoyed it a lot.  I did have to laugh when my wife got a gin and tonic at the intermission and it cost $23.  But, I guess that's life in the big city.

After the show, we wandered around Times Square for a bit, knowing that the fun and games were over for a bit.  I spent Wednesday working remotely and getting ready for surgery (bowel prep).  My wife managed to get in some walking and spent the late afternoon in a wine bar.  I have to admit that I was jealous, and I even joked that wine was a "clear liquid", and I should be allowed to have some.  My wife got a simple dinner from Whole Foods.  She didn't want to ask me to sit in a restaurant when I couldn't have any food.

Thursday morning, we walked to the hospital, and the important part of the trip started.  I'll skip those details here.  By Saturday, I was up and walking during the day, although still dealing with pain.  On Sunday, two college friends stopped by for a while.  My one friend is very uncomfortable in hospitals, and they had a long drive home, so they couldn't stay long.  They did bring me a bag of "goodies" - some chocolates and a half bottle of whiskey.  I don't know what made them think that I would possibly be allowed to drink or even want to drink whiskey, but I accepted it graciously.  The chocolate did come in handy later in the trip.

Later that day, my dad showed up, and he visited with me on Sunday, Monday, and Tuesday.  He kept offering to get food for me, but I was still limited to clear liquids, and I was only drinking water or Gatorade.  Given the cost of staying in the city, he headed home after a Tuesday visit.

On Wednesday, I was allowed to start eating solid food again.  I think I had one piece of toast, a scrambled egg, and a few bites of sausage, but that was all I could handle.  Food got better every day, although my appetite is still way off a week later.  I'm still so swollen from the surgery that I feel full after eating very little food.

Thursday I was discharged and headed to my room at the upper west side YMCA.  That night, I found a local pizza place on Yelp, and had a pizza delivered.  I was truly amazed when it turned out that the pizza was barely edible.  The sauce was bland, the crust was terrible, and I could barely eat it.  How does this happen in NYC?

The next day may have been the highlight of the trip.  A good friend from high school, Scott, came to visit me.  He got a room in the Waldorf Astoria, a place he'd always wanted to stay, and offered me the second bed for the night.  We met around 5:30, and talked to the concierge about dinner.  We ended up at The Modern, a newer style French restaurant co-located in the Museum of Modern Art.  Our seat overlooked a courtyard full of the museum's art.  Here, I ate my first real food post-op, and had my first alcohol since surgery.  The food was insanely rich, and the prices were commensurate.  Scott asked me to pick a wine for dinner, and he'd already made it clear that he was paying for dinner.  This made the wine list even more daunting.  Scott and I both like good wine, but the starting price was essentially $100, decent wines seemed to go from $250 and up, and the most expensive bottle on the list was $17,500.  I managed to find a decent Bourgogne Rouge for $130, and I imagine the sommelier thought we were cheapskates.

I had a foie gras course, an amazing turbot with celeriac and black truffles, chicken breast with pecans and foie gras sauce, and then a cheese course.  It was amazing, but just too rich.  By the time we left, I felt bloated and my stomach was not happy about that kind of food so close to surgery.  Even in the luxurious beds of the Waldorf Astoria, I slept fitfully that night after so much rich food.

The next morning, we had a nice breakfast together, and then Scott had to head home for a school event with his daughter.  He had already missed an important Cub Scout event on Saturday to make the trip, and I really appreciated the visit.  Plus, he picked up the tab for absolutely everything.  If anyone ever tells you that absolutely everything about cancer sucks, don't believe them.  It's a great time to find out how much you really mean to the people in your life, and I've been absolutely blown away by how generous people have been with their time and money, just to spend time together through this ordeal.  Maybe I'm just extraordinarily lucky in who I have as friends, but the kindness I've received over the last 6 months is something I can never truly repay.  My hope is that over time, I can pay it forward to others in similar situations.

After Scott left, I had the day to myself.  I walked in Central Park for a long time.  I had a cocktail at a great little bar on the Upper East Side.  I walked some more.  And then, had a simple dinner from Whole Foods in my room.

The next day, Diane, the girlfriend of a skiing friend/mentor came to visit me.  We explored the Highline area for a few hours, before ending up at the Whiskey Bar near MSG for a drink and some food.  Her boyfriend was in VT, teaching skiing for the day, and we joked about being on a "date" without him.  It was a fun day, but about 6:00, I found myself getting tired.  We hopped in a cab and got me back to my room, and Diane headed home.  As I went to bed on Sunday night, all I could think was how close I was to getting home.

On Monday, I worked all day.  I made a reservation to go to Lincoln Park Steak for dinner.  It had great reviews on Yelp.  So far, Yelp had been right about 2 cocktail bars, the Szechuan restaurant, the Italian restaurant, and The Modern.  The reviewers had been very wrong about the pizza place, and regretfully, they were wrong about the steak house.  The service was bad (very aloof to the point of being cold), the food was bad, and I ended up eating only half of a steak, and then opting out of a free dessert.  It's tough to pay $150 for a meal that isn't good at all.  The beef itself was the only redeeming feature of the place, and even that failed to meet expectations.

From dinner, I headed to my room, packed up, and got to bed early.  I saw the doctor early the next morning, to have my staples removed and to get my pathology report, and that's where I started this post.

After getting on the 11:30 train (my last "meal" in NYC was a Haagen Daaz chocolate milk shake for lunch just before I got on the train), I was home in Vermont by 7:00.  I had a little bit of dinner and got to bed early.  By Wednesday, I was back in my office, trying to catch up on the work I'd missed.

I definitely managed to salvage a little bit of fun in my 2+ weeks in the big city.  Except for the night at the Waldorf Astoria, I either slept in a hospital bed or a very uncomfortable bed at the Y.  Despite a couple rich meals, I dropped about 10 pounds during my trip.  I actually walked a lot more, even after my surgery, than I average here in VT, where I seem to be sitting at my desk, doing CrossFit, skiing, or fishing most of the time.

I still have a lot of healing to do, but I'm encouraged by the results of the surgery.  A cure is still a long shot, but if recurrences can be limited and be only well differentiated disease, rather that dedifferentiated, I will be very happy.  Regretfully, I'm almost sure there will be more surgeries in the future, but for now, I am glad to be home, I'm glad to be free of obvious disease, I'm glad the surgery went well, and I'm going to focus on healing and getting back to the things I love, like CrossFit and the impending opening of trout season.

While I would not wish this disease on anyone, I can also see many positives that have arisen from it.  I have the best friends I could have ever imagined.  My wife has been my rock, and I am especially looking forward to celebrating our 30th wedding anniversary this summer.  And even my kids, as aloof as they can be, were clearly worried about me and glad to see me come through this so well.  I really couldn't be happier right now.

Thursday, March 17, 2016

Discharge Day

Sometimes, I think of this space as just somewhere I go to put down my own thoughts.  I forget that others actually read this blog.  And yesterday, I got a phone call from a good friend, who was checking up on me because there was no update here.

I frequently use Facebook to disseminate info quickly to friends.  My wife and I have done that this time, plus used FB Messenger, text, e-mail, phone calls, etc., in the last week.  But, the blog sat here untouched, so here's an update for my 5 blog readers.  You guys actually get the details that others won't get.

In our pre-op meetings with the surgeon, the surgeon was very comfortable with the problem at hand.  The CT scan last Tuesday showed that the last two rounds of chemo had continued to help.  He also felt that the lesion "in" my liver wasn't really in the liver.  It was "on" it and that meant the liver did not need major resection.  

As for the bowel area, he thought there was a primary likelihood, and then two other possible findings - one better than expected and one way worse.  The expectation was that they would do some resectioning of the bowel.  I wrote about the options in my last post. 

I was warned that the cutting into the psoas muscle would cause some permanent (although allegedly harmless) loss of skin sensation on my right leg.

Pre-op went smoothly.  The doctor was there, ready to go.  Prep didn't take long at all, and I was allowed to walk into the OR - a first for me.  I hopped up onto the table, they put a mask over my face, told me to breathe deeply and I remember nothing for hours.  The first thing I remember after surgery is being in a lot of pain in the post anesthesia care unit (PACU).  I don't remember how all of the conversations went, but Fentanyl was not controlling my pain well.  Someone, possibly me, suggest Dilaudid as an alternative.  This switch provided near instant relief and we switched from the higher strength medication to the lower strength option.  I had a button that I could push as often as I wanted, but it only worked once every 10 minutes.  We then found out that the hospital was overbooked and they had no room for me.  By 10:00 or so, my wife left.  We still had half a dozen patients in PACU with a handful of nurses.

Oh yeah, before my wife left, she relayed news from the surgeon.  All of the tumors had come out in the best possible fashion.  He was able to get the tumor off the outside of the liver.  The two bowel tumors peeled right off and required no resection.  He was able to get good margins with the psoas tumor, although the numbness has been way more significant than I expected.  But, I lost very little healthy tissue and no organ tissue.

I was supposed to go to the 15th floor, but sometime after 11:00, a room opened up on the 16th floor.  They decided that was close enough and I went to my room.  I slept fitfully, but I had the pain button and got through the night OK.  In the morning, my breathing was a bit labored, but that wasn't fully unexpected.  But, my nurse told me that I had a pneumothorax and needed to have a chest tube installed.  This just hit me in the gut.  Chest tubes can be really painful.  I was alone in my room, waiting for my wife, waiting for the doctor, and contemplating trying to get up and walk out of the hospital to avoid the tube.  When the doctor showed up with the official news (the nurse had leaked it to me in advance), I explained my reticence, but also acknowledged the breathing problem.  The doctor explained that the tube I would be getting is a newer style of chest tube - much thinner and more comfortable than what I'd had before.

So, we headed downstairs to interventional radiology for procedure.  After getting the standard "twilight sedation" cocktail of Fentanyl and Versed, I was still talking a lot.  The anesthesiologist decided to "up her game" and added some propofol.  Ten minutes later, which felt like one second, I woke up and the chest tube was in.  It was never a problem, to be honest, and my breathing improved instantly.

My wife finally found me in the recovery room after the procedure.  She was in a panic.  She had gone to the 15th floor first.  They'd never heard of me, but finally tracked me down on the 16th floor.  There, they couldn't find me either, and finally told her I'd been taken downstairs for a "procedure".  But, they didn't tell her what the procedure was or why it was happening, and she was imagining I was back in major surgery.

From there, things started to improve.  I walked a bit that afternoon (Friday).  I got moved to the 15th floor and shared a room with a very nice gentleman from South Carolina and his wife.  Friday night, my wife stayed in the room as well.  Saturday morning, my wife flew home to take care of things there and I continued my recovery.  I found out that it was 14 laps to the mile walking in circles on the ward.  I did 3 sets of 10 laps on Saturday.

I was walking more and more each day and my night nurse asked me how many laps I'd done one night - maybe Monday night.  I told him I'd walked 64 laps that day, having built up from 30 a few days earlier.  He told me the "record" was 75 laps.  So, I walked 101 laps the next day, with my IV pole.  That's over 7 miles, and it took me about 3.5 hours total.  I knew then that things were over the hump.

I had chest x-ray's every day and the pneumothorax had fully resolved very early.  The tube stayed in for a while, but only because the IR team insisted.  My surgical team wanted it removed earlier, because they knew more details.  They had caused it by nicking my diaphragm with a scalpel during surgery, allowing some air into the pleural space.  They had also repaired the nick, so they weren't concerned about it returning.  The tube was finally pulled yesterday.

The original guess was that I'd be discharged Thursday (today), but I needed to pass some gas, have a bowel movement, and then eat some solid food before I could go.  I was bloated by gas for a few days as my bowels slowly came back to life.  I'd pass gas or have a bowel movement, and then lock up again.  Finally, on Wednesday morning, things really got going, and I moved a lot of gas out of my system.  I finally ate some food.  And then, we knew it was time to get me out of here.

That's a short version.  It appears that the surgery was a success, although I don't have the final pathology report yet.  But, liposarcoma is relentless, and there's no guarantee that I'll be disease free when I have my next CT scan in July.  For now, I want to heal, get back to my life, help my daughter decide on college for next year, and I'm looking forward to a family vacation to Lake Tahoe in June.  And maybe start training for the Ghost Train ultras in NH in October, although I am planning to hike rather than run most of my miles there.  Oh yeah, it's soon trout season.

I finished reading Atul Gawande's "Being Mortal" in the hospital this past week.  Reading that book while spending a week in one of the top cancer centers in the country, where some of the toughest cancer cases aggregate, has been eye opening.  You can be sure I'll be writing more about the book and the related experience in the near future.