Things continue to go quite well.  Mom had almost all of her tubes pulled today except for her peripheral IV's.  She was up and walking and even got a shower today!  We are really just waiting on a fart... This has never been a problem for mom in the past (sorry mom)! So why now?!?! ahahha.  Maybe all those times she was blaming Boomer she wasn't lying! This is pay back for all the times I've been exposed on your blog! I'm kidddddinnng.  But honestly - we're waiting for the green light to start eating and she can't do this until she lets one rip!  Mom's lost quite a bit of weight in the last 6 months and can't afford to drop too much more - so we're all anxious for this next step.  Hopefully tomorrow...

Not much else to report from a surgical point of view... so i'm going to take this time to give a little tribute to mom (because I know she'll be reading this in a few days).  In the last year I've spent a lot of time sitting and waiting while mom's been in surgery, in chemo or radiation sessions and recovering in hospital.  I've made it to most her doctors appointments with radiation oncologists, medical oncologists, thoracic surgeons and liver surgeons.  I've had my claws in her care since day one. Mom is always trying to talk me out of everything "don't move back to Calgary," "don't come home for the surgery," "don't come up till the end of the week," "you don't need to come to this appointment," "everything's finnnnee...really." Sometimes I feel a bit overbearing - and I wonder what other people must think about my escort service.  The truth is --- I don't want to be anywhere else...  

When I think back over my life my mom has been present for every single moment of significance - good and bad.  The things I wish I could share are those moments unique to a mom and daughter....there's a lot of them.  She's been my biggest fan, my friend, my support, at times - my rival, my teacher, my partner, my side-kick and my inspiration.  I remember one time this summer riding along in the golf cart, mom looked at me and said, "we're lucky you know, not all mothers and daughters are this close."  I do feel lucky. So lucky. She has been there literally and figuratively my entire life.  She has either been part of my many adventures or always there to drop me off and pick me - I always look forward to her smiling face at the airport.   The countless number of badminton tournaments we attended together - celebrating my victories and pep talking me through my tears.  I specifically remember being distracted by her outragous cheering during my national doubles final in Vancouver! She has been the proud and exuberant mom at my graduation(s). She's picked up the pieces when I've had my heart broken.  She kicks me in the butt when I need it most.  She was the first person I called when I got a medical school interview - and her and my dad called me in Ghana the day I was accepted!  She bought me my first stethoscope and even made me a mother survival-package when I finally moved out of home.  It's of course the big moments but also importantly the small moments - the cups of tea, a new pair of pyjamas, pedicures, chick flicks, sunday dinners, reliable phone calls and emails, left-overs, and my mom's intuition...

Last week I went over to my parent's place for a cooking lesson.  Hanging on the front door was some junk mail  - in big bold letters it read "Need Joy?!"  I jokingly brought it in the house and said to mom "Need joy?!" - she laughed and said - "my joy has arrived."  Mom's love and enthusiasm for my life has filled it with worth, building my sense of self and has made me who I am.  She's been my shoulder, my back-bone, my conscience and the beat in my heart for my entire life.  So - during this incredibly difficult year - I ask, why would I be anywhere else than at her side?!?!  I can certainly guarantee that if our situations were reversed she would be doing the exact same thing!!

Love you mom.

A new woman this morning.
We showed up this morning to find mom perched on the side of her bed - hair brushed, teeth cleaned and dare I say - perky. The nausea was significantly better today. Holy can this woman bounce...man, she continues to blow my mind every single day.  She is the world's toughest - and i'm not just saying that!  Today, mom used ZERO pain medication...ZERO.  How is that even possible???  She had her belly opened in two directions and a massive chunk of liver removed...mind over matter???  Mom was even up for a few walks today - pushing her pole, eyes forward, brow furrowed in determination!

Mom's sense of humour isn't broken.  Over the past couple of days we've shared many a chuckle.  In fact, the first thing mom whispered after waking up from surgery...in a very serious tone was... "Did they do the renovations???"  Today mom's nurse came in to check on her and asked "did you go for a walk?" - mom smiled proudly and answered "yes! now i'm working on a fart!"  It didn't happen today - but we're hoping for a fart party tomorrow!

In all seriousness - mom's doing great.  Tomorrow they are going to start pulling tubes and will allow her to start to eat again!  I know in my heart she will be home for Christmas!  It's going to be the most amazing Christmas ever!

A bit of a rougher day today...
The ongoing battle with nausea continues.  This obstacle was somewhat foreseen as she had the same issues with narcotics with her previous surgery.  Unfortunately it's a bit of a vicious cycle - pain meds lead to nausea, nausea leads to using less pain meds, less pain meds leads to pain...and so it goes on.  In an entire day mom hit her "pain button" 3 times - that's 3 mini doses of fentanyl.  Technically she is allowed/expected to hit the button as much as every six minutes - so that gives you some perspective.  Unfortunately she was STILL nauseous and then on top of it had pain.   At this time there isn't a heck of a lot they can do but to just wait and ride it out.  Geoff and Linds drove down from Calgary this afternoon.  They always have a way of putting a smile on mom's face.  I know she was incredibly glad to see them both!  Around 7 tonight she kicked us all out and sent us out for dinner.  Hopefully she gets some rest tonight - we're hoping tomorrow has a bit more comfort in store.

While sitting around with mom today I got to thinking... this year there has been a lot of bad news and A LOT of challenges.  The initial devastating diagnosis of esophageal cancer followed by 5 weeks of chemotherapy and daily radiation. A radical esophagectomy --- mom has a way of downplaying her surgeries, but really what they did was remove her entire esophagus, pull her stomach up into her chest and attached it to the back of her throat.  Her surgery was complicated by vocal cord paralysis – resulting in difficulties swallowing and the initial loss of her voice. Then the unthinkable... the cancer spread throughout her chest and to her liver - making it incurable.  What followed was nine more rounds of IV chemotherapy and a daily chemo pill.   

BUT - in a year fraught with devastation we have also had so SO many incredible days and even some good news.  I can’t believe how much "good" we've managed to squeeze in: New Years with our cousins in Whitefish on the ski hill.  Two mother-daughter weekends in Vancouver.  Geoff and Lindsey’s wedding in Mexico – which mom attended 6 weeks post op!  The Ride to Conquer Cancer with Leslie’s triumphant Honey Badgers.  An amazing summer in Windermere packed with sun, golf, beach time and daily happy hour! Mom and dad’s 3-week road trip to the Grand Canyon with amazing stops along the way.  Mom was the recipient of her own Terry Fox Award.  Two weeks on the Big Island in Hawaii with Mike and I - we boogie boarded, did a night snorkel with Manta Rays and swam with hundreds of dolphins.   A week in Maui with mom’s friends Maureen and Duane -  they swam with dozens of giant turtles and biked down the volcano!  The highlight of the year however was just recently when we received news that mom’s cancer has responded in a very unusual way to the chemotherapy and that she was a candidate for a potentially curable resection of her liver tumour.

The above feats may sound normal or typical to the average person – but in the context of our year, nothing but overwhelming gratitude has accompanied each of these events. There was a time we weren’t sure if mom would ever eat or drink by mouth again – she was on a feeding tube for 3 months.  We wondered if we would ever share a latte at Artigianos again or if she would ever have people over for dinner again.  There was a time we thought we would never hear her laugh again.  There was a time we thought she may not speak up in a crowd again.  There was a time we thought she most definitely would never swim, let alone snorkel, ever again.  There was a time we wondered if she would be able to walk on Nose Hill with Boomer, ride a bike or jog.  She has done them all...some with grace and some with scrappy tenacity.   Call me a pessimist – but I’m not too proud to say I've been wrong.  Since the get go mom has set out to “beat the odds” – and this is exactly what she’s already done time and time again.   Do I sound like a proud daughter or what??!? ahahah. Until tomorrow....

Kelli here -- I'm honoured to have been handed the blog torch for the week!  I have to admit I've been looking forward to it! At the same time, anytime I get to fill in on the blog it means mom must be in pretty rough shape.  Incidentally today marks the one-year anniversary of my mom’s diagnosis of esophageal cancer.  I remember the phone call I received in Vancouver last year as I was heading out the door to my residency Christmas party. When my mom told me the news my world stopped.  Every tomorrow disappeared.   I couldn’t remember much about esophageal cancer from my medical school lectures – but I did remember that in 90% of cases by the time the cancer was diagnosed it was already very advanced.

I'll cut to the chase because I know a lot of you are sitting on the edges of your seats....

Mom's surgery went very well.  We were at the hospital by 5am.  It was a bit of a rocky start when the pre op nurse insisted mom remove her Christmas pedicure that we just got THIS week - I was major annoyed. She was whisked off to the OR at 7:30am.  Made it to recovery by 12pm and then to the ward by 2pm.  

The surgeon was very happy with the results of the surgery.  Mom was supposed to have the entire right side of her liver removed -- but she had a bit of white rabbit luck today.  Turns out she had an accessory hepatic vein supplying the inferior portion of her right liver. Because of this he was able to salvage that 1/4 of the liver and only had to remove 1/4 in total.  He was happy with the tumour margins (by the naked eye anyway - the pathology report will have the final say).  Most importantly he did not see ANY other cancer.  Our worst fear was that she would be opened up and other small flecks of cancer, that were not apparent on the scan, would be visible by the naked eye.   We were warned that if that was the case they would close up and no surgery would be performed.  Thank goodness that didn't happen.  

Mom is being her typical stubborn self.  She declined the nasogastric tube which is used to decompress the stomach after surgery to help with post op nausea.  She had one of these tubes for nearly 3 weeks during her last hospital stay and I think it was a pretty traumatic experience for her.  Honestly I think  this go around she was more afraid of this particular tube than the surgery itself!  In any case - she did have some pretty severe nausea today - but that's typical for her with just about any narcotic.  She doesn't tolerate narcotics well and despite aggressive anti-nausea management it's almost impossible to avoid.

Our experience today was a stark contrast to our experience at the Foothills back in March.  Instead of being cramped into a 4 person room with a communal bathroom for 8, mom has her own private room. Instead of being squeezed onto a general surgery ward where care was much more depersonalized - she's on the transplant ward and her nurses are great! During mom's last three week admission we saw her surgeon twice - today we saw her surgeon three times in one day! He's great - he's well known and respected in his field but he's also, importantly, kind.  I know this stuff sounds trivial but the impact of these small details should not be underestimated.   

So....... what a way to celebrate a one year anniversary -  it certainly has been a year to remember.  As all of you blog followers already know when mom was diagnosed with cancer she got BUSY living.   She barely skipped a beat.  She adopted an attitude that she would do everything she could to fight this terrible disease and anything out of her control wasn’t worth worrying about. I am learning SO much from my mom every single day. I have learned courage, toughness, and the incredible power of a positive attitude.  I have learned the importance of physical fitness despite physical capabilities. I have learned and witnessed the true unremitting gifts of friendship. I have learned that life is most definitely WORTH living, despite unbearable struggles and the terrible things that happen to good people.   I have learned how to be a better doctor and importantly the limitations of our knowledge of medicine. I have learned how important it is to adapt when life brings unexpected challenges – that redefining your expectations can take you a very long way. I have learned what marriage means – what unconditional love looks like  – modelled by my most amazing parents. I have learned not to take the ones we love for granted – and I’m not just talking about my mom. 

Well.... i'm signing off for tonight - I will be posting again tomorrow!  Thank you to EVERYONE for the enormous outpouring of support.  From our individual friends, family friends and even strangers - your thoughts, prayers, personal stories and words of encouragement have carried us through.  

Had to be up and at the hospital by 8 AM to complete pre op stuff.  Did the preadmissions things, had blood work, a chest X-ray, met with the anaesthetist, watched a video and bought a parking pass.  All took about 4 hours!  Grabbed a quick sandwich and soup.....typical hospital food I'm afraid....basically was quite tasteless but I needed to eat before noon because as of noon I was ordered off of all solids and am restricted to clear fluids and a nasty draino product to clean me out before the surgery.  Met Jim and Colleen for a rather poor lunch (they ate....I watched) and then headed home to have a shower and scrub my belly with a sponge disinfectant they gave me at the hospital.  I have to shower twice before tomorrow and need to scrub down each time with this stuff.  Very different prep than I had for my first surgery.  Oh well, you do what you are told, right?

So it will be early to bed, early to rise!!!  By this time tomorrow it will be all over!  Kelli will post something tomorrow if you are following along on this journey!