I have not had the energy for blogging this week, but at the same time it's important that I write things down. I found myself going back through the blog to figure out how long Rich's recovery was from the first surgery. And while Facebook has served a purpose for immediate dispersal of information, it's not the same vibe. So let's sit for a bit and catch up, shall we?

When last we talked, we just had to survive a week until we could make it to Winston-Salem and have Rich "debulked." Surviving that week proved more difficult than anticipated. Rich was taking 45mg of morphine every four hours or so. We had no reference to know that was the medical version of a shit ton of morphine. The drug references we later consulted went up to 30mg every four hours despite his bottle saying he could take up to 45mg every two hours.

The hiccups were wearing Rich down. They were relentless. On Monday night (June 2), Rich went to bed in the guest bed. He wanted to spread out and be comfortable. I heard him coughing and hiccuping at midnight when I fell asleep. When I woke up at 4am with low blood sugar, I heard this odd gurgling sound. I got my juice box but then went to investigate and discovered I could not wake Rich up at all. I called my parents first to come down and then called 911. In the movies it always seems like paramedics are dispatched as soon as you state your address, but the operator asked me a million questions. I think she did all that while also dispatching help because our guest room was full of EMTs within minutes of my hanging up.

Narcan roused Rich, but we still headed to the hospital. We spent the next two days getting him stabilized as we figured out how to get him to his original Winston-Salem appointment. We discussed helicopters and ambulances but in the end Rich was stable enough to ride in our minivan. Over the week, though, Rich has gotten much worse. By the time we got to his 3pm appointment, Rich was curled up in the fetal position on the exam table, shivering and faint.

Rich was admitted that evening. It's been several days of just trying to get back to where we were two weeks before. We've gotten Rich rehydrated. We've gotten his pain under control. As of yesterday, we have total parenteral nutrition (TPN) being delivered through a central line. So we're hoping Rich will be better each day.

We found out today that we can't have surgery until Monday the 23rd. So we have almost two more weeks of waiting around. It's going to be a little rough. But it will allow Rich to be as healthy as possible before major surgery.

So what about that surgery, huh? How did we go from two attempts at paracentesis to drain fluid to a full repeat of our original cytoreductive surgery? Honestly, I'm not sure myself. It just kept escalating. According to the surgeon, there is a large tumor in Rich's upper abdomen, but there is also a lot of gelatin slime in his lower abdomen. We won't really know the specifics until they do the surgery, but we're okay with that since we've already learned that CT scans only show but so much.

A lot of this seems like deja vu all over again. But we're in a slightly better place than we were 18 months ago. We've had 13 months of drug trial treatment. We know more about the surgery itself and how it works. We are at a facility hand-picked by our trusted doctor in Nashville. We understand better the support network we need for the surgery and recovery period. There are still many unknowns, but life would be pretty boring if not.