Yeehaa

Yesterday we went to meet with the surgeon, Dr. V., and James had a long list of questions including when does feeding tube come out, when can I start eating again, when will prosthesis be placed, etc. Dr. V. rushes in an hour late which is his norm because he stays with you for as long as you need in your "20 min" appointment. Before James asks a thing he sits James in the med chair grabs a surgical kit and gets to work. Within 10 minutes....

The feeding tube is OUT!! The pen cap catheter is OUT!! The prostheis is IN!! Wahoo!!!

Feeding tube OUT.... real food IN.... wahoo!!

James can eat anything. Absolutely anything. His appetite doesn't seem to be what it is but I also need to get to work creating interesting things to eat. Our kitchen is currently dysfunctional as it was only Phoebe and I eating and we've been grazing. Time to clean up and make a little somethin-somethin. James' sweet sister baked a chicken dinner for us a night or two ago––absolutely perfect timing, thanks Dije––I may take the remainder to morph into a chicken pot pie. One of James' favorites. We'd share the pot pie baked by sweet neighbor Jess last week but Phoebe and I baked/ate/as soon as it was dropped off whoops.

The voice prosthesis will be a work in progress. It's a tiny plastic device that redirects the air from the trachea through a one way valve to the esophagus. The way you redirect the air is to block the stoma so the air is forced through the valve. James' stoma is quite low due to the size of the tumor. It sits in the notch at the base of his throat. He had more success swallowing air to create sound. He'll keep messing around with it but for now written word communication is easiest. Speach will hopefully be easier if/when an HME (heat and moisture exchange) device is placed.

We see Dr. V. again in a couple weeks when we'll discuss the HME which will help with speech but more importantly temperature/humidity control and also serves as a filter. Currently James is still hooking himself up to the humidifier unit by hose to stoma mask to keep things moist. There is still swelling and wounds are healing around the stoma so it's too early for the device. Crossing fingers that placement will work in his particular case (stoma placement, low, near clavicle) and that insurance won't give us any grief.

We have an appointment to see the PCP next week, the visiting nurse will visit, we have an initial appointment with the Rad Onc and they're booking an appointment with a Med Onc. Chemo and radiation were expected to start 6 weeks out, I think from surgical date so we may be getting close.

While I was chatting with the nurse in Dr. V.'s office about supplies we needed for the house James was asking Dr. V. the remainder of the questions so I was out of the loop but James told me after we'd left that Dr. V. thinks he got all the nearby lymph nodes and as previously mentioned margins were clear around the tumor. Looks like we're in pretty good shape moving forward with treatment!

Next steps will be bulking James back up again (he'd lost 30 lbs prior to surgery) and regaining physical strength. We'll be making lot's of smoothies with the weight gain protein powder and if you'd been dying to cook something yummy for us maybe now is the time :^) We need to whet his appetite!!

Thanks for thinking of us. xxoo Beth and James