Update -- She's in the OR

Good morning,

          It's been a very early day for all of us and everyone is running on very little sleep. 

          We arrived at the hospital at 5am and checked in to pre-OP. Over the course of the morning we met with all of the nurses and doctors who would be in the OR (at least most of them). She also spent 2 hours doing the sentinel lymph node testing. The point of this test is to follow injected radioactive dye and see what lymph node lights up first. But after waiting for 2 hours none of them lit up. Her doctor said this isn't unusual when you have already had a procedure done in the area, and he is going to go ahead and remove part (or all) of the parotid gland and see if there are any cancer cells there, as he suspects that's where it would have moved to if it has spread. The parotid gland is one of the salivary glands we have in our head and neck (You can click here to see where the gland is. It goes to a wikipedia page, which I hate referring to, but I'm tired and the image is clear).

          This was the first time I had met her UMD physicians, and they seem really nice and knowledgeable, so she is in good hands. One doctor will be doing the cancer removal and the other will take over this afternoon for the reconstruction (he's the lead doctor). A few other things we learned today:

1. We knew there was going to be surgery to clear the margins on her face. This will be filled in/reconstructed with skin and vessels from her arm (described as a "skin flap"--their words, not mine). Her arm will be covered with a skin graft from her thigh. We didn't quite realize all of these steps before, but now they are much more clear. 

2. To provide the "skin flap" on her face with ample blood supply, she will have an incision along her hairline, ear, and under her jaw (another scar that was a little unexpected) to connect the flap to vessels in her neck.  

3. They may or may not be removing the lymph node beds on the left side of the neck. This would have happened if the sentinel node tested positive, but now that they are taking the parotid gland and testing that instead, I'm not sure what it means for additional node beds. I should have asked the doctor, but the thought didn't occur to me until a few minutes ago. If they end up taking the node beds, they will do that today as well.

4. The goal of her doctor is to not have her on a ventilator or have a nasogastric tube in after surgery (the need for ventilator and nasogastric tube came from a plastic surgeon she had consulted with, but he's on vacation right now). This would maybe keep her out of the ICU, but a lot will depend on how late the surgery runs. If it ends late, they may put her on a ventilator overnight and take her off tomorrow.


          She was taken into the OR around 10:00am. There is an information board that keeps us updated, but it says she is still in pre-op, so perhaps it is a little slow to update. 

**Updated to add: Her surgery started at 11:22am (that's when they made the first incision).

          Dad and I will be hanging out in the "Healing Lounge" all day. On a different note, UMD has an incredibly nice hospital. I will post significant updates as we get them. 

          Please feel free to leave a comment, send an email, or send me a direct message through facebook if you have any questions. Thanks! 

Below, a picture of her before we left for the hospital this morning in her cancer-fighting butterfly leggings curtesy of Miss Jane (she's also wearing some "f*ck cancer" socks that I got her for Christmas). The guaze wrapped around her right arm is just to prevent any IVs from being started where they are going to take the skin from.