Sunday, October 23, 2011

Medical Update: A Chest Half-Full (Not Half-Empty)

As most of you know, I had reconstructive surgery at the Medical University of South Carolina in Charleston last Wednesday (10/12). Following the ten-hour surgery (in which tissue from my abdomen was used to reconstruct my chest), I had two main complications that were both related to my blood system.

I began bleeding internally in my chest on the Friday morning following the surgery (10/14). The loss of blood made me incredibly weak and really messed up my blood levels, so I had to have a blood transfusion to stabilize me. It took several days for my body to recover from that difficulty, but I was finally able to go home from the hospital the following Wednesday (10/19).

Some MUSC residents discussing my internal bleeding.
It was so good to be able to be home and see the kids. The night before we returned home I was looking through pictures of the kids on my phone and I just couldn’t stop crying. I missed them so much! God was so gracious in allowing me to be able to come home to see my babies. As it turns out, I was only able to spend a day with them before returning to the hospital in Charleston.

Hudson and Samuel getting ready to watch the Cardinals play in the NLCS.

Lydia at Hudson and Samuel's train-themed birthday party.
The day after I returned from the hospital (Thursday, 10/20) I developed a blood clot on the left side of my chest. I began having significant pain, swelling, and bleeding from my incisions, so I knew something was definitely wrong. Shortly after midnight I called my surgeon and described my symptoms. He told me to come back to Charleston immediately so he could see what was happening and to make a decision about what to do. Thankfully, my mom was in town to help with the kids, so she came to the house and Matt and I made the long, painful, nerve-wrecking drive to Charleston. Matt hates driving when he is tired and he hadn’t gone to bed before I began having problems, so that drive was especially hard for him.

We arrived at the hospital at 3am on Friday morning (10/21) and it was quickly determined that I needed surgery to resolve the situation. The clot was in the vein dedicated to taking blood away from my newly formed tissue flap on my left chest. If the vein remained clotted, the tissue flap would be consumed by blood and would die. So in order to preserve my reconstructed left chest, surgery was absolutely necessary. I was in surgery from 6:30am to 10:30am, allowing the surgeons to remove the clot and repair the vein. My surgeon was not sure what caused the vein to clot, but was pleased with the quality of the vein following surgery. He and his team were very diligent in checking the vein regularly for healthy blood flow, and it initially appeared to be working well.

Heading towards the operating room before my final surgery.
But about twenty-four hours after the vein repair surgery, on Saturday morning (10/22), I once again started having pain, swelling, and bleeding in my left chest. My surgeon quickly came to the hospital and sure enough, there was no blood flowing through the vein. For the second time in two days, the vein had clotted. And for the second time in two days, I had to go back into surgery. Sadly, despite their best efforts, my surgeon was not able to repair the vein. In one last attempt to save my reconstructed chest, he removed a vein from my left ankle and attempted to connect that to my tissue and chest vein. But after about an hour, that new hybrid vein clotted as well. My arteries were delivering blood to my chest, but I had no vein to pump the blood out again. There was nothing left to do except remove the tissue transplant. My surgeon had spent months preparing my chest to receive these two tissue transplants, and had spent dozens of hours in the operating room attaching and forming the tissue in order to restore my chest’s natural shape. But now one of the transplants was going to die; it literally had to be cut out and thrown away. My surgeon and his team have performed over five hundred of these surgeries, and I was the first person who has ever lost a transplant due to vein failure. 

When I woke up in the recovery room I asked myself, “I wonder if I have missed any of the Cardinals game (Game 3 of the World Series).” And after the surgeon told me that I had lost my reconstruction, my mind quickly shifted to the seriousness of the situation and I asked myself, “Why would God allow this to happen? Isn’t it enough to have cancer? Isn’t it enough to have complications in my cancer treatments? Isn’t it enough to have multiple blood transfusions and surgeries to sustain reconstructions? Why would God put me through all of this just to have half of my new chest thrown away?” I waited for answers, truths, and Bible verses that I had hidden in my heart to pop into my head. Quick, easy answers didn't come. But a phrase from 1 Corinthians 6:19-20 kept coming to mind, “You are not your own. You were bought with a price, so glorify God in your body.” I may not have all of the answers to my questions, but God's call on me is the same: glorify me, glorify me in your body, glorify me even in your broken body.

For my chest to be broken is very discouraging – both for me and for my surgeon. My body is only half-way repaired, and his work was only half-way successful. But to borrow and modify a common saying, my perspective on the situation is this: “my chest is half-full, not half-empty.” Sure, it’s discouraging that the left side of my reconstruction was lost after so much work. And it’s very discouraging that I am now left with no good options for reconstruction on that side. But I am so thankful for my surgeon’s hard work, and I truly am thankful that half of my reconstructive surgery was successful. As Matt has reminded me, the shape of my chest doesn’t change my beauty one bit. And as God’s Word has reminded me, my beauty isn’t defined by the shape of my body, but by the quality of my soul.

In the days and weeks to come I hope to be able to discern more answers to some of my "why" questions. But for now, I can take comfort and joy in the fact that God is good, faithful, and will be glorified even in this tough situation. And of course, it doesn’t hurt that the Cardinals won their game last night thanks to a record-breaking performance by Albert Pujols…and that I get to watch them again tonight. Go Redbirds!

Sunday, October 16, 2011

Medical Update: Progress

Posted by Matt Fray

After a couple days of difficulty, Erin is finally making some good progress in her recovery from her surgery. Though the doctors are still watching her carefully for blood loss and infection, her body is growing stronger. She is off her IV's, has been up and out of bed for a few minutes several times today, and is eating better as well. She might not feel like she is getting better (she is still very tired and is frequently in pain), but she really is doing much better.

If she keeps working hard to eat well and keeps her body active, and if she isn't slowed by any more complications, we should return home on Tuesday or Wednesday. It will be wonderful to get home; we're eager to see the kids, and I'm excited about being able to sleep in bed instead of a chair! We are so thankful for the family and friends that are helping care for Lydia, Hudson, and Samuel while we are here in Charleston.

As you pray for Erin, please pray especially for her perseverance in this recovery process. She has had and will have to push through a lot of pain and discomfort - even for basic tasks like finding a comfortable position to sleep in, moving across a room, and eating. Pray that she would have the determination to do what is necessary to strengthen her body, and that her hope and joy in Christ would be steadfast all the while. Also, please pray for grace and patience for me as I help care for her here in the hospital and at home. Pray that I would be faithful to serve her in humility and love in deeds of service, words of encouragement, and spiritual nurture just as God in Christ has done for me (Matthew 20:28; Ephesians 5:28-30; Philippians 2:3-8).

In the same way husbands should love their wives as their own bodies.
He who loves his wife loves himself. For no one ever hated his own flesh,
but nourishes and cherishes it, just as Christ does the church,
because we are members of his body.
Ephesians 5:28-30 

Saturday, October 15, 2011

Medical Update: A Slow Recovery

Posted by Matt Fray

As most of you know, Erin had reconstructive surgery on Wednesday. She made good improvement on Thursday, getting her pain under better control and, though it was very difficult, even got out of bed to sit in a chair for an hour or so. But her recovery process slowed down on Friday.

For those of you who don't have the time or desire to read the medical play-by-play, here's the authorized Cliff Notes version:
  • Erin began having internal bleeding in her chest on Friday morning. 
  • She lost enough blood that she needed to have some blood infused on Friday evening. 
  • She is now being monitored to see if her body will heal the bleeding itself or if surgery is required.
And for those of you who appreciate medical details, or who love Erin so much they want to know everything that is going on, or who simply have spare time on their hands today, here's the unabridged version:

  • Erin began having internal bleeding in her chest on Friday morning. Throughout the morning she became increasingly weak and pale (even her lips turned white). In addition, her temperature and heart rate were rising steadily, her blood pressure was falling, and bruises were appearing on her chest. So in the afternoon the doctors did an ultrasound (to check for excess fluid in her chest) an some blood tests (to measure her hemoglobin count, which helps indicate blood loss). The ultrasound did show excess fluid and her hemoglobin count was very low (a normal hemoglobin count for a female is 12, and hers was at 4). While some blood loss is normal following surgery (because of the blood thinner used during and after surgery), she was losing too much.
  • She lost enough blood that she needed to have some blood infused on Friday evening. While the doctors wanted to avoid giving her blood (because it risks the viability of the transplanted tissue), they determined that the blood loss was affecting her overall health in such a way that she really needed the infusion. So on Friday evening she was given 3 units of blood. She quickly regained her color and strength (enough to watch the Cardinals win Game 5 of the NCLS), her hemoglobin count rose to 8, and we both got a good night's sleep.  
  • She is now being monitored to see if her body will heal the bleeding itself or if surgery is required. While her improvement last night was encouraging, it will take a day or so to see if her body continues to improve. So far today she does seem to be maintaining her strength (as you can see in the picture to the right, she even got out of bed to sit in a chair for a while this morning), though her hemoglobin count is down to 6 (it is normal for the hemoglobin to rise dramatically following an infusion and then fall slightly). Her doctor came by about an hour ago and he said he anticipates that her blood loss will stop now (since the blood thinner is completely out of her system) and that her body will be able to absorb any lost blood. However, there is still the possibility that a surgery would be needed at some point if the problem persists.
We are very thankful that Erin's condition has improved since yesterday. Please continue to pray that God would heal her body so that she can avoid another surgery. Lord willing, she will continue improving and will be able to go home on Monday.

Thursday, October 13, 2011

Medical Update: Yesterday's Surgery

Posted by Matt Fray

As most of you know, Erin had reconstructive surgery yesterday at the Medical University of South Carolina (MUSC) in Charleston, South Carolina. The procedure she had done is fairly new, first developed by a surgeon here in Charleston several years ago, and involves taking skin tissue from the abdomen to reconstruct "natural tissue" breasts.

The surgery was scheduled to take 6-8 hours, but they worked on Erin for just over 10 hours. Apparently the doctors had a little trouble reattaching the venous vein on Erin's left side, so they took their time to make sure it was attached well and providing good blood flow. Though it made for a long day for me sitting in the waiting room (along with our pastor, John Fender), I'm thankful for good doctors who care more about doing things right than doing things quickly! The most encouraging part of Erin's surgery is that it appears that all of the transplanted tissue is infection free and will survive successfully. Whenever tissue is transplanted, there are risks of infection and tissue decay, so we are very thankful that neither of those appear to be issues for Erin.

I first saw Erin about an hour after she came out of surgery. Despite being highly medicated and in great pain, her first words to me were, "How was your day? Did you get a lot of work done? When does the Cardinals game start?" For those of you who know Erin well, I'm sure her interest in my day and her excitement about the Cardinals playoffs run come as no surprise to you. Still, since I am someone who struggles with being self-centered, Erin's selflessness never ceases to amaze me. In sickness and in health, in busyness and in boredom, Erin consistently disregards her own issues in order to focus on the needs of her husband, her children, and her friends.

Erin spent the night in the ICU, partially due to a shortage of rooms in the normal post-surgery wing, but also to allow her to have greater attention from the nursing staff. The nurses in the normal post-surgery wing are each responsible for 4-5 patients, but in the ICU they are only responsible for 2. I'm thankful that she is being taken care of so well! And I'm thankful that the ICU staff allowed me to stay in the room with Erin last night, since ordinarily visitors are only allowed in the ICU for an hour in the morning and an hour in the evening. Lord willing, Erin will require less attention throughout the day today and she can move to a normal room where she can get more rest. The care in the ICU is great, but it's also less private and more noisy than a normal room.

As you pray for Erin's recovery, please pray especially that her pain will subside so that she will be able to get some sleep. And you can pray that she will gain enough strength to begin getting out of bed and moving around a little bit, as that will help her recovery.

Tuesday, October 11, 2011

My Body Rests Secure

Matt and I are in Charleston tonight, getting ready for my reconstructive surgery which is scheduled for 7am tomorrow morning. Lord willing, this will be the end of a long road in dealing with my cancer and I am thankful that it is almost over.

Since I will be in the hospital for the next five days and will miss being with my boys on their birthdays (Samuel will be 1 tomorrow and Hudson will be 3 on Sunday), we celebrated their birthdays this past weekend. I can’t believe that Samuel is already a year old! He has become quite a tough, fast, and energetic little boy, but he is as sweet as can be! He tends to need his cuddle with mommy in between climbing the table and getting into the toilet. J 

On the other hand, it seems like Hudson has been two years old forever – so I am very glad he is turning three. He has developed quite a personality; always the comedian and always very particular about things (for instance, if you try calling him “buddy” or “son,” he will firmly remind you that his name is Hudson). I am so blessed by all three of my precious children! 

I am so thankful that my sister Katie came in town today from St. Louis to take care of the kids for the next several days. I am sure she would appreciate your prayers! J It was hard to say goodbye to the kids this morning, especially Lydia because she is very aware of what is going on. She remembers what it was like the last time I had surgery, so she has not been looking forward to the next several weeks. But I know that they will have so much fun with Auntie KK, Matt's mom, and my mom as they each come help out over the next two weeks!

Before I left town I was able to visit my friend Elizabeth St. Clair as she was in the hospital having baby boy number three! It brought back mixed emotions being at the same hospital, in a very similar delivery room, with the same doctor, exactly one year ago when I was having Samuel. It was sad thinking about the events that led to me finding out about my cancer, but it gave me joy thinking that I have come so far only through the help of my faithful savior Jesus Christ. And of course it gives me great joy to know that Elizabeth will be welcoming another beautiful boy to her sweet family!

It is intimidating and overwhelming thinking about tomorrow and the weeks of recovery to come, but God’s Word is a tremendous source of comfort. A friend of mine recently pointed me to Psalm 16:8-11, which says,

I have set the LORD always before me. Because he is at my right hand, I will not be shaken.  Therefore my heart is glad and my tongue rejoices; my body also will rest secure, because you will not abandon me to the grave, nor will you let your Holy One see decay. You have made known to me the path of life; you will fill me with joy in your presence, with eternal pleasures at your right hand.

On the eve of major surgery, it is an unspeakable comfort to know that not only my soul, but also my body rests secure in God’s hands!

Wednesday, October 5, 2011

Medical Update: Preparing for Reconstructive Surgery

Matt and I went to Charleston yesterday for two pre-op appointments for my reconstructive surgery which is scheduled for next Wednesday, October 12th, at the Medical University of South Carolina (MUSC). It was a long day, but it was good to spend time alone with Matt and to get everything ready for the surgery. Still, it was not fun to think about having the surgery. For the past six weeks, I have been healthier, stronger, and more active than any time in the past year, so it is hard to think about going back into surgery and dealing with another long recovery process.

You may remember that our original plan was to have this surgery at the same time as my double mastectomy in February, but they had to cancel the reconstructive part of the surgery because they discovered a second tumor in my lymph nodes. So after more chemotherapy and radiation, it is finally time for reconstruction. The reconstructive surgery I will be having is called a DIEP (Deep Interior Epigastric Perforator) Flap surgery. This is a specialized surgery that is only performed regularly at a few hospitals throughout the country, MUSC being one of them. As the name indicates, the surgery involves removing interior tissue from the abdomen and using it to reform the breasts. If you want to learn more about the surgery, you can watch a short informational video about the DIEP Flap surgery here. The surgery should last about 6-8 hours. Following the surgery, I will probably spend 4-5 days in the hospital for my initial recovery, though it will take around 6 weeks to make a full recovery. 

After my appointments in Charleston, we made the two-hour trip back home and arrived just a few minutes before the youth group from our church came over for Bible Study. I love having the youth group over - they have such energy and joy, and it is a privilege to help them understand God's Word! We ended the evening around the fire pit in the backyard, enjoying s'mores and a time of prayer for my surgery as well as several other needs in the group. It is so amazing that God invites us to cast our cares on Him, the God of the universe! To think that He hears us, loves us, and will answer our prayers is an amazing reality I too often take for granted.

As we prepare for my surgery, I would appreciate your prayers. Please pray that the surgery is a success and that my recovery would go smoothly. Also, please pray for the kids while Matt and I are in Charleston for the surgery and initial recovery. My older sister will be here with the kids for the first several days, and then Matt's mom will come for a few days. And pray for Matt, especially when we return home and he has to balance caring for me, the kids, and keeping up with his work responsibilities. Thank you so much for your prayers and support!

Tuesday, October 4, 2011

Voices and Faces Interview

As I mentioned in a previous post, several weeks ago I was invited to be one of ten breast cancer survivors to share the story of my battle with cancer through an annual breast cancer awareness campaign called Voices and Faces of Breast Cancer Survivorship. The campaign is sponsored by the Savannah Chapter of the American Cancer Society. They launched the campaign this past Saturday with a luncheon and fashion show with this year's survivors serving as the models. My outfit was not something I would have picked for myself, but it was fun to participate in this great event.
The media sponsor of the Voices and Faces campaign is WSAV, Savannah's local NBC station. They are airing short television ads during October with clips from interviews they did with each survivor. You can check out my thirty-second television ad here, or you can watch my six-minute interview below.

Please pray that God would use these videos to point people to the hope we have in God and His Word!