Today's the Day

"So now you'd better stop and rebuild all your ruins For peace and trust can win the day despite of all your losing."-LZ

The team at MD Anderson took Jack back to the OR at 7:01am this morning. Things run like clockwork down here.

After spending a couple of days in Houston last week for more than a few pre-op appointments, scans and tests with the doctors and team involved in his surgery at MD Anderson, Jack went into this morning feeling confident and comfortable. So do we.

It’s going to be a long day, and I likely won’t get back here for updates until he’s comfortable in his room. Thought it might be helpful to share some information about his procedure.

During his appointment last week with his orthopedic oncologist, Dr. Val Lewis, she reviewed his surgery with us on a model of a pelvis. During the (much needed) anatomy lesson, we realized it was a 3-d printed model of HIS actual pelvis the team had prepared for surgical planning. Jack was already trying to figure out how to return to Dallas with that as a souvenir. I just want a photo of this amazing doctor with Jack and that model. Maybe we’ll get both.

The best news of the pre-op appointments was that Dr. Lewis signed off on Jack joining us in Austin for Charlie’s birthday last Thursday. It was also parent’s weekend for the boys. While he didn’t dive head first back into the full offerings at the FIJI house, he did enjoy a few well-deserved days away from his parents, played some golf (thank you Alan!!!), hung out with his roommates, girlfriend and pals. It was a WONDERFUL send-off before some mandatory bench time.

Now we’re back to business. Jack’s surgery: Type Three Internal Hemipelvectomy. Type Three refers to location on his pelvis-which is specifically the anterior of his right pubic bone; internal means that surgery will preserve his limbs (legs); hemipelvectomy is a resection (removal) of the diseased bone to achieve clear, cancer-free, margins. They may/may not use a small amount of bone graft. No other allograft or 3-d reconstructed bone will be used; instead, a biologic mesh will be anchored in his pelvis and used to reattach his abdominal wall muscles and adductors. The mesh will also keep his internal organs in the right place. Dr. Lewis will do her work and then Dr. Adelman the plastic/reconstructive surgeon will put Humpty-Dumpty back together again.

The doctors have assured us that in Jack’s case, his tumor is located in as “good a place” as any in the pelvis. It’s also a non-weight bearing bone which is very encouraging for his return to full range of activities and, hopefully, a faster overall recovery.

Multiple surgeons will be in the OR—orthopedic oncologist, plastic/reconstructive surgeon to rebuild his abdominal wall, urologist, vascular surgeon. He’ll begin physical therapy right away (as in walking to the nurses’ station on Day 2) and hope for a short-ish stay in Houston. Depending on his progress, he may need to return to his chemo schedule in Houston before he can return home. But we are definitely hoping to get back to Dallas as soon as possible. He’ll return to chemo schedule as soon as doctors feel his surgical incision is in tip-top healing shape. We’ll know more about return to Dallas later this week.

This morning Jack was ready to go. Already asking when he can eat a hamburger. Undoubtedly stomach grumbling since he hadn’t eaten since Saturday early evening. Dr. Lewis asked for his music choice for the OR—anything but country-western. Well, at Jack’s request they were all tuned into Led Zeppelin’s Immigrant Song for the first 30 seconds at least. I’m guessing it will not be the top of her Spotify playlist for long.

My hourly mantra: Jack is really strong, unbelievably positive, undeniably determined and otherwise supremely healthy, so we are ever hopeful he will come through this with flying colors.

In the meantime, continued gratitude and love to all of you who are simply the most incredible team of supporters we could imagine. You are lifting us up and toward the finish line. A very, very special thank you to the incredible medical professionals from far and wide who have gone out of their way to be available to us, take phone calls, field questions and encourage us to ask more. In particular, BIG thanks to Dr. Karl Rathjen, our hero and close friend, for all of the above and for sitting with our family and holding this mama’s nervous hand.