TUMOR REMOVED!

At 6:30 am this morning, Theo was admitted into the pre-op staging area on the 3rd floor of Comer Children’s Hospital where he was prepped for his operation to remove the primary neuroblastoma tumor that engulfed his left adrenal gland.  He was weighed and then examined by four nurses, two anesthesiologists, and two doctors.  He changed into a surgical gown, he selected bubble gum for his sedation mask flavor, and his abdomen was signed.  He politely declined the oral pre-sedative that would help calm his nerves, and announced that he would walk to the OR on his own.  At the entry way of the surgical wing, his parents hugged and kissed him, assured him that they would be near by, and promised that they would be with him when he woke up.  Kosta and Eleni watched Theo walk away towards the operating room holding his plush Cross with the words “Health” embroidered on it, escorted by the two anesthesiologists.  And when the two large steel doors slowly closed in front of them, and their son disappeared from view, Eleni and Kosta felt stunned and petrified and could no longer control their emotions.  They slowly adjourned to the waiting room where they anxiously awaited the hourly progress updates that they were promised.  And as they settled into their chairs, Dr. Liu briefly came by to meet with Eleni and Kosta and answer any of their last minute questions.  Everyone was in agreement that the game plan was simple:  Get all of the tumor out, preferably laparoscopically. 

The operation began at 8:30 am. As each hour passed, Eleni and Kosta’s worries became that much more unbearable.  Would the team be able to get all of the tumor out?  Could Dr. Liu avoid an invasive procedure?  Was Theofanis alright?  Updates came every hour...sometimes by phone, sometimes by nurses that emerged straight from the OR.  At each update Kosta and Eleni were assured that Theo was doing well and that he was strong. They were told the procedure was progressing, and they were told that Dr. Liu was taking his time. He was taking it slowly.  Why?  Was something wrong?  With every passing hour, from the first, to the second, to the third, to the fourth and to the fifth hour into surgery, the fear that something was terribly wrong hovered in their minds.

Finally, at 2 pm, an OR nurse came into the waiting area and told Eleni and Kosta that the tumor was out and Dr. Liu was finishing up!  She explained that it was a much more complicated procedure than anyone initially thought.  When Dr. Liu went in, he discovered that the tumor had wrapped itself around the aorta and all the major abdominal blood vessels and veins.  It was a very difficult maneuver to reach and cut out all the tumor cells while protecting the critical vessels in his abdomen. Yet, miraculously, Dr. Liu was able to resect the tumor completely and he did it all laparoscopically!  Minutes later, Dr. Liu came out with color photos of the tumor and he explained to Eleni and Kosta exactly what he did. He said, “It was a tough one.” And, he even apologized that it took so long! No apologies necessary!  He was able to chisel out the tumor which had surrounded critical vessels, did not harm any existing organs or other structures, kept Theo’s well-being at the forefront, and did this through the aid of scopes and no major incision.  And, as the nurse said, when it got tough, Dr. Liu didn’t give up. He continued on instead of resorting to traditional invasive surgery.  Dr. Liu is truly amazing!  In joy and relief, Eleni hugged him and the head nurse, too. 

Another amazing aspect of this laparoscopic surgery is that Theo lost no blood during the operation. (Again, another benefit towards a faster recovery.) But as the anesthesiologists were keeping close tabs on Theo throughout his nearly 6 hours of sedation, they decided to give Theo a red blood cell transfusion because his hemoglobin was a little low. Post surgery, his counts were strong. But, taking into consideration that the surgery was complicated and took a long time, Dr. Liu decided to transfer Theo to the Pediatric Intensive Care Unit for his post anesthesia recovery for at the very least a 24 hour observation. 

When Kosta and Eleni arrived at the PICU, they were exalted to see their little boy.  Although he had tubes in his nose that ran down his throat into his stomach, an oxygen tube, and a catheter, Theo was resting comfortably.  He was still groggy from the heavy sedation, and they sat and waited for him to wake up. They were warned that he would have a lot of pain when the anesthesia wore off and that there are open orders to administer morphine. But the fact that he only has 3 small pieces of surgical tape on his belly and one strip over his belly button (smaller than a pinkie band-aid), they felt re-assured that Theo’s stay in the PICU would be short.

As the afternoon turned to evening and evening turned into night, Theofanis remained asleep, obviously very exhausted from the surgery, groggy from the anesthesia, and probably uncomfortable with the stomach tube which made him unable to swallow. So, under constant observation in the PICU, his body has started to heal. His temperature is slightly elevated (expected), his abdomen hurts (expected), his breathing is a bit labored (expected), and he drifts in and out of wakefulness (expected).  

At 9:00 pm, Father Andrew Georganas visited the PICU to bless Theofanis. He offered a prayer to God for not only his recovery, but also to the doctors, nurses who were instrumental in his progress towards full health.  He anointed him with holy oil, and it was evident that Theofanis was comforted by Father Andrew’s familiar and loving voice. Eleni and Kosta thank Fr. Andrew and Presbytera Dimitra for their constant love, support, and prayers.

So, what’s next? If all goes well, Theo will be moved to the 6th floor of Comer tomorrow as he continues his recovery from surgery.  Dr. Panigrahi, one of Theo’s oncologists, had his Chemo #6 orders ready to go as soon as Theo was rolled out of the operating room. Happy with Dr. Liu’s amazing work, Dr. Panagrahi expects that Theo will begin his 6th round of chemotherapy on Monday, which will then signal the end of the first phase of Theofanis’ four phase treatment plan.  Also, the resected tumor will be sent for pathology testing.  The doctors should know by the end of next week whether the tumor is necrotic and whether the tissue surrounding the tumor, the marginal area, has any evidence of neuroblastoma cells.  Eleni and Kosta are praying for a necrotic tumor and negative presence of other cells in the marginal tissue.

THE POWER OF PRAYER       

Thank you to all who have sent their best wishes and prayers on behalf of Theofanis.  We are all very fortunate for your friendship at this time.  Thank you to Dr. Liu and his staff at the U of C.  The tumor is finally out and that is now a prayer that has been answered.  Thank you, O Heavenly Father! Love, Eleni and Kosta