The Plan

Us at Fenway Park

Yesterday was a pretty big day. Alex had more tests in the morning and then we met with Dr. Linuti in the afternoon. The results of the biopsy confirmed that the tumor is non-aggressive carcinoid cancer. We were actually able to watch a video of the tumor which amazed us both. The images showed that it has grown slightly in size and encompasses the majority of his right airway.

The surgery. Thursday Alex will check in at 6:45 am. Thursday is rounds day at Mass General so the OR (there are 190 operating rooms here) doesn't begin surgeries until 9:45 and he is first on the schedule. We've had a lot of questions about the surgery, so below is a description of what will take place. If you're not one for this sort of thing you might want to stop reading here. The procedure for the surgery is as follows: An 8-9 inch incision will be made on Alex's right side. They will cut through the lateral muscle and remove most of a rib. Then, the lung will be detached and deflated. The piece of the bronchial tube where the tumor is attached will be cut out & removed with the tumor. Some reconstruction of the carina may be required at this point. The bronchial tube will be reattached. They will then transplant a piece of muscle from his rib cage to wrap the tube for strength. This muscle is expected to regenerate and lessen the risk of separation. The right lung will be re-inflated and the incision closed. The rib bone will not be replaced as it is thought to be better to not irritate the rest of the area. The bone will apparently re-grow over the course of the coming months. The surgery is estimated to last 5-6 hours. Alex is expected to be in the ICU for a couple of days and in an induced coma until the breathing tube is removed. At that point he will be transferred to a regular recovery room where he will likely be for another week. The recovery times posed to us are the average. Like everything else with Alex, I have complete confidence he will exceed the expectations.

While he is tiring in energy and even a bit in appearance, Alex's spirit is far from it. He has taken this experience and turned it into opportunity. He is determined to visit every historical monument in Boston. We often find ourselves following along with 5th grade field trip groups and having a pretty good time at it! He figures if we are not at the hospital we might as well make the most of our time. Since something about us sadly screams that we are out-of-towners, we are frequently asked why we are here- vacation, work, etc. Alex's standard response now is that he's simply here for some warranty work. :)