Update

I spoke to Mom and Dad last night and was happy to hear that Dad has an appointment with radiation oncology in Everett on June 4, and an appointment with the thoracic surgeon at U of Washington that Dr. Nichols at Mayo recommended on June 6.  I think that both of these appointments will give them a better idea about when they'll be able to start the radiation and chemo and maybe a proposed plan for sugery afterwards.

Home

Not a whole lot to report, but I talked to Mom last night, and she let me know that they made it back to Stanwood yesterday.  The trip went fairly well, and they got a chance to spend some time with Grandma in Jamestown, and saw Tim and Jan, as well as some Dalbey's in Billings.  They'll be spending the rest of this week figuing out where and when appointments will take place. 

Heading Home

Just got back from a lovely evening with Andy's family.  Supper on the patio and an impromptu game of dictionary.  Mom and Dad are packing up and will start the trip back to Washington tomorrow after spending a couple of days with Nathan and family in Fargo.
Mom and Dad have had a busy week dealing with paperwork to deal with Washington state insurance and working to get records transferred from Mayo back to Washington. 

While it is not playing out how I had hoped it would, Dr. Nichols, the thoracic surgeon at Mayo has assured us that Washington (particularly the University of Washington) has good care for esophageal cancer and that proceeding with care as outlined here in Rochester (6 rounds of chemo and radiation and then surgery to remove the esophagus) was a good option and could be done there as well as here.

Dad's still feeling good, and able to eat most things he wants to.  They will be taking their time driving back and Dad assures us that he's feeling good to drive. They are pretty sure that they will be able to begin treatment in Seattle or Everett in early June  Once we know more about when and where Dad will be getting treatment, I (Sara) and the boys will probably make some plans for trips to be helping out, but of course we won't really know plans until we know both when Dad's starting treatment and how he reacts to the radiation and chemo. 

Andy's family is reading through Daniel, and we were able to join them in reading Daniel 6 tonight.  The chapter concludes with the words of King Darius after seeing God rescue Daniel from the lion's den.  These words were a reminder to me that God uses seemingly impossible situations to bring glory to himself, and that it is indeed a privilege to be a piece in God's work.
"Peace be multiplied to you.  I make a decree, that in all my royal dominion people are to tremble and fear before the God of Daniel,
   for he is the living God,
     enduring forever;
  his kingdom shall never be destroyed
     and his dominion shall be to the end.
  he delivers and rescues;
     he works signs and wonders in heaven and on earth,
  he who has saved Daniel from the power of the lions."

Tests

I found this video educational.  Dad has undergone most of the tests/scans discussed.
http://youtu.be/pIVWNjIOmd4

Monday

So, a busy couple of days.  Dad met with the GI doc and surgeon on Friday who went over the results of the endoscopy and ultrasound.  They were not able to put the scope as far down the esophagus as they would like, but from what they were able to determine, the esophageal tumor is a T3 (The tumor has advanced through the entire esophageal wall) and the surrounding lymph node is at an N1 stage (Cancer has extended to nearby lymph nodes).  I found this link helpful in discussing some of the different staging of esophageal cancer if you are interested
http://www.healthcommunities.com/esophageal-cancer/staging.shtml

With this, the recommendation from the surgeon was to proceed with meeting with Oncology and likely 6 weeks of chemo and radiation to prepare the esophagus for surgery to remove the infected part of the esophagus and pull the stomach up to connect with the upper portion of the esophagus.

Dad and Mom met with the Oncologist and radiation oncology this morning (Monday) to discuss next steps for the radiation and chemo and they confirmed some of the tests and treatment options as discussed on Friday. 

However, they met with the Business Office on Monday afternoon, who told them that because they were not Minnesota resident and uninsured, and because treatment options are available in Washington, that they are not able to continue treatment here unless they are able to pre-pay for the treatments.  Not what any of us wanted to hear, to say the least, but they did give some advice for working with hospitals and insurance companies in Washington.  Understandably, Mom and Dad are not sure exactly what this means for next steps. 

Thank you to all of you who have been praying for us.  We know that God hears our prayers and will answer them according to his good will.

I'll update more as we know it.

Essence of Esophagus

I've decided to bring back Essence of Essie to keep people up to date on how Dad is doing, since posting some of this stuff on facebook just doesn't seem right.  I hope that this will be a place to answer some of your questions, and most importantly let you know how you can be praying for Dad and Mom right now.  I know that they wish they could talk to each one of you and keep you up to date, but it has been a whirlwind of activity the last week and are only just beginning to have a sense of what is going on.

Last Tuesday Dad had an Endoscopy at Everett Clinic (in Washington) and tissue biopsy of his esophagus because of some issues he's had with swallowing and weight loss.  The result of that biopsy showed  esophageal adenocarcinoma and evidence of Barrett's esophagus (a disease associated with acid reflux and irregular cells in the lower third lining of the esophagus.)  The recommendation for next steps was to have a PET scan to determine how far the cancer had spread.  Because the PET scanner in Everett was down and Dad would not be able to get into the hospital in Seattle for a couple of weeks, I made some calls and was able to get Dad an appointment at Mayo this week.  I flew out to Washington Saturday morning, and Mom, Dad, and I took off after church on Sunday to drive to Rochester. (A long fast trip with great weather and roads).

Dad (and Mom) met with Dr. Ravi, a GI Consultant, Wednesday morning, and he got Dad in for a PET scan that morning.  Yesterday afternoon they met with Dr. Ravi again to go over the results of that PET scan and received the very good news that the cancer has not spread outside of the esophagus.  Today (Thursday) Dad had an endoscopy and ultrasound of the esophagus to determine how deep the cancer goes.  This is a small camera (scope) with the ultrasound "machine" wrapped around it that is sent down the throat to allow the radiologists to view the inside of the esophagus.  Once the doctor and surgeon have had a chance to review these pictures, they will be able to advise on next steps for Dad. 

Next steps almost certainly involve surgery to remove the portion of the esophagus that is cancerous and then pull the stomach up to attach to the remaining portion of the esophagus.  Most likely there will be 6 weeks of chemotherapy and radiation before hand to prepare for surgery, although there is a slim chance that Dad could go right to surgery without the chemo if the cancer has not spread too deep or too high into the esopohagus.   Dad and Mom meet with the surgeon tomorrow afternoon to review the results of the ultrasound and discuss next steps.

Dad has been feeling pretty good, but has had to be careful what he eats - soft foods and soups, and take his time when eating.  However, after a long day of tests and discussions yesterday, he still spent an hour and a half doing yard work when he got back to my house, and who am I to stop him from doing what he wants :-)  There are a lot more questions than answers right now, but Dad knows who holds the future, and is trusting that God will continue to exhibit His glory through all the moments.  Your prayers for peace, trust, and wisdom are coveted.

Just checked with Mom to make sure there were OK with my posting this, and got this message back from her  
I just walked into the "computer" room to open this up, and what did I see but your father's face looking through the window.  When I asked him what he was doing, he told me that he was removing a wasp's nest. They told him he couldn't drive or operate heavy machinery today, nothing about climbing ladders to the second story to deal with wasps, though.

I'll post more as we know it.

For those of you who are interested, Mayo has some decent information about esophageal cancer, Barrett's esophagus, and some of the tests here
http://www.mayoclinic.com/health/esophageal-cancer/DS00500