Seth's Info

Hi everyone. This is my first post to Seth's blog, and I will try to post after Seth's surgery tomorrow and let everyone know how he's doing.

We have had another crazy week, as Seth likes to say. Seth is now scheduled for surgery tomorrow (Friday) to permanently bypass his esophagus.

Seth’s esophagus has been severely damaged over the last 5 months from the initial high dose of radiation and the repeated administration of Adriamycin (one of the chemo drugs he had for the first 5 chemo cycles). After endoscopic examination on Wednesday, the surgeon found two major problems. First, a fluid-filled sinus has pushed out from the esophagus wall to about the size of a plum (where the wall had weakened). This alone would warrant removal of the esophagus, and is a life-threatening event in itself. Second, a fistula, or tunnel, has developed between the espophagus and the left branch of the windpipe. This is a more serious condition and complicates matters because the risk of infecting the lungs is very high. It explains very well his inability to swallow anything, and his persistent cough etc. The doctors were somewhat amazed that his lungs were in the reasonably good shape that they are. Frankly, I think it is miraculous that in his immunocompromised state he has not developed anything serious, and is walking around, talking, and not in pain.

Were his esophagus in better shape, it would be completely removed and the stomach stretched up to the throat to create a new connection to the GI tract. Because of the fistula, the surgeons want to seal off the esophagus and leave it in place to minimize the risk of infection in the lungs. This is “sub optimal” but should get the job done. The stomach will still be pulled up to the throat, bypassing the esophagus, and attached to the back of the throat. By not removing the esophagus, they will not have to disrupt the chest cavity at all, and will minimize the risk of spreading infection into the airway. The long term effects essentially amount to a life style change in the way Seth will eat. Small, frequent meals, non acidic food, etc will be the norm.

Additionally, a feeding tube, called a J-tube, will be inserted to allow for direct feeding until Seth can eat 100% through his mouth. This gives us a lot of flexibility in adding more complex foods to the diet while still maintaining a high calorie diet. Recovery in the hospital will probably be 10-12 days, but it is always hard to predict these things. This is a major surgery with the biggest risk being a severe infection developing in the lungs or interior cavities.

The good news is that Fox Chase treats a lot of esophageal cancer. Although Seth's problem in the esophagus is not a malignancy, he is in essence getting the kind of operation someone with esophageal cancer would have. Seth's surgeon is heavily experienced and published, and we have the utmost confidence in his judgement and skill. I would guess that he's around 60, so he's been taking out esophaguses for a long time. This type of surgery is technically complex, so we are relieved that we are already at the right place and don't have to travel even farther from home to have the "right" surgeon take care of Seth.

Needless to say, we have had to process a lot over the past week, and this whole long episode with Seth's esophagus has been a major setback to say the least. Seth is looking and feeling remarkably well right now. He has lost a significant amount of weight over the last month b/c of his difficulty, and eventual inability to swallow. I am amazed at how Seth's body has compensated for this major defect in his esophagus and trachea.

Seth will certainly be out of commission for a while, but I know that he would definitely like to get some mail while he is here. The address here is:

Seth Edmondson (patient)
Fox Chase Cancer Center
333 Cottman Ave
Philadelphia, PA 19111

I want to make a hasty apology to our friends and family. Because these last few weeks have been so incredibly busy and hectic, we have failed to acknowlege packages, emails, and phone messages. I know that you all understand, but I want you to realize how much your love, generosity and concern mean to us. Thank you!

Please keep Seth in your thoughts and prayers. My beautiful husband continues to amaze me with his strength and grace throughout this ordeal. I know that we both continue to draw our strength from all of you.

With love,
Jenny