The End for Now (FAP - Part 5)

Wait! Have you read the other posts? They are here... part one, part two, part three, and part four.

We got a call on December 23rd that that the biopsy results were normal. No dysplasia or cell changes at this time. That was good news! It doesn't mean he won't need surgery, it just means he doesn't need surgery immediately. The doctor wants to see Wesley again in six months to see how things are going and to check his thyroid and liver. FAP, especially Wesley's type, can have other non-colon issues like cancers of the thyroid and liver. The chance is small, but a greater risk for him than someone without FAP.

I asked the doctor if it would be "straight forward" from here on out now that we know for sure Wesley has FAP. He said no, nothing is straight forward about this. It is a rare and unpredictable disorder. He only saw it twice when he was in school and Wesley is his first patient to have it since he has been a doctor. There are doctors who specialize in FAP and other hereditary colon cancer disorders and he wouldn't be offended at all if we wanted to get a second opinion from one of them.

So, where do we go from here? The next step is meeting with a genetic counselor. FAP is usually inherited, although about 30% of cases are spontaneous gene mutations. We are pretty sure that neither Jerry or I have it because we would already have colon cancer if we did, but it is pretty much standard to have the whole family (parents and siblings) tested when there is a known affected family member.

Beyond that, Wesley will have another colonoscopy in a year. We will see how many polyps he has at that time. When there are more polyps than the doctor can remove during a colonoscopy then it will be time to think about a colectomy (colon removal). Our goal is to keep him whole as long as possible without putting him at risk for cancer. Every FAP patient is different and there really is no exact timeline.

Please let me know if you have any questions. I know this was a lot to read and take in especially for those of you who had no idea this was even going on. Thank you for "listening". Now that I'm all caught up, I will post any updates as they happen. Prayers, especially for Wesley, are always appreciated! The prayers we have received up to this point have made a huge difference! No matter what we know God is in control of it all and He knows what He's doing!

If you want to read more about FAP, here are some links for you:
Familial Adenomatous Polyposis (MD Anderson)
A Patient's Guide to FAP (HCC Takes Guts)
Gardner syndrome (cancer.net)
Familial Adenomatous Polyposis (cancer.net)

If you want to read more about hereditary colon cancer disorders (including Gardner syndrome and FAP) visit HCC Takes Guts. The gentlemen that runs this website calls people like Wesley cancer "pre-vivors" because they fight cancer in a special way - before it happens!

One last thing... I know it's a little ways off, but March is National Colorectal Cancer awareness month. It is also happens to be Wesley's birthday month! March 4 is Dress in Blue Day to help spread awareness about colon cancer. We'll all be wearing blue! Feel free to join us!

Future updates can be found by clicking... HERE!

The Procedures (FAP - Part 4)

Please read part one, part two, and part three before continuing on...

They always say the prep is worse than the procedure when it comes to colonoscopies, so that is what I kept telling Wesley. He wasn't that worried about it. A diet of clear liquids sounded kinda fun to him. The thought a camera visiting his insides didn't even him bother him that much. He was more worried about getting another IV than anything else!

Bowel prep for kids is, thankfully, milder than the adult prep. I bought two over-the-counter laxatives and a shopping cart full of clear liquids to have on hand. We made several batches of jello and Kool Aid ice cubes to turn into popsicles and slushies and got started.

It went well. It went really well. There were, of course, trips to the bathroom, but nothing too bad. Wesley is my lightest eater so he didn't even really feel deprived skipping meals. He really enjoyed the broth and jello and drinks of all kinds. Everyone else was jealous of his special treats! Even completely fasting from midnight until the procedure wasn't that bad for him. He was hungry, but didn't really complain too much about it.

We were supposed to be at the hospital at 9:30am for the 11am procedures. Traffic and parking went better than expected and we were checking into admitting at 9am. We were called back to the prep area about 10:30am. Wesley was weighed and measured and got to pick out a stuffed animal to keep with him. He chose an odd looking little brown Beanie Baby bird (the tag said his name was Beak). Then he changed into a hospital gown and had his vitals taken. We met with both the anesthesiologist and Dr. B before the procedure.

The anesthesiologist was kind of a character. He asked Wesley if this was his first time with anesthesia and when he said yes, he replied "Me too!" He let Wesley choose if he wanted the medicine to put him to sleep through a mask or an IV. Of course, Wesley chose the mask. He would still get an IV, but this way he wouldn't be awake for it!

I asked the nurse about how long the procedures would take. She said an hour, but not to worry if it went longer than that. Thankfully, they were running on time. I was able to stay with Wesley up until they wheeled him into the procedure room just before 11am. I gave him a kiss and a hug and went to wait in the waiting area.

I checked Facebook. I sent a few texts to Jerry and Roz. I read a couple magazines. I tried to read a book I brought. An hour passed. Then an hour and a half. Then two. Just when I was starting to pace and get really anxious they called me back to recovery. Wesley was still groggy. He tried to sit up a couple times, but we told him to just lay down and rest. He came around pretty fast and was sitting up and chatting with me before too long.

Dr. B came to talk with us. The good news: the endoscopy was completely normal. No issues at all. The bad news: the colonoscopy was not normal. There were already polyps. Lots of them. I think even he was surprised how many there were. He removed over 40 and he was sure there were some he missed. He said it was the ones he missed that worried him most.

There is no way for them to ever get all the polyps. It's not that he gave up taking them out, he got as many as he could see, but there were probably some hidden in intestinal folds that he didn't see. The polyps are very small (2mm) and the same color as the rest of his intestine so they are camouflaged and hard to see. They were not concentrated in any one area, but spread throughout the whole colon. He saw one right at the beginning and more around each corner all the way to where the large intestine meets up with the small.

This is why they will eventually have to take out his colon. They know they could never get them all and it only takes one they miss that could be the polyp that becomes cancerous. The polyps he did remove were biopsied and sent to the lab. If any of the biopsies come back already showing dysplasia (cancerous cell changes) then we will have to start thinking about surgery sooner rather than later. If they come back okay then we will wait and do a repeat colonoscopy in one year.

Despite some of the less than positive news, we know prayers were answered! Wesley did great throughout the whole thing - both prep and procedures couldn't have gone smoother. He had no trouble at all with the anesthesia. There was no pain or bleeding from the polyp removal. His only complaint was hunger and you couldn't blame him for that!

Once he was good and awake the nurse gave him a much needed apple juice to sip on. Not too long after that he was up getting dressed and we were on our way home! Well, we didn't go right home... we made a quick pit stop to grab me a late lunch and Wesley a milkshake. We were just following orders - a milkshake was actually suggested on his discharge paperwork as post-procedure food!

We had a little surprise waiting for him when he got home. We had asked family and friends to send a card. I had intercepted the mail all week so he wouldn't see them before he got home from the hospital. A few kind friends even secretly brought small gifts. Wesley was so surprised and thankful! He asked several times how we managed to keep it a secret! He spent some time on the couch opening his big stack of envelopes and reading everyone's notes.

He wanted to display them in his room, so we hung them all up on the wall where he could see them.

Special thanks to all of you who sent something! It really made him feel special and loved.

On to the last post...

The Results (FAP - Part 3)

Read part one here and part two here, if you haven't already.

Ten days before the scheduled endoscopy and colonoscopy, I got a call from Dr. B. The final results of the genetic testing showed that Wesley does have FAP. The endoscopy/colonoscopy would remain on his schedule for the 18th, but he wanted to make Wesley the last case of the day so he could take his time and possibly remove any polyps that had already formed.

Jerry travels for work once or twice a year. He was on a plane when I got this call. I texted him and asked him to call home when he landed. I told him about the results as he walked to his next plane between flights. Then I told Wesley. He was upset, but took the news pretty well. We had already been talking about it and answering his questions for several weeks. I told him (and everyone else I talked to) over and over what a blessing in disguise it was that he had that lump on his jaw to alert us to what was going on! Not everyone with FAP has osteomas and/or CHRPEs and without those we would have never known!

There was one benefit to all the waiting. The whole thing had been such a slow process, spread out over months, that there was plenty of time to get used to one thing before moving on to the next. Since we were the ones to discover it in the first place there was never really a shock moment with a doctor where the doctor had to sit us down and break the news to us. 

The hardest part for me was back when we were first waiting to see the ENT doc and I had an idea what was going on but didn't know for sure. I couldn't sleep or think about anything else, but when we got no answers, I moved from worried to angry and determined to get answers. Then with all the delays, we got to the point where there was nothing to do but wait and pray. So that's what we did. We shared what was going on with a few close friends and family members and asked them to pray too.

We are just really thankful that God left all these clues for us and we followed them. I truly believe God has a plan here, He has all along. The plan for us to find out about Wesley having FAP was set in motion as far back as 2008/2009 when the eye doctor found that CHRPE in Wesley's eye and took the time to explain it to me. If we didn't have one piece of the puzzle, or even if a different parent had taken Wesley to a past appointment, we wouldn't have figured this out. None of us wanted this, but we're grateful we found out now and not when it was full blown colon cancer in a few years. 

Are we upset? Sad? Worried? Even a little mad? Yes! But here is the deal... Wesley has had this all along. From the moment he was conceived and his whole genetic code was written he has had this. We just know about it now. And it's much, much better to know about it!

The plan was to have Jerry take the day off and stay home with the rest of the kids when I took Wesley to hospital for his endoscopy and colonoscopy. Before we got the genetic test results, I have to admit I was a little worried about the fact that I would be alone when the doctor shared the news that Wesley did, in fact, have FAP. There was no need to worry about that now! Because of this phone call, I knew before we even went in. He definitely had it. The new unanswered question was: had the polyps already started to form?

We would have to wait until the 18th to find out.

Go on to part 4...