More on Mark's Kidney Tumor Removed Using the da Vinci Robotic Surgical System by Da Vinci

Mark was seen today for postop follow-up in Houston. His oncologist and surgeon both told him his tumor was cancerous and the cancer was called "clear cell" carcinoma.

You can read about the da vinci robotic arm system at http://medgadget.com/archives/2005/07/da_vinci_robot.html See picture of same above. It is like three arms on a post. Each arm has a wrist with 8 degrees of function. The surgeon sits across the room from the patient with their arms inserted into a console. The focus is adjusted by foot pedals.
Addendum 1/12/2011 Four days before Mark's surgery Time Magazine Dec. 13,2010 had a seven page article on the Da Vinci surgical robot. We just read it today. The article says there are a thousand hospitals and clinics in this country and 400 others in the world that have this machine and that half of all prostate cancer operations are done using this robot.Dr. Mani Menon, born in India, was the first surgeon in this country to use a robot to remove a cancerous prostate gland. He was a protege of Dr. Patrick Walsh of Johns Hopkins and learned Dr. Walsh's technique for doing surgery for prostate cancer that left the patient still potent and continent. This technique had the surgeon doing the work using his hands and going by feel not sight. Using the robot, Dr. Menon and now others, can see the surgical site. In 2000 Dr. Menon opened the country's first center for robotic prostatectomy at Henry Ford. Currently the da Vinci robot is used for many types of surgeries in various parts of the body. The da vinci robot costs more than one million dollars and after each procedure parts worth around $1,500 have to be replaced.

Happy Holiday Wishes From Mark and Family and Follow up on Gout vs Infection
We are having our family gathering at our house on Christmas eve. We will cook a lot and our friend Suzie will help us cook. We will do a white elephant gift thing and play some games. Mark's sister will stay in Okinawa. We urged her earlier to take her Christmas vacation and head to Thailand for her health check-up which she did...and it was a good thing. When Mark gets better maybe we can go visit her.
Mark is not feeling peppy. He is taking it easy and will go to the VA hospital in Houston on Dec. 29. He will see his oncologist and the doctor who did his kidney surgery. Maybe there will be a report on the kidney tumor. Maybe we will will find out if it was malignant or not and if it is a primary tumor or metastasis.
To follow-up on Mark's earlier hospital stay for intense pain and swelling in his elbow: It was gout. Mark had another bout but managed it at home and it subsided just before going to Houston for his kidney surgery.

Mark is "a lucky man" According to the Surgeons
Mark was released from the hospital yesterday (Sunday) after the doctor told him how lucky he was. It turns out the docs were able to save 99% of his kidney. The doctor explained that the tumor was growing on top of the kidney like a tree with only the trunk dipping into the kidney so it seems they only had to core out the trunk. Mark had great doctors and great nurses and nurse aides. Everyone of the staff were super. The pictures above include Susan his favorite nurse (although he liked and appreciated all his good nurses) and the cutest Santa whose name I did not get. You can also see a picture of Mark's wounds...a few incisions where the robotic arms were inserted and his Jackson-Pratt drain.
On his fist and second post-op days, Mark was no longer doing dance steps and was not joking with the nurses as much. He was still in and out of bed and walking a lot but he was having pain and was tired.
Mark was worried about the trip home and all the jarring from the road which causes him pain, but he survived the ride home nicely and without complaint (except for my driving), reading a book all the way home..

Mark's Kidney Surgery and Follow-up About the Gout ... We started the 3 hour Houston drive on Thursday at 4 pm not knowing if the surgeon had clearance for Mark's surgery on Friday or not. We were 90 minutes on our way going on faith that the surgery would take place when the surgeon called to say that the surgery was cleared. Traffic was very heavy as we got into Houston but we arrived safely...and too tired to go out to eat so we ate at the hotel.

We were told to report to the VA Hospital at 0530, so we were up at 0415. Mark was in surgery at 0740 and stayed there for four and a half hours. It was a partial nephrectomy, robotic arm assisted. The doc finally came to tell me that surgery went well...they saved 90% of the kidney. The margins around the tumor which was cored out were clean.
After about 25 minutes I was able to go to recovery room and Mark was wide awake and joking with the nurses. He immediately asked me to get his Kindle book reader his sister Stephanie sent him. He was in his room in another 30 minutes, and luckily he got a private room. He retaped all his tubes himself, got up, stood at the bedside and did some dance steps, sent me to get iced tea and candy, joked with the nurses and walked all over the hospital. At one point the nurses thought he was walking the hall, but he'd gone downstairs into the fresh air. He may get to come home tomorrow (Sat) to continue his recovery. More info on the tumor that was removed, when Mark gets a report.
PS Mark's elbow pain and swelling was due to gout. He had a second bout of gout but not as bad as the one which put him in the hospital. See earlier post. The second bout subsided in time for the kidney surgery. Good timing.

Mark is in the VA Hospital in Temple Texas
The guys from Reno, Alan and Mike, were here and great fun was had by all especially at the football game which UT won on a beautiful sunny day. Mike went back on Sunday and Alan on Tuesday before Thanksgiving. On Tuesday before Alan left, Mark was up at 3 am complaining of excruciating elbow and arm pain. When the local VA clinic opened James and Alan took Mark there. Mark ended up going by ambulance to the VA in Temple. He had x-rays, labs, fluid taken off elbow and now bets are being taken over whether it is an infection or gout. Mark will miss turkey day at home. The docs have disappeared for the holidays and there is apparently no one to discharge him or give him a pass home. What a turn of events! Oh well, this too shall pass and we'll go on to the next adventure.

Mark Will Be in Austin Soon and And So Will His Buddies Allen and Mike

Mark's friends and former coworkers Alan and Mike are coming from Reno for a visit this week and Mark is coming from Thailand to get ready for his kidney surgery in December. The guys have tickets to the University of Texas football game on Nov. 20th. Barry who sold us some of his family's season tickets has invited the guys to a tailgate party. This is exciting like getting extra icing on your piece of cake. Barry let me know that someone has been making a documentary of their tailgate party and they have a lot of footage already, but wouldn't it be fun if Mark and the guys could get in the film scarfing down some ribs or chicken or something? Mark gets his energy to fight cancer from doing fun stuff and being with fun people. Having something to look forward to and then enjoying is always good medicine.

On August 2nd Mark went to the VA to Schedule Surgery for Renal Tumor

Mark and I made a mad dash for Houston on Monday for a 3:30 appointment regarding his upcoming surgery for a renal tumor. About 4 pm he saw the most knowledgeable lady doctor who showed us the MRI and the tumor. Mark will probably have three incisions which is lots better than the large incision we thought he was going to have. Mark is hoping to schedule the surgery for a little over a week before Christmas. The plan is a couple of days in the hospital and then home for about a six week recovery. This may be renal cell cancer separate from his adenocarcinoma or it may be metastasis from the adenocarcinoma of the esophagus or it could be benign. We will know when the tumor is examined after surgery.
As you may have guessed we got away from the VA in time to play with the rush hour traffic in Houston before exiting the city for Austin.
We wonder how many people have experienced two different kinds of cancer. If you had two different kinds, please post a note.

Mark just back from an 11 day trip to Lake Tahoe, Reno, and California
Mark went camping, fishing, and seafood-eating with Alan and Mike, guys he used to work with in Nevada. They had a lot of fun, caught a lot of fish and saw a white whale. Mark needs days of fun to help him deal with fighting off cancer. At the present time he is 5 years and 5 months out from his diagnosis of esophageal cancer with metastasis to the liver. Does he have cancer now? Is it in his kidney or lurking somewhere else?

Although Mark's recent pet scan was clean, his MRI showed that his small kidney tumors have doubled in size in the last year. He will see the urologist/nephrologist this coming Tuesday and he will see his new oncologist at the VA the next day. Mark is staying positive. He's ready to head to Thailand and has a ticket for August 11, but could end up staying longer for kidney work.

We'll miss Mark when he heads to Thailand. We really enjoy having him close by - he is good company, keeps the pool clean (having brought it back from green to beautiful blue), keeps the grass mowed, the kitchen clean, cooks, and is upbeat and positive. We've all seen what a tough battle he wages against this cancer, and it's both impressive and especially nice to see him in such good spirits.

In the meantime, Marks sister, Stephanie, has taken a transfer of sorts with her job and moved to Okinawa, Japan, with her ancient cat, PingPong, in tow. This means she will be much closer geographically to Mark and I will be able to potentially stop in to see her both on the way to/from Thailand. We're waiting to hear her first impressions of Okinawa, and perhaps both Mark and I will be able to visit her while she's there.

I'll put some more cultural information about Thailand on the blog soon.

Mark in Austin at the Tacco Express

Ever heard of the expression "Keep Austin Wierd?" One of the places that lives up to this motto is the Tacco Express on South Congress. On Sunday at noon and some evenings, there is live music. Today's music was a gospel and blues group. Some people dress up in things like tutus feather boas and dance. That includes men as well as women. Sometimes people show up dressed to the nines while most go casual or off beat. If you go, you will fit right in.

Mark has been busy since getting to Austin. He has been to the Veteran's Hosp. in Houston twice and has to go again. He has cooked brisket in the smoker, brought the swimming pool back to blue from an ugly algae green, been working on healthy living from eating healthy to exercise and has cared for the yard. Another trip to the VA for an MRI is scheduled for next week. You might want to pray (or send good energy Mark's way) that his test results are good.

Life in Thailand
Soon I will put something more on this blog about life in Thailand.

Mark is Leaving the Land of Smiles (Thailand) Today and headed to the USA
When Mark is in the airport in Bangkok, he will be in one of the most beautiful airports in the world. There are beautiful huge statues of mythical characters and scenes from Thai myths. Orchids are in magnificent abundance along with other flowers.
Mark is coming to get a check-up with his oncologists at the VA hospital in Houston this coming Wednesday. Say a prayer for him. It's been a long time since he had a scan of any kind or a check-up.
Mark just called to say his flight out of Thailand or somewhere else along the string of flights got canceled so he is on a new flight schedule. He is on his way

Happy Birthday Mark

Shoe Cart in Pattaya/Jomtien Beach Thailand

Tomorrow is Mark's 6th Birthday after Prognosis of 3 Months or Less to Live

After the frightening discovery of cancer and metastasis in 2005, I was afraid Mark wouldn't live until his birthday in April of 2005. Not only did he live until that birthday, but he'll celebrate his 6th birthday after diagnosis, tomorrow.

How thankful we are that Mark has survived. It could easily have been otherwise. Yesterday dear friends lost their young adult daughter who had lymphoma. She died not because of lymphoma but rather to decreased immunity due to treatments for the lymphoma and then getting a bacterial infection. How sad this is.

While Mark wasn't lucky enough to have health insurance for the first two years of treatment, we were lucky to be able to pay cash at Bumrumgrad Hospital. We lived a 50 cent Taxi ride from the hospital. The hospital kept a close watch on his WBCs and RBCs and would let me take injections home to give him to stimulate WBCs or RBCs as needed. Mark and I kept a close watch on his temperature and other signs of infection. In Thailand we could buy antibiotics at the pharmacy without a prescription. When we were on a trip, we could start antibiotics ourselves. So many things have kept Mark alive: grace of God, prayers, lots of support from so many people, his love of reading, fighting spirit and luck. Love of reading really helped as he could take his mind off his situation. This helped keep the stress down. We think we know what helped keep Mark alive, but in the end no one really knows why one person lives and another does not. We know it wasn't from avoiding sugar as Mark loved sugar and ate things with sugar. We know it wasn't from herbal medicine or special seaweed preparations. He had to choose between herbal medicine and his oncologist and radiologist. He chose the doctors, which for him turned out to be a good decision. There were times when it felt like Mark could slip away from us, but somehow he survived.

More on the Culture and Life in Pattaya/Jomtien Beach, Thailand
In Jomtien Beach, a vegetable and meats cart comes by nearly each morning. Small portions of meat hang in plastic bags to keep flies out and there is a wide variety of vegetables. When I was in Thailand recently, I bought things from this cart to have made into soup or other dishes in the guest house where I stayed.The guest house manager "Da Da" was eager to cook me delicious things with lots of vegetables and pork, chicken, and/or shrimp but not beef. Many people here do not eat beef for religious reasons.
Sometimes a cart comes down the street with a wide variety of clothing for women. There are carts down the beach road and main roads that have all kinds of food for sale. Vendors are on the streets selling all kinds of articles made by hand. There are people selling women's underwear on the street. One of my favorite carts is the shoe cart which has racks of all kinds of fancy women's shoes on a cart powered by a motorcycle. See picture above. Click on any picture to enlarge it.

Mark is still in Thailand and Using Easy Cheap Transportation to Get Around in Pattaya/Jomtien Beach Thailand



In many ways life in Jomtien Beach Thailand is less expensive and easier. I thought I might do a few blogs on how life is different there and perhaps give you a little insight into why Mark stays there so much.

In the pictures above you see the popular truck with bench seats transportation. It is called a Songtao and sometimes Songtail by Forang (foreigners) . For 10 baht (100 baht = approximately $3) you can travel lots of places in the city and for 20 baht you can travel to more distant areas. You simply flag one of these vehicles down and climb on. If the vehicle is full or if you just want to, you can stand on a back platform and hang on. Many people who live in Pattaya/Jomtien Beach do not own a car thus avoiding all the costs and other problems that go along with operating a car. This can make life a little less stressful. Maybe less stress will help Mark stay in remission. When he comes home, he'll go to the VA hospital in Houston and the doctor will try to find the answer to the question of remission or not.

Mark at Jomtien Beach at Sunset

Mark and Mom in Pattaya-Jomtien Beach Thailand

I (Mark's mom)arrived in Thailand at 1:30 am. Mark had sent a driver (Mr. A.) for me. The plane was late but Mr. A waited and he recognized me right away. After sleeping on the plane and on the ride from Bangkok to Jomtien Beach, I was up and ready to go the next day. I am staying at Angel's guest House on Chiaprauk Road and Mark has a one bedroom condo a mile or two down the same road. Mark had been saying he was putting on weight and indeed he had put on some, but of course he is still not very pom puey (fat). everyone remarks about how handsome he is.

The movie is off. The proposed cast was very "wiggly", coming and going and not available for critical times and some prospective cast members thinking this movie was going to gross millions and wanting to be paid accordingly. Here movies have to be approved by the Thai govt. but that didn't seem to be any problem. The real problem was getting a working cast committed to the project.

So far our adventures have been confined to Pattaya-Jomtien with one foray out to the Silver Lake Winery and gardens which is very beautiful. There is a gorgeous lake viewed from the abundant flower gardens. Across the lake there is a windmill that looks like a scene from Holland.The vineyards are beautiful.

We also went to the turtle conservatory at the Sattahip Naval Base. Our driver and guide was a Navy Marine. Apparently you can be a marine in the Navy. There is a submarine on the navy base. Farang (foreigners) can see the outside but are not allowed inside the submarine. There were many many turtles at the conservatory from very small to very big ones. At one point we were driving along the coast on the navy base and came to a barricade. Our guide got out to talk to the guards and later told us, we could not go on that road as the Thai prince was staying somewhere on a nearby hilltop at the navy base.

Mark and I made one Rotary meeting at the Cliffs Hotel Complex where the Rotary Club has their own dedicated room. When the hotel was built, one room was created especially for Rotary. It is a round room with the Rotary flags displayed all around the room. When the meeting begins, we face a picture of the king, not the flag and the national anthem is played. The food is good. We had duck and red curry. Each person orders what they want from an extensive hotel menu. The speaker talked about an orphanage he has created in the north of Thailand. Like Mexico, children are not necessarily orphans. Families send them to the orphanage if they can not afford to feed and care for them. The children can stay as long as they stay in school and are encouraged to finish high school.

We had a picnic with friends on the beach last Monday night This was an official Budha holiday. The weekend was a three day holiday and was packed until Mon. night when a lot of people had returned home to go to work Tuesday.

I am thinking about going to Hua Hin for a few days. This is a city on the coast and it is the location of one of the palaces of the royals. The king and queen used to spend a lot of time in Hua Hin as well as in Chang Mai where there is another royal resident. Years ago they would go in motorcades out from Hua Hin to meet with the farm families and the king would drive his own car. They would stop wherever people had gathered on the road. The king and queen were very concerned about the welfare of the people. I read that they also loved animals and would stop for any domestic or wild animal and once stopped to let a pair of cobras cross the road.

It is very hot here. I change clothes 3-4 times a day. I wash my clothes in the sink and hang them on the balcony. I walk one hour in the morning and am drenched when I return to my room. There is a lovely breeze off the gulf of Thailand which helps a lot.



Mark and Mom

After 4 days of Marti Gras Mark's Mom Headed to Thailand
I just spent four days in small towns in Louisiana with Mark's step-father James. We experienced the customs and festivals around Mardi Gras beginning with supper at DI's on the Evangeline Highway near Basille, La. DI's had Cajun music and the people in costume dancing and begging for food and money. For information on DI's and some Cajun music go to http://www.discajunrestaurant.biz/music.htm
We went to the Savoy Music Store for the jam session by people from all over who came with their music instruments. We went to Jennings for the Squeezebox Shootout which is an accordian contest.
For more about Louisiana customs of Mardi Gras go to http://www.virtualmuseum.ca/Exhibitions/Festiva1/en/lsm/page4.html

In the morning I head to Thailand to spend time with Mark and see how he is doing.
Stay tuned for more information and pictures

Mark is Close to his 5 year Anniversary After Being Told He had Three Months or Less to Live
Around Valentine's Day 2005,I listened to the messages on the phone answering machine. Mark's voice came on "Mom, I'm in a bit of trouble" Lots of possibilities swirled in my mind as I called Mark back and learned that his bit of trouble was a huge doughnut shaped tumor in his esophagus at the gastric juncture with several tumors in his liver.
He was given a bottle of liquid morphine and told to get his affairs in order. Not one to give up easily, a major battle with cancer followed. Mark, his sister, and I are thankful every day for all the care Dr.s Theera Umsawadi and Sunantha Srisiebut Playsongsang at Bumrumgrad Hospital in Bangkok gave Mark and for all the support of family, friends, and strangers and later his VA doctors and nurses.

There is every reason to celebrate this 5 year anniversary, but weighing heavily on Mark's mind is the possibility his cancer could come back and not feeling as well as he would like and not having as much energy as he would like. He perked up this week and is cooking tacos and is closer to his positive and cheerful self. Perhaps he is perked up because he began helping our friend Jerry Barrett to make a movie in Thailand. Not to be left out, I am headed to Thailand next week to assist in casting or production or whatever is needed. This is the third movie Mark has been in since his diagnosis.
Check in periodically to learn more about this movie and to keep up with Mark's other adventures.
Note the picture above is from the first movie Mark was in. He is second from the left. Third from the left is Jerry Barrett, film maker.