Mixed Bag

Well, the surgery was considered a success. He’s recovering just fine, right now lying in Daddy’s arms asleep to the sounds of the Indians season opener in the background. No PICU, just a nice big room on our regular floor. His kidney looks fine and does not seem to be involved in this recurrence, which is good. The surgeons biopsied a small lesion on the top pole of the kidney and it turned out to just be normal kidney that has darkened due to scarring. Also good.

They feel confident that they removed the entire tumor, which is now being sent off for a full pathology/histology report, the results of which we hope to get on Wednesday or Thursday. Also good.

But (there’s always a but, isn’t there?), there seems to be some involvement with the lymph nodes. We are awaiting a lot of information from the pathology but they found one “thing” floating near the tumor that at first seemed like a lymph node, which they removed. When they did a frozen biopsy on it right then and there (which gives you some quick information but not a complete picture), its cells were mostly Wilms’ tumor with rhabdomyomatous differentiation (Austin’s rare variant) without much “lymph node structure” at all. I’m not entirely sure what this means but it sounds like we’re waiting to see whether this thing is cancer that has spread to a lymph node or just another cancerous tumor. “Just another cancerous tumor”?  That sounds absurd, I know, but would indeed be better than if it has spread to the lymph nodes. They also removed five other lymph nodes, which they’re pretty sure actually are lymph nodes, to compare them all with each other and with the unusual one. Are you confused yet?

We’re all a little confused, doctors included, (Jeff said the other day, “We’re already well beyond two standard deviations from the norm with Austin”)  but are hoping that the pathology report will provide some clear answers. Depending on what those answers might be, there is still a possibility that he could receive radiation. It would be targeted specifically to the site of the tumor(s) they removed today, which has been marked with a titanium clip. This would be better than full abdominal radiation but could still damage the kidney. Again, we just don’t know enough yet to start preparing for any of this, mentally or otherwise.

It’s hard to know what to think or feel.  A lot of today was good. He looks fine and has mostly just been sleeping, interrupted by brief pleas for apple juice. Knowing Austin, I imagine he’ll be asking to go to the playroom by morning. Mark is there for the next few hours, since I’ll be the one to stay the night, so I’ve come home to go for a run. But I am looking out my window at fat wet snowflakes, which happen to be blowing horizontally.

So again, we’re back where we were two weeks ago. We wait and we worry and we wish. And then we wait and we worry and we wish some more.