Plans

We met with Jake's surgeon today to discuss plans for surgery. We thought it would be a quick visit but it ended up taking all afternoon. Jake had new x-rays and then we talked with Dr. Oskouei for a while. He said that from the x-ray it looks like the tumor is responding well to chemotherapy and he is confident that he can remove the entire tumor. He will do an allograft, which is replacing the affected area with a cadaver bone and he will use screws and a plate to attach it to the remaining bone. The doctor left the room to check the schedule for surgery and we spent the next several minutes freaking out a bit. For one thing, the tumor is not the size we thought it was. Not that we ever asked, but we assumed from the first x-rays that it was about 2 inches of his tibia just up from the middle. The tumor is actually most of his tibia and in the bone marrow of the tibia! So now instead of picturing that he would remove a couple inches of bone he will be removing all of the bone from one dotted line to the other. (see picture)  The dark circle is where a piece of bone was removed in the biopsy.  All of the white shaded area is the tumor. 

He will have a scar from below the knee to his ankle. Then Randy said "he won't be able to play contact sports," and I just about lost it. He is (was) such an active kid and loves sports so I was really sad thinking about having to keep him away from those activities. The doctor came back in so we could ask more questions and he said "Of course he can play sports. He can sky dive for all I care! He can completely resume normal activity after it heals (in about 9 months)." We assumed that the cadaver bone would act as a rod or a placeholder but it will actually become his bone with blood flow and will act just like it was always his. It will also not effect his growth since the growth plates will not be harmed in the surgery. As in everything having to do with this journey, we were on a bit of a roller coaster worrying about what would happen and how Jake's life would be. But, from today's consultation we are feeling a bit better and we think that the outcome will be a good one. After that, we just continue to kick this cancer's butt! Jake has to get through two more rounds of chemo and provided that there are no setbacks, surgery will be on 2/12/13. Thank you to everyone who has been praying for Jake and for us. We know it's helping and God is listening.