So what is this PMP?

I wanted to give you guys an idea of what the surgery is that Doug will be going through and what we're expecting as far as hospital stay and recovery time.


A little bit more about PMP---there are a couple of different types of PMP, and due to the nature of the disease we won't know exactly what the specific "grade" or diagnosis is until after Doug's surgery is completed and we get a pathology report back. I'll update when we know for sure.

There are a couple of different schools of thought on what the best treatment is for this. Because its so rare (we always knew Doug was one in a million, right?!?) it is what is termed an "orphan disease"--which means there is no set protocol like one would see with a more "typical" type of cancer (breast, lung, etc). It can cause some bumps along the way, one of which is getting insurance coverage for everything. We were lucky enough to be paired with such a great team in Baltimore that they took care of everything for us, and insurance has been approved! Thank goodness!

The surgery that Doug will undergo is known within the PMP community as the "Mother of All Surgeries", or MOAS as I'll refer to it from now on. Nice, huh? well, they aren't kidding, its a big deal. What will happen is Dr. Sardi and his team will perform a complete cytoreduction followed by a Heated Intraperitoneal Chemotherapy bath (HIPEC). In laymans terms, basically what will happen is the doctor and his team will go in and remove all of the tumors that he can safely get to, as well as get all of the mucin out. Basically, they just clean him out! Depending on what organs are involved, he may lose some stuff--appendix, or his spleen, gallbladder, etc. Who needs those anyways? Then a heated saline solution which is infused with an intense concentration of chemotherapy drugs is put directly into his abdomen, like a bath. Basically what this does is hopefully kill any remaining microscopic cancer cells that might be left. This portion of the surgery is called the "shake and bake". The surgery is a long one, usually lasting between 8 and 14 hours. Doug's Dad, Elizabeth, Jason, and myself will be there and they will give us periodic updates, which I will post throughout the day of the surgery.

Usually the hospital stay ranges from 2-3 weeks, and then we will remain in the Baltimore area for another 5-7 days to ensure he is ready for a long trip home. He will be in the ICU directly following the surgery, but they expect him to move to a regular room within 36 hours or so. Once he moves into a regular room I will basically move into the hospital, as they have a sofa bed/chair in the room and doug will have someone there to fluff his pillows and change the channel, all of that good stuff! Doug is also fortunate to be able to have his family there for support--his family is fantastic and have been with him the whole way which is so important to him. I know he's looking forward to having other visitors when he feels a little bit better! As soon as I have a room number or address I will post it so that if anyone wants to send cards or anything they will be able to get to him. The hospital staff will also have him out of bed walking around and sitting up pretty soon after his surgery--this will help him get better quicker! Everyone heals at their own rate, but Doug has a lot of things going for him. One is his age--- 26 is VERY young, the average PMP patient is in their 50s. he's also very healthy, and i've been feeding him vitamins and feeding him as many calories as possible and he is staying as active as possible leading up to it. Good thing he loves golf and goes every chance he gets! John Kim--i know you have a lot to do with getting him out there :-). He will probably be out of work for a couple of months, but if I know him as soon as he can he's going to want to stop in and visit all of his friends out there at Mannkind--and probably cause some trouble! (but not without the help of the usual suspects...you know who you are! haha)

So thats kind of the deal! Doug is now working on getting all of the pre-op testing done over the next couple of weeks--nothing that is a big deal, just some bloodwork and things like that. We've been keeping busy and have had such a great summer spent with both of our families and all of our friends. Doug is in good spirits, and is determined to try to make it to the last Mets game at Shea Stadium and i know that if anyone can do it, he can!

I'll keep everyone updated on how we're doing in the next couple of weeks leading up to the big trip, This is a very difficult time for everyone, but thank you to everyone--i can't possibly name you all--who have done so much for us and continue to give us your love and support.

Love, Lindsey