Marykate's surgery started at 9:30 am Wed. April 8th. The staff was really good at updating us every two hours. Things went as well as could be expected, and there were no complications. The total surgery time was about six hours, which was better than we expected. The plastic surgeon did not need to take her quadricep to use in the reconstruction (avoiding a graft) and was able to use muscle and tissue that was already there. This will help substantially in her recovery. However, when the thoracic surgeon removed part of the chest wall, and was able to look at her lung, he felt that a small portion of that should be removed too, as there were some changes in that area. This was most likely due to prior radiation scarring, and hopefully not tumor related. We will find out the results of that a few weeks from now. He felt that since she was already having this amputation, it would be best to remove this area regardless. The orthopaedic surgeon, Dr. Lewis, did the amputation, but was able to leave her shoulder blade which gives a little better form and may help with prosthetic options down the road. Dr. Lewis felt confident she was able to achieve a large margin of tumor free tissue around the area. After the arm was off, they looked at the tumor area and determined that a limb salvage surgery would have been impossible as the tumor had invaded the brachial plexus (nerve, blood vessel bundle in the shoulder).

Overall, everything went very well and Marykate did great. As we were waiting to go back for surgery in the morning, she was very relaxed, calm and confident. She was not afraid and was looking forward to getting this behind her and getting on with her life. After surgery she was kept comfortable and was able to respond well to us. She hasn't been able to eat because she's had quite a bit of nausea and vomiting from the pain meds., but is resting well and reasonably comfortable. Breathing is a bit painful, but manageable. Today, she was able to get up with some help and sit in a chair for about ten minutes. She is drinking water and eating ice chips. She has been very matter-of-fact and hasn't mentioned anything about her arm. So far there have not been any phantom pains and her main concern is breathing and the drain from her chest. Her nurses and doctors have been very pleased with her attitude and progress considering her age and the magnitude of what was done.

Today the goal is to get up and move a few times and hopefully eat something. I (Julie) am staying with her in her room at night and Mark is with us all day, then goes back to Ronald McDonald house at night. We are all, including Marykate, doing well and in good spirits and really looking forward to coming home.

We really appreciate all of you, who have supported us with encouragement and prayer the past two months. Thank you for all the love you have shown us. We feel so blessed to have such great friends and family and we know that has helped us deal with this situation. You really have helped us carry this burden. THANK YOU!

Please continue to pray for swift healing, pain and nausea management and a clear perspective mentally and spiritually on dealing with this in the weeks to come.

Julie