What Happened, What's Next

We're not quite sure why the doctors didn't have the results of Enrique's blood test before we arrived at the hospital. Enrique had several blood tests during the past week.

It's seems as though they just fucked up.

In the meantime everyone got ready for a big surgery that didn't happen today.

His parents flew from Mexico, we psyched ourselves up and packed our bags for an extended stay at the hospital. My parents, his uncle, friends, everyone got ready.

Somehow it feels more difficult to have had nothing happen.

I told enrique that we're lucky, because what happened today won't matter in a week or a month or year. But today, it really sucks.

In the next couple of days we'll get a new surgery date and his parents will need to figure out if they're going to fly for a third time.

In, Out and then Home

It's been a crazy and frustrating day. After seven hours at the hospital Enrique has come home, with nothing accomplished.

First, his surgery was delayed an hour and a half.

Then he was sent into the OR by mistake, before the results of his blood tests had come back.

After some time in the operating room - but before they'd begun to cut - they realized their mistage and sent him to the recovery room (where visitors are not allowed).

When they got the results of the blood test they decided that the surgery must be postponed for "a week or two."

This has left us all in a state of extreme frustration and emotional exhaustion.

surgery postponed. Enrique is fine. More soon.

Update: Enrique's surgery is on hold. They're waiting on a blood test before they begin (or postpone).

The Surgery Has Begun

The anestesiologists wheeled him in a few minutes ago, with an IV cocktail.

They were cagey about how long it will take.

We told them the surgeon had said six hours, and they seemed to suggest that it might be shorter and that the surgeon was just being cautious. But then they said it might be longer.

I guess no one really knows.

My parents and I are in the cafeteria eating some cookies that my mother baked.

Yesterday's Giggles

Yesterday we went to the voice doc for another pornographic look down
Enrque's throat.

In the adjoining rooms we could hear the awful singing that patients must do with the video cam down their throat.

While we were waiting we leafed through the only reading materials in the offer: brochures for Restalyn facial rejuvanation treatments (complete with before and after photos) and Martha Stewart Living.

We couldn't stop laughing.

Everything was fine with Enrique's voice.

a famous surgeon and a delay

there's a back-up in the operating room, so enrique's surgery has been
delayed for at least an hour.

his regular surgeon came by the pre-op ward and told us that another
surgeon will be joining her in the operating room.

"He's one of the top 10 thyroid surgeons in the world."

we're waiting for him to come by and introduce himself.

a funny coincidence

After the first surgery, Enrique's parents were back in Mexico
watching TV late one night. It was a program on the discovery channel
about food and nutrition in hospitals.

The outside of UCSF appeared on the screen and suddenly they we seeing
the inside of the cafeteria where we all spent so many hours.

Then they began to interview one of the hospital staff -- and it was
Enrique's surgical resident!

He was eating pizza and being criticized by the program for poor nutrition.

We're about to leave for the hospital. I am eating breakfast on the sly since enrique can't eat.

The Last Supper

We ate well tonight - and felt far away from our anxieties.

Enrique's mother brought homemade sweet tacos and gorditas from Mexico. She heated them up and covered them in homemade guacamole, fresh chopped lettuce and hot chiles.

It was so good I couldn't let a single bite go by with saying "MMmm" or "Oh" or "mmmMMmmmMM."

There's just no Mexican food in the city that comes any where close to this quality.

I told her, "This is the best Mexican food I've ever had in the U.S."

Enrique gave me a look and asked, "What about the chile rellenos I made for your birthday?"

That's when I learned the spanish word for tie, "empate."

What Tomorrow Will Be Like

Enrique and I will leave the house at 7am in a cab and pickup his parents at their apartment. We'll go to the hospital and hang out in reclining chairs in the dreary surgical waiting room until Enrique is called upstairs to the pre-op ward.

He'll change into a backless hospital gown and we'll sit around his bed and tease him and generally try to keep him occupied.

The surgeon will come in and take a pen to his neck and initial the area she'll cut. This is to avoid any mistakes in the operating room.

Nurses will come by for various reasons and each time they'll ask his name and birthday twice, just to be safe.

The surgeon will introduce the anesthesiologists. The surgical resident will come by. Everyone will be friendly and jokey.

Last time, one of the anestesiologists said "He'll wake up fine, not believing he's been under for so long; the whole time you'll be frightened to death. That's the way it goes every time."

He was right.

When it's time for the surgery, they'll usher us out into the hallway and then give Enrique a shot of a happy tranquilizer.

We'll see him one minute later, just as the drug takes effect as they push his guerney into the operating room.

He'll have a big hazy smile on his face and a glazed look in his eyes. He'll smile at us and waive and for the first time in a month he won't be the least bit worried about what is about to happen.

Then we'll go downstairs and wait.

The surgery is supposed to last six hours, but your never know. We'll probably go for a walk, have some lunch, maybe even make it to the deYoung museum.

I'll update the blog as we learn things.

Preparing

Enrique and his parents had lunch at Boulette's Larder and then picked up a large to-go order for the hospital.

Later tonight we'll pack clother, dvds, toiletries and my bottle of scotch to bring to hospital. I won't stay the first night, unless Enrique gets a private room, which we won't know until the last minute.

The second hospital statement came and strangely a private room costs no more than a shared room. They're both $4,100 per night.

Right now, Enrique's mother is making dinner from some food she smuggled in from Mexico. Some sweet tacos, fresh guacamole and a few other suprises.

A good night with Enrique's parents

Last night Enrique, his parents and I met for dinner at Delfina. We had a very good time. For Enrique and I it was a chance to break out of the pattern of worrying that we've fallen into. Also, the food was excellent.

We all drank a Sudwerk beer, because they're made in Davis and Enrique's parents had never tried one. Enrique only had a sip because alchohol interferes with several of his medications.

Enrique's father said he hadn't drunk a beer in a 30 years. I hadn't drunk one in two weeks. It felt good.

Timing

Enrique's surgery time is set for 9:30am. That means an 8am arrival time. Earlier is better since he can't eat anything the morning of the surgery.

He doesn't want to go back to the hospital. Neither do I. We're both nervous.

I can't decide if it's easier this time around because we know what to expect or if it's worse.

Tomorrow we're going to the voice doctor. That should be another funny look down Enrique's throat.

Enrique's parents arrived this morning. It will be nice to see them.

On Surgeons

We LOVE Enrique's surgeon. She's intelligent, caring and very sensitive. (She also seems to be good at surgery.)

But, listening to her describe cutting into Enrique, I couldn't help but think that surgeons must be very strange people on some level.

Gearing Up for Round Two

We're both pretty nervous about this next surgery.

Like last time, the risks are small. But they're different:

There's a 1-2% risk of injury to the nerve that controls Enrique's shoulder. That could leave him with a weak shoulder and/or a clavicle that juts out of his back.

I think he's more worried about the aesthetics of something jutting out than having a weak shoulder. Fair enough.

The larger concern is that they may need to call in a thoracic surgeon, if there's a lymph node in his chest that needs to come out.

That would require cutting into his chest with a saw -- and, of course, a much bigger scar and longer recovery.

They'll make that decision in the middle of the surgery, with no input from him (or from us, I imagine).

Happily there's only a 10% chance of that being necessary. It's still a difficult image for us to get out of our heads.

Updated Prognosis

Enrique's prognosis remains good.

The surgeon removed 27 lymph nodes. The pathology report showed that 19 of them were cancerous.

Apparently, that's quite common and doesn't really effect his prognosis.

Of the 19, one of them had cancer that was beginning to spread beyond the node. That's not good. But the fact that there was only one in that condition is good.

So, it's mixed news, but mostly good.

He'll need to get regular scans and blood tests for the rest of his life to be safe.

The next surgery

The next surgery is tentatively scheduled for Friday, September 29th.

It's tough to know how to feel about it.

We're looking forward to it being over and we're also dreading it.

We're amazed at how quickly he's recovered and we also know that the first days after the surgery are going to be awful.

Enrique's parents are planning on flying in that Wednesday.

The Bill

We got the first statements from the hospital today. The cost for the surgery and two days in the hospital:

$55,000.

That includes $4100/day for a shared room.

The basic charge for the surgery appears to have been $40 per minute. It lasted 555 minutes.

There were lots of other charges, but the bill was pretty incomprehensible.

I'm estimating that this whole episode will end up costing about $150,000

It seems that Enrique's insurance will pay for everything apart from a $1500 deductible. That sounds good. But, it's hard to know until we've received all the bills.

Going for the Jugular

The surgeon told us that Enrique's cancer has been inside him for a while. "Years."

The lymph nodes in the surrounding area had swollen so much that they had begun to choke off his jugular vein. This didn't effect his blood supply, however, because the vein responded by growing all sorts of bypass vessels around the blockage.

She has to work around those extra vessels, which is one of the reasons that the surgery is so complex.

The surgeon said she might need to totally cut-off the blood supply in his jugular vein (permanently!) -- but that it wouldn't matter, because all the bypass blood vessels are already in place.

Pretty amazing.

Removing the Bandages

We went to visit the surgeon today and she took off Enrique's bandages.

It's a very thin horizontal line, about two inches long, right where Enrique's neck meets his chest. The skin comes together like a seam on a piece of clothing where the pattern meets up, but the two sides don't quite match.

I think it looks fine. It certainly doesn't distract from his good looks.

There was no mirror in the surgeon's consultation room so he had to wait a while to see it. Once he did, he was a little upset. But he seems to be over it now.

There's good news and there's bad news for the future of the scar. As it heals, it will look better. But they may have to enlarge it significantly during the next surgery.

[Update: he just came out of the bathroom and said, "You know, it's really not that bad." He's right.]

Spending The Night

We just read an intersting article reprinted from the NY Times about the value of having a patient advocate.

It rang true. There were times I noticed things before the nurse's did - like when his arm was swelling up. Or when I encouraged him to take pain medication when I could tell he was in the mood to be brave.

I'm convinced you really do need a patient advocate, besides your doctor and yourself. This is especially true at 3am, when the doctors are tired and the hospital is short-staffed.

Food

Enrique is still on a semi-restricted diet. It's not too strict. Whenever I eat something he's not supposed to eat (say a piece of chocolate) I'll give him just one bite.

The surgeon called today with the results of his blood test. "Whatever you're doing, just keep doing it."

His calcium levels are normal, his phosophorous levels are nearly normal.

Thanks to our friends and family who have brought us so much good food from bi-rite and teh farmer's market.

Round Two

The next surgery is tentatively scheduled for September 28th or 29th. It should be shorter (six hours) and shouldn't mess with his calcium levels like the first one did.

They'll have to lengthen his scar a bit (which we haven't seen yet - it's still covered with the original bandage).

With a little luck, he'll be home in 1-2 days, rather than the full week of recovery the first surgery required.

Before the surgery, he'll need to visit the vocal cord specialist to see if anything changed during the first surgery. His voice sounds the same to me, so I think that visit should be easy.

He's Ready for Visitors, I'm Not

Over the past few days Enrique has gotten remarkably better. He can walk up our hill or wash a load of dishes or make the bed. He's also in excellent spirits.

For me, the past few days have been tougher. I was usually pretty functional during the worst days at the hospital: bringing in food, going to work, quizzing nurses. Now that we're home, I find myself really exhausted and moody. I guess that's no big surprise.

Anyway, we're both enjoying a touch of normal life in between surgeries.

Cleanliness is next to Wellness

Enrique is home and much better. Even before he left the hospital he was straightening up his night stand and clearing his throat loudly if I left a glass in the wrong spot. This is a good sign.

Today he even ironed a shirt.

Last night was the first time either us had slept in our own bed for a week. For Enrique today was his first day without an IV or someone barging into his room to draw his blood.

My mother and his parents took care of all the moving out of the hospital so that I could do some work. Thank you.

It's good to be home.

Food restrictions

Enrique is doing much better, but is still having trouble with his calcium levels. To help with that, he needs to lower his phosporous levels. That means limiting his intake of most proteins including dairy, meat, fish, soy and nuts. Chocolate is out, too.

That's a bummer.

His surgeon wants him to stay in the hospital until he's gone a full 24 hours without needing IV calcium. It's not clear when that will be.

That said, he does seem to be responding better to the oral calcium (tums) and is in good spirits. He had a good nights sleep and is mostly comfortable.

Today he plans to go for a short walk outside - a first.

The Surgery Ahead

Enrique's surgeon is postponing his surgery slightly because his recovery has been slower than expected. Apparently, anesthesia and low calcium levels don't mix.

The doctor now thinks the surgery will be held about two weeks from now. We had hoped the second round would only take about three hours (compared to nine for the first). Today she estimated six.

Birthday Cake

Yesterday I discovered the patient refrigerator on Enrique's floor. Since then I have more or less taken it over. I pushed aside the prune juice and protein drinks to make way for roast lamb, smoked tomato soup, greens sauteed with garlic and more.

I am happy to report that today Enrique ate food from Boulette's Larder for breakfast, lunch and dinner -- all courtesy of friends. Thank you.

Afterwards, our four parents and the two of us had some chocolate mouse cake from Tartine. Enrique blew out three candles for his 30th birthday.

We considered sharing the leftover cake with the nurses - but thought better of it and put it back in the refrigerator.

Today was a good day for Enrique. No tingling, no shaking. He's still on an IV drip and it's not clear when he'll be able to go home. But, he's comfortable, he's smiling and feeling good.

Better for his Birthday

Enrique slept well last night and woke up feeling much better. It was his first good sleep since the surgery and the first time in two days he had no tingling or numbness at all.

The resident said he might be able to go home today. Later, I saw the surgeon, and she was a little more cautious and suggested maybe tomorrow would be better. It's her call.

Last night things were pretty grim - but the chocolate tart with harissa from boulette's larder did give him some pleasure, when nothing else could.

I know some of you will want to give him birthday greetings today. Here's is what I suggest: leave a message on our home answering machine or one his cell phone. He's still not ready for visitors or callers - but he is looking forward to being back in touch.

Tough Day

Enrique had a tough day in the hosptial today. His calcium levels remain too low to go home.

He had a lot of numbness and stiffness in his extremeties and his face. He also had some shaking. Everything from eating to bathing requires help. I fed him a dinner from Boulette's Larder tonight, courtesy of friends. We are going to try and keep him off hospital food for the rest of his stay.

I am out of his room now while the nurse tries to switch his IV to a new vein. The arm with his vein had begun to swell up.

There was a brief good period when we went for a walk around the hospital corridor with his IV in tow.

It hard to know when he's going home. It doesn't feel all that close right now.

Back At The Hospital

The tingling and stiffness from the low calcium got really bad and the surgeon told us to go to the emergency room. We did.

After a couple hours there and some tests, Enrique is back in the hospital for the night. Sigh.

He got calcium intravenously, so he more comfortable. I'll spend the night with him again.

The doctor said the results of the tests were encouraging and he might only need one or two more days in the hospital.

We did have a couple good hours at home. But now we are in the same room we left a few hours ago. Unfortunately we took all the flowers home. Hopefully we'll be back with them tomorrow.

Visits, Schedule

I think Enrique will be ready for calls and visits soon. But he isn't ready right now. We'll let you know when he is. I know he really does appreciate all the good wishes and support.

The surgeon thinks Enrique's second surgery will probably be on the 20th or 21st of this month. That means he'll probably be off work for a full month.

This coming week he'll have a couple of blood tests and an check-in with the surgeon.

Enrique's 30th birthday is Monday. We'll probably have a quiet dinner at home. His mother may cook some homemade Mexican food.

Home

We're home. It's great to be out of the hospital.

Enrique was a little unsteady getting up the stairs, but now he's surprisingly energetic. He's walking around the apartment and eating solid foods.

Unfortunately, the tingling from low calcium has returned. We left the hospital with instructions to call the surgeon if it didn't go away after taking calcium. It didn't, so we called.

The surgeon told Enrique to take more calcium and wait a couple more hours. He has six different prescriptions.

Enrique won't be able to take a shower until tomorrow. It'll be his first since the morning of the surgery. Before we left the hospital a male attendant came by to give him a sponge bath. Sadly, he wasn't at all cute.

Better - and maybe going home

Enrique is doing a lot better today. "It's nice to feel like myself again."

He's still sleeping a lot, but when he speaks, he can say more than one word and he sounds and looks like himself.

Yesterday evening there were some unpleasant moments when he was shaking uncontrollably (from the low calcium levels). That has passed.

The resident came around this morning and said his calcium levels are much better and that he can probably go home today. Then the nurse came around and gave him his first synthetic hormone pill. He'll take one everyday for the rest of his life. Or, as he says, "Until they invent something I only have to take once a month."

He got a private room last night, so I spent the night with him. Some angelic friends picked me up at the hospital, took me home to get my overnight stuff (stocked the fridge with food they had bought and washed the dishes while I packed) and then brought me back to the hospital. Thanks.

There have been a few funny things. We saw a squat little robot moving down the hallway delivering pills. It was smart enough to move to the side as we passed.

Also, two nights ago, Enrique's parents and I were going home after the surgery in a cab, exhausted. Enrique's mother found what looked like a glasses case, left behind in the back seat. Inside was someone's marijuana pipe. Welcome to San Francisco!

Recovery

Enrique is very, very tired. He had a terrible bout of nausea this afternoon, which only dissapeared after they gave him two medications intravenously.

Travelling the 18 inches from his bed to his chair required the help of two people.

But, overall he is recovering well and not in pain. He won't be ready for visitors for a day or two, at least. Right now, when I am in his room, we barely speak at all. I ask if he is in pain or if he needs some water and that's about it.

He still has his manners, of course. Most of the talking he does is to ask how everyone else is doing and to thank the nurses, doctors and attendants who are helping him.

The silver-lining to all of this has been the family bonding. His parents and my parents have been getting along famously - chatting in the waiting room and the hospital cafeteria. I told Enrique "I think they would like each other just as much even if they could understand each other."

Visiting

Enrique's parents and I are visiting him at the hospital now. He's doing pretty well. He's tired and hoarse, but seems to be in good spirits. He says he isn't in pain and keeps asking about us.

Unfortunately, he's right by a construction zone, so his room is noisy. He panicked a little this morning, before we arrived. He couldn't find his glasses (he's blind without them) and the noise and the place were totally unfamiliar. But he's fine now.

The surgeon came by his room to check on him and said he is doing well. She explained the need for a second surgery and said he won't be going home today. "Maybe tomorrow."

The next surgery will be in 1-2 weeks. During the surgery his parathyroid glands had to be removed and then transplanted. They control calcium levels. Right now his are very low, so he is experiencing tingling in his extremeties, which is uncomfortable.

I'm typing this at the public terminal outside the hospital cafeteria. It's the most disgusting keyboard imaginable. It's like using an old pay-phone in a new york city bus terminal. I am going to wash my hands.

One Operation Down, One More to Go

Enrique's surgery lasted eight or nine hours. The tumor had grown around his vocal nerves, and had to be removed very delicately. The good news is that it went well. And his prognosis remains good.

The not-so-good news is that he will require another surgery, to remove some remaining cancerous lymph nodes. This surgery should be shorter and less complex. they're aiming for a a week and half from now.

Enrique doesn't know about it yet, since he was just coming out of the anasthesia when left the hospital a few minutes ago.

He asked if they had removed everything and I just said "It went very well." Which is true. We'll tell him tomorrow about the need for a second surgery, which I'm sure will be dissapointing.

It was difficult to see him attached to all those tubes, semi-concious in the fetal position. But he looked as handsome as ever.

His parents were glad to see that his color was good after the operation.

We all wanted to spend the night in his hospital room, but since it was a shared room, we couldn't. And part of me is glad to get the chance to sleep in a bed. I did enough napping on hospital chairs for today.

One small note: please don't text message me or call me before 9am tomorrow morning. I need to keep my phone on - in case of emergency - but would like to sleep in, if possible.

no word yet

enrique went in to his surgery around nine hours ago. since then we haven't heard much.

they told us a longer surgery didn't necessarily mean anything bad.

but when then give you an estimate of 3-5 hours you start to worry around the 8th hour.

still at the hospital

no word. the operation started at about 1pm. Around 5pm they said it was half-way done. Orginally they had said 3-5 hours. They also warned that if it took longer it wasn't a bad sign, necessarily.

they keep saying "the operation is going well." It's hard to know if that actually means anything other than "the operation isn't done."

at the hospital

we are in the waiting room. they tell us the surgery is going well. but its taking a long time. four or five hours so far.

his parents, uncle, a good friend, my parents are waiting.

The intense week

On Monday night we began to get nervous again. Friday's news was good, but Enrique still had cancer and still had serious surgery. Plus our families were about to meet during a very intense week.

This was the schedule:

Tuesday - I meet Enrique's father for the first time
Wednesday - My parents meet Enrique's parents, aunt and cousin for the first time
Thursday - Enrique's thyroid removed

Since we're about to go to the hospital right now, I'll just say that the families meeting went really, really well. Everyone had a good time.

Now we're a little nervous, but hopeful that everything will work out just fine.

thanks for all the good wishes. I'll let you know how things go.

The intense week

On Monday night we began to get nervous again. Friday's news was good, but Enrique still had cancer and still had serious surgery. Plus our families were about to meet during a very intense week.

This was the schedule:

Tuesday - I meet Enrique's father for the first time
Wednesday - My parents meet Enrique's parents, aunt and cousin for the first time
Thursday - Enrique's thyroid removed

Friday Night

We had planned to go out for dinner with my parents anyway. After the good news, it became a celebration with champagne. We ate outside at Foreign Cinema. Afterwards Enrique and I went dancing in the Castro.

The rest of the three-day weekend, we did a lot of work getting ready for the surgery. Buying apple juice, which is one of the only things he'll be allowed to eat or drink the morning of the surgery. Making sure that all his medical paperwork is in order. Looking for a place for his parents to stay.

We also managed to go for the massages that my parents had sponsored, at the Nob Hill Spa. That was a much needed break.

Hardcore Karaoke

On Friday, after the good news from the surgeon. Enrique and I went to see a voice specialist. They inserted a small video camera into his mouth that pointed down into his throat.

We watched the whole thing live a flat screen TV, specially placed for the patient. The doctor's had their own screen. It reminded me of the dual screens at grocery store checkout lines.

They made Enrique read a passage and then sing a little. "Say OOOOH. Now AHHHH. Now, really quickly EEEEK!"

The whole time we watched his vocal cords do their thing. On screen it looked pornographic. I could not stop laughing.

The doctor said, "That's why god put all that on the inside."

Basically, his attitute seemed to be a very pleasant version of "Why are you here? This is pretty routine. In the unlikely event that something goes wrong, come back and see me."

That works for me.

Got an Extra bed?

Enrique's parents arrive tomorrow. It's looks like we've secured the studio apt above ours for them to stay in for the next few days, but it's unfurnished.

So we're looking for a bed we could borrow for a week or two. Ideally queen size.

We've got inflatable beds, but would prefer to have them sleep on something more comfortable. If someone has a spare bed, please let us know.

Great News

Enrique just spoke with his surgeon and got great news - he still has the same excellent prognosis for a full recovery. Our additional worrying since Monday was unnecessary.

Enrique's surgeon is bringing in the other surgeons as a precaution.

There is a slightly higher risk that his parathyroid glands will be damaged or removed and that he'll need to take a calcium supplement for the rest of his life. But that risk remains small (it's gone from 1-2% to 3-4%) and the consequences relatively mild.

The only other relatively minor downer is that his scar will be larger and more visible. Instead of being a horizontal line than runs along one of the folds of his neck, it will be t-shaped. We can live with that.

This is great news. Hopefully the vocal cord specialist this afternoon will have similarly good news.

Leave that suitcase of cash at home Dad

Enrique was very concerned about figuring out how much - exactly - the surgery would cost. Learning this in advance turns out to be an almost impossible task.

The surgeon's assistant said "I'll send a request to Financial Services - but if we're lucky they'll take a few weeks to get back to us."

It seemed odd that he didn't know it off the top of his head, since they do this surgery several times a week.

For Enrique it was more troubling. In Mexico they won't let you leave the hospital until you pay in full.

His father was planning on coming with several thousand dollars in cash to bail his son out of the hospital -- and needed to know how much to bring.

When we all realized the misunderstanding, the surgeon's assistant laughed.

"You won't even get the bill for about a year. Then there will be a big negotiation, once it's settled, you can just pay a few dollars a month for the rest of your life, if you like."

That was a medium-sized relief for Enrique.

Imagine it taking a year to generate a bill, for a routine surgery that they do multiple times a week! The way we pay for health care in this country is really fucked up.

How much more risk?

There was some kind of scheduling error with Enrique's main surgeon, so today we're only meeting with the thoracic surgeon to discuss the risk to his vocal cords.

I'm hoping he'll also be able to shed some light on the increased risk that comes from having cancer in the surrounding lymph nodes. But we don't know if that is his expertise.

A good friend of mine who is a radiologist, told me that even with cancer in the lymph nodes, the risk of mortality over the long term is very, very low. That said, he doesn't know what the surgeon saw when she reviewed the CT scan, so its hard to know if that will apply to Enrique.

Right now Enrique is trying to speak with his main surgeon by phone. Otherwise it looks like we'll have to wait until Tuesday for an appointment.
That's frustrating.