Update - back in Coffeyville, back in the hospital

Joe & Vicki returned to Coffeyville (from M.D. Anderson in Houston) around April 20th.  His bilirubin was trending down and his pain was better under control, so they sent him home to continue to recover from the multiple procedures they had done in Houston to unplug the bile duct.  Joe did really well on the 10 hour drive back home.  Joe rested and appreciated being back home, but was still uncomfortable due to pain and was unable to eat much (which translated to zero energy).
Last weekend, Ben & SallyAnn (plus gestating baby and Milo) came to Coffeyville to spend the Easter weekend with Joe & Vicki.  At about 1:00 am, early Sunday morning, Joe went to the emergency room due to difficulty breathing.  They found this was due to fluid in and around this lungs.  On Easter day they removed 1500ml of fluid from one lung.  The next day they removed 800ml from the other lung.  Joe felt some relief with this liquid gone and the addition of a nasal oxygen tube, but was still plagued by very low energy, pain and disinterest in food.
As the early part of the week passed, his disinterest in food turned into uncontrollable and unmanageable gas (belching) and the inability to keep food of any quantity down.  With his strength and energy level already low, they looked further into this new issue to discover there was a blockage between the stomach and the small intestines and moved him to the Intensive Care Unit on Thursday (4/28/11).  They continued his oxygen and I.V. and added a feeding tube.  A cancer tumor outside of the stomach was pushing against the duodenum (the "door" between the stomach and the small intestine), causing pressure, reducing the size of the stomach and not allowing it to do its job.  This morning (4/29/11), surgery was performed to bypass the duodenum to allow his body to regain the ability to take in and process nutrients.  They also removed 2.2 liters of liquid from his stomach and added a tube to continue the draining after surgery.  He did well in surgery and his vitals are good.  He is back in the ICU recovering and resting.  The doctors plan to remove the ventilator tube tomorrow (Saturday) morning, which will allow him the freedom to speak again.  Vicki has been by his side all week and Ben & Sally arrived around 2:00 pm on Friday.  With the tube and medication, he is unable to speak, but we were able to talk to him and he could hear us.  He was moving his eyebrows and squeezing our hands in reply.  He is so strong.

(This picture is from Tuesday)

It's worth noting that each step in this journey has been made with considerable thought, weighing the pros and cons at every turn.  Each day and every hour seem to bring a new set of options and choices.  It can't be said enough - we appreciate everyone's thoughts and prayers.  They truly comfort Joe & Vicki & Ben and each know the army of love standing behind them.