Update on Jess's son

This is my FINAL SUMMARY and REPORT on my son, RYAN that I sent to my family and am now sharing with you. 

 

Ryan's health problems started in August 2020 when he called us to let us know he could not breath well. Alarmed at a possible Covid pneumonia, he was rushed to Allegheny General hospital. Thankfully, my PHI fraternity brother, Dr. Marvin Balaan, pulmonologist, happened to work there and was able to attend to Ryan's needs and to continuously update us. Ryan was admitted as a possible Covid case but tests revealed that his breathing difficulty was not Covid related. CT scan instead detected an incidental 13 cm mediastinal tumor that encroached his pericardium. He had to undergo thoracoscopic biopsies twice for a definitive diagnosis. The final pathology report after consultation with experts was "Atypical Thymoma," an extremely rare tumor of the thymus gland. He survived sepsis and clotting problems post operatively.

 

After discharge, he switched his care to the UPMC Medical Center, a major cancer institution in the US. His Heme-Onc physician administered chemotherapy to decrease the size of the tumor before surgery. After only two cycles, (Sept 15, Oct 6) the tumor miraculously shrunk to half its original size. His thoracic surgeon has extensive experience with this rare tumor and is reputed to be an expert on Thymoma surgery. He explained to Ryan that surgery would either be a "minimally invasive" procedure or if necessary, sternotomy, a more involved procedure that meant splitting his breast bone for access to the tumor. We were anxiously monitoring his surgery (Dec 9). Ryan's wife, Rachel, updated us with progress reports during the procedure. I was waiting for her to tell us that the surgeon had proceeded with a sternotomy. Miraculously, the surgeon was able to totally remove the tumor using the minimally invasive technique. And furthermore, he reported that his pericardium was not  involved after all.

 

When the final surgical pathology report came back, we were relieved to know that the tumor was totally removed, the surgical margins were clear.  The attending physicians decided that no additional treatment (chemotherapy or radiation) was indicated. By God's grace, he is now tumor-free. However, like any malignancy, he will be on continuous surveillance to detect any possible recurrence so that this can be addressed quickly.

 

After surgery, Ryan's most bothersome post-op complication was paralysis of his left vocal cord. This was due to surgical manipulation around the area of his left recurrent laryngeal nerve in an effort to completely remove the tumor. An LEMG (Laryngeal electromyography) performed revealed an abnormal study and a most discouraging comment: that said, "the prognosis for spontaneous recovery is poor based on these data." Ryan would speak with difficulty in painful whispers. He was seen by a voice specialist who recommended vocal cord injection with carboxymethyl cellulose. On the scheduled date at the end of March, evaluation indicated miraculous improvement of his vocal cord, the procedure was no longer necessary. Ryan's voice is now back to normal without any difficulty, without interrupted coughing. 

 

We just got back from visiting Pittsburgh. While there, we met up with Marvin and his wife Susan. I am including a couple of photos with one of Ryan's former physicians.

 

Thank you for your prayers.