CANCER FREE

This is the last post I'm going to write because ROBERTO IS CANCER FREE!

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The visit to the surgeon on Wednesday was full of great news!

First, the surgeon divulged some more tidbits about the surgery.  Another reason why the tumor was difficult to remove was because it was "hard" and "had cartilage" in it.  :\  The cartilage is actually normal for teratomas (teeth and hair have been found in some). 

Second, the tumor had NO malignant cells!  Hooray!  I'm guessing this means the teratoma was around for a while (maybe since birth?) and the seminoma was a recent development.  Also, the teratoma will *probably* not come back.  Roberto will have to follow up with the oncologist to periodically check for the seminoma.

Third (I told you, lots of news), the surgeon took the staples out of Roberto without any trouble and put some skin glue on the incision.  There's some tape on the incision now so Roberto doesn't burst open.  Oh yeah, the adhesive I mentioned in the last post is from all the bandages for the dressing and tape to keep the sensors on Roberto's body.  Yep, there's still bits on him because I've been lazy.

So, all in all, ROBERTO IS CANCER FREE.  FREE!

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Roberto is making really good progress and is slowly weaning himself off of the pain medication.  We are cautious because we don't want him to get to a point where he is "chasing the pain."  He's slightly more mobile now but it's still hard for him to move his arm around.  There's a part of Roberto's chest below the pectoral muscles that are numb.  The surgeon told us that when they spread his ribs during the surgery, there is a nerve that was affected.  Roberto might be numb there for a long time. 

I feel like I can finally breathe a sigh of relief now that the surgeon has told us that Roberto is cancer free.  It's almost strange to think that I won't have to occupy my thoughts with how sick Roberto is feeling or how to juggle Roberto's care with life's other activities.

We're lucky:  the doctors found the cancer in time to treat it effectively and the treatment only took up 6 months of our lives.  I know others who were/are not as lucky.  I said this already, but I'll say it again - I'm going to cherish every day that I have with Roberto now. 

Robostrong!!!

Is this it?

Roberto is doing great.  We compromised and he's on a 5 hour schedule for his pain medication.  He's also having an easier time moving around.  He still has random bits of adhesive on his skin, though.  No, we aren't lazy.  There are some parts of his body that are a bruised and tender from his stay at the hospital so we're just leaving the adhesive stay for a bit longer.  

Wednesday afternoon, Roberto will meet with the thoracic surgeon one last time.  Roberto will have the staples removed from his body (yikes!).  I'm fairly sure Roberto is at the end of his treatment.  The next step would have been radiation - but that's out of the picture because the teratoma tumor cells are dead.

Unfortunately, Roberto's cancer, specifically the seminoma, has a 50% chance of recurrence.  The seminoma was the cancer that responded well to chemotherapy but grew rapidly.  Roberto will have to be checked every couple of months or so to make sure that the cancer has not come back.

Honestly, this scares me.  The unknown of whether or not it will come back and if it will come back stronger and worse.  There's also the suffering that he may endure if he has to undergo chemotherapy again.  I didn't take Roberto for granted before (at least, I hope I didn't) and now I have even more motivation to enjoy every day I have with him.  :)

I hope this Friday will be the last post I'll write for this blog! 

Slowly Recovering

Hi all!  My bad about posting late.  Roberto is continuing to make progress and even tried to wean himself off of the pain medicine by relaxing his medicine schedule from every 4 hours to every 6.  I thought he was being a little ambitious and made him get back on the 4 hour schedule. 

My friend Martin stopped by with his wife to drop off dinner for us yesterday!  It was delicious and more convenient than I realized.  Driving back and forth to and staying late at the hospital last week really drained me of energy.  Also, the stress of the surgery probably took more of a toll on me than I had realized. 

While Roberto is recovering fairly quickly, he still needs lots of help because he can't lift his arm too much.  I have to run around and get food and drink for him, but at least he is not feeling sick!  It's easier to take care of someone watching TV all day than someone who is throwing up all day.  Although, he made me go out at night to get him soda.  I'm pretty sure that wasn't a medical emergency.

Home Sweet Home

Good news everyone!  Roberto was released from the hospital in the morning!  The surgeon checked on him in the morning and said that Roberto was making great progress!  The more important news is that the pathology report came in and the tumor cells are all dead!  DEAD!  That means NO RADIATION! 

I'm not sure if this is the end of Roberto's cancer woes, but he is at least out of trouble for now.  The cancer Roberto had has a 50% chance of returning so he will be monitored for the next few months.  Also, he is not out of the woods just yet.  Roberto has to make sure to do his breathing exercises and walk around to help his body heal.  The incision still has the staples, but those will be removed on Wednesday when we see the surgeon one last time. 

I'm going back to the MWF updates for at least one more week now.  Hopefully, I won't have to update this blog for much longer.  :)

Totally Disconnected

There's not too much to report on for Friday.  Roberto's chest tube was removed and he's no longer connected to an IV bag.  It's amazing how free Roberto feels to not be connected to so many tubes.  I didn't know this, but apparently the chest tube was sewed onto Roberto somehow?  I wasn't around when the tube was removed, so I didn't see it, but I really don't want to know any more about it.

Roberto will definitely be going home on Saturday!  It'll be so nice to be at home and not at the hospital for a majority of the day (I guess the entire week in Roberto's case). 

I got a glimpse of Roberto's incision, and it's crazy looking!  They closed it up with staples.  Roberto looks all Frankenstein's-imonster-y.  I have a picture of it and I'm hesitant to post it...but why not?  I took this picture on Thursday when Roberto still had his chest tube.  You can see the bandages and such on him.  It's normal for the chest tube stuff to leak. 

Anyway, don't scroll down if you don't want to see the giant incision.



This one is a little worst than the PICC line picture...

By the way, when we asked the surgeon how big the incision was, he indicated that it was 5 inches or so...basically less than what is shown above.  Gaaaaaaahhh, so gross!

Fewer Poking Tubes

Another boring day, which is a good thing!  Thursday was full of removing lines from Roberto's body and receiving plants.  I could probably stop right there; that really is all that happened.

In the hallway and outside the patient rooms are signs asking visitors to be quiet and such.  However, the typo on one of the signs just cracks me up every time I look at it.

hahahahahahaha!  That's such a funny sound!

Roberto is getting stronger everyday.  :)  He went for another walk down the hall today with a physical therapist and I got a front picture of him this time.

They seem to be doing a great job with the pain medicine because Roberto has not been in any pain since getting out of surgery.  I just hope that we can keep that up when he gets home.

Along with walking, Roberto has been doing his breathing exercises with the spirometer.  Roberto has to take a deep breath and get a little plastic piece to a certain height.  The exercises help Roberto's lung and prevent him from getting pneumonia. 

Also, Roberto got a few flowers today!  I got a picture of the first one from the Hendersons.  I forgot to take a picture of the ones from the Fergusons.  :(  Sorry!  It's really great to have some plants in the room.  Also, Roberto loves to be spoiled with gifts.  :P

 Okay, enough with the slide show.  Roberto is getting stronger everyday.  He got a lot of good sleep yesterday because the machines were not as noisy as the ICU ones.  The nurses took out several lines today:  the epidural, the catheter in the bladder, and the central line in his neck.  All that's left is the IV and the chest tube.  I was told that the chest tube will come out tomorrow sometime.

Speaking of tomorrow, it's looking iffy for Roberto to be leaving that day.  Not for lack of progress, just for medical reasons that haven't been explained to me.  Also, they (the resident and nurses) might be just hedging their answer so I don't flip out if Roberto is not released tomorrow.  The definite thing is that Roberto will be home on the weekend and he will be so happy to be home!

I'll be happy, too, because I haven't been getting much sleep for various reasons.  Well, maybe I could stop updating the blog, but that's no fun!  Sleep deprivation has definitely taken its toll, though.  It was definitely a struggle at times to form coherent sentences.  Hopefully, tomorrow make better words.

ICU - No More!

Roberto has been upgraded to the main patient floor of the hospital!  It kinda doesn't feel like an upgrade, though, because the room is smaller and he is definitely sharing it with another person.  The ICU suite was much bigger and Roberto had a neighbor for maybe 1/4th of the time he was there.  Before I get ahead of myself, let me tell you about the other exciting things that happened to Roberto.  

The morning seemed to go pretty well.  Roberto had some breakfast.  Then the nurses moved him into a nice chair so he wasn't just in bed the whole day.  Unfortunately, this made Roberto throw up.  The nurses think it's due to one of the pain medications.  Boo.  :(

The good thing is that throwing up was the only setback of the day!  At some point, a physical therapist came by to get Roberto moving.  After spending several minutes untangling the lines and getting the machines on a movable stand, Roberto, the physical therapist, and the nurse took a short walk around the ICU.  In the picture, you can see them walking down the hall.  Pedro is trailing them in case Roberto felt like throwing up.  The nurse and physical therapist would comment on how fast Roberto was!  For the next couple of days at the hospital, the physical therapist is going to get Roberto strong enough to climb stairs since that's what we have at the townhouse. 

After that walk, the nurse took out Roberto's arterial line that was in his wrist.  This is great because it's one less line sticking out of Roberto's body!  He only has the IV, central line (in his neck), the epidural, the chest tube, and the catheter in the bladder.  That's all. 

If you want to send anything to Roberto at the hospital, you'll have only a couple of days!  The surgeon came by to check on Roberto and was very happy with his progress.  In fact, the surgeon said that Roberto would probably be able to go home on Friday!  Hooray!!!

Alright, I'm actually writing this post near 1:00 am instead of having it scheduled to be posted at 1:00 am.  I'm going to catch some zzz's.

Surgery Recap - Roberto DOES Have Lungs

I'm going back to the old format of writing about the previous day.  For today's post, I'm going to talk about Tuesday - the surgery day.  I know that the two blog posts from yesterday were extensive, but there are some tidbits I didn't include and some things I want to clarify.  The important bits are in between the *** below if you want to skip.

The morning wasn't too bad and went pretty smoothly.  All the pre-operation prep was standard: change into a gown, get an IV, and sign consent forms.  The nurse did sort of mess up inserting the IV, though, and got a bunch of blood over Roberto's gown.  He had to awkwardly change into a new one with a blanket over himself (I'm not sure why the nurse didn't just give him the gown and some privacy).

Then came the anesthesiologist.  While he was talking to Roberto, he said, "I saw in your chart that you were suffering from heartburn.  Is that gone now?"  Roberto said, "I haven't had any heartburn."  The doctor then said, "Okay, I'm going to go talk to a nurse.  I'll be right back."  After a while, I took a peek around the corner and saw the anesthesiologist looking over Roberto's CT scans.  Yeeeah, I guess he looked at the wrong chart?  Well, thank goodness he did that mini-cram session because he definitely needed the proper info about Roberto.  When he came back, he informed us that he'll have to keep Roberto partially awake during the surgery.  If Roberto went too "under" the anesthesia, his lung could collapse and that could lead to death.  Conveniently, even though Roberto would be awake, he would not remember the surgery.

Most of my ramblings from yesterday are probably all you need to know about the 3.5 hours we waited to hear any word about Roberto.  I felt as though I would burst into tears at any moment once we passed the 2 hour mark (the surgeon said the surgery would take only two hours).  Having Pedro and Adam around definitely helped.  I would have probably started bawling as I curled up into a ball on the floor of the waiting room.

******  The Important Bits ******

Okay, this is what the surgeon told me.  The reason why the surgery took so long is because part of the tumor grew from the right, through the middle of Roberto's body (medaistinum) to the left side.  I don't know how much of the tumor this was.  The reason why this was hard to remove is because they made the incision on the right side of Roberto's body.  I imagine it's like reaching for something in the back of a super full freezer; that is probably the worst analogy I could use.

The other complication is that there was a lot of scar tissue from chemotherapy.  The surgeon stated that the chemotherapy was really effective because of all the scar tissue.  You know how a scar forms on your skin?  It's a nice covering the connects all the bits of skin together where there is no skin.  Okay, now think about your internal organs.  They are made to be slippery inside you, because you're a flexible person that might bend in weird ways.  When there is internal scar tissue, slippery internal organs are now connected.  This is what happened to Roberto's tumor and his lung - they got connected via the scar tissue.

The surgeon told me, "I had to remove part of the upper and middle lobe."  Okay, I don't know about you, but that sounded like he removed a chunk of the lung!!!  Thankfully, I saw the surgeon again at night and asked him specifically about how much of the lung he removed.  He said that he "didn't remove that much of the lung" and, in fact, Roberto's entire lung is inflated.  *Whew* and hooray!!

This is super important:  Roberto might need to have radiation later.  It depends on what the pathologists find when they study his tumor.  We'll just cross that road when we need to, which might be next week when we see the surgeon again.

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Roberto has a nice room in the ICU with a window view.  It looks down into an unfinished courtyard of the building, but from Roberto's vantage, he gets to see the pretty sky.  To help rehabilitate his lung, Roberto has to do breathing exercises using a spirometer.  It's like a plastic toy that you blow air into and it moves a plastic bit in a tube.  I'll get a picture.

Also, Roberto has a bunch of tubes sticking in him.  There's the IV, the central line, the chest tube, a catheter for the bladder, and possibly another IV somewhere else?  The chest tube did have disgusting red liquid.  I did not freak out, though, because I was prepared.  Thank you, Lucile!

Unfortunately, the anesthesia made Roberto nauseated (nauseous?) and he's vomited a few times.  It bought us all back to the chemo days, but Roberto said that this made him over come the fear he developed for vomiting.  I guess that's good...?

Okay, the hard part is over.  Time to sleep!

SURGERY DONE

10:56 am
I finally got up and talked to the nurse in the waiting room here and asked if she could check on Roberto's status.  She said that she couldn't while the patient is in surgery...but that he just got out of surgery and they will be taking him to the recovery room.  YAY!  Why couldn't she have lead with that???

11:03 am
Theories:

1)  The tumor was a bit more complicated than anticipated.
2)  They didn't start the surgery right away
3)  The TV with patient statuses is not accurate
4)  Roberto made a deal with the surgeon to get some bionic implants (this is the most likely)

11:09 am
Roberto's official time out of surgery is 11:06 am.  The surgeon should be out soon to tell me the gory details.

11:18 am
Good News:  he's doing well and is awake.  There was no blood loss and they got the tumor out.
Bad News:  the tumor had actually grown past the mediastinum to the left side of his body.  This is partly why the surgery took longer.  Also, because the chemotherapy was so good, there was a lot of scar tissue around the tumor which made it harder to extract.  They took part of the middle and upper lobe (I don't really know what that means).

I should be able to see him soon.  The surgeon thinks that Roberto will be out of the hospital by the weekend.

11:49am
Wow, I didn't realize how much time had passed.  I just saw Roberto and he looks good and totally out of it.  He's still in the recovery room and is going to be moved to the ICU soon.  Adam told me that "removing the lobe" part means they removed part of his lung.  :(

12:05pm
I just want to say that they didn't remove an entire lobe, so it wasn't that much of the lung. 

Surgery Day

5:27 am
We're awake somehow and at the hospital.  Roberto has checked in and now we're waiting on ... something.  I'm totally not sure what is going to happen next, but I'm trying not to let myself get too nervous.  I had five hours of restless sleep.  Perhaps now is a good time to drink some coffee...

6:11 am
Roberto is in the back patient area, and I'm waiting with him. I've confiscated his phone for now. Roberto is all cute in the patient gown that opens up in the back and he has little booties on his feet.

6:22 am
Roberto and I just realized that today is 11/12/13! That's some sort of good luck, right?  We briefly spoke to a nurse here and she lauded the skills of the surgeon. Apparently he is the best in northern CA. We've heard this before, so I don't think she was lying to make us less nervous or anything.

6:35 am
Another nurse is now getting his vitals and started an IV.  She has the Grey's Anatomy brand scrubs (call back to a previous post!).

7:13 am
We just spoke to the anesthesiologist. This surgery just got really scary.  If Roberto goes too far under, there's a chance his lung will collapse because the tumor is right on top of it. With a lung collapse, there's a chance of mortality. Also, Roberto is going to have a lot more tubes in him than we thought. He'll have an epidural, a central line, and some arterial line as well.

7:30 am
 Roberto's been wheeled away from us and we've been sent to the waiting area.  I could see Roberto getting a little scared as the nurse took him away, but I think he felt a little better when Pedro comforted him.  There's an interesting setup in the waiting room; they have TVs setup showing where patients are such as "in transit" and "in the OR."  We might be able to see when the surgery is done before the surgeon comes out to talk to us.  Okay, it's time to play the waiting game.

7:52 am
Here's a picture of Roberto before all the scary surgery talk.  I was able to make him laugh.  He shaved his mustache yesterday and I didn't realize that until this morning.

8:37 am
I started getting anxious about the surgery but then realized that they are half-way through.  I cannot believe Roberto is getting cut up and having things taken out of his body.  :'(  Just one more hour and Roberto will be in recovery.  Pedro and I might be able to go see him during that time, which will be nice.

9:21am
A couple of therapeutic dogs have come to visit all the people in the waiting room!  This is a nice distraction and the mood of the room definitely changed. There are a lot of people here today getting surgery.

9:35 am
No word yet.

9:44 am
I keep checking the TV with the patients statuses.  I feel like I'm compulsively checking sports scores.

9:51 am
Still no word.  :(

10:07 am
Is it wrong that I'm jealous of the other patients and patients' families whose surgeries are done?  Also, I think we chased some people away from us to the other side of the room.

10:11 am
Just got accosted by a person in the waiting room.  Awesome.  No, I do not want to listen to you expound about WEAVE.

10:18 am
OMG, she's on the other side of the room now, too.  Am I a terrible person???

10:24 am
I lied, she left the room completely.  *sob*  Patti just told me that I'm not a terrible person, though.  So I feel a little better.

10:40 am
I don't know what to say right now except that I can feel my emotions wanting to bubble out of me, but I won't let them.

10:44 am
I just exchanged a mutual, knowing look of concern with Pedro. *sigh*

10:51 am
There's an equal number of people playing Candy Crush that are reading books in here.  I'll let you mull over that number.  It's more than one.

*Taking a deep breath*   *Remembering to exhale*

10:58 am
I started a new post because Roberto is OUT OF SURGERY.

Last Day of Being Normal

Well, we are about 24 hours away from Roberto's surgery (depending on when you read this, I suppose).  I got a bit more explanation from a friend of ours who is a nurse about how Roberto will be after the surgery, so I'm feeling a better now that I'm armed with more knowledge.

Here's a recap of the surgery information that we have.

Roberto is having a major surgery called a thoracotomy which is an incision on the chest.  There are several types of thoracotomies; Roberto's will be on the right side of his chest.  The surgeon wants to do a thoracotomy in order to preserve the cells of the tumor for further study.  This way, we can know what the tumor definitely is rather than extrapolate from the needle biopsy.  That's about all we definitely know about the surgery.  From reading up on what a thoracotomy is, I learned that small incisions are 4-6 inches long which does not seem that small to me.

The surgery is on Tuesday, November 12th.
5:30am -  Roberto will have to be at the hospital at this time to prep for surgery (insert IV line, etc.)
7:30am - The surgery starts
9:30am - The surgery ends and Roberto is taken to the ICU
11:00am-ish - Roberto can see visitors

For at least 24 hours (maybe up to 3 days) Roberto will be in the ICU.  He will have a chest tube during this time to help drain fluids from his chest cavity.  Apparently, this tube is gonna look crazy but I shouldn't freak out because it's absolutely normal.  I will probably still freak out.

Once he is well enough, the chest tube will be removed and he will be moved out of the ICU.  His total hospital stay is estimated to be 3-5 days.  Hopefully, Roberto will be home sometime during the weekend.

***If you want to visit Roberto while he is at the hospital, just message me and I'll let you know when he's up for seeing visitors.  I can also give you our address if you want to send a card!***

I'm planning to "live blog" the day Roberto is in surgery (Tuesday).  That means I'll keep updating the day's post with manual time stamps.  You can then refresh the blog during the day, or just wait until the end of the day to read all the updates at once.  The general timeline is at the top so you know when the major events of the day will occur.

Gah, I'm getting more nervous.  The reality of having major surgery is also hitting Roberto now.  On Saturday, we had a night dinner and games night with a bunch of our close friends.  Explaining the surgery to our friends made the surgery more concrete for Roberto.  He's not freaking out (he is Roberto after all), but he knows it won't be a walk in the park.  We had a nice talk while driving to see our friends near Berkeley on Sunday.  Roberto realized that, while this all is pretty terrible, he's still pretty lucky he didn't have some other type of cancer that would be harder to treat.  He's optimistic about recovery since he's handled pain before (50 mile races anyone?) and that will be much easier than handling nausea. 

Roberto's hair is really showing now and he's grown a mustache!   Before he lost his hair, he usually shaved the mustache area, so it's amusing to see him with one.  I'm going to make a tasty steak dinner for Roberto for Monday's dinner.  He can eat regular food after the surgery, but I think it'll be a nice treat. 

Clever Post Title

I read my last post.  I'm going to blame the cold medicine for the few incoherent moments.

Roberto has started his smoothie regimen.  I tried a bit and they are actually pretty tasty!  And tiny.  This is good because we didn't want it to become a huge hassle.  When he was on chemotherapy, there were only a few foods and drinks he could tolerate but the lack of variety made it hard to continue with the same diet. 

I'm still sick, but I can see healthy days in my future!  So far, this wasn't a terrible cold ... and hopefully I'm not speaking too soon... Roberto was super sweet and made me breakfast one morning when I was in a cold medicine haze.  Do you think he's starting early on making up for when I took care of him on chemotherapy days?

We don't have any big plans for the weekend, which is just as well.  Maybe it'll be good to just stay at home and enjoy each others company.  We might also plan a huge last-minute party!!! 

For next week, I'll be updating the blog daily until Roberto gets back from the hospital.  I figure I'll just be complaining a lot about Pedro (Roberto's brother) and how So Cal he is and that Nor Cal is better (you know it's true).  We'll be at the hospital at 5:30am on November 12th and the surgery will start at 7:30am.  Maybe I'll do a pseudo-live blog update on Tuesday if I'm awake enough.

Anyway, please send good thoughts and prayers Roberto's way!

Less Than a Week!

Sorry for the lack of a Monday post.  Things have been going well for Roberto, so there's not much to report.  I, however, have a cold.  Well I was careful about bringing germs to Roberto, I neglected to be cautious about not getting germs *from* him.  I think it's the same thing he had which is a scratchy throat and feeling terrible.  Hopefully, this will pass soon!  My mind has been in a fog and sometimes it's hard to concentrate on ...

Like the blog post title says, we have less than a week now until Roberto has his surgery.  Yikes.  I'm getting a little scared about it all.  Tomorrow, I may spend the time thinking about how to get ready for it all.  I already made an information sheet about the surgery and the post-surgery recovery advice I got from the surgeon and whatever my mom found on the internet.  I showed it to Roberto who read it all in a couple of minutes.  His biggest concern is that he cannot lift more than 10 lbs for about 6-8 weeks.  I can worry about the other stuff for him, I suppose, like the 4-6 inch incision that he *may* have (that's for the smaller type of thoracotomy incision). 

Roberto is practically back to his old self now.  He's been full of energy and even made dinner a couple of times!  I've embraced the change since that means I don't have to get burgers and pizza or make jambalaya for a full week.  Also, he's been admiring the peach fuzz that has started to grow on his head.  The eyebrows have come along nicely in the past few days, and Roberto looks like a normal person again!

On Thursday, Roberto will be starting a regimen of a special nutritional smoothie that the surgeon recommended.  The drinks have a patented combo of nutrients that purportedly support the body's immune system and reduce the chance of infection after surgery.  I'm not sure if it works, but it's good for Roberto to be as healthy as possible before the surgery anyway. 

Am I ready for life to change again?  Not really.  Well, I still have time to find some more confidence!

Late Happy Halloween!

Well, the brain cupcakes didn't work out.  I didn't have time to work out the logistics of my mold with the frosting I had.  :(  I guess I'll have to make Thanksgiving-themed brain cupcakes now.

We did spend Halloween playing the appropriately themed Ghost Stories board game ... and won!  Finally!  Now we might be ready to play on normal mode instead of easy. 

Roberto seems to be mostly over his cold even though he still has the sniffles.  At this point, the cold is just annoying more than anything else.  Roberto called up the nurse today to ask how long the surgery would be.  We were thinking something like five hours or so.  The nurse told us that the surgeon set aside *two* hours!  Thinking about it, that does make sense since the surgeon only has to cut out the tumor.  He's not doing anything too complicated...?  My training in optimization algorithms and machine learning techniques is really failing me right now. 

The other day, I heard Roberto yell in surprise.  I raced up the stairs to the bathroom to make sure he was alright.  He happily told me that his eyebrows were growing back!  He has the cutest little eyebrow hairs now.  Maybe now the rest of his hair will start growing back. 

I've been reading up on a thoracotomy and the recovery afterward.  Apparently, thoracotomies are one of the most painful surgeries.  Also, it'll be really important for Roberto to stay on a regular schedule for taking his pain medication and for him to perform the rehabilitation exercises daily.  Hopefully, Roberto will be back to his normal activities by the end of December!