Surgery (3 of 4)

Once upon a time I had an emergency transverse loop colostomy to relieve extreme blockage in my gastrointestinal system due to a great big old cancerous tumor (#1).  About a month later, I had another emergency surgery to remove the great big tumor that had perforated and metastasized and was kind of exploding my ovary with infection, and a bowel resection and a total hysterectomy and an appendectomy, and a reversal of the first colostomy which was replaced with an end colostomy  (#2); that was The Big Surgery.  Then I decided to take a break from surgery, shake things up with some chemo and radiation, and everything was very successful.  I did some exercise and raised some money and went for a really long walk and contemplated the wonder of it all.

Maybe I could have stayed away; maybe I could have resisted the lure of the OR and anesthesia's siren song.  In the end, a chance at having more or less normal anatomy was too enticing, and I decided, on purpose, to go for surgery #3: The Re-Connection. 

I wasn't expecting this one to be a blockbuster like #2.  The previews totally gave away the story, and the couple of plot twists they managed to sneak in were pretty vanilla.  I mean, probably lots of people go all vasovagal on the anesthesia team when they put in the first IV, and lose literally every drop of super-Gatorade that was supposed to enhance recovery after surgery before the surgeon even shows up for work.  And do that in front of their 5-year-old son, who had to come with because you had to be there at 5:30am, and oh yeah it's his birthday too!  It's okay honey, mommy's fine, really...

There was some comic relief after getting the epidural - which went totally fine - when the senior anesthetist validated its placement by poking me with a tiny yellow plastic toy sword.  Good one.  It was even funnier a few hours after surgery when they wanted me to stand up and didn't think I should be in so much pain and then did the big bag of ice test and realized the epidural was only working on my left side.  Super jokesters, those pain team dudes!  Seriously, I only wanted the left side numb.

The tense stuff was in the middle though, when my surgeon wasn't sure if she could get to the stub of rectum I have left, because it had adhered to other body parts, and she had to do the surgery through some of those other body parts, and then separate them, but at least there was length in my colon, and lo and behold the two again did meet!  I'm all intact again.  I do have an ileostomy so everything can heal, and even that she managed to pull up through the existing open spot in my abdominal wall - one less hole!  This was the potentially big ironic moment.  I knew that if I woke up and the ostomy bag was still on my left side, that would mean surgery was not successful.  My husband knew this too and wanted to get to me as soon as I woke up so I wouldn't be upset if I felt the bag placement before he could talk to me and let me know what happened.

And now, in 8-12 weeks, assuming everything else goes well, I can opt for surgery #4: The Final Takedown.

With all due respect - my surgeon is amazing.  And everyone on my surgical team and all the nurses and the phlebotomists and the anesthesiologists and the woman who answers the food ordering line... you are all amazing.  I am so grateful to have access to incredible medical care and especially a surgeon who respects my wishes and goes the extra mile. 

It also proved true that not being wicked sick going into major surgery really helps a lot.  I was up and walking around the morning after, able to sit in my chair for all my meals, and would have walked out of the hospital no problem if the wheelchair transport hadn't been so well-timed with my discharge.  Oxycodone is doing its part for sure but I'm quite certain recovery will be a relative breeze this time around.

Onward and upward.

Planning

Yesterday morning I had my pre-op appointments.  Last time I had surgery I did not have any pre-op appointments.  I don't remember the day before my last surgery.  I remember speaking with the anesthesiologist the morning of and signing a piece of paper and that's about it.

I highly recommend the pre-op appointments if you can swing it.  In fact, it turns out there are all kinds of benefits to planning major surgery in advance.  Right after you book the procedure you get a nice little packet in the mail full of info about the hospital, the gift shop, where you can eat at the hospital and in the area, support services as an in-patient, what you should and shouldn't bring, directions, hotels, all kinds of goodies.  During the pre-op orientation you get a detailed timeline of when to eat and when not to eat, when exactly to take the pre-op antibiotics, when exactly to perform the other prep steps (think colonoscopy), and when exactly to drink the gatorade on steroids that is supposed to help you recover faster.  You learn how you're supposed to take a shower with the special soap for three days in advance.  You are instructed not to use any products with fragrance the morning of, or anything with alcohol, not to have nail polish on your fingers (toes are okay), not to wear any jewelry and to be sure to remove all piercings.  You get to see the first ostomy nurse you met at Brigham & Women's after the second surgery who showed you the right products and basically made it possible for you to leave your house and try to live a normal life; you see her because she gets to mark the spot on your abdomen where the ileostomy should go, in the event you have to have one (because maybe, just maybe, if everything looks good, you won't have to have one, says your surgeon).  You talk about options for pain management and discover that the one everyone recommends by leaps and bounds - the epidural - is the one that scares you the most because it took three people five tries and over an hour to give you one when you were twelve hours into labor with your son.  You find out that you are the first surgery of the day, a VIP, however be sure to call the day before to confirm the time just in case something comes up.  (And then you realize, oh right, I was the something that came up for somebody else, way back then.)

Yet there are drawbacks.  It turns out that having major abdominal surgery in an emergency situation with no lead time is in some ways preferable to making deliberate arrangements to be gutted like a fish.  Until yesterday I had been able to keep this event on the horizon.  Now it is looming and giant and speeding towards me and in my face and it won't shut up and all this stress can't possibly be good for me going into it.  On top of it all I have this fear that when she opens me up my surgeon will find more cancer, something capable of evading the blood tests and the scans and triggering no symptoms whatsoever, something she will discover on the eve of my almost being eligible for life insurance again, a day I was really looking forward to so my family wouldn't have to struggle if their sole breadwinner succumbed to this disease or some other unfortunate accident.

On the bright side, when this is over, I'll have even more medical expenses to tally up for you, and together we can marvel at the price tag attached to the miracle of modern medicine.  In the meantime I will take your thoughts, well wishes, meditations, prayers, and positive vibes.  Peace.

Bellies

Yesterday Facebook reminded me of this belly shot.  This was a little over two weeks before my son was born, nearly five years ago.  I am quite sure this is the last picture of my belly I have, from before he was born, before I was gutted like a fish thanks to cancer, before the new normal.  If I am very, very lucky, in a little over two weeks from now, my anatomy might be in one piece again.  And in another 8-12 weeks from then, I might have an intact belly again.  Never again will it look as amazing as it does in this picture; it will be a whole other kind of amazing.  Fingers crossed.