Tuesday, January 5, 2010

The Big Cut

A brief summary of what the white coats said today....

Blood tests, EKG, etc., all good. Nothing new. I meet with the anesthesiology team tomorrow.

Surgery will be early Friday morning.

They will only remove what needs to be removed. If my doctor at Froedert was accurate, that may involve "scraping" my small intestine, to get the little "baby tumors" off. (Tumies! So cute. New from Hasbro.) If he has to, Keith will remove a section of my small intestine. Plenty of footage to play with, though.

They will also explore every other nook and cranny in my abdomen, to look for mucin and tumor. Hence the need for The Big Cut, sternum to below the belly button. Where possible, they will only "scrape" tissue. But he said if the spleen has tumor, it comes out, you can't "scrape" it. He can scrape or slice the liver if necessary. His goal is to remove any tissue that has any involvement with tumor. If it is "involved," it comes out. He has to get the tumors out, down to a certain tiny size, for the HIPEC (chemo wash) to be effective. He is reasonably confident that things will go well. No promises of course, but he is optimistic.

The side effects of the HIPEC treatment could include some ulcers, fistulas, and perhaps a temporary kidney shutdown (which is rare, but still something they watch for). Some other really small percentage side effects not worth discussing here. Overall side effects from the surgery include  exhaustion, and complications could be leaks, etc. If I run a fever, they'll know something is leaking. But a fever is also a regular side effect of HIPEC-type internal chemo. So they watch closely.  I have my own private medical staff (hi mom and sis!) so I'll be in good hands.

Post surgery, I'll be in a room that is halfway between ICU and a regular hospital room, if things go well. Hopefully after one day they'll move me to a regular hospital room.

No tube down my nose when I wake up. That's a relief. But I will have a G tube (stomach) and J tube (feeding directly to my intestines) for a while. A chest tube if they have to mess with my diaphragm too much. Praying for no ostomy--any I had would be reversible, though. Knock on wood.

He said that 10 days in the hospital would be the absolute shortest I could expect, but not to hope for anything that short. Most people are there 3 weeks. It all depends on any complications, and when my innards start working again. It's impossible to predict. They want to get me out of bed and walking the day after surgery (ouch) to start avoiding blood clots and pneumonia.

Overall, it was a very good meeting. Keith is ready to go at it.

He's going to fillet me like a catfish for a po boy, and rinse me out with gumbo.


Anonymous said...

You have such a way with words! Filet like a po boy...honestly!