It’s done! Cancer has been surgically removed from my body.
It has been a while since I posted, and this is because I am recovering from surgery and adjusting to my new living conditions.
- January 12th I checked into the Portland VA Hospital. Cancer, with margins and all close lymph nodes, was removed. An ileostomy bag was installed (is that the correct word?).
- January 29th, after a few trials and tribulations, I am released to go home.
- February 5th, I am released to go to work.
If you don’t want to know any of the gory details of this time period, then just re-read the above summary and move on to the next post. What follows is a more detailed breakdown of the events, and may contain parts that more sensitive folks might not like.
Note the NG tube sticking out of my nose. The gory details below (for the brave).
Surgery is never a minor thing, especially when you must go under general anesthesia. The prep was pretty much what one expects: two IVs, some “man-scaping”, and lots of different doctors coming by and all asking just about the same series of questions — name, social, birthday (guess they are wanting to make sure they have the right patient), do I understand what is about to happen, and different questions on medical history as concerns the flavor of doctor asking.
After about 45 minutes of this, I say good bye and give love to Julie, and I am off to the operating room. Funny how such things as preparation areas and operating rooms never look quite as they do on TV (and maybe that is because it’s the VA). The room was huge, with an 8-seat-dining-table sized metal table covered in surgical stuff sitting off the foot of the operating table. That was all I could glance before placing an oxygen mask on my face. The nurse/doctor (didn’t really see who) said “I am going to push down on this a bit to make a better seal” (because of my goatee). And then I wake up in the ICU. The surgery took 6 full hours.
I have few memories of the night I spent in ICU; lots of sleep between my nurse taking vitals and adjusting things.
The next day, I move to a regular hospital room. For the VA, that means my bed and three others are in the same room, which may or may not be occupied. In fact, during my stay there, several came and went. My room was nice otherwise, on the 9th floor with an awesome view of Portland from high on the hill where the VA hospital sits. And after 5 days in the room, I was able to transfer beds to one next to me with floor to ceiling windows covering the entire south-west wall. Wonderful!
Now, I am not going to go into a minute-by-minute treatise of my stay — just the highlights.
My stoma and Ileostomy Bag
A stoma is another name for a bit of your internals poking out for a purpose. In my case, the very end of my small intestine is pulled out a hole on my right side just above and to the side of my belly button (which pretty much has been sliced in half by the cut from above my belly button to my pelvis to get in there an do all of this). My stoma is about one inch in diameter, more an oval than a circle, and is “meaty red.” I am told this is good, and the meatier the better. There are two holes, since they pulled the small intestine a bit out of my body and just opened it kind of on the side. One hole comes from my small intestine, the other hole leads to my large intestine.
The large intestine hole is pretty much not used for anything and is there just waiting for the next surgery to put everything back together. The small intestine hole, however, is now where I “poop” from. An ileostomy bag is basically a plastic bag stuck to your body with two holes: one hole to allow the stoma to do its thing into the bag, the other hole allows me to empty the bag into a toilet.
Generally, if you are OK with changing messy baby diapers, you would be OK with maintaining an ileostomy bag. However, it can be a mess at times. I have had some problems recently (and I am still trying to work out the why’s so I can fix it) with the adhesive part that holds the bag on my body blowing out on the side. In short, this means I am not pooping in the bag, but rather under the adhesive bond. This has two issues.
The first is it’s a mess, and if it sneaks up on you with little warning, there is usually an hour of recovery and cleanup to get things back in order.
The second is the leakage is rich in enzymes necessary for digesting food. The enzymes don’t know the difference between last night’s steak and your skin. If they stay on your skin for too long, the skin becomes irritated as it is being eaten. I currently have some very irritated spots, as again, it can sneak up on you and I didn’t realize what was going on.
Normally, for health reasons and equipment integrity, the adhesive and bag should be changed about every 5 days. I have gone 7 before. Lately though it seems I am changing it every other day to compensate for blowouts.
It took a bit of getting used to in the hospital. I don’t have bowel movements. Until I was doing it myself, the nurses would just lift my shift and check my back, and if it needed emptying, pull up a container and bang, the bag is empty. There is however, some finesse to closing the bag properly. One night a nurses aid emptied my bag and didn’t close the bag securely. Later I went into the bathroom to urinate and the bag just opened up and dumped all over the floor, my feet, etc. It can be messy.
When they say liquid diet, they mean liquid diet
So I am on a broth/clear liquid diet when I first move into the room. As other patients in the room got their non-liquid meals, I was a bit envious. I was handling the clear liquid diet OK (I thought) and practically begged for something more. They bumped me up to a liquid and soft foods diet — pudding, soups, etc. And the first meal I get has tomato soup. Now, I would have thought, even on a soft foods diet, that tomato soup would be a bit too acidic. I ate a bit of it, and pudding, and milk (to try and cut the acid that was now refluxing after the tomato soup). But all was for not, as it was determined after the fact that my digestive tract had not completely woke up after surgery yet. I threw up the meal.
Now, the event was not really an issue, I could handle it. But the doctors determined that since I could not process things through, that I would need an NG (nasogastric) tube. That’s the tube you see going into one’s nose on the TV. The purpose is, after hooking it up to a vacuum, to pull all the contents out of one’s stomach. Thats all well and good, and the concept doesn’t bother me so much. However, getting it installed is another matter.
Many among my family and friends know I don’t like needles — at all! Well, I am here to tell you, that I am OK with them after getting the NG tube put in. It is my new hate/fear.
RN Bill, a retired Marine nurse, is the best on the floor to get this done. And he looks like a Marine — yes, a bit of excess around the waste, but his chest, arms, and demeanor show he served in the military. Thankfully he had a great sense of humor too.
Julie insisted that if they were going to do this to call her. One of the nurses did, and 10 minutes later she was here. She was here to support me, but Bill, seeing she was not squeamish or shy about any of this asked if she would like to help. Of course Julie said yes.
Bill squirted something he explained was a lubricant and mild anesthetic (afterwards he explained is was the same stuff they used to put in catheters) up the chosen nostril. Not only was I gagging because of this thick oil like stuff just injected up my nose, but it smelled and tasted like something I would have expected to be scraped from an axle on a big rig. Really nasty. He then hands Julie a cup with water and a straw, and says when he says go, give me the straw and hold my head forward. Bill told me that when he says go to suck on that straw and swallow until he was done.
I started sucking like my life depended on it, Bill was shoving what felt like a one inch PVC pipe up my nose and down my throat, and though I tried to pull away from it all, Julie was holding my head in place like a vice.
The whole thing took like 10 seconds. It seemed an eternity. The entire time I am trying to swallow this tube I am gagging on the tube and the lube. Eventually it is in place, and only occasionally over the next week do I turn my head just so and caress my gag nerve at the back of my throat with the tube. The whole experience was absolutely horrible.
Afterwards, talking with different doctors and nurses about the experience, they mentioned all kinds of wild statistics: 20% of patients need this done, half of the patients need this done, it is rare, it is common, etc. It seems no one really has a handle on how often this happens (the internal organs not fully waking up after surgery). Next time I think I am going to ask they put one in during surgery and plug it. If we don’t need it, fine. Removing it was nothing compared to putting it in.
Loves and Visits
Not all was bad. Family and friends stopped by either personally or through social media to give there best wishes and love. Everyone, you must know that the support and prayers are appreciated and never taken for granted. You all helped Julie and I get through this rough patch.
I especially want to give a shout out to John my brother, and his better half Lenore. I had not seen him for decades, and it was great to catch up. Jamie made it up a couple of times, and my cousin Bill and friend Gary made several trips as well.
Julie and I had a surgical follow up in early February. We learned that, from what they took during the surgery, all cancer has been removed. If there is anything left, it is undetectable by today’s science. Next week we go to Portland for a follow up with Dr. Lu and the oncology department. Oncology will probably outline the schedule of chemo I will be undergoing. Just in case there is anything left floating around, they want to burn it out. I am OK with that. Well, maybe. Hopefully my body takes this round of chemo as well as it took the last.
Sorry, no pictures of the gory details for this post. Julie determined that they were either inappropriate or too much for the average viewer.