SURGERIES

Tumor found. Next step: Semicolon!

FIRST SURGERY:

On September 26^th (2013) I went in for what was to be a minimally invasive (laparoscopic) colon resection (anastomosis). When they got me knocked out and on the table, however, and actually used their hands to feel my abdomen (you’d think they’d’ve done this at one of my pre-op appointments), they discovered that the tumorous section -where the perforation was- had adhered to the abdominal wall.

So they sliced me wide open and necessarily dug out the tumor. They placed permanent “markers” of a sort on this area of the abdominal wall for later use in identifying where radiation ought to be aimed.

22 centimeters of the descending colon were removed (roughly 1/7 of the entire colon). When the colon comes out, so does some of the tissue surrounding it. This is inevitable given that the two are attached to each other but serves a useful purpose nonetheless: to test nearby lymph nodes for metastasis. The pathologist tested 18 of my lymph nodes and 16 of them were found to contain cancer cells. Not awesome.

I’ve discovered that a lot of people wonder, but are afraid to ask, if I received a colostomy. Fortunately, I did not. For this type of surgery that’s only necessary if the surgeon is for one reason or another unable to successfully connect the two sections of the colon that were cut. My surgeon is a perfectionist and did the connection twice just to be absolutely sure he got an excellent seal. Impressively, after a colon resection, one is back to a regular diet within 2 to 3 days!

SECOND SURGERY:

The first surgery went really well considering how invasive it ended up being. I was only in the hospital 5 days and was stoked to be healing so quickly because I was anxious to get the chemo going as soon as possible. ASAP, according to my surgeon, would’ve been 3 weeks from the date of surgery.

Unluckily, though, after being home only 3 full days, things turned around. What started out as merely feeling a bit sick turned into nausea, vomiting, and severe abdominal pain. Severe is really an understatement here. My savior this time, my mom, drove me to the emergency room… somewhere around 4:00 am. Déjà vu. Evidently not my favorite time of day.

I’ll spare you the details of what transpired those 9 hours in the ER but, suffice it to say, I developed a passionate and intense love affair with morphine and an enduring and deep-seeded abhorrence for nurses who have a knack for finding that nerve, when sticking you for an IV, that sends a paralyzing electric shock up to your ear and down to your fingertips. That biotch is lucky she didn’t get a black eye.

Another CT scan (my third at that point) exhibited a bowel obstruction. During my first surgery they thoroughly examined all of my innards for visible metastases- from my liver to my ovaries. In order to do so, they had to dig around a bit. This meddling inevitably causes scar tissue, which forms in a sort of web-like fashion. My small intestine managed to get hung up on one of these sections of web and was kinked like a hose. This purportedly happens in less than 10% of abdominal surgery cases. Thanks luck!

So… I was admitted to the hospital again. Often times these bowel obstructions resolve on their own, but to help this along they starve you (for obvious reasons) and shove a nasogastric (NG) tube up your nose, down your throat, and into your stomach (to be left there indefinitely). It’s job is to suck out the nasty green bile that the liver produces (at the rate of about 500 mL/day), which, under normal circumstances, travels down the digestive tract to aid in digestion and is either reabsorbed or eliminated, but in the case of a bowel obstruction, backs up into the stomach. Yummy. 

If you ever find yourself on a television game show and the question is “What is the very best torture method to use against one’s enemy?” The correct answer is: Give them an NG tube. While the installation process is by no means pleasant, and the gagging sensation that never completely goes away definitely sucks, what I found more torturous was the swollen, raw, and excruciatingly painful section of the throat against which the tube rubs that develops about 24 hours after insertion. Every time I swallowed, I was swallowing a porcupine. I was unable to sleep and when the pain was at it’s worst, I was so distracted by it that I couldn’t concentrate on anything else. Couldn’t read, couldn’t hold a coherent conversation, could barely pay attention to a television show. One minute in real time equaled and hour in NG time. Several nurses and I tried our best to come up with ideas to relieve the pain- everything from strapping an ice pack around my neck to convincing the pharmacy to concoct a special Lidocaine cocktail. Nothing could reach that spot. No pain medications helped. Even my beloved morphine would not have relieved this condition. You all know how stoic I am. This shit made me cry- more out of frustration than pain, but I cried nonetheless.

The Attractive NG Tube

I digress. A wretched week had transpired and the blockage had not resolved itself. Thanks again luck! Next option: a second surgery. So… they used the same incision and sliced me open again to remove the offending scar tissue. And they removed the NG tube!!!

I should have healed from this second surgery and gone home a few days later, but it was apparent that luck had some unwarranted vendetta against me. I was fine for a couple of days but then the pain and vomiting returned. I was told that body organs kind of shut off during surgery and have to “wake up” afterward. The intestines wake up before the stomach does, so they thought my stomach was just being a little bit tardy. They had started me on a clear liquid diet and at this point asked me to advance to a post-surgery diet (bread, crackers, applesauce etc.). The last thing I wanted to do was eat, but I gave it a try. I had a half of a Popsicle. And a cracker. That’s all I could manage.

Soon I was barfing up colossal volumes, but didn’t mind a bit because I’d rather do that than have the NG tube put back in. One time I hurled just as the clan of resident surgeons & med students entered my room on their daily rounds. My mom was happy for this because they got to really see what I was going through.

Upon seeing this they deduced that I ought not to try to eat after all. I think at this point I was on my 12^th consecutive day of fasting (except for the popsicle & cracker that I threw up) and I needed some nutrients, so in went a PICC line. This is a catheter that gets inserted through a vein in the arm and navigates through several other veins until the end of it reaches the superior vena cava near the heart. One use for a PICC line is to administer TPN (Total Peripheral Nutrition). This is a bag of white, milky-looking liquid that the pharmacy customizes based on the patient’s nutrient needs (according to blood work). They put that shit straight into your venous system! Crazy. Each of these bags cost $2000 and I probably had a dozen of them. Also crazy.

TPN Bag With My Mom's Sense Of Humor Attached To It

My PICC Line When It Started To Leak

Finding out I was getting a PICC line was pretty scary to me for some reason, probably because I had to be awake during the procedure, but even worse was when they told me the NG tube had to go back in. Gah!!! I had already declared that they’d have to kill me before giving me an NG tube again. I chewed and swallowed those words as they explained that throwing up gets rid of the bile but doesn’t have the suction effect that is needed to take the pressure off of an obstruction. Another obstruction! Double Gah!!!

They ordered another CT scan (#4) to confirm their suspicions. As if drinking the contrast fluid for a CT scan isn’t bad enough- try having it in squirted into you via NG tube when your stomach is already distended 500% and full of bile. Not comfortable.

CT Report: Sure enough- another blockage- in a different area. This is the point at which I had the completely irrational thought (which I thoroughly and honestly believed at the time) that I would never, ever, leave the hospital.

Another miserable waiting period commenced, but things gradually improved based on what was coming out of the NG tube. The amount lessened and the color was becoming more and more transparent. I had somehow made amends with Luck. The second blockage had resolved on its own. One glorious day the NG tube was removed! A few days later I was on a regular diet. A couple of days after that I was on my way home! Hallelujah!

My recommendation after this experience is to not get cancer. It’s clearly overrated.

Stats from July 21^st until present (November):

Days hospitalized (including stint in July): 33

Days I consumed no food or beverage: 26

Number of pounds I lost: 20

Number of days I was attached to something (IV, PICC line, blood-oxygen detector, leg circulation device, NG tube, etc.) and could not walk around freely nor shower/bathe without difficulty: 29

Times anesthetized: 4

Number of CT scans: 5

Number of PET scans: 1

Number of MRIs: 1

Number of X-Rays: 4

Number of Ultrasounds: 2

Number of times stuck with a needle: well over 50

Number of people who compare to my mom: 0