Monday, April 22, 2019

Recovery mode

Well, here it is.  April 20th (420 to some) and I am recovering from some major surgery.  April 3rd I went into Swedish First Hill and had them open me up to see what was what.  Prior to that though, I had many, many doctor appointments.  So many.  I have two urologists now (Dr. Chapman and Dr. Han), a transplant doctor (Dr. Precht), an oncology surgeon (Dr. Ong) and of course, Dr. Gold who is my oncologist.  I'll leave out my two oncology radiologists although they are great people.
The ureter on my left side was being constricted by a mass that looked like cancer on the PET scan and the CT scan.  It also looked like I would have to have a colostomy bag (again...) but this time permanently due to the mass looking like it was connected to my large intestine.  That was some heartbreaking shit right there.  Did all that recovery for the reversal of my last colostomy and it looked like it was going to be for naught.  I was pretty upset about that.
So the plan was to have Dr. Ong do a mid-line incision (vertical) that would almost look like a c-section.  He would then poke around and see what needed to be done about the large intestine bit of it all.  Dr. Chapman would be right next to him and would take over for the kidney part of it.  Either removal of the kidney or resection of the ureter.  Dr. Precht would step in if I had to have my kidney transplanted down near my bladder.  That is called auto-transplant.  This would occur if they had to snip out the part of the ureter that was being constricted (and damaged by that constriction) and the remaining length wasn't long enough to reattach to itself.  You want two kidneys for chemotherapy.
April 3rd finally rolled around.  I spent the two prior days absolutely miserable doing bowel prep.  Some of you have had colonoscopies.  You know the drill.  Imagine that for two days...the vomiting started on the second day.  I think my electrolytes were thrown off.  Lord, I was miserable.
Got up at 0430 and took the pre-surgical shower.  Basically bathing in anti-bacterial soap for 10 minutes.  Arrived at the hospital and started the check-in procedure.  IV started and then Dr. Ong walks in with a marker in his hand.  "We are going to draw on your belly where your new colostomy is going to go.  Where is your belt-line?  We don't want this too low..."  That is when it got real. You think about the surgery and life after.  You dread it.  You get anxious about it.  Then you just want it to happen.  I met all the doctors at my bedside.  We all talked about what we were going to do that morning.  "Exploratory laparotomy with new colostomy and possible kidney removal or auto-transplant" I repeated back to them.  How in the hell did I get here...
Pre-op.  Getting ready to go in.
They wheeled me into the surgery suite with a bunch of RNs standing around.  I was going to get a foley catheter (tube into my penis and then the bladder) and I was also getting a nasogastric (NG) tube placed into my nose down to my stomach (left nostril please) that would then decompress my stomach.  These two tubes were going to stay in for a couple of days.  I have, over the course of being an RN for a couple of decades, placed hundreds of foleys and NG tubes.  Maybe thousands.  Having them placed in you is another whole different animal.  You get used to it but I didn't like it.
Showtime!  They give me some medicine and I remember asking Dr. Ong to please make my surgical incision to look like a shark bite.  Much cooler to take the shirt off at a pool and say "Yeah.  That's right...shark attack!"  And I was out.
Ah.  The good old NG tube in the nose trick.  I'll spare you the foley catheter picture!
Woke up in recovery and other than the aforementioned tubes in me, nothing felt different.  No colostomy bag.  No lump in my groin where my kidney maybe now resided.  First thought...I was so full of cancer that they opened me up and then closed me.  You hear about those cases.  The recovery RN must have seen my face because she said "Wait!  The doctor is going to talk to you.  It is not bad news."I get wheeled into my room on the 11th floor and start to piece together what exactly happened.  My surgeon said that they opened me up and I was full of lesions that looked like cancer.  They were devastated.  They called my oncologist and told them what they found.  "Get some biopsies for genetic reasons and close him up.  Chemo will start as soon as he gets strong."  The genetic testing would be for Sam.  She can get tested to see if she carries a gene for this cancer. 
I was basically screwed.  Except the biopsy came back negative.  Another call to Dr. Gold.  "Do more biopsies..."  Twenty total biopsies.  No cancer.  From devastated to elated.  The thing that was trapping my ureter?  Not cancerous.  Not only that, they were able to get the ureter out of the mass and when it popped out of the constriction, it immediately plumped up and started to get blood flow.  No need for a resection or a transplant!!
Dr. Gold came into my room and called me his miracle patient!
All tubes pulled!!
Still swollen belly.  That incision goes down another three inches...
I spent five days in the hospital recovering and finally got to go home.  I am still recovering but doing better.  Have good days and bad ones.  Mostly good ones.  I see the surgeon Tuesday and go from there.
Renal stent gets pulled in the next 4 weeks or so.  I also go back to my normal 6 month CT scan schedule and do watchful waiting. 
Not sure if I live a charmed life but it isn't dull...

Tuesday, February 12, 2019

I thought I was done with this...

Well...I thought I was kinda done blogging and such. I might be still. I have to see how much energy I have. Lemme back up a bit.
Yesterday, the 11th of February, I had my routine CT of my abdomen and pelvis. Cancer screening. Did the scan and the blood work early and then had one hour till the doctor came and got from the waiting room, telling it is all clear. I decided to go to my office in the next building over and change out of my scrubs. Got back to the waiting room and found out they were looking for me. Forty minutes early and they were looking for me...that is not good. Got into the exam room and couldn't even take off my coat before Dr Gold came in.
When you doctor holds your hand or grabs your shoulder or ,God forbid, hugs you...that also, is not good. Dr Gold did all three. Seems I have a new growth that is choking the tube that drains my left kidney. This growth is down in my pelvic area near the bladder right about where we took out my old tumor. Seems we didn't get it all. Also seems like the scorched earth policy I allowed to ravage my body in the form of chemotherapy didn't really help either.
Had a PET scan today. They only give you these, if you have cancer, when they want to find other growths that aren't yet wrecking havoc on your body.  Results tomorrow. Regardless of the result of the PET scan, I have an appointment Thursday morning early to have a silicone tube placed in the tube (ureter) that connects to my kidney. This will help drain urine from the kidney to the bladder because right now, my kidney is swollen and can't drain well.  They go in through the penis and place it. Cytoscopic stent placement.  Metal hollow tubes placed in me to place a flexible tube that stays. I will be knocked out for this.
Dr Gold says I will probably lose the left kidney because the cancer is wrapped tightly around the ureter and it is usually impossible to separate them. I might not but he didn't sound optimistic. I will also have more radiation and chemotherapy.
So same drill.  Big surgery, big radiation, big chemo.  Except my survival rate is now in the 20% range. That's doesn't mean I won't fight though.
Let's see what tomorrow brings...