Post-op

This cancer journey of mine is certainly an adventure with endless twists and turns.  I came home yesterday after 8 days in the Norfolk and Norwich, having had my surgery.  I did my factual update for those on my friends and family group e-mails last evening, but this blog is for me and anyone who wants to share it with me. If you don't have the stomach for the detail and reflection, you don't have to read it, but I have found that keeping this diary helps me get things in perspective and look at the bigger picture.

I read through my last blog before starting this post and it reminded me of how jubilant I was to have a named consultant and a PLAN.  On our wedding anniversary on July 8th we were supposed to be having a meal with Steve and Kate and our minnister and his wife in Gressenhall.  By lunch-time that day I was fairly sure I was obstructing.  I took some laxative just to give mysef every chance of being wrong, and suffered an increase in pain and wind all afternoon.  It was Friday!  I had a visit from my GP after evening surgery and was able to persuade her that admission that day would lead to the same sort of chaos that accompanied my previous admission last April.  I was not completely obstructed, vomiting or toxic in any way, so I 'sat on it' all weekend, eating very little apart from yoghourt and doing odd jobs that needed doing before I could be admitted (like pairing up socks, and picking and freezing blackberries.)  I saw the weekend doctor on the Sunday morning and he assured me that it was not an emergency as I was not vomiting poo.

First thing in the morning I left a message on the colorectal nurses answerphone, and before 9 o'clock I had a call from GB to say she had already spoken with my surgeon and he wanted me admitted to the admissions ward, no GP visit or letter required.  Dave was working, and we agreed a time of 11.0 o'clock to present myself.  I was very calm; I had known all weekend that this was inevitable, and it felt like for once I was in control!  I made some flapjacks, which was a nice easy thing to do and stopped me moping.

The admissions ward was very sniffy about my not having a GP letter.  I was being admitted as an emergency anyway, and my surgeon was not on call.  It was beginning to feel a bit chaotic, and when I was told that my surgeon had been on call all weekend I felt my attempted manipulation had worked against me.  At some point in the afternoon I was admitted onto Dilham Ward, where I had been last April.  Blood tests, Xrays and ECG were done, and a cannula inserted ready for a drip.  I had the stoma nurse visit that I was due to have on August 5th, and she left me with two black felt-tip sites marked out for an ileostomy or colostomy should either be necessary.

The duty surgeon for the day was in fact a colorectal surgeon, and he assured me that the chances of tomorrow's duty surgeon also having that speciality was very high.  He also told me that my surgeon had a full scheduled list for the next day, and although he was fully involved he would not be able to do my op.  At this stage, and I cannot remember how it happened, the way opened up for me to be frank about my insecurities regarding emergency treatment, and my fear that the plans we had hatched a couple of weeks before would come to nothing.  He appears to have taken it all on board, because the next morning I was told that I was on my surgeon's list for the afternoon.  I don't know how to thank him because I don't know what went on behind the scenes, but from my point of view it was a perfect outcome.  I also acknowledge that for me to get my way there may well have been others who didn't, but at the time I could only defend my corner and let those in control make things as good as possible.  I do feel that God was in it, that all the prayer being offered up on my behalf, and the blessings that were showered on me at the last cell-group, were somehow holding everything together and I hope everyone was blessed by it.

So I had my promised surgery.  And the rest!  Things were pretty much stuck down and muddled down there.  Somehow the small bowel had got involved, so a chunk of that was removed in order to free the recurrent lesion.  The latter was threatening the patency of the ureter on the left, so a stent was inserted to hold it open.  The uterus (womb) was stuck too, so they called in the gynaecologist who removed it together with the remaining ovary and tube.  The dysplastic area in the right colon was removed.

I don't remember anything before about 9.30pm when I woke briefly in the ward to be told Dave sent his love and would see me tomorrow.  I remember asking if I had missed visiting time.  During the night I had a feel around and my fingers found steel closure clips and shiny soft vinyl.  I remember thinking that it had come to a colostomy after all, but that I had been well prepared and would cope.  I was just glad it was all over.

My surgeon came to see me very early and explained what he had done.  The description was missing the ostomy word - was he leading up to it gently?  I asked.  No, he said, everything joined up again.  Wow! I had been fingering the spray on dressing over my clips and jumping to conclusions.

By the end of the second day I had managed to pull out both my drip and the epidural, so pain relief was initally by iv morphine via a patient controlled device rather than epidural fentanyl.  I wasn't good on the morphine, very sleepy and with less reliable pain relief.  I was transferred to a combination of paracetamol and oramorph, but didn't like it because I was restless and confused, so most of my week was managed with paracetamol and codeine.  The pain was horrible and made moving about very difficult, in spite of the chiding of the physio and the example of other people in the ward.  It was a week before I emptied my bowel and realised that about 70% of the pain was internal poo pressure.  Suddenly I could straighten up, stride a bit and feel I could eat more than a couple of teaspoons of food at a time.

What follows below is detailed poo-talk:
I forgot to say that the evening before my surgery I had had a major explosive clear-out, causing the surgeon to ask me whether I would like to go home and be scheduled in later.  He explained that an incomplete obstruction may do this from time to time but that it did not indicate a resolution of the problem.  This meant that I was filling up afresh as a result of eating, and that the usual early diarrhoea was modified by the codeine.  So I have had the reassurance of several panfuls of normal sized poo, after fifteen months of little stringy bits.  (Squeamish please note:  I did give you permission not to share this!)

My surgeon went on holiday at the weekend (how's that for timing), but I was well attended both by the original surgeon and my sugeon's team.  It had been mentioned that once I got 'things moving' I should be able to go home, and I was able to negotiate that quite quickly the morning after, so that Dave could pick me up at the start of visiting.  I was feeling much less dependent by then, and longing for my own bed (and control over how long I spent in it), a cuddle in the night, the boys happy voices, edible food and freedom from bleeping.  The nurses say they hear the bleeps at home - the problem is that they don't appear to register them at work!

This morning I put a white loaf in the breadmaker as I am supposed to be on low-fibre for a while, did some work on this blog, made courgette soup for lunch and motivated Dave to get on with my strawberry bed.  The 60 day plants were holed in just before I went to the hospital, and need t o spread themselves as they are supposed to fruit in September.  Dom cleared the lunch things while I went to bed to read and sleep for an hour and a half.  I feel quite pleased with my first day.

I am prepared to hear that adjuvant treatment is needed.  All that invasion of adjacent organs means that the tumour was more active than we had believed, at least, that is how I see it.  If I recover as well as I have begun there is a strong possibility that I coud go on the canal holiday.  Once I get on the boat I could just rest there without getting off for the whole week.  No locks for me I am afraid.  I hope that by the beginning of the autumn term I shall be able to resume at least some of my grandma days, which I certainly couldn't have done with the August operation date.

I have been well and truly blessed in the last two weeks, in timing, relationships, kindness and care, the skill of the right surgeon at the right time, and the sense that God is smiling as he blesses me.  When I have felt able I have continued with the Celtic Daily Prayer readings, and been amazed at how they have spoken into my situation, with a mixture of reassurance of God's wisdom and power as he brings me through this, and reminders that these blessings are to be passed on.

Medical research is all about outcomes - short-term outcomes.  It talks about life expectancy, prolongation of life, cure of disease, but never about how many people die eventually!  Death is the ultimate failure of medical science, and pushing it back is what drives research, but we don't have to adopt the attitudes of medical science.  They have a purpose which is secondary to the business of enjoying the journey, growing closer to the Creator and looking forward to an assured end.  I am still enjoying the journey, still able to feel wonder and excitement, to recognise small blessings.  God is so good!