Post Operation Low Down

Currently I’m sitting in my recovery bed in my third hospital day, so kinda sorta day 2.5 of post surgery. It’s a mixture of pain, boredom, rise and fall of lucidity with pain killers I take, and oh did I mention pain? Yeah, pain management has been a major focus of all this so far. I figured I could fill some time trying to write my stream of thoughts as I try to process the current news and what we still don’t know. If you want to be a long for the ride, be ready for a gory photo or two and some likely rambling. You’ve been warned.

Heather was great to post a quick operation update and hopefully you saw my note of admiration for what any amazing person she really is. This is nothing new, but just a continual reminder of how far I married up and amazed she continues to stick with me. She continues to be patient with all my needs here in the hospital, including the sponge bath, foot massage and constant helping me with the drug induced itchiness. I’m not being facetious when I say she’s a saint. I mean it wholeheartedly.

The Good

Seems like I have a Clint Eastwood theme to many of these journaling notes, following The Good, The Bad and The Ugly breakdown. Seems most fitting though. Recapping the good from the surgery mainly is that they were able to leave almost every organ intact. The spleen was a goner, and we knew that all along. But the stomach only had a portion removed, which means some much better digestive quality of life for now. The tumor masses were primarily able to be peeled back from what they were touching rather than having to resect parts of those organs. That’s a huge win. The pancreas was a close one, but with some work she was able to not cut into it, which is a plus because if cut the pancreas tends to cause more abdominal infections post operation and even long term.

The photo at the top of this post was a bit of morbid family humor. My brother Jason Hall thought it would be fitting to give me some Canopic Jars. Yes, I had to look up that name. They are tourist versions of the Egyptian Organ Jars used in the mummification process. Yes, we use humor as a coping mechanism. Of course they didn’t “let” us keep any organ tissue (gross), but we thought the photo in the hospital was funny. I’ve explained it to a couple of nurses and assistants that have asked about them and mostly got a courtesy laugh along with a raised eyebrow.

So back to the good from the surgery. While I do have a huge scar and they had to root around throughout causing a ton of swelling and areas of impact, it’s at least mostly intact. My colon was completely clear, they didn’t have to reset part of my diaphragm, my kidneys were left intact. So, so good to have those areas unaffected other than scraping and therefore just swollen rather than cut apart.

The Bad

So it wasn’t all good. In fact there’s plenty of room for concern in what the doc was able to do and not do once they dived in. A chunk of the stomach removed as mentioned, and that was done because it was the likely site of origination for the primary tumor mass. This is where tumor was just too embedded to scrape away. The omentum, a fold of peritoneum connecting the stomach with other abdominal organs, was riddled with tumors. This is a fairly important part of the abdominal connective tissue and serves a role, but not imperative to keep. So it’s gone.

We knew there was some tumor mass by the liver, but it was much bigger and embedded than expected. The surgeon called that part of the surgery “tricky” and extended some of the time as she worked to remove two large masses. One the size of an orange and one golf ball sized. Those were not seen previously on scans anywhere near that size, so the possibility of a fast growing mutation or different cancer type is going to be tested in pathology.

Also in the bad category is the small intestines. They were found to be riddled with small tumors, as in a lot of them. So much so that the surgeon made the decision to leave them in place. They are smaller tumors and her perception was that they were likely older tumors that have been present for a very long time, so the risk of leaving them was less than having to remove the entire small intestines to get them out. With so many it just wasn’t possible to remove them individually and be able to keep the small intestines intact and functioning. So that means along with other likely unfound cancer within my system, these tumors are known to still exist. The plan is to watch them with frequent scans and if they grow we will have to decide if they are able to be addressed.

The Ugly

Ok, here goes some photos. I figure the visuals in this case are the ugly part. Ready or not...

The primary tumor mass

This is the big ugly, otherwise known as the BFT. The organ at the top is my spleen, the rest is ALL tumor mass. For size we were told this is about football sized (American football). That’s so frickin’ big. This was all residing in the left upper quadrant of my abdomen. I have to admit my vanity makes me feel a little better about what I was able to maintain in terms of my cardio and physical efforts, especially during these last few months To even have had some abs with this sucker pressing out from the inside. I’ll try not to hurt my arm patting myself on the back though.

I was also having a lot of pain on right upper right quadrant in the last few weeks, increasing seemingly daily. On the big cycling ride to celebrate life I was frustrated when I had to stop 4-5 times on the ascent because I was just breathing so hard and unable to catch by breath. Well now I can say I feel a bit vindicated. My diaphragm was being impeded and I just couldn’t create the lung volume with all this stuff in the way. While there is a massive recovery ahead, having this bulk out of my system will hopefully make a big difference in quality of life.
Another “ugly” is the pain. It’s a very real thing and staying on top of the pain management has been harder than I hoped. For the surgery I was given an epidural which has remained in place. The hope of course was just like a c-section or birth in general that the epidural could numb the area completely. They placed it in the T8 region, and while it helps, it definitely does not reach all the areas they had to touch.

It hurts. A lot.

Then we’ve had some issues with the other drugs and the function of the epidural itself along the way. Timing on drugs always seems to be a little off. The syringe for the epidural last night had a crack in it, so for about 6 hours we didn’t realize the pressure was leaking out of the side and therefore not giving me a complete dose. Let’s just say that wasn’t ideal. Or more succinctly, it really sucked last night until we found the pool on the floor and fixed the issue.

I’m getting a mix of Toradol and when I request it Dilaudid to help with the pain, which does help. It’s short acting and doesn’t make it completely go away, but takes the edge off and allows me to walk around.

The big ugly scar. I’m super swollen right now. In fact everything is pushing out so hard it feels like I’ve still got the tumor in me. Skin is pushed to it’s limit and pulling on the incision adds to the discomfort. But I do know this is short term, and while sucky it will pass. Just something more to whine about.

Heather was reminding me that this scar will need to be kept from sun and water for some time for proper care, but then this baby has been earned so I plan to let it show off in all it’s glory. Maybe I’ll come up with different stories for the scar each time I’m asked. You know, shark bite, grizzly attack, or a really wicked cycling accident. Or maybe just stick with the BFT cancer, that’s pretty wicked on it’s own.

Still Going Beyond

I know it’s a bit cheesy, but I’ve been trying to keep my mind in the “go beyond” mentality. I’m able to do so little with the limitations of pain and knowing I shouldn’t push too hard to cause any problems, but when asked to do two laps around the hospital floor, I do three. When I need to do my breathing exercises I just do it, even if it hurts and I want to do anything but what they ask. I’m not a model patient at times, but I know I’ll only be better off if I can keep doing that little bit more each time.

These first days on the epidural and IV drugs are some of the worst, but I have those crutches to help me through. I know when they pull them off and I go to pills instead it’s only going to get harder and more painful. But the more effort I can put forward now, the more benefit I will reap now and prepare myself for when it’s even harder. And right now I have the physical help of Heather and next week she’s back at work getting in those required training courses after the school year. Heather’s amazing parents are also here helping run the house and take care of the kids. Eventually all that will change and some “normal” life limitations will come back into play. So strike while the opportunity and help is there, and we’ll get this recovery process moving along as it should.

But in the end, patience. It’s going to be long, slow and painful. It is now and it will be. I know this and will have to be reminded of it frequently I’m sure. We’ll get there, and it’s only baby steps right now But my goal is to eventually be back on that bike and enjoying life in whatever form I can make it.

Thank you for all the wonderful comments of support, texts, notes, donations, words of love and everything else I can’t think to name. All of you are amazing and such a help.