Tuesday, August 01, 2006

Down to the wire

I've spent the day in pre-op testing. I've been poked, pricked, prodded, phlebotomized (pity that doesn't have a percussive p in the pole position), and generally prepared. But let's begin with last week's activities. Kath and I went to Savannah for a week's vacation last week. We had a great and very relaxing time - very hot, beaches, cheap beer, and good sea food nearly everywhere. While there, we visited Charleston SC and Hilton Head Island. Only problem was that it was just as hot here in Boston as there in Georgia, so instead of being able to pose around in a tight white T-shirt over my six-pack abs (more like a keg actually) with a nice suntan annoying everyone, I just rejoined the tanned throng here in New England.

Back to work this week, interrupted today by the pre-op testing. First I saw the cardiologist who pronounced my heart fully fit and fully recovered from its early chemo shock. Then onward to pulmonary function testing where I had to breathe into a brand-new Klingon machine. I wouldn't be surprised if it were connected to a large air accumulator that the medical staff use to inflate their car tyres. I certainly felt as if I had blown up the Goodyear blimp at the end of it. But once more. pronounced fit.

Next a long consultation with the anaesthesiologist and finally a couple of chest x-rays. At the end of it all, I was pronounced quite ready to be cut open, chopped up, and reassembled. I feel as healthy as a horse acually. If it wasn't for this bloody cancer thingy, I'd be in great shape. Ah well.

For those interested, I'll go over the mechanics of the surgery. As the surgeon told me just before the vacation, it's a big deal. This is a life-style changer. The basic plan is to remove my esophagus - the swallowing tube - and part of my stomach, and to take the remaining part of my stomach, refashion it into a tube, pull it up into my chest, and reconnect it to the stubby little bit of the esophagus that's left in my neck. Thus my stomach is now in my chest, and "all you can eat" buffets are but a distant memory. A free stomach stapling and paid for by Blue Cross - how good is that?

I will need to sleep sitting up from now on as there's nothing to stop food from coming back up when I lay down.

There are two main types of operation - the trans-hiatal where the surgeon opens the stomach and the neck and works up and down the chest, and the trans-thoracic, where the surgeon opens up the chest at one side, between the ribs, collapses a lung, and works through the side. The esophagus is a bit diffucult to get at; it wriggles along behind the heart and lungs and pretty close to the spine. My guy is using a version that includes both, called endearingly the "three-hole" esophagectomy, which involves incisions in the belly, chest, and neck. I won't go into the details of why, but there are several advantages to this, although it's about the most invasive technique. As for invasive, here's a picture that I snagged from the web of the trans-hiatal operation, the one that's a bit less invasive than mine.

Cool eh? It surprised me too. It looks like he's actually trying to climb in there and rip bits out with his teeth.

Click on the picture for a better view.

So, with any luck, the three-hole technique should allow my ologist to put on his wellies (rubber boots) and a miner's lamp, climb in, and have a good look around. The operation is around six hours so he'll probably take his lunch in there too.

So, there you are. This will be my last post before the big event which takes place next Tuesday 8th. Kath will add a couple of entries while I'm in early recovery to let everyone know how I'm doing, and I'll start to post as soon as I can. See you all later.


At 9:20 AM, Anonymous Anonymous said...

Roger - Good luck !I'm so glad to see that your wit and powers of observation have not deserted you over the last few months. this blog has made great reading, even if the subject has been far from ideal.
I was wondering - and you may think this a rather morbid thought - but do you get to keep "the beast' after the event.
The idea of seeing it trapped and beaten in a bottle of formalin appeals to my darker side.
Trivial comments really when the main purpose is to let you know that we're thinking of you
good luck Dinsdale

At 10:04 AM, Anonymous Robin said...

Well done Roger, in coming through the initial treatment in good shape; which a lot of people do not.
You do know of course that we are all behind you over here in Blighty and looking forward to seeing your blog resumption. Pleased to see that Kath will be joining in the fun of blogging.
The very best of wishes Rog.....
from your bruv, family and friends in Blighty.

At 9:00 PM, Anonymous Simon Sherrington said...

Dear Roger,

We continue to be addicts of the blog and admirers both of your style and huge spirit. We read the latest one about your surgery next week. I (Simon) had always wondered what a “doozy” was ever since hearing the word for the first time in Groundhog Day (when Bill Murray repeatedly steps in the puddle outside the general store in front of the obnoxious insurance agent). But, looking it up in Merriam-Webster, I think that the procedure counts as “an extraordinary one of its kind”. It certainly puts the colonoscopy I am having tomorrow (for which the preparation is just beginning to have its gurgly, purgatory effect) in context. In both cases, though, it is very comforting that they have done it many times before.

Our thoughts are with you now and will certainly be on Tuesday. We will keep a look out on the blog for Kathy’s postings about your progress – which, to judge from your track record, will be swiftly upward. We look forward to seeing you when you are ready to grant an audience!

Lots of love to you both,

Gill and Simon

At 7:10 AM, Anonymous Julie said...

Roger - All the best coz, for your op on Tues. Love your courageous spirit and sense of humour its going to carry you through. We admire you and wish you loads of luck! Not too sure about your pictures though and certainly didn't click on them for a better view - just hope the surgeons got more at hand than his teeth!!! We'll be thinking of you and look forward to Kathy's entries.
Julie Steve and boys.
Robert and Denny


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