A Partial Left Colectomy
I’m starting this blog on my first day of chemotherapy treatment, but in the interests of chronicling my whole experience, I’m writing a few posts that go “back in time”. I’ll try to present things as clearly as I can remember them. Given that this has all happened over the last few months, that shouldn’t be too hard. Also, I’m writing about colon cancer, which means that from time to time, I’ll be referencing things that I otherwise wouldn’t talk about in polite company (stool samples, bowel function, etc.). Fair warning…
The symptoms that led to my diagnosis started in late April/early May. I saw my primary care doctor at the beginning of June, and by the end of June I’d had tests run, been referred to a gastroenterologist, had a colonoscopy, and been delivered a confirmed diagnosis of a malignant tumor in my descending colon. I do feel lucky that this all happened so quickly. I’ve heard way to many stories about people being misdiagnosed for months/years, and in my case, what started as some pretty vague symptoms were definitively diagnosed in just a few weeks.
I met with a colorectal surgeon in Boston at the very beginning of July to discuss what the next steps were. The next steps were to remove the section in the middle of my colon that the tumor was growing in (along with a little extra on each side) and then stitch the two ends back together. Allow a little time for me to recover and I’d be all set. Official name of the procedure: a partial left colectomy.
This is one of those times when a doctor is telling you something that sounds like a big deal, and they refer to it as routine. I think that’s supposed to make you feel better, and on some level I suppose it’s comforting to know that you’re not dealing with some once-in-a-lifetime event, but it’s not all that comforting.
I’d been referred to the surgeon that I met with by a friend who works for a gastroenterologist (not the same one that did my colonoscopy). That plus going to one of the major hospitals in Boston definitely made me feel like I was getting the best care I could.
The initial consultation was pretty straightforward. The doctor described the basics of the procedure, and confirmed that they’d do it laparascopically, which meant that my incisions would be smaller and recovery would be faster. The highlights of what I was told:
- The surgery itself would take 2-3 hours
- I’d probably be in the hospital for 2-3 days. They’d basically let me go home once I was able to get up, walk around, and go to the bathroom.
- I should plan on taking 2-3 weeks off of work after the surgery to recover
- Recovery wouldn’t be bad. I’d have some pain and sensitivity at my incision sites, would have to ease back into eating and would probably have some decrease in my appetite, and would be tired and need to rest. The doctor actually said that the biggest thing that recovering patients report/complain about is fatigue.
- It would also could be as much as two months before my bowels might get back to normal. While it adjusted to a section of it being removed, I might have to go to the bathroom more often, etc.
With the surgery, they would remove not only a section of my colon, but also some of the surrounding tissue, including lymph nodes. Once everything was taken out of me, they’d be able to do some additional pathology testing, basically to see whether there was any evidence of spread of cancer to the lymph nodes, and to see how deeply it had penetrated into the wall of the colon. This is how they assign the cancer a “stage” (there’s some great info on the differences between colon cancer stages here). It’d take about a week for the results of that testing to come back, and they would determine if I’d need any additional treatment. Basically, if the results said that things were Stage 2 (meaning that there was no spread to the lymph nodes), then the surgery would be all I’d need. If it was Stage 3, then they’d recommend a course of chemotherapy.
Once I’d recovered, I’d need to come in for office visits 3-4 times a year and have some blood drawn; I’d have a CT scan once a year; and I’d need a colonoscopy ever 2-3 years. They’d monitor me for 5 years, and if there wasn’t a recurrence, I’d be in the clear.
There was one moment during the meeting that totally took me off guard:
Doctor: “We could do the surgery soon, if you wanted.”
Me: “When’s soon?”
Doctor: “Thursday.”
Me: “…”
What felt like a minute, but was probably just a few seconds went by.
Me: “Do we need to do the surgery that soon?”
Doctor: “No, this isn’t an emergency situation, we’ll just need to wait a few weeks if we don’t do it this week.”
I opted to wait, as I definitely needed some time to prepare for being out of work for 2-3 weeks. My surgery was scheduled for July 26th.
The next few weeks was the time when the name for this blog was born. Many well-meaning people in my life told me that it sounded like I was really lucky that I “only” had to go through this surgery and then it’d probably all be okay. I know they meant well, but after a while, that really got to me. This wasn’t a flu shot. It wasn’t a quick outpatient trip to the hospital. It could have been a lot worse, but it was a BIG FUCKING DEAL, and I got very tired of people talking like it wasn’t (despite their best intentions to try and spin things positively).
Waiting also got hard the closer the day of my surgery got. I was definitely nervous, mostly because I wasn’t sure exactly what to expect. I wasn’t so nervous about the procedure itself; I didn’t think that I was going to die on the operating table or anything, but I just didn’t know how I was going to feel afterward, and how long it’d take me to get back to feeling “normal”.
Remember how everyone warns you that the worst part of a colonscopy is the prep? Well, that’s not true for surgery, unfortunately, though there’s also a prep to go through. This time, the stuff I had to drink was different: magnesium citrate. It’s not pleasant, but I was able to get it down. It’s a clear liquid, but it’s a little thick and bitter. However, I only had to drink 10 ounces of it at a time, so it wasn’t so bad.
The day of surgery was actually pretty uneventful for me, since I was asleep for all the real action. We got to the hospital and I was brought up to the surgical waiting area, changed into a hospital johnny, and laid down on a gurney to wait. Over the course of the next hour or so, I spoke with nurses, an anesthesiologist, my surgeon, and a surgical resident. Several people went over my medical history and the details of the surgery. I found out that not only was the surgery being done laparascopically, but also robotically. I’m not gonna lie to you, Marge… I thought that was pretty cool. At the time, I posted the following to Facebook:
Found out that there’s a robot involved in my surgery. We live in the future, people.
I remember being wheeled into the operating room, moving from the gurney onto the operating table… and that’s it. Next thing I knew, I was waking up in recovery. After a little while there, I was wheeled up to my room.
For the first couple of days I was hooked up to a pump that would deliver pain medication (morphine, I think) whenever I pressed a button, as often as every six minutes. This worked very well while I was awake. The first night, I fell asleep for several hours straight, and when I woke up, I was hurting, and was hammering the button pretty hard. After 15 (well, probably 18) minutes or so, I was okay.
It’s hard to rest in the hospital, even when you’re tired after surgery. There’s a lot of noise, even when everyone’s trying to be quiet at night; a nurse comes in every four hours to take your vital signs (blood pressure, temp, and blood oxygen levels); and you’re uncomfortable because there’s an IV needle sticking into you. I ended up sleeping for an hour or two here or there.
Getting out of bed for the first time was strange. I had no idea how to move my body. Getting back in was even weirder, and one of the nurses had to help me swing my legs back onto the bed. They want you up and moving around as much as possible, though. Surgery shocks your system and walking around helps wake everything back up.
For the first 24 hours I was very sore and in noticeable pain. In general, things got better each day. At the end of day 2 they took me off the IV morphine and I was able to drink some water, and then they started giving me pain meds orally. Late on day 2/early on day 3 the catheter got removed (that was one of the weirder experiences in my life) and it was easier to get up and move around.
The big “event” that they’re waiting for after surgery is for you to pass gas. That shows that your digestive system has woken up and is moving again. Unfortunately for me, this didn’t happen very quickly. The original “2-3 days in the hospital” estimate ended up being almost 5 full days. I’ve never had so many people ask me about whether or not I’d farted…
Not only wouldn’t they let me leave until I’d passed some gas, but they also wouldn’t let me eat solid food. So, for four days, I only had liquids: beef or chicken broth, Jello, and a frozen flavored ice of some kind. I came out of the hospital close to fifteen pounds lighter than when I went in.
I was really down on my fourth day there. In retrospect, I feel bad for both my wife and the nurse that was on duty that day… I was pretty inconsolable. By that time, I just wanted to go home, I hadn’t slept at all the night before, it was my wife’s birthday and I felt bad about still being in the hospital, and I was just wanted my body to get with the program.
The next morning, I farted. Never in my life was I so happy to do so. You’d better believe that I reported it to the nurses and the doctors that came by on rounds in the morning. A little later that day, I was allowed to have some solid food. Scrambled eggs and toast never tasted so good.
Once I ate and held down the food without any problems, I was cleared to go home, around 6pm on day 5. The nurses had all been fabulous, my roommate had been a very nice guy, and the eggs were delicious, but I was so happy to get out of there and get back to my own bed.