Post Surgery Update

 It has been brought to my attention that I have not updated since surgery. Sorry! Surgery was surgery. I read the report and it took 8.5 hours total. Urology did their part first. No issues there other than i went in with a UTI, which caused issues later. The liver surgeon did her thing. Initially, she told me the liver met was actually something that grew from the diaphragm into the liver, but pathology said otherwise. It only had 30% active cancer and was removed with clear margins. The chemo worked on that spot. She also found another spot on my diaphragm that she removed. The gallbladder got to stay, so I guess that is good. Her part was done. Then the bulk of the surgery happened. There were a few spots that were removed that showed no cancer in pathology, so that is good. However, there was a lot of cancer. Both ovaries and fallopian tubes were removed as well as the big mass. Since ovaries are sanctuary sites, there was quite a bit on active cancer there. The plan was to leave my uterus, but the cancer has wrapped around and grown into it, so it came out too. Cancer was scraped out of my abdominal cavity. However, scraping wasn't enough for some areas. There was a part of my sigmoid colon and rectum that had to come out due to cancer growing into it. My PCI going into surgery was a 10. I was afraid it was going to be much higher since we knew the cancer burden was heavy in my pelvic area. The Peritoneal Cancer Index (PCI) is a scoring system used to quantify the spread and size of tumors in the abdominal cavity. It ranges from 0 to 39 and helps surgeons determine if tumors are removable and if a patient is a candidate for cytoreductive surgery. My CCR score after debulking the cancer was a 0. CCR score refers to how much visible tumor is left behind. CCR-0: No visible disease remains after surgery (the optimal outcome). The surgeon was confident she got it all. Of course there could still be microscopic disease there somewhere, but I will be praying there is not. This is the best prognosis given the extent of my cancer. Prior to surgery, I was in pretty debilitating pain daily, especially by the end of the day. That pain is gone!

I remember little about waking up after surgery other than being hot. Come to find out, the ac in that room was busted, so on my walk the following day, I walked myself to a new room. Walking wasn't so bad that day, but I think there was still some nerve blocks or something, because the next day was torture. I was about to be bumped to the step down room, but at some point in the middle of the night I spiked a fever of 102.8. That prompted worry. Let me tell you, THREE surgeons pulling off your dressings looking for signs of infection is not fun! They deal with sleeping people, so were not too gentle until after I screamed because I lost some skin. Lots of tests were run, but there wasn't a definitive cause. It may have been lingering UTI, but not sure. I was put on antibiotics. That delayed my move to a new room and more freedom. I think it was Saturday night when I finally got moved up to a different floor. Things were going well. There was so much pain. Let me tell you, this surgery is not for sissys! Sunday night, the nurses mentioned I may get to go home on Monday, but I knew I wasn't ready. Later that night I started to have horrible stomach cramps. This of course prompted more tests. This diagnosis was an ileus.  What is an ileus? Ileus (also called paralytic ileus or adynamic ileus) is a medical condition in which normal contractions of the intestines stop, temporarily paralyzing the bowel. Unlike a mechanical obstruction, there is no physical blockage. Instead, waste, gas, and fluids accumulate, causing painful bloating, nausea, and vomiting. That was NOT fun. It was suggested that I try acupuncture. I had always wanted to try it for the neuropathy, so figured why not? Well, everything on the right side went fine. However, once everything was in place on the left side, I seemed to develop restless leg syndrome, except it was my whole left side. We cut the session short. I was sitting in a ball on the bed, not an easy feat after major abdominal surgery. I had nurses with ice packs and cold rags on each side. I was given Ativan to relax me, because the feeling was not going away. It was an experience! Needless to say, I did not do the next session. I switched to massage. The ileus seemingly resolved, so I went home Wednesday...a week after surgery. It was nice to be in my own bed, but I sure didn't sleep any better. Everything just hurt! I was also plagued with nightly low grade fevers. 

Either the ileus didn't completely resolve or I got it again. I knew on July 4...Saturday that I was not well. I went to bed and started throwing up. I held that barf bag tight until Marc got home from work. I could not move to throw it away or get a new one. After a call to the after hours number, back to the hospital we went. After a few hours they told me I was being readmitted. UGH! Back to NPO and IV fluids. I vomited a lot as I was getting up to the room and settled in. The early morning rounding doctors wanted to put an NG tube in, but I protested that and won...as long as there was no more vomit. For some reason I was confined to the bed and had to have a nurse basically stare at me to pee. I was NOT happy. Sunday mid-morning morning when the doctor made the rounds I asked why I was not allowed to walk and use the bathroom on my own when I had been at home for a few days. I even had an alarm on the bed incase I tried to get up. She quickly fixed that issue. I walked and walked and walked trying to wake things up. Finally, around midnight things got to moving. Monday morning rounding doctors told me I would be there until Tuesday, at least. I protested. They told me I could plead my case to the surgeon Monday afternoon when she rounded. I was walking the halls and ran into the doctor. She ok'd me to go home with the promise to call for any other issues. Truth be told, I probably should have stayed, but I just wanted to go back home. 

It has now been 3.5 weeks since surgery. Recovering is going ok, I guess. My intestines are still sluggish. Hopefully, they will be back to normal soon. I get up and shower daily. I walk several times a day. I am so bored! I think the pains I have are just part of healing. I have an incision from my breast bone to my pubic bone, so the internal part of the surgery was quite extensive. The insides will still be healing for another 6 weeks or so.

Prayer Requests: Please pray for recovery to continue smoothly. Please pray for my intestines to fully function. I plan to go back to work next week.  Please pray that goes well. 

 I am thankful for the calls, texts, cards, meals, and meal gift cards! I am on my own all day every day, so it has been nice to not have to worry about making myself food.