I had to ask a lot of questions and tell them about the numerous "healthy" all natural supplements I was taking. The nurse told me to stop the following as they could interfere with surgery and may complicate recovery and blood flow: Essiac, Probiotics, Omega 3, Tlc.30, all anitioxidants in excess. Regular vitamins were okay to take such as my calcium, D, zinc etc. I was also told NO nail polish, no perfumes or lotions or makeup. I was also informed how to take the Fleet enema that I would have to do the night before surgery (lovely experience....worked wonderfully to clean out intestines!)
On November 18th I went for a CT scan in preparation for the surgery. I received the news the day before surgery that they had found another pelvic mass.....
"Central pelvic mass measuring 7.5 x 6 .6 cm, image 135, with irregular thick nodular enhancing walls, with a cystic appearing centrally. The rectum is displaced posteriorly, and is intimately related to the mass without evidence of proximal
obstruction. The uterus at the level below or uterine segment is intimately related to the mass again with no clear fat plane present.
Pelvic adenopathy is noted:
-right iliac bifurcation lymph node 1.5 x 3.5 cm"
Of course this was sobering news...but it was if I had become numb to receiving what normally would be shattering news such as this. I knew that in a few days I would be having surgery and what better time to get this news when they were already going in and it would be all removed. The Dr. informed me I would most likely be having open surgery as opposed to laporascopic so they could get in there and see what was going on and be able to remvove everything properly. I had been wanting "open" surgery from the beginning ...I wanted them to get in there and get every bit of cancer they could possible see!
I arranged with Rose Miller, friend and "boss" for my "Sick leave of Absence" from Realstar, my job would be waiting for me when I was recovered...however I would not receive benefits or sick pay. One negative thing about Realstar. I think if you have been with the company for over a year you should be entitled to some sort of program. I arranged with Unemplyment for sick benefits...a big drop in $ coming in but I knew we would manage...despite my shopping each week at Planet Organic. :)
On the morning of November 24th I woke up early...had difficulty sleeping...wonder why? lol I took a shower, finished packing my "over night bag".....we headed to Sunnybrook. I checked in...was sent to change into the lovely blue gowns they provide...thank goodness for the 2nd one or my backside would have been flashing for all to see. Instead of the flimsy blue foot covers they provide...I saw in a box these "cute" tighter slippers in blue and green...I grabbed a pair and pulled them on. On the top was a smiley face.....made me smile...how can you not. I have always LOVED smiley faces and also love making faces on dirty car windows.
I was taken into a room to prepare for surgery. I was given a pre-op medication and my arm was prepared w/IV site. Johnny waited with me. It was a sobering time...scary but relieving as well. I just wanted to go home and lie in John's arms and snuggle and make this all go away. Not my lot in life however so here we go....
It was finally time to head up to the OR. Johnny gave me a sweet kiss and told me everything would be fine. I knew he would be waiting for me when I came out of the anesthetic. I had tears in my eyes and just wanted to go and get this over with he stopped the stretcher to grab a bobby pin I had left in my hair.
I was taken on my stretcher to wait outside the OR. I met the "team"..nurses and anesthesiologist. Dr. Covens came and said hello and reminded me that they would be doing an open surgery due to the mass found on the last CT scan.
Once I was taken into the room I was put onto the actual operating table and the room became a bee-hive of activity. I was strapped down and finally given the anesthic and told to count backwards....the smell of the anesthetic was overwhelming and I felt panicky but it quickly sent me under and out.
The following is the surgical report summarized by Dr. Covens and his team. A little technical but tells it better than I can:
"With the patient under general anesthetic, she was prepped and draped in semi-lithotomy position. A
Foley catheter was inserted into the bladder. A 1 cm supraumbilical incision was made in the skin
and taken down to the peritoneal cavity, which was entered uneventfully. Two lateral 5 mm ports were
inserted. Visualization revealed there to be a mass in the rectovaginal septum, which was palpated
on pelvirectal examination. It was deemed that she would likely need an anterior resection, and
therefore conversion to a laparotomy was performed. The patient was informed of this preoperatively.
A midline incision was made from the symphysis pubis up above the umbilicus. Exploration of the
abdominal contents revealed there to be no abnormalities outside of this mass in the rectovaginal
septum. It was felt that it likely was a clear cell cancer arising in the previous site of
endometriosis. She did have a suspicious-feeling right periaortic node.
The retroperitoneum was opened up bilaterally, the ureters identified, infundibulopelvic ligaments
clamped, divided and tied. The bladder peritoneum was incised and reflected inferiorly off the
vagina. The uterine vessels clamped, divided and tied. Cardinal uterosacral ligaments clamped,
divided and tied. The vagina incised, and the specimen consisting of uterus, cervix, right ovary and
tube removed. An attempt was to made to resect this mass without an anterior resection, and it was
deemed unsuccessful, and therefore a suitable area on the sigmoid colon was identified. It was
divided with a GIA, the mesentery rendered hemostatic with surgical ties. The pre-sacral space
opened up after clamping the superior rectal artery and vein. The lateral attachments were
cauterized. A 1 to 2 cm posterior vaginal wall had to be incised to get clearance around this mass.
The distal rectum was identified and fired across with a TA 55 3.5 staple. The rest of the mesentery
was rendered hemostatic with clamps and ties. The bowel was then sized to a #28. The superior
sigmoid colon was mobilized on its vasculature, keeping the inferior mesenteric artery and vein
intact. A tension-free anastomosis was going to easily be obtained, the anvil inserted and brought
out just proximal to the staple line in the antimesenteric border. The distal staple line was
oversewn with 3-0 Biosyn after using the TA 55. A tension-free anastomosis performed. Both donut
rings of the bowel were identified, and an underwater seal was confirmed with air insufflated into
the rectum. At this point an infracolic omentectomy was performed in the usual fashion, as well as a
right common iliac and periaortic and left common iliac periaortic node dissection. Hemostasis was
achieved with the use of Hemoclip and cautery and some fibrillar placed in the dissected beds. A
Jackson-Pratt drain brought in through a left lower quadrant incision was placed posterior to the
anastomosis and some fibrillar placed in the pelvis. A #34 Malecot catheter was inserted into the
rectum and sutured in.
The fascia was closed with a running loop Maxon. Skin was closed with clips. The estimated blood
loss was approximately 1000 cc. Sponge and instrument counts were correct. The patient was awakened
from anesthetic and taken to Recovery in stable condition."
I was fianlly taken up to my room where I was supposed to be for 3-4 days. I was on the 6th floor, D-wing (surgical oncology) in room #649 (Go buy a lottery ticket Johnny) I was in the 1st bed when you come in the room but the next day transferred over to the window bed when my 1st room mate left. Sooooo wonderful to have a bed with a view, saw part of the park, the eastern skyline of the city which included my "twin towers"
It was nice having such a wonderul view seeing the sun rise in the morning and feeling the sunlight on my face throughout the day.
One of the benefits of having open surgery I was hooked up to a pain pump. It was Hydromorphine which is stronger than regular morpine. The pump allowed you to medicate yourself without having needles constantly. It did have a "lockout" so you could only press the button a certain amount. Worked GREAT....considering being cut open with 35 staples, 2 taped camera sights, a drainage tube and a rectal tube..... having it was much appreciated.
I had lots visitors, besides John & Neiman, Jack & Zulmira, Mom & Dad and Alanna, Lourdes, Rose, Gofrado and Christine, Paula, Denise, Ayrine and of course Joe and Laura. I had the window ledge of my room covered in flowers...it looked like a flower shop....so pretty to look at...the nurses said they could smell how nice they were before they walked in the room. Gofrado and Chris brought me a few magazines and scratch tickets...I won $25.00 :) Rose brought me some organic fruit and granola bars. It was such a nice feeling to know there was such a wonderful support system around me.
They removed the pain pump on the 28th. On the 29th they removed the "poopoo" tube and bag. So happy to have that removed...it smelled so bad every time you passed wind etc. I had my new room mate , Joan Chapman, "move in". She was 85 and just had surgery to remove a tumour attached to her bladder. She is such a wonderul warm woman, full of spirit and soooo positive. Such a great person to have around during recovery.
On the evening of the 29th....early morning of the 30th I started feeling nauseous and began throwing up in the middle of the night, all that was coming up was a green bile like liquid....but it would not stop. The Dr. instructed the nurses to insert an NG tube (nastrogastric tube) down my throat and into stomach. It was a horrible exerience as they had to try twice to get tube down. They had to insert through the nose and down throat into stomach. I was taken off food and had IV only...a few ice chips were allowed. :( I looked like an elephant woman the way the tube was taped on the outside to my nose with the tube coming outside as well!) My throat started hurting and it was extremely painful to swallow. I felt miserable and told John I didn't want any visitors or phonecalls during this time as I couldn't talk from the pain in my vocal area.
I had a CT scan done on the 30th of November. I had another done on the 2nd of December. They inserted fluid in through NG tube and inserted constrast directly into the rectum. FUN. There was nothing really to be concerned about. The bowels and intestines were adjusting from surgery and it may have been the chicken sandwhich John brought me to eat (the Dr. DID say family could bring us food but it might have been tooooo much tooooo soon. Slowed things down a bit.
I never thought I would say this but farting and pooping became the highlight of my days. A thing of beauty to be celebrated! They made the decision to cap off the NG tube for the day and night to see how I handle it. I made it through the night and managed with ice chips to soothe my throat.
December 3rd the Dr approve the removal of the NG tube...I had tears in my eyes when they told me and I cried because I was so happy after it was out. I was now going to graduate to a fluid diet...soft solid the next day and regular on the day after. Whoooooohoooooo.
Johnny supplied me with lots of movies as I had my laptop to keep me company and my blackberry to stay in touch with everyone!! Mom sent me many emails which were wonderful and Alanna and Laura stayed in touch every day. Paula sent some uplifting texts as well as Rose.
They decided to let me go home on December 5th!!! Soooo happy!! The surgeon removed the surgical drain tube......
it was basically empty by the time they removed it....NOT like the photo above which was taken 2 days after surgery. I know it is kind of gross but I find it fascinating.
My Frankenstein surgical staples were also removed!! It took about 20 minutes to remove about 35 staples...I couldn't watch...only because I had to lie down flat. I counted as they were pulled as I could hear the clink of the staple as it hit the bottom of the bowl.
I got dressed, did make up, packed up bags, tidied up flowers and cleaned window ledge, had breakfast and waited for Johnny....my hero come to take me home.
This part of my journey is over.....Many thanks to the nursing team on the D-wing of the 6th floor and of course to Dr. Covens and Dr. Luc...my life was in your hands and you have given it back so I can move on to the next chapter of this journey.
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