Part 7: Surgery (The Origin of My Semi-Colon)

January15th, 2015 was my surgery to remove the tumor, the area around the tumor and what would turn out to be 30 lymph nodes. I’d never had surgery before (technically I guess the insertion of the port is surgery, but considered “minor” surgery and done as an outpatient), and I’d never spent the night in a hospital before. I was both nervous and anxious. After all, I had been working to get to remission and get my CEA down so I could have this surgery. Also there was something psychologically cathartic about having the tumor and tumor site- the source of the Cancer- removed from my body.

Before surgery I had to get medical clearance from my Primary Care Physician.  That was basically the same as an annual physical with blood work and a chest X-ray (for the anesthesia). Everything came back normal- my Dr. told me once again, that just looking at my test results and the rest of my physical, you wouldn’t know there was anything wrong with me. Small comfort, all things considered, but it beats the alternative. The prep for surgery was the same as the prep for a Colonoscopy. Not fun at all. My parents came in from Texas to be there for the surgery and after- until it was clear things were okay. Of course my girlfriend was there as always- she is amazing! I had to go to the hospital the day before and register for the following day- it was also when I had to pay them my insurance deductible.

Originally my surgery was scheduled for 7:00 AM, but because they couldn’t get a urologist at that time, it was moved to 12:30 PM- more time to angst. I was looking forward to getting to the hospital, getting hooked up to the IV and then getting “something to relax me” as the surgeon’s office promised when I saw them for a pre-op consultation. When I got there; I got undressed, put on the hospital gown given to me, and then climbed into the hospital bed. I answered a bunch of questions from the admitting nurse, and waited. The nurse came to insert the IV, and she couldn’t get the vein right. I have really good veins- easy to see, and easy to hit, but she missed! Not only that, but this wasn’t a little butterfly needle, this one was big and it hurt as she was moving it around inside my arm. After removing the needle, and trying again in a different spot- and more digging around, it was set. She then got up to leave, and I asked her about getting that something to relax me. She said not yet, the surgeon wanted to talk to me before surgery. I asked how long until he came by, and she said about 15 minutes. 45 minutes later the surgeon showed up to give me a rundown of what would be happening.

They were doing the surgery laparoscopically, and would be going in through an incision that curved vertically through my belly button. They would remove the tumor, the site around the tumor and about 20 lymph nodes (it ended up being 30). Then he was going to palpate my liver and see how that felt since the Cancer had metastasized there- though the pre-op PET Scan I had showed that there was no evidence of disease anymore. The reason they needed a urologist was because they had to place a couple of stents by my bladder for a clear path to get where they needed to go, and I assume to make way for what they were removing. When he finished removing everything necessary, the urologist would then remove the stents and insert a catheter. I’d wake up and be all done. Needless to say I was nervous- scared even. Seems with Cancer there’s always something you’re scared of- and the (not so) funny thing is there always seems to be something new that is frightening.

I then got the something to relax me I was promised- just in time for them to wheel me to the operating room. I said good-bye to my parents and then to my girlfriend- which I don’t remember (seems I was relaxed as promised). From what she has told me, she came over to the bed as they were starting to wheel me out. I gave her a nice kiss, and then looked up at her and said, “Please don’t leave me!” I remember none of this, but feel really bad about it all the same.

I woke up after surgery, and the first thing I asked for was my girlfriend, so the nurses went out and brought her back to the recovery area. I was groggy and needing two things- to urinate and drink. My throat was so dry it hurt, but at the same time I couldn’t remember how to swallow- it was a strange combination. They were taking wet sponges of some sort and putting them on my gums. As the water came off the sponges I would remember how to swallow, but then forget as soon as it was gone. This went on for a while. At one point the nurse gave the sponge to my girlfriend and she was giving me water. In between sponges I was telling them that I had to pee really bad. They told me go ahead and pee, that I had a catheter in. In my confused state it took a while for this to sink in. Also, I am not used to just peeing wherever- I usually go in the toilet. Finally I peed, which made part of me feel better, though my throat hurt from being intubated.

I was lucky that my surgeon was Assistant Head of Surgery at the hospital, so I got a room to myself. Although as I understand it, if you have Cancer they put you in a room by yourself to limit your exposure to germs since Chemo lowers your immune system. Once I was in the room and more conscious, they showed me the best part (if there is a best part) of the process- the little green button. The little green button was connected to an IV with Dillaudid, which is a painkiller. I had the button in my hand, and every 6 minutes it would light up indicating I could press it and get another dose. I was in pain from the surgery and uncomfortable with the catheter in- I pressed that button every 6 minutes unless I happened to pass out- the drug also made me groggy. Later that evening, I was told it was time to stand up. They want you standing and then walking around to get your body back in “normal” working order as quickly as possible. I slowly sat up, got to my feet, and having successfully managed that I went back to my bed, and probably hit the green button again.

One of the perks of a private room in the hospital is that my girlfriend was allowed to stay there with me. Honestly, I would have felt bad for anyone who tried to tell her she couldn’t stay. Unfortunately in the hospital they take your vitals every couple of hours and blood is drawn and tested at 5:30 AM. Hard to get a good night’s sleep that way. The drugs made it easier. At one point we had ants in the bathroom. The hospital staff were quick to act and move me to another room. Later that day as I was taking another couple of laps around the ward, I saw the exterminators getting off the elevator, so I helped direct them to the right place, which brought puzzled looks to their faces.

Sometime later that day they removed the catheter. The nurse doing it was new and it was painful when she removed it, but I did like not having a tube in my penis, so I was glad it was gone. I had to keep track of my urine output by peeing into a plastic bottle. However, after the catheter was removed it hurt to urinate. This made it difficult to pee for an extended period of time, which made them do an ultrasound of my bladder to see how much urine was in me. It was more than was normal so the surgeon was contacted. He gave me 2 hours to reduce the amount of urine in my bladder or they were going to put the catheter back in. I told the nurse. “You’re going to knock me out for that, right? After all, it’s the catheter that caused the pain in the first place.” She said they wouldn’t be knocking me out, and to try and get the amount of urine needed out. I went back to the green button- I hadn’t been using it as much through the day, but at the thought of being catheterized again I watched for the green light every 6 minutes, gave myself a dose and then went to try and urinate. Sometimes I would get so loopy from the Dillaudid that I wouldn’t go, but at then end of the two hours, when the nurse came in and took another ultrasound, I had evacuated enough that there was no need for another catheter. Thank G-d. I honestly think the amount in my bladder was borderline, but she didn’t want to deal with trying to put a catheter in me in my mental state. By the next morning the pain while urinating was gone, and things there were back on track.

The next day they wanted to take me off of the green button and put me on oral pain meds. Seems the pain meds can make you constipated, and I needed to have a bowel movement to get discharged. So I went from Dillaudid to Percoset. I was also moved from a liquid diet to a low fiber diet- I got to have both chocolate pudding and ice cream. Best thing in the hospital since the green button. I also needed to get up and walk more- which with the encouragement and help from my girlfriend I did. All of this to get the bowels moving- as soon as they did I would be discharged.

During my stay, the surgeon would come to visit once a day, and by day 2 he said he didn’t need any “movement” just some passed gas. My primary care physician came by as well to check on me. They both told me that everything went very well, and we just had to wait on the pathology from what they removed. I was told that there were Cancer cells found in the lining of my colon- though no tumors. The third morning when my Primary Care Physician came around and was doing his routine exam, my blood pressure was high- approximately 160/105. He had my girlfriend come over and hold my hand, as he took my blood pressure again. It dropped 10 points- which made me smile and gave him a chuckle. If you’ve ever needed an example of how people can affect your life and well being, there you have it.

So it came to pass on the fourth day that I passed gas. Never was a fart so celebrated and high-fived as when I let that one rip in front of my girlfriend. For the record, this is not something that I had done before- I’m just not one of those guys who takes pride in his flatulence- at least not publicly. That day when the surgeon came to check on me, I told him about the great event he had missed. He said I could be discharged and go home. I asked how long that would take, and he told me about 45 minutes. Two hours later, I was packed, and out of the hospital. Thus began "The Adventures of Me and My Semi-Colon".