Day 273 – Treatment update, path forward
31 May
Yes, it’s been 273 days since the original diagnosis of cancer, and here are some highlights of my treatment and recovery experience since I last posted on 1-Feb-2011.
Chemo-radiation treatment ends – 7-Jan-2011
I knew that it would take several months to regain strength after treatment, but I’m still in awe at how difficult it was. I developed pneumonia and shingles in mid-February, both of which were unexpected of course. During this time period I learned the absolute value of “doing my dailies” and hanging on when that seems to be the only thing left to do. I made brief notes on lots of insights during this recovery period, but I didn’t have the energy to consistently respond to emails, or to post to this blog. Management of pain and fatigue had become a full-time job for me.
Goal: Heal and gain strength in preparation for surgery.
Surgery, “Take 1” – Friday, 15-Apr-2011, St. Mark’s Hospital
I entered St. Mark’s Hospital in Salt Lake City for an esophagogastrectomy performed by two surgeons. But, before this complicated procedure had progressed to removing any tissue, the surgeons accidentally nicked the major artery to my stomach with the optical camera cable – which was a first for both of them. The artery was “hiding” behind some fatty tissue as the procedure started. To suture the artery they made a 6-inch incision between my sternum and belly button and then sewed me up to give me at least 2 weeks to heal, including 5 days in the hospital before going back home. So, it was actually 3 weeks before I returned for Take 2. My son, Alan, and I often share golf metaphors with each other, and this one is right on,“Play the ball where it lies.” No regret, no remorse, and what’s the next best step?
Goal: Heal and strengthen for Take 2 surgery.
Surgery, “Take 2” – Friday 6-May-2011, St. Mark’s Hospital
The esophagogastrectomy (you can Google it to learn more) procedure is done in two stages: (1) From an abdominal incision, remove the top part of my stomach and the bottom part of my esophagus to clear all cancerous tissue, plus, cut out a 10-inch piece of my transverse (horizontal) colon. (2) From a rib cage incision below my right clavicle (shoulder blade), rebuild my esophagus with the segment of colon. This time the procedures worked as planned, and I was on a normal path of recovery and healing in the ICU for 3 days, then a week in normal recovery, called “progressive care” at St. Mark’s.
However, all along I had a consistent, sharp, internal pain to the left of the abdominal incision, which resulted in the development of a colocutaneous fistula (Google this one too, if you wish). This is an unexpected fistulous passage connecting the colon and the skin through my abdominal incision. So, I now have a temporary colostomy-type bag over the leaky incision as I wait for the fistula and incision to heal, or seal over.
The surgeons also sent lymph node tissue biopsied from both sides of the esophagus and the pathology report was “negative,” showing no real impact from the original cancerous tissue on my lymph system. Good news!
Rehab hospital – 25-May-2011
I was in St. Mark’s hospital from 6-25 May (19 days). And I’m now in this rehab hospital in Provo:
It’s a very nice facility, less than 5 years old, and with an excellent staff of caretakers (and I found the same care at St. Mark’s). The average stay here is 25 days, so my initial projected discharge date is 21-June. While here I will accomplish three objectives: (1) Monitor the healing of the abdominal fistula so there is no drainage, (2) Get past my consistent nausea which prevents me from drinking clear liquids, or eating solid foods. My newly “organized” gastrointestinal tract needs time to continue to heal and to “wake up” toward near-normal functioning., and (3) Increase my overall body strength and stamina through daily physical therapy exercises.
Goal: Heal the fistula and be able to take solid foods orally (or at least feeding tube liquid) in preparation for going home.
Path forward
I was a 17 year-old baseball fanatic (and pitcher on the high school team) back home in St. Anthony, Idaho when Harmon Killebrew hit 40 home runs in his major league baseball rookie season with the Washington Senators. Killebrew was only 24 years old then, but to a 17 year-old he seemed to be so much older. He went on to become a Hall of Fame player and legendary home run slugger.
During my stay at St. Mark’s I saw an announcement on the web that Killebrew, now 74 years old, had been diagnosed with esophageal cancer last December at the Mayo Clinic in Scottsdale, AZ and that all treatments had been tried with no success. He entered hospice care to be with his wife and passed away a few days later. He was one of the truly good guys in professional sports.
So, here I am, diagnosed in September and have gone through the standard treatments of chemo, radiation, and now surgery, and there appears to be some length of a path forward for me. I don’t know how long the path will be, or how hard it will be, but I’m very grateful for it today! I’ve come to embrace the possibilities of lasting a few months, or a few years, and I’m OK with either.
Goal: My hope and prayer is that I will choose to live larger for however long I live, based on what I’ve learned from this 9-month journey, and my mission-purpose for being here.
