The Devil’s in the Details

First things first – have I thanked you today? Even if I had – it wouldn’t be enough. Honestly I can’t stop saying it – THANK YOU. This has definitely been a team effort and my GOD what a team we have behind us.

THANK YOU. THANK YOU. THANK YOU

Second things second – there’s been a few mystery text messages with lovely and thoughtful and wonderful messages – from mystery people.  Awkward.  If you’re sending any of us a message in the next few days at least – can you kindly tell us who you are.  🙂

And last but certainly not least, I think I may have inadvertently led you astray.  Things did not go perfectly yesterday.  Yes, we got clear margins, and as that was Goal #1 of the surgery – we’re happy, but we’re not quite in  smooth sailing state of mind yet – so if I made it seem that way, sorry, but what follows will hopefully clear things up a bit.

Yesterday I started with the end – all clear, complete and good.  Today I’ll start at the beginning.

Mom’s surgery was booked for 1:05.  She was to arrive 2 hours before for prep. At about 8:30 she got a call from the office to say there was a cancellation, so really any time she could get there – they would get started. She obviously left immediately.  Getting from Alliston to Sunnybrook took some time, and after some waiting, they took her away to get started at about 12:15.  So not that much earlier, but nevertheless – the sooner the better.

There is an OR family waiting room at Sunnybrook where the doctors come to find you afterward and where you can get updates during the surgery from a friendly volunteer.  Obviously, the people there are feeling a little stressed so its quiet, hot and packed. We were advised that if we waited in the “cool and comfortable” (read: cold and uncomfortable hard chairs) cafeteria they would come find us – and we could check back in when we expected her to be finished.  So we did.  At 3:30 Dad went in to check back, and the lovely volunteer said she knew just where we were sitting and she’d come to find us when needed – should be about an hour.

At 4:00 we decided to give the comfortable chairs a try and at 4:30 we got the update, still in surgery, should be about an hour.

Same at 5:30.

Same at 6:30.

Shortly before 7:30 (I think) the Surgeon (Dr. Calvin Law) came in with his team and gave us the goods.  He started with the end, she’s out. It’s done and she’s breathing on her own. Goal #1 was get clear margins, they were able to do that.  All in all, the surgery was a success.

Everyone exhale.

From the beginning though, things did not go exactly perfectly as planned. When they put her under, the anesthesiologist had some concerns.  Her blood pressure went down.  This can happen for 2 reasons, 1. reaction to the anesthesia (Dr. Law does not feel this is what happened); 2. Reflux of contents in the stomach moving up into the lungs. (More likely)

They had two options, 1. wake her up and stop everything. 2. Wait and see.

They chose #2 because as a team they felt it was not in their best interest to cancel the surgery because “Carol would have killed us” HA! Good decision Dr. Law!!

She did come around and sorted herself out and they continued but it delayed things a bit.

Once they opened, they were able to see that exactly what they were dealing with, and while the CT Scan had indicated the tumour was at the bottom of the stomach, it had actually moved higher.

In order to get clear margins, they had to take her entire stomach.

Goal #2 was to leave her with 40-60% of her stomach, so needless to say – this is not what we wanted.

Mom knew this was a possibility going in. It’s not what she wanted, but everyone was in agreement as to the priority of the goals.

They also took all lymph nodes anywhere close to the stomach, and  her entire spleen.  This was unexpected (in that no one really remembers them talking about this as a possibility before), but because the spleen acts like one giant lymph node and it’s proximity to the stomach – they decide this was the best option. And it seems logical to us.

We were able to see her in recovery last night, she looked really good – her make up was unsmudged by the surgery!

Next steps:

Given the complications with the anesthesia and the length of the surgery, ICU was asked to do an assessment in the recovery room.  They have since done that and she is in ICU.  This means only immediate family can visit her right now.  It also means only immediate family will be given any information or updates over the phone.

Despite not having a stomach, Mom is “fully connected.”  She will be able to eat, but will need to work with the dieticians to learn how to eat and will be doing so very slowly and in very small portions.

Mom will have “dramatic and permanent” weight loss.  So that beautiful new North Face coat she just bought? Likely going to be under the tree for me this Christmas, as are all her new Joe Fresh pants!

Because of the complications with the anesthesia, and her lack of a spleen, she is at higher risk for infection (this is the new Priority #1 for recovery) she will need a series of vaccinations, which she’ll get in the hospital, and a series of boosters which will be managed by our family doctor.

Because she no longer has a stomach, she will need some vitamin supplements by injection – B12 for example – this will also be managed by our family doctor going forward.

Her pathology is not expected to be back for at least 2 weeks, this will help determine what goes in the cocktail for the next round of chemo.

To end on a positive, Dr. Law said Mom is one of the strongest and most positive people he has met.  Tough doesn’t even begin to describe it.  All of the support she has around her is amazing and she will adapt and move forward without a doubt.

So that’s it.  I’ll try to keep everyone as up to date as possible.  We have lots of questions going forward and it’s not the last we’ve seen of Dr. Law and his team – he’s still working for us and was clear to please ask all the questions we need to.  For right now, we’re happy it’s over and happy she’s safely on the other side.

Message from Mom: When Dad told her last night that they had to take all of her stomach; “Fuck”

 

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11 responses

  1. Meghan, so glad to hear your mom is safely out of surgery and the margins are clear. She sounds like a great fighter and I’m sure will be home in no time on the road to recovery. Lots of love from Calgary!

  2. Hi Meghan. Thanks again for the details. So glad the surgery is over. Now the road to recovery. Please kiss her for us and tell her she is the strongest person we know!! I will be coming for a visit next week if she is well enough for visitors. xoxo Susan

  3. So happy to hear that your Mom has come through the surgery and know she has the spirit to what she needs to do now. She is an amazing lady! Evidence…she coved the outcome perfectly in just one word. I’m with your Mom!
    Hugs to your Mom

  4. Meaghan, we understand. Tough day and tougher news. So big hug to everyone, particularly your Mom. The “F” word was the best possible reaction. When you see her, please give her my love and wish her well. We appreciate your blog so much. Marcy (Cannell)

    Date: Wed, 23 Oct 2013 17:06:31 +0000 To: cannfam@sympatico.ca

  5. I can’t express how thankful I am that your mom is now on her way to recovery……my prayers continue to be with her and with all of you…Can’t wait to have her back on Tuscany Grande….hugs jan and dan…xoxo

  6. Megs, that is a great update…. despite the unexpected events. May I add that this is quite humbling… I complained today that I had too much work to do and am tired. Needless to say, I’m over it. The strength of your family brings me to knees… especially that amazing momma of yours. Love you guys. Dev

  7. So thankful that Carol is now on the way to recovery. With the surgery behind her, Carol and all of you are now able to move forward! Carol’s positive outlook and strength is an inspiration to all of us. Looking forward to sharing a cup of tea (or something stronger Dave) with our dear neighbours on Tuscany Grande when we get back. Please keep us informed Meghan! We appreciate your updates!! Hugs to all! SUe&ROn
    P.S. I will keep the prayers and positive thoughts coming up your way!! S.

  8. Hi Meaghan-We are on our way to Florida(driving) and left Wed morning. Sheilagh and Cary were updating me the day of surgery. Your family sure has been in our thoughts and prayers. You have written such an amazing summary. Thank goodness they were able to do the surgery. The Dr. is right- your mom is such a positive woman- she will move forward. She is so fortunate to have a wonderful family and tons of friends to support her. Love to you and your family, Meaghan. Bonnie and Ken

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  9. Thanks Meaghan. It sounds like the major goal – and most important one – was accomplished in your Mom’s surgery. Cancer gone – clear margins. It’s always a roller coaster ride until you know how things are really going to go, but the Doc’s sound very positive, and I consider that very encouraging. It sounds like they know well how to cope with no stomach, and I trust that they do. I have a friend who just had her whole colon removed & is doing great! -just back from a Mediterranean cruise & in a new relationship! We love all your posts. Keep them coming – about # 1 – Carol, your puppy, the boy – anything – love them all! Xo, John& Mary

    Sent from my iPad

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  10. Thank you Meaghan for all of the communication. Please let Carol know our love and prayers for a full recovery are with her. Plus, our thoughts are with all the family. You are such a wonderful support to not just Carol, but everyone. Love Holly.

  11. Many thanks Meaghan for the recent update. Obviously from reading the comments of support, positive energy and prayer that your mother is much loved! We all know that. Know that all concerned send heaps of the above. I wrote your Mother that we wanted to toast together to all good things in Fort Myers Beach next November and know that we shall! Give her a big hug from us and all the others who care so much. Keep the faith and know that you are being a huge help in many ways, but also by keeping friends and family updated. Don’t forget to take care of yourself on the journey also!

    Judi & Trucker (Orillia, presently in Florida)

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