Good Enough for Them

Good enough for me.

Surgical skirmishes

Picture this.  No don't.  Just follow along; it will be graphic enough.

The evening I checked into the hospital, they gave me a third purge.  This is when you drink a perfectly abominable salt-tasting concoction -- 2 litres of it -- and then sit on the toilet until "everything runs clear."

So, there I am -- sitting -- when someone comes into the room, calls out and I call back.  And the bathroom door opens.  (Why do they have doors on hospital bathrooms?  Anyone?)

It's my surgeon and he'd like to know if I can take a 90-second break, so that he can mark me up for surgery.  Teeth clenched, I say, "No."  He thinks for a moment and then kneels in front of me, pauses to read my T-shirt -- "Behind every successful woman, there is usually a rather talented cat" -- nods, lifts the shirt and begins to draw with black marker.  "Will this stay on through my three showers?", I ask, cool-like.  "No problem," he says, rises and leaves.

Gheesh!

When he came around on the day after surgery, I asked, "Did you say you got the tumour, the ovaries, and the uterus and I don't have a pouch"?  "Yes," he said.  "That's what I thought you said,", I said, but I didn't believe it."  "Neither did I, he said."

Better a great underconfident surgeon than a mediocre overconfident one, I say.

To my great disappointment, he didn't take out my appendix.  "It is normal procedure," he explained, "but only when things are optimal" -- which answered a dozen other questions.  Optimal is when they get it all and can clean up.  Sub-optimal" or Incomplete is when there remains 2 cm of tumour.  I got this out of the booklet from the hospital cancer library.

Not that I'm disappointed at being sub-optimal.  It beats dead and leaves a lot of room for improvement.  And no doubt 5 1/2 hours in the operating room was enough.  The booklet says 6 hours is the limit.  I'd have liked to have lost the appendix, though.

Returns and Replies

I'm home!  And this is all for today.  Tomorrow there will be all the news that I'm capable of.

*  *  *

CHERYL - No computers in hospitals here.  We've only recently been able to use our own cell phones.

JOHN & CAROLE - You lose John, but if makes you feel any better, you didn't lose to me.  The room mate had 42 staples.

GEORGIA - Bananas were the first thing I thought of.  But, also: does downing litres of water per day wash the potassium out of your system?

SUSAN IN CALIF - You've got your priorities right! No cake.  :-(  The nurses felt kind of bad when they hadn't noticed my birthday.  (I have pages and pages of bar code labels over my files, my wrists, all my medications, my charts, e.v.e.r.y.t.h.i.n.g,  Each contains my name, place of birth and birthday  Every time they touch me, they have to verify who I am.  Stuff just doesn't stick does it?)  They thought they should have had at least a flower.  Since they didn't, we shared my little wooden and woolen cats.  I'd already had the best birthday present it was possible to have.

EVERYBODY - who wrote called and commented.  Thank you.  You might have to be there to realise how important the support is and I don't wish that on you.  Just use your imaginations.

Consultations

Yesterday I saw:

• the anaesthesiologist (isn't there a short form for this?)
• the surgeon
• had a cardiogram
• a chest x-ray (so they can locate exactly where my little plastic box is)
• a blood test

After the blood test, the technician came running to the elevator to return my bag just in time to see my arm start dripping blood in the lobby.  Can't take me anywhere.  She fixed it.

When I suggested that the anaesthesiologist (isn't there a short form for this?) not touch my stomach, she immediately gave me a prescription for painkillers and sent us to the hospital pharmacy where they gave me a couple to get started.  I am feeling better.

She was also appalled at the state of my feet and ankles, but she couldn't do anything about them.

The operation has been pushed back to 29 June.  As I'm not paying for any of this, I can't accuse of the surgeon of taking a longer vacation in his second home.

Assuming that he can do anything at all, once in, he will remove the tumour or, at least, reduce it.  If the tumour is attached to the colon, there are two options.  If the colon is undamaged, he will sew it back together again.  If it is damaged or otherwise unhealthy, he will do something called a Hartmann's Procedure and I will have a little sack.  He thinks there is an 80% chance that I will leave the hospital with a sack.  At least I will be leaving the hospital.

The anaesthesiologist said I will have an epidural to counteract the after-surgery pain.  I will be in intensive care for five days and then move to a regular room for the rest of my stay while I am educated about my new appendage.  Whoo, sounds major!  I asked if the hospital makes good birthday cake.  At least I will be leaving the hospital.

Speaking of food, three days of not eating produced a weight loss of maybe 2 kilos (4-5 pounds).  Not much, but down is better than up.

Everything scheduled

May 25:    Consultation with urologist and anaesthetist.
June 1:     Hospital - stents into kidneys
June 7:     Consultation with surgeon and anaesthetist.
June 22:   Surgery

Now if I could just get an eye appointment.  I have one, but I doubt I'll be up for it on June 24.  I'll throw myself on the secretary's mercy and see if she'll fit me in.  I'm not optimistic.

Then I'll throw myself on the mercy of the dentist.  I have more hope there; she's really nice.  You can't get your teeth worked on while you're having chemo because you don't heal.

However, even if the optomotrist doesn't work out, I can now watch television.  We bought a flat-screen 102cm (40 in) screen.  It's a whole new experience after watching our portable for the last couple of years.  I can see!  I can read the subtitles!  I don't need the subtitles!  I can hear!  (Better sound).

Lance Armstrong's foundation, LiveStrong, does fabulous work for cancer: lobbying, supporting patients and carers and providing information.  I entered their virtual Tour de California.  If I get placed high enough, Lance or one of his team will ride the Tour de France with my sticker on his bike.  I am a big fan of his -- as a rider and as a fighter against cancer.

You can push me up in the ratings by cheering for me.  You can cheer every day.  Please do -- and tell your friends and FB friends, too.  Thank you.  Link.

Meet the surgeon

Yesterday I met with the surgeon, the nice man who recommended Douglas Kennedy's books to me.  That worked out well.  I recommend them to you.

He says he's not going to know what he can do or how much he must do until he goes in and looks.  The tumor is very big and and he thinks he can't get it all.  The good news (I'm not sure why) is that it moves, which makes it a better bet for surgery.


Next I have a consultation with the urologist, then a day in hospital for him to go in with camera and double-J stents  Then I have another consult with Dr. Meeus, the surgeon, to make sure I understand what's going to happen and decide how many things I'm willing for him to take out. Even though he may or may not take things out depending on how they look.


That's three more visits to Lyon.  Dr. Meeus's secretary said she'd at least try to schedule the anaesthesiology consult the same day as the surgery consult.  Surgery is scheduled for June 22.

New Surgeon

Very nice. Good looking. Speaks English, although we didn't. Recommends I read Douglas Kennedy. (Since I was reading Janet Flanner's Paris Was Yesterday, a collection of pieces from The New Yorker about Paris 1925-1939, do I assume Kennedy is "literary"?)

Can't operate until my "symptoms" have gone. I knew that. Apologised for me having to go all that way for nothing, but said he needs to see the patient. That's all right with me. The journey gets shorter with repetition.

AND WE DIDN'T GET LOST! GPS rules!

Tomorrow, chemo. Blood tests turned out all right.

Lotta Cooks in this Broth

Don't you just hate it when your doctor is trying to reach you and can't? New GP, Dr. Leriche, was trying to reach me all weekend, but our phone wasn't ringing (now fixed) and he didn't leave a number. (He does seem a bit odd.) He even called the garage across the street.

By the time I got the messages, it was too late to really worry, so yesterday I called and went to see him. He had my blood results from Friday. Everything is off and platelets stand at 5. It's true that I'm covered with enough bruises to get Nick jailed for life (doctor's little joke), but I wasn't actually bleeding, so I didn't think it was that serious.

His face was a picture when I told him I'd been canoeing. "But you could hit your head and then it would be bleeding internally like your legs and you'd die"! Well, thanks for that hindsight. So glad I'm here for it.

He wanted me to go immediately for the transfusion, but I already had an appointment with the new surgeon and I said I'd go this morning. I always win these arguments, so Nick and I went to Avignon for shopping and then Carpentras to the doctor.

What a hunk! Perfect for Dr. Sériené, the now-divorced, former Dr. Litor. Perhaps I'll find out if he, Dr. Kanor, is married.

If I wanted the straight story, this was the place. My cancer is Stage 3c. I pretty much knew that, but I prefer the professional opinion. Internet research has its limits.

As for operating, that would be a last-ditch effort. He would have to remove not only the ovaries and uterus, but the bladder and anus as well. Then you get two pouches. He has several patients rolling along, merrily or not, seven years after this procedure, which is encouraging, if not especially attractive.

Would it restrict my life very much, I wondered. Well, he said, he had a footballer patient with a pouch (or two) playing at national level. I said I didn't really aspire to that. You know, a little jogging, a little cycling, a little canoeing. . .

I asked if he thought clinical trial would be appropriate and he said he would present my case to the interdisciplinary board next Tuesday. ("Like ours," Dr. Séreiné said when I told her. She didn't seem mad.) He wants to see my next "control" (checkup) scan after another chemo session or two.

Nick and I left, truth be told, a bit overwhelmed by a lot of information that is necessary to face, but still comes hard. But this morning I felt a lot better after I had digested the fact that this last resort. Chemo is still the way to go to control the cancer.

Unfortunately, it doesn't look to me too under control at the moment, blood tests being all over the place. My CA-125 is over 1100. I thought that was up from 358, but Dr. Litor said today that my last test, which apparently no one gave me, was at 1000, so that's O.K. She said I need a second treatment before a decision can be made on the protocol, and I am already scheduled for next Monday.

Here's the state of play. I've had the transfusion (more about that tomorrow). Dr. Kantor is going to call Dr. Latil, my current surgeon ("Not a bad surgeon, you know," said Dr. K.) Dr. Sérieiné is going to call Dr. Kantor. I assume they'll find a good story for me and tell me about it later.

You wouldn't think there would be a positive side to all this, would you? Well, there is. The other day I realised that I have finally stopped worrying about getting old and wrinkled. Bring it on!

The American Patient

Thank you all for your prayers and thoughts and even your jokes.

And thank you to my blogger replacement who has done sterling work, as always. (I married him, didn't I?)

On March 31, we arrived at the hospital reasonably on time and were promptly seated in front of an in-take person. Good. She immediately got a telephone call, evidently from a friend. Bad. After 5 minutes, I was muttering to Nick. After 8, I interrupted her to ask, loudly, if someone was available to take care of us. She hung up. (Credit where due, many others would have continued nattering.)

She had no record that I was being admitted. She had no file. She had no private room. That's when I exploded. It was a loud explosion. (Poor Nick; he does put up with some stuff. I have never been able to get the hang of the stiff upper lip, mustn't complain, let's find a queue and join it attitude.) It got loud enough to have the entire waiting room's attention and, better, a supervisor. We sat down with the supervisor.

Gosh, my file was exactly where I'd said I'd left it (on the surgical floor). And, son-of-a-gun if there wasn't a private room for me, too. Breathe in, breathe out. Lower voice.

I was scheduled for surgery at 10:30 the following morning. Priority, even! And yes, Jane, the cute orderly was there to take me to surgery, again. That's all I remember. Boy, that anaesthetic works fast.

Woke up in less pain than last time, probably due to the extra drip and the extra pump. The rest of the stay went pretty much as usual, except that my platelets were low, so they had to give me a different kind of anti-coagulant that required 2 shots a day, rather than 1. Picture of right leg. Left leg is the same with bigger bruises.

Normally, I have to continue the anti-coagulants when I come home, but my platelets are too low.

Platelets are what make the blood clot, right? Why was I getting anti-coagulants at all? Anyone?

Between my inability to formulate questions until after rounds, and the surgeon's "you don't ask; we don't tell" policy, it took until this morning for me to get the report straight. Maybe. The tumors on the ovaries seem to be connected to other tumors on the bladder and intestine. Or the tumors on the ovaries are also connected to the bladder and intestine. One way or another, they couldn't take them out.

But -- get this -- he did drain my abdomen and remove some fat that came with the cancer (?) and had tumors in it. Liposuction -- the hard way.

I will be going back into chemo, probably with a change of drugs or protocol and we will try, again. Appointment with the oncolgist is scheduled for April 27.

This stay was good for lots of blog material. More to come.

Short Stay

Where to begin... the beginning?

Got to hospital last night. They now have a form for you to check off anything you don't want to eat. Hooray, didn't have to look at ham. Green soup, pork cutlet, mashed potatoes, cheese and apple/strawberry sauce.

The first bad news is that I'm scheduled for surgery the next day at 3:30 in the afternoon. I can have a light breakfast at 7:00 a.m. ("toasts" and tea) and then nothing further to eat or drink. After my breakfast, I went back to sleep, which got me through most of the morning.

At 1:00, I took my second Betadine shower and put on my fetching navy blue hospital gown. About 2:00 I was given a sedative. I read for a couple of minutes, then the next thing I knew I was being wheeled to the surgery floor by a really cute guy.

He left me and I nodded and dozed until the anaesthetist, Dr. Koala, came by to say hello and drop my folder on the bed. Then the surgeon, Dr. Latil, came by and did the same.

Then all hell broke loose. A surgical nurse was running down the hall past me with a phone to her ear screaming, "Dr. Latil! Dr. Latil!" Other people began running. They kept running.

This went on for quite awhile, although, occasionally, someone would stop next to my bed and say, "We didn't forget you." I wasn't worried about being forgot. I was worried about my surgeon having killed someone.

Eventually, Dr. Latil came by and explained that all the anaesthetists were called into surgery and he was having to wait for information. At least it wasn't his patient that had had the relapse.

An hour or so later, bored out of my mind and having finished reading my medical records that they'd left on the bed (I'm doing very well), Dr. Latil returned to explain that there was no anaesthetist and they'd have to reschedule my operation. Like, in two weeks!

I asked if I could go home and he asked if I didn't want to stay for dinner. How kind. No, I wanted to go home. All the surgical staff dropped by with apologies and the cute guy wheeled me back to my room.

There, the staff wanted to know if I didn't want to "stay and have dinner with us," and, when I declined, insisted upon a snack, so that I wouldn't leave with an empty stomach. All the nurses came by to say sorry, wish me luck, and say goodbye.

Nick came to get me and I'm home. Tomorrow morning, I'll call for a new appointment. Stay tuned.

Behind Me

As in "I am behind."

We've had a lot to do this week and, as we're running around, we've been running errands for Polo and Nadine. Then, when we get home, we go up to their house to make deliveries and Nick works. I provide moral support. Anyway. . .

Monday I saw the cardiologist and had an electrocardiogram, as you have to do here before surgery. I am fine. (I knew that).

Today, I saw the anaesthesiologist, as you have to do here before surgery. He is fine. His name is Dr. Kaoula, which I can remember because I call him (silently) Dr. Koala.

They're going to give me a morphine pump this time. I hope I don't get hysterical and start crying the way our friend, Philip, did when they gave him one.

Here's the schedule: I go in at 4 o'clock in the afternoon on Monday. The operation is Tuesday. I stay in the hospital for 8 to 10 days. The recovery period -- I finally read the papers the surgeon gave me last week -- is reckoned to be 45 days.

I have a fuzzy head; I think my hair is growing. So by the time I start chemo, again, I should have some more hair to lose. Really, losing your hair once is O.K. Losing it twice is annoying.

It also appears that it's going to be growing in white. It must appear that way to the hairdresser (wigdresser?), too, because she told me she can colour it a little with some kind of vegetable dye. And she gave me a card for the first appointment free.

While running medical and construction errands today, we bought an expresso machine to be built in to our new kitchen. When we have one. The budget for the new kitchen is considrably reduced now. But it was on sale.

Not Hospital Bound

I'm back!

Wouldn't you just know it? Perfectly packed, didn't forget anything, and all for naught. Dr. Latil has given me a date for the hospital of March 16. He says I have to regain my strength first.

Upon being questioned, he says he can't really know from the scan if he'll be able to operate successfully this time, but the results look good enough to unzip me, again. Smaller tumours, no ganglions. ??? After examining me, he said my stomach is supple, too. I have no idea what that means, but it seemed to please him.

As we were out by 9:30, we drove down to Marseilles and Ikea. The furniture all looked kind of tacky, so I guess we won't get our kitchen there. I got some sheets, a couple of mirrors and a new meat tenderiser thingy in metal. Much heavier than the wooden one I have.

Time to hit the dog food.

Hospital Bound

I'm not sure when I'm going in, but in case it's tomorrow, talk to you next week. If it's not tomorrow, talk to you sooner.