Wednesday, October 24, 2007

why it's important to remain humble

You all know how pleased I was with the good news about the dramatic drop in my CEA count. I was also very happy to be in that final "boost" week where the radiation treatment field was finally reduced to just either side of me instead of from my back as well. I was thankful for these things and looking forward to the time in between the therapy and surgery.

Monday afternoon Jody and I met with Dr. Grasso as planned for when the chemo/rad was finished. I'd been doing some research and had some specific questions about his approach and what to expect afterwards. I wanted to know instead of wonder so I asked.

I will not lie; some of the probabilities are unpleasant if not absolutely shocking. I have been pretty upset since then but I am holding onto my faith. It has not failed me yet.

I'm going to lose the better portion of my rectum and an astonishingly large section of my lower colon. Dr. Grasso's plan is to resect back far enough to take out the blood vessels and lymph nodes surrounding/supplying the area including the tumor. It is aggressive, but I believe there will be little to no chance of ever having a problem again. Again, I will not lie. This scares me a lot. I'm looking at what seems to be a quarter of my lower bowel using the illustration Dr. Grasso used to describe this too me.

The resection is going to be limited by the size and shape of my pelvis. Beyond just attaching the healthy sections together in a straight line, he has two techniques that will make up for the lost capacity of the rectum. The one he wants to try is called a J pouch where the rectum is turned back on itself to form a J-shaped area to hold more waste. The bottom of the J becomes the new opening to the rectum and this is a proven method used by lots of surgeons with success. Another is to cut the lowest portion of the new section and stitch it back together sideways making another larger space. The downside to both of these methods will be more urgency and more frequency in trips to the bathroom. There is no getting around that it seems.

Recovery is going to be kinda ugly as I will be wearing an ileostomy bag for most of December. I am hoping the resection will heal in time to lose the bag before Christmas. To my perfect shock, my diet -still- will not matter and I can eat anything I choose. Go figure.

The worst is the risk to my reproductive system. I do not want to be gross nor do I know the biomechanics of the nervous system, but there is a probability that I will not be able to have kids the "normal" way. I may have to go through minor surgery to collect and/or bank my semen because this colon resection may leave my plumbing turned backwards. He is confident I will not lose any ability to have sex with Jody but my ejaculate may wind up in my bladder instead of outside where the little swimmers can try to make a little John or Jody.

Above all else this was the most heartbreaking for me. Jody endured a miscarriage two years ago. For the few days before it happened we were both profoundly moved that we would be parents. This was one thing we both wanted but had given up to God to decide when we were ready. Suddenly, we were ready. Even though we didn't feel prepared, that decision had been made and God thought we were ready. But we weren't and that time was really only to enlighten us both that having a baby was something we both really want. And that we need to be patient for the time to come instead of try to force it upon ourselves at the expense of our relationship or our friends and family. We knew then we would probably need help getting pregnant. Though it has crushed my spirit for a few days now, the reality is we will probably still need help. Just now it will be both of us needing help. Adopting an unwanted child is also still out there and may turn out to be what we are supposed to do nonetheless.

So yeah, my radiation is done and the last of the chemo pills are gone. I'm still hurting but I can now look forward to healing up and getting some strength back. One thing is most clear as well; I've no room to be proud for "surviving" this or any other ability except to lay it all out there and pray for help. This is my test and I know I will pass.


Anonymous said...

John -

Keep the faith. Thousands of people go through this surgery. Removal of half of your large colon is pretty much standard fare for EVERYONE with colon cancer operations. They want to get as much blood vessels and lymph nodes and these are attached to the large intestines higher up in the abdomen....perhaps far from the tumor. In your case, you may have a lower tumor than mine and thus the consideration of Jpouch and ileostomy. My tumor is at the recto-sigmoid junction. I met with my surgeon yesterday and they think they can do without this, using a Lower Anterior Resection (cut through the belly and a stapler device up the rectum to pull the two parts together). Not sure if this is available to you, or not.

Reproductive capacity loss is a real possibility in these surgeries. In fact, I may already suffered this as a result of the radiation and Xeloda treatment as things ain't working right. I understand your feelings as my wife and I am in a similar situation as you regarding this.

Please keep the faith in God.

Greg in WI

Anonymous said...

You are not walking alone John.