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Rectal Cancer Surgery
Waiting:
After the chemo and radiation were complete, I had to wait at least 4 weeks before surgery. This time was required to let my intestines
heal from the chemo and radiation so I wouldn't simply bleed to death during surgery.
Pre-Surgery Appointment:
The day prior to surgery I had an appointment with Dr. Heppell to re-evaluate everything. Digital examination revealed that the cancer
was in fact much smaller due to radiation and chemo. The doctor also mentioned that his preferred radioligist had looked at my
original CT scan and identified 3 lesions (potential metastises) on my liver. The earlier (inital) radiological evaluation was performed by
a local guy who completely missed these. So the doctor recommended an MRI the next day, an hour before surgery, to evaluate the lesions.
He also suggested that the cancer may have attached to my prostate, in which case the Mobetron would be used. I said, "good."
The next day's MRI determined that the lesions were non-cancerous. This, of course, was good news.
Surgery:
First, they set me up with an IV. Then we sat around waiting for the operating room. During this time, the Dr. Heppell mentioned that he had done
260 surgeries just like mine, with recurrence in only 2 cases. These odds sounded supremely good. He also mentioned that the Mobetron can
cause permanent and fairly severe pain. I essentially said, "Use it if you need to, we can deal with the pain later." (Fortunately the
Mobetron was not needed.)
Then we wheeled off to surgery, and the next thing I remember is waking in "my room." This room was adjacent to the nurse's station to help
them keep a close eye on me. At this point I had the following attachments to my body. (1) Urinary catheter, (2) two abdomen drains to remove
fluid seeping into my abdomen, (3) IV with a morphine button, (4) nasal stomach tube with pump, and (5) an ileostomy bag near my belly button.
The surgical incision extended from a couple inches above my belly button to the pubic bone.
Later I read the surgical report. It stated that my anesthesia was excellent, everything went well, and to test their stitching, they filled
my abdominal cavity with saline solution, then poked an air hose up my butt, and looked for bubbles. No bubbles were found.
The doctor also stated that although the cancer had in fact penetrated the rectal wall, no metastises were found locally in fatty tissue
or 20 lymph nodes that were removed. This was a very good picture (relatively speaking).
It's also important to note that the surgery was performed through the abdominal incision. Some people assume that the surgery is performed
via the anus, which it isn't.
Recovery:
I was in the hospital for 5 days. Then spent 5 more days in a friendly house with family members present for support. Then flew home.
In the hospital, things went relatively smoothly, with the various attachments gradually being removed. However, after the stomach pump was
removed and I began eating (around day 3), I developed what is known as post-operative ileus. This is where your small intestine swells a
lot and you puke a lot. This condition is VERY common amongst abdominal surgery patients. It turns an otherwise pleasant, morphine-laced
experience into something you absolutely don't want to endure ever again.
During recovery various nurses stopped in to show me how to change the ileostomy bag. This is relatively easy, unless you have shaking
hands. General note: the contents in the bag look like digested food, and smell sort of like digested food. It is also relatively watery
and in my opinion much less offensive than "normal turds." Indeed, it is weird to have your intestine poking into a bag, but so it goes.
The exposed intestine is pretty tough. It's initially a bit swollen and will shrink during the first few weeks. It has no sensation of touch
or pain, so it sort of precludes letting the dog use your stomach for a trampoline.
Eventually I recovered sufficiently for discharge. So I stayed at the friendly house and puked some more. Because of the puking it was
suggested that I readmit myself to the emergency room. However, I didn't and instead simply made sure to drink lots of fluids.
(Dehydration is a primary concern with the ileus condition.)
After 5 days at the friendly house I made the flight home without passing out, falling over, or puking.
However, my strength was definitely low, so I had to
sit a lot. Even holding up my head was an effort.
Upon arriving home, I began going for short walks, and within a few days could walk 2 miles with hills. My ileus and surgery-related
stomach pain took a couple weeks to subside. Through necessity, I quickly became accustomed to the ileostomy bag, a.k.a. the "poopy bag."
Waiting:
After surgery I needed another round of chemo. This required another 4-week wait to let my new rectum heal properly, otherwise the
chemo might negatively influence the healing process.
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After all I've been through I still appreciate fart jokes. However, I sincerely apologize for any jokes I may have made regarding
proctologists and colo-rectal specialists. They're the greatest.
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