It was just over a year ago that I received my rectal cancer diagnosis and a year to the day that I first landed in Houston for my first visit to MD Anderson. And now, a year later, I am back in Houston about to embark on the last leg of the journey. Back in April, I had surgery to remove my entire rectum, about 15" of my colon and all the associated mesentery and lymph nodes. If you remember the now infamous "Save the Anus" campaign, you’ll also remember that the surgeon was able to spare the anus. That sounds like a not so big deal, but really it is. We’ll get to that in a minute.
For 6 months, the remainder of my colon had been on sabbatical. It needed some down time after major surgery so the team brought the terminus of my small intestines to the outside of my body (they gave me an ileostomy). That gave the large intestines and the surgery site time to heal. In the meantime, I had 6 months of chemotherapy. Now that is complete, my guts have healed, my blood counts have normalized so it’s time for the Humpty Dumpty surgery – they’ll put me back together again. It's called a Take Down. That will happen Wed., Dec. 16.
As surgeries go, this is not a bad one, especially compared to April’s ordeal. They take my ileostomy, which is still literally hanging by a thread (OK, some tissue) to the large intestines, make me some fresh ends, stitch the two ends back together, put everything back inside, and sew the hole in my abdomen shut. Now here’s the part where I need you all to keep your fingers crossed. The lower intestines have to wake up from their long nap and get back to work in concert with the small intestines, who did not get a 6 month vacation. They may be pretty steamed about that, so we’ll see if they are in the mood to pout, or if they suck it up and stay on the job and cooperate. The docs will let me out of the hospital only after I demonstrate that the new route is fully functional and everyone is playing nicely together. What gives me pause is the fact my guts went on strike after the April surgery and refused to work until they decided they were darn well good & ready. I have been sweet-talking them and promising them all sorts of deals if they’ll just cooperate this time. Again keep your fingers crossed. If all goes well, they’ll kick me out of the hospital on Saturday, Dec. 19.
Thus opens the next chapter; The New Normal. Without going into too much detail (like all the stuff above isn’t "too much detail"), a body has no voluntary control over the intestines, with the exception of the rectum. But wait! Barb – you have no rectum. Oh, yeah. That’s right. Well, this is where it gets interesting. In the long term, a person learns to understand and manage the new plumbing to some degree. In the short term… Well, who the hell knows?! This is where the aforementioned part of my anatomy that you all campaigned to save gets to play the hero's part.
In thinking all this through over the last several months, Joe and I decided it'd be best to drive home rather than fly. The mental scenario went like this: "The captain has turned on the fasten seat belt sign. Please remain in your seats for the duration of the flight. The very long flight. Oh, and bumpy flight. It’s going to be a doozy folks! Coffee?" I have visions of my guts hearing the preceeding message, and with their warped and cruel sense of humor deciding it would be a good time to send a message to my brain marked "URGENT. Must. Go. NOW!" I press the call button, only to be told no; moving about the cabin puts both me and my fellow passengers at risk, so I must remain seated, no ifs, ands, or but(t)s. I wait approximately 5.2 seconds, unbuckle my seat belt (by lifting on the buckle, duly noted during pre-flight instructions) and make a mad dash for the back of the plane. Conveniently, there will be a US Air Marshal on my flight, seated about 1/2 way between me and the restroom. He'll tackle me in the aisle, there will be a struggle and then.... all hell breaks loose. And by hell, I mean my newly reconfigured plumbing. Oh dear Lord. The possibilities are endless and terrifying. Believe me, I've run every last lovin' one through the fertile fields of my brain. Said fields received additional fertilizer during my pre-op appt when my surgeon, Dr. Rodrigues-Bigas, actually used the term "explosive diarrhea." Ah, thanks RB. That poor Air Marshal. I almost feel sorry for him. Almost.
Getting back to the plan; I'm to get out of the hospital Friday or Saturday. I then spend about a week in Houston after which I am free to go home. If you'll flip to your calendar, you'll see that's right on top of Christmas. Surgical staples come out 2 weeks post surgery at which time, I'll be home. In discussing that with my surgeon, he said, "You all are ranchers, right? I figured you'd know how to do that." Well, 2 minutes later, we were in possession of a staple extractor and some Steri-Strips. We were admonished by the surgical fellow to first pull out every other staple. If everything seems to hold together and my guts don't fall out, then go ahead and take out the rest of them. We can always call the vet if we have trouble (Dr. Amy, you're on call). I love these guys.
For 6 months, the remainder of my colon had been on sabbatical. It needed some down time after major surgery so the team brought the terminus of my small intestines to the outside of my body (they gave me an ileostomy). That gave the large intestines and the surgery site time to heal. In the meantime, I had 6 months of chemotherapy. Now that is complete, my guts have healed, my blood counts have normalized so it’s time for the Humpty Dumpty surgery – they’ll put me back together again. It's called a Take Down. That will happen Wed., Dec. 16.
As surgeries go, this is not a bad one, especially compared to April’s ordeal. They take my ileostomy, which is still literally hanging by a thread (OK, some tissue) to the large intestines, make me some fresh ends, stitch the two ends back together, put everything back inside, and sew the hole in my abdomen shut. Now here’s the part where I need you all to keep your fingers crossed. The lower intestines have to wake up from their long nap and get back to work in concert with the small intestines, who did not get a 6 month vacation. They may be pretty steamed about that, so we’ll see if they are in the mood to pout, or if they suck it up and stay on the job and cooperate. The docs will let me out of the hospital only after I demonstrate that the new route is fully functional and everyone is playing nicely together. What gives me pause is the fact my guts went on strike after the April surgery and refused to work until they decided they were darn well good & ready. I have been sweet-talking them and promising them all sorts of deals if they’ll just cooperate this time. Again keep your fingers crossed. If all goes well, they’ll kick me out of the hospital on Saturday, Dec. 19.
Thus opens the next chapter; The New Normal. Without going into too much detail (like all the stuff above isn’t "too much detail"), a body has no voluntary control over the intestines, with the exception of the rectum. But wait! Barb – you have no rectum. Oh, yeah. That’s right. Well, this is where it gets interesting. In the long term, a person learns to understand and manage the new plumbing to some degree. In the short term… Well, who the hell knows?! This is where the aforementioned part of my anatomy that you all campaigned to save gets to play the hero's part.
In thinking all this through over the last several months, Joe and I decided it'd be best to drive home rather than fly. The mental scenario went like this: "The captain has turned on the fasten seat belt sign. Please remain in your seats for the duration of the flight. The very long flight. Oh, and bumpy flight. It’s going to be a doozy folks! Coffee?" I have visions of my guts hearing the preceeding message, and with their warped and cruel sense of humor deciding it would be a good time to send a message to my brain marked "URGENT. Must. Go. NOW!" I press the call button, only to be told no; moving about the cabin puts both me and my fellow passengers at risk, so I must remain seated, no ifs, ands, or but(t)s. I wait approximately 5.2 seconds, unbuckle my seat belt (by lifting on the buckle, duly noted during pre-flight instructions) and make a mad dash for the back of the plane. Conveniently, there will be a US Air Marshal on my flight, seated about 1/2 way between me and the restroom. He'll tackle me in the aisle, there will be a struggle and then.... all hell breaks loose. And by hell, I mean my newly reconfigured plumbing. Oh dear Lord. The possibilities are endless and terrifying. Believe me, I've run every last lovin' one through the fertile fields of my brain. Said fields received additional fertilizer during my pre-op appt when my surgeon, Dr. Rodrigues-Bigas, actually used the term "explosive diarrhea." Ah, thanks RB. That poor Air Marshal. I almost feel sorry for him. Almost.
Getting back to the plan; I'm to get out of the hospital Friday or Saturday. I then spend about a week in Houston after which I am free to go home. If you'll flip to your calendar, you'll see that's right on top of Christmas. Surgical staples come out 2 weeks post surgery at which time, I'll be home. In discussing that with my surgeon, he said, "You all are ranchers, right? I figured you'd know how to do that." Well, 2 minutes later, we were in possession of a staple extractor and some Steri-Strips. We were admonished by the surgical fellow to first pull out every other staple. If everything seems to hold together and my guts don't fall out, then go ahead and take out the rest of them. We can always call the vet if we have trouble (Dr. Amy, you're on call). I love these guys.
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