Yesterday was a travel day. We left the security of MD Anderson and headed for home. There was something about being at MDA that was comforting. THEY weren't out of their comfort zone. THEY knew the terrain like the back of their hand. With them to follow, it was easy to navigate this new world of cancer patient. Then all of a sudden, the map was gone, the terrain looked unfamiliar and foreign and the way was just not quite clear. But it will get clearer, and because I'm female, I'll pull over at the gas station and ask directions if I have to. Had enough of the metaphors yet?
Joe and I have weighed and discussed, laid out options, discerned what we believe to be all the pros and cons of different courses and have made some decisions. I'm going to lay it all out for you in the next few paragraphs, so if you're uncomfortable with some of the earthier facts and terms of the matter, heed the warning and instead of continuing on, click on the video below. Then be distracted by the suggestions that You Tube will make for similar videos (try the one about the new dog coming to the house first; it's cute), kill way more time than you intended and then go on to whatever you were supposed to be doing in the first place.
Joe and I have weighed and discussed, laid out options, discerned what we believe to be all the pros and cons of different courses and have made some decisions. I'm going to lay it all out for you in the next few paragraphs, so if you're uncomfortable with some of the earthier facts and terms of the matter, heed the warning and instead of continuing on, click on the video below. Then be distracted by the suggestions that You Tube will make for similar videos (try the one about the new dog coming to the house first; it's cute), kill way more time than you intended and then go on to whatever you were supposed to be doing in the first place.
Well, if you're still here, you're ready for the details, so I'll only keep you waiting one brief moment while I tell you that after a particularly stressful day recently, Joe asked to watch cat videos, so I queued up a 20 or 30 minute one on the Chromecast and made it all better. Can't have a bad day after watching cat videos apparently.
Concurrent Chemo & Radiation
Jan 5 - approximately Feb. 20
This is conveniently know as chemoradiation. Clever. I start on Jan. 6 with a simulation where they do some Xray mapping of everything, meet and plan and get it all lined out. Then a couple of days later, they tattoo my hind end for permanent guide posts and begin the treatment. This of course brings up very interesting scenarios where I ask folks if they'd like to see my tattoos. Ah, the possibilities are endless!
- Chemoradiation will occur 5 days/week with weekends off. I consider the weekends "time off for good behavior."
- I will be backside up in the air with my guts kind of vacuumed into a kind of beanbag chair (actual terminology used to describe it to me) with the intent that this and gravity hold most of my guts out of the way of the radiation. Go ahead; try to picture this because I can't. If you think you've figured it out, make a stick figure drawing and send it to me.
- I am also instructed to have my bladder as full as I think I can tolerate and manage when I arrive for my appointment each day. This also helps push my guts away from the target site and protect them from injury. However, the possibilities of miscalculation on my part as to what exactly I can tolerate and manage brings up additional possibilities of embarrassment, as if having your backside up in the air and all your tattoos showing isn't enough.
- The treatment itself lasts only a couple of minutes. The undressing and positioning take longer.
- The treatments go on for about 6 weeks, putting me somewhere around Feb. 20 for my last treatment.
- Once/week, I will have appointments with my docs to monitor my progress and assess any complications that need to be addressed. In addition, CT scans will be performed at intervals to monitor the injury to The Little Bastard. I can't wait to see those!
Rest & Recovery - March & part of April
Surgery - Mid April
6-8 weeks of getting strength back puts surgery sometime around April 15. Man, this is almost too easy. I may have some sort of contest as to who can make the best joke that ties together the IRS and what's going to happen to me. Stay tuned for details, need not be present to win, one entry per household please.
- They will remove my entire rectum and possibly some of the colon.
- There is a possibility for the surgery to be done robotically, which makes recovery easier. Also, it's just plain cool.
- With luck and really skillful and closely watched radiation, there will be healthy tissue between my anus and the resection site. Enough healthy tissue that it can be reconnected in the future. (Hey, I warned you this was going to be earthy. Feel free to go back to cat videos.) In the interim (about 6 months or so), I will have an ileostomy. There is the possibility that when they do the surgery, they won't be able to save the anus. In that event, I'll have a permanent ostomy. There are worse things. My sister made me an Inigo Montoya t-shirt. $20 to the first person who makes and wears a "Save the Anus" t-shirt. It can even be hand lettered with a Sharpie. Note: you must provide photographic proof and there must be at least one witness who knows neither you nor the context of the slogan.
- I will be in the hospital for 1 week and will need to hang around Houston for another week after that.
Rest & recovery - Mid April - May
Chemotherapy - June - Nov/Dec
- 4-6 months of chemotherapy.
- Infusions are done periodically, I THINK every 2 weeks
- The length of the course and the actual drugs used depend on the final pathology of the diseased rectum and the lymph nodes removed.
So there you have it. The battle plans are drawn. We've decided I'll have the course of chemoradiation at MDA in Houston. The tumor is so very close to my anus for one thing. There are a couple of other complications too and my surgeon feels strongly about MDA doing the radiation. Heeding the wisdom of "you only get one chance to do it right the first time," we feel most confident in MDA. 6 weeks away from family, friends, the ranch and cattle, the winter weather in KS (wait - that last one is a GOOD thing) is tough to think about. But 6 weeks in exchange at my absolute best shot of coming out of this with the best possible outcome made the decision easy in the end.
What has become affectionately known as "Camp Bucky" aka our camper, will be making the drive down to Houston to spend the next 6 weeks at a campground conveniently located just 3.1 miles from MD Anderson. That way, I'll have my stuff, my place, a workable office set up, WiFi and all the other things I think I'll need to make the time bearable and productive. The route up there is on a main thoroughfare through a nice neighborhood, so while you people are slogging through ice and snow, I'll be strolling up to the campus for my daily treatments. Should I not feel like walking, they'll valet park the Mega Cab (THAT ought to be interesting!) for me everyday for free. Should I not feel like driving myself, the campground has a free shuttle service.
When last we met I talked about Inigo Montoya and I said that like his journey, this one requires focus, determination, planning and preparation, then execution. I'd say we've got through the planning stage. A little more preparation, then we start on the heart of the matter; the execution. Prepare to die, you Little Bastard. Prepare to die.
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