The good...
Well, once my guts started to cooperate, I made a speedy recovery. The kind of speedy recovery the team was originally expecting before my intestines decided to ignore the game plan. What was supposed to be 4-7 days in the hospital (and more likely 4, they'd predicted) turned into 2 weeks. And while I'm reasonably pain tolerant and stoic, I felt like a big baby in the throes of it all. The pain caused by this dysfunction of peristalsis was much more than anything caused by the surgery. I have a new found understanding of the agony felt by a horse with colic. I got out of the hospital on a Friday, and my doc released me the following Tuesday and Mom & I gleefully boarded a plane for home, with me wearing my new doc coat (see below). We secured a donut pillow and loaded me up with pain meds before boarding. Come to think of it, those are 2 things you need for air travel these days, regardless of any recent major surgery!
Me in my K-State Flying K branded lab coat, replete with lots of initials, courtesy of friend and KSU professor Dr. Bob Weaber and his wife Tami. The credentials below my name read "N.C.W., F.A.C.B.S." That means, "No Credentials Whatsoever, Fellow, American College of Bull $&!+#%$." That was fun!
I came home to a ranch that was in full AI season swing and had received significant rains since I left. I could not believe the lushness! While I missed heifer AI, I got to work the 1st calvers, registered cow, and recip cow synch and AI. I found I handled everything well, but I would be tired by the end of the day and found that the end of my day needed to occur a few hours before the day ended for Joe, the girls, Brock (herdsman) and any unfortunate volunteers. One day, my day didn't end early and I paid dearly, so I learned a valuable lesson. The other thing I noticed is that I'd lost considerable aerobic conditioning. 2 weeks in a bed will do that. Combine that with very low hemoglobin and I was huffing and puffing like the wolf from the Three Little Pigs. But with my good friend Beef (an excellent source of easily utilized heme iron and other very valuable nutrients), I'm working on my hemoglobin. A delicious job!
I mentioned I missed heifer AI, and that leads to a not-so-little anecdote about how we've been treated by family, friends, neighbors, strangers, and casual acquaintances. I was originally supposed to be home by AI season, and was planning on doing all the semen handling/record keeping for Joe. Well, when it became clear that wasn't going to happen and that the workload had been increased by the sudden presence of A LOT of mud (we'd forgotten what that was for the last 5 years), I put out a request for help on FB. Within literally minutes, Joe was inundated with help. More help than he could possibly use. We had people to sort and keep the heifers coming down the alley to the chute (the "mudders"), people to record keep, handle and thaw semen and load the AI guns, people to help Joe with the actual AI itself (heifers are the most difficult to AI and your arm and hand can quickly turn to an unresponsive blob after breeding a particularly tough heifer), people to feed the crew and people to haul the heifers out to pressure. I tell you, this is such a humbling experience to realize the depth of goodness and generosity of people. I mean, I knew it on an intellectual level, but until you experience it first hand, you just don't realize the powerful impact. I'm tearing up just thinking about it. And this wasn't the only experience. Cards, prayer chains, gifts, meals brought, moral support, other cattle help, cleaning, etc., etc., etc. If you don't think that God answers prayers and effects a lot of them through the actions of everyday (albeit extraordinary) folks, then I don't know what to call it. God bless you all.
I'll undergo chemo here locally. I have a doctor here that proposed the exact treatment as MD Anderson. Not unexpected as it's the clear standard of care for this tumor. And I really like this Doc a lot. I'll have the treatments every 2 weeks and wear a pump for 2 days during each treatment. He asked me if I had morning sickness during pregnancy, which in general, I did not. In his experience, women who didn't have trouble with morning sickness, do better in terms of chemo & nausea. Interesting. I told him, "It takes a lot to put me off my feed!" He had the good manners to laugh rather heartily, so I think we're a good match.
I mentioned I missed heifer AI, and that leads to a not-so-little anecdote about how we've been treated by family, friends, neighbors, strangers, and casual acquaintances. I was originally supposed to be home by AI season, and was planning on doing all the semen handling/record keeping for Joe. Well, when it became clear that wasn't going to happen and that the workload had been increased by the sudden presence of A LOT of mud (we'd forgotten what that was for the last 5 years), I put out a request for help on FB. Within literally minutes, Joe was inundated with help. More help than he could possibly use. We had people to sort and keep the heifers coming down the alley to the chute (the "mudders"), people to record keep, handle and thaw semen and load the AI guns, people to help Joe with the actual AI itself (heifers are the most difficult to AI and your arm and hand can quickly turn to an unresponsive blob after breeding a particularly tough heifer), people to feed the crew and people to haul the heifers out to pressure. I tell you, this is such a humbling experience to realize the depth of goodness and generosity of people. I mean, I knew it on an intellectual level, but until you experience it first hand, you just don't realize the powerful impact. I'm tearing up just thinking about it. And this wasn't the only experience. Cards, prayer chains, gifts, meals brought, moral support, other cattle help, cleaning, etc., etc., etc. If you don't think that God answers prayers and effects a lot of them through the actions of everyday (albeit extraordinary) folks, then I don't know what to call it. God bless you all.
I'll undergo chemo here locally. I have a doctor here that proposed the exact treatment as MD Anderson. Not unexpected as it's the clear standard of care for this tumor. And I really like this Doc a lot. I'll have the treatments every 2 weeks and wear a pump for 2 days during each treatment. He asked me if I had morning sickness during pregnancy, which in general, I did not. In his experience, women who didn't have trouble with morning sickness, do better in terms of chemo & nausea. Interesting. I told him, "It takes a lot to put me off my feed!" He had the good manners to laugh rather heartily, so I think we're a good match.
..the Bad...
Here I am, 5 weeks from surgery to the day. I go today for the surgical consult for my port placement, which happens the first of next week with chemo to start that same day. The docs were adamant that the chemo start within the 6 week window after surgery. Which brings up the unpleasant part of this post. I've been very frank with you all and intend to continue. Here it comes. When you're staged at diagnosis, the actual pathology samples are from limited samples during biopsy and other CT and MRI evidence. Of course, after surgery, they have the entire tumor, adjacent tissue, lymph nodes and other info that let them more accurately assess the cancer. While TLB is now excised, his name has been upgraded to The Evil Little Bastard, TELB. It appears TELB has some other characteristics that aren't good. The pathology showed the following:
Stupid tumor. Stupid, stupid tumor. This means full-throttle chemo. I'll have 6 months of a regimen called Folfox. This puts the last chemo right around sale time, in early November, which is the ranch's joint, annual production sale. Which means I hope we have all the catalog pretty much lined out for the sale pretty quick. It also means we're going to a video auction, which we've been wanting to do anyway. At this point, Anna will be up on the block on the computer with Mary Ann Kniebel. I will be backing her up as I can.
- Poorly differentiated tumor cells - when you're an embryo, what were once identical cells differentiate into their specialized tissue types: muscle cells, kidney cells, etc. including adenocytes lining the rectum that secrete mucous (my tumor's origin). My tumor was graded as poorly differentiated, meaning it had gotten pretty far away from an adenocyte. This was part of calling the tumor a high grade tumor, which makes it more aggressive.
- Narrow margins of the resection - 1mm margin from invasive carcinoma tissue means recurrence at the sight is more likely.
- Lymph-vascular invasion present - Independent of the lymph nodes (we already knew 3 were cancerous, and 2 were still cancerous after the neo-adjuvant chemoradiation I had in Jan-Feb), the tumor had invaded normal blood and lymph vessels, the highways to the rest of the body. Additionally, they had invaded and grown along some nerves.
- Tumor deposits - independent tumors from the original tumor that aren't connected to it. The presence of these is not the best news. It demonstrates that the original tumor had wanderlust.
Stupid tumor. Stupid, stupid tumor. This means full-throttle chemo. I'll have 6 months of a regimen called Folfox. This puts the last chemo right around sale time, in early November, which is the ranch's joint, annual production sale. Which means I hope we have all the catalog pretty much lined out for the sale pretty quick. It also means we're going to a video auction, which we've been wanting to do anyway. At this point, Anna will be up on the block on the computer with Mary Ann Kniebel. I will be backing her up as I can.
...and the Not Ugly at All!
I know I've said this before, but I am peaceable about all of this. Part of it's my nature (I'm not a worrier, hence my personal hero, Alfred E. Neuman makes an appearance). Part of it I believe to be the blessing of peace (thanks for those prayers!). Part of it I believe to be my overall good health. Part of it I believe to be staying active and taking good care of myself nutritionally. A big part of it is excellent medical care. And part of it I believe to be positive attitude. Again, I've got a LOT of factors on my side. That doesn't mean there haven't been some tough moments and some tears. OK, OK - some downright meltdowns. I'd be lying, and I'm not going to do that. But they have been infrequent and of short duration, and then before long, I'm back to my normal self. Which is, as you know, not really "normal" at all! ;-)
Monday sees me getting my port placed in Manhattan by Dr. Lance Saville, who did the original diagnostic colonoscopy. He's a great guy and I'm glad it's him placing the port. This port will be how they access the big vein for chemo and it stays for the duration. They can also pull blood from there for tests. Excellent! After I'm all woke up, Joe will shuttle me over to Dr. Travis Koeneke, (the doc who laughed with me about my eating abilities, also a good sign) for my first infusion. While both docs have very full schedules and originally couldn't see me til later, after I told them about the pathology and the recommendation I start chemo ASAP, they both squeezed me in and we're off and running. I am so pleased with how my case has been handled by both docs and their offices.
The other good news is no one thinks I'll lose my hair. It might thin, but there's baseball caps and cowboy hats aplenty in my closet. So, while hair is not going to make or break me, at the same time, NOT losing it is fine by me. My medical oncologist at MD Anderson, when I queried him about hair loss told me of another patient who showed up for her first post surgery appointment with him having preemptively shaved her head. He had to tell her she was most likely not going to lose it. As you might expect of a lady with that kind of take-charge attitude and courage, they shared a good laugh. I think I really like that lady, and I believe she's probably kicked cancer. Much like I will.
Monday sees me getting my port placed in Manhattan by Dr. Lance Saville, who did the original diagnostic colonoscopy. He's a great guy and I'm glad it's him placing the port. This port will be how they access the big vein for chemo and it stays for the duration. They can also pull blood from there for tests. Excellent! After I'm all woke up, Joe will shuttle me over to Dr. Travis Koeneke, (the doc who laughed with me about my eating abilities, also a good sign) for my first infusion. While both docs have very full schedules and originally couldn't see me til later, after I told them about the pathology and the recommendation I start chemo ASAP, they both squeezed me in and we're off and running. I am so pleased with how my case has been handled by both docs and their offices.
The other good news is no one thinks I'll lose my hair. It might thin, but there's baseball caps and cowboy hats aplenty in my closet. So, while hair is not going to make or break me, at the same time, NOT losing it is fine by me. My medical oncologist at MD Anderson, when I queried him about hair loss told me of another patient who showed up for her first post surgery appointment with him having preemptively shaved her head. He had to tell her she was most likely not going to lose it. As you might expect of a lady with that kind of take-charge attitude and courage, they shared a good laugh. I think I really like that lady, and I believe she's probably kicked cancer. Much like I will.
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