The C Word – Day 39 Surgical update

Today we met with the surgeon for pre-op information.  I have to give Dr. Bastidas kudos for taking the time to sit and answer our questions and explain more details of what is going to happen.  Also, his office assistant who is so reassuring each time we go to the office.

Although we had signed off on the clinical study paperwork, we missed initials on two pages (easy to overlook because those two pages required signatures so we did not realize they also had to be initialed).  George thought that great because the doctor caught those – meaning he really pays attention to details.  We had more paperwork to sign off on, dotting the I’s and crossing the t’s.

We had our list of questions including when to start drinking the Impact nutritional supplement – and when to stop eating (Sunday night will be the last night for any real food).  Monday, the 29^th, will be a clear liquid diet, including a lot of water and then a “tasty” cold drink of laxative.  Once midnight rolls around there will be nothing to take by mouth as we will check in at 5:30 AM on the 30^th for surgery.

We inquired as to whether I would be given updates throughout the day and found out that there will be a couple of times when word will be sent out.  The first will be once they have him prepped and initial surgery done, someone will come out to tell me whether or not they will proceed with surgery.  (There is only one issue that would change that determination and chances should be slim that this would happen.)  Once they begin the HIPEC process the surgeon will actually come out to update me on what is happening and the estimated time to finish.  That portion of time is the only time he will get a decent break in surgery. 

We also found out that George will be in ICU definitely for the first night and perhaps a second one as well.  After that he will go to a regular room for the duration.  I will be allowed to stay in the room with him as much as I want to.  During his ICU stay I will have to leave for about 45 minutes during shift changes, but other than that I can be in the room and be his advocate as much as is possible. 

When we spoke to the doctor about climbing stairs and that we were planning on getting a hospital bed for a downstairs room, he gave an emphatic “absolutely not”.  He says to climb the stairs and move around.  He says he won’t let anyone go home unless they are ready to go back to their current living situation.  Wow, that was good news.  That is not to say it will be easy for George, but they really are encouraging getting patients moving around as soon as possible.

He drew a small diagram about what he needed to do and outlined the benefits, risks and alternative treatments if we did not go through with the CRS (cytoreductive surgery) and HIPEC (heated chemo).  Basically, the odds appear to drop (sometimes dramatically) if we choose an alternate treatment.  Of course we are choosing the one with the best odds.

We asked about the chances of the cancer coming back.  Of this we are told that it will come back.  This treatment is not a cure, it just brings the cancer down to much lower levels than it currently is.  That is why there is “watchful waiting” for at least five years but will most likely be ongoing for the rest of George’s life.  What we do achieve procedure from this is a much longer life span. 

We spoke about his relationship with Dr. Fisher (a renowned cancer researcher at Stanford) and he knows him well (together they formed the current cancer center there).  That was reassuring news. 

All in all, the pieces continue to fall into place.  Each time we meet a doctor George’s confidence is enhanced.  Still not looking forward to the actual surgery, but that is normal for anyone who is facing surgery. 

George has just two more days of work – but mentally he is already clocked out so he may not accomplish too much.  He will probably manage to tie up a few loose ends and then bid adios for at least the next nine weeks.  Everything is in place for him to be able to concentrate on resting and healing for however long it takes. 

The day has ended on a very positive note.  Hopefully sleep will come easy tonight!