Twenty-four hours from now (Thursday, May 21st. at 6:30 am), I’ll be registered at the Victoria General Hospital. By 7:30 I’ll be on the table with the surgical team getting organized to start an Esophagectomy at 8:10 am. The world as I know it will never be the same but I am hours away from calling myself a cancer survivor.
I can barely pronounce the word Esophagectomy. Most of the tube which carries food to my stomach will be removed, my stomach will be reshaped, stretched up to what remains and reattached around the level of my nipples.
For several days, I will be fed intravenously and remain in the hospital recovering until I am able to consume food orally. I understand that in 20% of patients, a leakage at join happens and results in a longer hospital stay. It will take time to heal and recover.
The surgery is done laparoscopically which means small incisions will be made in my sides; one side is for cameras and the other for tools to dissect the tissues and the carry of the reattachment of the stomach. This is referred to as minimally invasive and offers the advantage of reduced risk of infection.
This highest risk in this procedure is separation of the join. Other common complications are infection and pneumonia.
I am healthy, strong and fit which will improve my healing and recovery time. My goal is to be up and about as soon as physically possible. Mobility reduces the likelihood of developing pneumonia as it ensures the lungs are active and the movement of air in and out keeps the lungs clear.
From beginning to end I will be asleep (anesthetized) during the surgery. Typically an Esophagectomy lasts about eight hours which is a long time to be out. Immediately after, I will go to recovery to wake up.
Once awake, I will move to an Intensive Care Step-down Unit for a day or two. At this location, there is constant monitoring with nurses in the room around the clock.
I can expect pain at the incisions and internally for a couple of days. It will be managed with medications and should improve quickly as I heal. Once I am stable, I move to a regular room for the remainder of my time in hospital.
My hospital stay will be at least a week. Should any complications arise, there are well established protocols to manage them and ensure a rapid recovery. To be released, I need to be able to take food orally and be infection and pneumonia free. Should I develop infections or pneumonia, my time in hospital will extend up to a month. This is not what I expect.
There will be changes in how I consume food and drink in the future. I will need to learn to swallow again. I have no idea what that will be like but there will no esophagus with muscles to move food and drink in the direction of my stomach. Also, the value at the entrance to the stomach will be gone so I expect an increase in the odds of regurgitation. I understand I will need to remain vertical as I consume food to allow gravity to help getting food into and past my stomach. I can’t say I spent much time standing on my head swallowing but going forward, that will never again be an option. Ah well … no cirque du soleil in my future!
Due to the pandemic, no one will be able to visit during my hospital stay. I can see a lot of Facetime in my immediate future. Over almost forty two years of marriage, this might be the longest time that the love of my life and I have been separated. My wife Janet will get lots of support from our huge family and circle of friends but I suspect we will both struggle with the time apart.
I am fearful of this next stage in my treatment. There are risks with all surgeries and the potential for complications. I have never faced anything so beyond my control in the past. I believe this fear to be normal.
I completely trust my caregivers. My personal experience from the start of this adventure has been first rate. We are the benefactors of a wonderful health system in Nova Scotia with superior care for all Canadians. Even in the face of pandemic chaos, although modified due to physically distancing, my care has proceeded according to plan.
Like any massive system, there is always room for improvement, but my care is not unique. Any Canadian in my shoes receives the same care I’ve had through the last several months. It is no secret I’m a proud citizen but we all have every right to brag about our access to healthcare in our country.
I continue to be thankful for all the encouraging messages from family and friends. Along with a helping hand from God I will come out cancer free on the other side.
Peace, Love and Laughter
PS – My daughter Meredith will prepare and post a blog on Friday after my surgery to let you know how I’m doing.