This morning, I had a question and answer session with Dr. G.
That's right. I scheduled an appointment so I could get some information straight from the horse's mouth. Because as much as I do love Dr. H's impressions of Dr. G, there are some things a girl needs to talk to her surgeon about in person.
Case in point: When I told him that H had told me he didn't want to operate "because he wasn't sure there would be enough left to put me back together again", G rolled his eyes, laughed and said, "Yeah, I can see where you'd need some clarification on that".
So, he clarified it for me. It's not pretty, and I'll get to that. But FIRST, I have to show you what he showed me. See that down there? That is my guts. Also, #9.
I really wish I had a cool program on my computer (like Paint... I looooove Paint!) so I could circle the tumor for you, but I don't have a cool program on my computer, so I'll just tell you to look at the right side of the picture. (The picture's right is my body's left, because the scan was taken from the top down.) See that gray mass that's roughly where my left kidney would be if I still had one? That's the tumor.
It's not little.
(For scale, look left. See the organ to the left of my spine that looks like a giant C? That's my right kidney.)
Mind you, it's also not as huge as this picture makes it out to be. This is just one frame of a moving picture, so it's the angle that's making it out to be bigger than a kidney here. But still, it's grotesque.
And it's wound itself around maybe three feet of my small intestine.
Now, I just asked my friend Google, and he told me that the small intestine is generally about 20 feet long. So, maybe three feet isn't such a big deal. Buuuuut, maybe it is. (And Dr. G is guessing it's around three feet that are impacted. He can't be certain how much of the organ he'd have to take unless he opens me up... just to look, and that alone would be risky with my body.) He clarified that he was quite certain that he'd be able to "put me back together again" (literally, he knows that he could put me back together again) - his concern is more along the lines of not knowing if there would be enough of my small intestine left for it to be able to deliver the nutrients to my body that I would need to... you know... live.
Here is what I learned today:
The large intestine and the colon are the same thing. These are interchangeable terms for the same organ. ... I had no idea! (All you medical people are shaking your heads at me right now. It's okay. I don't mind.) And I could easily live without my large intestine/colon. I mean... I'd have to carry around my poop in a bag, but I could live a fairly normal life without it.
The small intestine... that's a little (read: a lot) harder to live without. It's possible. (Sort of.) But if there wasn't enough of it left post-op (an adult body needs 140 cm of the small intestine to have enough absorption to service the body), I'd have to get all my nutrition from an IV. (That's horrifying.)
There is such a thing as a small intestine transplant, but I'm not a good candidate. ... Because of the cancer. (Shoot. Me. Now.) And not because my history with cancer would keep me off a transplant list, necessarily, but more because the immunosuppresant drugs could cause/allow the cancer to spread. (I don't really know how that would happen. I'm just telling you what he told me.)
This is a lot of new information to process.
He gave me a list of questions to ask any surgeons I meet in Texas:
- Can this come out?
- Will you be able to get all of it?
- Is there a benefit to debulking? (taking part of the tumor prior to treatments - follow the link for more info)
- Is there a possibility of intra-peritoneal chemo or radiation during surgery? (bathing my peritoneum in chemo and/or shooting rays of radiation directly at the tumor site while I'm open - this isn't something they can do here in Gilbert, but they do have that capability in Houston)
At the end of the appointment, he told me that isn't unwilling to perform the surgery, he just isn't sure it's my best option and he doesn't want to do me harm. (Something about an oath he took when he became a doctor?) He ultimately said that he would do it, if Houston thinks it's my best option, and if there isn't anything they could do there that couldn't be done here.
So, we'll see. The man doesn't want to make a surgical move without having other surgeons look me over, and I don't blame him for that.
Today has been hard, but it has also been awesome. I'm so grateful for a surgeon who knows who I am, who jokes with me about the gender/names I give my tumors, who gets teary eyed as he shows me pictures from my last scan and explains how invasive my cancer has become, who tells me stories about his three year old and shares some of his beliefs with me (I learned a Hebrew word today!), who apologizes that he can't stay and talk to me because he has another patient waiting, who holds his arms out to give me a hug before I go to Houston.
Here's hoping I can make the same kind of impression on the doctors in Houston as I have on my doctors here in Arizona, because, frankly... it's going to take a village to pull me through this time.