I am afraid that the issues that I joked about in the last few posts have turned serious.
When performing the Gastroscopy, my doctor apparently stopped the procedure and decided that my case was so serious that he needed to have the facilities of a major hospital at his beck and call rather than what was available in a Day Surgery at a private clinic.
The net result is I am booked in to have the same thing tried in Canberra Hospital on Tuesday next, this time with all of the additional imaging and emergency facilities available and standing by.
Considering what the doctor has told me I thoroughly approve of his conservative approach!
It appears that there is a serious blockage some 22 centimetres down my throat right where the junction of the remnant oesophagus and the stomach is. Some of you may recall that when the Ivor Lewis operation was performed it resulted in some 15 cm of my oesophagus being removed and around a third of the stomach being removed the remnants then being joined with staples.
What's more, with the removal of the oesophagus the action which enables all of YOU with healthy bodies to swallow your food, was also removed. All of you have a sort of unconscious action in your throats that massages the food down the food tube. This facility is NOT available to people like me. So we are continually having to find ways of swallowing and getting the food to go down. If there is a narrowing of the aperture of the food tube this becomes difficult if not impossible.
It appears that the gap at the join there is so narrow that the doctor was afraid of inserting a wire into the space without additional visual aids and tools being available to enable him to see what he was doing and so to avoid piercing tissues and causing a leak he stopped the procedure and re-scheduled it for the following week.
We all know the size of a piece of wire and - to be perfectly honest with you - it's not big! We are NOT talking about the transatlantic cable here.
That apparently is what is causing my inability to eat and to swallow - there is no place for the food to go down and into the stomach . Obviously a rupture around this are would be most serious considering that we are in the thorax and hence near the Bronchi. If its a choice between having a tube inserted into my stomach and absorbing food through that for the rest of my days or breathing I know what I would choose - and its not eating!
However there is a chance that perhaps a balloon inserted into the space can simply expand the area without rupturing the tissues and if that does not work then actually trying to insert a stent - hopefully a removable stent. Many apparently are not removable and can slip and do some interesting damage. Yet more risk.
For those of you who have not seen a stent there are many versions but all of them appear to be about 6-9 inches long and about 3/4 of an inch in diameter, this cylinder is somehow inserted into the area which needs to be expanded and then hopefully sits there and enables the person in whom it has been inserted to eat and swallow normally!
Just seeing some of the stents with a sort of wire mesh surrounded by some form of plastic covering does NOT give one a great feeling about what is going to happen - but since it beats dying I guess it's worth the try. If it's a removable stent then at least if it fails you still have the option of being fed directly into your stomach with a food tube! I have had one of those after the big operation and I have to tell you that not being able to eat, or drink or let anything pass the lips is psychologically terrible. What's worse is that the tube actually needs continual cleaning and maintenance and over time can become - yeah well let's not go there just yet - if needs must fine - but not without a struggle. They can become infected and frankly they can smell! That smell is NOT something I can forget and frankly its not something I would like to have again!
Meanwhile the biopsies were not available when we went to see the Dr the day after the aborted gastroscopy so I still have no idea what the results were. I was supposed to receive a phone call in the afternoon of Thursday but since it did not come and with everyone out for the long weekend I have no idea if the cancer has returned or not.
I can assure you that the mind is a terrible thing and I have wondered whether the receptionist who was going to ring me with the results - took one look and decided that this was a pleasure she would rather leave to the doctor or whether it just slipped from the agenda of what is a very busy practice. Suffice it to say that I am assuming the worst case scenario and dealing with it as anything short of this is likely to be a pleasant outcome.
The worst case scenario I can paint is that I am riddled with cancerous cells and that since there is no more possibility that I can actually get any more radio therapy the only option for treatment will be chemo therapy which means palliative use of the substances as the chemo does not usually work well just on it's own and especially in soft tissue cancers.
In other words I think I may well have "bought the farm" as no doubt some of our Anzacs would have said at some point - or was that an American phrase!
Since this possibility is something I have lived with now for over four years I can't say I would be surprised if this is the outcome. Annoyed that I will not have more time, angry about how I have used the time I have had so far and worried that it will all end in agonising pain which is NOT capable of being dealt with by the medication.
Frankly I would rather go quickly under anaesthetic than linger - but that apparently is not a choice I can make.
I will obviously let all of you know what the results prove to be - but for the time being let's assume the worst and then either not be surprised or pleasantly surprised if the possibilities are better than expected.
For those of you who have gallantly followed my scribbles up to this point - thank you and for those of you I have met again following the initial trials and tribulations - thank you for your concern and your continuing remembrance of something I must have done right at some point because you have been kind enough to greet me with a smile and very lovely inquiry as to my health and well being!
Well that's all for today and I expect that for many of you this will be more than enough!
Enjoy the long weekend!
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