It has been a great 3 months since the resection, all has gone very well and about 2 weeks ago I was aware that I have all my energy back. Still some work to do to get to an acceptable level of fitness.
And about 4 weeks ago I started to put on weight, challenge now is to stop it rising by building up my exercise.
However, feeling quite spaced out now thanks to this event. Fortunately there was little physical damage to our property but it has been very stressful supporting other family members. The after shocks continue and we are all suffering from sleep deprivation.
But, the really good news are my latest blood test results. Liver functions have all returned to normal, and my CEA is 1.2, down from my last test of 1.8. Rising CEA is a highly reliable indicator of colo-rectal metastatic disease, I feel really good at that result.
Monday, September 6, 2010
Friday, July 9, 2010
Back To Work
I went to the office today, for a few hours. It should have been yesterday but early Thursday morning, between about 1:00 am and 5:00 am I had a bad bout of vomiting and diarrhea. Initially I thought it was the dreaded norovirus, but I did not really have stomach pain and by late morning I was feeling OK, but quite washed out. I strongly suspect it was too much pumpkin soup or perhaps lunch at a Chinese buffet.
Work was OK, but standing and walking tires me quite quickly. It was great to see that all is going well at work, did they even miss me? I expect to build up during next week, on current rate of progress I should be full time by end of week.
I am feeling great, better than before surgery, no doubt due to less stress as I have known there was a problem for about a year. And also my headaches, which had been present most of the time since late last year, have now gone.
Called the Doctor's surgery today and got my latest liver function results, all are OK, apart from a minor damage marker which in not of concern to me.
Next update to this blog should be in 3 months when my CEA is next checked.
Work was OK, but standing and walking tires me quite quickly. It was great to see that all is going well at work, did they even miss me? I expect to build up during next week, on current rate of progress I should be full time by end of week.
I am feeling great, better than before surgery, no doubt due to less stress as I have known there was a problem for about a year. And also my headaches, which had been present most of the time since late last year, have now gone.
Called the Doctor's surgery today and got my latest liver function results, all are OK, apart from a minor damage marker which in not of concern to me.
Next update to this blog should be in 3 months when my CEA is next checked.
Friday, July 2, 2010
Good Progress and Good News
The trip to Glentunnel went well, got one night of great sleep (best since well before the surgery) and one night of good sleep. For some reason we both sleep better in the caravan. The overnight frosts of -3.8C were bracing, but it was warm inside. I ran out of energy, but only after some reasonable activity.
This afternoon we visited the oncologist to work further through the process of determining whether I should have chemotherapy. Initially the consultation session came up with a strategy based on 1/2 bottle of wine a day, plus chocolate, then the oncologist came in and the administrator, who is a friend of ours left, the oncologist was not confident that Kerry's approach would be of benefit.
The good news is that my CEA test, taken 2 weeks ago, is 1.8. This is right in the middle of the normal range for a non-smoker, and strongly suggests no tumour is present. After going through the figures again, and getting some more data, Teresa, the oncologist and another member of the oncology team considered that no chemotherapy is indicated at this stage, but CEA and my general state of health should be carefully monitored. I agreed with this, so that is the approach we will take.
The plan is:
A not so good result today were my liver function tests, some were abnormal. This is likely due to recovery after the surgery but I will get follow up tests done in 2 weeks via my GP. I guess my slow recovery (by my expectations) is due to my liver taking its time getting back up to full performance.
Currently I expect to start work mid to later next week, I still have energy problems, but they are getting better every day.
Overall, I feel pretty positive and we are both looking forward to years of good times.
This afternoon we visited the oncologist to work further through the process of determining whether I should have chemotherapy. Initially the consultation session came up with a strategy based on 1/2 bottle of wine a day, plus chocolate, then the oncologist came in and the administrator, who is a friend of ours left, the oncologist was not confident that Kerry's approach would be of benefit.
The good news is that my CEA test, taken 2 weeks ago, is 1.8. This is right in the middle of the normal range for a non-smoker, and strongly suggests no tumour is present. After going through the figures again, and getting some more data, Teresa, the oncologist and another member of the oncology team considered that no chemotherapy is indicated at this stage, but CEA and my general state of health should be carefully monitored. I agreed with this, so that is the approach we will take.
The plan is:
- CEA test 3 monthly, arranged via my GP
- Review 6 monthly by the oncology dept, for at least 2 years
- Continuing reviews by the colo-rectal unit, currently 6 monthly with 2 yearly colonoscopies
A not so good result today were my liver function tests, some were abnormal. This is likely due to recovery after the surgery but I will get follow up tests done in 2 weeks via my GP. I guess my slow recovery (by my expectations) is due to my liver taking its time getting back up to full performance.
Currently I expect to start work mid to later next week, I still have energy problems, but they are getting better every day.
Overall, I feel pretty positive and we are both looking forward to years of good times.
Wednesday, June 30, 2010
It's All On Today
First up, a new alliance between New Zealand, Australia, Canada and UK is underway to do something about Colon Cancer. In New Zealand today, the Beat Bowel Cancer Aotearoa is launching in Parliament. I will be supporting this effort. Right now, about 100 people a month die in new Zealand due to colo-rectal cancer, around twice the road deaths and more than alcohol related deaths. Both road deaths and alcohol problems get extensive publicity, government education and correction programs, but colo-rectal issues get next to nothing. Why is this?
Second, I am meeting my mother in Christchurch Hospital shortly, my brother is bringing her through from Ashburton for a liver biopsy to try to identify the cause of her liver lesions. At this point the most likely reason is metastatic cancer, but the source in unknown.
And finally, we plan to go to the caravan in Glentunnel this afternoon, until Friday morning. Need to be back to meet with the oncologist on Friday afternoon. Weather is looking good and I am feeling ready for it.
About the oncologist meeting, for the past 2 days I have been researching and thinking about the decision on whether to have chemo or not. That work, plus the fact that I am not able to live life the way I want to due to slow recovery, has really done my head in, and I have got quite depressed. I am feeling better today though.
In terms of the chemo decision, it is clear that there are incremental changes taking place in colon cancer screening and treatment. However it takes at least 5 years to truly evaluate the 3-5 year non-recurrence and survival rate. And some of the promising chemotherapy regimes have proven to have negative consequences over time. Unfortunately most currently available clinical trials do suggest I have limited promise of a 5 year survival, and reading that data is quite depressing, I had expected at least another couple of decades to get everything done that I have in mind. However realistically there is hope and I do have fair cause to expect to be able to hassle people for quite a few years yet.
I have yet to commit to a position on chemotherapy and will be seeking more data on Friday, I also have a few more people to talk to. There is no hurry, but it will be good to get this situation resolved.
Second, I am meeting my mother in Christchurch Hospital shortly, my brother is bringing her through from Ashburton for a liver biopsy to try to identify the cause of her liver lesions. At this point the most likely reason is metastatic cancer, but the source in unknown.
And finally, we plan to go to the caravan in Glentunnel this afternoon, until Friday morning. Need to be back to meet with the oncologist on Friday afternoon. Weather is looking good and I am feeling ready for it.
About the oncologist meeting, for the past 2 days I have been researching and thinking about the decision on whether to have chemo or not. That work, plus the fact that I am not able to live life the way I want to due to slow recovery, has really done my head in, and I have got quite depressed. I am feeling better today though.
In terms of the chemo decision, it is clear that there are incremental changes taking place in colon cancer screening and treatment. However it takes at least 5 years to truly evaluate the 3-5 year non-recurrence and survival rate. And some of the promising chemotherapy regimes have proven to have negative consequences over time. Unfortunately most currently available clinical trials do suggest I have limited promise of a 5 year survival, and reading that data is quite depressing, I had expected at least another couple of decades to get everything done that I have in mind. However realistically there is hope and I do have fair cause to expect to be able to hassle people for quite a few years yet.
I have yet to commit to a position on chemotherapy and will be seeking more data on Friday, I also have a few more people to talk to. There is no hurry, but it will be good to get this situation resolved.
Friday, June 25, 2010
The Visit to my Doctor
Earlier this morning Teresa's two daughters plus the 2.5 year old Grandchildren arrived, Teresa was to look after the kids while their parents were out house hunting. I really struggled to keep up with the level of activity and strange conversation going on, which would suggest I may not be in a position to cope with normal workplace activity - not to say that people at work behave like 2 year olds, at least not all of them ;=)
So then I went to see my Doctor (GP). I explained to Mark that I really felt close to being ready for return to work and how could I fairly quickly get my energy back. He was a bit abrupt with me, effectively said I was nuts to think I would be ready after "only" 4 weeks and should be looking at 6 weeks or more if all does not go well. I am getting the same story from other "experts", so looks like I have to adjust my expectations.
We discussed my sleep issues, he has prescribed some medication but I think I will leave it for a while and see if it resolves without medication. I also raised the question of whether to do chemo or not, he cannot offer any further insight but is available if I want to discuss any options after the next oncology visit, I am still thinking not to do chemo but instead I will keep a close look at how my body is performing.
So back to the boredom for me - sorry, feeling sorry for myself, must harden up.
Next update to this is likely next Friday after the oncology visit.
So then I went to see my Doctor (GP). I explained to Mark that I really felt close to being ready for return to work and how could I fairly quickly get my energy back. He was a bit abrupt with me, effectively said I was nuts to think I would be ready after "only" 4 weeks and should be looking at 6 weeks or more if all does not go well. I am getting the same story from other "experts", so looks like I have to adjust my expectations.
We discussed my sleep issues, he has prescribed some medication but I think I will leave it for a while and see if it resolves without medication. I also raised the question of whether to do chemo or not, he cannot offer any further insight but is available if I want to discuss any options after the next oncology visit, I am still thinking not to do chemo but instead I will keep a close look at how my body is performing.
So back to the boredom for me - sorry, feeling sorry for myself, must harden up.
Next update to this is likely next Friday after the oncology visit.
Thursday, June 24, 2010
Continuing Progress????
This morning I felt great, had planned to meet with my GP today and consider return to work mid to later next week. Quite honestly the way I felt earlier this morning I felt that I should be at work next Monday.
I have been off pain medication since last Monday, weight has stopped going down, after losing 9 Kg, and I have a good appetite, so all is looking good. Only real issue is that I am not sleeping well at all, despite avoiding sleep during the day.
Then reality kicked in. First the GP appointment has been deferred until tomorrow morning, apparently he has to appear in court today, not sure if he is a victim, perpetrator or witness. Then I went out with Teresa to do some shopping, just a couple of shops, one set of stairs, some walking, and some standing. We were out for no more than 1.5 hours. I feel absolutely shattered, my whole body is tired, and this update is taking forever as I am making many mistakes.
I did drive this morning for the first time since surgery, that went OK.
Clearly I have more recovery to go. Over the next few days I will push myself a bit harder, I cannot see how that will do any harm, but will not over do it.
I have been off pain medication since last Monday, weight has stopped going down, after losing 9 Kg, and I have a good appetite, so all is looking good. Only real issue is that I am not sleeping well at all, despite avoiding sleep during the day.
Then reality kicked in. First the GP appointment has been deferred until tomorrow morning, apparently he has to appear in court today, not sure if he is a victim, perpetrator or witness. Then I went out with Teresa to do some shopping, just a couple of shops, one set of stairs, some walking, and some standing. We were out for no more than 1.5 hours. I feel absolutely shattered, my whole body is tired, and this update is taking forever as I am making many mistakes.
I did drive this morning for the first time since surgery, that went OK.
Clearly I have more recovery to go. Over the next few days I will push myself a bit harder, I cannot see how that will do any harm, but will not over do it.
Monday, June 21, 2010
Glentunnel and Back
Saturday morning we packed (the we meaning 99% Teresa) and drove to Glentunnel. We bought lunch on the way at Darfield Bakery - highly recommended. At this stage I was feeling OK. Then we setup the caravan, which for me means connecting power and water and setting up the satellite decoder. I was then absolutely buggered and starting to think this was not a good idea.
Weather on Saturday was good, but forecast for the next few days turned bad, with rain and cold temperatures. I spend most of Saturday afternoon trying to rest, and had a fairly sleepless night, I could not get comfortable, this is most unusual as normally we both sleep well in the caravan. I did feel slightly better after watching the All Black's win over Wales.
Sunday was cold and damp, as forecast. I was feeling quite washed out, last time I felt so bad was about a week ago. So we decided to return home.
Today I am feeling quite good, clearly I was not yet ready to get out, but the experience does not appear to have done any harm.
Plan for this week is to have 2 days of rest and light exercise. Wednesday I will go out visiting for a while, and try to replace the spare wheel on my car, still waiting for that after getting a puncture repaired just before this current wee issue. Then visit GP on Thursday to review blood test results from last Friday and talk about my recovery and return to work prospects.
Weather on Saturday was good, but forecast for the next few days turned bad, with rain and cold temperatures. I spend most of Saturday afternoon trying to rest, and had a fairly sleepless night, I could not get comfortable, this is most unusual as normally we both sleep well in the caravan. I did feel slightly better after watching the All Black's win over Wales.
Sunday was cold and damp, as forecast. I was feeling quite washed out, last time I felt so bad was about a week ago. So we decided to return home.
Today I am feeling quite good, clearly I was not yet ready to get out, but the experience does not appear to have done any harm.
Plan for this week is to have 2 days of rest and light exercise. Wednesday I will go out visiting for a while, and try to replace the spare wheel on my car, still waiting for that after getting a puncture repaired just before this current wee issue. Then visit GP on Thursday to review blood test results from last Friday and talk about my recovery and return to work prospects.
Friday, June 18, 2010
A Visit To The Oncologist
This morning was my second visit to Christchurch Hospital Oncology Dept. The first was 3.5 years ago when it was determined that chemotherapy was not indicated. The oncology consultant I met today (Dean Harris) was a registrar at the time of my first appointment and he was quite upset at the apparent wrong decision made following my first surgery - not to have chemotherapy. However I am still confident that it was the right decision at the time and that I was just unlucky.
We had a long discussion today, basically the situation is that without chemotherapy I have a 60% chance of survival for 5 years. Chemotherapy would increase that by between 10% and 20%, but carries significant risk and side effects. Further, using a 5 point standard indicator for chemotherapy, I get a no on each point, normally a patient would get at least one yes in such an evaluation. Plan is that I return in 2 weeks for a final decision, following blood tests and also some thinking on the part of Teresa and myself as well as some more research and analysis by the oncologist. We have been given a large amount of documentation to look at - homework I guess.
At the moment my thinking is not to proceed with chemotherapy, but this may well change as we learn more.
Recovery is slow, but steady. I coped quite well with the long walk in the hospital, but I find that engaging with more than one person at a time is very tiring.
Tomorrow we go to the caravan at Glentunnel for a few days, weather is not great, but it will do both of us some good to get away. Then meet with my GP around the middle of next week to discuss readiness to return to work, among other things.
We had a long discussion today, basically the situation is that without chemotherapy I have a 60% chance of survival for 5 years. Chemotherapy would increase that by between 10% and 20%, but carries significant risk and side effects. Further, using a 5 point standard indicator for chemotherapy, I get a no on each point, normally a patient would get at least one yes in such an evaluation. Plan is that I return in 2 weeks for a final decision, following blood tests and also some thinking on the part of Teresa and myself as well as some more research and analysis by the oncologist. We have been given a large amount of documentation to look at - homework I guess.
At the moment my thinking is not to proceed with chemotherapy, but this may well change as we learn more.
Recovery is slow, but steady. I coped quite well with the long walk in the hospital, but I find that engaging with more than one person at a time is very tiring.
Tomorrow we go to the caravan at Glentunnel for a few days, weather is not great, but it will do both of us some good to get away. Then meet with my GP around the middle of next week to discuss readiness to return to work, among other things.
Sunday, June 13, 2010
Cold Weather Slowing Me Down
We had planned to go to Glentunnel today to spend a few days in the caravan, but the weather is not good. Cold weather in itself is OK, caravan is warm and well heated, but if I cannot get out and walk around I won't make progress, either physically or mentally. The weather forecast is for snow showers, rain and windy, so we will likely try Glentunnel at the end of this week for a few days.
Progress on recovery is OK, but too slow for me. Yesterday I went to the local library and had to climb stairs to the mezzanine floor, the climb was OK, taken slowly, but I felt quite woozy for a while. My target recovery milestones are not being met on time, but I am not too fussed about that, all is going OK, just a bit slower than I had optimistically estimated. An interesting issue is that I continue to lose about a Kg every 3-4 days, despite eating OK. I guess when my body has finished internal repairs that will stop, I don't want to lose too much weight as I may need it for chemotherapy.
Most mornings I feel quite out of sorts, but by afternoon I am feeling quite good, as long as I don't do too much. Down to panadol 3 times a day now.
Progress on recovery is OK, but too slow for me. Yesterday I went to the local library and had to climb stairs to the mezzanine floor, the climb was OK, taken slowly, but I felt quite woozy for a while. My target recovery milestones are not being met on time, but I am not too fussed about that, all is going OK, just a bit slower than I had optimistically estimated. An interesting issue is that I continue to lose about a Kg every 3-4 days, despite eating OK. I guess when my body has finished internal repairs that will stop, I don't want to lose too much weight as I may need it for chemotherapy.
Most mornings I feel quite out of sorts, but by afternoon I am feeling quite good, as long as I don't do too much. Down to panadol 3 times a day now.
Thursday, June 10, 2010
All Quiet At Home
Possibly more boring than quiet, but I am making slow but steady progress.
I am back on to two panadol 4 times a day, will keep that up for a couple more days. Currently only real issue is VERY sensitive skin on my abdomen, below the scar. Apparently this is quite common and can last for quite a few weeks, it is not a big deal though.
So far I been largely entertaining myself by reading the second and third parts of Steig Karsson's Millennium Trilogy. I had read The Girl With The Dragon Tattoo last year and have been given The Girl Who Played With Fire and The Girl Who Kicked the Hornet's Nest as birthday presents, just prior to my surgery. The first book stands quite well on it's own, but the Fire finishes prematurely and Hornet's Nest would be unintelligible if Fire had not been read first. Currently about half way through Hornet's Nest and can strongly recommend the whole set.
Hoping to get the the caravan in the next day or so, unfortunately weather is not good until later next week, but we both need a change.
Today the appointment with the oncologist arrived - Friday 18 June at 10:00AM. That is when we will discuss chemo options and the approach to be taken. I have got a lot of useful information from The Association of Cancer Online Resources. The colon group has given me much support and useful information, and so far medical professionals have not been upset that I am well prepared.
Got a get well card from some of the team in Twizel - thanks guys, great to see that I am not yet forgotten.
I am back on to two panadol 4 times a day, will keep that up for a couple more days. Currently only real issue is VERY sensitive skin on my abdomen, below the scar. Apparently this is quite common and can last for quite a few weeks, it is not a big deal though.
So far I been largely entertaining myself by reading the second and third parts of Steig Karsson's Millennium Trilogy. I had read The Girl With The Dragon Tattoo last year and have been given The Girl Who Played With Fire and The Girl Who Kicked the Hornet's Nest as birthday presents, just prior to my surgery. The first book stands quite well on it's own, but the Fire finishes prematurely and Hornet's Nest would be unintelligible if Fire had not been read first. Currently about half way through Hornet's Nest and can strongly recommend the whole set.
Hoping to get the the caravan in the next day or so, unfortunately weather is not good until later next week, but we both need a change.
Today the appointment with the oncologist arrived - Friday 18 June at 10:00AM. That is when we will discuss chemo options and the approach to be taken. I have got a lot of useful information from The Association of Cancer Online Resources. The colon group has given me much support and useful information, and so far medical professionals have not been upset that I am well prepared.
Got a get well card from some of the team in Twizel - thanks guys, great to see that I am not yet forgotten.
Tuesday, June 8, 2010
The Weather Is Not Helping
It is quite a wild day today, have had rain, hail, snow sleet, and sunny weather. I have been able to walk to the road twice today, during a break in rain etc.. Yesterday was wet most of the day, so did laps around the house, 10 laps is 500 metres, OK for walk exercise, but not very exciting.
I took my staples out yesterday, no drama, and feel better for it. Today I am down to one panadol 4 times a day, from two 4 times a day up until yesterday. May have been a bit premature as there is now some discomfort in my upper abdomen and I have an occasional headache. If this does not come right later today I will go back to two for another couple of days. Nurse Maud called today, can do nothing for me so won't come back. Plan is for me to see my GP around next Tuesday and look at progress and readiness for work in the future.
Tummy is now performing more reliably than prior to the surgery, but from past experience all hell can break loose at any time.
Jay from work called to see how I was going, it was good to get the call. He did comment that my milestones were targeting return to work rather than recovery, fair enough, but I am not changing them.
I took my staples out yesterday, no drama, and feel better for it. Today I am down to one panadol 4 times a day, from two 4 times a day up until yesterday. May have been a bit premature as there is now some discomfort in my upper abdomen and I have an occasional headache. If this does not come right later today I will go back to two for another couple of days. Nurse Maud called today, can do nothing for me so won't come back. Plan is for me to see my GP around next Tuesday and look at progress and readiness for work in the future.
Tummy is now performing more reliably than prior to the surgery, but from past experience all hell can break loose at any time.
Jay from work called to see how I was going, it was good to get the call. He did comment that my milestones were targeting return to work rather than recovery, fair enough, but I am not changing them.
Sunday, June 6, 2010
Depressing Sunday
The weather is cold and wet, I am bored and frustrated, tummy is acting up and I have a sick head.
Having got that out of the way, I am doing OK. Tummys normally act up after gallbladder removal and of course a long term impact of colon resection is instability there. Immodium is my friend. Only pain killer now is panadol, today not feeling pain while static and I expect to start to slowly cut back on panadol tomorrow.
The surgical staples are still in, research suggested 10-14 days to come out, likely they will be out tomorrow.
I have put together a recovery calendar, it is an indicative target only and shows me back at work from 21st of this month. At this stage I really don't know if this is realistic, but I have milestones along the way, if I meet them I should make the target for back to work.
I really appreciate the fantastic support and encouragement I am getting from family, friends, workmates and people I have never met. It give a nice, warm and very humble feeling.
Having got that out of the way, I am doing OK. Tummys normally act up after gallbladder removal and of course a long term impact of colon resection is instability there. Immodium is my friend. Only pain killer now is panadol, today not feeling pain while static and I expect to start to slowly cut back on panadol tomorrow.
The surgical staples are still in, research suggested 10-14 days to come out, likely they will be out tomorrow.
I have put together a recovery calendar, it is an indicative target only and shows me back at work from 21st of this month. At this stage I really don't know if this is realistic, but I have milestones along the way, if I meet them I should make the target for back to work.
I really appreciate the fantastic support and encouragement I am getting from family, friends, workmates and people I have never met. It give a nice, warm and very humble feeling.
Thursday, June 3, 2010
The Surgeon Is Finished With Me
Just returned from surgical clinic. All OK. The major object removed was confirmed as metastatic colon cancer and the resection was well surrounded by cancer free tissue. The other small object was a duct defect, likely there since birth.
Next step is to remove staples early next week, either I can do them or my GP's nurse can. I will likely do them myself unless the wound has a problem.
I can expect a appointment in oncology within a few weeks, to agree the approach to chemotherapy and get it under way.
Feeling good although the walk from the hospital car park, within the hospital, and back was a bit of an effort.
My sister called in before we left today. My mother is not in good shape, very yellow and just wants to sleep, unfortunately she is around 90Kms from us and I am not up to the trip yet.
Next step is to remove staples early next week, either I can do them or my GP's nurse can. I will likely do them myself unless the wound has a problem.
I can expect a appointment in oncology within a few weeks, to agree the approach to chemotherapy and get it under way.
Feeling good although the walk from the hospital car park, within the hospital, and back was a bit of an effort.
My sister called in before we left today. My mother is not in good shape, very yellow and just wants to sleep, unfortunately she is around 90Kms from us and I am not up to the trip yet.
Tuesday, June 1, 2010
Tuesday
Woke with real pain, first time this surgery, about 2-3 on the pain scale. By mid-afternoon the panadol and voltaren are doing their thing and I am starting to feel comfortable.
Nurse Maud in to check the wound, all OK. Apparently they will be in weekly from now, I don't quite see the point as the wound is very clean and tidy.
Sleep is still a real problem. Google advises that this is typical after major surgery and I just need to get over, should be OK within 2 to 3 weeks but in the meantime I must avoid napping during the day.
Late afternoon my sister called. She was with my mother at her GP today and apparently a recent scan on my mother shows several lesions on her liver. Not good news, it really hit me quite hard. Mum is 86.
Nurse Maud in to check the wound, all OK. Apparently they will be in weekly from now, I don't quite see the point as the wound is very clean and tidy.
Sleep is still a real problem. Google advises that this is typical after major surgery and I just need to get over, should be OK within 2 to 3 weeks but in the meantime I must avoid napping during the day.
Late afternoon my sister called. She was with my mother at her GP today and apparently a recent scan on my mother shows several lesions on her liver. Not good news, it really hit me quite hard. Mum is 86.
Bad Day Monday
Felt really sluggish all day and clearly I have a cold or similar. To make it worse it is clear, by end of day, that the local anesthetic has done it's dash. I step up the panadol and voltaren. I also have codeine available but would rather avoid that stuff.
Near panic by end of day as my temp goes over 38. I am supposed to call the surgical team if that happens, but it settles down and is probably caused by the cold virus. I do feel quite sick.
Bright spot of the day is a great card I got from the Wellington work team members. I really appreciate that card.
Near panic by end of day as my temp goes over 38. I am supposed to call the surgical team if that happens, but it settles down and is probably caused by the cold virus. I do feel quite sick.
Bright spot of the day is a great card I got from the Wellington work team members. I really appreciate that card.
OK Sunday, For A While
Day started well, felt good. I had noticed that the area under the scar was quite numb - clearly the local anesthetic is still there.
Decided to start reducing the panadol from 8 tablets a day to 6 and cut out the voltaren, seemed logical due to lack of pain - bad choice.
Had visitors, Nurse Maud to check wound and local friends. Then started sneezing and coughing, just like a couple of nurses at hospital.
Decided to start reducing the panadol from 8 tablets a day to 6 and cut out the voltaren, seemed logical due to lack of pain - bad choice.
Had visitors, Nurse Maud to check wound and local friends. Then started sneezing and coughing, just like a couple of nurses at hospital.
Tired Saturday
After a poor night's sleep I struggled to get out of bed, really felt I had overdone it the previous day.
Early afternoon Nurse Maud acute services called and removed the pain catheter. She also removed the wound covering, it looks good, the row of steel staples looks really impressive.
I now have my first proper shower since Tuesday.
Early afternoon Nurse Maud acute services called and removed the pain catheter. She also removed the wound covering, it looks good, the row of steel staples looks really impressive.
I now have my first proper shower since Tuesday.
Home Day Zero
Arrived early afternoon feeling quite proud of myself, but Teresa was not happy, she felt very poorly equipped to deal with a patient that really should be still in hospital.
I was feeling fit and pain free, really started to wonder why it would take 4-6 weeks to recover.
Then followed a stream of visitors:
I was feeling fit and pain free, really started to wonder why it would take 4-6 weeks to recover.
Then followed a stream of visitors:
- Melanie from work, good to see her and thanks guys for the magazines
- Nurse Maud acute outworker to check my vitals and make sure we understood what was going on
- Brother Murray from Ashburton
Exit Lounge
I left the Surgical Recovery Unit Thursday afternoon feeling great. The main reason was that I had two local anesthetic infusion catheters in my quite impressive scar. The scar is held together with around 40 steel clips.
The catheters were fed with a PainBuster post-op pain relief system. It worked, I really had no pain. I was offered panadol, which I refused as I did not seem to need it. I also had a PCA which allowed me to pump morphine into my IV line as required. The only time I used it the morphine made me feel quite sick in the head.
The nursing and surgical were surprised at my lack of additional pain medication, I had various reasons, such as being a male I have a high pain threshold, but I don't think my reasons were taken very seriously.
Next step was into a general surgical ward, where I got a single room, with ensuite. I had not expected that, but it did mean I got my best night's sleep for a long time.
Friday morning my catheter was removed and I was off supplementary oxygen. Then the surgeon arrived and asked if I wanted to go home that day (Friday) as part of a fast track release program. This was a surprise, it was less than 2 days since surgery. That meant that I would be leaving with my pain relief catheters still in as the system would not finish until Saturday.
The acute nursing staff then briefed me on the fast track release program and confirmed that I still wished to go ahead with it. I definitely was not pressured into leaving early.
Teresa arrived at 11:00 AM and was shocked at me leaving so soon. The Hospital really should have involved carers in the decision process.
We left the hospital and were home by about 2:30 PM.
The catheters were fed with a PainBuster post-op pain relief system. It worked, I really had no pain. I was offered panadol, which I refused as I did not seem to need it. I also had a PCA which allowed me to pump morphine into my IV line as required. The only time I used it the morphine made me feel quite sick in the head.
The nursing and surgical were surprised at my lack of additional pain medication, I had various reasons, such as being a male I have a high pain threshold, but I don't think my reasons were taken very seriously.
Next step was into a general surgical ward, where I got a single room, with ensuite. I had not expected that, but it did mean I got my best night's sleep for a long time.
Friday morning my catheter was removed and I was off supplementary oxygen. Then the surgeon arrived and asked if I wanted to go home that day (Friday) as part of a fast track release program. This was a surprise, it was less than 2 days since surgery. That meant that I would be leaving with my pain relief catheters still in as the system would not finish until Saturday.
The acute nursing staff then briefed me on the fast track release program and confirmed that I still wished to go ahead with it. I definitely was not pressured into leaving early.
Teresa arrived at 11:00 AM and was shocked at me leaving so soon. The Hospital really should have involved carers in the decision process.
We left the hospital and were home by about 2:30 PM.
The Surgery
Surgery started at about 2:00 PM on 26th May and was over about 5:00 PM. Once in the Surgical Recovery Unit after surgery I vaguely recall Saxon Connor telling me that it had all gone well, and that he took out 2 objects. One was the identified lesion, the other was a small object found during direct hand ultra-scanning of my liver during surgery. Most likely the small object was a fatty deposit but would be identified during pathology of both objects.
Teresa came in to see me in the evening following surgery, but I have little recollection of that.
I stayed in the surgical recovery unit, a small 6 bed unit part way between a normal ward and an intensive care unit, until 2:00 PM on 27th May. What really surprised me was that I had no pain, I felt quite good and could move around easily.
Prior to surgery I was given various expectations as to the length of my stay in hospital,generally there were between four to six days.
Teresa came in to see me in the evening following surgery, but I have little recollection of that.
I stayed in the surgical recovery unit, a small 6 bed unit part way between a normal ward and an intensive care unit, until 2:00 PM on 27th May. What really surprised me was that I had no pain, I felt quite good and could move around easily.
Prior to surgery I was given various expectations as to the length of my stay in hospital,generally there were between four to six days.
The Plan
On 6 May I met with Saxon Connor Hepatopancreaticobiliary Surgeon at Christchurch Hospital. An interesting person, very active, but happy to answer any and all questions. He seemed confident that the tumor could be removed safely, but of course detailed all the risks.
He also proposed to remove my gallbladder, as it would get in the way of the liver surgery and removal should not have a significant impact on my quality of life.
We discussed further treatment following surgery, he considered that chemotherapy would be a good idea, even if it appeared that all tumors were removed. Following my original surgery in 2006 the oncologist evaluated my condition and said that I had a less than 2% of the original cancer spreading. Due to the impact of chemotherapy on me and based on the low probability that it would do any good we agreed to do no subsequent chemotherapy - sometimes we make the wrong decisions.
Saxon explained that, based on past cases, I had a 45% probability of surviving 3 years and a 24% chance of surviving 5 years. A bit rough but it is reality when a cancer type is invasive, as mine clearly is. Chemotherapy would increase both percentages by about 15%, so it looks viable.
I was offered a couple of dates for surgery, I selected 26th May as the first available.
He also proposed to remove my gallbladder, as it would get in the way of the liver surgery and removal should not have a significant impact on my quality of life.
We discussed further treatment following surgery, he considered that chemotherapy would be a good idea, even if it appeared that all tumors were removed. Following my original surgery in 2006 the oncologist evaluated my condition and said that I had a less than 2% of the original cancer spreading. Due to the impact of chemotherapy on me and based on the low probability that it would do any good we agreed to do no subsequent chemotherapy - sometimes we make the wrong decisions.
Saxon explained that, based on past cases, I had a 45% probability of surviving 3 years and a 24% chance of surviving 5 years. A bit rough but it is reality when a cancer type is invasive, as mine clearly is. Chemotherapy would increase both percentages by about 15%, so it looks viable.
I was offered a couple of dates for surgery, I selected 26th May as the first available.
The Sky Falls In
By March 2010 I decided I was accountable for my health and needed to get proactive. Why I waited so long I have no idea. I met with my GP, explained the situation and asked for a CEA blood test, he scheduled a full set of tests, including liver functions.
Just over a week later we returned from a weekend away in the caravan to find a phone message from the GP, left on Saturday morning, asking me to contact him by cell phone to discuss the blood test results.
I called him, all the blood results were fine except that CEA was 20.8!
Very quickly the hospital scheduled a CAT scan of head, chest and abdomen and on 21st April I met with the colon surgical team.
Prior to the meeting the worst possible outcome for me was no tumors detected by the CAT scan, which, with a CEA of 20, would indicate multiple small tumors through out my body, second worse was something in my brain.
Fortunately (??) a single 26mm lesion was evident in my liver. I was VERY relieved, actually felt quite happy with the discovery.
Next step was for a meeting with the liver specialist.
Just over a week later we returned from a weekend away in the caravan to find a phone message from the GP, left on Saturday morning, asking me to contact him by cell phone to discuss the blood test results.
I called him, all the blood results were fine except that CEA was 20.8!
Very quickly the hospital scheduled a CAT scan of head, chest and abdomen and on 21st April I met with the colon surgical team.
Prior to the meeting the worst possible outcome for me was no tumors detected by the CAT scan, which, with a CEA of 20, would indicate multiple small tumors through out my body, second worse was something in my brain.
Fortunately (??) a single 26mm lesion was evident in my liver. I was VERY relieved, actually felt quite happy with the discovery.
Next step was for a meeting with the liver specialist.
A Wee Glitch
In May 2009 a blood test taken as part of my regular 6 monthly check up showed a CEA level of 8. To say the least, this was a shock. Follow up was a chest and abdomen CAT scan, result showed no abnormality, but I was aware that small tumours would not show up.
Despite reassurances from the medical team I was very apprehensive and waited for the next CEA test, due in November 2009.
However come November, the colon outpatients clinics were delayed until December, then February, than March. Apparently the colon clinic nurse had broken her ankle and had no backup.
Becaue of a sense of impending doom I was not a happy chappie, very emotionally fragile (sorry Teresa, family, friends and co-workers) and worst of all for me, I started getting persistent headaches in late 2009.
Despite reassurances from the medical team I was very apprehensive and waited for the next CEA test, due in November 2009.
However come November, the colon outpatients clinics were delayed until December, then February, than March. Apparently the colon clinic nurse had broken her ankle and had no backup.
Becaue of a sense of impending doom I was not a happy chappie, very emotionally fragile (sorry Teresa, family, friends and co-workers) and worst of all for me, I started getting persistent headaches in late 2009.
CEA
Over the past few years I have developed a close relationship with CEA, but it is a very volatile relationship.
CEA is carcinoembryonic antigen and is produced when colon cancer is established outside the colon through a process called Metastasis. Before my colon resection my CEA level was less than one which typically means that the cancer had not spread even though it was well established at the original site. Generally any level below 5 can be caused a number of fairly normal conditions. Between 5 and 10 would indicate some form of lesion or colon related trouble, but not necessarily malignant cancer. A CEA of over 10 indicates that colon cancer has almost certainly spread and over 20 would indicate the presence of many small or few large metastatic tumors.
CEA is carcinoembryonic antigen and is produced when colon cancer is established outside the colon through a process called Metastasis. Before my colon resection my CEA level was less than one which typically means that the cancer had not spread even though it was well established at the original site. Generally any level below 5 can be caused a number of fairly normal conditions. Between 5 and 10 would indicate some form of lesion or colon related trouble, but not necessarily malignant cancer. A CEA of over 10 indicates that colon cancer has almost certainly spread and over 20 would indicate the presence of many small or few large metastatic tumors.
Home and Recovery
I left hospital on 22nd October 2006, still quite weak and having lost 7Kg. Over the next 5 weeks strength built up and I was ready for work.
Cancer was sorted - or so I believed and apart from 6 monthly checks for 7 years I could put the big C behind me.
There were ongoing impacts though, prior to the surgery I could comfortably do 8-10 hours manual work on our property, after I run out of puff after 4 hours. And certain foods can have rather spectacular results on my digestive system.
Cancer was sorted - or so I believed and apart from 6 monthly checks for 7 years I could put the big C behind me.
There were ongoing impacts though, prior to the surgery I could comfortably do 8-10 hours manual work on our property, after I run out of puff after 4 hours. And certain foods can have rather spectacular results on my digestive system.
Colon Resection
In early October 2006 I attended a pre-admission clinic at Christchurch Public Hospital. The objectives were to ensure I fully understood what was to happen, that I was ready for surgery and that I was prepared for the consequences, the greatest potential consequence being a tempory or permanent colostomy. I was not impressed with the idea of the colostomy however I did learn shortly after that a person that used to help us on our property had had one for over 40 years, and he seemed very fit and healthy.
Friday 13th October was the big day. Surgery was in the afternoon, it went well, but I have little recollection of the event. However there was a small hitch - during preadmission I had agreed to an epidural anesthesia for pain management, however the procedure for inserting the epidural did not go well, anethesia was not able to be introduced via the epidural, but the tube was left in.
Following surgery I was given very limited pain relief as I had an epidural (cue Tui's ad). During the following day the pain was intense and excrutiating. The pain team arrived and administered Ketamine. It did the job, but produced a strong hallucinogenic reaction in me. After a couple of hours pain was down to 2-3 on the pain scale of 1 (no pain) to 5 (worst possible pain). Pain was persistent for 5 to 6 days.
Friday 13th October was the big day. Surgery was in the afternoon, it went well, but I have little recollection of the event. However there was a small hitch - during preadmission I had agreed to an epidural anesthesia for pain management, however the procedure for inserting the epidural did not go well, anethesia was not able to be introduced via the epidural, but the tube was left in.
Following surgery I was given very limited pain relief as I had an epidural (cue Tui's ad). During the following day the pain was intense and excrutiating. The pain team arrived and administered Ketamine. It did the job, but produced a strong hallucinogenic reaction in me. After a couple of hours pain was down to 2-3 on the pain scale of 1 (no pain) to 5 (worst possible pain). Pain was persistent for 5 to 6 days.
The start of it all
In August 2006, after ignoring blood leaking from where it should not I visited my GP for a checkup. He strongly advised an investigation of my colon. The options available were a barium enema via the public hospital system, which could take up to 6 months, or a colonoscopy through a private specialist which could happen within 10 days. I went with the colonoscopy and selected Frank Frizelle. I had met Frank a couple of years earlier when he performed emergency surgery on Teresa's mother following a perforated ulcer.
On 21st August I experienced my first colonoscopy and had expected it to confirm Irritable Bowel Syndrome or an ulcer, both due to the stress I had been experiencing. I will never forget waking from the procedure and being told that I had cancer.
A couple of days later I had a CT scan and chest X-Ray and met with the surgeon on 24th to plan the next steps. My choices were to ignore the cancer and live for another year or so with reducing quality of life (no way), or remove a segment of colon, either privately at a cost of around $40,000 or via the public hospital system. I went public and certainly do not regret that decision. As I was already locked in with Frank he would be my consulting surgeon in Christchurch Public Hospital.
On 21st August I experienced my first colonoscopy and had expected it to confirm Irritable Bowel Syndrome or an ulcer, both due to the stress I had been experiencing. I will never forget waking from the procedure and being told that I had cancer.
A couple of days later I had a CT scan and chest X-Ray and met with the surgeon on 24th to plan the next steps. My choices were to ignore the cancer and live for another year or so with reducing quality of life (no way), or remove a segment of colon, either privately at a cost of around $40,000 or via the public hospital system. I went public and certainly do not regret that decision. As I was already locked in with Frank he would be my consulting surgeon in Christchurch Public Hospital.
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