So What Happened?

As a reader of this blog would realise, this surgery and initial recovery did not go as per my earlier liver resection on 26th May last year.

From my own faulty recollection and Teresa's input, the surgery completed as scheduled a little after 6:00 PM, it started shortly after 2:00 PM.  I went into recovery until about 10:20 PM then was transferred to the Special Care Unit.  My first memory is of a nurse phoning Teresa so that I would talk to her about 10:30 PM.  At this stage all was as expected.

The next morning, Saturday, I had little pain but felt very ill.  The main issues were very low blood pressure, vomiting and Postoperative Confusion (POCD) .

In order to resolve the low blood pressure I was literally pumped full of intravenous saline solution.  I suspect I may have had some drugs to help as well.  I am not sure yet, but I think the low blood pressure was as a result of some drug administered during surgery to reduce bleeding from the liver.  I gradually recovered normal blood pressure and by Monday morning was around my normal levels, but I was like a balloon.

The vomiting may have been complicated by the excess fluids, I don't normally have this problem after surgery.  In order to assist to resolve it a Nasal Gastric tube was inserted.  While the insertion process was not too bad, I would not recommend it as a required life experience.  With the tube in place my stomach contents were sucked out.   Nothing bad was found, but lots of fluid.  I continued to suffer from nausea until Tuesday, but medication pretty much controlled it.

The POCD was "interesting".  I was warned about the potential for it before surgery.  Apparently it's probability increases as I get older and the more time I spend under general anesthetic.  For me, it meant that I was quite confused at times, even paranoid.  At one stage I believed that there was some conspiracy to kill me!  Looking back it seems stupid but it was very real and disturbing at the time.  That has resolved during this week, but I do feel for some of the abuse the nursing staff got from me.

Overall these problems seem no big deal, but I was very concerned about my state of health at the time.  Only after I got home Teresa told me that  one of the Registrars had said that I borderline on recovery, I assume without having to go into the Intensive Care Unit for a while.

On Monday I went into a general surgical ward (the normal stay in the Special Care Unit is usually only about one day) and gradually recovered until release on Wednesday.

Recovery at home has been a struggle, I have suffered from nausea at times (with no vomiting) and also some diarrhea.  For the past 2 days I have got more lazy and not pushed myself as much.  I am sleeping 14 hours a day but have my full appetite back and I am feeling quite good with little pain.

Looking back at progress from my last liver surgery, I am now in the about the same point as last time.  I am losing 1Kg of weight a day (same as last time) but this should stabilise over the next few days.

Writing this post has been a real struggle, my brain still has a way to go to recover.

Back again

Jut a quick update.

• The surgery went as planned
• I came home Wednesday afternoon
• This has been a very tough time, but I am OK and getting a little better each day.

More in a few days.

All Clear For 4th Surgery

Last week I had an MRI of the liver area, to try to identify the smaller lesions.  This was not particularly successful, the MRI is only showing the main lesion.  The plan is to remove the right side of the liver and scan the rest with ultra-sound during surgery.  If the ultra-sound does pick up any anomalies they will be taken out, if possible.  I am cleared to have up to 70% of my liver removed.

While at the MRI clinic I got my CEA results from shortly after the lung resection. My  CEA was 2.4, which is just within the normal range of 0-2.5.  Before chemo my CEA was 7.3.  Clearly the chemo has done a great job of reducing the cancer, but my normal is around 1.0 and with no further action now the CEA value would start climbing soon.

This morning I attended the pre-admission clinic ahead of my liver surgery on Friday afternoon.  It was quite a drawn out process, but very thorough.  During my time at the clinic I had:

• A very thorough evaluation by a nurse
• Much blood taken
• An electrocardiogram
• Another evaluation and discussion about the surgery with a surgical registrar
• Yet another evaluation, discussion and consent signing by an anaesthetist
• A chest X-ray, to make sure my lung has recovered OK from the lung resection

I left the clinic with 2 sets of nutritional drinks to be taken over the next 3 days.  This should prepare my body for surgery and help recovery.

I check into the hospital at 11:00AM on Friday, apparently surgery will start about 1:00PM.  Assuming all goes well, there should be another update here next Monday or Tuesday, once I am out of hospital.

Liver Surgery #2 Scheduled

Today we met with the liver surgeon, as expected the next step is surgery to remove the lesions in my liver.  Despite many scans there is still some uncertainty as to what is possibly cancer metastatic tumours and what may be fatty deposits.  In order to get an up to date picture I will have another MRI scan next week.

At this stage it looks like about 60% of my liver will be removed, but surprisingly I was told that in general my recovery time is not affected by the amount of liver removed, as long as at least 30% remains.

The surgery is scheduled for 16th September, before then I will have another session with the liver surgeon next Friday 9th September to confirm the likely approach, based on the MRI results and a review with the multi-disciplinary committee, due next Thursday.  I will also need to attend a pre-admission clinic some time in the next 2 weeks.

It is good that it is all happening quickly, but the speed does surprise me a bit.