Surgery, Immunisations and stuff

Phew, it was a big day on Thursday. In the morning we walked the 1.5 km over to the hospital for appointments with the surgeon, the nutritionist and the stem cell coordinator (who later walked into a bar…), after that we had another short walk to catch up with a friend for lunch, then it was back to the hospital to pick up some medications and then we walked back to the apartment.  When we got home it was a matter of go straight to bed, do not pass go do not collect $200.

At the appointment with the surgeon I was told me all about the upcoming surgery, at the appointment with the stem cell coordinator I was told all about upcoming immunisations, at the appointment with the nutritionist I was told to eat more food. Guess which appointment was my favourite.

The surgery I am having is known as a bilateral retroperitoneal lymph node dissection. Be careful not to say that too quickly or you may require some surgery yourself. It is scheduled for the 15th of July and it will be done at St Vincent’s hospital instead of Peter mac as St V’s has a couple of addition surgical services on hand that are not available at Peter Mac. This will be my first major procedure to be done away from Peter Mac so we will see how we go, hopefully the surgeon is better at his job than I ever was at this game:

The purpose of the surgery is to remove two enlarged lymph nodes in my abdomen, one of these lymph nodes is low down in my groin near the psoas muscle, the other node is higher up and sits next to the aorta (the major blood vessel that goes down to the legs). Additional lymph nodes around the enlarged nodes will also be removed as a safety measure as there is a chance they may also be diseased, overall about 10% of my lymph nodes will be removed. 10% may sound a lot but like a lot of the body’s systems the lymphatic system has plenty of reserve capacity built in, so I shouldn’t miss them under normal circumstances.

The surgery itself will take about four hours. To gain access to the lymph nodes the surgeon will make an incision in my abdomen from just below my sternum down to a bit below my belly button, so I should end up with another fine scar to add to my collection. I will have to make up another story as to how I got this one, shark attack maybe? Done that one. Or defending little old ladies from a rampaging hoard of thugs? Dunno, I’m open to suggestions, here is a pic of an RPLND scar for inspiration, sorry if you are eating your breakfast while reading this:

After making the incision the surgeon will take out my bowel and plonk it on the table next to me while giving a stern warning to the nurses that my bowel is not a skipping rope and it should not be used as such, thank you very much, and no I don’t care how hungry your dog is, you cannot take it home as we need to shove it all back in somehow before we are done.

 Once my bowel is out of the way the surgeon will shove the other organs aside, identify the things like blood vessels and nerves that need to be protected and then get on with the task of identifying what should and shouldn’t be removed (“no nurse, that is not an enlarged lymph node that is his liver, we will leave it in as he might need it”). Once the diseased and suspect lymph nodes have been removed everything is put back where it should be and I am sewn up with a nice fancy needle work. Simple.

The usual warnings about this being major surgery with the attendant potential risks and complications apply, blah blah blah.

Recovery will require a stay in hospital of between five and seven days. Most of the post-surgery complications involve the bowel, which understandably gets a bit upset by being yoinked out of my body and then shoved back in again. We’ll see how we go.

 

I learnt some more interesting stuff during my appointment with my stem cell coordinator Trish (who has been an absolute marvel throughout this whole process). Even though my blood counts have returned to normal and I have a functioning immune system again it turns out that I do not have a fully functioning immune system.  The process of destroying my immune system and then restarting it with the stem cell transplants has led it loosing it’s ‘memory’ i.e. my immune system no longer fully recognises a lot of the diseases that I was vaccinated against as a kid and therefore it may not make an effective response if I am exposed to them, which leaves me open some pretty nasty infections. To combat this I will need to be re-vaccinated, as I will be receiving injections usually received by babies I fully intend to cry like a baby when I get them. The re-vaccination won’t happen for a couple of months as my immune system needs to build up a bit of strength of its own first, in the mean time I need to continue to avoid sick people, which is kinda hard to do when you have to hang around hospitals so much! We’ll see how we go.

Cheers, Pete.