Liver resection surgery

Several weeks passed and nothing happened. I was beginning to think I had been forgotten when Georgia, the cancer nurse from Poole phoned to ask what was happening. When I told her that I’d heard nothing, she seemed concerned, and said she would follow it up. True to her word, I received a letter from Southampton to say the operation would take place on Mon 22 August, just 10 days away. I felt a combination of relief and apprehension.

The following Wednesday we went to Southampton for the pre-operative tests. Sadly, before we left I received a text message from my friend Steve in which he implied that his death was near and wishing me well for my operation. It was a really moving message, in which he thanked me for 40 years of friendship, and for sharing our experiences during the previous 6 months. I was deeply moved. All went well with the tests, but when we got home, Steve’s son Robert phoned to say that his dad had died that morning. That was a real blow for Masha and me even though we had expected it. Steve and his family had been our close friends since moving to Wareham in 1976.

The previous day I had received an appointment for a PET scan which I attended the day after the Southampton visit. It involved taking a small dose of radio active material, followed by a full body scan. The radiologist told me afterwards that each scan cost over £1000. I wonder what I am costing the NHS. I am just thankful for its existence.

We had only just arrived home from the scan, when the hospital rang to say that there were shadows on my lungs, and asking me back in the afternoon for a further CT scan. It was not the happiest of afternoons for Masha and me, but when we arrived home the hospital rang a second time to say that all was clear. A false alarm, but a bit of a worrying one.

The surgery was due on the following Monday, but on the Friday Southampton hospital rang to say that the operation had been postponed because they were unable to get an anaesthetist. I was disappointed, but later in the afternoon the phoned back to say that it would go ahead on the Thursday. Only a 3 day delay.

On the Monday I began the pre-surgery diet; no alcohol and restricted food intake. On the Tuesday we went to the theatre in Bournemouth to see “Dirty dancing” to take my mind off what was coming up. Unfortunately, the storyline was not to my liking and the production was hopeless. I couldn’t even dull the pain with a few pints!

The next day I was due to report to the hospital at 3pm. We stopped on the way at a Golf-course for lunch, and the prospect of another fairly major operation, did make me feel a bit low. One of the most common symptoms of cancer is depression, but luckily I hadn’t really felt down apart from the first couple of days after the initial diagnosis. That Wednesday was the nearest I got.

When we arrived, I was put into a pre-surgery ward, but soon after Masha left, I was told that they were short-staffed’ and I was moved to the post operation cancer ward. I never understood why they called me in the day before the operation, but that sleepless night in a ward filled with moans and groans and with the prospect of surgery the next day, meant that the night was almost as bad as the one before the first operation. To cap it all, I was told late in the evening that my operation was scheduled for the following afternoon. Yet more hanging about. I think it must have been worse for Masha because I phoned and moaned at her several times and there was nothing she could do about it of course.

The following morning passed slowly, but at last at about 1.30pm, I was taken to the anaesthetic room to prepare for the surgery. Once again, the team of anaesthetics were fantastic. They reassured me that all would be well and that when I awoke I would be in the High Dependency Unit where I would be given special care before returning to the normal ward. As with the previous operation, I have no memory of passing out, and sure enough I woke up in the HDU about 7 hours later. There were only 3 of us in the ward and we were looked after by 2 superb nurses who catered for our every need. In my case it included changing my stoma bag. Not everyone’s activity of choice! By the following morning they had me out of bed, and by lunchtime I even walked down the corridor with their support.

After lunch, Masha arrived. It was fantastic to see her, and I appreciated that to get to Southampton hospital involved a 2 hour journey each way. including a car, a train and a bus journey. Despite that, she visited each day I was there which made the stay in hospital that much more bearable.

As after the previous operation, my stomach had several small cuts where the keyhole surgery entered, and one larger scar where they removed the liver and call bladder. Ironically, the scar this time was just above the pelvic bone, whereas for the bowel surgery the main scar was in the central stomach area. It all seemed the wrong way around, but I think they knew what they were doing.  Once again, I was connected to a catheter, and several tubes and drains, which made moving around quite difficult. In all I had about 14 cuts into my stomach during the 2 operations. I felt a bit like a pin cushion. Apart from the first night in the main ward, I had very little pain, and only needed a few paracetamol tablets during the first couple of days after surgery. I was lucky.

During the next couple of days, I was kept moving as much as possible. And one by one the various tubes were removed. As previously the nurses and doctors were great, but again it was clear that they were working under considerable stresses. I hope it isn’t typical, but once again I shared the ward with and incredibly difficult man. Not only did he call out throughout the day and night, but he constantly insulted the nurses, even racially abusing one as she did her best to clean him up. How anyone could be quite so unpleasant, I don’t understand. It is a credit to the nursing staff that the carry on with their dedicated work despite the likes of him.

The operation had been on the Thursday, and by Monday they decided that I could go home. Before I was signed out I was examined by My Armstrong’s assistant, who discovered that the drain from my liver on the right side was still leaking bile, and that it should therefore remain in place for another 10 days. He arranged for me to see him at Bournemouth on the following Wednesday. That seemed OK, but it was uncomfortable to have a second stoma type bag next to the original one.

As ever the fantastic Masha was there to pick me up, and for the second time in a couple of months it felt great to be going home. They had warned me, but for the first few weeks after the operation, I felt totally exhausted. As with the previous operation, I made myself walk a bit further each day, and gradually my strength returned.

Two days after I came out of hospital, Steve Cooper’s memorial service took place in Bere Regis. I was sad to miss it, but Masha along with 200+ people did attend, which was a measure of his popularity. Since our diagnoses were just weeks apart, and because of the time that we had time spent together, I have really missed Steve, and realise how lucky I have been to survive so far.

Bowel surgery

The four weeks waiting for the bowel surgery were long ones. It was a combination of apprehension about the unknow, whilst at the same time wanting the whole experience to be over and done with. Deep in my mind I also knew that when it was over I still had to face major surgery on my liver and possibly another round of chemo, before a final operation to reverse the stoma. I tried hard not to dwell on that.

It is also difficult to avoid the “what ifs” crossing your mind: what if I get a bad cold, what if the surgeon falls ill, what if there is a power-cut during the operation, and so on. In the end, it was an unpredicted what if that caused the problems.

At last the day of surgery approached. My operation was due on Tuesday 6^th June, and on the Sunday before I could only eat “light meals.” On the Monday morning, the laxative/energy meal regime began. The plan was to take 3 doses of powerful laxative and 4 high energy drinks at set times during the day. I had been warned by a neighbour that Maxilax lived up to its name, and he jokingly said that he expected to hear the results from his house! I think it was a joke!

When nothing had happened by lunchtime, I was surprise, and by teatime I was beginning to worry. At 6 o’clock I was sick for the first time, and by midnight I was retching continuously, but nothing was happening at the other end. That night must rank as one of the worst of my life. On top of being continuously sick, and suffering from awful stomach pains, I became convinced that they wouldn’t be able to operate in the morning. At 3 am we even phoned the hospital, and the rather bewildered nurse simply told us to come in as scheduled. It was a bad night for me, but must have been equally difficult for Masha who just had to sit, watch, worry, and clear up the sick.

At 6.30 we set off for the hospital where we were due at 7.15. Incredibly, as we entered the doors of the hospital I felt the first movements below, and rushed to the nearest toilet. Whether my neighbour who was now 7 miles away heard the resulting explosion I don’t know, but the relief was indescribable. In the next hour before the operation began, I had a further 3 equal episodes, and the pre-operative nurse reassured me that the surgery would go ahead, and that all would be well. He then went through the now familiar list of questions: name, date of birth, have you false teeth, etc etc.

Before that, Masha had left me in the day surgery ward, and so she faced the whole morning, uncertain of whether the operation had gone ahead. It was only when she phoned in the afternoon that she was told that I was in the theatre.

At about 8.30, the nurse led me down to the operation area where I was taken into the anaesthetics room. There were 4 anaesthetists present and they explained what was about to happen in a friendly and reassuring way. At one point the door to the operating theatre was open and I was surprised how many people were there, and how high-tech the whole place looked. 

        The next thing I remember was being in the recovery area, and then being trolleyed to the ward where I would spend the next 5 days. On arrival, the porter told me that I had the best view in the hospital, and indeed my bed which was in a ward of 4 did overlook Poole park, with the harbour beyond. The time was 6.30 which meant that I had been out of it for about 10 hours. I later learnt that the operation itself had taken about 6 hours.

At about 7pm Masha arrived. I think she was as glad to see me as I was her. She had had a really difficult day. Having left me at 8 that morning, it wasn’t until early afternoon that she knew that the operation was going ahead. She then phoned the ward several times to be told that they expected me but that I hadn’t arrived yet. Finally, at 6.30, they said I was there and that she could visit. Probably because of the drugs I had been given, I remember feeling on quite a high that evening. It was just great to have Masha there and to know that the operation had gone ahead, despite the problems of the day before.

The following morning reality set in. On nurse’s orders, I did manage to sit up and eventually get into the bedside chair. It was then that I realised just how sore I was, and how many tubes and bags I was attached to. If you are squeamish you might want to skip to the next paragraph at this point.

I had been told about the catheter up my willy and the stoma before the operation, and fortunately the catheter was inserted under anaesthetic. What I hadn’t expected was a tube up my bum which was stitched in, a drain into my stomach, and a drip into my arm attached to a bag on a walkable trolley. When the surgeon suggested that I tried to stand and take a few steps, I wondered if that was possible with all the attachments that I had. On a follow up visit to him a few weeks later, he laughed at the thought of me carting all those bags of unpleasant looking liquids around the ward with me.

Later that day the stoma nurse arrived and explained and demonstrated all about the stoma, and how to look after and change the bag. As I found with all the specialist nurses, she was kind and encouraging and offered follow up help should we need it. Apparently, many people are upset about having an ileostomy (The medical term for a stoma), but despite the inconvenience of regularly changing and emptying the bag, I have not found it to be a huge burden. Someone once described it to me “As having your bum in a different place,” and I think that is the way you need to think of it. Hopefully it will be reversible at some time in the future.

Over the next few days, I was encouraged to walk around the ward and corridor, and by the Friday, Masha and I were able to walk to the hospital café for a coffee. One by one the tubes were removed, which was a huge relief, especially when they unstitched the one from by bum.