I had surgery for stomach/esophagus cancer on August 5, 2014. It was first diagnosed in April of 2014 by endoscopy. My initial symptoms were fatigue and shortness of breath. I had to sit on the edge of my bed after climbing the stairs to get to the bedroom. I finally went to see my primary care physician who decided to draw some blood. He called me at my office that afternoon and told me to go to the emergency room immediately because my hemoglobin count was only 5. It should have been at least 13 or above for someone my size. I had been slowly bleeding for quite some time and didn’t know it. I was given three units of blood and my blood count came up to around 9.
I had the endoscopy the next morning where the physician could easily see the area of the bleeding. They conducted a second and more extensive endoscopy the following morning which indicated that the cancer was probably localized to the upper stomach and lower esophagus. I found it hard to believe at first but then realized that I needed do all that could be done to lengthen my life.
The cancer team recommended five and one-half weeks of chemotherapy and radiation followed by the esophagectomy. The first two and one-half weeks of treatment were not too bad. However, I really started feeling the effects of chemo./rad. in the later weeks. I started to get really weak and by the end of the fourth week I could hardly walk more than ten steps or so before I would have to sit. Meanwhile my hemoglobin remained low because the chemo drugs in my bone marrow would not allow production of more hemoglobin.
The esophagectomy was performed by Kenneth Kessler, M.D. at the Indiana University Medical Center in Indianapolis. He has a reputation of being one of the best surgeons in the mid-west if not the entire country who performs this procedure. No food for two days before surgery. Had to drink the prep that you usually drink for a colonoscopy the night before. What fun! Surgery the next day took about six hours. Nearby lymph nodes were removed too. I think I woke up two days later. Ended up with an incision from sternum area down to belly button. Had another long incision from a few inches below my right armpit which curved up and around my right shoulder blade. A third four inch incision was made on the right back/side for a chest drain which ended up being the greatest source of my pain. Finally, a fourth incision was made on the left side for a smaller bulb type of drain. There was significant pain following surgery and I was heavily medicated. I had some of the strangest dreams in my life. I had to continually use an inspirometer which really hurt in the area of the right chest drain.
Following the surgery the removed esophagus and lymph nodes were biopsied. They found no signs of cancer anywhere. That means the radiation and chemo shrunk the tumor completely which was great news. There is no other way to rule out the cancer completely. That can only be done after complete removal. If a patient chooses to not have surgery after chem./rad., it is possible the cancer could spread and it usually ends up in the liver.
I did have a bad side effect of the surgery. When I was finally awake I noticed that I had no power in my voice. I think that the doctors and nurses were aware of the cause of the problem. It was probably a paralyzed vocal cord. I was scheduled for a scope by an otolaryngologist. The scope confirmed that the left vocal cord was paralyzed. I was then scheduled for a vocal cord injection where a small amount of gel is injected to help close the cord. I was able to talk better, but the gel usually lasts for only three to four months. It is a temporary fix in hopes that the nerve will start to function again.
I was already weak from the chemo./rad., but the surgery only added to the weakness. I was at the Medical Center for two weeks and then transferred to the Parkview Rehabilitation Center in fort Wayne by ambulance. I would never recommend a transfer by ambulance. The transfer “cart” was hard and the ride was very bumpy. An ambulance is basically a truck and it was one of the roughest rides I have ever had. I used my arms to hang on to a towel hung over a bar on the ceiling to try and cushion the ride. If you know someone with a huge Buick with soft reclining seats, take it! Don’t ask for an ambulance for a long transfer. By the way, the cost of the ambulance from IU to Fort Wayne was $3260. I am not kidding.
Two days after entering the rehab. center I contracted pneumonia. I was going to PT, OT and ST and I kept telling everyone I could not breathe. Finally they ordered X-rays and found that I had pneumonia. I was on drip antibiotics for eleven days. So everywhere I went, my little IV stand came with me. Once the pneumonia started to clear, PT and OT were a breeze. I could breathe. After two weeks I came home.
Recovery has been very slow. I am very gradually getting stronger and stronger. I would guestimate that at this point in time I am about 70%. The surgeon told me three weeks ago that it may take another couple of months before I feel stronger and all the pain dissipates. Some of the chemo./rad. is still causing weakness coupled with the effects of surgery. If you read blogs on the internet, you will see that it takes some people over a year to fully recuperate. My appetite is getting better but not good at first. Nothing sounded or tasted good. I have lost over forty pounds since last April. I would like to keep my weight low because I know it is better not to carry excess weight. I can actually see my old six pack that I have not seen in years!
This is the third week of October and I will be receiving a second injection for my vocal cord in Indy next week. If my voice is not better after the gel of the second injection wears off then I may need surgery to have a permanent “band” inserted. The band will serve as a new cord that will basically always be closed to give more power in my voice.
I continue to exercise. Not as much as I should, but I am trying to increase my strength and endurance. Because recovery is very slow, it has been sometimes emotional. I wanted so much to be outside on the golf course with my wonderful friends. Or just work out in the yard that has been neglected.
On the upside, I have not experienced many of the side effects that others have experienced with the esophagectomy. I can eat just about anything I want. I have avoided ice cream so far because of what other have said about their problem with ice cream. I have not had any problems with vomiting or nausea. I can sleep in a slightly inclined position OK. Our bed is automatic so that has been good. I have never had trouble with food coming back up while sleeping. This is all good.
So I just have to take more time to fully heal. Am I a cancer survivor? I am an optimistic, but cautious survivor. I will have future PET scans and further scopes of the esophagus to make sure cancer does not return. My local cancer doctor in Fort Wayne feels that my cancer may have been the result of the severe acid reflux I had experienced over the years. So I caution everyone with severe reflux to talk with their primary care physician and inquire if a scope is indicated.
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