Esophagectomy/Gastroesophagectomy

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 daysimagesN4L6QK8S 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.

Please feel free to leave any comments.

30 thoughts on “Esophagectomy/Gastroesophagectomy

  1. You are amazing big brother! I am so proud of you and I know this has a been an agonizing ordeal, but you stayed strong and kept the faith. We are so so proud of you Greg! Great job!!!!!

  2. Thank You For Sharing The Details And Every Thing You Have been Through. I Am Glad To Hear You Are Feeling Better. My Prayers Are With You!

    • Thank you Debbie! I am happy to live in this time where so many cancers can be treated. It isn’t easy but there is light at the end of the tunnel.

  3. Greg, as a 5 x survivor, I felt every thing you said…again. I pray a quick regaining of strength and am so glad you are seeing thee positives of this prognosis. Rock it out and stay STRONG!

    • Thank you Randi. I can’t imagine battling cancer 5 times. Stories like yours make me wonder what the heck I am complaining about!

  4. Greg, Thank you for sharing. At Rotary I noticed your soft voice (with my great hearing aids).I feel that with your great recovery so far, you will come back to “normal”. Continued prayers will help too.Arnie Spiering

  5. Greg, I pray God’s blessings upon you and also upon your family. I know it has also been difficult for your wife and kids to see you go through all this. God always answers our prayers and I know He will sustain you and your family through all of this. Life’s trials have a way of helping us grow closer to God and to each other. And when we emerge and look back on them, we can often see His tender mercies and the many times He has carried us. God bless you. Stay positive. Enjoy the little things.

  6. Greg, thank you for your transparency and sharing your journey. We never know when we will be required to head down a path we’d rather not travel. Your courage and recovery is an inspiration to us all. We will continue to pray and look for future blessings.

      • Hi Jeff for the kind words. You are not anonymous. We all know who you are. You are the man who is not allowed to look at Carol at Rotary!

  7. Greg – You are an inspiration for me. I have had acid reflux for years and was taking the purple pill from time to time to deal with it. I developed a very irritating cough and constant throat clearing behavior pattern. There were other symptoms too, but one evening, Lynda and I went to an informational session by one of the IU Med doctors who spoke about what might happen. He gave some good advice. I even went in for an endoscopy and they told me that it wasn’t cancerous yet or too badly damaged, but it was getting close to being a problem. I started taking the acid reflux reducer on a regular basis and have been much improved. The throat clearing has improved a lot too. Anyway, I have a clue as to what to expect if I don’t pay attention to this problem and I thank you for sharing. You are a tough guy and very focused. I know you will make it back to the yard work and more importantly, the golf course. Keep up the good work and know that you have a lot of fans and we are keeping you in our thoughts at all times.

    • Thank you Darryl. I had been using 20 mg Omeprazole for years. Apparently that was not good enough. I am on 20 in the morning and 20 in the evening. Will be getting routine PETs and scopes. Good that you were checked out. If caught really early they can simply scrape off the lesion before it becomes a tumor. Let’s do golf next summer!

  8. Greg, Barbara and I had been wondering how you were doing. You and the family have been much in our prayers. Thank you for sharing this with all of us. I have told my dad about all that you are going through and he has been praying for you also. It is hard to realize 1 in 3 of us will have some form of cancer. Christina and I are each now five years clean, praise the Lord. I know you will also reach that milestone. We will celebrate each anniversary with you. Our love and prayers for you and yours.

  9. Greg-
    I am so happy to know that you are recovering. You are a survivor, in many different ways. As you know, cancer is a family disease and I am sure your wife and children have many side effects as well. Joel, my husband, was diagnosed very early with kidney cancer 7 years ago. They got it all and he is at the point that they only need to see him annually. You’ll get there too. Just listen to your body and do what it wants you to do, not your brain which wants to get out there raring to go. This is a year of reflection and healing and be grateful for it. God bless you and your family. Catch up on the books you wanted to read but didn’t have time to and the movies you wanted to see. And for goodness sake, don’t read any professional stuff unless you need to go to sleep.
    Cydney

    • Cyd, no more professional reading. I will be reading a lot more. Remember the books we were supposed to read in high school? Well I finally read them in the past year! I read Joel’s book about Lincoln and I will try to download his newest. I enjoyed the Lincoln book. I will be patient and listen to my body; it speaks often.

  10. Greg, your Siemens family is thinking about you and praying for you. Glad to hear about the improvements, and always praying that the rest of your recovery goes smoothly.

  11. Greg, Thanks for in-depth story. I can’t really imagine what you have been through!! I hope and pray that you will continue the upswing without any new valleys. I also hope that you will be ‘singing without the band’!!! (can’t convey anything without the Asher warped humor slipping in.)

  12. You are such a strong man Greg, and I know God has been with you through all of this.Still praying for you Lori

  13. May the Lord bless you Greg and shine his countenance upon you. You were always one of my favorite Anthony Wayne Rotarians! I always knew you as one of God’s meek and mild, and often wished I was more like you. I too have had esophagus issues for years… have had Barrett’s esophagus for 15 years and have lived with 2% chance of cancer the whole time. Why did such a nice guy get it and not me…yet? I really appreciate you sharing your story. My dad had stage 4 prostate cancer when first diagnosed… was given less than a year to live… but with his willpower and Christian faith lasted 7 years! Two weeks before XMAS we were all called home and were told the end was within 48 hours. He lasted 2 weeks and would not die until XMAS night. I was there alone as mom and other family members went home for dinner. It was the most meaningful moment of my life. I believe I was there for God’s purpose.
    I am serving as President of New Smyrna Beach Rotary Club this year and am pretty tied down now. Bur after July 1 Donna and I will be back to Fort Wayne to see Brien and his family (Jenny Parks Abbott….Dwenger {wife} and grandaughters Maddi and Molly}. I want to reunite with you at Rotary next August… so get well… as I will pay for golf at Cherry Hill. Luv u guy!!!!

  14. Jeff, sorry but I just read your entry, Thank you so much for your comments hope to se you when we get back this summer! Sorry to hear about your dad. Greg

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