Diagnosis: Afterparty

The whirlwind of the last two weeks has finally calmed down enough to do a proper update on everything going on. Three separate surgical consults, a colonoscopy, an MRI, and a CT scan– all over the course of 13 days.

The biggest headline, besides the surgical plan I’m about to get into, is that last week’s colonoscopy showed Krang no longer looks like a brain blocking off my entire colon like he did on my first colonoscopy. He’s been whittled down to some barely-there side swept curtains; some real squint-or-you-might-miss-it kinda thing. Even the colonoscopy team said they didn’t even notice him on the way in! They didn’t measure how long he still is compared to the original 10cm, but he’s surely run to the hills enough that surgery is definitely the answer.

That being said, I’ve got all the information I need about my upcoming surgery, and we’re just waiting on a date to serve Krang and his spawn their official eviction notice! 

The plan is essentially a three-for-one special: remove the part of my colon where the original tumor lives, tackle the liver tumors, and install a HAI (Hepatic Artery Infusion) pump, a hockey puck sized device that can deliver chemotherapy directly to the liver (and avoid major side effects). Because so much of my liver is currently occupied by tumors, they’re using a specialized two-stage procedure called ALPPS (Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy), which sounds like a law firm but is actually one of the most aggressive liver surgery techniques out there. It requires a couple operations during the span of one hospital stay, so I’ll be packing up for a temporary hospital residence for about 7-10 days.

During the first operation, which will take around 6-7 hours, the colorectal surgical team will remove Krang, alongside the section of the colon he calls home, and resect the remaining colon; temporary colostomy bag/stoma unlikely, but possible if something comes up that requires it. During that same first operation, the liver surgical team will divide my liver into two sections, and leave everything behind so the healthy side can go to the gym and bulk up over the next week.(aka hypertrophy enough to take over all liver function).

A few days later, I’ll get a scan to make sure that side has grown enough to safely take over the workload (no seriously, I stopped the surgeon to check if I heard right too- it only takes about 5 days for a small section of your liver to hypertrophy enough to function as the entire thing). If all looks good, they’ll head back in for the second operation and remove the tumor-heavy portion of the liver. The HAI pump is placed during surgery and can then deliver chemotherapy directly where any microscopic liver cancer cells might be hiding. There’s one pesky calcification in a super healthy spot of the liver that may require this if the surgeon can’t see it & ablate it while he’s in there. They said there’s a chance I may never even need the pump, and it can easily be taken out once I’m NED (no evidence of disease) for 2 or so years. Easier to take out then put in, so it’s a solid insurance plan.

The entire thing is an incredibly complex operation that only a relatively small number of surgical teams perform regularly, but fortunately I’ve landed with an institution that has extensive experience doing exactly this. So yes, this is major surgery with a capital M (think weeks of recovery, not days) but it’s being approached with curative intent from start to finish. In other words: they’re not sending in a cleanup crew armed with good vibes; they’re showing up with a demolition team, a construction crew, a maintenance crew, and the blueprints.

The biggest factor for scheduling the date of surgery is waiting for the chemo to fully leave my body. Like I’ve stated in the past, one of the drugs I was being given (Bevacizumab) makes it hard for wounds to heal, and you clearly don’t want that flowing through your veins before something like a root canal let alone this massive surgery. Luckily, Krang and his spawn are in such deep remission that no one is worried that this time off chemo while we wait is going to allow for anything to grow. The likely window, given what I know, is sometime between July 8 and July 22. The team is super excited for this, I’m super excited for this- to me this is just another nap with some stitches when I wake up!

So for now, we wait for the scheduling team to organize this undertaking while I start figuring out what I’ll need for recovery. There are hospital bags to pack, vegan protein shakes to stockpile, a few Amazon orders, and lots of pool time to get in while I can.

Everyone’s starting to pack their bags around here.

Krang included.