Diagnosis: Afterparty

Here we are, finally 5 weeks out from the colon surgery, pump placement, and ALPPS stage 1, and 4 weeks out from ALPPS stage 2.

I think the majority of the post-surgery depression cloud has finally cleared, and I’m back to a place of hopefulness, planning for the future, and generally feeling like my world is getting bigger again. I’m beginning to plan my running comeback for whenever I’m cleared for it, and I’m already daydreaming about what half or full marathons I might want to run in a couple years. (Once the liver pump is removed down the road, assuming I never wind up needing it. Until then, doctor’s orders are short runs only.)

One of the things still keeping me from feeling fully like myself is that I have my post-operative drain in place thanks to something called a chyle leak. Basically, some tiny lymphatic vessels were damaged during surgery, causing a milky, fat-rich fluid called chyle to leak where it isn’t supposed to. Eating fat makes your body produce more chyle, so the treatment is to dramatically limit fat and give those tiny vessels a chance to seal themselves back up.

Which means I have now spent 30 full days eating less than 10 grams of fat per day.

Fruits, vegetables, sourdough bread, rice cakes, tomato soup, angel food cake, nonfat Greek yogurt and cottage cheese, and (bless them for being 0g fat) the occasional candy gummies have comprised most of my diet for the last month. That alone is depressing enough, but every week my surgeon’s office has me do a “fat stress test,” where I eat something fatty and we see what happens. So far, watching the drain fluid turn milky afterward has been my own personal version of Groundhog day (except Bill Murray could eat whatever he wanted.)

But this is a bump in the road, and this drain WILL be gone one day. So in the meantime, I’m trying to focus on all the things going right. And there is a LOT going right.

The pathology reports after surgery brought some genuinely fantastic news. Everything they removed, both the section of my colon containing Krang and the large portion of my liver containing his spawn, was sent to the lab for a much closer look.

On the colon side, they successfully removed the cancer with clear margins, meaning there were no cancer cells at the edges of what they removed. Even better, the lymph nodes they examined were negative for cancer.

The liver pathology was especially encouraging. They found three metastatic tumors in the portion they removed, measuring 1.5 cm, 5.5 cm, and 7.1 cm. But after eight rounds of chemotherapy, only about 10–20% of those tumors still contained viable cancer cells. In other words, chemo had killed or damaged roughly 80–90% of the cancer in them.

And once again: clear margins. One liver tumor came extremely close to the cut edge, within 1 millimeter, but did not reach it.

So rather than turn this into an episode of Grey’s Anatomy, the important part is this:

Chemo absolutely clobbered the liver tumors. The surgeons removed everything they could see. The margins were clear. The lymph nodes they examined were negative.

There are never guarantees with cancer, especially Stage IV cancer, and no surgery or scan can completely rule out microscopic cells hanging around somewhere. But as far as the actual results from these surgeries go, this was about as much good news as I could have hoped to receive.

Also, a silly false-alarm complication landed me in the ER this week (I’m all good now!), but it came with one very cool consolation prize: I had a CT scan done and I got to see Little Liver’s progress.

And Little Liver is apparently not so little anymore.

From the CT, it looks astonishingly close to a normal-sized liver already. Meanwhile, my bloodwork shows that this thing is somehow simultaneously regenerating itself AND casually doing all the jobs a normal liver is supposed to do; absolutely showing off.

Next week I’ll follow up with both my oncologist and liver surgeon. The colon surgeon has already released me from his care, which feels like another tiny graduation. Then we’ll figure out what comes next, likely some cleanup chemo, and hopefully after that, just settling into a regular scan schedule.

So, all in all: there are still bad days. There’s still a drain hanging out of me. I would commit minor crimes for half of an avocado right now.

But more good days are piling up. I can feel the warmth on my skin from the light at the end of this surgery journey. And for the first time, I think I’m starting to see some light at the end of the entire cancer journey, too.

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