There Is A Plan
Last week we packed up and headed to Houston. August 12 was the start of staging week at MD Anderson, which is a nice way of saying they looked at everything. Consultations with both surgery and oncology. Labs. Chest CTs. Days built around waiting rooms and wristbands, all of it pointed at one question. What exactly are we dealing with, and what do we do about it.
Then on Tuesday, August 18, I sat in a room with Dr. Hop Tran Cao and his team while they walked me through my test results, my scans, and his recommended treatment. He was thorough and he was comforting, and somehow both at full strength. I was overwhelmed. I cried probably the hardest I have this entire process. And I still felt at ease, which I did not know could happen in the same room. That is the kind of doctor you want when the conversation is about your own cancer diagnosis.
Here is what they found. My tumor sits in my left bile duct and is moving into my liver. In this house we name the things we live with, so the drain is Barton and the tumor is Timmy. Timmy is not paying rent, and he is a terrible tenant.
And here is the plan. Timmy’s eviction date is September 23, when I will have surgery at MD Anderson. A left sided liver resection, which means removing the left side of my liver, my gallbladder, and my left bile duct, then reconstructing my right bile duct so it connects directly to my intestines. The liver is the one organ that regrows, which still amazes me. I head down on the 20th for preop testing first. More scans, more labs, heart tests, the works. The surgery itself takes anywhere from seven to ten hours.
You might wonder why Timmy gets a whole month’s notice. The answer goes back to my ERCP in July. Part of that procedure involved cutting the sphincter of my bile duct, and overnight I began bleeding internally. By morning I was in hemorrhagic shock, and two rapid response codes were called to my room within a few hours. I had to be resuscitated. It took an embolized artery to stop the bleeding and seven units of blood to bring me back. Seven units means seven strangers rolled up a sleeve one day and saved my life without ever knowing my name. If you have ever donated blood, thank you. It is not abstract to me anymore.
So my surgeon wants my body fully recovered before it takes on an operation this big. He explained that what my body went through was like running a marathon. Anyone who knows me knows I would never voluntarily run a marathon. Leave it to me to find the one version you can do lying in a hospital bed, and I did not even get a t-shirt or a medal out of it.
So my assignment for the next month is to sit around and get stronger. That mostly means gaining weight, because I have lost nearly 30 pounds since the summer started, and this is not the weight loss plan anyone should ask for. Ryan has appointed himself director of calories and he takes the job very seriously. Some days the thought of food makes me want to puke. Other days a meal tastes like the finest delicacy in Texas. There is no telling which it will be until the plate is in front of me, and either way, the plates keep coming.
There are two things we will not know until the surgeon is actually in there, and I am going to write them down because this journal does not skip the scary parts.
The first is a main artery that sits right behind my right bile duct. If the tumor has spread to it or is sitting on it, my surgeon will have to stop and pull out of the surgery, and we move to a plan B. That would likely mean chemo and radiation first, then surgery later, either a resection or a full liver transplant depending on how I respond to treatment.
The second is my pancreas. If the cancer has reached it, the team will do a Whipple procedure instead, which removes everything above plus part of my pancreas.
I am hoping hard for best case.
After surgery I will spend about a week in the hospital. Then I stay on site at the Rotary House, the hotel connected to MD Anderson, so I am close to my surgeon in case anything happens. Once my body heals, chemo begins.
I saw this on their screen during staging week. Their whole logo is the word cancer with a line through it. That is the goal.
The concerns scare me. I will not pretend otherwise. But the optimism I carried out of that meeting was the best moment I have had since this diagnosis began. There is a plan. It has a date. Dr. Tran Cao is one of the best in the world at exactly this, and he believes he can get it.
So do I.
Amber