Bile Duct Diaries VI

8 Feb. 2008

Yesterday I went in for the laproscopy which is a keyhole investigation with a camera under general anaesthetic, so Mr Sharma and I had a dress rehearsal for what is to come and I got to see the op. theatre and meet the anaesthetists which is a big part of the procedure for a long operation. The operating table is surprisingly narrow and you feel like you could easily roll off, but once the anaesthetic kicks in, which it does in seconds, you are’nt rolling anywhere. As I came around Sharma showed me the photographs which were surprisingly bright and clear. He found nothing ‘sinister’ in the peritoneal area, but there were a few small nodules in the area and a spot on the stomach he is sending out for biopsy. This will determine what gets worked on and excised during the operation. And he is still assuming the cancer is deep in the bile duct or pancreas area.

And we now have a date for the operation, Tuesday, 19th Feb. But because the Royal Free is also a liver transplant centre, those operations take precedence if they come in as emergencies. Next week I have one final CT scan (on Monday) for any further diagnostic information and that’s it. I have had a discussion with Sharma about the operation; it’s usually 5-7 hours long, and most patients usually have some form of complications like infection, bleeding, fistulas, etc. following the surgery. The list is pretty long so I won’t depress you with it.

I’ll ask Jesse or Briony to update the weblog after the operation, so you can pick that up on: http://www.davidcampbell340.blogspot.com/ I had previously given out this address with a dot missing, so do try again.

So now Jane and I are facing a really challenging time. How do we best prepare body, mind and soul for this operation? How much to muster my anger and frustration in to fighting mode, or how much to accept my situation; how to manage fears about the future and how much to stay calmly in the present? How much to think about this at all, and how much to rely on delicious denial and go out to the cinema? And the tricky bit is that Jane and I will have different needs at different times. There are times I will want to retreat into myself and she may want more companionship, so we have to keep talking about it.

Now I am just thinking, ‘what’s the best way to prepare myself physically and mentally for the operation’. I’ll do the best I can…….. then on the 19th, I just have to hand myself over to Sharma. Isn’t life fascinating!!

Thanks so much for all your attention and support. It makes a huge difference to know we are not really going through all this alone.

Love,
David (and Jane)


PS. As I gather my thoughts about things, do believe life is precious and serious and…..also a bit absurd, so let’s end this Diary with some relevant humour.

Bile Duct Diaries V

….or….’The Mysterious Case of the Travelling Stent’


Since my last report, I have had two internal infections, marked by fever and shaky shivering. The first time this was managed with antibiotics, but the second time the yellow skin (jaundice) and intense itching recurred. Mr. Sharma assumed this was related to the area around the stent, and he was worried this could blow out of proportion, so he arranged for me to go into hospital to have the old stent removed and a new one inserted with the ERCP procedure. Because this was done urgently, I had to be shifted to UCH, the new hospital on Euston Rd. It’s a magnificent place. Very spacious, bright, obviously done with the aid of interior decorators. As long as you are not remotely interested in parking, it is number one on our Rough Guide to UK Hospitals.

Now, regular subscribers to this diary will recall that the pancreatitis I have been wrestling with originally flared up following the original ERCP at the Radcliffe Hospital, so at the front of my mind was the worry that more messing about with stents would trigger more pancreatitis. I had the ERCP procedure this morning and so far, 6 hours later, I am feeling pretty good, but a little superstitious about saying ‘good riddance’ once and for all to pancreatitis…..but at least I can do the diary!

When the surgeon went in after the stent he couldn’t find it at first. His terminology was that it had ‘migrated’ further up into the bile duct, and he had to work for some time, including some incisions to get it out. Following that, he was confident that the new one is well placed. Lest we ‘laypeople’ become overawed by the medics terminology, I thought as an antidote, you might enjoy this excerpt from the surgeon’s formal report: ……‘Unable to engage stent with basket or balloon, but eventually stent grabbers succeeded in removing stent’. It does make you wonder what he was going to try next….a paper clip?

I have certainly learned the limitations about anticipating the future, but we do now have a PLAN. (Joke: How do you make God laugh?.......Tell Him you have a plan.) It is to do the laparoscopy next Thursday, followed by a final CT scan, leading up to the operation some time after the 18th. My morale has lifted a bit today and I feel now that there is a little less pain and something definite to aim for, I can tackle this next period leading to the operation.

By the way Jane’s nephew set up a weblog for me if anyone wants to check from time to time, but I can’t guarantee how I will keep it up to date. Address is: davidcampbell340.blogspot.com

It is incredibly touching how expansive you all have been in thinking, and acting, on ways to help us through this situation. We have paused to wonder how this experience fits together for all of us, you and us, many times.

Love

David (and Jane)