Bile Duct Diaries IX

I am so happy to be writing all this from home now!


I woke up from the 10 hr. operation as I was being lifted from the operating trolley onto the intensive care bed. Lots of people were pushing and pulling and I was immediately aware of two thoughts: “Thank God, I made it” … and… “I think this whole thing is a big mistake.” So now I’ll have plenty of time to dwell on this second thought. The best thing was seeing Jane, Jesse, and Briony’s faces a few minutes later. Then I had some fleeting idea that things will work out.

I spent the next 20 hours or so with one nurse by my bed in the ITU unit. Also very reassuring as the tubes, drips, drains, and bags of various yellow fluids (totalling 7) were continuously monitored. The operation took longer than expected because Mr. Sharma had to cut away more pancreas than he anticipated (about 40%) and because there was so much inflammation, he had to go very slowly and carefully to excise the damaged tissue and leave the healthy. He then rejoined what was left of the pancreas to a lower section of the intestine. He did the same reattachment for the remaining parts of the bile duct after having removed gall bladder, main bile duct and the first section of the small intestine (duodenum). Malignant cancer was confirmed, officially it is called, I think, “cholangeal carcinoma.” In a week or so Sharma will go over the biopsies with the oncologists and we will have a conference to look at the options for further treatments.

A big ordeal for all of us. On the day after the operation, Sharma invited Jane to see him in his office. At one point, he reached across his desk to take her hand and said, “Yesterday was a much more difficult day for you and me than it was for David”, and Jane thought to herself, “probably more difficult for you than me.” I now have a 15” scar, a railway track of 51 staples across my belly. The first challenge of the recovery was balancing the medical support in the form of pain killers, laxatives, antibiotics, digestive pills, etc with the need to shed these so the body can rebuild its own immune system and general digestive functioning. There seems to be a lot of tissue that has to gradually get to know tissues they have never been connected to before. Apart from a lot of pain, the only medical worry was that I was producing too many white blood cells which can be a sign of internal infection. (normal count is 10-14 and I was around 16-18). My registrar had talked about me going home last Sunday, pending the blood test results. On Sunday they were late collecting the sample and late analysing the results. By now I was SO keen to get out of the hospital, that I phoned the registrar at home to explain what was happening, in a pleading voice, and he said he thought it would be OK if I was feeling well in myself. So Jane came and we packed up and went down to get into the car. We were literally driving up to the barrier at the Royal Free forecourt when Jane’s mobile rang and it was the ward doctor saying she had just got the blood results (up to 22) and she wanted me back on the ward immediately!! The whole thing felt a bit like the Keystone Cops, but ironically I was not feeling that great and I spent the next 12 hours throwing up enormous quantities of green liquid in what the medics call ‘gastric emptying’, where fluids come up into the stomach from the lower parts of the abdomen.

But on Tuesday, things settled down and I got the green light to go home. I am SO happy to be here. I don’t think I realised how the hospital atmosphere was getting me down, as I feel a big boost of resilience and optimism today that I haven’t felt for months. So I will enjoy sitting at the computer and sharing a few more reflections about this process and the NHS over the next few weeks, while we await the meeting with the oncologists.

What a wonderful surge of support and thoughtfulness all you demonstrated around the time of the operation. Thank you so much for that. I certainly didn’t go into the theatre alone!

Love,
David (& Jane)

P.S. My cousin Nancy has arrived from North Carolina to be “the Carer’s Carer” so we are very lucky to have her support, love, company, and very importantly her sense of humour!