Day 124 – Meeting with consultant

Today I saw my consultant to discuss the surgery to remove the tumour. 

This has been arranged for Monday 23rd January. 

I can expect to be in hospital for about a week, this is quite big surgery!!

WARNING! Anus and rectums will now be discussed, close your eyes if you don’t want to know the next bit!

The procedure is called an  abdomino-perineal resection (AP resection). In laymans terms it means that all of the bowel ‘equipment’ left after my stoma was formed will be removed. 


As my cancer is very low in the rectum, it’s not possible to remove it and leave sufficient anal muscle to leave a properly functioning anus. There is another procedure called the APPEAR procedure, more here:

http://www.bowelcancerresearch.org/bowel-cancer-research/the-appear-procedure-for-sphincter-preservation/

Having discussed this with my consultant he advised that in his experience this is likely to leave you with a leaky anus and having to go to the toilet much more often than normal. Often it will require more surgery if it doesn’t work first time. I don’t much like the sound of that so I’m going to stick with the AP resection. 

So, to get back to what I was originally saying!

On the above diagram you can imagine that everything bowel related below the stoma circled on the right hand image will be removed. This includes all of the lymph nodes in and around the bowel, all of the rectum and the anus. 

I will be left with a scar where my anus used to be. This, I am reliably informed is called ‘a Barbie bum’!! 

The procedure is completed in two halves. The first is done from the front via keyhole surgery. This will be removal of the remainder of the bowel left behind after the stoma was formed. 

Then, I will be laid on my front and they will enter via the perineum to remove the lower parts and then stitch everything up. Sounds quite easy, doesn’t it?

The operation will take about four hours and recovery is 6-8 weeks.  I won’t be able to drive for about five weeks. 

Everything that is removed will be sent to the lab to be looked at to see if all of the cancer has been removed. If not, or they are not sure I will have some mop up chemo to get rid of anything left behind. 

So, how do I feel about this?

I’d rather not have the op if I’m being honest! I’m not particularly worried about it, I know that I am in excellent hands and that the team looking after me will do their best but I’d be telling a lie if I said I wasn’t a little apprehensive. Not about the procedure but post operatively. Sitting down is going to be an issue for a while because of where the wound will be and I am told that there is a 50/50 chance of the wound breaking down. This is where the wound won’t knit together and heal properly. In that instance it will have to be packed and redressed every day. They will send a nurse to do this, I hope she/he has got warm hands!!

In readiness for being away I’ve got a fair amount of diary rejigging to do. I’m really busy with work at the moment so have some meetings to postpone until I’m recovered sufficiently. I could have done with the op being a week or two later actually but my consultant is away both weekends of those weeks and he wants to be around, just in case, which is good of him (would have been better if he’d cancelled his holiday!!) so it has to be this date. I’m sure my clients will understand, in fact I exchanged text messages with one yesterday and offered them the chance to meet a colleague instead and they very kindly said they only want to deal with me and will wait for me.  A nice thing for them to say. 

I am waiting to hear from the hospital as I will need a pre assessment appointment, obviously this will be this coming week, please don’t be Thursday, my busiest day this week!! 

I’m also having a blood test first thing on Monday. This is a CEA test that measures whether there is cancer in the body.  This should be at a lower level than the one that I had before I was officially diagnosed. 

So, the next phase is about to begin, hopefully this is the last. 

As I sign off for today, I ask you to keep Paula in your thoughts. She’s got a tough week coming with me being away from home. She’s much tougher than she gives herself credit for but this will be a hard week for her. 

I am currently reading a book written by the BBC presenter/journalist Sian Williams. It’s called Rise – A First Aid Kit For Getting  Through Tough Times. She was diagnosed with breast cancer two years ago and had a double mastectomy. The book details her journey (groan!) a bit like my blog although she’s made a better job if it. One of the things that she said early on was that she got the easy bit, it was her loved ones that it was hardest for. I have also said the same thing. 

Everyone asks about me or ‘the patient’ but forget the worry and strain that the ‘bystanders’ are going through. 

Anyway, I think that’s it for today. I will be blogging as and when I have news and from my hospital bed!

My thanks to you for reading this, apologies if it’s a little graphic but I did warn you! 

Pat. 

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