Surgery day

My surgery was planned for 17th, but after the TWOC fiasco they decided to bring it forward.

So surgery actually happened on the 6th. The night before I wrote some notes on my broken phone, just in case things came out badly. Just a few little messages for my mum and girlfriend, and a final invitation for my brother to fuck off.

I’ve deleted them now. They were very sentimental, which isn’t like me at all.

The show started at 1pm, so in the morning I watched everyone else eat Weetabix, and then had a nap on the bed. If I was worried, it wasn’t preventing me from sleeping.

Am I a sociopath?

Brother arrived at 12:00 and told me he’d wave me off for the operation, and welcome me back afterwards. He must be concerned, he’s never been nice to me before. Mum isn’t coming because “she doesn’t want to get in the way”. We laugh about this. Typical: she worries about everything, and now she thinks that her presence in the hospital will somehow put off the surgeons? She’s an absolute nervous mess.

I read for a bit, and then the porters came in and wheeled me down. En route I was overtaken by my surgeon. He’s so confidently blasé about it all, the polar opposite of my hilariously terrible GP. An operation this big probably happens to 1 in 10,000 people, and is an incredibly big deal for me. But for him it’s every day. Probably twice a day. It’s a job.

Prep was unexpected, but then I don’t know if I’ve ever thought about it before. It’s a small ward of perhaps 20 beds, with a constant turn-over. I was there for maybe 35 minutes, and in that time the entire population of the ward changed twice. It’s a production line. We’re not patients down here, we’re a bunch of malfunctioning machines.

I’m asked the same questions 5 times, once every 5 minutes. I guess they have to be very certain they’re doing the right thing to the right person:

  • What’s your name?
  • What’s your date of birth?
  • What’s wrong with you?
  • What surgery are you having today?

I like saying “right radical nephrectomy” rather than “right kidney removed”. It gives me that same sense of belonging that you get when you manage to use a few words of French in Paris.

The anesthesiologist told me they’re going to give me an epidural so I can cope with the pain after the surgery. Odd: I hadn’t even thought about pain after surgery. I’m glad he has! So I’m wheeled in to pre-op and made to sit on the side of the bed. An assistant sticks a huge plastic sheet to my back and makes a small hole in it. I’m asked to arch my back as much as I can, so my chin is pressed on my chest.

I try, but I’m a rugby boy. Thick set, sturdy, inflexible. I can’t bend enough to make a gap between the vertebrae, and he keeps trying and trying. He’s put the needle in 4 times, and still can’t get into the epidural canal. I can feel him getting frustrated behind me.

The assistant holds me by the neck and pushes my head down as far as he can, but this just isn’t happening. So they give up and tell me they’ll work out a different pain regime for me while I’m under. They tear off the plastic sheet, and I feel like I’m being waxed.

I lie down. A drip or two go in, and a bunch of cardio sensors on my ankles, chest and neck. I’m perfectly calm, I notice. Am I a sociopath?

The anesthesiologist gives me a cord to hold with a button at the end. He tells me not to press it, and suddenly I’m reminded of Dougal in Father Ted, being invited into the cockpit and seeing a big red button marked “Do Not Press”. They’re bustling around above me.

And… nothing.

Travel broadens the mind

They say that travel broadens the mind,
Til you can’t get your head out of doors

Elvis Costello

Over the last few days I’ve had a battery of tests:

  • Something called a PET scan, which the technician described to me as being like an opinion-poll. It doesn’t give final results, but it’s an indication of the way things are going. Looks like we might be able to win, but it’s going to be close. More campaigning needed, and probably a better economic policy (i.e. I’m not working and can’t pay my bills… but that’s a story for another post, I think).
  • An ultrasound of my kidney, which gave me the first ghostly view of the horror story growing inside me.
  • A CT scan, which gives the surgeons a millimeter-accurate 3D view of the tumour so they can decide the best way to go at it.

For a few days they’d been talking about keyhole surgery: a 2cm incision in the lower belly, then they put a pipe into my abdomen and inflate it like a balloon to give them more room to work. Then they go in with instruments like Satan’s Long Spoon, and scoop out the kidney in bits.

But it looks like that option is off the table, because the CT scan didn’t look good. The surgeon came to see me to tell me all about it. He’s a natty little man aged about 30, with the kind of tan you only get on the very finest ski slopes, and a suit with a pinstripe so vivid it would make a banker’s eyes bleed. I couldn’t see his red braces, but I know they were there. The knot of his tie was as wide as his neck. He had metal taps on the heels of his shoes so everyone would know he was striding proprietarily down the ward.

He put me in mind of a premiership footballer, until he spoke. Then he put me in mind of minor royalty. Which around here, he probably is.

He looked at me as if he thought getting cancer was a sign of weakness, and I should pull myself together. Then he announced that he wasn’t going to do the operation himself, because he’s going to be in Gstaad tacking a particularly tricky black diamond piste. He didn’t say that last part, but his demeanour did.

Instead it’s going to be done by a colleague, but the colleague is “brilliant too”. I must have looked like I’d spotted his gigantic ego rampaging around the room, because he gave a self-depricating little smirk and tried to brush it off. I don’t care how big his ego is, frankly, as long as he’s a wizard with a knife.

First he told me about the tumour. It’s big. Very big. They’re all poets round here. I asked for more detail and assured him I was capable of understanding big words, and wasn’t going to cry.

The tumour has taken over one side of my right kidney, and has swelled up to a very large size. It’s 17cm across (a healthy kidney is only 9-12 cm, so that’s a pretty big tumour). As far as they can see it hasn’t breached the kidney or spread, which is a good sign.

And it seems to be a slow-growing cancer. Fast-growing ones tend to push the skin out and be clearly visible from outside. Slower ones tend to ease other organs out of the way and remain hidden until, like mine, they grow so big they tear open the organ they’re growing inside, and cause a bleed.

Mine seems to have crushed my right lung to about 50% of its normal size. The lung will re-inflate after the surgery, and I’ll probably feel high on oxygen for a few weeks – it’s likely the cancer has taken 5 or even 10 years to get this big, and for much of that time I’ve had oxygen depravation. How odd.

The bad news is that cancers which start in the kidney don’t respond to chemotherapy or radiotherapy. So if the surgery doesn’t work there’s little else they can do.

So they made the decision to give themselves the best chance of a successful surgery, and that means opening me up rather than keyhole. The surgeon traced a little line from the bottom of my sternum down to my hip, which I estimated was around 10 or 12 inches. Big hole.

Surgery is scheduled for 5th April. Good. I’ll be glad to get the malignant little fucker out of me.