Sunday, May 9, 2010

Wrestling With Cleveland

My, what big teeth you have Cleveland!

I have been wrestling with the repercussions of having driven to the Cleveland Clinic last week. To say that my thoughts have been a little preoccupied the past few days would be an understatement. Before I delve into the morass, let me share the fun stuff.

After Aurora got home from school Tuesday afternoon, we loaded up the van and headed out. Driving headlong into the sun for the better part of four hours left us pretty beat so when it came time to take a break for dinner we were both more than ready. Watching the sun set over Great Lake Erie was something neither of us had seen before.

With a few more hours behind the wheel, we rolled into Cleveland wicked tired and ready to flop. Rummaging through our pile of maps and printouts and directions, we figured out how we were supposed to find the Cleveland Clinic Guesthouse. I had expected parking to be a four letter word with such an enormous medical complex. Someone else must have had the same concern, because there was parking by the bucket!

Before Aurora and I could do more than flip through a couple stations, we were out like a light. Click. Next morning found us sitting in the waiting room of the Digestive/Intestinal Diseases Department. I figured based on the alliteration alone, we were doomed. Hardly. Turns out, they rock!

An hour and a half later, we walked out. My head was more confused than ever. Might have been a product of having the nurses actually listen to what I was saying. Or it could have been all the different surgical scenarios the surgeon laid out. (HINT: For those of you who are even the least bit squeamish, this is a great stopping point)

Let's skip to the good stuff. Turns out, I am a candidate for a reversal. What does this mean? Well, for all intents and purposes, it means that I could rid myself of this colostomy bag and have my plumbing reconnected the way it was intended. In talking with this amazing surgeon though, I came to learn that this surgery is going to be far more complicated than I was led to believe.

Here are the surgical options:
Scenario One: We reconnect what is left of the large intestine to the rectum. Sounds easy right? Not quite. Due to the peritonitis and sepsis, there is a ton of scar tissue throughout the abdominal cavity. The intestines are essentially adhering not only to themselves but also to other organs. This means that they wont stretch nicely or unroll like they would have prior to the first surgery. As a result, he may have to move a huge array of blood vessels that are in the way of bringing the large intestine over the front of the abdomen. Probably a six hour surgery with the potential for some hairy scary complications.

Scenario Two: Take a loop of small intestine and make an illeostomy out of it. Since the waste stream would end there, he could then put the large intestine wherever he wants, and could then hook up the rectum and the large intestine without pulling on everything. This would require two surgeries separated by about six months to a year. More bags dangling off the belly and more chances of herniation.

Scenario Three: This was sort of a last resort solution and one that fills me with the greatest dread. Skip the large intestine completely and go straight from the small intestine to the rectum. For anyone who has ever had Anatomy 101, the function of the large intestine is primarily to de-water stool. What this means in terms of the surgery is that I would have liquid bowel movements six to 14 times each day. With very little control over them. In other words I would be a prime candidate for starring in a Depends commercial.

And then came the caveat: He wouldn't do any surgery until I had lost 50 pounds. Tentatively, he thinks we can do the surgery in September... that's four months. Fifty pounds. Sure. Cake, right? Oy veh.

After leaving the surgeon's office, Aurora and I went to the Cleveland Museum of Natural History. I guess I have never thought much about Cleveland's academic, cultural and cerebral offerings. Lo and behold, it's a pretty snazzy place! The area that surrounds the Natural History Museum, also encompasses the Cleveland Art Institute, the Museum of Fine Art, the Botanical Gardens and a LOT more. Aurora was in seventh heaven.

She got to see fossils of all sorts of dinosaurs including tyrannosaurus rex, a nano-tyrannosaur, triceratops, smilodon (saber toothed tiger), Lucy, dunkeleostus (armored fish), and way more than I can remember. It would have been the perfect way to spend most of an afternoon, but we needed to get hurrying home. We'll save the rest of that museum for another visit.

After returning home I met with my physican to talk about my blood workup he had done before I left. In turn, I shared with him the consult with the surgeon at Cleveland Clinic. As anyone who has been keeping up with this bizarre saga on either the blog or FaceBook is aware, I have been having a devil of a time sleeping. Add to that I am now verging on narcolepsy during my "waking" hours. During a short drive to Ithaca, I find myself falling asleep at the wheel regardless of time of day. I have to have someone beside me talking to keep me engaged and awake.

So I shared these new developments with my GP, and he shared the results of the blood workup. Looks like sleep apnea (as opposed to a drug side effect which was my first assumption)... so in the next few weeks they'll be putting a CPAP machine in my bedroom. We'll see how that affects things.

The most productive concept to come from my meeting with my GP though, was the idea that maybe after having lost fifty pounds I will be more inclined NOT to have the reversal surgery. My gut will be mostly gone, and hopefully the hernia will have subsided substantially. If that ends up being the case, I can't see a good reason to continue with this reversal. We shall see. For now, we diet like madmen and exercise like crazy! We'll see where things are a month from now. Wish me luck!

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