Cancer debulking surgery is actually pretty heavy

The baby is becoming more and more fun even as Amanda's cancer treatment becomes more painful. He's babbling and bouncing and kicking and smiling. She hasn't been doing much of that.

It's been nearly four months now since my wife gave birth to our son Gordon by c-section and doctors discovered ovarian cancer in her abdomen. Surgeons quickly removed most of her omentum and put her on course for treatment: three rounts of IV chemotherapy with Carboplatin and Taxol, cytoreduction surgery (tumour removal, usually called debulking surgery), then intraperitoneal chemo squirted directly into her abdominal cavity.

The surgery took several hours and Amanda was in rough shape afterward. They sliced from around her breastbone down to just about meet the perpendicular incision scar from her delivery.

Her gyn-oncologist says the surgery removed the rest of her omentum and along with it a bunch of cancer, a tumour about the size of a cherry tomato from her sigmoid colon, and another tumor smaller than a grain of rice from her small intestine. They also took out her ovaries, tubes, uterus and cervix -- a basic radical hysterectomy.

They left some cancer inside her, on an area of her diaphragm that doctors decided would be too dangerous to scrape. It's hoped the next wave of chemo will make direct contact with this patch of several 2-3mm bumps and kill them dead.

The news that worries Amanda the most: the first three rounds of chemotherapy did not shrink the tumors as much as Dr. K would have liked.

Still, the doc says it was a "great day" and a "great success" now that Amanda's been "optimally debulked."

A few of the many staples that held Amanda together for a week after her debulking surgery.
(Click to embiggen and gross yourself out.)
Probably true, but damn, she's been hurting. Through Dilaudid (made her dopey, weepy and vomity) and Tylenol-3 (didn't do much of anything), her pain was not well-managed in hospital, and she was sent home a little sooner than we'd figured with 30 morphine tablets to be taken one or two at a time every three hours. I'm not good at math, but I know that she went through them fast and never achieved relief from the pain. She even augmented the morphine with naproxen and Tylenol. Not much help.

She gritted her teeth and made it to our family doctor to have her surgical staples removed. Wow! Forty-six (46) staples in total, including the extra incision around her ribcage where they installed a port for the direct-injection chemo to come. FORTY-SIX staples! Ouch!

(Family members began to put up their guesses for how many there actually were, using The Price Is Right rules: Closest to the actual count of wire skin-closers without going over. Congrats to Kendall who got it correct. You do not win both showcases.)

Our much-loved doc sent her home with a scrip for more morphine. Didn't take long to realize that there was another problem, though: the wound was not closed all the way. There was a shallow bloody hole about the size of a nickel at the bottom of the incision, and another a little smaller than a dime. Near the top there was a drier but deeper hole. I drove her to the Emergency Room at one of the local hospitals where we've had good service before.

Last time we were at the Cobequid Community Health Centre was shortly before the birth. We were there for a prenatal class. It seems so long ago. Strange to think back to how nervous we were then.

She got in quickly and the doctor was not alarmed at what he saw. He said to keep the wound clean and put some Polysporin on there and it should all take care of itself. It's unfortunate but not unusual for big abdominal wounds like these to have spots that don't close have proper primary closure. Another prescription means another bottle on the counter. This time it's antibiotics.

She can't afford to have an infection right now. An infection would mean a delay to the start of the next round of chemotherapy. Chemo needs to start ASAP so any remaining cancer cells floating around her abdominal cavity can be snuffed out before implanting and creating new tumours. And we really want to blast the hell out of those bumps on her diaphragm.


That's Gordon seeing his mom up close for the first time in a few days. Because of the surgery, Amanda can't pick up anything of size for about six weeks, let alone something squirming and kicking. She misses holding him. She loves him so much.

It's been hard to see Amanda in so much pain. The incision is gross. I don't mean to be insensitive and of course I love her, but yuck. That's one big-ass cut. Doctors had my wife cut wide open, had their hands all over all her internal organs, cut pieces off, took out her reproductive parts and put her into instant menopause, then stapled her back together and sent her home. Hell yeah, she's sore. She's begging for relief. She's crying and begging for just some kind of vacation from the unrelenting pain. There's nothing I can do to help but try to make her comfortable and be there for her.

The next phase will probably be just as hard. The next wave of chemotherapy starts a week from today and it's an experimental procedure in which heated poisons are injected into her abdomen and sloshed around. It'll take eight hours a shot, on top of regular intravenous chemotherapy. She's going to be feeling awful for the next several months.

Hey, I'm turning 40 next month! W00t.

See how strange that sounds? Even when I have things to be happy about, it feels inappropriate to talk about them. I know one of the rules for caregivers is to take care of yourself, but that's hard to do. I have an appointment this week to speak with someone in some kind of support role through the cancer care system. I look forward to finding some ways to feel a little better through this.

More updates to come. Thank you for reading and thank you for all the support from Twitter, Facebook, Google+ and all corners of the internet, PLUS all the people in our face-to-face lives who've been wonderful.

Rush returns to Halifax, Nova Scotia, and I'm up close

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For my first time in the photographers' pit at a concert, it's Rush, probably my all-time favourite band.

Rush hasn't been to Halifax since 1987, so the fans were so rabid, the band added a second show. Here are some of my best shots from the first night at the Halifax Metro Centre.

Very exciting! I had a great time shooting these pictures and learned a few things along the way.

Big thanks to the promoters for the photo pass and to the other photographers for being so welcoming and generous with their advice! I hope to do it again. They say I should come back for KISS on August 1, but my sister's in town, so that's probably a no-go. One day, though, I'll be in the pit again!

Twin City Wrestling: A bit of lighter material for a change



With everything around here being so, well, HEAVY lately, I thought I'd put some of my other activity up here. It might be good for a laugh.

You may recall that I was working with a new wrestling promotion in the Halifax area a few months ago to publicize their debut and capture some of the highlights on photo and video. That outfit, NWAAtlanticCanada.com, seems to have trailed off into silence, but my fandom has not.

Along came another promotion, seemingly out of nowhere. Twin City Wrestling promised to bring the kind of action I'd been hoping for with NWA-ACCW: regular events at a fair price, run professionally, featuring capable local talent in simple, understandable and entertaining stories. Basically old-fashioned territory wrestling in the modern age.

I got in touch with promoter Cyril Richards and offered my services for their next show in Dartmouth. I went out with three HD cameras and an audio recorder and took some pictures and video. I don't have much spare time any more, but I've managed to edit three matches and some photos with commentary and graphics.

I think they turned out pretty good, considering it was an all-HD, three-cam, separate-sync job done entirely DIY by one sweaty dude!

Photos: Twin City Wrestling photo set from Dartmouth NS on Flickr.com\
Videos: Twin City Wrestling video playlist at YouTube
Follow: @TCWPromotions on Twitter

Tough news to hear, surgery ahead, talking Ovarian Cancer

It's been a rough few weeks. We met with Amanda's gyne-oncologist for a serious sit-down about the future. We pressed for information about the remaining course of treatment, how likely her ovarian cancer is to return, and a prognosis for future survival.

The often-quoted statistic for surviving newly-diagnosed ovarian cancer is 20% at five years. That means that out of every five women diagnosed, all but one of them will be dead five years out. Her doctors suggest a more accurate current stat is about 24%. Still not encouraging.

We've been holding on to hope that her mitigating health factors would raise the likelihood of survival. After all, her tumours were discovered during childbirth before they caused symptoms, in contrast to most patients whose cancers are found only after they were big enough to be noticed. Amanda's relatively young -- in her mid-thirties -- and in otherwise decent health. She should be able to endure aggressive chemotherapy. The cancer was staged at 3C, indicating it had spread beyond the ovaries and into other parts of the peritoneal space. But most of it -- in the omentum -- was taken out at the time, and the rest seemed limited to a couple of small-ish tumours around her uterus. Surely, we thought, the odds were in our favour?

Three years, we're told. Most people with this kind of ovarian cancer survive three more years after treatment. This cancer usually comes back. It usually kills women by causing multiple bowel obstructions. So, three years is what we're told to expect. Actually, four, since Amanda's going to be given an aggressive and still somewhat experimental kind of chemotherapy that involves pouring warmed poisons right into her peritoneal cavity and sloshing it around in hopes of bathing any remaining cancer cells in full-contact chemicals, rather than just sending it through the bloodstream. With that, maybe four years.

Live your life accordingly. If you have things you want to do, do them now.

This is probably going to mean significant changes to how we plan the next few years.


Now, it's not like the doctors have given up or anything. The goal has not changed: Destroy the cancer entirely and hope it's never seen again. But all it takes is a few rogue cells to hide away and regroup. This stuff is known for making a comeback in a fatal way.

So, friends, if you've noticed us being a little glum, defeated, sad or edgy lately, that's why. We love our life in Halifax and had imagined life after treatment as being a bit tense but full of potential. Now it feels like we have to seriously consider end-of-life or last-few-years planning right now. Not now-now, but soon-now. Sooner than we want.

Sigh. I'm so mad at cancer right now. I wish we could just raise our child and deal with petty annoyances and everyday troubles. Our boy is three months old and if the doctors' stats turn out to match our outcome, he may have a limited memory of his mother. And I can hardly imagine what my life would be like. I can't remember any more why I was so hopeful, because this news is so heavy.

My hope is that the treatment works. I hope it kills the cancer forever. Even if it does, our life will probably end up being lived differently than we'd hoped in the next few years.

- - -

Amanda goes in for surgery on Thursday. She's having a radical hysterectomy -- uterus, ovaries, tubes, cervix. They'll also handle her guts quite thoroughly, pulling her intestines out, checking for any tiny tumours. They'll take out the rest of her omentum. It's a big deal. She won't be able to lift the baby for something like six weeks. She'll be in the hospital for about a week, I think.

Not long afterward, though, it's in for the intraperitoneal (IP) chemotherapy. That's the intense, nasty kind. She's already been experiencing some neuropathy. That's nerve damage in the extremities that we hope is temporary, but might be permanent. Side effects like those are said to be much worse with IP chemo.

- - -

I was delighted to have Emilie Chiasson from Ovarian Cancer Canada on my talk show, Maritime Morning Weekend Edition. We had Emilie on for a full half hour on Saturday and covered a lot of ground. If you're new to learning about ovarian cancer, please have a listen as we give a crash course.

The interview begins about half-way through:


[Download] (To download: Right click, Save as)

Today was my last day at work, and I'm okay with that

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