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.