16 ~ M.O.A.S.: HIPEC

December 2016

We went down to Mercy the day before my surgery for all things pre-op, including bowel prep before the M.O.A.S. (Mother Of All Surgeries), to which HIPEC is referred. This hospital has scheduled prayer times over the hospital loud speaker. I LOVED this! My surgeon also leaves a rose in a bud vase for his patients in their room! I got all settled in and had to do the bowel prep for my surgery, had my abdomen marked for a possible ostomy, and went over pre-op prep with the anesthesiologist. Kris stayed the night on the “sofa” in my room.

The next morning I was preparing for surgery, getting all the needed IVs and speaking with the nurses. Dr. Sardi came in to see me to see if I had any questions. I had a very bad scar from my wound vac that had left an indent that was extremely sensitive to any clothing that rubbed against it. He assured me that my scar would be much better! It was then time to go to the OR. Kris went to wait with his father, Kert, in the waiting room after seeing me off for surgery. I remember lying on the cold, hard table, aware of the magnitude of the surgery I was about to have performed.

Here is an overview and animated video of CRS & HIPEC. CRS stands for CytoReductive Surgery and is the 1st step which removes all visible cancer. HIPEC stands for Hyperthermic IntroPEritoneal Chemotherapy and is the 2nd step in which 2 catheters (inflow and outflow) and 2 temperature probes are placed in your abdomen. The main incision is temporarily sutured shut. A saline solution is heated and perfused followed by the heated chemotherapy (106°-109°) that flows into your abdominal cavity to kill any microscopic surface cells. It only penetrates about 3 mm, so any resections that are done during CRS are left open for HIPEC. The solution is in you for approximately 90 minutes while your abdomen is gently moved to aid in the distribution of the chemo solution. The heat of the chemo enhances its effectiveness in killing remaining cancer cells. Systemic chemo (thru a vein or port) doesn’t reach the areas of concern like HIPEC and there are fewer side effects than with systemic.

I woke up intubated, which I knew was a possibility, but I didn’t know how it would feel. It was terrifying! I was awake with a tube in my throat which wouldn’t allow me to swallow or make any noise. I felt like saliva was gathering in my mouth with no way to expel it! My hands were also tied down so as not to pull out the tube. I saw a nurse at the station and did my best to make noises and move as much as I could to get her attention! She told me to stay calm and someone would be with me soon. It was not soon enough!

Finally the tube was removed and I could breathe and swallow on my own! My throat was a bit sore, but to be expected. I had a catheter, NG tube, and 2 chest tubes along with several drains, and staples from my bra line til, well as far down as one can possibly go! I was soon wheeled into my room in the ICU and Kris was able to see me. Physical therapy wasted no time in making sure I could get out of bed!

Day 1 post-op: I was moved out of ICU to a regular room on the oncology floor. PT had me doing some laps in the hall. I didn’t make it too far as I felt dizzy and they had to get me a chair.

Day 2 post-op: They took the catheter out, so that meant more times I had to get up out of bed. Ouch!

Day 3 post-op: I was in need of blood and hemoglobin cuz I kept feeling dizzy. My poor PT guy – every time he worked with me I got light headed! Both chest tubes and the NG tube were removed! I felt so much better!!! Chest tubes are scary looking and I find NG tubes very uncomfortable as they hurt my throat!

Day 4 post-op: I could finally have a liquid diet. Y’all, I was so hungry! All I had was a saline drip thru my IV and some ice chips up til then. At this point I hadn’t had solid food for 6 days! They also took away my beloved Dilaudid pump that I could press whenever needed and switched me to oral pain meds.

Day 5 post-op: Onto solid foods since I was able to doo 😂 a little extra on the potty. Percocet was giving me nightmares so they had to change that back to oral Dilaudid (best pain med ever!!!), and one of my JP drains, and my On-Q pump (pain med delivery system) were removed.

Day 6 post-op: They had to test for C-Difficile (a bacterial infection of the intestines that can cause diarrhea – remember this as you read further posts) which was negative.

Day 7 post-op: my remaining 2 JP drains were removed and they were letting me go home the next day!

I was so excited to be going home much sooner than I thought I would be! I couldn’t wait to sleep in my own bed or couch again because those hospital beds do you no favors! I was sent home with the usual Lovanox shots to help prevent blood clots and a whole lot of other meds to keep me comfy.

As exciting as all that progress sounds physically, there was a lot going on emotionally and mentally. Daily I would cry as I laid in bed. The Mercy Hospital rooms all have a little window by the door so the nurses can peek in without disturbing you. One of my nurses came in and said “Why are you crying? Every time I come by your room I hear you crying!” I told her that I was scared the procedure I had would not work. She said “Remember that there is always somebody worse off than you. There is someone who may not have been a candidate for this surgery. You can’t just sit in here and cry!” She was a straight shooter and really put things into perspective for me! She reminded me to be thankful for the chance I’d been given and not to waist each day on the what ifs.

A lot can happen in 7 days! That’s how long it took God to create the world (6 + 1)! We read in Genesis chapters 1 & 2 how each day a new thing happened, each day positive, miraculous changes took place! God, as our Great Physician, never stops working on our behalf. Even though it says He rested on that 7th day, it doesn’t mean He curled up on the couch and took a nap because He was tired. He took that day to set it aside to show us how we should live – to take a day and rest from our work. Even though my body was working hard, it also needed rest in order to continue getting stronger. What a great model God has prepared for us to follow!