My Dad's Story

by Cathy Weeks

The Treatment: Surgery

Friday, January 12th, 1996: The day of Dad's surgery was a fairly tense day for me. I went to work as usual (I wasn't sure if I could stand waiting around at the hospital), since Mom said she didn't need my company. G waited with her, so she wasn't alone. My mind wasn't on my work, though. Surgery started pretty early in the morning (why do they always do that?), but Dad had checked in the day before, so it wasn't so bad. I'm not sure Mom was even at the hospital yet, when Dad went in to surgery. I called the hospital at 10:00am or therabouts to inquire whether Dad was in surgery or not, and was surprised at the amount of info they could give me (they were surprisingly well-informed). Yes, he was in surgery, and yes, everything was going smoothly. He was due to be out of surgery at noon. I called at 11:30, and they told me that they were finishing up, and that Dad should be out of the OR within 10 minutes. I had walked to work that morning, so I walked into my boss's office and asked if she'd drive me to the hospital, which she did.

I found the surgical waiting room without too much difficulty, and when I walked in, Mom was sitting at a table with G and a friendly, smiling man dressed in scrubs. Mom introduced me to him as "our adult daughter." He was Dad's surgeon, Dr. G. He was a large, balding man with strong shoulders, big hands and a ruddy complection. I was struck by what a good mood he seemed to be in. (A nurse later told us that he always "glowed" whenever a surgery went well) I had met him once before, but hadn't remembered much about him. He told us the origins of his name (Basque, I believe) when we asked about his rather unusual last name. He said that Dad had come through the surgery with flying colors, and that he was certain there would be no leaks where the stomach had been joined to the remainder of Dad's esophagus. He also thought he'd gotten all the cancer. He didn't have the pathology reports yet, but he was expecting good news. Mom told him about the EC Web pages that I was working on, and he seemed to like the idea, though he made it clear that he wouldn't have time to participate (and from what I've heard, he really *is* extremely busy.

I think he spent nearly an hour with us, talking about the case. Dad had two incisions: One on the right side of Dad's neck, and another on his abdomen. He preferred this method to the one where they crack the chest, because he feels it is less harsh on the body, and easier to heal from (broken ribs hurt a LOT). He had removed Dad's spleen (evidently, because it's hard to go back in after this type of surgery, if ever Dad needed it removed in the future), the majority of the esophagus, and part of the stomach. He then pulled the stomach up and re-connected it to the small part of the esophagus that remained.

Dad's surgery was the 100th of this type that he'd performed. We found out later that he had such a good success rate for this surgery (none of his patients had ever had a leak where the stomach was joined to the esophagus), that he'd been invited teach the other surgeons at M.D. Anderson Cancer Center how to perform this surgery, and did so, spending over a month in Texas. Wow.

It was then that we realized that the statistics he had given us a month ago (85% vs. 50% depending on lymph node involvment) were for at the time of surgery, not whether or not the lymph nodes had ever been involved. Again, we had to wait for the pathology reports to be sure, but he thought Dad was going to be in the 85% group!!! I felt amazingly joyful.

Mom and G and I went to lunch in the hospital cafeteria (I ate too many meals there!) feeling drained. After that, we went to see Dad. The only Intensive Care Units I'd ever seen were on TV, so this was a first for me. It was a big open room with a nurses station at one end. The ICUs were basically cubicles in a semi-circle around the nurses station. Each ICU had three walls: one outside wall with a window, and two that separted one ICU from another. The fourth wall was open, (a curtain could be pulled for privacy) and faced the nurses station. You could see into each ICU from the nurses station. Visiting hours were for 15 minutes every two hours, for only 2 immediate family members at a time, but the nurses made exceptions when it was prudent to do so. After that first afternoon, the nurses let my Mom stay as long as she wanted, simply because Dad was calmer and happier when she was there. They also let G see him, along with Mom and I, when we saw him the first time.

Dad was unconscious when I first saw him. He was bare chested and covered to the waist with blankes, and he had an enormous number of tubes and needles stuck into him. A respirator was taped to his mouth, and his chest rose and fell in short quick breaths. He had a blood pressure cuff on his left arm, and another BP sensor taped to his chest. He had an odd, hot-water-bottle shaped thing on his chest. It was small, only 4 inches long (unlike the usual hot watter bottle size) and clear and had some blood in it. A nurse explained that it was a drain, and allowed Dad's incisions to drain without swelling. IV's went into his arms, and a device fit onto his finger (it tested his blood oxygenation level). There was a monitor above his bed that displayed his blood pressure, his temperature (he had a fever, which is very common for this surgery), his blood oxygenation, etc.

Mom leaned down and spoke quietly into his ear: "John, you did great. I'm proud of you. Everything's going to be OK." She stroked a bit of bare skin on his arm--it was hard to find a spot where she wouldn't interfere with some tube or monitor. I talked to him, too. "Dad, I love you. You did great."

We had to leave soon after. I went back to work (after a 3-hour absence), but returned in time to see Dad at the 5:45 visiting period. Mom and I walked in together. Dad was asleep, but off the respirator. He opened his eyes, saw Mom and me, and his first words were: "I don't feel bad." It was funny, somehow, that simple little, positive statement. His voice sounded funny, kind of airy, something I found out is normal for when you've been on a respirator. I found out later that those weren't his first words after surgery: He'd talked to Mom earlier, when she'd visited him without me, and also to a nurse just after the surgery was over.

Dad was only on the respirator for maybe 4 hours after surgery. It had gagged him so much that they had had to sedate him to keep it in. They then decided that it was better to not drug him and let his breathing be a little slower than they liked, than keep him so uncomfortable, especially when he really didn't need it that much.

Dad told us that he remembered that while waiting for surgery, his bed was in the hallway outside the OR, and the anesthesia had not yet taken effect. The next thing he knew, he was still in the hallway. He asked the nurse why he was still waiting for surgery; hadn't they gotten to him yet?? Dad remembers being quite annoyed that they'd kept him waiting so long. The nurse laughed and told him that he had already had surgery, and that they were just transporting him to the ICU.

He also remembered waking up later (after Mom and I had seen him the first time), and gagging so badly because of the respirator. They took it out for awhile, but his breathing was too slow so they put it back in, and drugged him. It was later that the anesthesiologist gave them permission to remove it permanantly.

I went home shortly after that, and when I saw him next, the following morning, Dad was sitting in a chair by the window of the ICU. They moved him out of the ICU Sunday evening to a "critical care" ward (normal ward). It turned out that Dad's pneumonia was one of the "super bugs" that are very drug-resistant, and, Dad was back in isolation, though this time to protect other people from *him*. When a person is in isolation, they merely put up a sign on the door, listing the precautions needed to protect either the patient or the staff from contamination. In Dad's case, we had to wear masks around him to protect us from the pneumonia, which none of us ever got, wash our hands regularly, and avoid physical contact. This time, since the isolation was to protect us rather than Dad, Mom and I often pushed the mask off our face, and wore them around our neck. Mom had spent a lot of time around him before they knew the pneumonia was a superbug, and had touched him without washing her hands afterward, that the hospital staff said that if Mom hadn't gotten sick by now, that she probably wouldn't.

Dad wasn't allowed any liquids by mouth during the first few days, and was very unpleasant for Dad, who was only allowed an occasional piece of ice to wet his mouth.

Dad was hooked up to a morphine pump during this time, and it was an interesting device; there was a large syringe inside a locked box (there was a window that allowed us to see inside), and every time Dad pushed a button, a small amount of morphine was released into his bloodstream. After only a few days, though, they weaned him off it. There was also a "J-Tube (Jeujenum) inplanted into his belly that allowed this liquid food to be dripped directly into his small intestine.

Nurses and nurses aids, four at a time in the beginning, came to help Dad get out of bed, walk and get around, something that was fairly painful at first. But by the end of Dad's 10 days in the hospital, he was walking slowly, but on his own.

Entry 7: The Recovery.

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