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30 Sep update -
Those of you keeping up with this blog are already aware that yesterday, the 29th, was the "big day" for Brandy and I, the day where we met with the actual surgeon at the University of Texas Southwestern to discuss all the details of the procedure and prognosis. Those of you just getting involved are hereby informed
It didn't go off as we expected, but I will try and keep the steps we went through as concise as possible (go ahead and snicker at me ever being concise; I'll wait). You could just skip to the end, but you may end up confused as there has been some misunderstanding and the only real way to explain those errors is to at least touch on the steps within the visit itself.
To begin, I have to offer my absolute endorsement of UT Southwestern. I cannot remember a hospital in which I or anyone was treated with such dignity, professionalism and tact. They were friendly and warm, never once sighed at our simpleton questions, and were completely forthcoming. Because I am used to working with the VA, I research everything so that I am ready for the runaround and the ensuing lecture to the so-called doctor to stop BS'ing us. That was never an issue at UT, and her surgeon even applauded us for being so educated on the matter. We were not lied to once that I can tell, and Brandy's doctor even admitted to a few questions she had no answers for - a far, far cry from the know-it-all's at the VA.
After completing all the financial rigmarole (with an actual person in an actual one-on-one explanation session in a private room that covered every detail) we were whisked off for the standard visit precursors: height and weight; pain scale assessment; medical history screening; blood pressure, pulse and temperature; and information of that type. That was done by the Physician's Assistant (PA), who seemed to be a nice enough lady sans her smoking lectures. Lecturing Brandy is one thing. I am a 40-year old Infantry veteran and don't need lifestyle lectures from a would-be, want-to-be doctor when we are there to discuss gutting my wife like a fish. The lady, as I said, was nice enough. She simply lacked tact in some areas.
After that and another nurse visit and finishing more paperwork, we saw the surgeon (I also refer to her as the oncologist and Dr. Kehoe, so accept those terms interchangeably, please).
Pause for an inappropriate comment. I love Brandy with everything I am, and straying is never something my personal honor would ever allow me to do. But Dr. Kehoe is hot. I'm not sure what my subconscious envisioned her as, but a mid-30 shazaam specimen of the female curvature with an alluring smile wasn't it, obviously. After surreptitiously absconding with a few paper towels and blotting up the small puddle of drool that had fallen from the corners of my agape jaw, I caught hold of my facilities and was able to continue.
The first thing she admitted to, a welcome reprieve to the narcissistic nature of the VA's doctors, is that the tests we'd already been through were not comprehensive enough for her to make an absolute determination as to exactly how invasive the surgery needs to be. She said, and I am quoting from memory here, "My heart tells me that we will be proceeding with a Total Radical Hysterectomy, but without further testing there is just no way to tailor your procedure to be the very best for you, and that's what I want to do before we operate."
Yay, doc. Points for that. I should show my gratitude by taking her fishing sometime.
What? I have two sleeping bags.
Dr. Kehoe also clarified all the cancer-specific terminology, but it all matched my research I have already annotated here, so there is no need for redundancy. The end verdict remains the same: definitive sub-cell cancer of the uterus and a possible "second" cancer area around the left iliac area, specifically the left ileum (the ileum is your pelvic bone, and the top is called the iliac crest).
After that came the dreaded exam. This is going to be a bit graphic, so if female anatomy and procedure makes you squeamish, look away now.
Brandy has been complaining of some pretty severe pain "down there" and has been bleeding from her rectum pretty badly since the LEEP biopsy (conical biopsy, but of the type in which they cauterize while they cut versus a cold cut and then cauterization). She's also been severely bloated, and has some edema (water retention) in her legs and her belly. In all, she has gained 26 pounds in two months, the majority of it since the LEEP (Loop Electrosurgical Excision Procedure).
The doctor gloved up and in she went. She did a visual inspection, a tactile (feeling) examination of first the vagina, and then the ****, and then both at the same time, and finished with yet another biopsy (a simple one with the clipper thingies). By that time, Brandy was fighting back the tears and losing the battle and had a death grip on my hand that -- I kid you not, people -- hurt the hell out of these hands that have been working construction for over 20 years. She was in pain, and badly.
Again, accolades to the doctor and nurse here. The way they spoke to Brandy was just about as warm and concerned as I have ever heard from anyone. And they were kind to me, as well, as I guess I was showing some distress at Brandy being in all that pain regardless of the poker face I was doing my damnedest to keep on. The VA doesn't even allow me in the same room when these exams are going on, much less behind their curtain of secrecy they refer to as the patient privacy screen. Dillweeds. Have I mentioned how glad I a UT is doing this?
[Pssst, guys: mystery solved. Yes, a doctor can be sexy when she's fondling your wife downstairs. I really need to express my gratitude with dinner.
OK, what?]
Alright, joking aside, here are the findings:
Brandy has a pretty bad infection in her vaginal track and cervix due to the LEEP biopsy (again, up yours, VA. I will be writing some people). Before we can even do anything, she needs a one-week regime of antibiotics to clear that infection up, as she is so internally swollen that the oncologist can't even see everything she needs to see, much less isolate the one possible iliac polyp.
During that time, the doctor wants more blood work and a PET scan just to see what else the VA missed. The PET scan has to be done after the week of antibiotics, but the labs have to be done today. Sigh. Back to the VA, as they (the VA) didn't approve extra testing. Of course they didn't - it's just my wife's life, so why let red tape and paperwork and bureaucracy rule the day? Millions of coffee breaks are counting on it. Grrrrr.
Sorry...
The surgeon feels strongly that the tests will only verify what she thinks, that we need to proceed with the Total Radical Hysterectomy. So we have scheduled that as early as possible -- all swelling and infection has to be gone, lest a surgical mistake happen due to the tissue being "wrong" -- which is the week of the 17th (2.5 weeks). She again made sure that we knew that all of this was tentative, as she is going to alter whatever she feels she needs to in order to preserve Brandy's best interests. I respect the HELL out of that.
So, blood work. Start antibiotics today. PET scan in 7 days. If nothing new pops up, surgery on the week of the 17th.
After that comes the scary part:
When the doc guts her, she is going to remove every polyp she can find (usually in the 17 to 20 range, she said, as there is no realistic way to get them all). Those and all of Brandy's insides get shipped off for further testing, which will give us the knowledge to judge whether or not we need chemo or further surgery.
We have the option of leaving the ovaries or having them removed IF -- the big if again; sigh -- the tests don't reveal anything more... dire. <shudder> If we can, and if we decide to, and if the doc is able to follow through during surgery, she (the doc) will move one ovary to the back in order to (hopefully) shield it from any radiation/chemo treatments and preserve its function to make estrogen.
It is those tests, combined with next week's PET scan, that will offer us the extent of the invasive direction and power this crap has. The doctor was very adamant that because Brandy is only 36 and is in good health, the prognosis is excellent. That may be a little too optimistic for my cynical nature when it comes to doctors, but I am doing my best to offer this one as much trust and latitude as I can with my positive initial impressions of her.
So that's where we're at today - a holding pattern, the waiting game, circle the wagons and watch for dust on the horizon, the sounds of incoming. Bah.
Dr. Kehoe even said as much: "I know that your response to all this is typical: 'Let's not wait, let's cut it out of her now!' But we all want what is best for Brandy's individual case, and that means we have to show some patience and let the tests guide us." Something along those lines, at any rate. Still, I remain anything but assured.
We're off to the VA for this blood work and to pick up these antibiotics. Thanks again for reading, the prayers and the well-wishes. It means the world to Brandy and I right now.
My friend, as I have said both you and yours are in my prayers. I pray for success and wish that you too will have many more years together. She sounds like a fighter.... that's good. The mind controls the body.