Esophageal Cancer 101
The official diagnosis was the following: Adenocarcinoma, cancer of the esophagus (EC), located at the gastroesophageal junction, where the stomach meets the esophagus. For the next 28 days, our lives overflowed with medical tests, surgeon consults, and round-table family discussions. Those days constituted a span of time focused on a disease process, fueled by an initial shock, followed by a surge of adrenalin, and choreographed by the meticulous and calculated actions of a wife, nurse, and mother. I had no time for self-pity—not now, but more about that later.
Preparing for the unknown
I quickly became an astute student of the transhiatal esophagectomy surgical procedure, which would be performed when my husband had his business and personal matters settled, as one surgeon advised. Just listening to those words, “settle your affairs, put things in order” brought to the forefront feelings we normally keep in reserve—emotions connected to thoughts of loss we try not to think about: losing a loved one, a husband, a vital partner in our life, and dealing with the possibility of death and dying.
When I looked at my husband, a robust and muscular man from years of biking and workouts, I wondered what the results of this surgery might be—a surgery which entailed removing ¾ of the esophagus and stretching the stomach vertically to replace a removed muscle, leaving behind a portion of the stomach in tact. The surgeon warned us of the various types of potential complications such as a leak, a lung puncture, losing the vagus nerve, or vocal cord damage. He told us we should expect an initial weight loss of twenty to thirty pounds and possibly more during his postop bout with radiation and chemotherapy. At the end of his consultation, the surgeon looked us in the eye and said, “This isn’t your “typical” surgical procedure.”
There wasn’t a day I didn’t receive a phone call or an email from well-meaning friends who had a cure for cancer. If it wasn’t a Four-Herb Ojibwa green tea from Canada, it was an alternative clinic in Oregon, or a surgeon who performed a laparoscopic less invasive surgery in California. The options were overwhelming, as was the research that followed.
In the days leading up to his surgery, our love for each other blossomed: we went on long walks, communicated our deepest dreams and hopes, spent more time with family, worked together on business projects, held hands as we slept pressed together, kissed in the dark, and talked kinder to one another.
Days before the surgery, when darkness fell upon the house and Michael lay sleeping soundly next to me, I’d listen to the steady rhythm of his breaths sounding like small puffs of air. When he’d fall into a deep sleep, I’d silently slip into the bathroom, close the door and softly sob. I’d ask God why this was happening to us. In a whisper, I’d pray, feeling ashamed of my lack of faith.
Day of surgery
The family filled a small private surgical waiting room. There were ten of us: our adult children, Michael’s brother and sister-in-law, two of my dearest girlfriends (nurses) and my husband’s best friend, Steve, a retired orthopedic surgeon. We sat there making small talk for thirty minutes until a colleague of mine, a clinical manager in the perioperative area, asked me to follow her back to preop holding where Michael was getting prepped for his surgery.
I watched the preop nurse fumble in her attempt to insert an intravenous catheter (IV). It blew within seconds, (nurses’ jargon), which means it went through the vein. I thought about all the IVs I’ve started over the years and how uncomfortable it was when a family member was present, especially when it was a nurse. I took a step back and began to talk about my work as a preop and postop nurse at this very hospital—in this department for over twelve years. I must have prepped hundreds of patients undergoing a variety of surgeries: open hearts, kidney and liver transplants, mastectomies, cholecystectomies, appendectomies, every type of surgery imaginable, yet I never remembered prepping a transhiatal esophagectomy patient.
And yes, the nurse’s second attempt to start an IV was successful.