Rectal Cancer Surgery – Day One

After having my last meal at 9 pm the day before, and very little sleep (4 hours), Trine (my wife) and I had to get up early this morning (3 am) in order to prepare for surgery. I had the cut-off for drinking liquids at that time, I also had to drink 8 oz of Gatorade and do a fleet enema (emptying my rectum). Once done, I could take a nap until 4 am, where I did another fleet enema and showered using the chlorhexidine sponge that was given to me. (I had to do a shower, using one sponge before bedtime, and then again shower using new sponge at 4 am)

We left Mountain View at 4:45 am and arrived at the hospital around 5:15 am. We had valet parking for the car, and went to the surgery department of Stanford Cancer Center, Palo Alto on the 3rd floor. Since they already have my picture in their systems, checking in was as simple as to fill in a small form about my health and travels in the last three months. Next, I checked in again with some other people, this time I had to sign to allow the surgery, and have the cost billed to the insurance company. I also handed over my Advance Directive (Living Will) that would allow my wife Trine to make decisions on my behalf while unconscious. It also gives directions on decisions on Transplants, brain death, etc.

Next we were sitting in the waiting area for a little while, and then I was called in to prepare me for surgery. Once into the prep room, I switched into a hospital gown and socks.

A nurse came over and started a series of questions of which I don’t remember much. Then the anesthesiologist came and started the IV (this was a resident doctor), and a minute later the anesthesiologist in charge arrived as well. (we had a little discussion about Denmark, where I am born, and about Germany, where he had lived for a while). Then came Doctor Kim that would be the resident rectal surgeon, and Dr. Welton that would be in charge of the rectal cancer surgery. It is a two person job. I will have more details when I have spoken to Dr. Welton Friday morning. An intern also showed up, she would be there during the surgery. While juggling a few conversations and the setup of the IV, if was then ready for surgery. As “usual”, I got the shot of anesthesia of the same type as the one used for colonoscopies, and I passed out right away. I think this happened at 7:10 am. Next I was rolled into the surgery room, and a catheter was inserted, allowing my bladder to empty itself with no help from me. (I think the nurses will remove the catheter after 24 hours). They inserted a breathing tube in my mouth/throat and started the Propofol, (I believe this is what was used. A stronger anesthesia). The surgery ended at around 11:10 am, so it went on for roughly 4 hours.

I gained consciousness at around 12 PM. It was a weird experience. I did not know that I was in the recovery room. I was lying there and could not figure out if I was waiting for my surgery to start, or if I had had it already and was in recovery. I did notice that something was different in my pelvis/stomach area and found it wise not to move. I did notice that I had the full sense of my rectum muscles, and all of the other critical muscles in that area (sexual as well, I believe), and I lay there for maybe 10 minutes before a nurse came over and said that she would get my wife. 10 to 20 minutes later Trine came in and confirmed to me that I had had the surgery already.

Complete Success
Trine told me that the rectal cancer surgery was successful, no ileostomy bag was necessary, everything was in perfect order. I was then rolled over to my hospital room, where Trine got down in a chair next to my bed.

I have chosen the PCA pump for my pain medication, and a nurse connected it to my IV. In the first few hours, I used it every 45 minutes (max every 15 minutes), but after that, I used it every two to three hours, and of the writing of this post, I have not used it for 5 hours.

At around 5 pm, when I was lying sleeping while listening to an audiobook, a group of doctors came in and woke me up. (I was startled, but woke up quickly). They asked me if I had any questions about the surgery, and I asked them if any of them had been with doctor Welton in the surgery room. It turned out that only the intern had been there. I told them that I did not have any questions, but I would appreciate talking to Welton about this experience, the result, and my situation. They said that he is doing surgery all day, but would probably be here at around 5 to 5:30 am Friday morning. That was the end of that conversation.

I was also encouraged to get up walking, to prevent blood clots, and to avoid soars from lying in the bed. I did my first walk at 4 PM (less than 5 hours after surgery) it went very well, I walked four rounds in my hospital unit. My first attempt was a little shaky, but at the end I was much more stable. When I came back, I tried sitting in a chair, but there I was overwhelmed with nausea, and the nurse, had to come in and give me some nausea medication. In the meantime, I had gone back to my bed, and the effect of the medicine took away nausea almost right away.

I had my first meal at 5 pm (Oatmeal, milk, and grape juice), and then I did another walk. This time, I was pretty normally functioning and had a good talk with the nurse that followed me around. No nausea upon return to my be.

Noisy roommate
Once back in my bed, I asked Trine to ask the nurse if they could move me to another room. My roommate woke up and cried and had great pain every hour. He was old, and I thought I would have tough night ahead of me if this continued. The staff was very understanding and moved me to an empty room, where a patient that was currently in surgery would arrive soon. They could not guarantee me that this patient would be easier to have as a roommate, but I took my chances and moved. One hour later the patient arrived, and he is pretty quiet, so that was good luck.

At 8 pm, I ordered a chicken noodle soup, a cup of coffee, and a few bottles of water. I started feeling dizzy one-third into the soup and lied down to sleep and rest. A little later, I woke up and finished the, now, cold soup and coffee. Slept a little more watching 30 Rock on Netflix. (yes bandwidth is high here).

One more walk at around 11 pm, where I was normally walking, and felt really good.

I called Trine right after, and we had a half an hour conversation celebrating the good outcome of the surgery.

The next VERY IMPORTANT step in my recovery is to bring my digestive system back to life again. I did what I could (eating twice), now we are waiting for me to start passing gas, and stool. Once I have done this, we know that my body is working as planned. That and the ability to urinate on my own (Catheter will be removed Friday morning, I think) are very important factors when it come to discharging me from the hospital, and, in general, to declare the surgery a success all the way.

Now it is 4 am, and time to sleep. (Trine and doctor Welton, will be here at around 5 am.