Losing Sleep

My mom often tells me I'm a worrier and to be honest she is probably right.  Lately my worrying has caused me to lose sleep.  I keep thinking about the surgery and what may come.  I know the surgery is weeks away and I shouldn't be so obsessed with it or the aftermath, but telling yourself not to worry and actually not worrying are two different things entirely.  Now that radiation is behind me all I can do is think about the surgery.

On Monday I met with my surgeon.  My discussion with her took several days to set in.  I told Dennis about it that night and even he had to stop me and tell me he needed some time to digest the information.  He is very supportive, but I know it is hard for him to hear what they are going to be doing to me.  

Here is what the doc said.  In mid March I will come back and see her so she can get an idea of how the radiation affected the tumor.  Based on the tumors previous location she wouldn't be able to the sphincter muscles thus a permanent colostomy would be required, otherwise I wouldn't have any control over my bowels.   If the tumor shrank and moved upward there is a chance they would be able to resect the tumor (pretty much remove my whole rectum) and attach my colon to my anus.  I know fun terms!  However this possibility comes with a few risks.  To start off when they do a resection, any resection, they need positive margins.  I believe my doc told me 2 cm.  My doctor says they can cheat the margins sometimes (say the go for 1cm instead of 2cm) but that will increase my chances of a local recurrence.  Yeah, that is the last thing that I want, to have to deal with this a second time around!  To ensure positive margins are met, they take a slice and have a pathologist call it on the spot.  If it is positive, they keep cutting until they get a clean slice.  Once the slice shows no evidence of disease (NED) they finish up the procedure.  After the surgery the slice is sent for further testing and should come back in a few days with a final call.  Now if the final testing comes back NED than I'm good and can proceed on.  If the final results come back  positive for cancer than they will have to perform another surgery and I will than end up with a permanent colostomy anyways.  The second surgery would need to be done within days of the first so scar tissue doesn't have a chance to set in.  If they are unable to do the surgery within 7-10 days of the first than they will have to wait another 4-6 weeks to go back in, thus pushing back the rest of my treatment.

Ok with all that information you may be thinking to yourself, think positive Melissa it will all work out!  Here is my experience though.  When my husband had his melanoma resected from his arm it took not 1 surgery to remove everything but 3.  He would get home from the hospital (his was an outpatient procedure) and within 3-4 days we would get a call from his surgeon saying that they had not met the positive margins and they had to go back in twice.

My surgery will be inpatient since it involves some major organs.  I will be in the hospital for about 7-10 days, obviously if I have a second surgery or any complications that time will be lengthened.  I wish I could just check out for the next couple months.  I've had my fair share of surgeries in my life, but this one is by far the most worrisome to me.  I don't feel like I'm in control of this on any level.  It has to happen, that I know!   Somehow I need to come to terms with what is about to happen.