Acquiescence

We all have expectations that are set by ourselves, and by others, which influence our perception of every aspect of life. Sometimes these are small and simple like expecting your morning coffee to taste bold but smooth with a strong comforting aroma and a warmth that lifts your spirit. Sometimes our expectations become blended with hope which can push us harder and fuel the drive in our life to meet or exceed those expectations. And sometimes these expectations, whether blended with hope or not, result in a cold honest look at reality. Words don’t always express the emotions felt in this last situation.

Though I have made every attempt to provide and manage appropriate expectations through this blog, to inform and explain, to blend hope and exceed statistics, I realized today that some individuals have different expectations than anticipated. I am also committed to an honest look at reality; the depths of which we experienced today.

Dad went down for pre-op early this morning and was rolled back to the operating room at 8am. Our expectations were appropriately managed by the anesthesiologist as he explained his portion of the morning and how he would be caring for Dad.  The surgeon explained his part as well. The plan was to place two or three small incisions in the abdominal wall and insert a 5mm camera to view the abdominal cavity with anticipation of determining the cause of Dads small bowel obstruction. Dad gave out a few last hugs and squeezes, holding on tighter than normal for slightly longer than normal. We were given a time frame and directed to the waiting room.

As we waited, the many various expectations that we have been given over the last year began cycling over and over in my mind. Some have been met or exceeded, some have been a disappointment, and others are still pending. The first post on this blog was from just shy of one year ago. In this first post, an overview of how the journey began is provided, along with an explanation of the type of cancer, and an expectation based on statistics and averages for the rough life expectancy of patients with similar diagnosis. This 18 to 24 month timeframe was based on successful chemotherapy treatment and was stressed as just an estimate. This was an appropriate expectation with which to blend hope; and blend hope we did. Some poorly worded communication from Dads oncologist on several occasions further impacted our expectations. As I mentioned in the post that went out early this morning, typical diagnostic scans have also played a role in these expectations – specifically regarding their lack of useful information in Dads case.

We were all sitting in the waiting room with distracted and anxious chatter when the surgeon came out to speak with us right on time. Straight forward, honest reality. The laparoscopy showed images of the abdominal cavity with many small cancerous tumors spread throughout. These appeared similar to the images from last summer, though todays images show an increased quantity and range over which they are spread. This was the information we were hoping NOT to hear.

Many questions were asked of the surgeon and he gave us all the time we needed and the best answers he could provide. This kindness and professionalism was greatly appreciated. Essentially, these cancerous sites have taken hold like seeds growing in rich soil. As they have grown and spread they have inhibited some of the bodies natural processes which has resulted in the same effect as a small bowel obstruction. There is not a large tumor or mass that is physically occluding the intestine. Instead, the many small sites are constricting the area and inhibiting peristalsis which is how the body moves food through the bowels by a series of constriction and relaxation of the smooth muscle.

This has turned an effective process of digestion into a non-interactive system of pipes. With the loss of flexibility and decreased peristalsis, Dads diet will need to be amended to ensure the nutrients are able to freely flow through the intestines with minimal assistance. This is highly suggestive of a full liquid diet.  We meet with a dietitian tomorrow to discuss this in more detail.

We also meet with Dads oncologist tomorrow to discuss details of the paths we will have the option to walk down as we move forward. One option includes chemotherapy and the other does not. The statistics and success rates, along with average timeframes for the current situation will also play a role in determining which path Mom and Dad choose.

Regardless of where we go from here, todays outcome was disappointing to say the least. Not shocking or completely unanticipated, but certainly disappointing. As such we must accept the honest reality and make the most of what we have been given.

More updates will flow later this week as pertinent info becomes available.

With Hope and Love,

Richard