A Spanish colleague at work had earlier this week spoken about his impressions of the Swiss health system. Whatever the problem, whyever you’re seen by a doctor, a blood sample will be taken. Common cold? Blood sample. Twisted ankle? Blood sample. Headache? Blood sample. A blood sample is the answer to everything, and impossible to avoid. It’s probably also a good way for doctors to make money with very little effort.
Yesterday, I had my fourth or fifth blood sample taken during the current miserable tour. Today, it turned out no one had bothered to check my blood type. This was remedied shortly before I left the hospital at 5. How much blood do you need to get the blood type right? The technician filled four vials.
But back to the beginning. The surgical consultation early in the afternoon was less than satisfying because not much was clear. The two main options with my diagnosis are chemotherapy and surgery or surgery and chemotherapy. The order seemed a matter of taste. Doing chemotherapy first might weaken the body too much for surgery. Doing surgery first might weaken the body too much for chemotherapy.
How do you decide between these options? It was easy for me. I want the tumor gone. The primary tumor presents the risk of blocking my colon and leaving my belly full of half-cooked shit with no way out. I’m not happy with this risk. The tumor needs to go.
The surgeon accepted this reasoning and was probably not thinking very differently herself. "Have you got time for more consultations later this afternoon", she asked. "I have a free slot for knife therapy on Monday." After a short think, I told her I was in.
Surgery should have a clear goal. You don’t cut a person open just so. My case is not that easy. Surgery will start out with a visual inspection (by remote controlled camera) of my ventral cavity. The goal is to identify tumors too small to be picked up by the PET-CT and get the best possible impression of what’s growing inside me, but that’s not really surgery. It’s just a tube inserted through a hole poked into my belly button, with a few more holes for accessory tools.
Based on what the surgeons see, surgery might start afterwards. And based on what the surgeon said, it sounded as if they’d juggle the scalpels and see which cut comes most natural. They might take out the tumor, if that’s unlikely to cause complications. With it, they’d also take out the surrounding lymph nodes. They might also remove the peritoneal carcinomas, if there are only as few as were visible during the PET-CT. If the entire peritoneum is covered as if with slime from a horror movie, they won’t touch it. They might decide not to do surgery at all and pass my case on to the University Hospital in Zurich for HIPEC, if that seems sensible. The surgeon wasn’t too convinced of this option. Or they might be totally repelled by what they see and not touch me at all before doing chemotherapy to shrink what’s grown too much.
This is a lot of options. Some might be better than others but even that’s hard to tell. It’s just not clear what would be the best situation, apart from not being in this situation in the first place. Anyway, I won’t have a say in this as I’ll be in general anesthesia. When I wake up on Monday afternoon, I’ll have to check my body to see what’s still there and how the knives have fallen.
0 comments:
Post a Comment