The toe bone is connected to the foot bone…..the esophagus is connected to the ?

This week I have two interesting things to discuss so I am going to split it into two separate blogs.  This blog will focus on a questions prompted by a few of my co-workers this week as well as Steve’s blog “I still have a torso“.

What exactly is the surgery that you are having?

I realize this week that I speak a lot about “the surgery” but not exactly what “the surgery” involves.  So today I’ll give a brief overview of what I will be having performed.  It is called a Total Gastrectomy with a Roux-en-y esophagojejunostomy (try saying that ten times fast!).

From my understanding, it is a fairly involved surgery that can take approximately 4-5 hours once you are in the operating room.  Just like an airline flight, I will need to arrive a the hospital three hours before surgical time, only this flight has no return ticket.  I’m not exactly sure what occurs in those three hours prior to surgery but I am sure they involve the preparation.  I bet it also ensures that people will make it to their surgery on time given the state of the traffic on Ontario’s major highways.  I know that I will be having more IV’s as well as an epidural (similar to what women can receive during labour) only this epidural will remain in me for some days after surgery to help manage pain.

Long story short, the esophagus is connected to the second part of the small intestine (the jejunum).  Here is a picture of what will happen to my pipework before and after the surgery:

The surgery is similar to gastric bypass surgery.  I think the difference is that the lymph nodes surrounding the stomach will also be examined and removed to prevent any chance of cancer going to other places of the body.  I am unsure if the surgeon will do a D1 or a D2 Lymphadenectomy.  This is also important because until this point, I will not know if my lymph nodes have been affected or not (meaning chemo and/or radiation afterwards).  But not to scare anyone, so far, my surgeon has not had any patients with Hereditary Diffuse Gastric Cancer syndrome who have needed chemo and/or radiation *knock on wood*.

After the surgery, I will likely be in the hospital for 8-9 days.  For the first 4-5 days, I will not be able to eat or drink anything to ensure that everything is connected and healing well and prevent leakage.  So for those who are planning to visit me, bringing delicious snacks is probably not a good idea during those days….haha.

In terms of nutrition afterwards, I will have to eat small frequent meals.  From reading other people’s blogs and watching my mom go through it, I believe the first month is the hardest and things get easier from there.  I think this is because your body is initially like, “What the?!?!” and then it’s like, “Oh, I got this”.  The body is an amazing machine.  I’m also going to gain 100lbs – Just kidding, if only it was going to be that easy!  I will likely lose 20% of my body weight over the next six months before it evens out.  I will no longer be able to eat copious amounts of sugar but that’s okay because you probably shouldn’t eat that way anyways. I will have to watch my vitamin levels and I will also need to have regular B12 injections.  I also will not feel hungry ever again which will be a new concept and I hope that will mean I no longer get, “Hangry” (hunger = angry).

In terms of work, I will be taking about two months off.  Because the job is fairly physical, I want to be sure that I’m fully recovered before jumping back into things.  This will be a difficult thing for me because those of you who know me, know that I love my job.  I am thinking that during the second month, I’ll start physiotherapy at one of our clinics because I will have stayed in the hospital over night, so I will be covered by OHIP.  Yes! *Shout out to all our OHIP funded clinic teams*.

So that’s about it in a nutshell. For more information, I encourage you to check out no stomach for cancer’s webpage link regarding the surgery and more.


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