Getting Ready for and Having Surgery
From my online research, I did learn the answer to two key questions that were valuable to me in prepping for surgery: What is pancreatic cancer? What is Whipple surgery? I was like most people: We do not know very much about a disease until we or a loved one is diagnosed with that particular disease.
Please read the following discussion with some care. It is pretty scary stuff (at least to me). I needed to understand what I was facing—but without viewing a YouTube video.
According to the Mayo Clinic:
Pancreatic cancer begins in the tissues of your pancreas — an organ in your abdomen that lies horizontally behind the lower part of your stomach. Your pancreas releases enzymes that aid digestion and hormones that help manage your blood sugar. Pancreatic cancer typically spreads rapidly to nearby organs. It is seldom detected early. Surgical resection is the only curative modality, but a mere 10% of patients are candidates for resection — and even then, the five-year survival rate after acurative resection is only 20 percent. 1
Memorial Sloan Kettering Cancer Center notes this:
The Whipple procedure is the most common typeof surgery for pancreatic cancer. It is used to remove tumors that are confined to the head, or the right portion, of the pancreas. It is also known as a pancrea to duodenectomy. The surgeon removes the head of the pancreas, part of the small intestine, the lower half of the bile duct, the surrounding lymph nodes, the gallbladder, and sometimes part of the stomach. The remaining stomach, bile duct, and pancreas are then joined to the small intestine so that digestive enzymes can mix with food. Surgeons may also remove part of the portal vein (a blood vessel that allows blood to flow into the liver) if it has been invaded by a pancreatic tumor. Although this procedure is complex, it is safe and effective for many patients. 2
In getting ready for surgery, we were extremely fortunate that everything happened so quickly. As much as my family was stressed out (they knew how to use the Internet too), it was just 4 weeks from the initial scan to surgery, with only a week between the consult with Dr. Coppa and the surgery itself.
As noted before, leading up to the surgery, I remained remarkably calm and took on the role of cheering up others—who needed a lot of pepping up. I’ve since learned that many people (by no means all) facing life- threatening surgeries are rather serene. I’m not sure why. In my case, I was so determined to live (despite the odds), to spend quality time with my family and friends, to be able to return to work, and to be at my daughter’s wedding that the negative alternatives didn’t cross my mind. In addition, I tried to focus on all that was good in my life rather than the dire situation I was facing. I guess Dale Carnegie called this the power of positive thinking.
It was then that I promised myself to live life every single day. To do more things that I truly enjoy. To stop being such a workaholic. To wake up and smell the flowers more often (see the good, not the bad in my life). And to not waste time dwelling upon the uncertain future.
Sometimes, we think so much about what’s going to happen down the road that we forget to live in the present.
Since my surgery, I am a much different person in both my outlook on life and in my priorities. Just ask my family and friends. I don’t put off activities that I really want to do because I am too busy or if certain experiences are “too expensive.” They’re not, in the overall scheme of things.
Prior to the day of the Whipple surgery, there were many more tests to complete, as well as a lot of additional paperwork to fill out. We were told that I would be in the hospital for about nine days. The first couple of days would be in intensive care and then the rest of the time in a regular room.
On the day of my surgery, the six of us (Linda, Jennifer, Stacey, Phil, Adam, and I) arrived at the hospital at the crack of dawn. Thus, began a very long, stressful, and anxiety-filled day for the entire family. [I didn’t know it at the time, but my friends Marc and Seth each dropped by during surgery to comfort the family. What a touching gesture.]
I tried to crack a joke to ease some of the tension. But I just got blank stares. My lame joke? The surgery would be the only part of this experience that I would enjoy more than the rest of the family. After all, I’d be asleep. And the family would be stressing out. Groan. Groan.
Groan. I tried.
Dr. Coppa stopped by before surgery and told the family that he would do his best to report back to them about halfway through the surgery to provide as much feedback as he could. He was a man of his word, which they greatly appreciated. Dr. Coppa reported that he was pleased with the results at that point.
Just before I was wheeled into the operating room, several other doctors stopped by to say hello to me and to give my final instructions. Because of the length of the Whipple surgery, teams of doctors and nurses would rotate throughout. Dr. Coppa would perform the most critical surgical techniques. Also, due to the length and sensitivity of the Whipple surgery, I received an epidural as well as intravenous anesthesia. Thus, I was in la la land before even reaching the OR.
During the surgery, while I was in a deep sleep, my family got to worry in the waiting room. As noted above, Dr. Coppa’s in-person visit at the midway mark helped them: Everything was going as expected. Thus, they could stress out a little less.
After the surgery was finished, Dr. Coppa told the family that everything went very well. He got the entire tumor out, and there was the desired margin to clear around the tumor. AND because I was diagnosed so early, more tumors had not formed in my pancreas nor had they spread to my lymph nodes. This was a very big deal indeed, and improved my chances for a long life.
Once I awoke from the anesthesia, my relieved family came to visit me in the ICU—two at a time. Dr. Coppa also stopped by and explained the surgery in some more detail. He stated that I had the best outlook of any patient he had treated for pancreatic cancer, and that he was convinced that my future prognosis was excellent. He said I should ignore the mortality rate statistics for pancreatic cancer, since virtually no one included in the research studies was blessed by the level of tumor containment that I had. Unfortunately, research studies often lump everyone together to form “averages,” regardless of the condition of the individual patient. I realized then—and now—how blessed I am.
Dr. Coppa also described what else he did during the surgery. My gall bladder was removed. Two-thirds of my stomach was removed, more than typical since he saw a mass in the middle area. Rather than finish the PC surgery and then get back biopsy results from the stomach, he decided to remove the middle part of the stomach during the surgery. He did not want to risk having to do a second surgery for the stomach with me in a highly weakened state.
As it turned out, the stomach biopsy was negative. Nonetheless, Dr. Coppa definitely did the right thing!!!
In addition, I learned that during Whipple surgery—once the procedure is completed -- the organs are placed back into the chest cavity in a different order than they were in originally. An anecdote: When my oncologist ordered my post-surgical CT- scan, the radiologist had a hard time deciphering it. The scan results had to be sent to Dr. Coppa so that he could explain that everything in my body was where it was supposed to be—and where he intended it to be.
Still being rather naïve about pancreatic cancer, I didn’t really appreciate the intensity of all the post- operation stuff I would go through. I don’t know why I thought things would be easy after surgery as long as all of the cancer was removed. I was about to find out how off target that I was. What followed the operation was truly an adventure.
Here's one reason why I consider myself to have been so lucky in this part of my journey and not unlucky. My family was fantastic in supporting and encouraging me. And so many friends and