Back in January I had two operations ten days apart, one of which I call ‘The Little Op’ and the other ‘The Big Op.’
I am choosing to write about both and in doing so I am going to reveal an awful lot of undignified, personal information about myself in the hopes that someone who reads this finds some comfort or knowledge in a shared experience.
The second hope is that it makes people think about their lifestyle choices when it comes to medical tests and if there is anyone flip-flopping about having a smear than maybe this will be the metaphorical kick up the ass they need.
Disclaimer – there is no kicking up any asses here. There is however an examination of the rectum. So maybe this is the metaphorical finger up the bum you need. No pictures.
Second Disclaimer – I can’t make any of this sound nice.
Let me talk about ‘The Little Op.’ This was a procedure of two components: –
Now I usually like to include a lot of images in my blog posts. Got to be honest, not too sure how visual I’m going to make this one. If you need the use of visual aids I may just insert a prompt of *use your imagination here.*
First off, let’s do some background.
Pelvic Examination Under Anaesthetic
Oh look, a picture! Maybe I don’t believe you have any imagination…
Thank goodness for gloves.
I spoke of staging cancer in this post which is helpfully titled ‘Staging.’ Cancer needs to be staged (determined how far it’s spread etc.) before treatment can start. With my staging I was required to have an EUA to determine if the tumour had spread beyond my cervix to my vagina, vulva, bladder and or/ rectum and bowel.
This is all about as glamourous and sexy as it sounds.
When I first heard about this part of the process I believe the face I pulled was something like this…
Then I thanked all the deities in the world that I was going to be fully unconscious for this because some people may enjoy being fingered in all three holes in front of a group of people but I can tell you this for free… I am not that person.
In essence, I pulled my finger out my own ass (figuratively speaking) and finally got my smear test done only for someone else’s finger to go back in (literally speaking).
This is clearly not a pleasant procedure and because they need to do a thorough and detailed investigation it is better for all involved that you are not awake during it. I remember nothing. On occasion when I chat to my consultant I think to myself ‘he’s had his finger in my bum.’ I feel no shame. He is, after all, a medical professional who was curing my cancer.
Pelvic Lymph Node Dissection
I knew nothing about the Lymphatic system before my diagnosis as I never needed to. I’d heard it mentioned all the time but didn’t know/ care what it did. I was alive and functioning so that must have meant it was working. Wonderful.
Oh. It is. Wonderful, I mean.
Here is a picture of your lymphatic system.
You can see on the image the word ‘nodes’ cropping up a lot and this is because they play an important part of the lymphatic process and are very important when it comes to cancer diagnoses.
Explanation
The lymphatic system is made up of thin tubes (lymph vessels) and nodes that exist throughout the body. This system plays a vital role in our immune system and helps fight bacteria and infections and even gets rid of abnormal cells. The vessels contain a fluid called ‘lymph’ which contains a lot of white blood cells that are essentially ‘the warrior cells.’ My words – not a medical definition.
This lymph drains into our body tissue and ‘feeds’ it. The fluid and the cells then collect bacteria, abnormal, dead and damaged cells and flows back into the vessels via the little kidney shaped nodes. In turn, the vessels drain into the lymph glands and all is filtered out of the body.
This system is the highway of the body (along with the circulatory system) with all the cells flowing away, nourishing and draining and filtering when needed. It does this all over your body.
Amazing.
It does this all over your body.
If you have cancer then the concern is this: –
A lymph node is near the cancer site. The lymph fluid has flowed towards the cancerous tissue and has ‘fed’ it. It then collects any nearby bacteria, abnormal, dead and damaged cells and flows back through the node, into the vessels and travels to other parts of the body. See the problem?
Along with ‘normal’ abnormal cells there could have been a hitchhiker. A very nasty hitchhiker.
You can see from the diagram that some lymph nodes are nearer vital organs or prominent tissues, a key one is the lymphatics of the mammary glands. Lymph node involvement is vital in instances of breast cancer. Breasts are not a major organ but damn if they aren’t near the lymphatic highway which goes to those that are.
This is the pelvic lymph node section…
What they also performed whilst I was unconscious was a ‘Pelvic Lymph Node Dissection’ or ‘Lymphadectomy’ which meant they removed all pelvic nodes and sent them off to some nice people in a lab who double checked that no cancer had spread into them.
Because I am a lucky girl I had no spread into the surrounding tissue or the nodes. If I did then my treatment plan would have differed and I believe this is where chemotherapy steps into play.
Does removing lymph nodes come without any impact? Does it heck.
The Operation
Let me begin my saying this:
It is never a good idea to eat out of date ham the night before you are due to go into hospital for an operation.
Even the cat refused to eat the ham that I dropped on the floor for her. That should have been my first clue that something was amiss. The fact that she turned her nose up and trotted off, tail in the air, was something I chalked up to her being a cat and was just therefore full of The Attitude and was in fact being Ungrateful.
What she was thinking was probably something along the lines of ‘my human slave is trying to poison me and then herself in some unusual murder-suicide pact. I will not stand for this.’ I don’t think I saw her for the rest of the night. This was a good thing as I became, understandably, quite unwell and it took my long-suffering partner to inform me that I wasn’t experiencing ‘pre-operation nerves’ but stupidity as the ham was weeks past its eating date.
Oh well. We live, we learn. Right? Right?!
The whole situation was made worse when I realised that as part of the operation I was going to have a rectal examination. Please take a moment of silence for my consultant and his team.
Let’s fast forward shall we to the Surgical Short Stay Unit at the Royal Surrey Hospital at 07.15am the next day.
It felt like going on a perverse holiday. You know when you have your bag packed and it’s dark and you’re travelling someplace? You know when you have the butterflies in your stomach and you’re feeling something akin to nerves or excitement? Yep, that was me. Nervous but oddly excited. Not excited to have surgery but you feel like there is finally movement. You have this horrible dark cloud of cancer that is constantly floating over your head and it’s only visible to yourself and the people that know about it. My partner swears they weren’t but at this point I was paranoid people who knew were looking at me funny. This was the first step to getting rid of that cloud and I couldn’t have been more relieved.
This was me (I mean it still is me, but this was me in January 2017): –
That is one sexy looking lady with no contact lenses in and no make-up on. The bra-less, hospital gown look is fetching but I feel that what truly makes the outfit is the surgical stockings in a colour that can only be described as ‘swamp-green’.
Hospitals should have a plaque that reads ‘Leave Vanity at the Door’ because… yeah. Just yeah.
This is how it went: –
Then came the bit where I had to say goodbye and was wheeled out to the pre-op area. It’s a bit weird as hospitals won’t let you walk anywhere even though I was able and actually wanted to, I had a lot of nervous energy to burn off, but sadly it was a no go.
I was most amiable. I mean ridiculously cheery. They told me I was one of the happiest pre-op cancer patients they had ever seen, especially at that time of morning. I think this was a combination of my naturally sunshiny personality (oh pipe down people that actually know me, I can be nice) and nerves.
The truth is this: I cried when I was alone in the pre-op area.
They came and asked me the checking questions and went through the procedure a final time. They wished me luck and told me that someone was going to be here to collect me soon and then they left. Another patient was wheeled in, we spoke about our nerves, wished each other luck and then they wheeled her out. And it was me, my nerves and the clock opposite. I had a quick, nervous cry.
The truth is also this: I still feel like crying when I remember being alone in the pre-op area.
It’s ok. If you, reader of this blog post, find yourself in that same situation and feel like having a quick, nervous cry it’s completely ok. It’s the natural response to a situation you don’t want to find yourself in. Even now when I feel like having a cry I think to myself ‘it’s ok, it’s the natural response to a memory of a time when you were scared shitless and all you could think of was how much you didn’t want to be in that situation.’ It’s ok.
If you find yourself in that same place just think of an idiot who ate out of date ham the night before a pelvic procedure, who couldn’t quite comprehend that she would need to remove underpants for said pelvic procedure and who had a little cry about the fact that they weren’t expecting to face this in their life at any point. It gets so much better. Trust me on this.
So, they came and collected me and wheeled me into the anaesthetic area. On the way, I saw my new friend. Let me introduce you: –
This guy is the Da Vinci robot and he (or she, robots are gender neutral after all) was the glorious piece of equipment that performed my surgery. Sure, I cracked jokes about Terminator and Johnny Five (ok, I should never have cracked the Terminator jokes as managed I convinced myself the robot rebellion was going to happen whilst I was unconscious) but this performed my surgery!
If you are so inclined here is a video of the robot sewing a grape back together: –
Clever little bugger. This guy went in through 5 points on my stomach. I’ll show you a fun picture later.
It turns out, because using the robot is a unique experience and having a trachelectomy is not very common, they like to use the opportunity to train other hospital teams in the full procedures from start to finish. So, the woman that was scared to get her smear test done due, in part, to embarrassment had the Birmingham and Belgium teams in to observe. That day I had eight people staring at my genitals and rectum. I looked to the cosmos and raised a caustic eyebrow. It raised one back.
Touché cosmos. Tou, fucking, ché.
I had to slide onto the operating table which had some odd, foam thing from my head down to my waist to stop me sliding about but with a strange gap in the middle which my pelvic rested over. I believe this was for, how can I put this delicately and ladylike and politely…
Hello exposed crotch. Meet world.
What happens is time travel. Other’s call it general anaesthetic but I call it beautiful. You close your eyes in one place, feeling one way and then when you open them you are in another place, feeing completely different. Things have happened during that time. Oh, such things.
What was a minute for me is a couple of hours for everyone else.
Here is a rundown: –
Yeah, remember when I said I would allow you to use your imagination. Hahahaha. The joke is on you because it’s too late, you can’t un-see what I have made you see.
They do all this after they have inflated you with gas because they need to puff you up like the girl from Charlie and the Chocolate Factory so they can see what they are doing.
I’ll tell you more about the gas later.
I woke up in post-op where I managed to successfully throw a cup of water over myself. One discrete gown change (I salute you post-op recovery nurse) and pad check later (oh yes, the mega sized sanitary towel of Doom positioned over my lady bits) I was back in the Surgical Short Stay Unit.
At this point I was half wondering what the fuck had happened to me and half desperate for a cup of tea. I am so British sometimes it goddam hurts. I managed to drink half a cup of tea before the side effects of the general anaesthetic kicked it…. vomiting.
A visitor to the lady in the bed next to me was the chatty type and had already started filling me in on her life when the nausea hit me full force. Now, I had two choices. Throw up on myself whilst this lady was talking to me or try and peg it to the bathroom and retain some dignity.
I opted for number two. I excused myself, incredibly politely, and then, in what I thought was a dignity retaining manoeuvre managed to run to the bathroom. Post pelvic surgery.
As it turns out this was not easy with a giant sanitary towel stuffed between my legs which I only remembered as soon as I hopped off the bed. I did a shuffle-run with my knees pressed together as tightly as possible which just heighted the impression that I was about to take a poo on the floor. My dignity saving move was also compounded with my now incredibly loose hospital gown flapping behind me in a self-made breeze caused by my shuffle-run and so my naked arse was on full display to patients, nurses and guests.
The moment I performed the most wonderful throw-ups of all throw-ups was the moment I heard the nurse bring my partner in. I heard her say, “oh, she was here a minute ago” whilst Huw got the delights of “bleuuuuuuuuuuuuuuuuuuuuuuurgh” greeting him from behind a closed bathroom door. Welcome to your newly betrothed Huw. Welcome.
Considering as I’d just had surgery through my abdomen, throwing up was not a lot of fun (is it ever?!). I got to clutch my stomach, mutter some swear words and pray that my glasses didn’t fall into the toilet bowl. (NB: Much like my over-sized sanitary towel did later on when I forgot I was wearing it and wanted a wee).
The nurses injected me with anti-sickness medicine and then I got to hang around the unit until 8pm.
This blog post is already a million pages long and those reading it have already aged twenty years and so I am being kind and will split this into two. Oh yes, if you had a wonderful time reading about someone’s Pelvic Examination Under Anaesthetic (and I mean, who wouldn’t!) then please stay tuned for part two and what happens when released from hospital.
Not a lot. I’ll be honest with you here, I’ve just had surgery. It’s not a lot.
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