Part 2, The Surgeon

We like his surgeon a lot. Dr. John Francis. More important, I can see how confident Kevin feels about him.

He stacked up well in the research I did beforehand--does medical missionary work, has an impressive experience record and is specially trained in laproscopic technique. He thinks he may be able to do Kevin's surgery laproscopically which would mean 4 to 5 small incisions instead of a full abdominal opening. We both feel good about his skills and decision making abilities.

Which is a major plus because Kevin's surgery is going to be one of those "decide as he goes" deals for the surgeon. Depending upon what the surgeon encounters, it could be laproscopic, a full abdominal resection or possibly go into an abdominoperineal resection. We won't know until it's over if he will have to have a colostomy. We really won't know much at all until after the fact. I felt like he heavily prepared us for the higher end of the scale but the window is open for it to be less. And I could see Kevin relax with this new hope of a less devastating surgery.

Surgery will be scheduled in the next few days and probably occur within the next couple of weeks. He may be hospitalized as long as 10-14 days, depends upon which surgery is done and how he responds.

It was a comfortable meeting especially considering the topic . He did a thorough exam (already I know we will never again hear the word "peek"--as in "doctor will want to take a peek up there"--without relating it to cancer) and I was allowed to stay which helped Kevin be more calm and let us get a lot of questions answered right there in the moment.

I'm not in the least bit squeamish and probably do better, in fact, when I can be with Kevin rather than shunted off somewhere to worry about him. Kevin doesn't hear well and he relaxes more if I am there to listen and repeat information he would miss otherwise.

The 'stand back and watch from the outside' part of me did think it was probably a pretty strange scene. The three of us in there chatting about missionary work in Africa while the surgeon was busily taking the aforementioned "peek up there."

The good news from the exam is that the tumor is higher than the surgeon expected it to be based on what he had read in the colonoscopy report. "You don't want to be able to reach up and touch these things" is how he put it.

I'm going to take his word on that not being able to touch it thing.

From a surgical standpoint, the higher the better in terms of allowing surgical access and enough room to work and put things back together. This increases the chances of both completing the surgery laproscopically and avoiding a colostomy.

We were ready to hear some good news today and doing so makes it easier to move forward.

**Surgical technical note which may be more information that some want so feel free to slide on past this portion. Having the tumor be located higher improves things in a number of ways, including:
First, it becomes easier for the surgeon to get to the area if it's more away from the pelvic bones. Higher increases the chances of laproscopic surgery succeeding and improves Kevin's entire recovery period.
Second, the tumor will be removed as well as an area above and below it along the bowel. This will limit the liklihood of there being other, scattered cancer cells left to grow. They refer to this as having "clear margins." You don't want pathology to find any cancer cells in the surgical margins. If the tumor is too low in the rectal area, there may not be enough room to gain a clear margin or, in order to do so, there may not be enough bowel left on the low side to reattach to. This would mean a permanent colostomy. In a worse case scenario, it could mean a more intensive surgery with dramatic and permanent body changes.**