The date for my surgery is set. On the 1st of June at 6.30 sharp I need to register myself at the Women’s Clinic. On the 17th of May, a nurse from the hospital called to confirm the date and inquire about allergies, weight and height.
“You will have a one-hour meeting with the surgeon next week to discuss the operation,” she said. “And the same day you will meet with the anaesthetist, the stoma nurse and the nutrition consultant. In between you should go to the lab for a blood test and a heart film,” she added resolutely.
*
Up until that phone call, the surgery had seemed far away. My unconscious goals had been to cope with the chemo treatments and their inconveniences and mentally come to terms with the fact that I have a deadly illness. These alone had already caused some sort of cognitive overload leading to forgetfulness. For instance, one day, I had found myself embarrassed standing at the counter in the K-Market, telling the cashier I’d forgotten my pin code.
So, I hadn’t given my operation much thought. Also, I have only had good experiences with surgeries. Exactly 28 years ago, my youngest was born with a caesarean in Heidelberg, Germany. Some years later, I had both wrist and ear surgery in Oulu, Finland. At the time I used to tell myself that many had gone through invasive procedures, whether giving birth, undergoing wrist fracture management, or a stapedectomy sometimes even in less favourable circumstances. “If they can do it, I can do it,” was my mantra. Looking back, I seem to have been almost fearless in my younger years.
*
The day after the call from the nurse, 14 days prior to the surgery, I suddenly started to feel anxious. June 1st was getting closer, and I tried to remember what the doctors had told me about surgery during the past five months. “You might get a stoma,” warned a female doctor sometime in January. “Your stay in the hospital probably takes 7-10 days,” said another doctor sometime later. I also remember flashes of discussions with my fellow-chemo goers. “My surgery took more than 10 hours,” one of the ladies proudly declared as if she had taken part in a fierce competition. “After the surgery, you’ll stay in the Gynaecological Ward,” the nurse told me during my fourth chemo treatment.
Snippets of information from different resources aren’t helpful at all. On the contrary, they cause insecurity.
I decided to go online to prepare myself for the one-hour meeting with the surgeon. I looked up debulking, surgery to completely remove visible cancer and CRS, cytoreductive surgery, during which all cancer within the abdominal cavity will be removed. Both operations seem likely procedures for my ovarian cancer with metastasis in stomach and liver. I wrote earlier that Google isn’t exactly a consoling platform. It took some courage to go through the details and try to understand the surgical procedures. Logically, my eyes also scanned the paragraphs about success and mortality rates. In both surgeries the prospects are incalculable. While my brain tried to make sense of the overload of information, I gradually started to freak out.
As always when I feel stressed, I started getting nightmares. For instance, one night, in my pyjamas, I stepped into a doctor’s examination room. I saw a red sofa, the kind of sofa that Freud used for his psychoanalysis. The floor was scattered with broken ampules, syringes and medicinal bottles. The bearded doctor harshly ordered me to take a seat on the sofa. I stood in the doorway, didn’t want to walk barefooted through the glass debris on the floor and freaked out. I woke up in sweat at 4 am.
The next morning, I decided to analyse my fear and started writing this blog post.
Preoperative proceedings
I’m not too worried about the anaesthesia. To be honest, I’m rather not aware of what is going on in my body during the operation. I just hope surgeons and nurses will treat my body with respect, but I suppose that is a matter of trust. Generally, I love the drowsy feeling before falling asleep.
Surgery
The chance I will die during surgery is low, less than 1 in 100,000 according to Google, but still present. My grandmother died during a hernia operation. “The surgeon made a mistake,” my traumatised mum used to tell me and my sister. Also, I know that blood clots or heart attacks do sometimes happen during surgery. But then, it doesn’t seem to be a bad way to die as I’ll be unconscious anyway. I’ll just make sure I will call my boys and their partners to let them know I love them the evening before I go under the knife.
Post-operative
Concerning the post anaesthetic phase, I do fear the moment I wake up after the surgery. How much pain will I have? How tired will I be? Will my hand feel a stoma on my stomach, or not? Will one of the surgeons come to my bed and tell me they were able to remove all cancer? Or will they regretfully tell me that there are still tumours left behind. Will I be able to comprehend this information? Is it possible to reply adequately, or will I react like a zombie, lying flat on a white hospital bed?
My uneasiness with my post-operative state has to do with potential dependence on the nurses or therapists. Whether bathing, eating or walking, I wonder if I need help? I’m an independent woman and rather take care of myself!
*
Finally, on the 24th of May my husband and I get the details of the operation during our one-hour meeting with one of the surgeons. “My colleagues and I will first start with a laparoscopy in the abdomen to check the intestines. If we find widespread tumours in the small intestines, no more extensive surgery will be performed. Three more chemo treatments will be scheduled then,” she explains.
If the surgeons can’t find tumours in the bowels, they will perform a CRS (cytoreductive surgery) and remove the uterus, the ovaries, fallopian tubes and ligaments as well as the omentum, spleen and liver nodule. As a precaution, also peritonectomy and bowel resection will probably take place.
“The bladder will stay intact,” the surgeon promises.
*
To overcome my fear, I schedule a last minute meeting with my therapist to ask her for a way to release my post-operative insecurities and fears. “What can doctors and nurses do to make you feel calm in the recovery room?” she asks. For a moment I look at her in astonishment. It never crossed my mind that I could ask for anything and don't know what to answer. “I hope someone will touch my arm and tell me that everything is fine,” I finally say. “Then communicate that with your doctors and nurses,” she states.
I later realise that I do have some sort of control and that I can bring my own pillow, ask the nurses for relaxing music or even a spray of my favourite perfume, lily of the valley, on my pillow. Anything to reduce anxiety can be arranged. I just need to communicate my wishes.
Despite these little actions, it’s clear the outcome of the surgery is unpredictable and that there’s an awful lot I can’t control in the coming weeks. Cancelling surgery is detrimental to my health, so I really don’t have a choice but to face reality, let go of control and hope for the best.
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