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Oncology 14.1

I have been a little lackluster of late with my updates. The main reason being that I have now been chemo free for over 2 months, and I have been playing the waiting game in anticipation for the upcoming surgery.

The surgery is indeed confirmed and going ahead on February the 14th. I have taken the time to speak to a number of very experienced surgeons at auckland hospital. Some of those will be involved in the surgery, some will not. The consensus seems to be that the surgery is an advisable option given my circumstance.

There is, however, no way of knowing what the outcome will be. Aside from the peri-operatively morbidity, which are the standard risks of infection, bleeding and damage to other structures, beyond that, whether the cancer comes back more aggressive, comes back in a few years time, or doesn’t come back at all is anyones guess. We are beyond the realms of evidence based medicine, beyond the ability of medicine to predict the outcome.

Its technically uncharted territory, and I may even get to publish a case report out of it (assuming I survive it).

One question that I repeatedly get asked over the past few weeks is how I feel about it. I’m not really sure what people are expecting when they ask that question, because how I feel is not something that is answered in a five words or less, which is usually the expectation or the context of the question.

If you do the maths, then going ahead with the surgery is a no brainer. When you take into the consideration the risk profile of the surgery (which is not insignificant), the possible outcomes of the surgery, and compare that to my current prognosis, then it makes complete sense to go ahead with it.

If you think about what it is like to have your belly cut from the xiphisternum to the pubic symphysis, have your intestines taken out and moved to one side whilst extensive dissection up the para-aortic lymph chain and left renal vein (with the very high chance of losing the left kidney) during a 4-6 hour procedure feels like… then you can imagine that I’m not particularly looking forward to the whole event.

I’m not excited, i’m not terrified, and i’m not apprehensive… I just have to do it. Its like sitting an exam, you never want to do it, but the work, the stress, and the learning is what you have to do in order to get the outcome you want.  I think the emotional flatness I feel towards this surgery is reflective of the roller coaster I have been on over the past 3 years. It is beginning to become routine for literal life or death events to have a hand to play in my life, and as such, I’m less responsive to them. I have a surprising amount of peace with the process, peace with the peri-operative morbidity and mortality risks, and peace with the unknown outcomes. If I didn’t have peace about this, I imagine that this would be a very stressful process.

Post-operatively, I will probably be in either the surgical HDU or DCC for a day or two afterwards, depending on what degree of support (i.e. inotropes or respiratory) I need after the anaesthesia, before returning to the ward. The expectation is that I will probably need about 14 days of recovery on the ward before going home, unless there are complications such as lymph leaks, or infections etc that may require me to stay longer. All things considered, there is about a 25% chance I will lose my left kidney, and a smaller chance that I will need my IVC and aorta grafted. All these will be intra-operative decisions that I wont find out about until after the surgery. They will also influence time in theatre, and time for recovery.

The long term plan is to get back to work in the 3rd quarter of this year, which is about 3 months off work. If i’m well enough to go back sooner, then I will do that.

Whilst I’m recovering, I shall endeavor to keep everyone up to date from the ward, as I imagine that between pushing morphine boluses, I shall have little left to do with my time.

In the mean time, I would appreciate prayers as I embark on the next chapter of this journey.

Until next time…

  1. Jas
    February 7, 2012 at 6:06 pm

    You have been and most definitely will continue to be in my prayers! I’m so glad God has granted you His divine peace. Will continue to pray for God’s throne of angels to guard you on that table and beyond.

  2. Renee
    February 7, 2012 at 7:20 pm

    Hi Jared,
    You don’t know me, but I just wanted to let you know I have been following your blog for a little while. I will be praying for you over the coming months. May the Lord bless you and keep you as you enter this chapter of your life.


  3. Kate Mitchell
    February 7, 2012 at 7:45 pm

    Jared you don’t know me – and I know the last thing you need is an internet stalker! My name is Kate and I am a med reg working at Waikato hospital. While I don’t claim to know what you have been through, and are going through – there are parts of your story that are so similar to mine – and I think we’re a small and special group! I have multiple medical problems which require regular and intensive hospital input. And yes, that is at the hospital that I work at. I also ended up having major heart surgery at the end of last year and also spent some time in ICU and HDU. That admission lasted 7 weeks and stretched my coping skills to the edge.

    I don’t think many people can quite understand the emotional roller coaster of being so vulnerable one minute as a patient, to the next day needing to be assertive and confident as a medical professional. Having house officers that are your doctors one day, and your junior the next can be tricky. And nurses that are holding your vomit bowl one week and then following your orders the next can require some special skills.

    There is no major advice I can offer to help through major surgery – I think each person experiences things slightly differently. Use your PCA so you can move around and walk and ensure you sleep – even if it requires a smidge of pharmaceutical help! Treat yourself to whatever you fancy – after not eating much all day I seemed to enjoy chocolate at 2am. I feel that your support systems will be similar to what mine were – fun friends to make you smile, amazing family for hugs and a few tears and a truly awesome and loving God who never leaves your side. The one image that helped me was that despite the drains, central lines, catheter, scars and hospital gowns – I was fearfully and wonderfully made. I was still perfect. May God guide you, bless you and comfort you throughout this surgery. You will be in my thoughts are prayers. Good luck!

    • Jared
      February 9, 2012 at 6:59 pm

      Hey Kate,

      Thanks for commenting, and nice to hear from you. I hope you are doing well, as it sounds like you have had your fair share of illness as well. I do think that as a doctor, our journey becomes a little bit niche, because the patient doc professional distance that exists normally, doesn’t for us, because the treating physicians/surgeons, are also our colleagues. Keep in touch and thanks for your thoughts and prayers.


  4. Ana Pinheiro
    February 8, 2012 at 5:54 am

    Dear Jared, good luck with your surgery! You’ll be in my prayers.

  5. February 8, 2012 at 7:04 pm

    Go Jared! Will you be allowed flowers?? I REALLY loved having some

    thing lovely to gaze at when I couldn’t move after surgery.

  6. Lois
    February 9, 2012 at 6:09 am

    Best of luck to you. May you find peace like a river.

  7. Baron
    February 9, 2012 at 9:39 am

    Hi 🙂 I enjoyed your style of writing, even if there were words that sounded like some martian language…hehe.. Are you a writer?

    I now know you (or should I say know a very small smidgen about you) through your cuz Kirsty Harkness. She’s one of my photography teachers… I’m a professional photographer (always sounds too mighty a name to give myself) but have so much to learn yet!! Kirsty’s great with adults and kids alike.. I’m better with kids and not so good with adults – I get intimidated too easily, so that’s where your cuz comes in. Though I haven’t really used her extensive knowledge yet…

    Surgery and anesthetic…as a child I was terrified of them but now not so much. I quite like anesthetic and surgery… well I haven’t had to have such extensive stuff done. My mere hole in the leg from a motorcycle accident pales into insignificance!! Though being able to see my own intestines next to me (as morbid as it sounds) would be interesting!? Hmmm!? LOL 😉

    I hope and pray that all goes well for you mate. speedy recovery n’all and hopefully no loss of kidney. I’d also be honoured to meet you some day.



  8. Christy Rolfe
    February 11, 2012 at 7:11 am

    Hi Jared, I’m Christy – we met at Claire’s 30th in Wgton.
    Love your photography.
    Just want to say un-pc that over 7 weeks my sister was in icu auckland then waikato and believe me, auckland is an ace experience in comparison. So there’s a tiny positive if you are looking for blessings.
    My thoughts are with you and Hannah, I’m sending big pink fluffy spangly clouds of gorgeousness to light your lives this morning. Actually I can see them now, forming on the top of the mountains out my window in wanaka . Vroooom – here they come ……

  9. Ainsley
    February 11, 2012 at 12:31 pm

    Like Renee, I have been also following your blog, Jared, and sincerely wish you well for your surgery – you and your family will be in my thoughts over the next while and beyond. Ainsley L.

  10. Sarah
    February 12, 2012 at 2:22 pm

    Hi Jared, this is an exciting opportunity. Praise God that you have this option to remove the cancer. Thinking of you and Hannah and praying for you both (and your families!). God bless, Sarah

  11. Jane
    February 12, 2012 at 6:35 pm

    Jared…all the very best for Tuesday. My thoughts and prayers are with you, Hannah and your surgery team. May health and healing flow through your body.So looking forward to your next update.

  12. Jane
    February 12, 2012 at 8:17 pm

    Hi Jared. All the best for your surgery on Wednesday. You, Hannah and the surgical team are in my thoughts and prayers. May health and healing flow through you body. I am very much looking forward to your next update. God bless you.

  13. felicity
    February 13, 2012 at 1:42 pm

    Hi Jared, I have been following your blog and wish you the best for tomorrow ill send you positive thoughts you never know what could help 🙂

  14. Maree
    February 13, 2012 at 3:48 pm

    Hi Jared and Hannah,

    Thinking of you – our home-group are praying for you and will continue to uphold
    you in our prayers during your recovery afterward. May you know the Lord’s strength, peace and comfort surrounding you.

    BIG hugs to you both,

    love, Maree xx

  15. Dyana Parore-Connell
    February 13, 2012 at 4:16 pm

    ALL THE BEST FOR TOMORROW AND THE FOLLOWING WEEKS IN YOUR RECOVERY. u ARE ONE BRAVE MAN. My prayers, everyday thoughts are with you and the UNIVERSE will be watching over you on your amazing journey. My thoughts are too with the fabulous medical team u have looking after you. They too are heros. So all in all. fingers crossed for you and the team. Take care. May your wife and families have the strength and attitude that you possess to see and be with you on your journey. All the Best. Dyana

  16. February 13, 2012 at 8:01 pm

    All the best in this next step in your life…. I pray that you will be stronger than ever before, that a protective hand will rest on you during your entire procedure…. & for a fast recovery!!! Good luck!!!

  17. Allan Lee
    February 14, 2012 at 7:13 am

    Jared, you’ll be in our prayers at RBG today. Hope it all goes well.

  18. Amanda
    February 14, 2012 at 12:50 pm

    Hey Jared – wow – all the very very best for today. I had meant to catch up with you before now for that dose of spiritual guidance but you need all you’ve got at the moment… will look forward to the next instalment to see that you’re out and about… nothing like getting to know your workplace like being a patient there!!!
    Hope to catch up when you’re back at work….

  19. February 14, 2012 at 6:11 pm

    Jared, praying all goes well – that the Lord watches over you, holds you in the palm of His hand, and gives you healing and full recovery.

    February 15, 2012 at 8:25 pm

    Hey Jared, have come across your blog through Kristian.
    Thinking of you and sincerely hoping your surgery went well.
    Know that you are in a whole bunch of strangers prayers !!

  21. Eve
    February 20, 2012 at 10:32 am

    Came across your blog while studying for oncology exam as a registered nurse here in the United States. Thanks for clarifying portal cath’s, internal jugular veins, etc. Many prayers to you & family and best of luck with your recovery!

  22. PK - Australian Expat in CH
    February 21, 2012 at 1:43 am

    Hope the surgery went ahead by now and that it was successful as possible.

    Thinking of you.

  23. Sharon Brooker
    February 21, 2012 at 11:25 am

    I came accross your blog prior to my hemicolectomy. My prayers are with you and your family, and I hope your surgery was successful.

  24. Melissa P
    February 23, 2012 at 6:05 pm

    Hey Jared… remember me… hysterical needle phobic you met late June last year in the heart ward. I am hoping that you are lying in a bed somewhere after a succesful surgery recovering.

    As a small twist of fate, my Dad discovered he has bowel cancer yesterday. He had some bleeding after my grandmother had a massive stroke last month & thought perhaps it was stress related…. luckily he decide to go for a private colonoscopy on his GP’s recommendations, for peace of mind more than anything. They removed some polyps & sent away for tests saying they didn’t look suspicious.
    Then my dad opened a letter that arrived in the post yesterday, saying that one was cancerous, it was a bolt out of the blue as he had basically we had written it all off as ‘A’ okay .
    We went back to the endoscopy clinic this morning to get tattooed where the polyp had been removed so the surgeon can see & has now been referred to a specialist, I joked with Dad he has his first tattoo at 66, what a rebel !!
    We understand they will remove a foot of bowel & hopefully that will be it. My dad is grimacing a bit as the $ are adding up, but man, you can’t put a price on finding something like this in time. I will send him a link to your blog…. Hi Dad I love you to the moon & back if you are reading this.
    I cannot stress enough how important it is to listen to your body, I knew Natalie Murphy, the young Mum who lost her battle with breast cancer, the tragedy was she had discovered the lump & let it go.
    I want to scream & yell how important it is to listen to your body & get second opinions if in doubt.
    I am thinking of you & your incredible journey & the gift you gave me pre surgery of courage
    Lots of Love Mel Paterson xx

    • Jared
      March 11, 2012 at 9:31 pm

      Hi Melissa,

      Sorry I have taken so long to reply, its been an eventful few weeks for me as you can imagine. Of course I remember you, and i hope you are recovering well yourself. I’m sorry to hear about your dad, but from your reports, it sounds as though the cancer was found early. I’m hoping and praying the surgery is effective for him. I hope you are doing okay amongst all the turmoil and uncertainty that cancer can bring with it.

      Take care,


  25. Jo
    February 25, 2012 at 7:08 am

    Hey Dr Jared 🙂 I’m a complete stranger! Came across you through Twitter. I was following Kristian’s blog, along with Twitter and I saw you and visited your blog 🙂 Just wanted to say that you are in this strangers thoughts.

    Best wishes

    Jo from the uk

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