Knowing the Known Unknowns

As the distraction of the family-centric Christmas week crashes to an end, I cannot keep my thoughts from straying ahead to the health-defining schedule for my next week.

Since last I wrote about my cancer, I have had a new biopsy, full-body CT scan and MRI scan. I was already on standby for a sooner surgery date, if one became available, based on the prior regrowth observations. It was unclear to me if this last round of tests might actually accelerate procedure timing, or if they were just for accurate diagnosis.

I was told quickly that the biopsy results were “inconclusive”. This was obviously the least-intellectually-satisfying possible answer, so it took others to remind me that inconclusive is medically better than conclusively bad. I accepted this with reluctance.

But weeks went by and I was not contacted with the scan results. I knew key members of my medical team were rotating away on year-end vacation and my calls were uncharacteristically going unanswered. Life and Christmas were marching forward, as they are want to do, so I made plans to take the kids to Saskatoon. I should have learned by now that making alternate plans is the best way to force a medical appointment.

Last Monday, I finally got the call to come in for results and further tests. Delaying my trip, I took the familiar road to the hospital to find a doctor I’ve never met before, reading to me tentatively from pages of notes. I let him mutter about nonsense for a few minutes before I point-blank asked him for the CT results that would tell me if I had only four remaining weeks on Earth. He flipped to the page that described my chest as cancer-free. I would indeed live to see February. “Maybe start with that,” I smiled.

With the news that my CT scan was clear, and that the cancer growth shown on the MRI is within pessimistic expectation, the young MD wanted to start in on a new invasive biopsy to shore-up the previously inconclusive one. My Christmas plans with my children were mere hours away, so I wondered aloud what practical impact such a test would have on my only-days-away surgery. A call to my vacationing lead oncologist confirmed my skepticism about biopsy usefulness, so I left the hospital unpoked and unprodded.

So… next Wednesday, January 6, I will arrive at the hospital before sunrise and be prepped for surgery. The first team will remove the flesh from the top of my right hand from my wrist up to the first knuckles of my fingers. They will cut out all the cancerous cells they find, which may well involve bone shaving, tendon snipping, muscle carving or even digit removal. As a side project, they’ll snip the silently ominous cancerous lymph node in my right armpit.

A second team will then attempt to reconstruct my hand from what is left. If it is determined that scarring will be too severe in the first pass, some repair may have to wait for subsequent surgeries. This might involve transplanting tendons from other parts of my body. Toe-tapping may lose out to 16-hour-a-day typing dexterity.

A third team will do a tissue graft, pulling flesh from my forearm to cover my hand and then harvesting thigh skin to cover my forearm. At least that’s the going-in plan as presented to me. I’ve given verbal permission to the plastic surgeons to make any improvements to any part of me they find time for, but they are mere humans.

I’ll need to remain in the hospital for three-to-five days while they monitor the grafts for infection. Immobile in the hospital will be a special torture. I hope to sample all of the drugs.

I’ve been craving the closure of this surgery for a while now, but as it nears, the thought of waking up to an unknown number of limbs, hands and digits is causing greater anxiety as the days draw near. I have trained myself to describe it unflinchingly when face-to-face with people, but it is an act.

If I’m honest, I’m scared. If I’m honest, I’m angry. But it’s equally honest to say that I’ll be OK.

While there are no guarantees, there is a chance that in a few weeks this could all be over. That’s more than many (including some reading this) can say.

(Photo credit: me)


3 thoughts on “Knowing the Known Unknowns

  1. Gosh, Paul, I just read this post and subsequently most of all else you’ve written here. I am sorry about the radiation treatments, the ominous surgery and the scary upheaval for you and your family. I will be thinking of you next week, and saying some Hail Marys for you even if you don’t think they work. 🙂 I wasn’t brought up with any religion because my Mexican American mother was beaten by nuns and witnessed abuse by priests. I’m pretty Buddhist but I do like to say Hail Marys which I learned while teaching art in Catholic school. I just wanted to let you know that one of the seminal religious experiences of my life was hearing you sing Amazing Grace in that little Nicasio church on or around 9/11. Well it was a beautiful thing in a horrible time. And we didn’t know what else to do. Love to you and your family.

    Liked by 1 person

  2. Paul
    I cannot begin to imagine how you and your family are feeling right now. I admire your honesty and your courage. Our thoughts are with you a lot. I realize we live about an hour away, but if there’s anything we can do…bring a meal to the fam while you’re enjoying the lovely pharmaceuticals the hospital has to offer, or whatever you guys might need, we’d be happy to do it.

    Liked by 1 person

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