Surgery number 3, and most definitely the biggest and scariest one to date, is done!

Another negative COVID test, and I found myself packing a suitcase in anticipation of a week in hospital. You would think the anxiety beforehand gets easier, once you know what to expect. Well, I’m here to tell you it doesn’t! What does make it easier though are the people you meet along the way. Whilst most of the country has been locked down with hardly any outside contact over the past year, my social life has never been more lively. With these 3 operations over the past 4 months, and all the consultations, blood tests, treatments and scans along the way, I have made a lot of new friends and spent a great deal of time with some truly wonderful people.

As I’ve harped on about in the past, I find the medical world fascinating… and for this operation I was admitted to the green surgical ward at the Heath Hospital in Cardiff. The green zone system is one that has worked really well during the pandemic according to doctors and nurses that I have spoken with. It effectively means that there are now “sterile” green wards, green operating theatres, green ICU and high dependency wards, and green staff! The nurses aren’t allowed to leave the ward at all during their 12 hour shift. And no one is allowed in – which I was told has resulted in zero infections since the beginning of the Covid outbreak. Quite remarkable. It has also meant that what used to be an upper GI surgical ward, now has 10 different specialities all crammed in to one space.

The morning of Monday 8^th Feb, I was wheeled into theatre awake and immediately got an epidural (eek). I haven’t had an epidural before, and I was really scared of it for some reason. The thought of something going into my back, into a tiny space so close to my spinal chord freaked me out. There is always a moment of full on ugly crying I have learnt (for me anyway) and this was it. It all just felt so overwhelming, sitting on the side of the gurney, in a theatre full of machines and computers. I was also facing a wall filled with pictures of livers (!!) and I could not. stop. crying. The anaesthetist was incredibly attentive, and praise be to diazepam, which she kept injecting into my cannula to help ease my hysteria. As soon as the epidural was in, I laid down and was put to sleep.

I woke up in ICU, and was quickly moved to PACU (post-anaesthesia care unit) where I would stay for the next 24 hours. I had a central line, which is a cannula into a big vein in your neck which has several lines coming off it. This means they can hook you up to different medicines all in one go, and the line is usually stitched in place. I had an arterial line coming out of an artery in my wrist, which was hooked up to about 3 computer screens showing every possible detail of how I was fairing up post surgery. The arterial line also had a little tap on it, from where they took blood every half an hour to check that my little half liver was doing what it was supposed to be doing. I also had a catheter and various heart monitors, o2 monitors etc. I had been told that I might wake up with a drain coming out of my abdomen (similar to what I had after my lung operation) to take away any excess bleeding or fluid build up. However, apparently I didn’t bleed much at all during the operation and therefore didn’t need one – a little win.

I was so incredibly impressed with how PACU worked. I had a doctor at the end of my bed pretty much the entire night, and as soon as I started to feel even the tiniest bit of pain he was at my side tweaking things to make sure I was comfortable. I had a dressing covering the incision on my tummy, but I could already tell that it was a lot less Frankenstein than I had been expecting. Sitting here writing this 4 weeks on, I can tell you that the scar the surgeons left me with, is really impressive. It’s one neat little line, which I actually quite like the look of.

I have to quickly mention the nurse that was looking after me in PACU. She was doing her third shift in this new role, after having worked for the previous 5 years as an ICU nurse – also at the Heath Hospital. We talked for a long time about how the pandemic had almost broken her. She was humble and discreet, but I could tell how frightening the last year had been for her. She was the same age as me, and also had a 3 year old at home. I spent a lot of my time in hospital thinking about what that building had seen over the past 12 months or so, but more importantly what the people working within it have been experiencing/continue to experience.

I was transferred back to the ward for the remainder of the week, and shared a 4-bed room with just one other lady. She was 25 years old, had a 5 month old baby at home and had just had brain surgery. We became quite friendly, through the good times that week and the bad. In all honesty, I was very comfortable and in little pain for the majority of my time there. Primarily because of my wonderful epidural which had been placed just perfectly, and kept my entire mid section completely numb. My down point came when they tried to remove the epidural, firstly on day 3 post op, secondly on day 4 (my worst moment) and then finally and successfully on day 5.

I’m going to end this on the biggest high. My wonderful surgeon, Mr K, came to see me every day whilst I was in hospital. On the Friday he came to see me twice. I was surprised to see him that evening, accompanied by the Hepatobiliary Specialist Nurse, as I had already seen him in the morning. He drew the curtains, and then told me that the pathology from my resection was already back from the labs and he had just gotten off the phone with the lead Pathologist. There was, “not a cancer cell in sight.” He continued to tell me that the spots that had been seen on my liver MRI scans were completely benign, and were something called haemangiomas. I have likely had them my entire life! I was in total shock, as was Mr K I think.

It’s funny that a lot of people who I have told this to since, have mentioned that perhaps it was a pointless operation and that I needn’t have gone through such a major ordeal for nothing. This is absolutely not the case. 2 of the 5 spots had changed slightly over the past 6 months, and the expert radiologists and members of the liver multi disciplinary team had spent hours comparing and scrutinising my scans. Any change in abnormalities, in a stage 4 cancer patient, has to be presumed metastases.

Of course I called Dr F straight away. He also couldn’t believe it, but was very quick to say how crucial this operation had been. If they hadn’t operated we would have always assumed these spots to be melanoma. It would have unnecessarily changed my treatment plan going forward, as it would have been decided that my current immunotherapy wasn’t working due to spread in the liver. It also would have caused major panic in the future when other treatments didn’t seem to be working. It shows us that my treatment has been effective to this point. My melanoma has never spread since diagnosed stage 4. From that first day I met Dr F back in June 2019 with 3 lung nodules, immunotherapy has kept my immune system functioning at top level. That’s crucial info, and means we continue with Nivolumab. It’s also worth noting that the liver fully regenerates, so whilst the recovery can be frustrating at times, it does mean that no harm has been done in having the operation. I am still eligible for further resections if I ever need one, but I’m really hoping that won’t be necessary. At least for now, a little surgery break would be much appreciated!!