Oesophagogastrectomy

28th.February
Yes you can see what the operation was called, alternatively the Ivor Lewis procedure. Was discharged from hospital on Monday 24th February, exactly 2 weeks after the operation. I think they were pleased with my progress and it was great to get home. However, having spent 2 weeks in hospital , the majority of the time horizontal in bed, it was quite tiring the first day or two to start moving around as 'normal'. From thereon the rest periods have become less. Bowel management continues. Food needs to be high in calories and protein, eating regularly now most of the stuff I would have previously avoided. I left hospital with 2 drains in place (stoma bags), one at the jejunostomy site and one for a drain in my chest on my bac. they seem to have dried up so looking forward to getting those removed as they are uncomfortable with regard to sleep. One thing I must say about the NHS is although people moan and groan about the service, they really did pull out the stops for me when I needed them and I am grateful to all the doctors and nurses that looked after me in hospital, I cannot praise them enough.
I am going to add onto this post a number of sections detailing my stay in hospital ie.,

a) Preparation
For anyone having to undergo this procedure, I would give one simple piece of advice - get as fit as you possibly can beforehand. If you can get 4000ml on the spiro-ball you should be OK. This is a lung function test but it does not mean you will have issues if you score below this.

b) Intensive care Unit
After the operation this is where I woke up with tubes and wires everywhere. Seems worse than it actually was. The epidural in my back was controlling and discomfort in my chest. Life in The ICU was quite good, I had virtually individual attention. The day after the operation the physios had me out of bed, I was quite weak and light headed at first but I did stand up OK with all my attachments. The next day I was walking and having a go on heir exercise bike. I passed so next day they kicked me out off to te surgical ward.

c) Surgical Ward
A smaller nurse/patient ratio here but still they looked after me well. Plenty of attention here from all the support and discharge groups in the hospital. The physios took me fo walks and up/down stairs. All feed at this point was directly intravenous with some sips of water allowed. Some of the tubes/drains were removed here to make it a bit more comfortable. Had a catheter and chest drain permanently attached so these had to be carried every time I got up. Had a small infection at my jejunostomy site so was constantly pumped with antibiotics and pain relief. I was not really in pain as such but quite sore and that was the thing being controlled. At the end of the first week I was sent to the general ward.

d) General Ward
Here I was fortunate to get a single room with its own toilet and boy did I need it! This is the bit they don't tell you much about in advance but for the first week after surgery your bowels are on strike, or kept inactive with medication, but this is the second week, getting the plumbing working again. However because the nurse/patient ratio on this ward was quite low, I was largely left to sort myself out. Initially I had 'overflow' but with laxatives, the original material in the bowels started to shift, not nice, hard lumps and painful. At this point the catheter was removed which helped mobility and I also lost one chest drain and my neck access. Thought I had got rid of all the old stools but no, one got stuck giving me grief so I had an enema. What a relief, you would not believe.
During the week I went from purely liquid food to to pureed to food with small lumps. My bowel management follows in sympathy, a long process though.

e) Problems
The only main issue that I had was canulas. Having removed my main neck canula, I was left with two in my arms for various liquid feeds, painkillers and antibiotics. Unfortunately, canulas only last a maximum of 4 days before needing replacement but not many staff seem to be able in insert them correctly. I had 10 failed attempts forma doctor and the 'official' canula staff in my arms so my veins were collapsing and bruises everywhere. Fortunately fo me, a brilliant nurse on the ward got my final one in place first time.

Surgery

Well I may have gotten the wrong end of the stick. Despite having an endoscopy report in writing which says there was no cancer, that was on the inside of the esophagus. A previous CT scan  showed that there was some cancer on the other side of the wall but no check was made at this point to see if it had also disappeared. However I questioned this with Mr.Knight who said he had never heard of one dose of chemo getting rid of cancer so he was not prepared to do another CT scan. So I am told I still need surgery. It is scheduled for next Monday and it is an all-day affair with 2 surgeons involved.  So there we have it. I have no choice, I am booked into the system. Not looking forward to it. My eating right now is fine, no problems at all with volume or swallowing. Could be 6 months before I can eat a normal meal again assuming everything goes well. However the team of 4 surgeons at the hospital do this operation all the time so they have plenty of practise at it which should be the good news. The downside is that it's a all day affair but it at least is all keyhole so recovery time should be better. Further updates when I get out of hospital