Tuesday 14th August- MOAS II Operation Day.

 I have been calling the operation the MOAS II but it’s probably not quite true technically speaking. Whilst just as invasive and with fundamentally the same proceedure’s (Midline laparotomy to redo complete cytoreduction for Pseudomyxoma) obviously there are certain elements of the operation that were done first time around that can’t be re-done the second time around such as the spleenectomy, removal of the gall bladder and so on.   The notes call this operation a de-bulking procedure.

 The day started early for me. I was awoken just before 06:00hrs to get ready for the op. I was handed a gown and went into the bathroom for a quick cool shower (not too hot or this can cause problems with bleeding during the op). I freshened myself up and then sat patiently in my room awaiting the staff. Tracey and Mum arrived to see me off. We sat quietly and chatted. I also donned the flight socks that I had been given to help stop deep vein thrombosis (DVT). I passed my jewellery over to Tracey; taking off the wedding ring is always a difficult moment. We tidied my stuff away and packed my case ready to go into secure storage until I needed it.

 At around 07:30 the medical staff arrived in their scrubs ready to take me down the theatre. Another change this time around is that there was no pre-med and that I was to walk down to theatre. As I left my room I waved a goodbye to Robin. I had met him on the ward, he was scheduled to have the full MOAS at the same time as I was having my operation and he too was all prepped ready to go. We wished each other luck and bid our farewells. Tracey and Mum joined me so far but Tracey had already decided that she didn’t want to see me go off to sleep as it was just too hard for her. So we had agreed that we would say our goodbye’s part way down to theatre. She and mum put on a brave face as we all hugged and kissed and said goodbye. It was really hard, I struggled to hold back the tears and Tracey was upset. We didn’t hang it out and soon parted company. I walked the final short walk to the theatre with the nurse. We turned into the pre op rooms and once through the door I was in familiar surroundings again. A smallish room with wall cabinets on either side, works tops below with cupboards underneath and double doors at the end leading directly into the theatre. These doors were open again initially but were soon closed as my gaze fixed on goings on in that room. There were three or four staff in the room and a gurney in the middle. It was quite narrow and was high off the ground. On top was an inflatable cover. I was told to remove my gown and to hop on the gurney the inflatable cover was placed over me and I found that this was full of warm air and I would not get cold. I led down and handed the staff my glasses. As before they worked very quickly and all seemed to be scurrying around and busying themselves. The anaesthetist talked to me throughout and then finally announced that an injection was coming that would send me off to sleep. I had no cannula in so he tapped my left wrist and found a vein then came the “sharp scratch” announcement and that was the last that I can remember.....

Tracey and mum headed back to the flat and composed themselves and began the long waiting game. They received a call at around 13:00hrs to say that the operation had gone well and that they had removed two tumours and an area from my stomach. They were at this point about to give me the HIPEC (Heated Intra Peritoneal Chemotherapy) bath. This is where the abdominal cavity is soaked and washed in a chemotherapy solution. Area’s that were affected by the PMP were given a particular scrubbing and extra attention. Mum and Tracey were told that they could come and see me at 17:00hrs in ICU once I was settled.

 Tracey and Mum arrived in ICU at 17:00hrs on the dot! On the way in the bumped into Vasili the male nurse who had looked after me so well last time around. He greeted them and let them in. I had managed to come through the operation and did not have any chest drains in or a ileostomy (stoma). I was however intubated (breathing tube) and had a centralline just below the collar bone used for feeding and administering drugs, five stomach drains in the left hand side of my stomach and a drain on my right side for administering the post op Chemo (I think!). I was also catheterized and had a nasal gastric tube in. I was still fast asleep at this point but Mum and Tracey were told if they came back at 18:30hrs then they would start to wake me up.

 Tracey was given a chair and sat down beside me for a while. Suddenly the head end of the bed started to raise with me on it fast asleep. The nurse came running over “what’s happening?” she said as the bed continued to rise with me now sat almost upright! Tracey thought the nurse had been doing it when in fact her knee was pressing on the button!

Tracey and Mum returned again at 18:30. Apparently the nurse was having trouble waking me up. Whatever they tried I just didn’t seem to respond, even Vasili had tried.

“I’ll wake him up” Tracey proclaimed, plonked herself next to me and squawked “Dave” quite loudly. That did the trick! Apparently my eyes opened wide immediately at the sound of her voice and I was awake. Tracey then spoke to me reassuring me that all had gone well, all the cancer had been removed and that I had not got a stoma. I responded with hand gestures such as thumbs up and the OK sign used by divers as I was unable to speak because of the breathing tube.

The only memory that I have of ICU is one where I made the nurse who was looking after me laugh. I was aware that she was close by me and said something about head and shoulders.....so yours truly started miming the actions to the head, shoulders, knee’s and toe’s children’s song! The nurse picked up on this and was laughing at me! I then drifted back off into my chemically induced sleep.....