Meeting With The Surgeon

After I had my injection on Jan 16, Jenna and I took a trip down to UCLA to meet with my surgeon, Dr. Busuttil. This was our first meeting with him so we weren't sure what to expect. Thankfully they seemed all over the situation and had a good plan.

The first thing they want to do is get me into surgery right away to remove the tail of my pancreas and my spleen. This was the first time anyone had talked about removing my spleen so we were a little surprised. I have drawn a picture to show you what the plan is.

The top picture shows where my

primary tumor is located. The
bottom picture shows what they
will be removing in this first operation.
Click on a picture to enlarge it.

They have found a tumor in the tail of my pancreas. It is sitting next to a vain coming from my spleen and I believe that is causing what is called Varices to grow in my esophagus and stomach. Four positive things:

• They have found what looks like the primary source and it will be removed.
• This operation will take care of the varices.
  
• People live without their spleen and pancreas tail without much problems.
• The Cowboys lost to the Giants.
  

I have to get a couple of vaccinations before I can have the surgery. We are trying to get those scheduled right away. I am getting:

• Pneumococcal
• Haemophilus Influenza
• Meningococcal Conjugate

I also have several tests I will be taking early this week. They will be doing a cardiogram and some other stuff to be sure I am well enough for surgery. I'm pretty sure I'll pass these. We are looking at surgery happening by the end of the week (Jan 20-25) or the next week. I've been doing a little research and it looks as though this is a 9-10 hour surgery. I will be in the hospital for 5 days and the recovery time is 8 weeks. I expect I will be feeling much better long before 8 weeks is up.

After I have healed from this surgery, we have 4 options for treatment, and I will probably be a combination of some of them. My options are:

• Debulking - Remove half the liver
  
• Chemoembolization - I'm not looking forward to this!
  
• Hepatic Artery Block - Much the same as Chemoembolization.
  
• Liver Transplant

At this point the goal is to prolong my life and shrink/kill tumors. My guess is we would do a debulking and then treat the rest of the tumors with either the Chemoembolization or the Hepatic Artery Block to shrink and kill them. Chemoembolization is usually used as a bridging therapy while we wait for the liver transplant. It is also used as a way to downstage the tumors in order to be eligible for a transplant. I would think we would move into these next steps fairly soon after I recover from the first operation.

So that's what I have to look forward to. On one hand, its real nice to have a more solid plan. On the other hand I'm pretty scared about going under the knife. I would say on a scale of 1 to shitless, I'm sitting in at about a 6.2. I guess thats not too bad. I can handle that.

My parents will be traveling out here for the operation. I will be nice to have them around. Unfortunately the hospital is about 1 1/2 hours from my house in some of LA's worst traffic. Thankfully, UCLA has a deal with some of the hotels next to the hospital. We are going to try and get some rooms there. It will be nice to have them so close by. Maybe they can bring me Starbucks every morning since they are so close! Of course we will also have to get them up to the house so they can see the baby.

I will try to be more timely with my posts this week. We should have quite a few tests to tell about and hopefully we will be nailing down a date for the surgery. Till then ...