More Decisions...

Tuesday 29th January 2013

Today Mum, Dad and I met with the surgeon at the Royal Berks to discuss the pros and cons of bowel surgery.  The last scan showed that the tumour in Mum's bowel was growing and suggested there is a danger of her bowel blocking completely.  Mum's tumour is too low down to be removed so we are here today to discuss the possibility of her having a colostomy.  The surgeon will create a stoma (an opening onto the abdomen) and bowel movements come out of this opening into a plastic bag.  It doesn't sound too appealing, especially to someone who has been through enough already.  It's just one more thing for her to be anxious about and an extra thing to take care of.

Prior to the meeting today Mum had pretty much decided that she just wants to be left alone.  She does not want any more intervention as she has suffered enough and the thought of major surgery is just too much for her to cope with at this late stage.  However, we have decided to meet with the surgeon today as we need to understand what is likely to happy if she does nothing.

Dr Farouk is the consultant who will perform the operation if Mum decides to go ahead.  He is a lovely man, very approachable and easy to talk to.  He considers all of our questions and answers thoughtfully and with great sympathy for our turmoil.  I instantly liked him and trusted him completely.

He explains that there are two possible scenarios that could happen if we decide not go down the surgery route.  Both involve a valve that connects the large intestine to the small intestine.  This valve prevents backflow from the large intestine, once any material leaves the small intestine and only opens to let waste exit.  If this valve is functioning correctly when the bowel blocks, the large intestine will fill up with a backlog of waste until there is no where else for it to go.  This will cause immense pressure and eventually the bowel will burst.  In this scenario Mum would be dead within 3 days!

In the second scenario if the valve is not working correctly, the large intestine will fill up with a backlog of waste which will eventually spill over into the small intestine.  The waste will continue to backup until eventually you start to vomit your own poo.  I bravely asked Dr Farouk how long this scenario would be likely to last before Mum died, to which he replied, "it could go on for weeks!"  Mum broke down at this point and said that it sounded absolutely horrific.  Dr Farouk confirmed that it is indeed horrific.  It was at this point, that I made my mind up that Mum absolutely has to go through with this surgery.  There is no way on earth I want her to die in either of the above scenarios.

We decided to go ahead and attend the pre-op clinic at the hospital whilst we were there, in order to save bringing Mum back on another day.  This department assesses your fitness prior to any surgery and gives the consultant the go ahead to operate.  There is always a danger that Mum may not be well enough for major surgery, however, Dr Farouk expressed his willingness to operate and said he would do it via key-hole surgery to minimise the after effects and recovery on Mum.  We just have to keep our fingers crossed that she gets approval, otherwise it doesn't bare thinking about what might happen.  We are advised to phone the colorectal nurse specialists tomorrow with our decision, at which point they will be able to allocate a date for surgery.  I think we all decided almost instantly what needed to happen next.

The likelihood is that Mum will undergo surgery within the next fortnight.  She will spend two to three days in hospital and then be transferred to the Duchess of Kent Hospice to recover.  I expect she could remain here for one to two weeks, as long as there are no complications and she does make a full recovery.  We just have to hope and pray that her bowel doesn't block prior to surgery.