Archive for August 14th, 2009

Meeting with a Surgeon

I had a much better day today. Although it started out a little rough (had to give myself an enema upon waking in prep for the Flexible Sigmoidoscopy, then had some anxiety when we were kept waiting in line at “registration” for half an hour past my scheduled appointment time – I imagined Dr. Rajput’s office didn’t know I was even in the building yet), but soon all was made well by a very good meeting with Dr. Rajput.

He was exactly what you would hope a medical professional might be: warm, personable, compassionate, understanding and seemingly unhurried. What’s more, when I questioned him, he assured me he was the most experienced colorectal cancer surgeon in New Mexico, having done hundreds of surgeries similar to what I would need, and managed to get that information across without a trace of arrogance. Pretty impressive in my book.

After he reviewed my records and then examined me, he surprised me by saying he didn’t think it was necessary to do the Sigmoidoscopy after all. The point of the procedure was to “tattoo” the area around the tumor so he would know where it once was in case the chemo/radiation treatment successfully reduces it down to nothing. But in my case, because of the location and size of the tumor, he felt marking the area wasn’t going to be helpful.

He went on to very gently tell me what I dreaded but suspected (my other doctors have been non-committal about this, but have prepared me for the possibility): when it’s time for surgery, he would not be able to save enough of my rectum to avoid a colostomy. He’ll need to have a “margin” around the area where the cancer was, and in my case it will involve taking a portion of the sphincter (the ultrasound revealed that it was already partially invaded by the cancer), which would effectively make me incontinent.

This wasn’t what I wanted to hear, but it also wasn’t brand new information. I had been hoping something might make it possible to avoid a colostomy (a miracle?), but Dr. Rajput kindly reminded me that the first priority is “cure” and the second is “function.” In order to have any chance at “cure” he’s going to have to sacrifice “function” in my case. (There’s a lot more information about this topic, but I’ll save that for another time when I’m ready to get into it.)

So, there was no need to “tattoo” around the tumor today. Despite getting the news I really didn’t want to hear, I was also relieved not to go through another procedure and sedation. And, although I’m not overjoyed at the prospect of being a patient at UNM Hospital for any length of time, this consultation left me feeling very comfortable with the choice of Dr. Rajput being my surgeon.

As we left the hospital and walked to the parking garage, Shawn and I both agreed we were really impressed with how Dr. Rajput had handled the meeting. At one point early on his phone rang and he apologized for needing to interrupt our conversation to take the call but said it was an emergency. I said, “I understand. I realize I’m not the only patient in the hospital.” Then, before he picked up the call, he said, “Yes, but I want you to feel like you are.”

Read Full Post »