HIPEC Surgery

I was again experiencing the shock no shock. Again I was in the ‘I have so many questions’ and the negotiating phase, only this time I was there with my wife. We quickly found out that there was a new plan, called HIPEC surgery, HIPEC surgery is where another surgeon opens me up, tries to take out the dots as much as possible, and then washes my abdomen with hot chemotherapy for about an hour before closing me up again. They will have to schedule it for the following year, as I need to undergo another regiment of the chemotherapy first. The surgery is going to be longer. HIPEC has only a 30% success rate, but those are long term statistics and based on patients who are generally older than I am, so my personal chances might be better. We were not happy. Adding another year to the recovery felt like a hard blow, but we believed I had a good chance of making it through it. The idea of having to undergo more chemo was not appealing, but I was a fighter, we both were, and we were going to fight and make it!

We started the chemo regimen about a month later, in January 2018, after a nice family christmas trip to Los Angeles.

The chemo I was on now was called Capox, which was administered centrally - I had to go to the cross cancer institute and have it dripped directly to my blood every two weeks for a few hours each time. If I thought the nausea was bad from the pill, I was surprised by the strength and shock of this kind of chemo. It was horrible, I lost my appetite and started losing weight again. I was in my low 80s of kg in December and quickly went down to high 70s. The lining of my guts were being destroyed by the chemotherapy to the point that I wasn’t able to digest or eat anything, after the second round of chemo I started getting dehydrated from losing too much liquides, and I ended up in the E.R. again, this time for a much longer stay - close to a month. During that month I was getting no treatment, but was getting central feeding while my intestines were recovering. I started getting scared that the cancer was growing during this time and that there was no exact plan of treatment yet. But a month later, my intestines recovered enough for me to be released from the hospital. I met with my oncologist again and was told they can switch me to a lesser dose and a slightly less harmful type of chemo called FOLFOX.

FOLFOX was bad, but tolerable. At around 77kg I was at least able to maintain my weight, though the ups and downs of the nausea with each dose were rough. After 8 rounds of FOLFOX, I took some time to recover and then had my surgery booked for August 2018. I was very anxious about the surgery but hopeful. I was young, I was fighting, I had a family, I was going to survive this! The surgery would go well and then I’ll be back to testing for the next 5 years and hopefully - cure! When asked I would say that there were three possible outcomes to the surgery - the surgeon finds nothing, which would be great news meaning that the chemo worked ; The surgeon finds some dots (most likely), which would mean that I will have to go through more chemo afterwards; or the surgeon finds more dots which would mean that the chemo failed and so will the surgery. It was supposed to be a long 5 hour surgery that would leave me with a larger scar than the previous surgery and would require two weeks recovery. I would wake up with the same nausea I usually get after chemo or worse. I was anxious but ready that fateful morning as I went down expecting and hoping for the best.

I woke up at the recovery room and looked at the clock. It was early, it was before noon. I only had been down for a couple of hours. It suddenly dawned to me through the haze of medication what this meant. I tried to ask a surgeon to confirm my fears - they had in fact found something, but he wouldn't tell me what. I understood enough, they found more dots and they didn’t complete the HIPEC, I was now beyond statistical hope of recovery. Being alone at that moment, not having my wife or my parents by my side was horrible. My family didn’t expect the surgery to be done so early so they all left the hospital. I cried, I told the recovery nurse that I was going to die. An hour or so later I was admitted to the surgery recovery room. I was still alone, still waiting for my family to return.