I had a great weekend teaching skiing, and hanging out with friends.
On Monday, my wife and I flew to NYC and checked into a hostel at at YMCA in the Central Park West neighborhood. We went out Monday night - a couple cocktails and then a really good (and very spicy) Chinese restaurant for dinner.
Tuesday morning was spent at Memorial Sloan Kettering Cancer Center. I had some lab work (one needle). Then, I had a CT scan with IV contrast (second needle). After that, we met with my surgeon and three other members of his team.
He was happy with my CT scan results and with how the chemo has shrunk the tumors. The one that had me most scared is not as bad as we'd thought. We thought it was inside the liver, but he thinks it's outside and he should be able to remove that one without cutting the liver. There are two spots along my digestive tract that worry him, one on the small intestine and one on my colon. He is going to try to "peel" them out without re-sectioning anything, but he thinks he'll probably have to remove some of the colon. The spot along my psoas muscle never really changed during chemo, but he's confident he can get clean margins there, although I'll lose a little bit of muscle. And, he has a few other fat deposits that he wants to remove.
He said that those deposits might simply be fat, or they might be well-differentiated liposarcoma cells, and they need to come out either way. Even if they are just fat tissue, he said they are where the cancer would be most likely to return.
So, he has a plan for the surgery. However, there is one risk that we hadn't heard before yesterday. He said that after they do the initial incision, it's possible that he will find lots of tiny tumors that are too small for the CT scan to identify. If that happens, and he thinks it's a remote possibility, he wouldn't be able to remove all the tumors, so he would essentially close me up and remove none. He said that would be a case where I was simply inoperable. I won't go into the implications of what that would mean, but it would mean a grim diagnosis going forward.
Otherwise, he hopes to get everything he knows about, and then do another scan in 4 months or so. He expects that I will be in the hospital for a week or so, and he'd like me to stay nearby until I can see him again on the 22nd. On that day, he would remove the staples, go over the pathology report, and then send me home. The social worker at the hospital was able to get me a room here at the YMCA hostel for the extra days in Manhattan. My "little" trip to Manhattan is going to turn out to be 16-17 days. Luckily, I've got my laptop with me and I have the kind of job where I can work remotely, although the first few days after surgery I won't be working at all.
After I saw the surgeon, I had my final pre-op testing (3rd needle stick of the day - why do I have a chest port if they won't use it?) with a nurse practitioner. It was blood work, lots of questions, a few vital signs, and an EKG.
We were finally freed from the hospital about 1:30. We spent the afternoon walking around Manhattan. Ate a late lunch. Met some friends. Had an amazing dinner at a nearby Italian restaurant called Masseria Dei Vini - a place I'd recommend to anyone. Saw Jersey Boys on Broadway. Took a walk through Times Square. Had a late night cocktail with my beautiful wife. Even though I spent half the day at the hospital, it was still an amazing day.
It was also a reminder of how lucky I've been in my life. I have great friends (I don't think we have paid for a dinner out in a few months right now), a great medical team, an amazing wife, and an understanding employer.
I wouldn't recommend cancer to anyone, especially not three different cancers in one couple in just over 2 years. It's been a financial burden, it's created a lot of anxiety, and it's forced our kids to take on more responsibility than they should have to. But, compared to so many people in the world, even with all of this going on in our lives, we are amazingly lucky.
Surgery is early tomorrow morning. I'll update here as soon as the pain meds allow me to write coherently.