Our Trip to Iowa City...in Excruciating Detail

Tuesday was a great day for a drive. Luckily for Ashley and I, we had a reason to take a leisurely drive to Iowa City to see our crew of doctors. It started out like any other road trip. Ashley was bummed that we were awake so early and became increasingly “delighted” by my cheerful attitude and singing throughout the 1.5 hour drive. We made it to appointment number one with plenty of time to spare.  

Appointment 1 - Urology  

We started the day out with an appointment in the Urology department. They were running behind so it ended up being 45 minutes of Ashley and I hanging out in the examination room waiting for someone to come talk to us and 15 minutes of us talking to a nurse, the student resident, and having three vials of blood drawn (from me, not Ashley).  We let them know that we had another appointment that was starting in five minutes, and they rushed us out of there and told us to come back after appointment number two.  Nothing was really learned during this appointment other than the fact that the Urology nurses “enjoy” my sense of humor.   

Appointment 2 - Oncology

This was a more comfortable meeting. We were meeting with Dr. Garje, who is the doctor that we met with when getting our second opinion back in February.  Dr. Garje walked us through the blood work and scans from a couple of weeks ago and explained everything in the clear, detailed style we’ve come to expect from him. We talked about everything.  It was like we were old friends catching up except we only talked about cancer stuff and we didn’t laugh or ask about each other’s families. We did learn a couple of things: 

Here is a comparison of the two CT scans.  The scan on the left is from July and the scan on the right is from February.

1. He would like my port to be removed this month
2. I will likely be on blood thinners until the end of October
3. He showed us a side by side comparison of the tumor from the February CT scan and the most recent scan from July 6th. I’ve included a photo of the scans.
4. He was very pleased with the effectiveness of chemo.   
5. He thinks the remainder of the tumor is a teratoma.  He explained that teratomas are treated surgically.  Meaning you remove them and then you are done. 

 Appointment 1.5 - Urology: The Sequel

After talking with our buddy Dr. Garje, it was time to head back to urology to meet our surgeon. This was the appointment I was most anxious about. After answering some pre-op questions with the nurse, the man of the hour appeared...with his hand in a brace. Our surgeon fell off of his bike and messed up his hand! He quickly made up for his lackluster first impression by diving right in and giving a detailed explanation of the procedure. The incision will go from the bottom of my breast plate to the top of my pelvic bone.  They will then need to move my bowels around in order to get to the tumor.  At that point they will wiggle the tumor around to make sure it isn’t attached to either the vena cava or aorta as it is pressed up against both of them (Dr. Garje does not think it is attached to either).  Just to be safe, our surgeon will be accompanied by a vascular surgeon just in case they need to separate the tumor from the vein.  Then they remove the tumor, put my bowels back in place, and staple the giant incision closed.  I’ll be in the hospital for about five days and will need to be off of work for about four weeks.   The tentative date for surgery is at the end of August pending the availability of a vascular surgeon.  

If I’m being honest, the recovery time and the risks that he walked us through are not appealing to me. This evening, I told Ashley that it will probably take me a few days to bounce back from that conversation.  I am dreading this procedure and the recovery just as much as I would have dreaded 12 weeks of chemo if I would have had time to think about it back in February.  Luckily, that started so quickly that I didn’t really have time to think about it.  In this case, I have more than a month to dwell on it.  Ugh.

Appointment 3 - EKG

This was a part of the pre-op process. They wanted an EKG for the anesthesiologist's benefit. It was actually really fast. I walked in the room, the lady put 7 or 8 sensors on me, pressed play on her machine, and a few seconds later it was done. She asked if I had been told that I have a low heart rate before. She said that my heart rate was in the low 60's, which is something they typically see in people who are either really relaxed or athletes. I am guessing that I was pretty relaxed at this point.

In Conclusion

After all of the appointments were done, we found a nice spot for lunch, browsed a local bookstore, and stopped at Trader Joe’s in Coralville. It was an exhausting day but at least now we have a plan and can wrap up this adventure in a few short weeks.