We nearly lost Doug.
How suddenly the ordinary days of our lives can encounter crisis. I write this as I sit in disbelief having just received word about how my father-in-law’s surgery went. Ten days ago we were given the news that Doug had cancer. Intrahepatic Cholangiocarcinoma. -A term I never had to explore before. What exactly is a carcinoma? I know it’s cancer, but what do we need to know about this one?
Christa and I sat in bed at 6am on a Friday morning I will never forget. We were listening in on my mother and father in law’s meeting with the General surgeon. They were on a phone 2500 miles away in the surgeon’s office while my wife and I sat in bed on speakerphone so we could hear everything the surgeon was telling them.
Leading up to the call, Christa was unable to sleep and stewed about our condo in anticipation. I laid in bed worrying if it was going to be bad. How bad could it be? Doug is a relatively young and healthy man. He gave such a great speech at our wedding only 5 months ago and he didn’t appear sick at all! It can’t be bad. Several weeks back, the surgeon thought the tumor was limited to the bile duct, and proposed a lengthy operation called a Whipple procedure. But that was later cancelled to run another test. An MRI. Doug since had the MRI, and we sat in bed on the phone to get the results.
When the call started, Christa came into the bedroom to sit up next to me. I was very anxious to get on this call as well. Her parents; Doug and Donna, sitting with the surgeon, answered the phone and they all said hello to us. The surgeon went immediately into the analysis of Doug’s MRI results.
“Mr. Sanders, I’m afraid your cancer has spread to the liver. If you look over here you can see the tumor on this area here” (as he points at the MRI imaging). He continues “I can’t tell if the cancer has spread to the portal vein or the lymph nodes, but I’ll know for sure when I get in there. I’m going to bring Doug in for a surgery in two weeks. It’s a long one: 6–8 hours typically, could be longer. It just depends on what I find. In this procedure, we’re going to be removing most of the right lobe of your liver. We’ll also take a portion of your portal vein and bile duct.”
Back in our Vancouver bedroom, Christa and I are picking up most of what the surgeon is saying. Although some of the cancer terminology is new, we understand the anatomy and physiology at a pretty good level. We both work in surgery as surgical reps, in that we represent medical device companies that make implants, instruments, and various surgical electronic systems. In short, we spend most of our days in the operating room. Technically speaking, we are not true medical personnel, however we have each integrated ourselves in the medical field for the past 18 years. Our careers have given us an unusual amount of medical/surgical understanding for someone who isn’t a nurse or physician. So when we’re talking about resection, anastomosis, and Whipple’s, we have a pretty thorough understanding of what is being proposed. And that can be scary as hell. Anything that needs more clarity, we look it up or ask our surgeon clients. Orthopaedic surgery, general surgery, thoracic, plastics and urology: Christa and I have been in all of these procedures, but cancer… cancer would be the next chapter in our learning. -Just not for professional development this time.
On the phone call, we’re hearing the surgeon discuss the details of the procedure with my wife’s parents. Christa and I are nodding as we envision how he is resecting aspects of each organ and he explained the careful dissection around the portal vein. And it’s all making sense to us… in theory. Of course it makes sense to remove, that which is malfunctioning, and bypass/reconnect what needs to be connected. It seemed perfectly simple in my mind. I don’t mean I could perform the surgery, but I find it interesting how clearly envisioning something (even as complex as organ removal) can make you feel like it’s easier than it is.
In my mind it seemed no more complicated than building the Lego Death Star. –A 3803 piece Lego mega-structure. Assuming each step is performed carefully and accurately then just like the surgical procedure, it seems straightforward -Especially for a highly trained general surgeon… right?
Then the surgeon says; ”Mr. Sanders, I’m afraid the prognosis type of cancer isn’t in your favour at this point. Given the location of the two tumors there is a 25% five-year survivorship.” This translates to: Doug’s probability of living for 5 years is 25%. That’s one-in-four chances. Only one in four people with this same type of cancer will live to see the year 2021. The other three are going to have a different story -A story that ends much too soon.
And with this information Christa gasped. We asked our questions, got the relevant information, and got off the phone. Christa was silent. She started to shake and the moment I grabbed her she broke. She wept so deeply, my heart was breaking for her. No words were spoken for what felt like forever, she just wept. This was her time. Saying nothing was the best thing I could do for her. Just let her have her long cry. When she finally did speak, she said something I will never forget. Christa pulled her head up from my shoulder and looked at me, briefly holding back her back her pain she innocently asked; “Why can’t we just go back to when we were young and everything was easy?”
After a long embrace, with the little reassurance I could give, I offered; “all we can do is support your dad, support each other, and hope that your dad is in the minority of this statistic.” Christa made her way over to the shower and for the next 20 minutes she just stood under the water and wept.
They say a girl’s first true love is her father and here my wife’s heart was in the act of falling to little pieces. Through the foggy glass shower door I was watching the happiest, quirkiest girl I know on the brink of realizing life’s greatest betrayal: death. It’s such a helpless feeling to watch a loved one experience something that you can’t protect them from.
And to think just the night before I was venting about finances and real estate. How we can’t afford a house for the family we want to raise here in the exorbitantly over-priced Vancouver Real Estate Market… It’s all so trivial today. -So unimportant in the shadow of this shattering news.
Christa’s one and only dad…. could be leaving us.
For the next 10 days until surgery, I felt like I ran the gamut on the first four stages of grief: Denial, Anger, Bargaining, and Depression.
But stage 5: Acceptance. No way. I felt certain there was still so much that could be done. This legendary man is too young and too marvellous leave… especially when we can’t fathom the idea that our future children could miss out on learning from such a wealth of knowledge and experience. It just can’t happen. -There’s my stage 1 (Denial) in action.
Doug is the friendliest man you’ve ever met. He’s the guy who will chat you up and offer you some information that he’s confident you’ll find useful. Doug is fascinated with the world around him and loves to share his discoveries. Whether it is about the interesting personality characteristics of the dog you happen to be walking, or he’ll draw you a picture as he explains. Perhaps he’ll tell you a story about his latest scuba diving trip, or if you catch him at the right time in the morning, you might be lucky enough to hear Doug describe his most recent bowel movement and how it relates to what he ate last night. He doesn’t care about being judged, he’s just fascinated! Doug trots along appreciating what each day offers. He’s sure to smell the roses, and always hugs the people he cares about…and in some cases even the people he meets. In short, he enjoys making people smile. And it’s damn near impossible to not smile when you’re around Doug because he loves being around YOU so much. If you could choose your father in law, you want this guy. I adore and respect his daughter more than anyone on this planet, and there’s something about Doug & Donna that somehow inspires me to find yet another gear for their daughter. Man… they did a great job with her.
After her shower, Christa dried off and announced, “I have to go home”. And the next morning, she was on the first flight to Toronto. For the next two weeks my evenings would be spent reading articles and researching alternative medicine. I figured, the surgeon has the clinical part of this ordeal dialled, but what can we do to help?
My mother, who is really into alternative medicine sent me research on Cannabis Oil and CBD oil. Both contain cannabinoids which has some compelling anecdotal evidence that when extracted properly and taken in the right doses, have put some people’s cancer into remission. Now if the term “have shown” doesn’t sound very reassuring, that’s because it’s not. There has been no clinical evidence to date that suggests cannabis oil can kill cancer. But some people claim it has so who am I to say it can’t work? Not being proven either way was good enough for me. I mean what do we have to lose?! Even if this gives Doug a tiny chance at beating this then why wouldn’t we absolutely consider this? So during the 10-day wait for surgery, I was restlessly tracking down info. My mom would sift through the bulk of the info and send what seemed relevant for me to read. I really needed to formulate my questions for a Naturopathic Doctor.
We’ve looked at a water ionizer system that apparently takes the acidity out of water, which… has also shown to help create an unliveable environment for cancer. Same with a strict nutritious diet: if this helps build Doug’s immune system then why wouldn’t we try that too? So basically, if Doug is game then we’re armed for when he recovers from surgery.
Day of Surgery: The day began at 4am to take Doug to the hospital, followed by a long morning and afternoon of anxiously waiting around. After what turned out to be a 9.5-hour procedure, the surgeon came out to debrief Christa, her mom, and brother Craig. The moment we had all been waiting for. He gave them the news.
The surgeon began by stating that he felt successful in removing the entire tumor. While all the cancer may be out for now, there is a possibility it can reappear. So moving forward, Doug will be monitored frequently and thoroughly. He may still require chemo in the future, or possibly another surgery if something turns up in a future test. But for today, it seems Doug might free of this terrifying disease!
Later that evening, just as Christa and the family were preparing to leave Doug’s side for the night and return home, Doug surfaced in consciousness for a brief moment while everyone was still in the room. Because of the anaesthetic and other drugs, he wasn’t able to articulate clearly, but it seemed to them that was trying to communicate something. Finally after some time, in a haze he mustered the strength to ask one question: “Is it out of me?” With a resounding “YES!” from his family, Doug fell back into a asleep into what I imagine was the most calm rest he’s had in months.
Life is good today.
So for now, we win. Today, we get to keep Doug for a while longer. My heart sinks for the many people get the worse prognosis, the other side of the coin. And while I feel sadness for those who get hit with that devastating blow at this juncture, I can let go of the distracting anxiety and fear I carried for Doug, his family and of course my wife. Today isn’t our day. Today all our worst fears can be put to rest… not forever, but for now. And now is all we have.
