This post is part of my Cancer & Healing journal, an archive of the updates I wrote while going through treatment for Stage III rectal cancer. These entries reflect what I knew and felt at the time.

A little update from the other side of surgery. 🤎

The Surgery Went Well

First, the really good news.

My surgery went well, and my pathology report showed that my surgeon was able to remove the entire “envelope,” the whole area containing the rectum, surrounding tissue and lymph nodes, with clear surgical margins.

That is very good news.

And I have to say, my surgeon is amazing.

We are incredibly lucky to have someone with his skill right here in our small community.

He was able to perform the planned open Low Anterior Resection, which means my sphincter was preserved and my ileostomy is temporary.

Once everything inside has had time to heal, I’ll have another surgery to reverse the ostomy.

Then begins the next chapter of teaching my body how to work and heal again.

For Now, My Job Is to Heal

I’m getting a little better every day.

I’m still pretty sore, and the fatigue can hit HARD, but overall I’m doing really well and I’m very grateful to be home.

Right now, my job is pretty simple.

Walk a little farther each day.

Rest when my body tells me to.

Eat.

Hydrate.

Learn this ileostomy.

Heal.

And Then There’s Healthcare

This experience has also given me an entirely different perspective on our medical system.

As a former RN, I’ve recognized gaps in my care and in the system that I honestly don’t think many patients without a medical background would know to question.

I don’t have the energy to take that on right now, but I have a feeling there may be a little patient advocacy in my future because, frankly, the list of bullshit is growing daily.

Calling providers.

Getting answers.

Billing.

Communication.

Timely care.

Accessibility.

Systems that sometimes seem designed around the system rather than the patient.

One small example:

St. Anthony Hospital’s billing office repeatedly called me while I was still in the hospital, leaving vague voicemails asking me to call them back.

When I finally returned the calls after getting home, I asked them to remove my phone number from their call list and revoked permission to contact me by phone.

They can communicate with me by email or snail mail from here forward.

Not once during those calls was I able to easily understand the person speaking to me, and my hearing is pretty darn good.

All I could think was:

What if I were 85?

What if I had significant hearing loss?

What if I were confused, medicated or scared?

What if I didn’t have someone helping me navigate all of this?

Healthcare has to work for those people, too.

But that fight is for another day.

Right now, my job is to heal, walk a little farther each day, rest when my body tells me to and be incredibly thankful that I get to say this:

The surgery went well.

The margins are clear.

The ostomy is temporary.

And I am healing. 🤎

One day at a time.

Looking Back

There’s something important about this post that I don’t want hindsight to erase.

The surgery really was successful.

Later pathology information was difficult.

It showed that I had not achieved the complete pathological response we’d hoped for. There was residual tumor, and four of the twelve lymph nodes removed contained cancer, giving me a post treatment pathological stage of ypT3N2a.

Those results mattered enormously.

But they don’t undo what happened in the operating room.

My surgeon was faced with an ultra low rectal cancer in a pelvis that had already been through radiation and chemotherapy.

He was able to perform the LAR.

He preserved my sphincter.

The mesorectal specimen was removed intact.

The margins were clear.

And my ileostomy remained temporary.

Those were wins. They still are.

I’ve learned that cancer has a frustrating ability to hand you good news and bad news in the same envelope.

Sometimes there isn’t one clean emotional response available.

You can be profoundly grateful for a successful surgery while being devastated by pathology.

You can celebrate clear margins while being frightened by positive lymph nodes.

You can be relieved that your ostomy is temporary while wondering what happens next.

None of those emotions cancels out the others.

The Other Thing I Notice Now

Even one week after major abdominal surgery, I was already thinking about other patients.

The billing calls bothered me, obviously.

But underneath my irritation was something bigger:

What happens to the person who can’t navigate this?

I had worked as an RN.

I understood medical terminology.

I knew how to ask questions.

I had people helping me.

And I was still finding the system exhausting and fragmented.

Cancer had already required me to become a patient.

Now I was beginning to understand how easily being a patient can become another full time job.

I wasn’t ready to do anything about that yet.

I could barely walk very far without needing a nap.

But apparently the part of me with strong opinions survived surgery completely intact.

That’s probably a good sign.

One Day at a Time

The last line of the original post was simple:

One day at a time.

At one week after an open LAR, that’s about as far ahead as I needed to look.

There would be pathology to process.

There would be more blood tests.

There would be decisions about when to reverse the ileostomy.

There would be a whole new vocabulary involving anastomoses, ostomy appliances, output, wafers and eventually LARS.

But on August 25, I didn’t need to solve any of that.

My surgeon had done his job.

Now my body had to do its job.

Heal.

One day at a time.