Isita came home from GOSH on Wednesday night but her recovery is far from over. She is still in a bit of pain and is a bit wobbly. She has lost some weight and although she is hungry, she can’t eat properly yet. All the chicken broth she drank on Thursday evening came out again before she went to bed and again this morning, so Marta had to take her to St Mary’s Paddington. Luckily they did not find any fundamental problem (for instance a blockage in her bowels). They think she has a stomach bug. The answer is to take things slow and easy. Regular sips of water or diluted juice and then some light food when she is ready.
While we are concerned about this – and the immediate concern always trumps every other feeling – we also have good cause to be as happy as possible. As soon as Isita is right, we have some remarkable news to celebrate with her. On Thursday midday Isita’s consultant Giuseppe gave Marta the results of the laboratory analysis of the tumour. Most of it was dead, he said. The small part that was still alive had differentiated. This is the term used to describe cancer cells that have converted back into something more like regular cells as a result of the treatment. In other words, even before the surgery took place and while the tumour was still in place Isita was free of cancer. She had a lump but not a cancerous one. There could hardly have been a better result. We still have to complete the treatment. So radiotherapy will start in the next week or so and go on until early in the new year. Then there will then be a series of end of treatment tests and further tests every three months to make sure the cancer has not returned. But for now, and possibly for some time already it has been entirely absent. This is a truly marvellous thing to know.
It is not impossible that Isita will come home at the end of the week. The first few days after the operation were rocky, as we had been warned they would be. But the most dangerous potential complications have been overcome.
To start with, the doctors had to work hard to get her fluid balance right. Her system was in shock and so retaining fluid, her bowels were not functioning, she was lying quite flat, and because she was in pain her breathing was shallow. All these things were expected but caused her to collect some fluid in her lungs.
So just before the weekend, Isita was breathing with the oxygen mask, the doctors were tightly managing her fluids, and we were cajoling her to do physiotherapy exercises like blowing bubbles into a bottle. She didn’t want to, but she has grit. Having complained and turned her head away, she pulled herself together and pursed her lips together and blew.
I am sure that part of her motivation came from her memory of the last time she needed oxygen after an operation. A year ago last October she was much sicker and the crisis took her to the intensive care unit (ICU), one of the most terrible experiences of the whole treatment.
Last Friday we were visited by a pair of clinical specialists – some of the most senior nurses in the hospital – cheerful, brisk, super-efficient and kind, but also the storm petrels of the ICU. They make the call when a patient has to go downstairs to level 3. We had a nervous night, but by Saturday it was clear that Isita was not taking that journey. She has done better every day since. Now we can all breathe more easily.
We just brought Isita back up to the ward from recovery. She is still sleeping but has opened her eyes a few times. No bad things happened during the surgery. She still has both her kidneys and fully functioning bowels. There was minimal bleeding; so no transfusions necessary.
The surgeon took out all of the tumour she could see. The target is to resect at least 95%. In all it is an excellent result, the best we could hope for. Now there is about a week of recovery in hospital before she can go home. So many people have sent prayers and messages of support. Thank you all.
Isita will have her operation tomorrow (Wednesday). She and Marta are sleeping at GOSH this evening and she goes down to theatre at about 8.30 in the morning.
The surgeon and anaesthetist came to see us this afternoon and were very calm and reassuring. The surgeon explained to Isita where the cut would be, pointing to the place on her tummy. She said the stitches will be under the skin so you won’t be able to see them. She also said they would make absolutely sure she wouldn’t wake up in the middle.
These are two of Isita’s biggest fears, so it was good for her to be told. Although there were some tears, she cheered up quickly. When she thinks about it she is terrified, but she is also genuinely happy that the moment has finally come. So are we.
Marta and I then sat down with the surgeon to go through the consent form, which is always a grisly process of talking through worst case scenarios. The surgeon explained it all in a gentle but unflinching manner. The tumour is wrapped around a couple of important arteries and veins, including one to the bowels, damage to which would be life-threatening. On the plus side, her right kidney is no longer under imminent threat. In general, it is like concrete that has set around the roots of a tree. The biggest risk is they will have to leave part of the tumour behind because it is too dangerous to go on. Most of the other risks are to do with what might happen if they went on.
It could take four hours, it could take eight or more. They don’t rush. We’ll probably get a progress report soon after lunch and then we wait. Thank you for all your messages and prayers. They will carry us through.