Well, there it is. I said it. I am scheduled for yet another surgery on June 27th, 2022. I have been avoiding mentioning it in the hopes it doesn't have to happen, but that isn't very realistic, so here I am to tell you all about it.
First, can you believe it has been almost a year since my last blog update?! I don't know where the time has gone, but it has definitely flown by. Lots has been going on. Andy and I, and the pets, moved to a larger home in April. We were lucky to be able to stay in the neighborhood we have loved for over 5 years now, which is great. It was no easy feat finding a home that checked all the boxes in this INSANE housing market. But, with much perseverance, we did it! We now have our own offices since we are both working from home permanently, and just some extra space to stretch out in. Our tiny house worked pre-pandemic, but not so much when we were quarantined there for 2+ years. It has been really nice having the space and new scenery. The pups are enjoying their new yard. I get out for 2-3 mile walks with Gus every day. The weather has been really nice, aside from the freak tornado sirens going off, high winds, and hail we have already experienced since moving in 2 months ago. Hopefully I will get back to walking pretty quickly after surgery because it helps me in so many ways, and without it, both Gus and I may be bouncing off the walls! So, stay tuned. Oh, and Gus turned 1-year old in May! Crazy. He is a good boy.
Work has been busy. I have taken on more responsibilities, gotten a couple of raises, and am partaking in a leadership course equivalent to a graduate level class on top of all my other work. Hopefully it will pay off and help me bag a position with more of a supervisory role in the future. Did I mention I love working from home? I like to get out in the garden on breaks, and spending all day every day with the pets is my jam. Work/life balance is just so much better working from home, at least for me. Not having a commute is awesome too. In fact, the other day I had to get up and make it downtown to court for work by 9 am, and it reminded me yet again how nice it is to not have to do that on a regular basis. It will make recovering from surgery and returning to work a bit less stressful as well. Ok, ok, I guess I will get on with the surgery part now.
Although bile reflux remains an annoying, painful, and nauseating symptom for me post total gastrectomy (TG), my symptoms are about 80% better than they were year 1 post op. I still, however, experience bile reflux more often than I would like to admit. I take medication daily, for which we do not know the long term effects, since it is an off label use and no one knows what potential side effects could happen if I continue to need it daily for who knows how long. Despite daily medication, prevention while sleeping (sleeping at a 30 degree incline), and avoiding things I know cause reflux (not eating frequently enough, eating too close to bed, eating too much at once, etc.) I still have symptoms. The frequent burning feeling in my esophagus is a worry for potential future esophageal problems, and is even a risk factor for future cancers if not treated effectively. These are just a few of the reasons I am moving forward with surgery again.
At my 2-year TG surgical follow up, I reluctantly discussed a possible revision surgery. Dr. Davis let me know that continuing to experience these debilitating reflux symptoms on a regular basis, despite taking medication and precautions is not normal. He knows me too well. He said, "Kate, just because you are used to it at this point, doesn't mean it is good." He suggested a potential surgical fix, which I didn't even think was possible. Here I was, resigned to the fact that bile reflux is just another weird part of my life now. Dr. Davis described the revision surgery as going in to make the roux limb longer. I have marked up the photo below as I understand it for your visual pleasure. They unattach the surgical connection made during TG at the circle and reattach lower down with the hopes that the longer limb between the jejunum and small intestine will keep the bile from the pancreas flowing downward instead of having the opportunity to make its way back up because there will be more space between the esophagus and the new junction. Currently, my roux limb is about 50 cm long, which is a standard length studied to be effective in reducing the likelyhood of bile reflux symptoms yet allowing continued absorption of vital nutrients. I am told my roux limb will be lengthened to about 75 cm, or maybe a little longer. Anything longer than that can cause absorption problems, but anything shorter for me, may not be helpful in reducing my symptoms. So, fingers crossed, this works. Dr. Davis says he has only done a handful of these revision surgeries. He states he has been successful 100% of the time thus far, but unlike the hundreds of TGs he has performed, this surgery is still a bit of a new thing for him. I say, it will be fine. This will be the third time his large and capable hands have operated on my body, so I have no worries at this point.
Although the thought of surgery makes me a bit nauseous, I am looking forward to a day when I may not have to worry about bile reflux any longer. I don't know exactly what that will look like, but I am excited to find out! My ongoing symptoms are that constant burning in my throat on days when I have symptoms, feeling nauseous, decreased fluid and food intake, etc. The burning causes damage to my esophagus, which takes days to mend. Certain foods hurt when my esophagus when it is raw and tender, like alcohol, citrusy foods, and spicy foods. I hope that with this surgery, my esophagus can finally heal, and I can get back to enjoying all of these things that I love, but haven't had in over 2 years! When I have the rare few days of no bile reflux symptoms, I feel great! So, here's hoping that will be the new norm!
I will be traveling out to the National Institutes of Health about a week early to be with my cousin as she undergoes her TG on June 21, 2022 (exactly 1-year after my dad had his TG). To say I am nervous for her is an understatement. I don't know why I worry so much more about others than myself, but that is just the way it is. We will have a few days together before her surgery, so hopefully we can enjoy what the D.C. area has to offer and get our minds off all that will be coming for a bit. I will be at the hospital with her through her surgery and the first week of her recovery. Then my dad will join us and I will undergo my revision surgery a week later. We are hoping to all be able to travel back home together after that. My dad will be having his 1-year TG follow up as well. So, Dr. Davis will once again get to be a part of our big King family reunion in Bethesda, MD!
So, there it is. I will continue posting updates on facebook and instagram, and will hopefully not wait another year to update the blog. Thank you all for your continued thoughts, prayers, and support.