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Surgery Today
As predicted, it’s been hard to write about my mom’s situation. She’s moved in with us, we are adjusting to living together, everyone’s trying really hard. In our home, there’s a constant spectre of illness, now matter how much we try to deny it, but we’ve been lucky so far and there have been many moments of joy. My mom’s been independent and in good spirits. And trying so hard.

After 6 rounds of chemo, my mom was referred to a surgeon who recommended that she have a procedure called alternately "cytoreductive" and "debulking".

He said there were no guarantees attached to this surgery, and that it would be quite a significant procedure, involving a full hysterectomy, the removal of the omentum, and then, once they are in there, the exploration and removal of any cancerous cells, aka "debulking" of cancerous areas.

The surgery is usually followed by 3 more rounds of chemotherapy once she is able to tolerate it.

The problem with finding case studies for this surgery is that her type of cancer - now being referred to as primary peritoneal carcinomatosis (although don't be fooled by the word primary, it's still 'unknown primary source') - is that it's a rare and relatively new category of cancer. While there are a million resources and blogs and testimonials on breast cancer, there is little to no information on this condition.

The other issue we grapple with is with the statistics: People who have the surgery tend to do better than those who don't. But of course, those who don't have the surgery are often faring too poorly to be candidates for the surgery in the first place.

There is this "tumor board" at Princess Margaret Hospital. Surgeons bring cases before the board, and the board votes on whether they recommend proposed procedures. In Judy's case, the board was unanimous in favour of the surgery.

Today at 6am we will arrive at the Toronto General Hospital, and the surgery began shortly after 8am.

The surgeon is a frank, warm, and bright person. Such a relief to deal with him rather than the oddly reticent oncologist. When mom asked him whether he would tell his own mother to have this surgery, he responded, "I wouldn't *tell* my mother to do anything. She would do it because she is someone who would take every chance to live longer. Because that is the kind of person she is."

Which I thought was a great answer. You have to decide what kind of person you are and act accordingly.

The waiting game - waiting for the inevitable return of the ascites - is a lot less appealing that it initially sounded. And while my mom is feeling a bit stronger, and growing back a lovely snow-white mane of hair after weeks chemo-free, the strain of waiting for the inevitable recurrence has been very difficult. And as much as this surgery and its recovery will be difficult, at least it is something to push through, and will provide answers that the CT scans and X-rays were not able to determine.

Now I’m in the waiting room, and the OR nurse came by to tell me all is going as planned. I am distracting myself with the laptop, 2 papers, and Franzen’s “Freedom” whose chapter with Walter’s perspective has me a bit stalled. But there are other distractions. I am very good at waiting.

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