My big news is that since that posting I met with the surgeon and his assistant. This visit was strictly a consultation, not the procedure itself, as I originally expected it to be. The visit also included a disappointment. According to the surgeon, the laparoscopic approach may not be able to do the job, that is, it may not be able to find the very small object it is supposed to remove—an object measuring 2.4 cm by 1.4 cm.
Searching Less Familiar Territory
Performing such a task is a challenge just a little less daunting than finding a needle in a haystack—for several reasons. First, the surgeon and his team are looking for an object that is very small. In our meeting, the surgeon described it as “the size of an olive.” Second, the surgeon and his team are dealing with less familiar territory than what they are normally used to as a laparoscopic team where known parts of the anatomy such as the gall bladder or appendix or spleen are the usual targets of a laparoscopic search. What they have to go on are the images from the CAT and PET scans. And that’s all!
Finally, even if found relatively easily, this “olive,” which is an enlarged lymph node, may turn out to be behind something important like a blood vessel that can’t be moved aside too easily, anyway not by something as small as a laparoscope.
Conventional Surgery An Option
If the surgical team cannot find or reach the object, then right on the spot they will enlarge the initial incision and perform a conventional surgical procedure. First, however, they will be using the laparoscope.
Laparoscopic surgery, what is it? Laparoscopic surgery is usually what people in medicine mean when they talk about “minimally invasive surgery.” Because it is minimally invasive, recovery time is normally much quicker than with conventional surgery. Hence my disappointment when the surgeon told me that he might not be able to complete my procedure laparoscopically.
Cavity Inflated
Here is how the online encyclopedia Wikipedia defines laparoscopic surgery (www.wikipedia.org/wiki/laparoscopic_surgery): “The key element in laparoscopic surgery is the use of a laparoscope: telescopic rod lens system that is usually connected to a video camera… Also attached is a fiber optic cable system connected to a cold light source …to illuminate the operative field, inserted through a 5mm or 10mm cannula [hollow tube] to view the operative field. The abdomen is usually insufflated with carbon dioxide gas to create a working and viewing space.”
The target of this tiny gizmo is, as the surgeon described it to me, “a thing the size of an olive.” Not only must this olive be found, but it must be cut away from the surrounding mass and then extracted. Once out of me, it will then be sliced and put under a microscope by a pathologist (an expert in the causes of disease) and a report prepared.
Lymphatic System Defined
The olive is an enlarged lymph node, a part of the body’s lymphatic system. What is the lymphatic system? Every cell in the body needs to be fed to stay alive. Every cell in the body also needs to be cleaned to remove the byproducts of metabolism or feeding. The feeding is accomplished by the body’s tissue fluid, which is part of the body’s blood system. The cleaning is the role of the lymphatic system, which is also responsible for defending the body against disease. Tissue fluid and lymphatic systems are linked.
On the web site http://www.lymphnotes.com, one of many that deals with lymphatic issues, tissue fluid and lymph are compared and contrasted. “The role of tissue fluid is to deliver the groceries to the cell. The role of lymph is to take out the trash [the byproducts of metabolism] that is left behind and to dispose of it.”
Known As Lymphoma
Lymph nodes play a central role in the production of antibodies, which the body produces to fight disease including cancer. Sometimes the nodes are cancerous themselves. That may be the case with “the olive” inside of me, found by both CAT and PET scans and shown to exhibit higher than normal metabolic activity by the PET scan. Cancer originating in the lymph nodes is known as lymphoma.
If the “olive” is found to be evidence of lymphoma, then my oncologist (cancer specialist) is likely to recommend chemotherapy as the treatment. Chemotherapy primarily involves the transfusion of chemicals into the blood stream. Sometimes chemicals are also taken by mouth.
Chemicals Are Killers
Most of these chemicals are killers. That in fact is why they are taken. Their job is to attack and kill fast growing parts of the body such as cancer cells. Unfortunately, there is no way to stop them from also killing other fast growing cells in the body such as hair follicles and parts of the stomach lining. Hence the sudden baldness we see in cancer patients. Hence the bouts of nausea they frequently experience.
By talking about chemotherapy at this stage, I am getting ahead of myself, and that is not a very good idea when dealing with anything as momentous as the possibility of a cancer reoccurrence. In fact, it is not a very good idea in any case. I am learning from my meditation practice to live in the present, and never has such a skill been more important.
It is the now that is important. It is learning to make the most of the present that is essential. That is the best path to getting the most out of every moment of life.
ABOUT MIND CHECK
Thank you for tuning into Mind Check, a biweekly effort to prove that we are what we think and that clear thinking leads to effective action and to a better world. Mind Check is intended to serve as a bridge between the realm of the human spirit, that center of our energy, mental and physical, and our rationality or reason, of which the scientific method is an excellent example. Mind Check is also intended to prove that the ideas of right and wrong are innate, not exclusively inherent in the situation or the whim of the moment.
To communicate with the author of Mind Check, please write to stephen.saft@gmail.com. For examples of the writer’s other writings, see the website http://www.iwillmeanpoetry.com. The author is also preparing to launch a site of podcasts consisting of spoken poetry, essays and short stories. Be on the look out for it.
Copyright © 2007 by Stephen Alan Saft
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