The last supper

When it comes down to it, I’m probably the perfect person to have his stomach removed—and I’m not just talking about the fact that I have a mutant gene that predisposes me to gastric cancer.

I have terrible taste in food. If I had to draw up a list of my top 10 favourite meals it would look something like this: 

  1. Perogies smothered in butter and sour cream
  2. McDonald’s Bacon ‘n’ Egg McGriddle meal
  3. Cheezies (yes, they can be a meal)
  4. Chocolate chip cookies (also known as bedtime supper)
  5. Beef tacos
  6. Salt ‘n’ vinegar chips with garlic dip (see parenthetical attached to No. 4)
  7. Those colourful Easter sugar eggs (an agreeable breakfast substitute)
  8. Hot dogs covered in bacon, cheese, and garlic
  9. Popcorn with layered butter (also known as movie supper)
  10. Cheese ‘n’ bacon hamburger with mayo  

Note that there are no fancy foreign words in any of the above meal descriptions (the closest I usually get to fine French or Italian cuisine is when I have French fries with my cheeseburger and request that the chef swap the cheddar for mozzarella). Also note that several descriptions contain unnecessary contractions of perfectly good English words—key to making food sound appealing to folks with trailer park palates. Last but not least, you’ll observe the complete absence of vegetables (hence my favourite Homerism: “That’s not food. That’s what food eats.”)

Point is, I’m pretty sure this diet would have been the end of me sooner rather than later. However, my total gastrectomy will likely have a substantial impact on how much of this sort of food I’ll be able to eat, and probably even how much I’ll enjoy it.

My new diet, as prescribed by my hospital-assigned nutritionist, will be much improved. High in fibre, low in carbs, lots of protein, little fat. Plus, I’ll be taking in significantly fewer calories per day, which means even if I do consume the occasional bit of bad food, it will be just that: a bit. I won’t be able to eat enough to do much harm.

The upshot is that I may well be healthier post surgery than I am now. I’ll lose a little weight, chip away at my modestly high blood pressure, and perhaps add a few points to my sagging good cholesterol.

Indeed, if all goes well, I’ll likely live longer without a stomach than I would have with one.

Of course, I still have a couple of days left to be a glutton, and I’m taking advantage of them. I’ve enjoyed all of the foods mentioned in my list over the last week—thanks, honey, for preparing your world famous tacos last night—and I plan on capping things off with a thick, juicy, medium rare steak tonight. And, since I’ll be eating much less tomorrow evening in preparation for my surgery Monday, it’ll be my last supper.

Not many people get to say that and then look back in future years to reminisce over it.

Standard

Living a full life

As our daughter would say, Chad’s got three sleeps to go before his surgery (though really—who are we kidding? There will be no sleeping on Sunday night). As the days have been winding down, we’ve been eating Chad’s favourite things that might not make the cut post-op. Smoothies! Grilled cheese sandwiches! Pizza! Tacos! To say I’ve felt full these last few days has been an understatement, but the big problem with this epicurean lifestyle (or just plain gluttonous, depending on how you look at it) is that I’m actually not getting my stomach removed.

The good news, I guess, is that my lifestyle and eating habits will shift along with Chad’s—or at least I’m going to try to see that they do. In the meantime, I’m not going to nibble on salad while Chad eats his last French fry. We’re a team. He fills up my life with all of the best things—the least I can do is join him in filling up his stomach one last time.

kp

Standard

The world of tomorrow is now (and it will be even better next year)

I’m pretty lucky to be alive in this era. From space flight to video games, the past half century has been a cornucopia of scientific breakthroughs and technological marvels that never fail to amaze me (hence my career as a technology journalist).  

Then there’s medical science, perhaps humanity’s wisest, greatest endeavour.

Hereditary diffuse gastric cancer has been killing humans for hundreds—perhaps thousands, tens of  thousands, or even hundreds of thousands—of years, and yet this is the first time in history that doctors have been able to identify the genetic mutation that causes it and offer preventative treatment.

I learned last night that my cousin, who had her stomach out in January and is recovering quite nicely, actually had spots of cancer that were found in pathology but not in any of her pre-surgery diagnostic tests. That means she was undoubtedly on her way to a terribly painful and drawn out demise similar to the one my mother suffered.

Had she been born a decade earlier, she’d have fallen sick before doctors had the knowledge necessary to identify her genetic mutation and help her. Simply put, the combination of modern scientific understanding and technology has saved her life.

It’s just a bummer that the prophylactic treatment is so extreme.

Still, if my lifelong obsession with science and technology has taught me anything, it’s not to underestimate future breakthroughs

This gives me hope for my daughter. Biomedical ethics keep her from being tested for the mutation until she’s 18 years old. The argument is that she ought to be able to choose whether she wants to live with the knowledge that she has the mutation, the ramifications of which range from emotional to financial (life insurance would suddenly be lifted out of reach). That, more than anything else, is what keeps me awake at night. Indeed, I suspect I won’t have a truly restful sleep until she reaches the age of consent a decade and a half from now.

However, even if she does have the gene she may not need to have her stomach removed.

I read an article in Wired magazine last month that described a race to create new diagnostic tools capable of identifying tumours at the cellular level—just what the doctor ordered (perhaps literally) for a disease like HDGC.

Researchers are predicting that these tools will be available within the next five years. If that’s the case then extreme prophylactic surgeries such as total gastrectomies may become a thing of the past. Instead, my daughter would be subjected to a diagnostic procedure no more intrusive than an ultrasound once every few months until they noticed the first microscopic tumours (which could be never).

So, as I said at the start of this post, I feel fortunate to live in this time and place. The surgery may be extreme, but I’d feel a terrible hypocrite if I didn’t take advantage of what the modern medical world has to offer.

I’m just sad that I don’t live even further in the future, when yet more advanced science and technology makes treating people with genetic mutations like mine even simpler and less traumatic.

Plus, it would be awesome to have my own personal interstellar starship.

Make it so, Number One.

Standard

My husband: the cheap date

 

On our first date, Chad and I went to see The Talented Mr. Ripley at the Capitol 4 theatre in Saskatoon. Despite the fact that I didn’t actually realize it was a date, it set the pace for our relationship: simply, we really like to watch movies.

Since the birth of our daughter in 2005, we’ve had a precious few opportunities to go on real movie dates, so we do most of our movie watching in our living room. However, tomorrow we’ve lined up some great friends to babysit for us while we go and see what could potentially be our last popcorn picture in a theatre for a long time.

Imagining what life will be like post-Monday is difficult for me. Imagining what going to movies with Chad without sharing a bag of popcorn and a big Diet Coke will be like is almost impossible. If there’s a bright side to this whole genetic debacle it’s this: going to movies will be a whole lot cheaper without a trip to the concession stand. In these tough economic times that’s a cloud with a lining made of buttery topping.

kp

Standard

If the way to a man’s heart is through his stomach…

 

…Then my wife is going to have to work extra hard for my affections once I haven’t got one.

This was the joke that I wanted to use to lighten the mood with my doctors when I first met with them after learning I had the CDH1 genetic mutation. When my wife learned of my plans, she rolled her eyes and suggested it was far too lame to utter in the presence of learned medical professionals.

So what does she do ten minutes into our meeting? Use it word for word.

I never knew how much respect she had for my wit.

In truth, humour has played a significant role in the way we’ve been dealing with my upcoming surgery. Here’s an example: We’d prepared a platter of snack foods for our annual date with the Oscars last Sunday. I’d been nibbling on Popcorn Twists and Doritos and had yet to make my way to the bowl filled with All Sorts candy, but I’d spied a couple of purses (that’s what I call those jellies coated with tiny pink or blue candy beads) buried halfway down the dish. Those of you who eat All Sorts know that there are rarely more than a couple in any bag; they’re like the prizes at the bottom. Kristy was aware of my passion for purses, so I figured they were safe—especially given that I might not ever be able to eat them again.

But the next time I looked over, both were gone. Both. I looked at her and said, “I thought my wife loved me.”

She knew immediately what I was talking about. She’d tried not to let on that she did, but the two chocolate martinis she had consumed over the previous hour got the better of her and she broke out laughing.

“Look, it was a mistake,” she said once she’d caught her breath. “An accident.”

“They don’t feel like any of the other candies. Even if you reached without looking you’d have known by touch. That was no accident. You made a conscious decision to eat those purses knowing full well the consequences,” I said, before turning my head away and adding quietly, “How could I have been so foolish?”

It was one of those wonderful moments of minor romantic mirth that probably seems banal to those who aren’t immediately involved, but, combined with others like it, ends up acting as a stanchion of a couple’s lifelong relationship.

And it’s probably something I’ll be thinking of to help relax next Monday morning while I’m freaking out waiting to be put under.

So, honey, this is my way of forgiving you for eating the purses.

Still, couldn’t you have left just one? 

 

Standard

And he thought the Battle of Waterloo was bad…

Napoleon_Bonapartes_portrait.jpg picture by kpryma

Here are a few stats I’ve run across in my recent research on the topic of HDGC:

1.       It’s believed that Napoleon Bonaparte died of familial gastric cancer—what Chad’s avoiding with this surgery.

 

2.       Under 5% of all patients with gastric cancer carry the hereditary genetic mutation.

 

3.       Worldwide, gastric cancer is most predominant in Japan (80 cases per 100,000) and eastern Asia. Incidence rates are generally lower in Western Europe and North America (10-40 per 100,000); however, most of the CDH1 mutations have been found in European populations. There is, however, the possibility of higher incidence of HDGC in New Zealand Maori families. Ontario has one of the lowest incidences in the world. Go figure.

 

4.       The average age of diagnosis of HDGC is 38 (Chad turns 35 in May).

 

5.       The full name of the surgery is total gastrectomy with Roux-en-Y esophagojejunostomy. We just refer to it as “getting his stomach removed”.

kp

Standard

Call it the Crockett gene

Kristy’s post Friday noted how it seems as though HDGC is popping up everywhere right now, from newspapers to popular television shows. A couple of other sources from which I’ve been gleaning information are family members who recently had the surgery.

As I’ve already mentioned, once my mom had been diagnosed with HDGC doctors recommended genetic testing for everyone on the Crockett side of my family (yes, we’re related to him, and no, I don’t currently own a coonskin cap). While many have declined—I don’t really know most of the Crocketts, so I can’t say why—a few decided to have the test done. Two came back with positive results, and both have already had their stomachs removed.

My sister, who lives in Vancouver, was the first. She had her surgery last October. Unfortunately, it didn’t go very well. The stitching connecting her esophagus to her intestine tore a little bit, forcing her to remain in hospital for some six weeks with half a dozen tubes protruding from various parts of her body as the hole slowly mended itself.

What’s worse, when she eventually left the hospital and started eating again, she discovered that there was nothing, save milk, that she could reliably keep down. There hasn’t been any rhyme or reason to the problem. Yogurt, for example, might be fine one day, but not the next. Same goes for everything else she’s tried. Her condition hasn’t changed, and she has yet to go back to work.

Conversely, a cousin of mine had the surgery done in Saskatoon in January, and reports from my stepfather indicate that the procedure went flawlessly. Apparently she was out of the hospital in a week and she didn’t seem to be having serious problems with any of the foods she tried.

Alas, there’s no telling how things will turn out for me. I’ve been told by just about everyone, including my genetic counsellor, my doctors, and my nutritionist, that the after-effects of the surgery vary from individual to individual.  

On the bright side, my surgeon is apparently one of relatively few to have studied HDGC. In fact, she’s performed several prophylactic gastrectomies already. We’ve been told by several MDs—including a friend of ours who happens to be a gastroenterologist—that if they had to have the surgery, they’d want her to do it.

Clearly, I’m in good hands. Whether that’s enough is anyone’s guess.

Standard