Yay. The PICC line was removed today!!  Based on the CT scan and the cancer markers the surgeon and oncologist see no need for more chemotherapy before surgery. I am so happy I almost cried when they removed the PICC line – which did not hurt at all by the way – it just pulled out. I no longer feel like a cyborg. James does no longer need to flush the line every day, and I do not need to use a cuff when taking a shower, and I no longer need to wear an annoying cover on my arm, or get an itchy rash from the dressing, or feel the sting when the line moves a bit, or being afraid that I accidentally pull it out.

Both doctors confirmed the results from Monday. They affirmed that I have several blood clots in my right lung, but they are not worried about it now that I am on blood thinners. The blood thinners will not remove the clots, but prevent new ones from forming. I will have to be on blood thinners for at least three months. They cannot see any tumor on the CT scan. And they could not see any mucin – so I guess my body has managed to get rid of most of the mucin remnants. Since they know that there is supposed to be a tumor on the diaphragm they perhaps can see a faint shadow. But being a surgeon he will need to go in and actually see for himself before committing to a large surgery. 

My white blood cells are finally back to above the minimum line, just about. Yippee. However for the first time two of my liver tests are completely out of whack. Not so yippee. I have not received a phone call from the hospital yet today, so I guess it is not alarming. No wonder my liver is struggling – I’ve had poison running through it for three months. I’m hoping exercise and healthy food going forward will sort that out.

The plan going forward has not changed. I am now prepping for a new large cytoreductive surgery and most likely a HIPEC – my next summit. Deciding to do HIPEC or not is dependent on what he can see through laparoscopy. The laparoscopy will take place June 3rd. Since I have already had a large surgery there might be a lot of scar tissue and hard to maneuver the laparoscopy equipment around and get a proper view of what’s going on in there. After that procedure, he will evaluate the tumor load and the chance for a complete cytoreductive surgery. The only reason why he would not do HIPEC is if there is more tumor than first anticipated and seen on the previous surgery and the CT and if he sees he cannot do a complete cytoreductive surgery. I’m not too worried about that since other surgeons have already been in there and seen it. In January the only visible tumor left was the one on the diaphragm. I will be surprised if there is more. But of course he needs to inform me of the “ifs ands buts”.

So – laparoscopy June 3rd and after that a new CT scan of my lungs – and legs to evaluate the blood clotting. If there are extensive blood clots in my legs I will need another surgery to put in a filter in my inferior vena cava in my abdomen. This is needed to filter out blood clots that possibly move around. The reason being that I cannot be on blood thinners for several days before such a large surgery. After this and some time at the end of June – probably cytoreductive surgery and HIPEC – including removing ⅓ of my colon and the surrounding lymphnodes. I also need a colonoscopy since CT cannot see inside the intestines and that will most likely be done the day before the big surgery since I have to do the same uncomfortable empty-intestine-drinking-foul-tasting-liquid-process and he wanted me to not have to do that twice. Holy smokes when I write this I realized that I most likely have four pretty large procedures ahead in June – with one new COVID-19 test before each surgery – yuck – my poor nose. That will sure be a different June than I have had before… But hopefully July will be a bright and shiny recovery month.

Since there is no more chemo at this time I can focus largely on getting back into shape so I can handle all these procedures without dissolving completely. No trip to the Sierras just yet though. High altitude is not ideal for me at the moment, but we can go camping anywhere else as long as I stay away from any activity that has a high risk of hurting myself – that is doable. However – walks, rowing, yoga, and healthy foods going forward. I can for sure do that.