Greetings friends and family.

I write to you from my hospital bed at Piedmont Athens Regional. I refrained from updating you on Monday afternoon, deciding, perhaps to your disappointment, not to write while still under the influence of anesthesia. Now it is just the Percocet pills, but that isn’t nearly as strong as a shot of Dilaudid, which makes me as foggy as the base of Mount Fuji appears in the featured image. I’m even getting some work done. I’m not much for sitting in a bed watching TV or Netflix (the TV has yet to be turned on). I thought y’all would like to hear how the surgery went on Monday, though.

To summarize, Vesuvius is gone like a volcano that burns itself out. Vesuvius is the pet name for the ileostomy that has been on the right side of my belly for almost three years and which randomly erupted with embarrassing sounds and flows of waste. I now have a ileostomy on the left side of my belly, and we’ve decided to call it Fuji, for no reason, really, other than the fact that I like Japanese food and I’m very hungry. I had hoped for a colostomy, but the doctor did not think reattaching my small intestine to my large intestine was wise because a large area of the small bowel was irritated and inflamed. There was too great a risk for a leak at the site of connection. So, the inflamed area was removed, and a new, now permanent, ileostomy was installed.

And the reason for the blockage and thus the inflammation?

…….  caesura ……..

You guessed it:  a tumor. And all of God’s people said, “Ugh.”

This was not the news I had hoped to hear when I woke up from anesthesia Monday afternoon. And you’ll recall that radiologists had reported nothing suspicious from the last two CT scans of the area. In fact, on the most recent scan, the concluding impression was that my issues had been resolved. Very frustrating. My surgeon wasn’t fooled.

As I mentioned in my post Saturday night, there were three outcomes for which I hoped:

1. that the swelling impinging on the wall of my small bowel was a benign issue like a kink,
2. that the doctor would be able install a colostomy, and
3. that my participation on the clinical trial that has been controlling my disease for over a year now would not be jeopardized.

Well, put a red X by numbers 1 and 2, obviously. And number 3 is up in the air. Naturally, I’m disappointed, but this is only by looking at the situation with my own eyes. When I talked to the doctor after the surgery, he was pleased. You see, his urgency to operate on me had nothing to do with needing revenue because of slow business (cynical humor), he was afraid that the inflammation was a tumor and, further, that there were many more like it in my abdomen that also weren’t seen on CT imaging. You may recall that the reason my abdominal surgery in 2016 was aborted was due to “cancer seeding” on the pelvic wall. As it turns out, upon examining me laparoscopically on Monday, the surgeon saw no other disease, no seeding, all clear. This gave him reason to be cautiously pleased having removed the mass that has been causing me much difficulty recently. He also removed a small, football-shaped region of muscle into which the tumor had begun to grow, too, replacing it with a mesh skin graft. I’m now an ab short of a 6-pack. Bummer.

It’s tempting to discuss the possible ramifications of there having been a mass growing on my small bowel while the disease we have been tracking has been controlled by the therapy, but I’m not going to do this. It is difficult for me to not entertain these thoughts privately. I’m trying to stay focused on the moment, and right now I need to recover from surgery, start eating solid food again, and put on some weight. The great news is that the doctor said, “I don’t care what you eat,” meaning that after I am discharged there will be no limits on my diet. As crazy as this will sound to many, I cannot wait to eat vegetables! What’s even more surprising is that they brought me turkey and gravy, green beans, mashed potatoes, and pudding for lunch Tuesday–the day after surgery. Wow.

As for my options for therapy, I should know more today. I should also have an idea of when I’ll be discharged. I’ll post an update when I know more.

I’ll end with this. I find it ironic that I so often believe that I know what is best for me, and I worry about scenarios out of my control. And yet, I have doctors with experience and knowledge that have a much better grasp of what is best for me, and they are the ones ultimately making the decisions regarding my treatment. They’re in control, at least of what drugs I receive and what can be surgically performed to help fight disease.

In vain I strive to understand what is happening inside me and to control the decisions made by my medical team. After all of these years, I certainly know a lot about my body and a little about cancer. I can make phone calls and write emails to ensure the right people have the right information, but, ultimately, there are smarter, more powerful people calling the shots, while witless cancer grows irrepressibly according to its own rules. This is certainly extreme, but at best I’m an educated and helpless patient.

Returning from those negative thoughts, I’m reminded that I’m merely a creature and that my Creator has all wisdom, power, and control over all His creation. In him I must continually put my trust, because there really is no other logical choice. Upon receiving difficult news or struggling with sleep or pain, when my mind spins with scenarios that seem to have no good outcomes, my only hope is that God’s providence is good, even if a valid justification escapes me. In my experience, God is not found by turning over stones but in having found stones turned over and hearing the stories of how and what was revealed. It’s usually when the story is more surprising than the discovery that you sense the hand of God. I’ve heard a lot of stories over the years, and been a part of a few myself, that have no other explanation than that there is a good God at work through his Son in this broken world. So, in any outcome, yes, even in death, God is good. But, again, I’m not going there yet.

My friend, Don, texted me this the morning of surgery. It is question 27 from the Heidelberg Catechism:

Q. What do you understand by the providence of God?

A. God’s providence is His almighty and ever present power, whereby, as with His hand, He still upholds heaven and earth and all creatures, and so governs them that leaf and blade, rain and drought, fruitful and barren years, food and drink, health and sickness, riches and poverty, indeed, all things, come not by chance but by His fatherly hand.

Thank you for all of your love. God bless.