Want to read a balanced perspective on the news? Please subscribe to A View from the Center for free. I won't clutter your inbox, just send you one or two new posts every week. Also, please follow me on Facebook, Instagram, and Twitter, where we get into some pretty good discussions. And please support independent journalism by sharing this with friends!
I underwent cancer surgery a month ago, after becoming one of the more than 1.7 million Americans the Centers for Disease Control estimates are diagnosed with some variant of the disease every year.
Developing cancer, especially if you live into your 60s as I have, is not unusual. The American Cancer Society believes the average lifetime risk in the U.S. of developing cancer is 40.2% for men and 38.5% for women. And I am now one of what the National Cancer Institute estimates are 18.1 million cancer survivors in the U.S.
Just before the surgery, I published a column about the operation, the long rollercoaster of emotions and medical procedures that got me to that point, the lessons I’d learned, and how I had dealt with my cancer diagnosis. My hope was that my experience would be helpful to others. The reaction the column received indicates that it was.
What I didn’t realize was how it would help me. The process of writing about it was cathartic. More important, though, were the many hundreds of comments on social media platforms posted by friends and lots of people I don’t know. If positive thoughts can be healing, yours certainly helped me, and I am in debt to all of you.
The following describes my post-surgical experience in lots of detail. I hope it’s not TMI and that it is useful to some of you.
I Got Lucky
It seems odd to say fortune favored me when, after all, I was diagnosed with a potentially deadly disease. However, as I described in my initial column, I was very lucky that doctors found the cancerous cells at all, and that they found them at an early stage. The cancer was Grade 1, which means that the tumor cells looked fairly normal, well differentiated, and slow-growing.
I also got lucky in that the robotic surgery could not have gone better. The plan was for me to undergo a gastrojejunostomy with a partial duodenectomy. In layman’s terms, doctors believed I had two small difficult-to-reach tumors in the duodenal bulb, right at the exit from the stomach to the small intestine. The planned procedure would have chopped off the duodenal bulb, closed off that exit from the stomach, and then opened a new hole in the stomach to connect it directly to the jejunum, the second part of the small intestine. In other words, the surgery would have meant a major restructuring of my digestive tract.
Fortunately, my terrific surgeon at the Baptist Health Miami Cancer Institute, Dr. Ramón Jiménez, found only one tumor, so the amount of tissue he needed to remove was less than expected. As a result, he was able to save the duodenal bulb and keep my digestive system intact. He also removed an unrelated umbilical hernia.
Finally, tests found that the cancer had not spread, so the hope is that the surgery will be a cure. That means that I will not require any chemotherapy or radiation.
This aerial shot shows the campus of Baptist Hospital of Miami where I underwent surgery on June 2, 2022. My family told me that my first room had a beautiful view of the lake on the right. I never made it to the window to look. (Courtesy Baptist Health)
So, It All Went Smoothly?
As I mentioned, the surgery couldn’t have gone better. The same is true for the 36 hours or so that followed. That did not come as a surprise because I’d done some research and found that noncardiac surgeries are safer than most people think, with very few deaths caused by the surgery itself or the anesthesia.
The recovery from surgery can be where the greater danger lies. An extensive study titled “Association between complications and death within 30 days after noncardiac surgery” published in the Canadian Medical Association Journal analyzed more than 40,000 noncardiac surgeries across the world of patients aged 45 and older. It found that only five deaths (0.000125%, about one in 8,000) occurred on the operating table. But 710 patients (1.775%, about one in 56) died within 30 days of the surgery. About 70% of those deaths happened while patients were still in the hospital recovering. Another 29.4% of the deaths occurred after patients were discharged. Bleeding, cardiac issues, and infection were the main causes of death.
I came out of surgery on a Thursday evening. I had significant but bearable pain, was groggy because of the painkillers, and slept erratically, but the immediate post-op process went well. I was even able to walk a little on Friday.
Things changed on Saturday morning. I woke up feeling a little feverish. By midday, my temperature had hit 101 F and rising, with a heart rate that felt like I was running on a treadmill and would not drop below 120 beats per minute.
Making matters worse, the fever, as it usually does for me, triggered asthma and coughing. Having seven incisions and pain, the last thing I wanted to do was cough. I can only imagine what it would have been like if the surgery had taken place before robotic surgery and they had really sliced me open.
Doctors and nurses quickly started trying to control the fever, began inhalation treatments to open my airways (which worsened the tachycardia), put me in a stomach binder to protect against the cough opening the incisions or developing another hernia, and gave me pills so I could sleep that night.
Unfortunately, I did not get better. By Sunday, I still had a fever and was coughing constantly. Everything seemed to be aggravated by a nasogastric tube that I’d had since the surgery. It seemed to increase secretions in my throat, making me feel, at times, as if I were almost drowning.
They rushed me to get chest X-ray, which showed I did not have pneumonia, and then to a CT scan to make sure I did not have a pulmonary embolism. The results did not come in until around midnight, at which point Dr. Filipe Kunzler, who had mostly been in charge of my post-op care, ordered the tube removed. Having a tube pulled all the way from your stomach through your nose was one of the more bizarre feelings I’ve ever had, although it wasn’t painful.
I am very grateful that Dr. Filipe, as everyone called him, stayed on top of it, even so late on a Sunday night. Filipe gives new meaning to good bedside manner.
By the next morning, I was on the mend, the fever had started to fade, and, following Filipe’s orders, I showered and shaved. I started feeling somewhat human again.
Home at Last
I headed home the following evening, on Tuesday night, June 7, after six days and five nights at the hospital. While I was certainly glad to be home, I can’t be more grateful for the excellent care I received from doctors, nurses, assistants, and all other personnel at Baptist Hospital, which also has great facilities. While major surgery is by definition an unpleasant experience, Baptist and its people made things as easy and comfortable as possible, and I could not recommend them more highly. My wife, two of my brothers, and one of my sisters-in-law also helped tremendously.
Once home, I could only eat very soft foods, so I was limited to things like soups and puddings, not a usual part of my diet. I also could not drink sodas, which, after a lifetime of addiction to Coca-Cola, then Tab, and, more recently Coke Zero, seemed like my biggest challenge.
The reality is that I had very little appetite for the first week, so the dietary restrictions weren’t an issue. More problematic was that the asthma and coughing continued, which forced me to use the stomach binder at all times, even in my sleep. My pulmonologist, Dr. Cristóbal Rísquez, treated the asthma aggressively with oral and inhaled steroids (which also helped with the pain), and things improved within a week.
As the coughing eased, the pain, for which I was mostly just taking Acetaminophen, began improving. Since leaving the hospital, other than when I coughed, the pain has been mostly an ongoing unpleasant discomfort, seemingly the result of the seven incisions more than anything else.
I slowly started gently exercising, moving around a little in the pool and very low-intensity cycling on a stationary bike.
Three weeks after the surgery, Dr. Jiménez gave me the go-ahead to return to a more normal diet and that has gone fairly well. He also said I could gradually increase physical activity.
However, even today, having just passed the 30-day milestone, I can only sit and work for a couple of hours at a time. Lifting weights and sit-ups remain off the table. As someone who lived in Manhattan for a long time, I’m inclined to walk very quickly. When I did that yesterday, my body quickly told me to stop. I did manage to play nine holes of golf, albeit hitting at only about 75% intensity. That’s an extremely welcome distraction.
Surprisingly, and thankfully, boredom has posed the biggest challenge because I have little tolerance for inactivity. My limited ability to write, along with reading, binging shows, and playing lots of Words with Friends and bridge online haven’t been enough of a distraction.
Still, I’ve been lucky and hope that in a couple of weeks I’ll be near normal. I’ll be happy to answer any questions about my journey, either here on my Bulletin site or my Facebook page. Thanks again.
Cover photo: I didn't have a great cover photo for this article, so I posted that one of me hanging out in December of 2019 on London's New Bond Street with the Franklin Delano Roosevelt and Winston Churchill Allies Sculpture by Lawrence Holofcener.
Please let me know what you think by leaving a comment below. You can also do so on my Facebook page (https://www.facebook.com/antoniomoraTV1/). Please subscribe (it's free) and share the link: https://aviewfromthecenter.bulletin.com/subscribe.