Heading Home Via the Casinos ....

Don't ask me how in the devil a huge distention of the small bowel has occurred above a high grade partial obstruction w/o my having more symptoms and discomfort than I have had!!!! Its a good thing Dr Tremaine showed me the CTE images or I'd never buy the story!!! There is also another area further down the small intestine that most likely will do well w/just a strictureplasty. No signs of problems at the ICV.

Absolutely LOVED the gyn/onco surgeon. Dr Mauriani. Very pleasant, a good listener, seems willing to respect the patient's opinions and decisions. Explains things well. I was surprised that he wasn't considering a full hysterectomy, that he felt removing both ovaries w/their big and little cysts was all that was necessary. Which is FINE by me!!! AND he does do laparoscopy but prefers open abdomen for getting a good look at EVERYTHING which fits my philosophy exactly.

If I were willing I could have seen the colorectal surgeon Monday and had the surgery Tuesday. Ha! Yeah, sure. Dr Tremaine still hasn't got me figured out yet obviously. The CTE images convinced me to at least talk to and listen to the colorectal surgeon. But the symptoms still aren't bad enough, I'm still not sick enough and the ovarian cyst is causing no symptoms .... so .... I'm getting my ducks all lined up in a row for when they are needed. Dr Mariani is no 2-4 year Mayo wonder. He's on deck at Mayo for the long haul. I told Dr Tremaine I would only talk to a colorectal surgeon who was on deck at Mayo for the long haul as well so we shall see.

I liked the ob/gyn I saw. Dr Cotter. But she will be leaving soon. Her husband is also a doctor at Mayo and he is moving on so she is moving on w/him, of course.

I sure do miss the old Rochester, MN tho. The outsiders and chains have taken over the town. There's no such thing as good food at a reasonable price anywhere near the clinic anymore at all. But Mayo itself is still the EPITOME of efficiency, the doctors and staff all a pleasure to see and work with. If you've gotta be sick this is the place to be! And if you aren't sick but still in need of top of the line medical care or diagnosis there's no better place to be.

Well, I've had time to "digest" the results of my trip to Mayo. I asked for and they gave me a CD of the CT Enterography images. Ahhh, the difference a skilled tech and radiologist makes!!! Or maybe I should say a Crohn's savvy CTE tech and radiologist make.

I dug out the CD w/last year's local CTE, interestingly almost a year to the day from this year's CTE at Mayo. WHAT A DIFFERENCE!

However, the BIG thing was the DISTENTION above that partial obstruction. As always the darn barium or whatever they use for the CTE took its time moving thru so I've had some bloating and discomfort since this CTE until today. Back to normal today. Last night looking at the two CTE image series I almost had myself talked into giving some SERIOUS consideration of scheduling the surgery as soon as I could get up the courage.

D*mn! I HATE going under anesthetic (and sedation too). I just do NOT like not knowing what is going on, having no say in what they do, having to rely on and trust some surgeon to make the decisions. I mean I made it clear I didn't want them touching the ICV area and the surgeon assurred me they don't like to remove 1 mm more than they absolutely HAVE to - and it didn't look they would need to do ANYTHING to the ICV area - BUT - it all depends on the blood supply to the area. If there is insufficient blood supply, even tho the ICV is healthy they would HAVE to resect it. THAT is what convinced me to WAIT, to push my luck and just bide my time until I felt sick enough that surgery was welcome. If I remember correctly he said the odds of that was like 3% or less. But I still don't like those odds.

And truthfully, the way they do surgery now where you just show up at the hospital the morning of surgery ...... I don't think I could do it. My other surgeries I was hospitalized before the surgery and the night before surgery when I panicked and started to walk out they were able to sedate me enough to stay. I mean I actually panicked so much I created quite a scene each time. And I was SICK and in PAIN prior to 2 of the surgeries, the other was an elective. And I was blackmailed into that one. I argued w/the surgeon for a year. He insisted on doing an appendectomy when he did the tubal ligation I wanted. I fought w/him for that solid year before giving in.

I've already told this Mayo surgeon that it is "my" ICV and it is "my" choice to risk needing another resection in a year or so if needed for the ICV. Unfortunately, I can understand what he is saying about the blood supply to the area. It makes sense even to me. And despite such a low risk factor for that I am NOT at this point willing to take that risk. My body, my decision. No one to blame but me if I'm wrong. I can live w/that.

This surgeon made the mistake of telling me that's he's known so many crohnies who didn't remember or realize what it feels like to NOT be sick they've been sick so long. I KNOW what it feels like to feel "normal". I had a 20 year remission, remember? So far, the symptoms I've been encountering have been mild, intermittent and have not in anyway impacted my life style and activities or the things I want to do and do do.

I think part of it is that "they" didn't stop to think that my resection was 30 years ago this past February. It was a side to end resection w/the loop left in, the "Eisenhower surgery". That alone would account for the "distention" when filled w/barium or other "matter". In addition, this CTE I drank the 3 bottles of "barium" or whatever in 15 -20 minute intervals and then the CTE was done. Last year, locally, I had a much longer span between the barium, don't remember that I had to drink that many of them and then had to drink water before leaving home and immediately upon arriving at the imaging facility prior to the CTE. That also would account for less distension on those images than on the current images.

I'm still thinking this thru as I'm sure the "smartest" thing to do is to have the surgery now - but I'm not always known for doing the "smartest" thing. I've had 10 good years since they first recommended surgery - and I've not regretted a minute of it ... so ..... we shall see.

I instinctively liked the gyn onco, Dr Mariani. I've found that my instincts are more trust worthy than my "common sense" and it was an instinctive confidence I felt immediately w/him. I was so darn nervous about even agreeing to TALK to a surgeon I babbled like a brook and couldn't shut up. Yet, in no time I felt completely comfortable w/him. That takes care of the ovarian cyst issue. I was hoping I'd run into that same "instinctive" confidence in the colorectal but it didn't happen. I didn't "distrust" or dislike him, I just didn't feel that instinctive "okay" either.

Nope. Have NEVER met a doctor, much less a surgeon that I "trusted". Some I have a good level of confidence in but "trust", when it comes to the medical profession? There is no such word as trust in my vocabulary.

Yup, I"m holding off on the surgery for now. But not done thinking it thru either. Most likely I'll just continue to rely on the symptoms when to agree to the surgery. Thanks, Fitzy!! Really. I wish you continued good luck w/the GERD. NO ONE knows better than "we" do when "we" are ready for surgery and agreeable to it.