Once More Into The (Surgical) Fray

I could begin by telling you “things weren’t supposed to be this way,” but let’s face it — they rarely are.

In fact, things aren’t supposed to be anything at all: they simply are what they are, will be what they will be, despite one’s best efforts.

Despite the best intentions, a solid foundation, perfect execution, even the most flawless plan can unravel, rather than unfold; Where the carefully aligned pieces fall just out of place, so that what was meant to be an intricate, completed puzzle — pieces tightly woven, interlocked, secured in such a way so that the final image is fit to be sealed and mounted — is instead noticeably flawed; Where a single, mislaid jigsaw skews the entire picture, forcing the players to painstakingly pour over their work, searching for a solution, so they can finally complete the challenge and move on to a new project.

And it pains me to say, but my puzzle is one in need of rejigging.

Rather than detailing each incident at length, belaboring every hurdle, I’ll try to provide an overview of what’s been happening, what will happen now, and where I go from there.

In addition to the removal of half my intestines in May (total proctocolectomy), I had adhesions (internal scar tissue) removed and a stoma revision (the part of my small intestine that is exposed) to fix the prolapse issue — that thing where my guts would snake out of my abdomen.

That ‘fix’ however, was undone as a consequence of the emergency surgery in June. Though to be fair, my surgeon was more concerned at the time with saving my life than  with anchoring/perfecting the intestinal port.

The stoma held up well in the beginning; even with the obstruction in October, the intestine remained firmly in place. By November, however, some instability started to present itself, and December marked the return of the prolapse, and the first of what would be many, increasingly severe, occurrences – sometimes with the intestine refusing to recede (or allow itself to be forced) back into the body for days on end.

(This is exactly what it looks like, by the way. It’s a surgical picture, though, not me. But if you want to see what I am talking about, have at it.)

With each severe prolapse came intestinal trauma, causing what was already suboptimal digestion/absorption to be further restricted until the attack had fully subsided, meaning an average span of 7-10 days of not only decreased caloric intake (due to a regular food intake/volume causing further prolapse), but scarce absorption of what could be ingested.

This has made keeping any weight re-gained since the 30+ pound loss incredibly difficult, and any further gains/complete recovery impossible.

I met with my medical team on February 4, and my surgeon and I discussed the options.

The lesser-invasive scenario — the one we agreed to go with — involves further intestinal resection (removal of more healthy small intestine) to create a new stoma (intestinal port) with careful internal stitching along the abdominal wall to tack the intestine in place. Ideally, this would provide the stability needed to prevent any future prolapse and allow the intestine to function normally.

The downside, of course, is losing more of the increasingly sacred, healthy intestine, which only exacerbates the short-gut syndrome. But if it, indeed, puts an end to the prolapses, then I’ll be able to take in enough extra nutrition without incident to make up for the suboptimal digestion/absorption.

If, however, the intestine prolapses again, the ‘fix’ involves a highly-invasive surgery, where internal scarring is intentionally created to forcibly anchor the intestine into place.

But due to the repeated trauma already inflicted on my gut and my body, my surgeon suggested we try the not-as-invasive option first, as it might be just enough to fully rectify the issue without having to resort to the most extreme procedure.

And that’s the surgery I’m having today.

There is no question that something must be done: every day since that meeting in February has become increasingly difficult, with the past ten days nothing short of excruciating.

If all goes well, it will likely set my overall recovery back about 4-6 months, which is entirely manageable. But because – again, if all goes according to plan – the gut will be given a chance to fully function without impediment, it’s not outside the realm of possibility that the recovery will actually tick up a notch and proceed in a higher gear than before.

But these are just guesses; nothing is guaranteed, and if I’ve learned anything, it’s that  trying to forecast how the gut will behave is a fool’s errand.

All I can do is keep on keeping on, doing everything in my power to tilt the odds in my favour, but accepting that there are things I cannot control, no matter what I do.

And that it’s not my fault – or anyone’s fault – if/when the recovery strays from the planned route.

Detours are a part of life, and you have to take them as they come. If navigated properly, they don’t have to lead you astray; they simply make the journey a little more scenic.

And as I re-evaluate and recalibrate the overall recovery plan, I also have a chance to rework my life-after-recovery forecast.

Prior to May, I’d hoped – perhaps foolishly – that the (what was to be final) surgery would prove the ultimate fix: that I’d be able, upon full recovery, to proceed with life as if the past decade had never happened.

However, I can no longer deny that this scenario will not happen, and perhaps never really stood a chance.

I initially had to shoot for that utopian conclusion, though, or else I’d have felt that I’d held myself, my life, back by ‘not trying hard enough.’ By making excuses. By somehow failing to fulfill my full potential, whatever the ‘potential’ may be.

(Think I’m too hard on/critical of others? You should hear the things I tell/demand of myself.)

What drives me more than anything is athletics: the intensive training regimen, constant competition with previous bests, the feeling of complete, glorious exhaustion after pushing the body beyond what the mind will allow.

It’s where I’m at home, what I’m most confident in doing, and what I love more than anything.

But I know that I no longer have a future in the competitive sphere, as my gut will not allow the predictability and consistency needed to commit to any one pursuit.

What I can do – what I will do –  is continue with what I’ve been doing as of late: training for me. Because it’s how I cope with stress, how I manage the anxiety.

And, for me, it provides that much needed sense of normalcy and routine.

That said, I’ve long searched for something to fill the void, to provide purpose, passion, beyond the physical, and I think I’ve found that in writing.

When not driven to train, I’m eager to write: my mind is constantly composing essays, op-eds, discussions in my head, even if they never make it to ink.

But I must improve the confidence factor; I have to learn to be as aggressive and self-assured on paper as I am in the gym.

That’s something I’ve already begun to work on, and in time, I know writing will feel just as natural an extension of myself as athletics does.

So, after this surgery, as I continue along in the recovery, I’m going to focus on balance: work on finding a happy medium between the training and the writing, and perhaps begin to chart a course for myself, post-recovery, for some sort of future, perhaps a career, spanning the two.

It may not be where I envisioned myself before this all started, but to be honest, I have little  cause to complain about where I’ve ended up; Where I find myself.

I wouldn’t trade the contacts I have, friends I’ve made, for anything. I have the best doctors, the most supportive, understanding network of friends and colleagues, and a family willing to sacrifice anything and everything to see me well.

Things are how they are, not how they’re ‘supposed to be,’ and perhaps there’s good reason for that.

Because how one envisions things should be at one time cannot take into account what may become in the future.

And that unanticipated future could very well be more promising than if things had gone strictly according to plan.