I’d like to introduce you to Barry. He is pink plushy stomach and on August 13, 2019, Barry will become the only stomach I have. It has been a crazy last few months, but via a series of serendipitous events, I discovered I may gastric cancer. It is a convoluted story, but the short version goes like this.
One day I was working out at the gym and noticed I was bruising easily. As I am the ever inquisitive doctor, I found this bizarre and had a friend order me some labs to check for anemia. Of which the labs confirmed an iron deficiency anemia. This is especially weird for me because I don’t have periods (Thank you Mirena IUD) and I had been eating really well so a nutritional deficiency was less likely the cause.. After some discussion with my friend, she recommended I get an endoscopy (stomach scope) to see what the cause of the anemia was. Being a typical doctor, I blew it off for a while, but there was a little voice in the back of my brain that said not to. One day I decided to listen to the nagging voice and I spoke with another friend, who is a gastroenterologist (the perks of being a doctor). She recommended a scope, so I had one. Turns out my entire stomach was carpeted with polyps and some of them after biopsy were positive for precancerous cells. Just so you know, this is not a normal finding and very unusual. Given this and my family history of stomach issues, I had to genetic testing done. Turns out I am a mutant and not the cool X-Men variety. Without going into the nitty gritty of the mutation in this post, it was discovered that I have a very rare genetic mutation to the APC gene which causes gastric cancer called Gastric Adenocarcinoma and Proximal Polyposis, GAPPS. This mutation is different that the mutation associated with Familial Adenomatous Polyposis (FAP), a mutation that causes colon cancer. The GAPPS mutation is so rare there is very little about it in the literature. Of what is known, having this mutation and my clinical presentation gives me a near 100% chance of developing stomach cancer. Also based on what little literature there is, the odds of this happening for me is sooner rather than later. Some of the people in the studies I have read had screening, like I had, were negative for cancer on endoscopic biopsy (like me), but were found to have cancer on surgery. What this means is there is the only one way to find out for sure whether I have cancer or not, and only one way to ultimately prevent it (presuming I don’t already have it). That is by having a total gastrectomy. Simply put, I have to have my entire stomach removed. Yup, you got it, whole stomach taken out. My stomach and I plan to part ways on Aug 13th, 2019 in San Francisco. As you can imagine my life will forever be changed, but hopefully this radical procedure will give me just that: life. For those of you who know me well, and know how much I love food, you will understand that making the decision to have this surgery was the easiest, yet hardest decision of my entire life. Just to answer a few inevitable questions upfront, yes I should be able to eat again, but it will have to be very small meals (a handful a time) and I will have to avoid carbs and sugary foods, as those can cause complications such as dumping syndrome. Sounds pleasant right? In the last 4-5 weeks since I made the decision to have the surgery, I have been eating like a pig, stuffing my face with so many sweets and carbs I actually have gained 5lbs. Since there is expected post op weight loss, I figured I could use a little extra pre surgery padding.
You may be asking yourself why I’m posting and blogging about all this personal stuff as I tend to be an intensely private person. The main reason, is that everyone I know is going to find out about this condition anyway. Plus when I was searching the web for blogs of people who had gone through the same thing I will have to go through, there was a paucity of information, so I thought it would be helpful to other people if I blogged my journey as a patient, who also happens to be a physician. Also, if I do a decent job writing, it may just be entertaining for other people to read about this insane journey I am about to embark on. Ready to come along for the ride? I know I’m not, but here we go.