I seem to have been walking around in a daze today, running around the hospital doing the obligatory pre-op appointments and lab draws. I have been in a dream like state I keep expecting to wake from. I had my last full dinner with some great friends here in San Francisco. After dinner as we chatted the expected questions of my surgery came up. I explained my surgery, bringing out my phone to show my friends diagrams of the procedure, explaining the basics of the 4 hour long surgery. I described my surgery and future  diet and what it will be like for the coming weeks, as if I were describing someone else’s therapeutic plan, not my own. There was a sense of detachment to it and a sense of disbelief. Not sure I can say it’s denial, but it might be. 

Earlier as I ate, I savored every morsel and started to mourn my now dying relationship with food, almost as if I am going through the states of grieving. Today has been a bit more somber, introspective, and contemplative. I try to be positive, but it is hard to do all the time. I try to rationalize what I am feeling and tell myself that it is normal to make myself feel better. I remind myself that I have had countless patients who have undergone open heart surgeries which requires cracking of their rib cages, what I imagine to be as one of the more painful surgeries there is, sit in a chair and tell me they’re doing fine, having minimal pain, and taking little to no pain medicines. Will I be that resilient?

I don’t think the eating part has me down as much today as the inevitable pain that will be associated with the surgery and the recovery. I consider myself a pain wimp, but then I have to remind myself I labored at home with my daughter for 52 hours before I went to the hospital and had an epidural. I passed a kidney stone without any pain meds and fractured my sacrum while practicing/trying out for roller derby, thereby ending my potential career as “Miss Diagnosis.” Did I mention I didn’t have insurance at the skating injury, so I didn’t go to the ER and was studying for Step 2, so I had to do a lot of sitting on said injured sacrum? 

I tell myself that of the pain I have I experienced, I can handle this, especially since they will be giving me pain meds, unlike the aforementioned scenarios where I had none, yet I am still fearful. I guess it is a natural human response. The anticipation of it all. The uncertainty of it all. As a physician I know all to well about all the possible complications that could arise and should I experience any, none of them will be known to me until I wake from anesthesia. No one can make the guarantee I will be okay after the surgery, but the alternative is letting this disease take its natural course which will be guaranteed to end my life painfully and early. Given the two options, there really isn’t a choice of which path will be the least painful. If you had to lose a major part of your body to guarantee not getting cancer, what would you  give up? 

I will go to sleep tonight and try to be positive. I will think about how lucky I have been despite being unlucky to get this diagnosis. I will think about how I have a really amazing family and friends who are supporting me though this. There are too many people out there who do not have a choice when it comes to gastric cancer because they find out too late and many others do not have the love and support I feel I have. I am grateful. I may be scared, but I know there will be people there who will hold me up when I feel like falling and if the pain gets to bad I will just ask for fentanyl.