Mets Day 15 - Surgery will be on May 2

These past 24 hours have given me whiplash.  Yesterday morning, Hopkins said that they could not move up the surgery from May 14.  Then MD Anderson questioned whether I should have surgery at all.  I was in the middle of arranging a consultation with MD Anderson when I learned that Dr. Gary Steinberg at University of Chicago might be able to do the surgery next week(!)

How did this come about?  Dr. Schoenberg had told us that Dr. Steinberg as a highly experienced colleague with whom we should check.  Chelsea emailed him with a summary of my case, and he promptly responded:

I would be happy to see your father and review his records and x-rays. I would recommend that he have surgery, but he needs to be seen and operated on by an expert. Many times the lymph nodes are necrotic and do not have residual cancer; however, an extensive and meticulous lymph node dissection needs to be performed. In addition, orthotopic neobladders are best performed by surgeons that perform them often, and few people worldwide, have my experience. I may be able to perform your father’s surgery next week. Wednesday May 2^nd  is not one of my block days but I can usually get additional time as needed. I do think that it is better to operate now rather than wait. I typically try to operate 4 weeks after completion of neoadjuvant therapy. Most important is surgeon experience as well as hospital experience. I have performed over 1300 radical cystectomies in the past 15-20 years and that experience is vitally important and helpful for patient outcomes.

I passed this information along to Dr. Schoenberg, who strongly endorsed going with Dr. Steinberg. After consulting with Jennifer and Chelsea, and exchanging a number of emails with Dr. Steinberg and his assistant, we've decided to go for it.  We're still planning all the logistics and some of this is doing it on the fly.  This morning I bought the tickets for Jennifer and me to fly to Chicago on the morning of May 1, then we will meet with Dr. Steinberg and do the pre-op.  Surgery will be at about 8:30 am on Wednesday.  We are expecting to be in Chicago for about 10 days.  Chelsea may come out for part of the time; she's checking on rearranging her finals schedule. 

This morning, Dr. Aragon-Ching called for an update.  We discussed the MD Anderson view, and she explained why she did not agree that chemo only was the best option.  I agree with her and Dr. Schoenberg and Dr. Steinberg -- surgery is the best, if not the only, chance at a cure.  The point is to remove the source of the cancer, so it doesn't keep pumping death throughout my body.  Hopefully, the removal of the lymph nodes, along with the bladder and prostate, will get most if not all of it.  To the extent anything remain, perhaps other chemo regimens can keep it in control, although those additional regimens probably would be part of clinical trials. 

Dr.  Aragon-Ching also wanted to make sure that we were carefully considering all of the pros and cons to going to Chicago for surgery, since it was so far from home.  She said that if there were complications, I might be there longer than intended.  I appreciated her acting as a check, and making sure that were were not reacting without thinking everything through.  At the end, she endorsed the decision to have the early surgery, and asked to me keep informed of my progress.  Maybe I'll send her a link to this blog. 

An interesting aspect of all of these developments was trying to balance this medical adventure with work.  I feel a deep sense of dedication to my clients and colleagues, and for a while was trying to balance the likelihood of moving up the surgery with the fact that I was scheduled to participate in a hearing in San Francisco 9 am on Monday, April 30, then be at another hearing in Norfolk Virginia at 11 am on Tuesday, May 1.  I had those flights all arranged, and I actually checked flight options to see if I could get from Norfolk to Chicago on Tuesday afternoon, before I realized that was insane.  I knew that my partners had offered to cover for me, and that I should be focusing on what is best for my health.  Once I made the decision to clear the decks of all work-related stuff, the work-related demands evaporated, and I was able to focus with greater clarity on my health.  That's the way it should be, and knowing that my partners are covering for me, and have my back, brings me a tremendous sense of relief.  I am grateful for their support, and working at a place that provides that support.