Several weeks ago, during the wonderful chemo-radiation, I asked one of the doctors (not the surgeon) for some more information about the surgery itself. He said that he was an awful artist but took pen to paper anyway …

If you know what to look for, this is actually a very good representation drawing. The tumor is at the intersection of the colon and the rectum (double circle near the bottom), the two “cut lines” for the surgeon show the foot long piece of colon to be removed, and the other drawing shows how the small intestine will be “tapped” into for the ileostomy. (I have been saying colostomy but in fact I will have an ileostomy … “a surgical operation in which a piece of the ileum is diverted to an artificial opening in the abdominal wall.” The name tells one the part of the overall intestine getting stomatized.)

Here is the picture I was given at the pre-op testing appointment yesterday. I like the doctor’s drawing better.

And of course I got my Home Ostomy Kit Book …

Yes, yes, I know, you want the to see my perfect belly. This is all about the “X” and its placement. As discussed in yesterday’s blog post, the nurse is tasked with finding the best placement for the stoma with both my quality of life and the mechanical workings of the stoma / bag system in mind. Once the placement was determined, she marked the “X” with a pen and covered it with a clear dressing.

So the next subject is the bag itself. These bags are clear and that is kind of rude as even I don’t particularly want to see the contents of my small intestine. There are lots of covers on the market, and searching led me to a small assortment that I find interesting …

And of course then there is my favorite:

All sorts of people do all sorts of things with said accessory:

What I don’t understand is why they don’t make manly covers … here is a mock up I just created, I bet I can sell a million …
What better cover to use when sitting around just shooting the shit with friends?

The takeaway is that I think no matter what, after surgery I very well may end up looking like either Bag Lady Mama:

or the lady in red …

I may be bummed that it is only temporary …

Franklin Roosevelt is often grouped in as one of the top three presidents ever, along with Washington and Lincoln, he ran the country from a wheelchair, and was played by Robin Williams in two movies. Barring the issue of the St. Louis, I would agree with his greatness. Roosevelt’s first inaugural address (remember, he was elected to four terms as president) (isn’t that thought scary as hell right now?), an address of 1883 words, contained in part:

the only thing we have to fear is fear itself

and that became his 10 most famous words. The problem is fake news. Lack of context^*. I argue that those words are completely out of context^* so how do we know what they mean? Here is the the context, as I remember it from primary school:

The only thing we have to fear is fear itself. And this fucking tumor up my ass. And surgery. And a stoma. And surgery by a computerized robot named after a guy who has been dead for 500 years (as of next May 2).

I know I will have a stoma, a hole in my belly where the contents of my small intestine will exit my body instead of continuing through my large intestine and out my butt. This type of stoma is, quiet frankly, a bit gross. They are pinkish red since basically the lining of the intestine, the lumen, is similar to the inside of one’s mouth. It would not be so bad if it was flat along my skin, but no, it typically sticks out. Seeing that the surgery may cause erectile function issues, this may be the only thing sticking out from my body, albeit not nearly as far. I find those pictures difficult to look at but it will soon be my view and I will be dealing quite a bit with the stoma. As of today, I really don’t want to see it. How I wish I had big boobs.

It is fascinating to me that medical people say what to them is a minor thing, or a quick piece of information, without specifically discussing that topic and it can make a huge difference, both positive at times and negative at times to the patient. For instance, the surgeon mentioned that I would have an MRI before surgery. When I said “oh?” he said, as an aside, “to see if the cancer is elsewhere and if surgery is still warranted.” That simple sentence made me anxious for over two months. Seriously. (No, this paragraph was not a non-sequitur.)

The other day I was speaking with a random woman, well, not so random, as I have known her for 47 years. Anyway, I was talking with her, not that she knows much about this topic other than the fact that she has been a nurse for 40 of those years years, and a wound and ostomy care clinical specialist. She works in a big city university teaching hospital and happens to live walking distance from me. We had not had a discussion of stomas, mine nor anyone else’s. She absolutely did not know of my concerns or feelings about it. And she happened to write:

Remember that right after surgery your stoma will be swollen as will be your abdomen a little bit. Because of this, think that you could have a stoma that has a base of between one and 1/2 and one and 3/4 inches initially. Protruding is good though. That really helps keep the perfect seal since the stool bypasses your skin and goes right into the pouch.

That last sentence, the advantage of a stoma that sticks out, and the reason for it, has totally changed my attitude and feeling about it. No, I still don’t want to see it, and if it is the size of whatever I have now that sometimes sticks out I will never find a bag to fit, but simply understanding the reasons and advantages, I really feel much better about it. I did text her that …

I may wear one of those dog cone collars so I can’t see it …

Which is always a possibility I guess.

I am not really fearful of the surgery itself. I have full confidence I will wake up afterwards; I have had surgery without problems in the past. I am not fearful of what the surgeon will see or find, between the CT, MRI, and flex sig I think we have a pretty good picture of what is in there. Although I am not fearful of the recovery, I really prefer it be pain free. Somehow I think that ain’t happening.

Sometimes it is hard to understand one’s feelings. During the chemo-radiation I never really knew if I had to poop, pee, or what. All the physical feelings in my pelvis were mixed up; thankfully that has gone back to normal. Similarly, right now I don’t know what my primary stressors are. What am I afraid of? Why do I feel stressed? Is it this fucking waiting? Is it that every ache and pain I have is now thought to be a rouge tumor? Do I have a touch of diarrhea because of my being nervous or that street peddler’s sushi last night? Or am I simply being a wuss?

I was born with my grandfather’s nose. It appears that strong noses skip a generation. I was generally fine with it, but I must say that I was teased about it in my youth. One day in my senior year of high school, out of the blue, mom asked me if I wanted a nose job. I said “sure.” That was all, and then it happened.

About a month later I was in a dressing room somewhere and stepped into one of those three-segment mirrors where you can see yourself at various angles. It was the first time I really saw my new nose.

And I freaked out. I can picture it like it was yesterday. I looked deformed; I thought it was horrible.

When you look at something now, you have three fields of view. You see what your left eye sees, then in the middle you see what both eyes see, and you see what your right eye sees. It is obvious if you move your eyes all the way to the left, then to the right. What you don’t think about, is you also see the shape of your nose. In my case it became vastly different. The entire shape of my visual world changed.

My profile was completely mangled. My nose went from sort of out then down to sloping down and out. Shaping my face like a muzzle. Or so it seemed.

Here is the only picture known to exist of my previous profile:

And today-ish (that’s me on the left):

I have never given my looks all that much thought. I did not ask for the nose job, although I agreed right away. I absolutely am not vain now. But then when you are a gorgeous 59 year-old Adonis you don’t need to be.

Body image is a person’s perception of the aesthetics or sexual attractiveness of their own body. The phrase body image was first coined by the Austrian neurologist and psychoanalyst Paul Schilder in his book The Image and Appearance of the Human Body (1935). Human society has at all times placed great value on beauty of the human body, but a person’s perception of their own body may not correspond to society’s standards.

The concept of body image is used in a number of disciplines, including psychology, medicine, psychiatry, psychoanalysis, philosophy and cultural and feminist studies. The term is also often used in the media. Across these disciplines and media there is no consensus definition, but body image may be expressed as how one views themselves in the mirror, or in their minds. It incorporates the memories, experiences, assumptions, and comparisons of one’s own appearance, and overall attitudes towards their height, shape, and weight. An individual’s impression of their body is also assumed to be a product of ideals cultivated by various social and cultural ideals. ~Wikipedia

My point?

I don’t want a stoma. I don’t like my tatoos, three small dark blue dots that no one can really see (radiation targets). I don’t like the “X” currently on my belly. I’m not even happy with the four or five other tattoos I have, and they are on the inside of my rectum. No one sees them, except me when I have my head up my ass. Which lately may be a tad more often than I prefer.