Another operation

 Fuck what a roller coaster ride. Geoff has to have the second (and last chance) muscle taken out of his back, replacing the one that is there now. I am so sorry for him. So that's what is going to happen now either today or tomorrow. LATER: had a call from the surgeon and he says it went well, and that the new muscle is taking in blood properly and that he can deem it a success. He is going home to say some hail mary's he says. LATER STILL: he says he's not sure anymore. 

Update

 Well, the second operation went off okay ... there is a faint pulse in the muscle still, so possibly he won't lose the whole thing. It was a very bad night. He had to have a ventilator down his windpipe and thought he had had a stroke and had lost the power of speech. He was very agitated and tearful. I was allowed in for one minute at eleven am on Friday and the first words he said to me were: "I thought I'd had a stroke because I lost the power of speech." Well, that immediately told me that he had not become brain-damaged and that mentally he was fine! I was worried he would have lost oxygen because he had a lung infection as well. But Dr Hellig gave him an antibiotic. What I still didn't know was whether he could walk or not. But today, that is five days later, most of his drips and tubes have been removed. However, the plastic surgeon Dr Landau is still not satisfied and wants him to stay in ICU for at least another night. So that's seven days so far.

Sudden emergency

At about half past five this afternoon I get a call from the hospital, telling me Geoff has to go into theatre again. A haemotoma developed under the prosthetic bone (between the brain tissue and the fake bone) and four of the five doctors had to attend: Dr Kessow the anaesthetist, Dr Landau the plastic surgeon, Dr Hill the neurosurgeon and Dr Hellig the physician. The operation went off okay, except Dr Landau (who is quite young) was very upset and disappointed that this happened. So now he is ventilated and sedated, and possibly has an infection in his lung so has antibiotics as well. My poor, poor darling. And I was holding his hand, wondering if I was hurting him because it's all bruised from the veins being taken out. I wasn't sure if me being there for a while afterwards was stressing him out because visitors are tiring, or if I was comforting because he knows me so well and knows I love him. I think he found me a bit tiring the first night because he needed me to leave.  

Today's ten-hour operation only took nine hours and he seems well just very tired

 Well, Dr Aneet Kessow the anaesthetist phoned me to say the operation was successful, went smoothly and Geoff is recovering in ICU. I went to see him seeing a visitor is allowed (considering Covid 19 restrictions have been relaxed a bit), he slept most of the time but when he woke for a little while he was pleased to see me and said he felt fine just very very sleepy. 

Another operation May 2021

 Not sure how to begin with this. I suppose with Atul Gawande's 'Being Mortal'. For me, I know what I can cope with, and were I to contemplate having surgery which may leave me in a worse state, I would not. However. In Gawande's book, a woman asks her father how he feels about surgery that could leave him in a wheelchair. Well, says the father, as long as I can eat ice-cream and watch sport, I'll be okay. I'd rather choose life. 

Geoff chooses life, such as it is for him. So we go to Dr Landau at Kingsbury, and go and see what we can do about the debridement of his skull not working, and me still having to do a fresh dressing every day. (I would rather not, to be honest. Anyway, it has to be dealt with, it is necrotic tissue.) And Dr Landau says well, the radiation slowly but surely affects the bone. The effect it has, insidiously weakens the bone over years. In other words, having had radiation ten years ago (which I was amazed at, I thought it was fewer years), the bone is crumbling and dying, basically, well, that's how I understood it. So Dr Landau says we will do the following: I have a team. We have Dr Graham, your original plastic surgeon, the one who has referred you to me because the debridement didn't work. So he and I will head up this operation. We need the neurosurgeon, to check the brain. We need Dr Tunnicliffe, Senior Specialist Vascular surgeon, to check if his veins are sound enough for the op. We need Joscelyn Hellig, General Physician, to see if he is strong enough to endure a ten-and-a-half hour surgery. And of course we need to keep his oncologist in the loop. So we have had a round of attending appointments with all these doctors. I haven't accompanied Geoff to all of them, including having bloods done every now and then. Not that I absolutely don't want to go, but because of Covid, besides anything else, the hospital plea is please do not accompany the visiting patient if possible. 

Dr Landau explained, as clearly as possible, this is how the operation will proceed. We will remove a large part of the skull and expose the brain. Then one of the doctors (I've forgotten which - I think the neurosurgeon) makes a paste, which hardens into fake bone, and he places that over the brain, in effect making a new skull bone. This seems to be about the size of a cd. I'd guess. Maybe bigger. Then the plastic surgeons remove a muscle from Geoff's back. (Geoff asks, so is that muscle going spare? What does it actually do? Doc Landau says don't worry you won't miss it. (!) ) It has to be a muscle, not just a skin graft, because the flesh on top of the head needs blood so that it doesn't just decompose, and there is no more flesh on this wound, it has actually died. Then he will take a vein from Geoff's arm, and attach it to the carotid artery in his neck, and that will feed blood to the muscle on his head, which Doc Landau says (cheerfully) will look like you have a steak stuck on top of your head, but never mind, it will go down after a while. And then finally, he says, we will take some skin from your leg, and graft that on top of the muscle, and sew it all up. And bob's your uncle. A very cheery doctor. And he says he will love dealing with all this blood and guts. So that is the op. And that is what is awaiting Geoff in two weeks or so. (18th May is the date set for this huge operation, which will take ten and a half hours or so, and of course an anaesthetist will be in attendance too). I haven't said anything, but I do hope we will be able to pay for all this! I don't quite know how. But we'll just have to do it and then sort out the payments afterwards. Oh and of course, besides the bloods, he has to have a covid test three days before the op.