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.
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