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Chances are Thin

Chances are Thin

On September 1, I weighed 125lbs, 50lbs less than I did on December 10 last, the day of the surgery to remove the tumour from my oesophagus, but only 25lbs away from my target regained weight of 150lbs.

On Sunday last, I weighed 105lbs.
Unbelievably to me, although it happened directly to me, I lost 20lbs in 24 days.
If Stephen King needed to recast a body double for Robert John Burke’s lead role in King’s 1996 horror film Thinner, he’d have needed to look no farther than me.
On August 25, I had a barium swallow, the first of several tests that required fasting from the night before, one of the main reasons for my weight loss. The test didn’t happen until 1.30pm, so I didn’t eat until 2pm and then only half a doubles, partly due to reduced appetite from fasting, but mainly due to the shrinkage of a part of what is left of my gullet to a diameter of six mm, the width of a pinky finger. I could eat, at the time, only as much as could pass through and fill that space.
After that swallow test, which revealed the severe gullet shrinkage, I had at least one other barium swallow, a CT-scan on September 1 (which revealed the return of my cancer) and a series of I think four or five endoscopies, all requiring fasting from the night before.
On September 20, I weighed 111lbs.
Last week Thursday night, eight days ago, was the last time I had solid food. On Friday and Saturday last, for a full 48 hours, I had nothing to either eat or drink by mouth; nor by any other method. Endoscopies had dilated the problematic portion of my gullet to 15mm but the development of a fistula, a small hole between my gullet and my right lung, made eating and drinking near impossible. Two sips of liquid would fill the shrunken portion of my gullet, causing the rest of the liquid to run into the fistula and through to the lung, causing racking, exhausting coughing that often led to vomiting up the little nourishment I’d taken in.
On Saturday night, my doctors put in an oesophageal stent, perhaps the longest one in Trinidad (which arrived just in time for my surgery – flashes of good luck within the bad) to cover the fistula (with luck, and in time) and to help keep the gullet dilated. The procedure was successful. I was put on a liquids only diet.
I had been looking forward to a drink of unsweetened apple juice for two days and nights.
But two sips of any liquid, including the hitherto trustworthy, high specific gravity coconut water had me coughing until I vomited again.
And again.
And again.
From Saturday night, it was a steady progression of very little liquid going in slowly and everything else coming back out fast.
On Tuesday, when I optimistically attempted to return to a soft solid diet, the soft food came back up a little slower, but with increased heartburn to compensate for the apparent benefit.
On Tuesday night, my doctors did another endoscopy to clip the stent, which x-rays showed to be wavering at the top of the gullet, in place. They also put in the nasal-gastric tube which I remembered with such resentment, post-surgery but which I am immensely grateful for today. On Wednesday, via the NG-tube, I had more nourishment stay down than I’d had for the fortnight before. Every waking hour since then, with luck, I’ve had 40ml of Ensure.
You don’t know what 40ml of nutrition an hour can do for you until you’ve had none at all for days.
For the first time in more than a week, I am able to stay awake long enough to, eg, write these words. Without eating, your odds are not good; without eating or drinking, your chances are even thinner.
At the time of writing, I have no way of knowing if the stent and my luck will hold. I am still dredging the phlegm out of my infected right lung but there’s less of it and it’s not as difficult to handle the hawking and horrible spitting.
And, if all continues to go well enough, I may soon be able to throw my weight around.
Fat chance.

BC Pires is on the tube and hopes not to bus’ it

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