On Sunday my sister and I traveled to Minnesota for my consultation at the Mayo Clinic. The hospital is just over an hours drive from Minneapolis and we both got our first taste of Minnesota. There was plenty of blowing snow but a clerk at the gas station pointed out what a nice day it was compared to the rest of February (and probably the previous few months). I pointed out some gas station cheese curds and bought them. It seemed only appropriate given our upper midwest location. We arrived at our rental house in Rochester full on curds and ready for a new chapter to my medical adventures. My brother arrived from Maine later in the evening.
Rochester is a city of about 100000 people and well over half of them work for the Mayo Clinic. The city has a small downtown area packed full of tall building that are all part of the hospital. There is a underground level that connects the various buildings. In a strange way it is sort of the Disneyland of hospitals. The first stop on Monday was to get some blood drawn for tests. My second appointment was with the MRI machine. I got a bit of a scare when one nurse could not get blood to flow through my chest port. It had been seven weeks since it had been accessed which is the longest I had gone since it was installed. Clots can form in the tubes if it isn't flushed regularly. Luckily another nurse was able to get the blood flowing. MRI machines are very loud and they gave me ear plugs and headphones. Sometimes I got instructions to hold my breath but mostly I just laid in the machine for around 40 minutes. Next was a CT scan. I think I'm a pro at these now. The contrast they inject gives you a 'oops-I-wet-my-pants feeling' but it didn't even phase me this time. Nice try CT scan!
After some lunch, where we may or may not have eaten some fried brie cheese curds, we had a meeting with a GI medical oncologist. First we met with a nurse practitioner who seemed to be the one responsible for coordinating all the different doctors on my care team. Then we met with the oncologist. He showed us the results of the CT scan. My tumor was pretty much the same size as my last scan in December. This is a good sign that my radiation treatment had worked and there was no growth. My tumor marker blood test (CEA) had dropped to 4.9 which was down from 40 something at the start of radiation treatment. This was another good sign. My original oncologist in Fort Collins had told me back in December that I was likely stage 4 now. The Mayo onc told me this wasn't the case and my current tumor is just a continuation of the tumor that was removed so I am still stage 2. The surgeons back in April likely didn't even see anything since the cancer may have just been some cells in this area of colon.
This doctor didn't have much specific info regarding my planned surgery but we did discuss some more general topics like why he thought there was an increase in colon cancer in younger people (a change in the gut biome likely caused by our wonderful American diets). He also mentioned new studies showing the dangers of mayonnaise which seemed oddly specific. Just for the record I don't eat mayonnaise. We left that appointment thankful he didn't say anything about cheese curds. However, at that evening's dinner we did skip the curds (and yes they were on the menu everywhere) and opted for a chicken sandwich with asparagus on the side.
The next day we first met with a couple of radiation oncologists. They were better equipped to talk about my surgery and what exactly they would be doing. The main reason I traveled to the Mayo Clinic was for inter-operative radiation, an option unavailable to me in Colorado. They basically move all your healthy organs out the way while you are opened up and give any nasty spots an extra high dosage of radiation.
My final appointment of the day was with the GI surgeon. He seemed very well prepared for me and very confident in his proposed courses of action. Basically, what I already knew was my tumor is doing some awkward stuff with my Iliac artery, some nerves, and my ureter. What I didn't know if it is also touching my small intestine. This means during the surgery not only will they remove the piece of my colon that the tumor is sitting on but they will also remove a little piece of my small intestine. Supposedly this should not be noticeable to me and my digestion in any way. The situation seems a little more questionable when it comes to the artery and ureter. A vascular surgeon will be involved with the surgery and they may have to resect/reroute the artery. A urologist will be involved and they may have resect the ureter then reattach it to the bladder. Regardless of all that he thinks the surgery is very much curative and I will only be in the hospital 3 to 5 days. The great news regarding the surgery is that he thinks they can also reattach my colon and I can lose the bag. The surgery is scheduled for May 4th. I still have some questions I am trying to resolve but overall feel good about the doctors and hospital.
We left that appointment hoping to meet with the vascular surgeon and urologist before we left town on Wednesday afternoon but unfortunately it did not happen. My brother left for the airport Wednesday morning. My sister and I went for a hike at a local natural area then drove up to Minneapolis where we took a good gander at the mighty Mississippi then enjoyed a brewpub before heading to the airport and yes we did order the cheese curds.
