Round 2: October 2020 - Chapter 5

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The day may have been October 14th 2020, however for all intents and purposes this was my 'D-Day' and it was time to storm Normandy!! The events of the previous few weeks and months all about to culminate with a very intricate surgery, of which the outcome would dictate my long-term quality of life.

Mood (Song I listened to repeatedly and/or would sing out loud):

It was 'Go-Time'!!

For those unfamiliar with what a 'Cricotracheal Resection' is, give this animated video a quick watch. Modern medicine really is fascinating!!

Heading in, the plan as laid out by Dr. Choi was to remove the portion of my trachea with the tumor attached, close the gap and allow me to heal. Once healed, I was due to be scheduled for a 3rd and final surgery a few weeks later to remove the tracheostomy tube and then return to breathing on my own, unencumbered . Now I say this was the plan heading in, as I later learned an "Audible was called at the Line of Scrimmage" which would change how things actually went down that day.

The 'original' plan was to have me in surgery for ~4 hours, then send me to the ENT Head + Neck ward at the hospital for 3-5 days in recovery before sending me home. The change however, would see that initial 4 hour surgery become a 6-hour surgery, and instead of waking up in the ENT Head + Neck ward, I was placed in a medically induced coma for the first 3 days before being woken up and transferred to the ENT Head + Neck ward from there.

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Fortunately for me, Dr. Choi, Dr. Agzarian, and the other Surgeons on-scene decided to pull forward my planned 3rd surgery and remove the Tracheostomy Tube as well. While this added some additional upfront risk, a lot of that was managed through the fact I was left in a medically induced coma for the first 72 hrs after surgery to allow me to begin healing without a risk of accidental 'tears' of any of the parts of my neck that had been operated on that morning.

This isn't to say that everything went as smoothly as possible. When I first awoke, finding myself in a blacked-out room with tubes and wires all over me, I apparently began swiping at everything in an attempt to 'get it off me', in one case ripping a key tube right out of me in the process. The ICU staff had to act quickly and carefully to restrain me to avoid any damage from this, while also being very mindful of my neck to prevent it from moving in the process. ICU visiting rules during the COVID-19 pandemic meant that Janelle was only allowed to see me for 1-hr / day, yet in between she found a way to let me know that she'd been there & was watching over me:

When I finally awoke from my coma, the Nurses assigned to my care began asking me questions to which my natural reaction was to continue in conversation with them. Not having fully become coherent, I respond to a question with an answer, only to then register the fact I was able to speak at all!! This was a VERY welcomed change having lost my ability to speak for the better part of the previous two months for all intents and purposes, and represented my first insight into the magnitude of what had happened during my surgery on October 14th.

In any case, Saturday rolls around after the initial critical time passes and I'm cleared to leave the ICU to be transferred to the ENT Head + Neck ward for recovery. Dr. Choi and his team make their rounds that morning (as they did every day), where he lets me know how critical it is for me to keep my head position 'anchored down' while I heal to allow everything time to strengthen. Any sudden head movements upwards potentially tearing the point where my trachea was closed, causing internal bleeding and potential suffocation in the process. Needless to say, it was serious enough to make sure I listened!!

Unlike my 'Day-1' experience in this same ENT Head + Neck recovery ward 2 months earlier (when the tracheostomy tube + open-neck biopsy operations were performed), I didn't have the same pain sensation or need to medicate this time around. Despite this surgery having many more moving parts and being significantly more invasive, my first day in the ENT Ward ended up being the only day I requested pain-medication of any kind for the remainder of my stay. Time continues moving on, with me on Surgeon-ordered bedrest and minimized movement.

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.. And Time continues marching on.

Janelle stops by during one of her daily visits (now extended from her 1-hr ICU visitation limit), to let me know she'd dropped in to see my Aunt Christina & Uncle Greg who lived not far away on her way home the night prior. Christina had asked Janelle to stop by to pick up a home-cooked meal so as to give her one less thing to do during all of the back + forth from the hospital and keeping our house running (not to mention taking care of Bear in the process). While there, many of my cousins as well as my Dad and Step-Mom were there and left a nice 'get-well soon' note for Janelle to take back to the hospital when she came to visit me next:

Similar to the video message sent to me from my friends at Klick, this too was a very nice message to see + receive in lifting my spirits to continue getting better!!

Tuesday October 20th rolls around (6 days after surgery) and Dr. Choi and his team let me know during their daily Morning check-in that they'd be back later in the day to run a bronchoscopy scope to have a look at how I was healing up internally in addition to a visual examination of my neck externally. The output of this scope determining how much longer I would need to remain in hospital recovering. Several hours pass and then the moment comes where I'm wheeled away to a testing room down the hall and things begin.

Discomfort from the scope itself aside, Dr. Choi gets the view he needed to see internally, letting me know that he's happy with the healing progress my body had made, but had some concerns over remnant swelling and was going to recommend keeping me in hospital through Friday just as a precaution, with a medicinal obturator treatment 2x daily to further support additional healing. Disappointing as it was to hear that I'd need another 3 days in hospital, at least the end could be seen in-sight. I'd come this far right? What was a few more days at this point?

Janelle continues coming to visit me day in. day out as she'd done faithfully from day 1 of my initial surgery in August, every day bringing her warm smile and room-brightening presence with her to help lift my spirits. Having been in hospital a full week at this point, I'm encouraged by the nursing staff to begin getting up and taking walks around the ward (with my neck brace on) to get some light daily exercise and rebuild up my lung capacity after being near bed-ridden for a significant amount of time:

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Thursday rolls around and Dr. Choi comes by to begin talking about my pending discharge process, including the length of time I'd need to continue wearing a neck brace, scheduled follow up, and other general Q/A. In the process, he shares with me the image from my Bronchoscopy a few days earlier, allowing me to take a picture from my phone:

He goes on to explain that the 'puffy stuff' on the right side of the image was the remnant swelling he'd mentioned earlier, but that the rest otherwise represented a fully-healthy + functional trachea with a sizeable airway opening. This was in stark contrast to the MRI technician's scan from June (summary note below for reference), where the takeaway was that there was 'No identifiable opening in my Airway and were surprised to see me walk in and out of that room under my own power":

Dr. Choi leaves, and the reality of everything I'd been through over the last 12 months, but last 5 months specifically, really sunk in + hit-home. Perhaps it had been my Agency Wars Boxing training kicking in (#OneMoreRound mental readiness). Perhaps it was God's peace keeping my mind clear and focused on pushing through without distraction. Perhaps both. Regardless, the fact I was sitting there in my room in the ENT Head + Neck ward, staring at my now fully-functional trachea after struggling so mightily to breath, tumor removed, tracheostomy tube removed, speech returned and free of pain-medication all really hit home at once. I was going to be able to leave under my own power the next day, surgeries behind me and with only rest, recovery and physio standing between myself and a normal quality of life outlook.

I wept. I wept with joy. I wept with relief. I wept with overwhelming gratitude over the second chance in life God had just given me through all of the turmoil of this year. His plan unfolding like something out of a 'perfection playbook'. In retrospect, despite the timing challenges and unknown uncertainties along the way, he allowed everything to unfold in a way that protected myself and my family from some very dark potential alternatives:

• What if I hadn't brought up my breathing issues with Dr. Zoudis last August (2019)?

• What if I hadn't taken Rick's advice to go the E.R. Dept. expressing my breathing concerns and was still waiting on Sunnybrook to get back to me (still no communication since my CT in May 2020 BTW)?

• What if the tumor had completely cut-off my airway prior to getting the tracheostomy tube in and I'd suffocated in my sleep?

• What if the pathology from the biopsy had come back instead as Malignant (Cancerous) vs. Benign (Non-Cancerous)?

• What if the there had been complications with the tracheostomy tube resulting in it being permanent?

• What if the tracheostomy tube had fully dislodged either in my sleep or during the Ambulance ride to the Hospital that first weekend home in August following the 9-1-1 call?

• What if I hadn't been able to clear the blockages in my airway + tracheostomy tube while I was in the ENT ward where the on-call E.R. Dr. had to be paged for assistance?

• What if my speech had never returned?

• What if the ICU attendants hadn't secured me in time when I woke up from the coma and I'd ripped out something critical or moved too abruptly in the process and created surgical complications in my neck in the process?

  • What if I'd caught COVID-19 or become ill with any other cold along the way? Would my reduced airway have allowed me enough oxygen to breathe if compromised due to cough/cold/flu?

The list, seemingly endless yet all very REAL in terms of potential, just became abundantly clear as to how big of a blessing I'd just received from God. I was sitting in my chair, overwhelmed with the power and grace witnessing his protective + healing hands on my life through these difficult few months. While I never once doubted that God was in control, it was at that moment, sitting in my chair in the ENT Head + Neck ward, that the reality of what I'd been through and what I was looking at from a long-term quality of life outlook was.

Mood (Songs I listened to repeatedly and/or would sing out loud):

The power of Prayer is real. My being alive today to tell you this story is evidence of this!!

Friday October 23 rolls around and I receive my Hospital Discharge papers. Fresh off of the epiphany from the day prior, all I can think about now after my 10th day in the Hospital is the pending joy of returning home. This must be what members of our Military feel like on returning from a tour of duty in service to our Country!!:

Mood (Song I listened to repeatedly and/or would sing out loud):

Janelle shows up and we pack up and leave, stopping to capture the feeling of this moment in time as we exit the Hospital:

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We stop to pick up some McDonalds from a drive-through as a food treat, then proceed the rest of the way.

Thinking about Bear and his propensity to jump with excitement, we wanted to approach him carefully to protect against any accidental sudden movements after not seeing him for the last 10-days. Janelle has the idea of a 'play' re-introduction where I got him to chase his leash and then came inside to give him a treat. Sitting down to enjoy my lunch, Bear comes out of his shell to 'Welcome me Home':

My Heart was again full. We'd won the war and I was finally Home!!

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