The Journey to the Hospital on 8th November didn’t go smoothly!
I had to be admitted to hospital for my surgery on 8th Nov 2010, but the surgery was not taking place until 9th November. The technical reason for that is explained further below.
Not a good start, 13 years ago today, Chris was driving me to the hospital for my first surgery, the “my big surgery” as I call it. It was “debulking” i.e. get as much as possible. In the end, the liver was left for another day.
Surgical Prep 8th November
As I said above, I had to be admitted 24 hours before the surgery, this was mainly to start the peri-operative octreotide infusion to de-risk the possibility of ‘hormonal crisis‘ which is a well-known risk with symptomatic NET patients with carcinoid syndrome. I had carcinoid syndrome at diagnosis, and it wasn’t fully under control with daily octreotide. It’s now just a waiting game, Chris was with me for a while, and I have a TV!
Shortly after my evening meal, a nurse arrived to hook me up to octreotide on drip. I had already experienced this prior to a liver embolization a month previously. But it still amazed me how much octreotide was in one of those cylinders (£££££).
The other special thing about this surgery was that I was going to be away from work for so long, I had to make my condition public. Prior to that, only a select few had the knowledge. That was a tricky one for me.
I had no perioperative issues during all 3 of my surgeries. I even had a non-NET surgery 1 year after diagnosis without any perioperative octreotide, but I was not showing any signs of the carcinoid syndrome I clearly had before and at diagnosis, so felt safe. There has always been controversy about who needs perioperative octreotide for surgery, i.e. it is for all NET types, is it for all syndromes, is it for all stages, for all grades etc etc.
Fast forward 10 years, I was surprised to see the status quo on this challenged and it was even going further than I had imagined. And it was coming from a source which I have always trusted to be first class. Dr Rodney Pommier now suggests that perioperative octreotide does not make any difference and should be discontinued adding that it is “not the correct treatment”. He also stated, “we need a new model for carcinoid crisis” (hopefully including a name that does not have the ancient misnomer word “carcinoid” in it).
Read about this very interesting intervention into something that has been in accepted practice since the 1960s. Click here or on the picture to read and hear more.
Read how that went – in two parts. Click here
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