Plan "B" is the "better" plan. It took me a day or so to come around to that.
Plan A was the Cadillac approach: 2 surgeries, 5 days apart, removing 95% of the tumor, inserting a big cage and a rod, and then requiring me to spend maybe 2 weeks in the hospital plus maybe 4 weeks in a rehab before even being allowed to come home.
But the vascular surgeon sort of put the kibosh on Plan A.
What with having two abdominal surgeries already (they should have installed a zipper), plus radiation, plus a mesh screen to repair an incisional hernia -- well that presents quite a tricky minefield of possible combinations. Dr Ford estimated that there was a 20% chance of him doing some catastrophic damage to my abdomen just trying to clear the path to the vertebrate. My quality of life could be completely wrecked, and what we are trying to preserve here is my quality of life.
Now, if Plan A had a chance to be curative, then 20% might be something we could live with, might be worth he risk. But it won't be curative.
So we are falling back on Plan B.
This will be one surgery, all done from the back. It will actually be a lot more technically challenging for Dr Jaikumar. Might take him 8 hours. He expects to remove about 85% of the tumor. He'll be leaving a lot of bone in place, so there might not be a cage. If a cage or other structure is needed (in addition to the rod) then he has a couple of options for whatever will fit in from the back.
Coming in from the back, he'll be right in there with all the nerve roots and stuff, but they will be sending electrical signals through to monitor that nothing is being stretched too far during the entire surgery. That is kind of cool.
I'll recover much faster from Plan B, which means I will be able to start a new chemo way faster after Plan B than after Plan A. And I need to get back on some chemo quick. Got to beat back the cancer, especially since it's starting to act all aggressive and annoying.
Dr Jaikumar also reminded me that his goal is not to scoop out all the cancer. His goal is to fix the compression problem and reinforce my spine so L5 does not abruptly collapse and leave me paralyzed. Since both Plan A and Plan B would do that just fine, why wouldn't we choose the one that will be much easier and faster?
The new date for the surgery is May 9. We needed a day when Dr Jaikumar could work on my all day long... gosh it's going to be a long ordeal for poor Lou, Patsy, and Omer in the waiting room.
I have already talked to Dr R about the next chemo.
I have also started all the paperwork for the short term disability. It is pretty upsettig not to be working. Plus I think I am driving Lou nuts by being home. He is trying to work and trying to keep an eye on me all at the same time.