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10/17/06 (日本語を後にいれました）

On Monday I went back to BWH for the post surgery check-up. The infection has cleared nicely, and everything else is going well. It is amazing how quickly the scars are healing.

“You can eat anything you want,” the surgeon announced. “Anything?” I could not believe my ears.

Since we had about 45 minutes before seeing a nutritionist, Mark and I sat down at Au Bon Pain and ordered a sandwich (for Mark) and vegetable soup. Even though I was told that I could eat anything, it was scary to eat anything chunky. I ate mostly the soup broth with a few minced vegetables, chewing very carefully.

I am glad that I was cautious, because we discovered from the nutritionist that there are quite few stipulations about what not to eat for the first few week; I can only eat very soft vegetables, I have to be careful with dairy products, it is best to avoid chicken, etc.

What I have to balance now is how to wean myself from the tube-feeding. The nutritionist suggested starting with one less can. Unfortunately, I was not feeling too well last night, so I reduced the amount of food by half a can, and started eating some soft food. What I learned is that if I do not reduce the tube feeding enough, I do not get hungry.

Total food I have eaten so far today is; One scrambled egg, brown rice gruel (1/3cup), yogurt (1/2 cup), banana (1/5), 1 slice of cheese, 1/4 cup of vegetable rice soup. Since I do not get hungry at all, I went out for a 1/2-mile walk in the rain. I am planning to reduce the canned food more tonight.

Another weaning happed today. I was “discharged” from the visiting nurse. She has been visiting me every week since my J-tube insertion in June. “You are one of the quickest recovering patients, and I am confident that you can manage your health from now on. I won’t be visiting you anymore. Sign here.”

With these weaning milestones, I finally feel that the end of this journey is near, and that I should start preparing for a normal life, post-cancer-version; work, hobbies, exercise, travel, and service to others.

At BWH a doctor who works with my surgeon as his chief assistant, and who participated in my J-tube insertion as well as my esophagectomy, explained to me what my diet would be like. He started by saying, “You are a patient who reads a lot, and you probably know all this…” I somehow felt embarrassed that I had given such an impression to the doctors. “Well, I could not help it. You can find so many articles on the Japanese internet because this is the 6th most common cancer in Japan.” “No, no, I am saying that in a good way. It is good for you to gather information.”

Thanks to my friends, some of whom are doctors themselves and others of whom have strong insider connections to the Japanese medical establishment, I was blessed with up-to-date knowledge about this cancer. For my doctors, however, I could have been a patient who is difficult to deal with.

“Everything went well, no cancer cells were found in the esophagus or in the removed lymph glands. You belong to the group of patients who will most likely survive the cancer. Statistically the survival rate is 50%, ” the surgeon said and left. It is sobering to realize that esophageal cancer is still a very difficult cancer compared to some other cancers (stomach cancer in Japan has more than a 90% survival rate, for example.)

I would have been dismayed to hear the number 50% in my pre-cancer days. With my cancer experience, however, I feel that anything can happen to us in life, and that we simply have to deal with each thing one at a time. 50% is not a bad number.