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“Please contact me sooner next time. Your stricture was pretty bad. The opening (to the new esophagus) was only pin-hole size. It is dangerous to dilate a small opening like that. Get in touch if you feel any stricture in the future, even after a few weeks,”

My surgeon at BWH said this on Monday when I saw him for the post-op check up after the dilation procedure.

Even though I wanted to say,“ Well, I did not know what was normal and what was not,” I swallowed my response.

I never felt comfortable swallowing after the surgery, but assumed that the difficult state was my new base line. My complaint about the swallowing difficulty to the oncologist led to the modified barium swallow exam. Even though I asked about the possibility of stricture at BWH as well as at the oncologist’s office earlier, they did not take it too seriously till the last check-up because it was too early.

I learned from reading Japanese esophagectomy patients’ Blogs, that some patients go through the dilation about 40 days after the surgery. I also knew that the length of time it took for me to finish one meal was much longer than other patients (also from reading others’ Blogs.) Since even the smallest crumb of toast tended to choke in my throat, I was chewing food till it got completely liquidly with saliva. Since the dilation, I can finish a meal in much shorter time.

I wonder if the doctors assumed that I had enough knowledge about the surgery and felt that they did not need to explain; none of the doctors warned me about the stricture. It was always me who brought up the subject and questioned.

It takes courage to bring up questions and subjects to the doctors, because you do not want them to think that you are psycho thematic or too self-conscious. So, when I asked them to look at the stricture possibility last time, I did not forget to add, “I may be too self-conscious, but I am choking on the food more frequently recently.”

I am glad that I was not imagining the stricture, and that my surgeon took my complaint seriously.

The BWH was crowded on Monday because of the upcoming holiday. My appointment was at 8:15, but it was after 10:00 when I finally saw my surgeon.

I naively made an arrangement to see Tomoko between 8:30 and 9:00 at a coffee shop in the building, assuming that I was the first patient to see the surgeon. Tomoko is the Japanese nurse who took care of me at the intermediate care unit after the esophagectomy operation in September. She was one of the most caring and attentive nurses during my 10 days stay at BWH.

Because of the long wait, I had to ask her to come to the thoracic surgery department waiting room instead. It was wonderful to see the nurse who took care of me during the critical time. Also, it was inspiring to see a young Japanese woman who is aspiring to achieve a goal. While working a 12-hour shift three nights a week at BWH, she is taking classes at Boston College to become a nurse practitioner. She is thinking of doing some community work next year because she is interested in public health, and planning to continue pursuing her interest in oncology. To befriend a person with purpose and optimism nourishes my energy more than anything else. She has become one of the very important friends I have in the U.S.

It was almost 11:30 when I was done with my surgeon, because he asked me to talk to a woman patient who was newly diagnosed with esophageal cancer. She was a woman in her 50’s and her grown-up sons were with her. She will go through the J-tube insertion and a few more endoscopic examinations for the staging soon. She was me a half year ago; she was confused and scared like I was. It turns out that she is my neighbor and she has the same oncologist. We talked a little bit and exchanged phone numbers, and I gave her my Blog URL. There were so many things I wanted to tell her, but I could only give her a hug, saying that she will come through OK. I hope that she will call, and that she will read the first few pages of my Blog.

I have been hoping to start a cancer support group of a sort; either through the oncologist’s office, BWH or through my church. Seeing her made me feel that I should get moving.

PS: The photo is of Tomoko and I in the waiting room.