Plan to work, work the plan.

So the last fibrin gluing attempt did not stick. Pun intended. After meeting with my surgeon the next steps and overall plan were agreed upon.

I am going to get a shot of the drug Octreotide today. Normally you have to give yourself a shot in the stomach every 8 hours. And we plan for me to be on it for 6 to 8 weeks. I said there is no way I could be compliant with that. In looking around we found a delayed release version that is a shot in the butt just every 4 weeks. I chose that!

What the drug does in this case is reduce your gastric secretions and motility. The hope then is that less material will exit out through the fistulas and then they will close. We are giving this approach 6 weeks to see if it works.

If it does not, the next step is to be on TPN. This would mean no food by mouth at all and just getting it through the special IV line from my arm to my heart. I've put pics up here before of my PICCS. Pun intended. This would go on for about 6 weeks as well. The hope being that pretty much total bowel rest will allow the fistula to heal.

Finally if that does not work, 12 weeks from now, so about October I would begin scheduling for surgery. The surgery would be another big one. Cut more bowel, more tissue, totally reopen and redo it all. He'd like it to be short and simple but there is no guarantee. Then it would be another two months to recover and so on.

That is the plan. Trying things for long enough to know if they will work or not, escalating the seriousness of each step until there is no choice. Surgery. It his opinion that surgery will fix it. He thinks that is the best option. But due to all my previous surgeries and lack of bowel, we have to go through these smaller steps to see if anything else will work.

I wish I had enough gut left for them to just cut and do it. If something is thought to be the best, it is tough to focus on doing intermediate things, just to see if they will work. I want to go with the higher percentage of success. But in the balance that also carries the greatest risk as well.

This is seemingly the story of my entire life and decision making process. Risk vs reward.