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Dear Ileocecal Valve,
It's been almost 5 years now, and every day I still miss you, whether I think about you or not. I'm really sorry that I didn't get to know about you better before you were gone. You did so much for me and I never really appreciated you until it was too late. You were always there for me, the unsung hero of my ileum, the gateway to the colon, the bile salt barrier of the bowel, until the day I agreed to let a surgeon in and take what bowel he deemed irreparable. Damaged. Diseased.
Sadly, that included you, dear valve. Even then I didn't know what you were. It wouldn't be until weeks later, when I was healing and expecting a certain pre-disease quality of life to return, that I would ask my nurse why I was so... Loose in the caboose... Constantly Russian, if you catch my drift. That was when she would tell me about you, about the role you played in motility and preventing bile salts from upsetting the colon. That was when I would be forced to face my possibly worst misconception about the outcome of surgery, and when I would wish I had known about you sooner. If anyone mentioned you before surgery I don't remember. I doubt it. I think I understand why though: compared to the prospect of waking up with a stoma, the loss of you was probably at the back of the doctors' and nurses' mind. Losing my ileocecal valve was probably in a best-case scenario for them, and I don't know what I would have done differently had I even known about you beforehand. I sometimes imagine I would've asked the surgeon to consider keeping you if possible, but I don’t believe that would have ever worked. You were just in the wrong place at the wrong time. You had to go, and I miss you terribly, because it seems like the only thing keeping me from being more "normal" now is the lack of you in my life. You really knew how to just slow things down for me. I sometimes feel guilty about it; I could have done more to prevent the need for surgery, to avoid it maybe. Then none of this would even be a problem.
But what's done is done. I probably shouldn't be so regretful, really. In fact I should be thankful. I may have lost you, but I could have lost more. I mean, I lost my appendix too, but that's cool, it wasn't doing much anyway. I lost almost a meter of bowel along with you, and I sometimes wish I could have some of that back too, so maybe my iron wouldn't be so low all the time. I am once in an odd while kind of upset that my "quality of life" hasn't returned to what I thought it would be, and instead I've been forced to accept a new standard as my own. I think that makes me upset mostly because I thought it was possible for me. It sucks to be told there's nothing to be done but to get used to it, and take more pills. I was aiming to be off of pills by now.
Such is life! It could be worse. I may not be off all the medications, and I may have switched out pills to deal with those bile salts you so effectively kept out of my colon before, but I'm better now than I was the year before surgery. I'm not on Prednisone anymore! It just wasn't what I was expecting for my outcome, is all. Even after 5 years it still gets me sometimes. It's hard to be truly prepared for something as life changing as surgery, and I'm sorry I didn't prepare well enough to realize you'd be gone when I woke up. I hope others will be more prepared than I was, and consider their possible outcomes carefully. I'm adjusting without you, my long lost ileocecal valve, and while it hasn't always been fun I'm happy I can say it hasn't held me back yet either. Though there have been a few close calls.
Goodbye, lost piece of me. You are irreplaceable (I've asked!), and I hope you are the last of my guts I will ever lose. You sure will be remembered now.
Yours truly,
Marc
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