Tiffany Thinks #8

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This surgeon does, I am afraid, sound quite shady. I've known good cancer surgeons (my husband had advanced cancer three years ago and I've seen truly exemplary, honest, inspirational oncological/surgical leadership. I don't want to unduly cast aspersions on Tiffany's surgeon, but I know that Indian society can belittle Indian women and girls, especially those who are naturally agreeable, as Tiffany and her mother are. I can't imagine the surgeon takes Tiffany and Amma terribly seriously, and may even end up being culturally biased against them (the patriarchy in India is terrible and women are treated like complete second-class citizens). I'm just speculating here, but having seen first-hand what good cancer mentorship and care looks like from my husband's case, I can tell you that the way Tiffany has been treated (/not treated) is shocking and concerning. We should be deeply sceptical about her surgeon and his honesty.
What a load of rubbish.

I had surgery for endometriosis, the endo specialist surgeon was both male AND Indian. I never once felt belittled by him. I felt heard and understood. He is a compassionate individual who helped me get back to a normal life.
 
On the subject about Matt. Love is practical too. It includes intimacy as well and that is totally normal. So if she can’t have ‘normal’ sex indefinitely, is a 32 year old man going to be deprived of sexual intercourse for the rest of his life?? He is human. What if along the way, he slips and has one night stands or cheats on her? This is highly possible. I think he should think very carefully, be there for Tiffany during this crucial time and after her recovery, discuss if they could have an open relationship or just move on. It is an important decision and he deserves the right to decide and should not be judged. If her surgery was relating to heart or lung etc, it would be a different story altogether and he should stay if he truly loved her.

I think, underneath the tears and sadness in her last video, I could feel her anger and pain, knowing that she might possibly and realistically lose Matt. This is her biggest fear and heart break. Of course, this is my opinion only.
 
I always wondered, maybe naively, if Tiffany was a virgin given how religious she seems to be and how she always seems to turn her head when Matt kisses her and gets all giggly and awkward.

With her surgery, did she say mid-December? Doesn't she risk even further spread waiting yet more weeks? I'm confused by all this waiting.

No way Tiffany was a virgin, she had a boyfriend previously for 6-7 years
 
On the subject about Matt. Love is practical too. It includes intimacy as well and that is totally normal. So if she can’t have ‘normal’ sex indefinitely, is a 32 year old man going to be deprived of sexual intercourse for the rest of his life?? He is human. What if along the way, he slips and has one night stands or cheats on her? This is highly possible. I think he should think very carefully, be there for Tiffany during this crucial time and after her recovery, discuss if they could have an open relationship or just move on. It is an important decision and he deserves the right to decide and should not be judged. If her surgery was relating to heart or lung etc, it would be a different story altogether and he should stay if he truly loved her.

I think, underneath the tears and sadness in her last video, I could feel her anger and pain, knowing that she might possibly and realistically lose Matt. This is her biggest fear and heart break. Of course, this is my opinion only.
Yes, it is such a sad situation for everyone involved. Tiffany said she tried to push Matt away at the beginning, but he refused to leave her and moved in with her.
I looked up some information about the surgery that Tiffany will (most likely) be getting. They offer counseling relating to intimacy for both men and women who have undergone this procedure. Maybe Matt really loves her and will stand by her, and be patient, and once she is recovering, they could get some counseling to help with all of this. I hope he really loves her that much. As some other people have pointed out, they aren’t married and haven’t taken all the vows. But maybe they feel like a married couple? I think maybe a counselor could help Matt out as well, so he could discuss and work out all of his feelings and emotions about all of this.
 
After reading this, I was wondering, if there was a definite plan months ago for surgery, or maybe not, if there was, why was Tiffany’s weak physical condition not treated aggresively? She has lost so much blood which means very low hemoglobin, her cachexia was also very evident with the extreme weight loss. The “ eat more” approach we heard she was told in the video where she revealed her scan results and surgery in December is not enough imo, she needs transfusions iron intravenously and intravenous protein intakes. And those 8 weeks without treatment but “ wait and see” approach makes one wonder. We are not hearing the real story here.

“ Survival analysis revealed that high preoperative hemoglobin levels were predictive of better OS and patients with higher serum albumin levels showed better RFS. These results underscore the need for better preoperative conditioning to nor- malize patients’ hemoglobin levels (blood management) by giving iron infusions and other supplements, thereby reducing the need for blood transfusion in perioperative settings [20]. A high preoperative serum protein level is necessary for improving patients’ nutritional status. It is therefore important to ensure adequate caloric intake, either orally or intravenously [21]. All these perioperative measures are aligned with ERAS programs, which include numerous methods for improving preoperative health, postoperative mobilization, and digestion in patients, especially those with a long history of cancer. The earlier conditioning of the patient is begun, the better the outcome may be. This leaves room for future trials [13, 22].
With regard to tumor-associated factors, we show that a positive nodal status and positive resection margins are strong predictors for decreased OS and RFS, which is in good accordance with previous studies [6, 15]. Moreover, we could veriify that primary tumors have better OS and RFS than recurrent cancer [23]. In addition, our data of the subgroup analysis suggest that a limited metastatic situation like singular metastasis in the liver and lung is not significantly associated with OS if an R0 resection is possible. However, as an indication of earlier tumor relapse, it might be of interest for future studies in order to extend the surgical indication. Therefore, individual approaches should be discussed in interdisciplinar”

Part of me wonders whether all the procrastination on the surgeon's part (and the other surgeon who failed to take a biopsy) is waiting for the inevitable pointlessness of the surgery as well. People typically procrastinate when there's a chance they won't have to do something. We try to conserve energy and resources when we're not sure the investment is worth the hoped-for outcome. The surgeon will have pushed this surgery back nearly 10-12 weeks by the time we roll around to mid-December. By then, with new scans, new biopsies (if indeed he does take a biopsy this time around), the cancer may have distantly metastasised and it'll be palliative care hereinafter. That might've been his expectation all along.

That might also explain why the surgeon has been avoiding Tiffany these past few months. There has been something so off about that.

Same thoughts passed through my mind..
 
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I think it’s important to note people have different sex drives and depression can cause low libido also. There are people out there who are a sexual, a lot of people, there are people out their with low sex drives. Sex is not the be all and end all for a lot of couples, whilst to others it is. We are all very different. My sex drive has always been low, I’m I bothered by sex and if my partner was unable to be intimate in that way it really wouldn’t bother me
 
After reading this, I was wondering, if there was a definite plan months ago for surgery, or maybe not, if there was, why was Tiffany’s weak physical condition not treated aggresively? She has lost so much blood which means very low hemoglobin, her cachexia was also very evident with the extreme weight loss. The “ eat more” approach we heard she was told in the video where she revealed her scan results and surgery in December is not enough imo, she needs transfusions iron intravenously and intravenous protein intakes. And those 8 weeks without treatment but “ wait and see” approach makes one wonder. We are not hearing the real story here.

“ Survival analysis revealed that high preoperative hemoglobin levels were predictive of better OS and patients with higher serum albumin levels showed better RFS. These results underscore the need for better preoperative conditioning to nor- malize patients’ hemoglobin levels (blood management) by giving iron infusions and other supplements, thereby reducing the need for blood transfusion in perioperative settings [20]. A high preoperative serum protein level is necessary for improving patients’ nutritional status. It is therefore important to ensure adequate caloric intake, either orally or intravenously [21]. All these perioperative measures are aligned with ERAS programs, which include numerous methods for improving preoperative health, postoperative mobilization, and digestion in patients, especially those with a long history of cancer. The earlier conditioning of the patient is begun, the better the outcome may be. This leaves room for future trials [13, 22].
With regard to tumor-associated factors, we show that a positive nodal status and positive resection margins are strong predictors for decreased OS and RFS, which is in good accordance with previous studies [6, 15]. Moreover, we could veriify that primary tumors have better OS and RFS than recurrent cancer [23]. In addition, our data of the subgroup analysis suggest that a limited metastatic situation like singular metastasis in the liver and lung is not significantly associated with OS if an R0 resection is possible. However, as an indication of earlier tumor relapse, it might be of interest for future studies in order to extend the surgical indication. Therefore, individual approaches should be discussed in interdisciplinar”



Same thoughts passed through my mind..
Yes, I have been thinking along those lines as well. The whole thing sounds so “hectic”. I think they knew 8 weeks or so ago, that she might end up needing this surgery. I would think there would be plans for building Tiffany up in case she would need surgery! I don’t understand how they were all so sure she wouldn’t need surgery.
 
Yes, I have been thinking along those lines as well. The whole thing sounds so “hectic”. I think they knew 8 weeks or so ago, that she might end up needing this surgery. I would think there would be plans for building Tiffany up in case she would need surgery! I don’t understand how they were all so sure she wouldn’t need surgery.

Two scenarios, either Tiffany refused surgery when the doctor told her back then that only surgery could save her life, but told her the raw truth of all the organs that had to be removed, plus the risks of such invasive major surgery. There is a telling video in August where Tiffany was having a dramatic monologue in her bed saying “ this surgery will bring many life changing situations, is it worth it”? So she knew since then the life changes brought by surgery.
Maybe she was hoping it would dissapear on its own, maybe the doctor did not push enough because he did not want to take such a serious difficult case like Tiffany’s. All these do not make sense. They saw there was no tumor shrinking with chemo and radiation but still chose the wait and see approach, which could have ended in metastases and inoperable. Nothing makes sense in Tiffany’s cancer journey because we were not told the truth.
 
I think it’s important to note people have different sex drives and depression can cause low libido also. There are people out there who are a sexual, a lot of people, there are people out their with low sex drives. Sex is not the be all and end all for a lot of couples, whilst to others it is. We are all very different. My sex drive has always been low, I’m I bothered by sex and if my partner was unable to be intimate in that way it really wouldn’t bother me
Yes, same here. There are many ways to be intimate and romantic. And to the commenter who wrote about T having to 'settle for an old man' that's pretty ageist and dismissive. I married an older man. He has more drive, energy and passion than I do! I wish people wouldn't generalise.
 
This surgeon does, I am afraid, sound quite shady. I've known good cancer surgeons (my husband had advanced cancer three years ago and I've seen truly exemplary, honest, inspirational oncological/surgical leadership. I don't want to unduly cast aspersions on Tiffany's surgeon, but I know that Indian society can belittle Indian women and girls, especially those who are naturally agreeable, as Tiffany and her mother are. I can't imagine the surgeon takes Tiffany and Amma terribly seriously, and may even end up being culturally biased against them (the patriarchy in India is terrible and women are treated like complete second-class citizens). I'm just speculating here, but having seen first-hand what good cancer mentorship and care looks like from my husband's case, I can tell you that the way Tiffany has been treated (/not treated) is shocking and concerning. We should be deeply sceptical about her surgeon and his honesty.
What a load of utter horse tit. You realise you are talking about an abject stranger - someone you have absolutely no knowledge of other than the airy fairy bullshit Tiffany has spouted?

Get out of here.
 
I think it’s important to note people have different sex drives and depression can cause low libido also. There are people out there who are a sexual, a lot of people, there are people out their with low sex drives. Sex is not the be all and end all for a lot of couples, whilst to others it is. We are all very different. My sex drive has always been low, I’m I bothered by sex and if my partner was unable to be intimate in that way it really wouldn’t bother me

Yes. Not everyone has the idea that close relationships must revolve around sexual intimacy to be fulfilling. There are many different types of happy, loving relationships which have various priorities that make them work.

My speculation about Matt’s inability to cope with the aftermath of Tiffany’s surgery has nothing to do with sexual issues at all. Matt left town during her last biopsy so to me that’s a red flag. Sexual intimacy is very different from intimacy required to help someone with their colostomy bag. Of course, Amma will be a caregiver for Tiffany but there will be times when she can’t be there and however competent Tiffany becomes with caring for her own body, there will be times when she needs help. I’ve seen various levels of help and concern from family members in hospital that reflect how they probably cope with a patient’s (various) needs at home. There are wives who care for their husband’s colostomy bags, nephrostomy bags, etc. and spouses who have to leave the room when nurses are caring for stomas. There are patients who come in with huge pressure ulcers because family members don’t or can’t clean and reposition them regularly. There are adult children who bring their elderly parent into hospital and then essentially ghost them. Sometimes, it’s just too much and may have nothing to do with depth of love.

Not everyone is cut out to be a caregiver. I believe Matt is one of these people. Nothing to do with sex at all. Maybe Tiffany will be very independent with self-care, who knows. Not everyone is able to watch another person suffer either. I believe Matt may fall into this category as well. Maybe Tiffany trying to stay optimistic is partly for him. This is all just speculation but my view of Matt changed a lot when he went out of town during her biopsy.

Tiffany probably is not a virgin if doing videos in bed when obviously naked is any clue.

Whoever said Tiffany would be “settling” for an older man was ironically showing their ageism while criticizing someone else for being ableist. 🙄

Yes, same here. There are many ways to be intimate and romantic. And to the commenter who wrote about T having to 'settle for an old man' that's pretty ageist and dismissive. I married an older man. He has more drive, energy and passion than I do! I wish people wouldn't generalise.

I was typing while you were posting. You expressed much of my thoughts in a much clearer, efficient way!
 
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Yes. Not everyone has the idea that close relationships must revolve around sexual intimacy to be fulfilling. There are many different types of happy, loving relationships which have various priorities that make them work.

My speculation about Matt’s inability to cope with the aftermath of Tiffany’s surgery have nothing to do with sexual issues at all. Matt left town during her last biopsy so to me that’s a red flag. Sexual intimacy is very different from intimacy required to help someone with their colostomy bag. Of course, Amma will be a caregiver for Tiffany but there will be times when she can’t be there and however competent Tiffany becomes caring for her own body, there will be times when she needs help. I’ve seen various levels of help and concern from family members in hospital that reflect how they probably cope with a patient’s (various) needs at home. There are wives who care for their husband’s colostomy bags, nephrostomy bags, etc. and spouses who have to leave the room when nurses are caring for stomas. There are patients who come in with huge pressure ulcers because family members don’t or can’t clean and reposition them regularly. There are adult children who bring their elderly parent into hospital and then essentially ghost them. Sometimes, it’s just too much and may have nothing to do with depth of love. Not everyone is cut out to be a caregiver. I believe Matt is one of these people. Nothing to do with sex at all. Maybe Tiffany will be very independent in this regard, who knows. Not everyone is able to watch another person suffer. I believe Matt may fall into this category as well. Maybe Tiffany tries to stay optimistic is partly for him. This is all just speculation but my view of Matt changed a lot when he went out of town during her biopsy.

Tiffany probably not a virgin if doing videos in bed when obviously naked is any clue.

Whoever said Tiffany would be “settling” for an older man was ironically showing their ageism while criticizing someone else for being ableist. 🙄



I was typing while you were posting. You expressed much of my thoughts in a much clearer, efficient way!

I agree with alot of your post, certainly that not everyone is cut out to be a caregiver and that is OK, however I do have to disagree with the depth of love element. I think if you truly love someone, it's unconditional (well short of them being like a mass murderer or something lol) and you'd care for them however hard. If you let them get pressure ulcers sooner than clean or preposition them - that isn't love. Leaving the room while someone else cares for them maybe, but actively letting them come to harm? Absolutely not.
 
I agree with alot of your post, certainly that not everyone is cut out to be a caregiver and that is OK, however I do have to disagree with the depth of love element. I think if you truly love someone, it's unconditional (well short of them being like a mass murderer or something lol) and you'd care for them however hard. If you let them get pressure ulcers sooner than clean or preposition them - that isn't love. Leaving the room while someone else cares for them maybe, but actively letting them come to harm? Absolutely not.

Nothing to do with Tiffany’s situation but being a caregiver can be pretty complex. Sometimes a patient is very overweight and can’t properly be cleaned and repositioned by just one person. Sometimes a person will not allow proper care by another person whether family or nurses. Sometimes a caregiver may be coping with other sick or disabled family members as well, or even their own illness. Not everyone can access outside care either. Yes, sometimes there is outright neglect and sometimes people aren’t able to be a caregiver no matter how much they love someone. Usually they do the best they can and social services will try to help them with placement. It’s not unusual for a patient to be in hospital for months because family cannot care for them at home and no nursing facility will accept them.
 
Nothing to do with Tiffany’s situation but being a caregiver can be pretty complex. Sometimes a patient is very overweight and can’t properly be cleaned and repositioned by just one person. Sometimes a person will not allow proper care by another person whether family or nurses. Sometimes a caregiver may be coping with other sick or disabled family members as well, or even their own illness. Not everyone can access outside care either. Yes, sometimes there is outright neglect and sometimes people aren’t able to be a caregiver no matter how much they love someone. Usually they do the best they can and social services will try to help them with placement. It’s not unusual for a patient to be in hospital for months because family cannot care for them at home and no nursing facility will accept them.

None of that is what you suggested though, again those reasons are different but you implied they just weren't doing it because they didn't want to because it was hard/unpleasant and to me that isn't love. Letting someone come to harm instead of accessing help isn't the act of loving someone. Also none of this is really relevant to Matt and Tiffany because none of those things will apply.
 
I should have rephrased. Of what benefit would TPN be to Tiffany right now when she is capable of eating?
Capable of eating does not mean capable of absorbing with a malfuctioning system due to advanced local cancer. She needs extra help and high intake. She mentioned herself in her latest video she does not understand why is not gaining weight with all she eats. The girl has obvious cachexia due to a very large tumor growth. Needing a pelvic exentaration means her tumor has locally advanced to many organs.
Also she has lost so much blood for months her hemoglobin level must be really low. The article I posted this morning clearly states the hemoglobin levels pre surgery should be high along her protein intakes.
 
I think it’s important to note people have different sex drives and depression can cause low libido also. There are people out there who are a sexual, a lot of people, there are people out their with low sex drives. Sex is not the be all and end all for a lot of couples, whilst to others it is. We are all very different. My sex drive has always been low, I’m I bothered by sex and if my partner was unable to be intimate in that way it really wouldn’t bother me

Good point, while reading I realised that I haven’t had sex for 11 years now. Not through any physical condition, more that I can’t be bothered to deal with all the nonsense that usually goes along with the penis. I can’t imagine Matt and Tiffany going at it hammer and tong every night with dear old Amma in the next room, my lord!
 
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