Surgery Day April 25th 2014

     Cancer changed my life when I was diagnosed four years ago.  Surgeries, chemotherapy and lifestyle changes seemed to remove this threat.   Then a routine colonoscopy in February showed it was back.  Now in the early hours of this cold April day I would undergo Colon Surgery once more.

     I had gone through this process before, and knowing what was coming up was not making it easier to handle.   Some elements, like the familiar bowel preparation were mere annoyances.  Some possibilities scared me like the need for a Colostomy bag.  Changes in my external image were sure to impact my mental and emotional self images.  Most disturbing of all:  why is this happening to me again?  But on this day I would once again change from Person to Patient.  That process began at 5:00AM.

     Hot shower, lingering in the warmth as I was chilled by the preparation from the night before.  I shivered, knowing what was  yet to come.  My scheduled surgery would be at 8:00AM.  I needed to be at the Hospital's Admitting department for 6:00AM.  Dark, cold, wet and miserable, and this was just the start of the day.

     Registration already has people waiting ahead of me.  I'm number four.   A mix-up, someone has forgotten their Health Card.  I'm now number three.   Minutes later I'm showing the clerk my well-worn red-and-white OHIP card.   And minutes after that I'm instructed to proceed to day surgery.  The change from Person to Patient has formally begun.

Patient and impatient

    Wristband checked, paperwork transferred, now the  waiting begins.  And I don't do waiting.  I pace,  and keep checking the time.  I'm cold, tired and tense.  Time inches by slowly, and soon I'm called into the room where I get to change out of my street clothes and put on a Hospital gown and robe.   By degrees I'm becoming more Patient and less Person.  Once robed, I'm brought to the waiting room outside the OR.   My next room will  be a sterile operating room.  When that happens I am now a Patient.  But first I meet my anaesthesiologist.

      He's pleasant and does his best to make me feel comfortable.  We go over the standard questions about any allergies or effects of being under.  He asks me to open my mouth as wide as I can.  Satisfied that there's no issue he departs, and I'm left to wait.   Finally my OR nurse appears and as I can't wear my glasses into surgery, I hand them off.  I'm proceeding blindly, gently guided by her arm on mine as I enter the Operating Room.  I've left the Person on the outside, in here, until my discharge, I will be the Patient.

     Operating Rooms are cold.  Bright lights that add no heat.  Conversation between the medical staff.  I can't remember when the IV is installed but have vivid memories of the epidural installation.  For that I have to curl up and arch my back like a sideways cat.  The needle placement is delicate, I don't move.  There's sensation, but  I'm focusing on the feeling that I'm utterly powerless, my fate is literally in the hands of the medical team in this room.  My doctor is ready, the mask is on me, I'm told to take deep breaths.  The mask is so tight against my nose, and days later I would wonder about the little blister I would see there.   One breath, two breaths, three maybe four, at this point time ceases once more for me.  My surgery had begun.

     I would wake up in the recovery room, groggy and hazy.  I was told that I smiled and opened my eyes when I heard my name.  I had survived my third major surgery  in four years.  All I could do now was sleep.

The eve of another cancer surgery

     Today I'll start the preparation process for my colon surgery.   Surgery is  scheduled for 8:00am tomorrow morning, April 25th.  For the past several weeks since my surgery date was set I have tried to understand what I'm feeling towards this latest discovery.   Overall I'm accepting of the need for the surgery.  A colonoscopy in February found cancer.    A subsequent CT scan and yet another colonoscopy  showed no evidence of cancer in my other organs.

     I met my surgeon who reviewed the prior colonoscopy  and decided to do another to make his own assessment.   At that time I was optimistic that this surgery would be performed laproscopically.  The second colonoscopy resulted in the removal of another polyp, and unfortunately the decision was made to make it an Open Surgery.   I would undergo major surgery for the third time in four years.

    There would be a pre-assessment visit to the local hospital where blood would be drawn, an EKG performed, height weight and other vital bits and pieces of medical necessities would be taken.  I would meet with the pharmacist to discuss what medications I was currently taking (B12 once a month, Vitamin D 1000u daily and Crestor daily).   Finally I would meet with the nurse to discuss my medical history.   The administrivia of patient care revealed that I've had some 10 procedures in four years that have had me under anaesthesia of one sort or another.  

    During the past weeks since my cancer was discovered,  my coworkers, friends and family expressed their concerns and offered their support.   I have good people in my life, and the most important lesson I have learned  along the way is that you can't do it alone.  The usual question I'm asked was "How do I feel?".   "Tired." would be my usual answer.  I'm tired of Cancer, I'm tired of worrying and tired of being cold! I just want a peaceful spring, and to be warm.   Surgery will resolve the cancer and the time off will let me rest.

    However my immediate needs are for another bowel preparation.  I'm tired of *that* too!  I've had three such treatments in as many months.   This latest product is called "Purg-Odan" and you take a little sachet with a glass of water a couple of times and  it "gently" moves thing along.   It's not a difficult process, it's really not that uncomfortable, but you're committed once you start!

  It's 7:00PM and I've just taken the second packet of Purg-Odan.  Water, Gatorade, more water, the occasional black coffee, and of course Jello.  I'm bloated but  'this too shall pass".  With surgery  scheduled for the early morning, I need to be at the hospital for 6:00AM.  I won't be able to drink anything after midnight, and it will likely be a couple of days before I can even drink water after surgery.  This is the last opportunity I'll have to drink, and I'm making the most of it.  Keeping hydrated is key to the process.

    Watching TV to pass the time, I note how many commercials are food related.  Earlier in the process this was annoying but five hours later I'm not hungry, just tired.  Three beverage glasses sit on  the table beside me, and I sample from them at regular intervals.  I'm so full of liquid right now, but the process is nearly finished.  A few more hours and I can sleep.  I'm tired already but probably won't sleep well.   The old fear of sleeping in and being late for my appointment has me setting  two alarms.  

   Evening is almost over,  my purge process appears spent.  I'm tired and cold.  Tomorrow's weather hints at a wet, cool and gray day.   On that gray morning my journey will continue once more, and I will endure so that my future will be bright.

Cancer Again

     For three years since my last Cancer treatment I've undergone regular blood tests and CT scans.   There were regular visits to the Oncologist.  My IV Port was removed, on the assumption it would no longer be needed.  In 2011 I had a follow-up Colonoscopy that showed no issues or concerns.   I've vigilantly kept watch on my health for anything out of the ordinary.  So it was a complete surprise to find out that a biopsy from my most recent Colonoscopy  this past February showed Cancer.

    There's a certain sense of urgency when your Oncologist calls you to discuss the results of your latest exam.   My Colonoscopy had been on February 26th,  and I was expecting to discuss the results with the Gastroenterologist on March 20th.  The preemptive call on March 10th from my Oncologist was a complete surprise.  An appointment was arranged to meet in two days.   A 'polyp-like' growth at the site of my previous tumour had biopsied as cancerous.   I did not sleep well the next two nights as that sense of urgency dominated my thoughts.

   On the appointment day I enter the Cancer Center and once more acquaint myself with the login process to fill out the ESAS form.  This is the self-evaluation form on how you feel:  Sick? Pain? Tired? Anxiety?   Usually all my numbers are zero, this time I scored a modest value for Anxiety.   I'll admit to being nervous.

  My name is called and I meet a nurse at the entrance to the exam area.  Preliminaries:  my weight is always checked whenever I visit  my cancer doctor.  Perhaps the scales could have reflected a more svelte reality than what was displayed, but at least it didn't show any shocking weight loss.  What a relief *that* was.  Three months ago I had my CEA blood work at this very facility, with no hint of any problems.  Never once have any of my blood tests been other than normal.  After my weight was recorded, I was brought to the exam room where I waited for my Oncologist to arrive.

   My Oncologist steps in the room and our usual pleasantries are exchanged.  She proceeds to review my Colonoscopy results, and  for the second time in four years, a doctor is telling me that I have Colon Cancer.  To my credit I didn't faint.

    The 'not-quite-a-polyp' biopsy done at the time of my Colonoscopy showed cancer cells.  I would need to get more blood tests and a CT scan.  A consultation with a surgeon would be arranged.   The treatment for cancer in the colon is surgery.  That's what I would need done.  The question remains as to the extent - had it spread like before, to my liver or other parts?  A CT would establish if there were other tumours lurking within.  Curiously, although I had very little new information, I felt marginally relived.  My Oncologist did not seem overly concerned, and her thorough medical examination (Something I like to call being Poked & Prodded) seemed to satisfy her that none of my major organs was in imminent danger of exploding.    I would leave the Cancer Centre  feeling mildly optimistic, encouraged by that fact that a testing process had done exactly what it was supposed to do:  identify the onset of a disease, and allow for a treatment plan.   

     There would be a spate of activities over the next several weeks as I underwent a CT exam and met my new surgeon.  My confidence would  ebb  and flow depending on my mood -optimism:  I've done this before, and pessimism -have I exhausted my resources?  I try not to think about what this means, this new-found outpost in my gut.  Does it herald a full invasion or is it merely a spiteful ghost from my previous adventures? 
  
   One thing I do know is that my resolve will be tested.  Once more I will have to make life-altering decisions based upon emotion as much as logic.   I set the bar pretty  high my last go-round dealing with Cancer.  I just hope I can do the same  once again.