Something completely different

     This past winter,  annoyances that were not cancer-related crept up on me.   One was my aching left knee, the result  I believed of too-strenuous snow shoveling after a particularly heavy snowfall in February.  The other was a crooked ring finger on my left hand, making some activities painful.  I had postponed investigating these issues, mostly to focus on my cancer treatment, but also with the vague hope that it would just 'go away'.  But the pain persisted through the winter,  and with no imminent cancer issues in my immediate future, I decided to get it checked out.  At first my family doctor thought I might have  fractured my finger at some point. An X-ray of my left hand was not conclusive, the worry that there was some sort of infection due to arthritis was suspected.  A bone scan would be my next procedure.

     Two years ago I complained of a sore back and vague, nagging aches, which led to  my first-ever bone scan .  The initial diagnosis was early onset arthritis.  Now I would undergo another scan.   So here's how I spent a half-day at a Hospital...

     Friday May 16th I arrive promptly at the Hospital for my 7:30am appointment.   It's a Hospital, so there's  paperwork then waiting.   If there's something I should be good at after all my medical adventures it should be waiting.  I'm no good at waiting, but I have learned to endure.   For today I would need to endure multiple tests spanning four hours.  First there was the scan of my hand.

     Simple process, place hands face down on the scanning table where the tech told me to and a few minutes later I was done.  The next test would require an injection of a mildly radioactive substance and a full bone scan.   A waiting period of several hours for the material to go through my system was required in order for the injected substance to spread through me.  I was advised to drink a lot of water during this period.  With nothing else to do, I wandered around a Hospital I had once been employed at 20 years earlier.

     Around 10:00am  and I'm back in the Nuclear Medicine department ready for another go-round.   I'm advised to go to the washroom (I take instructions to drink lots of water very seriously.).  For this next test I'll be strapped on a table (simply to keep my legs and arms from moving too much) while the table slowly goes through a scanner.  It's akin to a very, very slow CT.  Very slow.  It will take an hour for a transit.  During this time you try not to move, to think about that itch on the side of your nose, or the general not-quite-comfortable feeling -I really really want to roll over on my side, but of course that cannot happen.   So I try close my eyes and achieve a state of detachment, where the world fades away and calm is within me.  I think they call it "sleep".

     Sleep of course never happens in a hospital, but I achieved a degree of relaxation  I played a game where I would close my eyes and guess how far the table had progressed when I opened them.  In a Hospital you have to make your own fun.   Only an hour later -it seemed longer- and I was being unstrapped from the table.  A few more tests would need to be endured however.

    Specific tests would be done on my hands and knees.  I was rearranged, still on my back on that very narrow table,  with my hands on a supporting pillow over my abdomen.  Another pass through.   These tests were far shorter but it was getting past 11:00am.  There's simply nothing to be done, the processes take the time it needs, and the patient simply has to be stoic.  Finally, by 11:30 that morning my tests were complete.  In a few weeks my results would be ready.

    Tests concluded, and I'm ready to leave the Hospital.   But there was one caveat:  the radioactive tracer material in my blood would be active for a short time that day.  Should I need to cross the border into the USA, I would undoubtedly trigger their radioactive alarms!  Far be it from me to create an international incident, I would spend the rest of my afternoon at the local library.

     Waiting for results is another fun game we play with the medical system. For several weeks I waited for the phone call from the family doctor that would summon me to discuss the findings.  But there was no call.  My knee was really bothering me and I initiated a follow-up consultation with my family doctor.   What I would learn was what I suspected:  I have Arthritis.  Specifically, Osteoarthritis.

    Osteoarthritis is probably what I and many others assume to be 'old age'.  Everything aches, and some range of motion needs to be done slowly and delicately.   My family doctor and I discussed the extent of the arthritis.  It's in all my joints,  more pronounced in my aching knee but also in my finger joints and elbows.   He prescribed a topical ointment for my knee, and some pills that would hopefully alleviate some of the pain. To date the ointment seems to be working, but it's a chore:  I need to apply 10 drops, repeated four time for a total of forty drops.  Then I have to do that process four times a day.  That's 160 drops a day.  And the key is to massage it into your knee.  There are other considerations for this arthritis thing too.

     One is to keep active.  I don't have to run marathons (not that I ever did) but I should keep walking.  With summer approaching my bike and I have begun to do some riding.  I find that the knee responds well to this activity.  The other consideration is to keep your weight down -no point in making painful joints struggle with carrying more of a load than they need to.

   June is winding down and my aching knee seems to respond to this treatment and  exercise.  I'm just careful not to stress the finger, there's no way to straighten it without surgery, and at this point in life, it's not an option.  Another medical challenge accepted and managed the best way I am able.  I don't worry about growing old,  I'll get there in my own time.

Staples and Tape

     I was discharged from the Hospital on April 28th,  five days after my surgery for Colon Cancer.  I would need several more weeks to heal, to regain my strength, and find some measure of my former stamina.  First however I had to endure a week of sleeping with staples in my stomach.  Stretching, reaching, bending -any action that might cause undue stress on my tender tummy would require an element of discretion.    After a week or so of broken sleep and cautious movements, I had my follow-up appointment with the surgeon.     On May 8th I finally got those damn staples removed.  My doctor was pleased with how my incision was healing.    Which meant I could shower, I could walk at my usual cadence and overall, start doing typical Terry things once more.  The real healing would begin.  Yet there was one more annoyance in the aftermath of all my surgery:  tape.  Another sticky situation to deal with.

     Tape used by Hospitals is meant to adhere to your skin no matter what.  When I was released from the Hospital I had a new dressing covering my stapled incision.   I couldn't have a shower yet,  but I could luxuriate in a bathtub.   That's when I discovered I still had tape on my back from the epidural.   Removing it wasn't too bad, hair grows back.  Usually.   The real mess was from the  gummy residue that  clumps up and sticks to skin and hair, resisting all my attempts to remove it.   Soap and water, alcohol, and finally soaking the affected areas in baby oil would be used.   Baby oil would be my go-to choice in future:  just let it sit and it gently and painlessly  washes off.  I'm such a wimp.

    My first walk the day after the staples were removed was a wonderful half-hour romp:  to visit a doctor of course.   I needed to check in with my family doctor to complain about a few issues,  and get prescription refilled.   That Friday morning on a fine sunny spring day, I walked the 30 minutes to his office, happy to simply have that option available to me.  Upon arrival I would go through the usual medical rituals: weight, blood pressure and general health questions with the nurse.  Once these preliminaries were complete, I was ushered into the room to await my family doctor.

   We exchanged pleasantries, discussed my surgery, he seemed impressed that I was doing so well roughly two weeks from my surgery.   The reason for my visit today was to have my Crestor prescription filled (no sense having a heart attack after surviving Cancer!) and to see about some nagging issues.  Seems that I was creaky in some of my joints, specifically my left knee (I had twisted it shoveling snow in February and neglected to have it looked at due to my other priority), and an inability to straighten the ring finger on my left hand.   Cursory examination suggested I might have a fractured my finger.   I could move the finger but not straighten it out,  and it was painful in some cases.  I would need an X-ray.   More walking to the clinic where I would receive my X-ray.  A walk to the drugstore to pick up my prescription.  A walk BACK to the clinic, to retrieve the prescription that I inadvertently left there when dropping off my X-ray forms.  Back to the drugstore.  Finally with my prescription filled I wandered home.  I had walked for the grand total of about an hour and a half, most of that 'at speed'. I was exhausted. 

     Over the next several weeks I would regain some stamina and walking would not be the draining activity it was on that Friday.   I was feeling good.  More importantly, I was happy and some of my confidence that I would   'be OK' was returning.   The next few days saw a steady increase in the walks -few long ones but their frequency increased.  Plus a lot more naps between walks.  Everything seemed to be progressing as it should and I was happy.   Then I received a phone call from the Hospital.  My family doctor wanted me to have a Bone Scan for my hand.   Friday May 16th , one week after having my hand X-rayed I would be getting a Bone Scan.  My adventures continue.

Going Home starts with Jello

      My journey from Patient to Person made significant gains on Monday, April 28th.   It began with two events:  my first meal in days, and  moving to a new floor.

     Breakfast that Monday would be the first morsel of food I had consumed since the prior Thursday.  As it always is in this type of surgery, breakfast consists of Jello and juices.  The intent is to gently start up the normal processes without undue stress on the colon.  However after four days of nothing but fluids my appetite was slow to return.  Between the Orange Juice and and a few tiny sips of black coffee, and  slurps of Raspberry Jello, I managed to finish the small portion provided.   Clear fluids would be my diet initially,  and slowly progress to fuller fluids.  My lunch had vegetable soup - my first hot meal in days, and I drank it down greedily.   Having achieved the goals of eating without incident, I was now ready to be transfered from P.O.T.U. to another floor.  My Journey was literally continuing.

     Before I left the P.O.T.U. however I was divested of another of my tubes:  the catheter.   Not always comfortable, you're not even aware you're voiding.  It would be  removed early that Monday morning.     The process was not painful but somewhat disconcerting, as I would be an educational experience for a nurse who had never removed a catheter before.   From my past surgeries,  I recall this process being performed late at night (The "wee" hours of the morning?).  This time it would be mid-morning with me sitting on the side of my bed, gown up to my waist, looking anywhere but at the two nurses huddled in front of me.   I tried not to listen to their conversation regarding the mechanics of what they were about to do, but there was a moment when "oh..."  turned into "OH!...much better thank you...".   My relief was genuine and now under my own control.

    "De-catheterized"  I still needed to prove that I could void without problems.  Being a hospital they're not about to accept my statement, they want proof.  I'm instructed to use the provided plastic container, which also has graduations on it to measure volume.   On my first attempt I did an impressive 500ml.  Success in a hospital is not measured by extraordinary results, it's measured by how you manage normal everyday things.   So far I was walking without problems, I was eating without issue and now, oh joy, I was peeing.  I was deemed fit enough to move out of P.O.T.U.

    My new home for the next day and a half would be room 7105A, one floor below the the P.O.T.U.  For some reason however my impressive feats of filling plastic containers needed to be repeated to the satisfaction of my new nurses.    I obliged with a personal best that finally  allowed me to relegate the "pee bottle" to the shelf for the remainder of my stay.   I was making great progress, but was still tethered to my IV.  If I could get through lunch without incident it would be removed.  I had another goal, one I was confident I could achieve.

    Lunch didn't have Jello, it was a "full fluids" meal:  milk, cream of broccoli soup, and vanilla ice cream for dessert.   Having successfully taken in fluids and food without incident, my IV was disconnected, I was no longer tethered!   My freedom is on the horizon!  However, now that I was eating my nurses were asking me that extremely critical question:  Have I passed gas?

    Colon Cancer surgery  removes tissue from the (empty) colon and splices it back together.  Your body has not sent anything down that passage for days.  It has to learn how to do that again, and it has to be 100% successful to qualify for the 'get out of Hospital free' card.  Passing gas is an absolute prerequisite in the continuing transition from Patient to Person.  Eating starts the normal process, but it simply takes time and can't be forced.   During my stay my doctor and nurses listen intently to my belly sounds with their ever-present stethoscope.  I wouldn't disappoint such an intent audience.  Eventually the few meals I consumed would produce the expected results.   It is my personal belief that Cream of Broccoli soup can make a brick pass gas, such was its effect after lunch.  But there remained  a second prerequisite that would prove the success of my surgery.    Achieving this second prerequisite,  ( Number Two of my goals if you would prefer)  would be the key to my being released from the Hospital.  Before that would happen, I would keep walking to help the process along.

     Exercise after surgery is great. It's one of the few activities I could do to keep boredom away.  My visitors would come to see me, and  we would walk the halls of the hospital.  When they were gone I would walk laps around the floor.  On average, I was able to complete one lap around my floor in 74 steps.  Not bad for a guy in a bathrobe and slippers.   I would do perhaps 15 minutes of walking, then rest and drink water.  A lot of water.  Then walk some more.  Waking up in the morning after my shave and bath, before breakfast, I would do laps.  Before visitors arrived, more laps.  With visitors -laps.  I had two dozen staples in me still, but was cautious to not overdo my efforts and cause that tingling effect of  metal on sensitive skin.   It was only Monday, and I desperately wanted to go home.   My wish would be granted the next day.

    Early Tuesday morning my surgeon came to see me again.  Pleased with my progress so far he asked if I wanted to go home, and seemed satisfied with my immediate YES to his question.   My nurse however was a bit more cautious, as I had not fulfilled the second requirement of my obligatory prerequisites.  But I would pass that test soon: waiting in the wings was breakfast, and this time it was Oatmeal.

      Oatmeal is a high fibre breakfast cereal.   Lots of fluids, lots of exercise, and the effects of fibre were enough to earn my release.   I was happy in a way that I think only patients who have undergone this process might understand.   In a few hours I would be in my street clothes packed up and ready to leave.   As my discharge paperwork progressed my nurse turned to me an  said with some amusement:  "Will you require a wheel chair to bring you out of the Hospital?"  Another nurse chimed in "He'll probably just WALK down the stairs!".   They were quite aware of how mobile I had become, and knew what my answer would be before they asked.  By noon I would be outside, waiting for my ride. 

     The act of leaving my residence of the past five days imperceptibly freed me from the last vestiges of being a Patient.  I was now  a Person.  Once more I was Terry McAlinden.   Rain that had been  routinely falling throughout the morning had ceased.  The sun was shining  and I breathed in that unseasonably chilly air as I stepped out of the Hospital, and into the car that would take me home.

P.O.T.U.

     On a cold and wet Friday morning April 25, 2014 I had gone into the Hospital for Colon Cancer surgery.   I would wake up in the Post Operative Treatment Unit.  There I would remain until the following Monday afternoon.

      In P.O.T.U. I would be closely monitored.  It meant being woken up every two hours to have my vitals taken.   It mean ice packs would be used to determine the extent and effectiveness of my epidural.  It meant lying in my bed feeling disoriented, dry mouthed, spasms in my belly and nausea that would bring up nothing.   A breathing tube in my nose.  I was catheterized and my left hand was tethered to an IV.  I had no sense of the hour or the day.  For the spasms and nausea there would be medications.  For the constant dry mouth there would only be ice chips.  Sometimes I was chilled, other times uncomfortably warm.  I was unable to turn on my side or stomach.  My transition from Patient to Person had started as it always did:  in a drug-infused haze.

    The Friday I arrived in P.O.T.U. I was still under the anaesthetic's  spell.   I remember being woken up so that the blood pressure cuff could be wrapped around my arm and a thermometer placed in my mouth.   I especially remember the epidural tests:   a bag of ice being applied to various parts of my abdomen and me being asked if it was cold or if I just felt the weight.  By this action they made sure that the my lungs and mobility were not impaired.   I never knew what time it was.  I only way I knew that a new day had begun was  the bustle of activity when the shifts changed.    Mornings also brought the Student nurses and my bath.

     I learned about 'sponge baths' from my very first stay in a Hospital.   They're a poor substitute for a shower.  But I wouldn't be able to see the inside of a shower for some time yet, tethered and bandaged (and rather unsteady) as I was.   The name 'sponge bath' is  misleading:   I never saw a sponge,  just a washcloth and basin.   My nurse would fill the basin with warm soapy water,  and deliver it to me along with clean towels and facecloth.   With pulled curtains I would struggle to sit up and gingerly splash water on various parts of me with the some vague idea of trying to get clean.  I had another goal, also learned through hard experience in a Hospital: don't defer shaving.

     After the morning bath I was asked if I could sit in  a chair.   Big, sturdy and heavy,  these chairs were moderately comfortable and a key step in the transition back to Person from Patient.   It required all my strength and my kind nurse to help me out of my bed and co-ordinate the tangle of tubes attached to me.   No sooner had a I sat down than I decided that I wanted to shave.   My electric razor was in the nightstand an impossible four feet from where I was sitting.  So once again my remarkably patient student nurse retrieved the razor for me.  Of course my chair was nowhere near an electrical outlet which was conveniently located near the bed I just vacated.     We reverse all my previous manouevers to leave the chair and I sit on my bed to shave.  By now I've been vertical long enough to feel confident and I can slowly navigate my way back to the chair on my own.  But I have my sights set on another goal:  wash my hair.

     Hospital bath-in-a-bowl do not accommodate washing your hair. I wasn't looking for shampoo and blow-dry, my goal was simple:  rinse my head.  To do this I would need to bend my head under the faucet of a sink,  a moderately difficult  thing to do after abdominal surgery.   At my suggestion my nurse places one of the visitor chairs in front of the sink.    By kneeling  on this chair I can support myself without undue stress on my recent incision.  I hoped.   For a few minutes I know the feeling of cool, then warm water running over my head.   With eyes closed, water dripping over my face I feel fleetingly like my old self.  Towel-dry, then a return back to my  chair.   By first leaving the bed and sitting, then leaving the chair and walking I had accomplished two of my goals.  Each goal is a tiny achievement to my recovery.   It makes a profound difference being actively involved with the recovery, rather than lying passively back, waiting to be asked if I needed anything.   Now that I was cleaned up and back in my comfortable chair, I asked for help plugging in my computer.

     Everything I did that first morning was a struggle.  Cords and tubes seemed to intertwine in uncomprehending ways.   My student nurse would go through complex 'un knotting' procedures with my IV before one of the veterans showed her how to temporarily disconnect and reconnect the tubes, just to avoid that issue.  Finally with laptop plugged in and once more back in my chair I fired up my trusty netbook.   Which promptly failed to boot.   This is an unacceptable situation for an IT professional, so I applied all my 30 years of IT experience and tried it again, with the same results.   Instead I simply sat and observed the activity in my ward.  By now  I had been up for hours and was fatigued by all the morning's activity.   Unassisted this time, I returned to bed.   I wasn't independent yet, but I was far from helpless.  I was satisfied with my progress so far.    My computer would eventually work, but my glassy eyes simply didn't focus well enough to read, no matter how large the font.   I was too tired and just wanted to sleep.  But in a Hospital, you never really rest.

     I drift in and out of sleep throughout the recovery process.  There's  never a sense of being refreshed.  I cannot find a comfortable position. Whenever I try to  sleep, dark, disturbing images  emerge and I feel helpless.  The longer my eyes are closed, the worse it gets.  Eyes open, the images vanish, only to return after I close them again.  My pain-killing medication is responsible, the effects  progressively worsen the longer I am on it.   Throughout my weekend stay in P.O.T.U. I hope for two things:  to sleep, and to taste something that isn't an ice chip.

     Sunday afternoon the epidural is removed.  I know that my recovery is proceeding and I will get better.  I also know that pain is moving in to fill the void left by the morphine.   The heat in my belly is kept at bay by ice-cold drinks of water now.  I crunch ice chips, imagining them cooling the fires within.   I ask for a Popsicle.  It's a clear liquid, so nothing medically prevents me from consuming one at this time.    My evening nurse cannot find any  in the P.O.T.U. but asks other floors if they have any.   One is found and I find that a Banana Popsicle never tasted so good.   I eat slowly,  simply because I have no appetite.  The coolness seems to galvanize my determination to drink more ice water as well.  I would not experience the fiery pain as I had in my prior surgeries.   I still don't sleep well, but maybe I rested better.   With the removal of the epidural,  I felt I was rising up through hazy depths to clarity once more.   And I was able to walk.

      My initial walk in P.O.T.U. were unsteady steps, simply to a sink a dozen feet away and back.   Each day I strove to walk a little more.  By that Sunday two days after my surgery I was gently pushing my IV pole, catheter bag secured and wearing my own bathrobe and slippers,  to amble  around the P.O.T.U. floor proper.  These little jaunts did not last long, I had learned from experience that I needed to build my endurance in small increments.  Marathons were not being attempted at this time.   As the weekend drew to a close I was mobile, managing my pain but still not sleeping well.  My IV had been changed, now on my  dominant right hand, it hampered me slightly.    Sunday would be my final night in P.O.T.U., the critical aspect of my post surgery was over and the next day I would be moved to another room on another floor.   My journey from Patient to Person continues:  I was getting better.

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.

What I know so far...

What I know so far
   Is that the Sun is shining
     Spring is near
        and I have Cancer

What I know so far
   Is that I am alive
     The days are growing warmer
        and my question needs an answer

What I know so far
   Is that my life has meaning
     my future is always changing
        and I can cope
    
What I know so far
   Is that I am loved
     my fears will fade away
        and I have Hope.

Written March 21st, 2014, nearly a month after my Colonoscopy showed cancer in my colon.   I don't know staging, or prognosis.  I won't know til my doctors review the CT scan of a few days ago.   The results may be insignificant or may be life-altering.   For now, for today, life goes on, and I go with it.

A Saga, Posing Twists

     Up til now I've had two Colonoscopy procedures.  The first changed my life when cancer was discovered.  The second reassured me that the procedures I had endured up til then were not in vain.    On February 26th, I would undergo the Colonoscopy process for a third time.

     Two weeks prior to my appointment I met with the doctor that would perform the procedure.  We went over what would happen,  discussed the risks (minimal), and when I left the office I had a prescription for Purge-O-Dan.  More importantly, I was confident that I would be in good hands.   I would endure the ordeal that is the purge, which consists mostly of eating Jello and drinking a lot of liquids.   And a visit or two (or 17)  to the washroom.  I would endure the cold and soreness that seems to be my constant companion these days.   On the day of the procedure I would wear my extra heavy wool socks.  They'll let you keep those on at least.

    I arrive at the Hospital almost an hour before my appointment.  I'm registered first in the Admitting department,  and am handed some paperwork for the next phase.   This next phase is to wander through the maze of corridors to arrive at the waiting room for my procedure.  I deposit my freshly printed paperwork, and wait for my name to be called.    By arriving early, you get the full benefit of waiting, which apparently is More Waiting and Thinking What's About to Happen To You.

    I can't read with my eReader, I can't concentrate and I'm cold and tired.  I pace and wander around.  I look at the signs posted on the wall, which proclaim 'No Food Or Drink in This Area'.   I look at the chairs provided, some of which have beverage holders.  I strive to keep myself occupied,  but don't succeed.   In actuality I probably don't wait that long.  My name is eventually called.   My Colonoscopy is inching nearer...

   Every Hospital procedure requires that a patient be gowned in Hospital-issued clothing.  As mentioned earlier,  I was able to keep my warm socks.   Since having a Colonoscopy means curtailing calories for several days before the procedure, your body doesn't have all the fuel it needs to keep you comfortable.  For me, having a Colonoscopy in Winter means no chance of being warm and comfortable.   Wearing only a Hospital gown doesn't help.   Fortunately I would be in a bed for the remainder of the process.   Nurses would hook up an IV to my arm, and sensors would be attached to my chest.   I would have sticky tape residue on me for days afterwards.   I can honestly say that the only pain in the entire process was removing the tape.   Even though I'm in a bed I'm encumered with wires and tubes but figure I can probably read something now.  Then I realize that my eReader is in my jacket pocket.  In a  bag.  Under the bed.  It may as well be locked away in an underground vault in Greenland.  Instead I  close my eyes and try to rest.  That doesn't work, but it gives me something to do.

     Soon enough my bed  (with me along for the ride!)  is wheeled into the procedure suite.  Anesthesiologist, Doctor, Nurse, and Nursing Student are attending.  I'm going to be a learning experience for someone.  Hopefully a positive experience for everyone involved.   My nurses are fussing over the sensors, apparently they're not adhering properly to my chest.  More waiting while the sensors are adjusted.  My glasses are gently removed by someone.  I'm  asked to turn on my side.  The procedure is ready to begin.  I wonder when it will start...

     I wake up in the recovery room.  My procedure was probably 20 minutes, but I have no recollection of the exam or being brought back to the recovery room.  I was asleep for the entire process.    Now that time has passed, I can piece together the conversation that I had with my doctor about what he found during the process:   A polyp was removed, near the original surgery site.  There was some concern about the scar tissue, and the polyp would be sent for a biopsy.  I would leave the Hospital positive that everything was fine.  I would add this to my list of 'routine, boring, ho-hum' tests.

    Your stay in the recovery area for a while.  How long depends on  several factors: Your doctor's recommendations  of course, but  more importantly by a fundamental action you need to perform:  Pass Gas.  The longer it takes to achieve this result, the longer you remain in the hospital.   Suffice it to say that my lone technical contribution to that day's process was achieved.  Several times.   I could go home.

     You are not allowed to drive, operate heavy equipment, and should not make financial decisions when you are just out of surgery.   My caregiver was my chauffeur and my first decision of the day after I left the hospital was to eat something that wasn't Jello. 

     I would later find out that yogurt is probably the better way to resume normal eating activities:  it's not so hard on your gut to restart  its normal processing.   Yogurt would certainly be gentler than the  breakfast fare I had that morning.  I  really wasn't that hungry, but I was very tired.   I would spent the remainder of the day alternately napping followed by bouts of doing nothing.  I had successfully completed my third Colonoscopy.  Now all I had to do is wait for the results.

     When I left the Hospital,  I was given an information packet that indicated I was to  contact my doctor's office within six weeks to discuss the results of my procedure.   I called the next day and was politely informed that the biopsy would be a few days.  And a few days later I received a call:  my follow up would be on March 20th, almost a month away.  I felt confident that I had breezed through my Colonoscopy without issue.   Then on Monday, March 10th I received another call, this time from my Oncologist.  She had read my results, and there were some concerns.  In two days I was being asked to come in and see her to discuss the findings.  

     During that intervening time I thought a lot about what this discovery meant.  Would it mean a little detour on my journey, or the start of a path through uncharted territory?   I didn't sleep well for those two nights, and I thought a lot of what I had gone through and wondered if I could do it again.    In two days I'd know more, but until then I'd just have to wait.

    Finally one more observation:  the title of this post is: 'A Saga, Posing Twists'.  It's an Anagram for 'waiting to pass gas'.   Who says you can't have fun with a Colonoscopy?

Family Day

     A few years ago the province of Ontario announced that one day in February would become a civic holiday known as 'Family Day'.   I like civic holidays, as I usually get to sleep in.   Unfortunately this February the  holiday fell on Monday, February 17th.  No sleeping in for me that day, I was to meet my newest doctor.

     Back in October of 2013 my Oncologist  mentioned that I was due for my three year follow-up Colonoscopy.   An appointment was made that coincided with that particular February Civic Holiday.  Now a cold Monday morning finds me at my new doctor's office for my 8:30am appointment.  So much for sleeping in on a  holiday.   Meeting a new doctor means being prepared to go over not only my current  medical conditions, but past history,  and family history too.  It helps to have a list of all the meds you're currently taking.  It also helps when a family member, in this case my sister, fills you in on all the details of your parents medical history.   Both my parents had two incidents of cancer in their lives.  Both my parents died of cancer.  A detailed family history can make a crucial difference.

     Past experience has taught me that the 'patient waiting room' means be patient in the 'waiting' room, so I bought along my usual entertainment device: eReader and tablet.  I was ready to wait!

     However a deserted waiting room greeted me when I arrived that morning.  I suppose people were taking advantage of that sleeping-in-on-a-holiday thing.   The receptionist verified my health card and mentioned that some places were now refusing to accept the old Red and White OHIP cards.  My card is held together with tape,  the magnetic strip is scratched and unusable, the numbers are faded.  It's been with me through all my medical adventures,  but today it served me once more.

    Registration continued with paperwork for me to fill out:  my medical history, my current meds, allergies...all the usual questions. Except for Crestor and Vitamins D and B12, I take very little in the way of medicine.  Once completed I sat down for perhaps two minutes before I was ushered into the medical examination room.   I would wait a couple of more minutes before the doctor arrived.

     When he arrives, we chat about my current condition, why I am referred to him, if I notice any changes in my bowel or general health.   He asks about my Cancer and the treatment I received, and seemed surprised that I had liver surgery for the metastases.  I recount my  history and family history  There's a routine examination, and I'm up on the table being 'poked and prodded' once again.   Nothing apparently out of place and I'm headed back to the receptionist to confirm an appointment for the Colonoscopy exam.    I'll be scheduled for the next week, on February 26th at 08:40am.

     My appointment confirmed, my prescription needed to be filled:   laxatives and the preparatory agent know as Purgeodan.  In my past I was always prescribed Colyte for this process, I wonder what the differences will be.   I arrive at my usual pharmacy and discovered that they couldn't fulfill my prescription that day.  Although it was filled by the next day, it is advisable to not wait til the last minute.  Now all I need to do is plan the days until 'the main event'.

     For myself the dreaded 'purge' day actually takes a bit of planning menu-wise.  In general I've followed my old regimen to gradually reduces the food intake and the type of foods consumed prior to the purge.   In general it goes something like this:

     -No blood thinners / aspirin a week before the test

     -soft foods three days before the test, and no fibre/nuts,  things like scrambled eggs, mushy foods

     -two days before the test was full fluids:  plain yogurts, cream soups, nothing that you actually chew.  No fruits in the yogurt either!

     -one day before the test -the day of the purge is clear fluids only: so clear chicken broth and jello,  black coffee or tea, and those jello's better not be red or blue!

     The idea was to reduce the fibre and solid food intake, hopefully keeping lots of fluids in you for the day of the purge.  Gatorade was suggested to keep the electrolyte levels up.   Jello is suggested to fool you into thinking you're eating something good.   I only eat Jello when I have to,  sadly that summertime staple is now firmly associated with Hospitals and ("unfun") procedures.

     One week before my test and I've had my prescription filled,  and menu planned.  My work schedule is cleared and I have two days to concentrate solely on my health.  I'm as ready as I can be.    I've done this before, so not concerned about the procedure.   The only thing that matters is the results.    In seven days I'll go through a twenty minute procedure.   Twenty minutes that may change a life forever.

     In all likelihood I won't be conscious during the procedure.  Where else can you say that doing nothing for twenty minutes is the best thing you can do for your health!?  I just hope I don't sleep in that day!

Cold Prophecy

     Another Christmas, the fourth since my Cancer diagnosis of 2010.  This one was reminiscent of those of my youth in Northern Ontario, featuring as it  did snow and cold weather.  The New Year would bring more snow.  A lot more snow, due to a weather phenomena whimsically referred to as "The Polar Vortex'.  My dreams of  a vacation of idleness and relaxation were rudely dashed by episodes of snow shoveling, punctuated by numbing cold.   I'm getting older, my bones ache, I feel the cold that much more.  I'm  such a wimp.

      January crawls by, the cold creeping into the house causes the furnace to run continuously.  I dread the upcoming heating bills.  My only exercise is shoveling snow and my short walks to work.  I think if it wasn't for the B12 shots I receive monthly I'd have no energy to do anything.   This is my "Winter of discontent".

    January starts the quarterly cycle for my post-cancer blood work protocol:  every three months I show up a the local Cancer Center lab, where my blood is drawn.  The blood is basically a check of the CEA  values.   Since my treatment stopped 3 years ago, I have regularly had this test every three months.  To date, there have been no significant findings.  This is a good thing.  I will keep going  until my oncologist tells me to stop.

  There will be a more invasive procedure however:  In February I will meet with a new surgeon to discuss my upcoming Colonoscopy.   Three years since the last visit in 2011, time for some internal spelunking.   In the meantime I will be taking advantage of a free seminar put on by the local Cancer Clinic to talk about nutrition.   It's easy to fall back into old habits, and the price you pay is to watch your weight rise and your waistline expand.  The hope is that a little refresher on basic nutrition for (former) Cancer patients will help me manage both my caloric intake and my dietary motivations.  Plus I probably shouldn't eat everything put in front of me as if I'll never have that chance again.

    Aside from the fatigue of just getting through the dark dreary days and energy-sucking cold, I find that I'm tired and finding it hard to concentrate.  The simple explanation:  it happens when you get older and don't go to sleep early.   I hope that this year I start getting to sleep before 2:00am.  So far it's been an under-achieved goal.

      For once our television meteorologists are correct in their predictions:  they said it was going to be cold and it was.  I'll have my procedure in another month, and really can't predict the results of my tests.  The only thing I know for sure right now, is that January I spent a lot of time out in the cold, and sometime in February, I'm pretty sure I'll be out cold!  Hopefully the results of these tests will be ...heartwarming. 

A shot in the arm...

     For some time now I've been debating the merits of further posting to my blog.  Essentially I'm as good as I'm going to be regarding my Cancer treatment.  My last visit with the oncologist bolstered my confidence that this particular colon cancer likely won't re-occur.  My liver is in good shape apparently, and does whatever a liver does without any problems.  I'm not scheduled for anything major, save for a colonoscopy sometime in 2014.  Until then, it's basically dullsville as far as the cancer game is played.

     So what do I write about?  There are of course still some mundane yet medically important aspects, not directly treatment related, but helpful anyways.  For instance, I've never got a Flu shot.  Oh sure I figure I've lived through Cancer and can revert to the stoic 'nope I'm a survivor I don't get the flu (only life-threatening illnesses...)' mentality.  But realistically a short chat with a medical professional (a rather persuasive pharmacist in my case) convinced me of the merits of taking the proactive approach.  Basically if I get sick and cancer comes back (OR if the cancer comes back and I get sick) my immune system would need all the help it can get.   So I opted to get the shot.

     Having never had a flu shot before I wasn't particularly worried about Yet Another Needle in my arm.  I'm stoic, remember?   The pharmacist invites me to get behind the privacy screen where I'm informed that the shot will be high up on my arm.  Easiest thing to do is to simply remove my shirt.   I'm glad for the privacy screen, it means I won't be causing casual passers-by to faint at the sight of my less-than toned "muscles".  Or be blinded by the reflected glare off of very pale skin.   The shot is over in a minute, and I don't bleed.  A comment from the person giving the shot is that men don't bleed like stuck pigs; I guess we're basically all clotting fools.

     The shot completed, my shirt rebuttoned and I'm ready to leave....but..not yet.  Apparently there's a little cautionary note in the pamphlet handed to the 'flu shot-ees' that advises a 15 minute waiting period after receiving your shot.   Hey more waiting in a medical environment.  I'm pretty good at that by now.

     Fifteen minutes later, no fever, no projectile vomiting, no desire to perform  the Lambada, I'm free to go.  Simple. Easy. Quick. Done.  Some people complain that 'the flu shot makes them sick'.  Over the next couple of day I monitor how I feel, and overall I feel healthy  Until the weekend.  When I got sick.  Apparently migraine headaches due to a combination of weather change (it got cold) and not keeping hydrated were my undoing.  The flu shot prevents a bad case of the Flu; it doesn't stop you from being dumb and not taking responsibility for your own health.

     One week later and I'm as good as I usually am (other than a rather humiliating loss at chess to a young lady; who despite not yet being a teenager, is quite talented.  Did I mention I was humiliated?!).  I wonder if there's a shot to make me  a better chess player?  Probably not:  science is good but I'd need a a Miracle!

Protocol visit 2/2

     My post-cancer protocol calls for two visits a year to my Oncologist for general check-ups.  My first was without incident and my second would require a CT exam.     The exam occurred in September, and here in October, the day after Canadian Thanksgiving finds me at the Cancer Centre once more.

     Even though it's six months between visits, I still remember the procedure to follow:  stop at the main reception, get paperwork.  Next, go to a registration kiosk and  perform the ESAS survey (No Pain, Yes I was tired cuz I work all day, yes I'm anxious cuz I'm in a Cancer Clinic...).  Print survey results, hand paperwork bundle to another receptionist. Wait......

    Soon I was called in by the nurse, and the preliminary weigh-in (187 pounds) and some general questions about my health were recorded.   I was led to another exam room and asked if there were any specific issues I would like to discuss -not this time.  My nurse said that the doctor would be in soon.   Which meant I could open up my Android Tablet and do web surfing to occupy my time.

   The Oncologist arrived just as I was able to log on to the Hospital's public internet.  With my Chemo Chronicles Blog page on the screen (what else would I want to read at the Cancer Centre?!) I  offered my doctor a chance to see what a patient writes about the Cancer experience.  She accepted and spent a few minutes reading my last entry, detailing the CT I had the month before.

     I learned something that Oncologists who read that they 'Poke and Prod' a patient are actually performing a Clinical Examination.  But then she called me a WIMP.....

    It seemed that she was (mildly) amused at my description that the Worst Pain of  a CT is the bandage removal (hey it left a red mark and everything!  ) So my thoughtful,  caring medical professional used one of her numerous medical definitions to classify me as a "Wimp".   She's not wrong however.

  The Good News is that the CT of the liver showed no problems.  Nothing in the CT to be concerned about in general.  Although she did not have the CEA results from  my blood work it is unlikely that the numbers, which haven't changed in several years would spike up in the past few months.   I was extremely relieved at this news, and I could probably amend that ESAS report for 'Anxiety = 0'.

  Some discussion that in the next year I would have my three year Colonoscopy follow-up.  But that's routine by now  (Been there, done that, got the Johnny Shirt).   She mentioned that rather than a CT there might be an Ultrasound (I've had a few CT's now, more than I ever wanted).   However the big takeaway from this session is that the Cancer likely won't reoccur. 

     I left feeling satisfied,  with more confidence that 'The Big C' and I are done with our dance.   One more year remains according to the protocol I'm following.  One more year of quarterly blood tests and maybe one or two visits with my Oncologist.  Should  all the result be good, there's every reason to believe that the Cancer Centre and I can go our separate ways.  

YACTS -Yet Another CT Scan

     September 9th and I'm ready for my latest CT scan.  I've got my cell phone turned off because that's what the sign in every Hospital waiting area requires.   However my wi-fi enabled Android player is on.  And  my wi-fi enabled eReader is looking for hot spots.  Fortunately for the Hospital, I didn't bring my Netbook or Tablet!

     Back in May I did the first of two visits required by my post-cancer protocol.   During the prior visit I was basically poked and prodded by my Oncologist.  For the upcoming visit, I would need something more "medical-ly" ("medical-ish"?):   a CT scan.  CT exams have the remarkable ability to peer inside a human body by blasting it with radiation.  The downside of course is that they blast you with radiation.   Apparently Protocol required I get Yet Another CT Scan.

     A letter from the Cancer Centre  arrives, with details  indicating the date and time of my CT.  I'm instructed to have blood work before the CT, outside of my normal quarterly procedures.   I would also have to purchase the whimsically-named "Redi Cat" contrast drink.  Foremost was a requirement that I call the Cancer Clinic and report that I had received and read the letter.  Which I did and a question arose:  Did I really need to drink the Redi Cat.  I was pretty sure I didn't last time (or was it the time before? I can't remember -hint: RECORD EVERYTHING!)    The person on the other end of the call made some inquiries on my behalf, and they decided I didn't need to drink liquid chalk after all.

     I avoided the busy Clinic day that would surely occur on the Tuesday following a Labour Day weekend, and my cleverness to go mid-week for blood work was rewarded with a 15 minute in-and-out process.  All good, everything clicking along like clockwork so far.  My CT was on the following Monday.  I am not worried about CT exams, veteran that I am, it's just that if you keep looking I suppose you will eventually find something.   I'm not keen on surprises anymore.

    I am not supposed to eat or drink four hours prior to the exam.    So you change your morning routine, you skip breakfast, you skip that morning cup of coffee.   You also need to be at the hospital at least 30 minutes prior to the start time of the procedure.   Although a CT occurs in Diagnostic Imaging, the first place you go to is Admitting.  In Admitting a pleasant lady asks me for my OHIP card, my address, and why I'm in the Hospital today.   My responses earn me a smile and a piece of paper.   I then walk  over to Diagnostic Imaging, where I hand this paper to another smiling  lady.   In return the smiling Diagnostic Imaging lady hands me a pager.  This device will flash it's lights when the technicians are ready for me.

     I  can't get comfortable sitting, so I stand up and pace about.  I'm always cold in the Hospital.   I am hungry and really thirsty.   As if reading my mind, a clerk asks if I've brought my Redi Cat drink.   I'm sure the clerk has seen bewildered and uncomprehending looks on patients faces before.  But she's never seen my look of bewilderment.   It appears that I misunderstood the requirements:  I needed to drink the RediCat.  Technically I was supposed to drink some before I arrived, and then drink the rest  just prior to the exam.   I was mildly reproached that the Hospital runs the examinations, not the Cancer Clinic.  Since I hadn't followed the proper preparation the scan couldn't be done at the scheduled time, but I was presented with two options.

     The first option would require rescheduling the exam (and buy the RediCat in advance).   The second option would require I drink an elixir kept in the Vault of Terrible Tasting Concoctions just for people like me.    I chose to drink the Terrible Tasting Concoction.   After that I would be required to wait another full hour before  they could examine me.      

     The drink wasn't that bad, and helped to reduce my thirst a bit.    I only had another hour to wait, but it would be a miserable hour.  I was cold and kept standing up and moving around.  I couldn't get comfortable.  My attention span is measured in microseconds, so lugging 8 pounds of electronic  gadgets with me wasn't my best idea.   Eventually all annoying things come to an end and my pager went off,  displaying the room location I needed to be at:  Room Zero.

    Room Zero is the preparation room where an IV is inserted.   While the CT shoots radiation through you a contrast material is pushed into you via the IV during various parts of the CT scan.  This contrast material interacts with the contents of the Terrible Tasting Concoction I drank earlier and when hit with radiation produces a Warhol-esque picture of your insides.  I would microscopically glow in the dark.  From the inside.

     Earlier in the week I had blood work.  That day I also received my montly B12 shot.  The IV I was about to receive would be the third puncture in the Injection Triad.  It's not the needles, it's not the blood, it's not what they pump into my system, it's the tape that bugs me most.  Tape is used in hospitals to securely fasten IV's to patient's arms so the needle's don't spurt out at critical times.  Like in the middle of a CT.  Therefore the tape needs to be strong and adhere well to skin.   Which means peeling it off will remove all the hairs between the tape and the skin.  And probably some of the skin as well.  It will also leave gummy gray residue for days that neatly outline where your bandage once resided.   But it's only tape.

     The exam is routine by now.  I remove anything metallic from my  pockets.  Since the exam is my midsection  I simply have to lower my pants.   A light cover is provided for my modesty.  Which is pointless given that a CT looks though everything.  I still take the blanket.  The technician has me lie down on the table feet towards the entry tunnel of the CT device.   My IV port is connected, ready to receive the contrast injection.  My arms are flat back.  I'm completely streteched out, looking upwards.  The table begins to move towards the entry.  I always close my eyes during this exam...

     A voice comes over the intercom telling me to take a breath and hold it.  The table moves out of the ring and I'm instructed to breathe normally.  The contrast injection is next, the voice makes the same breathe-and-hold request.  I can feel the warmth of the liquid as it's infused.   I'm warm around my ears, my neck and my lower butt.   Fortunately it's not what you might think and after another pass through the ring my exam is over.   The IV is removed, and that industrial Hospital tape covers the site.  I get to pull my pants up and go home.

    After these exams I'm always wound-up, thinking that every phone call might be from the Cancer Clinic, saying they found something.  As days turn into weeks with  no such call,  I finally return to normal.  Or at least my version of normal.

     I won't know my results until I meet with my oncologist in October.  It's only a few weeks away.   The vague worries  I periodically experience are probably the same for every Cancer patient after a test.  But I feel OK right now.  And that's good enough to live with.

Soggy weather

     July was not really interesting, either as a month or medically in my life.  For most of July It rained or was hot, and frequently it was both.  But medically it was boring.

   I would do the quarterly blood work for my post-cancer protocol.  There would be no follow-up  phone calls indicating a problem.   I would see my family doctor to get my Crestor prescription refilled.  Aside from 14 hours of fasting, there was no issues with that blood work either.   And I would get an x-ray of my left hand, because I was complaining of soreness.

  It's probably arthritis. It's probably nothing.  It's probably the fact that I'm over 50 and hyper aware of my aches and pains.  The cancer may be gone. It's probably gone, but the doubts remain.  So now every little ache leaves me wondering if it's something dreadful working it's way back into my life.  Am I to be forever scared? 

  So July passes to August,  my tests are all negative, and I'm scheduled for more tests:   a CT scan in September.   Then a meeting with the Oncologist in October.  My monthly calendar arranged by  medical reviews.  I promise myself to watch my diet and exercise 'more often'.   My entire exercise regimen consists of walking or bike riding.   My 'gut feeling' is that my health is best served monitoring my caloric intake first before  trying to sweat it off. 

  I don't have any fun medical things planned for August.  The last bits of my Cancer Protocol  seem to be winding down.  The more boring medically, the better life is.  Pretty soon there won't be anything left to write about, and my blogging "daze" will draw to a close.  Then I can spend all my time doing much more useful things, like complaining about what soggy weather we're having.

 

Every walk is important

     Idyllic spring weather for me consists of days that are not too warm, skies that don't threaten rain, and evenings with a view of the moon and stars.  On June 21st I shared just such a day with hundreds of others during the 2013 edition of the Canadian Cancer Society's Relay for Life.

     Relay for Life is an annual event held in numerous locations across Canada.   Their goal is to raise money for Cancer research.  Their ideal is to erase Cancer as a disease.  Throughout this twelve-hour event,  they honour those who made it through their ordeal, and  reflect on the ones who have passed.   Their creed is summarized as:

     CELEBRATE - you are a survivor!
     REMEMBER  -  in honour of the ones we've lost
     FIGHT BACK! -  and help other so they don't have to suffer

     Early in my post-cancer period I had visited the Relay For Life  as a spectator.  During those occasions  it was to remember the passing of my parents.  Naively I had assumed that I needed to be "five years cancer free" to be considered a survivor.  Nothing so formal is required:   being alive and fighting Cancer makes you a survivor as far as I'm concerned.  But I wanted something definitive to tell the world --and myself-- that I was done with Cancer.   What I hoped to get was door-slamming, "In your face, Cancer!" closure.   So I signed up to do the Relay for Life Survivor Walk.

     The process begins with registering on the Canadian Cancer Society's website.   As a survivor, you are not required to pay an entry fee, and your yellow T-shirt says "Survivor" on it.  I'm not particularly fond of yellow, and the primary colours of my wardrobe are White, Black, Blue and Gray.  In particularly flamboyant moments I've been known to for the 'daring' earth tones of Beige and Green.   On this day however I am  resplendent in Daffodil Yellow:

Windsor/Lasalle Relay for Life, June 21, 2013

     I can truly say, "Been there, walked that, got the (survivor) shirt."

     In the weeks leading up to this particular event I would casually mention that I would be walking the Survivor Lap, as the inaugural lap is called.  What surprised me was the enthusiastic offers of people willing to pledge.  I did not wish to solicit sponsorship at this time, as I had distinctly mixed feelings about my motives for this event.   It is difficult to articulate, but suffice to say this was something personal between me and Cancer.

      On the event day itself I was eager to get going, to be among other survivors to hear what they had to say, to share this intensely personal experience with others who just know what you've gone through.   Upon arriving at the Relay site,  we received VIP treatment:  preferred parking for Survivors, so we didn't need to walk the approximately 17,000km from parking lot to the venue.  

      More pleasant surprises, the registration had a novelty 'hand tracing' banner.   All survivors were encouraged to trace their hand, as a sort of group High-Five I suppose.   During the event it would precede the walkers, carried forward by willing volunteers.   Speaking of Volunteers if you've got some spare time and are looking for a cause, I'm sure the CCS would be interested in hearing from you.

      Supper was in that fine Summer tradition of  hot dogs, hamburgers (or veggie burger in my case), pasta and salad, coffee and dessert.   Cheerful volunteers served us in picnic-buffet style.  I had lost my  ticket entitling me to a free dessert shortly after registration.  But I suspect the un-missable "Survivor"  caption on my shirt got me a yummy treat anyways:  cupcakes that were tasty works of art.

      To my way of thinking, the Relay For Life bears a similarity to a Wedding reception.   Both have lots of guests.   Both feature enthusiastic participants.  Both have lots of food and entertainment.  And finally, both have lots of after-dinner speeches.    As I was in the group that was to kick things off, we were semi-sequestered far from the stage where numerous officials, politicians, community leaders, fund raisers, and CCS representatives talked at length about why we were all here.   Though I missed most of what was said, my observation of the audience tells me they liked what they heard.   Speeches completed, the Knights of Columbus would be the honour guard as the walk commenced. 

      By tradition, the youngest survivors lead the walk.  They may be kids, but thanks to events such as the Relay For Life,  they are kids with a future.   Flanked by the K of C honour guard, we proceed with that inaugural lap.   I'm aware of how proud I feel to be here.  I'm startled out of my introspection when I suddenly realize that everyone wants to  high-five the survivors as we walk by.   Little kids reaching way up, eager to do their share to help us Survivors.  I'm happy to oblige and make sure I slow down to gently tap  small palms.  Victory assured, I keep walking.

      I walk fast.  I suspect that to some observers I might have appeared somewhat over-eager.  Initially the walk started out solely as Survivors.  Halfway through the Care Givers were permitted to join in.  As my first Survivor Walk drew to a close, I tried to figure out how I felt, if I had a better understanding of what I had gone through three years ago.  But it was just a walk,  shared with some nice people.    My hoped-for  closure did not manifest itself.  There wasn't any over-the-top emotional spillover.   I think I've  had enough cancer-related emotional drama for a lifetime.

      Yet I can't deny it wasn't uplifting to participate in the Survivor lap.  I had set out three years ago with a plan to get through treatment and return to work.  I reached my objectives and was satisfied.  I thought perhaps the Survivor walk might invoke a feeling of sadness for a life so changed.  But no tears from me at this time.  Later that evening however,  I would be emotionally ambushed  during the Luminary Ceremony.  

     Perhaps the most intensely  moving experience of the this twelve hour evening event is the Luminary Ceremony.  At its core it is  a simple thing, a white bag that wouldn't look out of place if it contained sandwiches and an apple.  Within this flameproof bag however is a small votive candle.   Upon these bags are written  the names of those we need to remember.  The names of those that may be going through their journey.  The names of those that made a difference when your life changed forever.   There are thousands of these little white bags, some, plain and unadorned (like mine), others cheerfully decorated.   Some bearing photographs or prayers.  Some are works of art.  They are all paper shrines with emotional bonds stronger than forged steel.

      As dusk approaches, prayers are said for those who have passed, and we observe our moment of silence.  I think of family could not be here this night.  Of coworkers and friends who were abruptly taken away by cancer.  Twinge of guilt for not being among their number.   Twilight no more, night is about us.  A moon close enough to be called full is rising.   The Luminary candles are lit,  while  the piper stirs within us that haunting sadness  whenever  "Amazing Grace" is played.   A ribbon of light encircles the field.   I walk around the track to find the two Luminaries reserved for my parents yet unlit.

     I cannot get to the luminaries reserved for my parents.  A woman sitting perfectly still blocks access to  them.   I cannot see her face, nor determine her age.   I presume that her luminaries are adjacent to the ones for my parents.  Another woman approaches, dressed in the same uniform as her seated teammate.   She kneels beside her friend,  maybe sharing in grief, maybe consoling her, I do not know.   There is no sound of crying,  but the shoulder-wracking sobbing is unmistakable for it's anguish  .  At that moment I'm profoundly saddened for her loss.  Self conscious now that I'm wearing a bright yellow shirt boldly proclaiming "Survivor".   Not wishing to intrude on this intense event, I quietly move away.   I do not wish to meet her eyes if she should look up.  How would I answer the unspoken question of why one survived, and one did not? 

         
      I continue my walk that evening with conflicting emotions.   I'm proud for meeting my life's toughest challenge,  but humbled by a stranger's grief.   There would be no cathartic release for me this evening, no feeling of joy at 'beating' cancer.   The walk did not release me from Cancer's hold, any more than it could erase other painful memories in my life.   Although my expectations of closure were not fulfilled, I did  not leave disappointed. 

     I guess what I learned from this event was  that in order to celebrate my life I don't need any grand gestures.   Whenever I want to explore life,  I just need to open up my front door.  And go for a walk.  

Protocol visit 1/2

     It's now May 2013, two years 'cancer free', and my post-cancer protocol has me visiting my Oncologist twice a year.   I'm somewhat anxious as I step once more into the Windsor Regional Cancer Centre.   Although I'm no longer receiving treatment, there's a twinge of anxiety when I sit down in front of a terminal to enter my health survey.   First challenge:  remembering my password.    Once logged-in I answer queries about my health in a mechanical, perfunctory fashion.  All the answers are scored on a scale from One to Ten.  Most of my answers are on the low-end of the scale.  I'm  telling the computer that basically everything is OK.   I hope I'm right, because shortly my name will be called and I'll be brought to the exam room.

     First there's a matter of stepping on a scale.   I divest myself of cell phone, wallet, keys, eReader, android device, pens and pencils, loose change.  I didn't bring my back pack with me this visit, 'cuz I didn't want to bring too much stuff...   I briefly consider removing my shoes, after all, I want to be accurate with my weight right?   I weigh-in at 186 pounds, not too bad.   It takes me a while to get all that junk back into my pockets, and then I'm shuttled to the exam room.   As the doctor walks in I realize that an exam requires that I be lying down on the  table,  which means I have to empty out my pockets. Again.

     My nice Oncologist lady sees the eReader I'm removing from my pocket.  A Kobo-Mini, very nice compact little device.   We chat for a couple of minutes, she smiles at my enthusiasm for electronics gadgets -boys and their toys.  Now the toys go back out of my pockets and onto the chair.  I get on the exam table.

     Although my primary cancer was in the Colon, it had spread to the liver by the time I was diagnosed.  Surgery and chemotherapy and a lot of support helped me recover.   My Oncologist is performing a follow-up check on my liver looking for whatever symptoms mean bad things might be happening.   Apparently the process of meticulous abdominal probing involves tickling the patient.   As the exam continue I am required do take deep breaths.   She's apparently satisfied that my lungs do what they should be doing.  And we're done.

    Once more I shovel all that hardware back into my pockets. My Oncologist is pleased that things are going well, and she reminds me  to keep going for the quarterly blood work.  I'm to be scheduled for yet another CT in September.  Note to self:  ask the doctor how many CT's are too many?

    Overall I'm relieved;  you can't help but feel happy walking out of a Cancer institution with no strings attached.  Or an I.V. tube.  It's the little things that make a difference.

     A day after my recent visit with the Oncologist,  I get a phone call:  my CT appointment has been scheduled for September.  I'll go for my blood work sometime in July.   However before any of that happens I register for the  Relay For Life :  I've decided to  join in on the Survivor Walk this year. 

     So this June I'll join with other survivors, walking  the inaugural lap of the all-night Relay.  I'll walk to show that having Cancer is simply part of the journey through life.  I'll walk and remember where I've been and how far I have yet to go.  And I'll get there, one step at a time.
    

The Month of Yellow Flowers

     This April 2013 marks the 75th anniversary of the Canadian Cancer Society.   April is also the month to wear a Daffodil, the yellow flower used to show support for those whose lives have been touched by Cancer.  Even though I've been through the whole "Cancer ruined my day" thing, I never had direct experience with the CCS until recently.

     During the prior month of March I wrote about the joys of getting tested for Colon Cancer at the request of the CCS.   Given my history, how could I refuse?  A complete surprise however was the subsequent invitation by the CCS permitting me to be present for the announcement of a new research program targeting Brain Cancer.   Intrigued by the prospect of meeting people actively involved in Cancer research, I quickly accepted their kind invitation.

     So on a cold but wonderfully bright and sunny spring day, I arrive early and wander around the Biology building of the University of Windsor.  The UoW is my old 'alma mater' as a "mater" of fact.  While strolling around the building I run into a group of suit-and-tie types, closely shadowed by folks with formidable-sized cameras being aimed in the direction of the suits. Believing that I've found the promised Tour portion of the program to which I've been invited,  I nonchalantly join in and proceed along with the group as they visit various labs, showing the machines that will hopefully coerce more secrets on how Cancer works.  I meet the Doctor who will be the recipient of the CCS grant and she patiently explains to me how the process is intended to work.    Details may be found here.  Suffice to say that diagnosing a cancer in the brain as a Brain Cancer -and it's subsequent therapeutic treatment -is difficult.  A cancer can be in the brain as a result of a primary at some other area.  Unfortunately it seems that if you treat for the wrong primary, the results won't be good.  Thus the vital need for research of this nature.

     During my conversation with the recipient of the CCS research grant,  it slowly dawns on me that something is not quite what it ought to be.  It appears that this is an official tour for the CCS CEO and staff members.  I've unwittingly invited myself in.  I'm bemused, but that feeling turns to one of embarrassment as I'm called upon to pose in a group photo and I quickly realize I'm suffering from a minor fashion faux-pas.  It wasn't the lack of a tie, or lack of a sports jacket, or even that my dress shoes were more casual and less shiny than my counterparts. No it was when I realized that I was not wearing my Daffodil pin.  Here I was, the veteran (and scarred, I can prove it!) Cancer survivor, amongst the very people who provide researches with the funds to help guys like me.  And I'm not wearing their eye-catching and very distinct logo!

Hey bud, where's your yellow flower?

      No one seemed to mind, and at the promised (and tasty) luncheon there were numerous pins thoughtfully provided for people like me to show support for, well, people like me I suppose.

    The luncheon flew by as I chatted with various folks about their stories,  sharing that intangible camaraderie that only those that 'go through it' seem to have.  I gratefully thanked the  CCS and summarily returned to work, glad to have a peek at what kinds of things are required to do nitty-gritty  bio-medical research.   I'm so glad I'm in I.T.  But my Yellow Flower story did not end there.

     A few days later a package arrives by courier for me.   Inside is a token of thanks from the Canadian Cancer Society:

My own Daffodil pin garden. No watering required!

     April would remain cold and wet and unseasonable for this clime, but I needn't worry.  My Daffodil Garden is full of happy Yellow Flowers reminding me that Hope is always near.

Third Anniversary

     Saturday March 30th, 2013 was the third anniversary of the day I learned I had Cancer.   Three years later and I'm more or less back to my old life.  The fears are gone (mostly) and I live normally, whatever that is at this particular time.   However I did not spend my anniversary day in quiet contemplation of what I had overcome, nor in celebration of my apparently victory.  Instead I helped a friend, and volunteered at a chess tournament for kids.

    One of the odder results from my brush with a life-changing illness was not so much navel-gazing and introspection (plenty of that during my illness) but a re-connection with something I enjoyed:  playing chess.  During my recuperation I had played a bit and sometimes served as 'chess fodder' for small kids.  I would help out with the occasional tournament, mostly in the "gopher-ing" and "shusher-ing" roles.   I simply enjoyed the experience of helping out with something not about my illness.

    So it was fitting that on this anniversary of 'the news' that I was involved with the playoffs of the Windsor Chess Challenge, a much more pleasant experience.   It was all about the kids and their dreams. 

    As for me, my dreams are just to keep going on as I am, and who knows, maybe even play some chess.