Saturday, May 9, 2015

Shadows revealed

  Wed May 6th, 2015, and I'm sitting in the exam room at the Cancer Centre, waiting for my oncologist once again.  It's a routine experience, but there's been an underlying disquiet during my recent visits that something was not right.  My most recent CT scan was three weeks prior, and I had blood work earlier this morning.  My doctor has arrived, and after the preliminaries, the news I didn't think I would hear for some time has rendered me shocked and helpless once more.

  Shadows in my lung are indeed cancer.  Cancer that has grown since January to the point where it is not considered viable for surgery. The emphasis, gently expressed by my oncologist, is that chemo is not a cure.   I am stunned, unable to think coherently.  For all my years as partner in this deadly dance with cancer, I have never stumbled.  Now the balance has shifted, and I am being inexorably pulled into the vortex where my only options are to hang on for the ride, as I don't think I'll escape.

  As it happened to me over five years ago, I'm only dimly hearing my doctor telling me about my treatment options.  I can feel the sadness well up, my throat cracking as I ask questions I forget, then hearing answers I can't remember.  I have another appointment card being handed to me, the session is over.  On autopilot alone I keep my composure.  We leave the cancer center, but stop at a nearby park.  Tears are the only way I know how to express myself.  When I return to work, the conversation with my manager an echo of the one five years prior.

  The toughest conversation is at home later that night, when I call my sister.   It breaks my heart to hear her voice, full of shock and anger at what I will be going through yet again.  I have no answer for her why this keeps happening to me. That night, exhausted, I'm in bed by 10:30pm, but sleep is filled with tears and despair.  I awake at 5:00am, for I still have another test:  a Bone Scan for my shin.

  I've done two bone scans already in my life, and they've shown that I'm shot through with arthritis.  This one is to find out why my shin is in so much pain.  The doctors and physiotherapist agree it's not a shin split.  The chronic pain of the past few months has abated however, and I'm walking much better.  I wonder if I've been walking on a fractured bone all this time. 

  The technician reviews my medical history, and I matter-of-factly mention the latest findings of cancer in my lungs.  It seems so surreal now, lying on this platform, hands and feet strapped in so you don't move during the procedure. The scan is in multiple parts, and I receive a mild radioactive injection.  For the bulk of the test I am required to lie on my back, motionless, for the better part of an hour.  Curiously I feel relaxed, and if I didn't fall into a deep sleep, I felt..better.

 After the scan I'm taken for more X-rays of my shin. By noon I'm  done and the rest of the day is mine, as I have no desire to return to work.  Still dealing with the aftermath  of yesterday, I resolve to contact the cancer clinic to meet with the oncologist again:  I need hard answers, and this time I'm ready to hear them.

Sunday, May 3, 2015

Another day, another Colonoscopy

    I've had the distinct pleasure of undergoing the Colonoscopy process four times in my life.   Three of those times showed Cancer.   It's been a year since my last surgery, time for a follow-up colonoscopy.   Of course that can only mean one thing:  The Prep.

   Four previous colonscopies and two surgeries have removed any mystery or fears around the preparation process.   The process itself is simple, as I follow the reduced-intake diet.  This means soft foods three days before the procedure, full fluids two days before, and on the prep day itself, only clear liquids.   As a result,  I know I will be cold and tired and  yes, at times, hungry.   But these feelings  only last for a little while.  I'm weary of continually doing this process,  but  will keep doing it again as often as needed.  Because it's absolutely necessary.

  My procedure is scheduled for a Tuesday morning at 9:30AM.  This is good, as I much prefer early morning than later afternoon.   Early morning procedures mean the prep is essentially one day.   My process however begins three days before, on the Saturday:  Soft Food Day.  On SFD I have scrambled eggs for breakfast (and sneak in a pancake).  Supper is more scrambled eggs, and instant mashed potatoes.  Cutting out  fibre seems counter-intuitive, but the process works.  Saturday was fine, save for the ongoing shin pain in my left leg.   I can't have any aspirin or anything that would affect the prep or might be a bleeding risk, so I endure the throbbing.  The most uncomfortable feeling during this latest procedure would be the shin pain; it made sleep difficult and walking painful.  In a few weeks I would be limping whenever I walked, but for now, I just endured it and proceeded with the task at hand:  not eating.

  Sunday I'm on full fluids.  This is actually the worst day in terms of hunger and eating, as there is a sharp decrease in my calorie intake, mostly because I'm eating plain vanilla Greek yogurt,  milk, and cream soups (without crackers!).  I don't particularly like creams soups for a couple of reasons. One, they're creamy, and just don't have the flavour and texture I enjoy.  The other is that they are not pure cream soups: they have bits and pieces floating in them which must be removed.  Suffice to say that I don't eat a lot of cream soups.  I drink a lot of water, some ginger ale and green tea.  I ignore any feelings of hunger, which do go away fairly quickly.  I spend my evening watching a lot of TV and puttering around the house.  Before I go to bed, I make Jello -green and yellow only, no red allowed!

  I book Monday off of work, as this is prep day.  It allows me to sleep in, and only do what I will need to do.   So of course I can't sleep in.  Instead,  I decide to do yard work.   I haven't done anything all Spring (not that we had much of a Spring so far), so naturally I spend the entire morning raking leaves and picking up sticks.  In a little over an hour I'm exhausted.  Moving inside the house I figure that a good sunny day requires a good sunny day activity:  cleaning windows.  That goes well but I'm feeling pretty weak and tired after this much manual labour.  Physical  work without nutrition is probably one of my sillier endeavors.  However  as I don't actually begin the prep until 3:00PM,  I can't just sit around doing nothing or watch TV.  Not yet at any rate..   I'm  not hungry, at least for the choices offered:  Broth, tea or coffee,  and of course, Jello.  Now I liked Jello as a kid.  As an adult I'd make it on hot summer days and throw in a glob (or two, or three... ) of Ice Cream.   After multiple go-rounds with the preparation process and hospital stays, I can honestly say that Jello is now firmly associated with some of the most unpleasant experiences in my life.   Suffice to say, I only eat Jello when I'm undergoing the Prep.  And this morning, I really don't  feel like eating  Jello for breakfast.

 I drink a lot of water and green tea.  I suck on hard candies (only green or yellow) for flavour.  I tell myself that fasting is good for the soul (and waistline).  The hard candies I am trying this time don't mix well with the green tea, and I find my palette has produced that annoying dry-mouth feeling that no amount of brushing seems to cleanse.  A Halls cough-drop however has enough punch to remove the dry, slightly metallic after taste.   But mostly my shin bothered me and  I was uncomfortable sitting.  Or standing.  Or lying down to nap.  My less-that-smart-choice this morning of doing yard work had aggravated my shin.   I couldn't nap, and time passed slowly.  Finally 3:00PM arrived, and I could finally start the preparation proper.

 This preparation is called Purg Odan and it comes as three small packets that, when mixed with water,  form the basis of the process.   Every four hours I need to mix and drink one of these  packets.  They don't taste great, but they're not the worst thing I've ever consumed.  During the process I drink lots of water.  And ginger ale. And tea or coffee (I tried coffee again -instant though, and couldn't stand it.  My taste buds are shot it seems)  Also strongly recommended is to drink Gatorade to maintain electrolytes.   The purge processes suck the liquid out of you and wash away electrolytes as well.   The Gatorade I have is lemony-yellow.  I would sip from it but found it difficult to drink.  I found I had little desire to consume things other than water or the occasional green tea this time.  I was tired and little energy to focus on highly technical activities, like changing the channel on the TV.  And I still was bothered by my shin splints.

 Within a few hours of taking the first packet ("sachet" is what the official packaging labels each packet) I was on my way to purge nirvana.  At 7:00PM and 11:00PM I repeated the process.   Having used other means to accomplish this task, I can say that the Purg Odan was no worse.  In some ways it was better as I didn't feel so bloated after drinking 4 liters of the other stuff.  But the end results were the same:  drink some stuff, go the bathroom.  Repeat.

Throughout the night the frequency and duration of the trips to the bathroom decreased.   Yet it wasn't until 3:30AM when my bowels called a truce.  I could finally sleep uninterrupted for a few hours.

 Tuesday morning and I awoke early, and thirsty.  I wouldn't be able to drink anything two hours before the exam.  Which in my case meant by 7:30AM  I was finished with consuming any fluids.   A good thing, as any liquid taken in wants to go out by any available means it seems.    At this point I'm essentially as cleaned out as I can be, and my weight is about 186lbs.  I've lost about 7 pounds since the weekend.  I'm tired and I'm cold, and I just want it be over.   The time finally comes when I need to go to the clinic to have the last step performed.

 My doctor's clinic has a remarkably large, very well lit, clean and modern looking waiting room.  En suite bathrooms are there for those last minute emergencies.  I arrived as instructed, 1/2 hour before my appointment time of 9:30.  The registration is perfunctory, and my waiting time is minimal.  I'm soon asked to go into the exam room.  I'm on autopilot now, the familiar process plays out as it has so many times before:  change into the standard johnny shirt, but you get to keep your socks on.  "ProTip" -I wore my thickest warmest socks, as the single sheet you are given to cover you won't be warm enough.  Everything is proceeding as it should, but my nurse informs me that there's a delay.  However I'm still prepped with the IV, the only painful part of this whole process is the IV needle into my hand.  My vitals are recorded, and once that's done I can rest.  I'm  somewhat tired but can't sleep.  I'm surprisingly not thirsty or hungry.  My shin pain is bothering me more than anything else.  Time drags by and I realize I left my Samsung Galaxy player in the bag with all my clothes, so I can't even read or play a bad game of chess.  Ten Thirty, I've been in this room for over an hour.  Ten Fourty and it's now my turn.  My bed and I are brought into the surgical suite.   More waiting,  then the anasthesiologist  arrives.  Some questions are asked: No I'm not a smoker - No allergies that I'm aware of save seasonal.  I'm wired up to the various machines that record my vitals, then I'm left alone for a bit.  During this time I play a game where I try to slow my breathing down to trigger the alarms on  the machine that monitors my  respiratory rates.   I'm rewarded by little beeps as I get below 74, but only momentarily.  It gives me something to do.  At last my doctor arrives, now the real fun begins.

 At this point my memory doesn't get hazy,  it simply fails.  There is no recollection what happened next.  One minute I'm being asked to roll on my side, and then...nothing.  My next conscious thought is the realization that I'm back in the first  exam room.  I have  absolutely no idea what time it is.   My nurse arrives and seeing that I'm awake, asks that all-important question:  "Have you passed gas yet?".   I answer in the affirmative.  Without this vital action, I would not be allowed to go home.   But the good news doesn't end there:  my Colonscopy was clean!  I had no issues with the previous surgical areas nor were there any polyps or concerns.  What this meant to me is that I don't have to have another procedure for three more years!

 I'm relieved and perhaps due to the medication I've received during my procedure, my shin isn't bothering me.   It's noon on a  sunny Tuesday, and I have a healthy colon. Life is balanced once more, time to celebrate. A small meal at a tiny restaurant just down the street from my doctor's office marks the extent of my celebration.   I've learned the hard way not to indulge too much too fast after one of these procedures.  However in a few days I'd be eating normally, with no adverse affects.  

 For the remainder of the day I simply rested, with numerous peaceful small naps.  I didn't eat unless I felt hungry, and I only ate a little at at time.  I drank more water, (but still couldn't finish the Gatorade).  This time fortune had smiled upon me, and life is good.  In three more years, we'll see if fortune begrudges me another pass to clean health.



Friday, April 3, 2015

Mystery in the Shadows

  April first, All Fools Day,  An auspicious way to meet one's oncologist.   We meet today to discuss the results of two X-ray's and a CT scan earlier this year.  My family doctor was concerned enough to inform my oncologist.  Now my oncologist is concerned too, for there is a shadow in my lung that shouldn't be there.

  In the oncologists office I am examined,  and all my vitals are normal,  no fever, no cough, and certainly no vestiges of pneumonia from three months prior.   I feel fine, save for an aggravated left tibia: shin splints.  But no, that's not the problem.   My oncologist was concerned about the shadow on my X-ray.  And now, so am I.

  We don't know if it's Cancer or an infection.  The unknown shadow will be viewed by a CT scan I'm to have two weeks from now.  However it was the CEA results from my blood work that I found troubling:  they're increasing, slowly, but steadily.

 Last May my CEA numbers hovered around 1.  Now they're around 3.  These numbers can increase significantly if I was a smoker.  I've never smoked in my life, so this begs the question:  why is it increasing?  Another CT and more blood work  will begin the investigation, but what will be the results?

 So there's a mystery in the shadows, and the possible answers are troubling.  I would leave this appointment preoccupied with the implications of what I had learned this afternoon.   As I was handed the card for my next appointment, I commented to the nurse that this would be an opportune time to say "April Fools".  She obliged my weak comment with a smile, making me feel somewhat better.

 For the first time in a long time I left the Cancer Clinic with less confidence than when I entered.  Cancer can still reach out to hit me, and not always physically.  Attitude is not only confidence -real or imagined - but being willing to yield when necessary, to adjust  attitudes, and just as importantly,  my outlook on life.

Saturday, March 21, 2015

"I don't want to scare you..."

   The New Year started with a cold, which morphed into pneumonia.  X-rays and  CT confirmed the diagnosis, so I was given antibiotics.  I would need to get another X-ray in a month.  This follow-up X-ray occurred on the last Friday of February.  The first Monday of March there was a message from my family doctor.  He wanted  me to go for another CT scan.

     Another CT scan.   My last scan was a mere two months ago.  I figured they were concerned about the slightly enlarged lymph nodes in my chest.  A call to the family doctor should clarify this, I thought.   Unfortunately it wasn't the lymph nodes, and Wednesday morning found me sitting in another exam room being informed of his concerns:  there was a small mass in my chest.

    This wasn't news to me, as it had been noticed on the prior X-rays, and was always assumed that it was pneumonia.   However considerable time has passed since that original diagnosis.  Now this disconcerting  X-ray has my family doctor concerned.   I  felt fine,  and relatively unconcerned.  That is until he said those words:  "I don't want to scare you...".  Uh oh...

   Actually I left the office more depressed than scared; I wouldn't be scared until I started doing internet searches.   I should have remembered:  when you have an unknown medical condition Don't Search The Web.  My family doctor's worrying was more that just a conversation, he contacted my oncologist personally to express those concerns.   So it wasn't a surprise when the call came from the oncologist's office:  I had an appointment booked for April 1st.  I would need to have my usual blood work a couple of weeks before that.  I hadn't expected to see the oncologist for another four months, and that only added to my concerns.   Now I was getting scared.

   So for a few days I tried to not surf the web for  'Lung cancers & other terrible diseases'.   My dad had died of lung cancer, but I never had his three-pack-a-day habit.  Nor did I ever work in Asbestos or Uranium mines like he once did.   Thus I firmly embraced my family doctor's thoughts that it might 'simply' be scar tissue.  Not sure what kind of atmosphere I'm breathing to cause that effect however.

  Eventually the concern subsided and I resumed my normal, humdrum boring life.   I  went to work.  I puttered with my hobbies.   Sometimes I would catch myself taking extra-deep breaths, as if somehow the inability to completely fill my lungs was a symptom of some horrible condition.  My fears gradually faded, and I stopped obsessing, remembered  that I felt fine, and was not  in any pain (actually my left shin was bothering me but I figured it's only my arthritis).  If there's a problem I'll find out soon enough.

  The remainder of March would find me getting poked by the vampire crews at the local lab and cancer centre.  Getting prescription refills for the cholesterol and arthritis medications I take daily, fulfilling the boring medical stuff of my life.  My calendar has  shifted from the Julian to the Caduceus manner of reckoning.

   April will be no less busy.  Besides the visit with the oncologist to determine what they'll do about my chest, there's an upcoming colonoscopy.   Even though it's my fifth such procedure (and my  seventh time going through 'The Prep') it's not something I look forward too.  But it's part of my process now,  and something necessary for my continued well-being.   I'll just have to adopt that same philosophy for whatever procedure my oncologist deems necessary for my lung examination.  Likely it's going to involve another tube going taking the scenic route through my body.  I'm sure I'll have something to write about after that experience.

 

Sunday, February 22, 2015

2015 began with a cough...

     January is only three weeks old and I've already had an Xray, blood work and a CT scan.  It all began on New Years day, with a cough.

     The cough started in the evening,  and at first I thought nothing of it. Chills followed shortly after.  I figured it was just a cold, and I'd be going to work the next morning.  Then a headache progressed to the point where I finally took an Aspirin in a vain hope of some relief. A runny nose,  watery eyes, and coughs that came in spasms soon followed.   Sleep was non-existent and I was worn out by the time morning arrived.  Determined -or perhaps just stupid -I tried to go to work.

       My resolve failed when it became apparent that I couldn't keep my balance while trying to stay upright.   New plan:  crawl back to bed and continue to be miserable for the rest of the day.  Nailed it.  My cold would last for days.  Only one other time in the  1980's have I ever felt this sick from a 'simple' cold.

      Four days after greeting the New Year with a cold I felt better and was ready to return to work.   That was Monday, and Wednesday I was scheduled to have my annual CT.   Being somewhat cautious, I opted to postpone the Wednesday visit, rationalizing that a few more days would make me less susceptible to any nasty bugs that might lurk in Hospital waiting areas.  With my exam rescheduled til the following Monday, I had a relatively boring and seemingly healthy work week.

     A CT exam for me is no longer a big deal.  In fact it's downright boring, so I thought I'd mix it up a bit:   Banana flavoured RediCat.   It's yummy delicious, that is if you're into chalk-flavoured banana drinks.   I would need to drink two bottle:, one the night before, and one just prior to the exam.

     I drink my room-temperatured flavoured chalk (a.k.a. "RediCat") at 10:00PM  the night before my exam.    I won't have breakfast as you can't eat three hours prior to the procedure.  First stop is at the Cancer Centre lab, where my right arm is picked.   The important maker here will be the CEA but that result won't be available for weeks.   Preliminaries are over, now it's time for the main event.

    After registering at the Diagnostic Imaging desk I'm directed to the CT suite.  From there I'm instructed to drink my second bottle of RediCat.  It tastes as good as the first bottle.  My left arm will be used for the IV that will administer contrast material during the exam.  I don't look forward to the warm, slightly unpleasant sensation that I've somehow soiled myself.  A few minutes of being told to "take a breath and hold....breathe normally" and my exam is complete.  I have two new badges to honour my visit:  bandages on each arm as reminders of what I went through today.  Finished with the Hospital, I can now go back to work, and finally have something to eat!

     My cough returns later that night, maybe I picked up something from my recent hospital exam.  The next two days the cough  gets worse.  So much so that my worried manager urges me to get it checked out.   At lunch I head over to the clinic, and by the afternoon they're pretty sure I have pneumonia, and order an Xray of my chest.  The clinic doctor is concerned, she sees a mass in my chest and wants to do another CT.  Since I just had a CT two days prior, I take a pass on getting irradiated yet again.  But I make an appointment with my family doctor just in case.

     The family doctor has the results of my recent CT, and sure enough, it's pneumonia.  He prescribes another series of antibiotics for me.   I'll take these ones for ten days, and in a month I'll go back to the clinic for another Xray.  All this in January, and I still had an appointment with my oncologist.

     Appointments at the Cancer Centre require a self-assessment (ESAS) , and aside from some tiredness, I think I'm doing OK.   My weight is checked and I notice that the value is in the 190lb range, back where I was five years ago.   I blame cookies.

     The meeting with the oncologist told me two things:  one the CT showed pneumonia(!) and  secondly that the enlarged lymph nodes in my chest had not changed perceptibly in the past year.   For now the protocol is to keep doing blood work every three months, with yet another CT in six months.  Should there be a significant increase in the size of the lymph nodes, I'll likely need to undergo chemo once more.  We'll see what Summer will bring me.

    However before the next CT, I'll undergo a follow-up colonoscopy in April.  This is my life now:   a CT here, a colonoscopy there,  and always one day at a time. 

Friday, January 2, 2015

Five years after


When I turned fifty I was diagnosed with stage 4 colon cancer.   Over the course of a year I was immersed in treatment.   Surgery, chemotherapy, X-rays and CT scans to see how far it had spread.   And always blood work.  I've probably given enough blood samples to sate Count Dracula.   That was five years ago.   Early in 2014 I had a recurrence of my cancer, which surgery has hopefully fixed.  In October I celebrated my fifty-fifth birthday.  Five years since my up-close and very personal encounter with Cancer.

Since my treatment ended in 2011 I kept up with the required tests:  blood work, CT scans and the always fun Colonoscopy.     It was a colonoscopy in February of 2014 that found a polyp.   This same colonoscopy  showed cancer has returned to the original site.  When I received the news I thought I would have to do it all over again:  the surgery,  the chemotherapy, the return to living only for today.   Fortunately  surgery  has proved sufficient.   I would be off for five weeks to recover before I returned to work full-time once more.  I had once again "beaten" cancer, so I should be happy.  But I wasn't.

It dawned on me that you simply don't cure cancer.  Certainly you can make it go away, eradicate it's effects for a time.  But you don't cure it.  It came uninvited into my life on two separate occasions.   Despite medical diligence it surprised both myself and my doctors with its return.   This has caused me to wonder what will happen next.

What happened next was simple:  life went on.   I returned to work after this latest surgery,  fortunately without any complications.  My biggest fear during the weeks before surgery would be that I would need  a Colostomy bag.  This time it wasn't needed.  But it made me wonder if I have the emotional strength to keep adapting to radical changes in my physical health and my  self perception.  I may be resilient and even adaptable, but I know that won't always be the case.

In time I healed.  Once more I returned to work.   The memories of my fears before surgery faded.  Seasons changed, the Fall arrived, and with it my birthday.  I would turn fifty-five in 2014.  In the  five years since my initial diagnosis  I've had my share of  adventures,  of fears and of triumphs.   The new year will bring more tests, and I'll worry when I need to worry.  Until then, just like everyone else, I'll live my life, one day at a time.

Friday, October 17, 2014

ER: a great TV show, no fun to visit

Labour day is one of those Holidays where you don't go to work, but stuff needs to get done.  Fortunately this obligation  required only about an hour of my time at the office, leaving the evening free for me to do whatever I wish.   This evening I wished to lay on the couch and watch TV.  Generally reclining on a couch is not associated  as being a painful activity, so imagine my surprise when I experienced pain from the simple act of sitting upright.    It was  sharp and sudden, deep inside, somewhere under my left ribs.  I had never experienced a pain in this location before.  I wondered if I was so lazy that sitting on a couch would cause me to pull a muscle.  It was annoying but seemed to be getting no worse.  That is, until I went to bed that night.

Normally I sleep comfortably on my right side.  My first sign that things were going to be troublesome involved the simple act of getting into bed and lying down.  It hurt. A lot.  Sharp pain, deep in my chest , seeming to be under the ribs on my left side.   It hurt to roll on my right side.  Or to the left.  Lying on my back was no better.  I spent a miserable night wondering if I should go to the ER.  The only position that was somewhat comfortable was sitting up.  I might have dozed, in fits and starts but I did not rest.  Morning did not bring any relief, and I was having a miserable time simply moving through my usual routine.  I would walk to work that day, and noticed that it hurt to take deep breaths.  It seemed that a visit to the local clinic was in order.

Fortunately that Tuesday morning the clinic traffic was relatively light and I was ushered in quickly after I was registered.  My nurse took the usual vitals: temperature, blood pressure, heart rate.  Everything seemed OK.  I was then examined by the clinic doctor, who said that although they could give me an EKG, they didn't have the resources to fully rule out any heart-related issues.  For that I would need to go to our local ER.

The last time I was in this particular ER was shortly after receiving my first chemo treatment.  Back then I was treated for Thrush and given a stern reminder about going to an ER when chemo-compromised.  Now almost five years later,  I note the changes that have occurred.   The registration process still consists of a security guard directing you where to sit, in this case the Triage Registration Waiting Area.  No longer the hard plastic industrial seats, these are almost comfortable.   I wait for my turn to be seen by the nurse, resigning myself to the fact that I must have something horribly wrong with me else why I did I come to Emerg?   My turn arrives to visit the nurse.  As I rise I struggle to lift my backpack without grimacing.  In triage  I dutifully tell the nurse my story of the sudden onset of my pain, the subsequent visit to a clinic, and the redirect to the ER.  My oxygen and temperature stats are checked,  then I'm sent to the Registration Waiting Area.

Registration is quick, and a familiar face greets me from the other side of the desk.  An associate who remembers me from when I once worked as an IT tech at this same hospital over twenty years prior comments that the last time we saw each other was in this same ER back in 2005.  Back then I was seeking relief from extreme pain caused by a kidney stone.    Today's issue were  not as raw, but I felt it was something that needed to be checked regardless.  Registration complete, I'm sent back to the waiting room.   Less than half an hour later,  I hear my name being called, and I think that at this rate I'll be back to work later that afternoon.   I would soon learn how inaccurate that thought would be.

It turned out that I was being called not to see the doctor, but to be given some preliminary tests.  As I had presented with chest pain,  I would be receiving an EKG.  A blood samples would also be taken.   In total my pleasant tech and I spent perhaps less than 15 minutes together, after which I returned to the waiting area once more.  My real ER experience was just beginning.

I'm well-prepared to wait it would seem:  laptop, tablet, MP3 player, all manner of diversions which make it appear that we are constantly connected to the larger world.  But WiFi reception was poor, the slowly loading web pages seemingly a mirror to how time crawls by in the ER.   I  canceled an appointment  for an eye exam that was scheduled for later that day.  That was at 2:00PM.  By 5:00PM I wondered if I should have had lunch.  During my wait I  had only sipped on some water, steadfastly refusing to eat anything "just in case".  Now going on six hours, I was no longer anxious, just uncomfortable, bored and tired.   I would continue waiting til around 6:00PM, when I was finally ushered into the ER proper.  I kept thinking that six hours wasn't so bad.  But I was wrong once more.

Inside the ER I get to wait some more.  This time I sit on hard plastic chairs consistent with my general perception of ER waiting rooms.   It appears that I'm just waiting until an exam room becomes available.   I'm brought in when it's ready, and the ER nurse performs more checks on my general health.  I'm informed I'll be going for a CT scan.  Before the scan takes place however, I'll  moved to another waiting area, the fifth of my sojourn.  The chairs in this waiting area  are the most comfortable so far.  There's a patient seated beside me,  receiving an IV.  She's wrapped in a blanket and looks exhausted.  I say hello, as I recognized that we had both arrived at the Hospital at roughly the same time.  We chat a bit, exchanging our medical histories as perfect strangers seem to do in this situation.  She has terminal stage 4 lung cancer.  I tell her my story.  We find we're both being sent for CT's.   Our porter brings her via wheelchair to the CT suite.  I walk the short distance, glad of the small relief for cramped muscles and inactivity of the past eight hours.

It's quiet in the CT suite, lights subdued and sounds muted.  My fellow patient has her exam  first.  My turn is soon after.  The methodical and efficient CT techs have us in and out of there in short order.  I have another CT exam to add to my collection.  Exam complete,  my co-patient and I wait for the porter to retrieve us, returning us back to the ER.   It is almost eight hours since I was registered.  I've had an EKG, blood test and my vital signs recorded. I've just finished a CT and now I finally get to see the doctor.    She's all smiles and tells me she has good news.

It's not a heart problem:  I have pneumonia.  How can this be good I wonder?  My doctor  assures me that it was caught very early and the antibiotics she prescribes will help.  She also mentioned that they checked for evidence of cancer in my lungs -given my past history I suppose that's a good thing.  There was nothing of note.  With that diagnosis my ER visit was nearly over.  A nurse would remove my IV lock, and after that I was free to go home, over eight hours after I had first walked into the Hospital.

On the way home we stop at a pharmacy to fill the prescription.  A course of five days, two pills the first night and one a day for the next four days.  I'm told by the pharmacist that I'll feel better tomorrow.  I figure I can't feel any worse:  sore chest, tired and drained of any energy, yet I did nothing all day but sit.  I  hadn't eaten until I was discharged from ER.  I had no appetite. I just wanted to sleep.

I would take the next day off, mostly to recover my energy, and hopefully not be affecting anyone when I returned to work.   When I was given my diagnosis of pneumonia by the ER physician, I had asked her how I got it.   She candidly admitted that she didn't know.  I guess in life we can never assume there's a visible cause and effect for everything.  But I was OK, and after my day off  which consisted of many many hours of doing nothing but napping, I felt a lot better.

I would take the entire course of my antibiotics, and by the end of the week my long vigil in ER was a fading memory.   It would be a footnote in my blog, something tangential to my history within our medical system.  I reflect on what this latest dip into the health care pool meant to me, and admitted to myself that my concern wins over my confidence these days.   Terry at age forty would have shrugged off the nagging chest pain as an annoyance and ignored it.  Nearly 55, I have learned to accept that you cannot resist the passage of Time, but you can still control the course of where you're going.  The day I spent in ER was something I chose to do.  Had I not gone, there might have been  considerable more time in Hospital recovering from far more perilous effects of that pneumonia.   The choices life gives us aren't always what we want, but what we make of them is entirely our own.

Wednesday, September 3, 2014

How I spent my summer vacation

I consider the unofficial start of  Fall as the day after Labour day.  On that day summer vacation is over and school begins.   It's the time to write your essay of "What I did on my Summer Vacation".

Technically resuming my day job in a full-time capacity would not be considered  a vacation.   But  Spring saw me going for  colon surgery at the end of April, and I would spend five weeks recovering.  During the month of  May I took the opportunity to get  some work done on my basement drains.  Returning to work could be considered my 'Vacation from Cancer'.    However there were a couple of events that stood out, those being my second  walk as a Survivor, and of course, a CT scan.

Last year I walked in the Relay for Life as a Survivor.  My inaugural walk  with other survivors that idyllic evening was emotionally uplifting  and I hoped for the same results this time.   With the kindness of friends and family,  we raised $1,000 to contribute to the Canadian Cancer Society.   While I was hoping to recapture the memory of my previous walk, I made new ones instead--most of which consisted of standing in drizzling rain on a cold June evening.   All through the ceremonies leading up to the Survivor's Victory lap,  the rains had increased.  I stood there, shivering in the chill and darkening skies.    But as the names of the Survivors were being called the rains stopped.  The skies  perceptibly brightened and I felt the warmth of pride as I joined the ranks of Survivors when my name was called.  Unfortunately the weather returned to it's  wet and miserable state, and I decided to leave well before the moving and retrospective event known as the Luminary Ceremony.  Maybe next year.   That was my fun for June.

My second event of note this summer was my oh-so-exciting CT scan.  Perhaps it was the experience of laying  motionless while the table slowly ran in and out of the gantry.   Or hearing the mechanical-sounding voice instruct me to Take a Breath and Hold it.  Maybe it was the prospect of having contrast dye injected through an IV - the warmth radiating from my ears down to my lower extremities, making you think you've soiled yourself. (I didn't but it's such a disconcerting feeling which I never get used to).  But the real excitement of a CT scan is drinking the RediCat.


RediCat is a contrast drink that looks like watery chalk.  It has approximately the same flavour as watery chalk, and in this instance, a hint of Berry.  Probably the Chalk berry.  For my test I would need two bottles of this beverage.   The first I would drink the night before the exam, the second I would bring with me and drink it just before I would have the CT.  One novelty I had not experienced before was getting blood work done before the CT.  Once the lab reported the results, the  CT techs ran me through the by now routine process.   My subsequent follow-up with the Oncologist would maintain the status quo:  CEA blood tests every two months, another CT scheduled for January of 2015 and oh, joy, another Colonoscopy for February next year.  That was my fun for July. 

My fun for August was the installation of a new furnace and air conditioner.  I truly had a boring month which consisted on nothing cancer related whatsoever.  I kind of like that.

This past summer was noted for it's less-than-ideal weather, too much rain, being cold, and of course, being over far too quick.  I made some small clock projects, but mostly just worked and did stuff around the house.  It was a perfect vacation from Cancer, one I hope to repeat next year.





Wednesday, June 25, 2014

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.

Thursday, May 22, 2014

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.

Saturday, May 17, 2014

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.

Saturday, May 10, 2014

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.

Wednesday, April 30, 2014

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.

Thursday, April 24, 2014

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.



Friday, April 11, 2014

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.

Friday, March 21, 2014

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.

Sunday, March 16, 2014

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?

Sunday, March 2, 2014

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!

Thursday, January 30, 2014

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.