12.30.2011

The CT Scan

I have a finely tuned gag reflex. That means I don't do keg stands or shots and am therefore a whole bucket of fun at a frat party! Just put me in a corner with the awkward sorority girl and we'll be great wallflowers at an otherwise raging gig.

Because of this gag reflex, one of my greatest fears in medical science was about to come true.

We got the call that Monday morning from the Patient Care Nurse and she said to head over to the hospital for the CT Scan. And then she said it. We could head over right away since I'd need to wait an hour while the contrasting solution coated my insides.

Contrasting solution meant only one thing to me. The dreaded barium milkshake. I almost crumpled in to a weepy mess on my own kitchen floor. If drinking tainted Gatorade made me gag, drinking something the flavor of chalk with the consistency of latex paint was going to be a mess.

Kyle just laughed and I promised that I would be aiming at him when the barium decided to reappear from my stomach. He vowed to be my biggest cheerleader as I took tiny sips at a time and pretended I was somewhere else, but it wasn't helping.

I spent the next 2 hours obsessing and trying to sike myself out enough to get the stuff down. And if they expected me to drink it within a hour, they were clearly delusional.

Just as dreamy as it looks.
I knew it was going to be a painful process, even with Kyle there for moral support. You can only imagine how it made my morning, day and week when the tech came in and brought me a liter-sized Styrofoam cup. Bile began to churn.

It was huge. Huge! I was about to start gagging right then and walk out when he told me it was just water mixed with a very small amount of "glow in the dark" medicine. So no barium? No barium.

How I escaped the barium cocktail I'll never know, but should they ever offer it again, I have a photo of what I got to drink and will demand it!

The CT was the shortest part of our day and Kyle and I took full advantage of the hour you have to wait while your insides get coated. We walked around the hospital grounds holding hands and admiring the mild weather like a bunch of old people. It was the closest thing we'd had to a date in a while, and obviously I'd gone above and beyond the call of duty to get some alone time with my man. Just call me the sacrificial wife.

Kyle and I returned to the waiting room within an hour and waited, because that's apparently what waiting rooms are for. And waited. Well past the hour mark I finally pointed out that we were still waiting. I was promptly called back where I was placed in another waiting room. And I guess all the waiting meant I needed a little taste of the good stuff after all. So because they were running late, I was being forced to drink of the barium milkshake after all. The first few sips went down like the Orange Julius I pretended that they were. The next couple of sips I tried to imagine were an Orange Creamsicle. And the last few sips gave everyone else waiting a good scare when I started to gag. All that effort and I think I managed to suck down an inch. Good thing the tech came and got me and promptly chucked the rest in the trash.

The CT scan was short but comical thanks to a talented and funny tech. He said results would be emailed and read within the hour, which just blows my no-so-technical mind out of the water. We were meeting with the surgeon bright and early the next morning so the wait wouldn't be long.

While laying on the table, I had to wonder if he could see what it was seeing. And had he been doing this long enough to know what was there. When he came back in to the CT room to free me up, I gave him a good long look and wondered if he already knew what the doctor was going to be telling us the next day. I appreciated his light sense of humor, because I'm sure he sees some very sick and very scared people. He was the right man for the job.

12.27.2011

The Colonoscopy

If there's one lesson I've learned from the two "bowel preps" I've had to do in the last month, it's to actually mix the Miralax with something you like drinking. I don't like Gatorade, but naively followed directions and spent most of the first day trying to drink a drink I didn't like that was made a little bit worse by the thickening affect of a massive dose of Miralax.

I called it my Miralax Martini.

I finally managed to get most of it down, but not in the one hour time frame they claim you need to drink it in and not without diluting it ten fold. In summary, I drank about five times the fluid necessary in about four hours longer than expected. All in the name of not gagging.

And don't let some nurse fool you into thinking Miralax is tasteless. It is, if you take it one dose at a time. But when you dump 7 doses into a 32 ounce drink, it can be a little crunchy if not mixed well enough and makes everything taste a bit more syrupy.

Now that I'm a master of the Miralax, I know it doesn't have to be consumed in an hour to work, I don't need to finish it all to get it to do the job and despite their recommendation, you don't have to mix it in Gatorade. As of this date, I'm still looking for the perfect mixer, and my chance will come again in the new year to try out of few new Miralax Martinis.

On the Wednesday afternoon before Thanksgiving, while the rest of you were watching the clock and eager for a 4 days weekend, I was looking forward to an uninterrupted nap on the gastroenterologist's table. As a stay-at-home-mom, you've got to get a nap in when you can. And if this is what it took, so be it. 

I was expecting him to confirm what was expected, which was the Ulcerative Proctitis. As he stood over me asking questions, the last thing I remember saying was I had to go the bathroom again and him saying not to worry: "We've got good suction." I'm sure a concerned look came over my face, but it didn't really matter because I was out.

The next thing I knew I was waking up from my drug-induced nap to see the doctor standing there saying "likely malignant tumor" and walking away. I was in a fog, and with those words it just got foggier. I left with nothing more that a piece of paper showing tiny photo of what was suppose to be the tumor and the note that they would set up an appointment for a CT scan and an appointment with a colorectal surgeon. I knew it was in my sigmoid colon and it was blocking so much of my colon that he was not able to get the endoscope past it. There was no rub on the back, no follow up call, no other information. I left there in a daze from the anesthesia and this news that left all of us stunned.

I spent the next 24 hours in tears. I'm not going to under exaggerate that. I woke up the next morning with eyes so puffy all I had were little slits to see out of. Going over to be with family for Thanksgiving wasn't even on my radar. I just walked from room to room with a million thoughts in my head and so many unanswered question. Kyle would occasionally walk around to find me and we would sit in silence or talk, but I don't remember being very useful that morning. I cried often and could not wrap my head around the unconfirmed fact that I had cancer.

I had spoken with one of my best friends the night before. As a Physician's Assistant and a friend, she didn't sugar coat it for me. She said when they use the word malignant, they mean cancer. Cancer. I still couldn't bring myself to say it, especially because it wasn't official.

By lunch time, we were well into distracting ourselves with Christmas decorating when we got a text from my dad. Prior to sitting down for dinner, my uncle mentioned that he was friends with a colorectal surgeon in our area and sent him a text to see if he could provide information. It was, after all, a colorectal surgeon that I would need. Not only did he text right back, but he offered to call us at home. On Thanksgiving Day? A surgeon calling strangers at home on a major holiday just to help put them at ease? We were hooked.

The phone rang and the road we would be going down started to open up before us. The surgeon called and spoke with us for at least 30 minutes. There was no rush to get off the phone and he wanted to make sure he had answered every question we could come up with. He told us exactly what was going on, what to expect and what the next steps were going to be. He even promised that I would be "pooping like a 20 year old in a matter of weeks!" and he wasn't kidding.



And for the first time in 24 hours, I finally stopped crying.

The Patient Care Nurse called as promised on Friday, but was unable to get us in for a CT scan over the weekend. Too much financial liability paperwork to sign, and ultimately it wouldn't get read until Monday. She told us to be ready first thing Monday morning and we planned accordingly. Childcare was arranged and my morning coffee was withheld.

In case you don't have any good movies on Netflix right now, here's a video staring the now famous Dr. Ramirez, remover of my sigmoid colon and restorer of my pre-baby belly button.

The Gastroenterologist

I passed the time in the waiting room trying not to stare at other people. It's like I was silently sitting among kindred spirits and wanted to gather everyone around the campfire to compare the scents of flushable wipes. These were my people, but staring too long would be taboo and we all had to pretend we weren't sitting in the very office of the doctor who deals with all things digestive.

As I waited to meet the doctor, I was able to admire all the pharmaceutical-supplied artwork in my room labeling the digestive system, illustrations of digestive issues, photos of the small intestine when plagued with things like Crohn's or Celiac Disease, graphic pictures of things even I don't want to write about and the stages at which the liver disintegrates and becomes a cesspool of Jack Daniels and Boone's Strawberry Hill. It really was skillfully decorated and it left me almost grateful for what I was now beginning to think might be a comparatively minor problem in the grand scheme of gastrointestinal disasters.

After going over all my symptoms with the doctor and using all my big girl words again, she concluded that I must have something called Ulcerative Proctitis (UP). She explained the symptoms of UP and I agreed we probably had a ourselves a match. I walked in fearful that I would walk out without knowing what was going on. Now it was so obvious that I was almost joyful.

Ulcerative Protitis is an Inflammatory Bowel Disease (IBD). Not to be confused with Irritable Bowel Syndrome (IBS), which is a label I think doctors give to patients with often unsettling and unpredictable bowel issues for which they can't find a cause. IBD includes some chronic heavy hitters like Crohn's and Ulcerative Colitis. If you know someone with either of these, you know their relationship with the toilet can be pretty miserable. I was certain these weren't my issue because I was missing the tell-tale symptoms like pain, cramping, bloating, pain, pain, cramping, pain and pain and massive amounts of blood.

She gave me a magical prescription that would start clearing things up in a matter of days and all the sudden the sun looked a little sunnier and future plans looked possible. I had already signed up to run the Surf-n-Santa 10 Miler and was doubtful I could run it if I wasn't even able to get though the longer training runs needed. Now I had an answer, the solution and a few more weeks to train. Inspired, I hit the pavement that weekend and was certain I'd be at the starting line after a successful long run without interruptions.

I had a week and a half between my GI appointment and the colonoscopy. I wasn't concerned because I knew I was going in just to get confirmation. I was so certain of the results that we'd planned for Kyle to stay home with the kids and my mother to be my responsible adult and ride home when I woke up from that special little nap.

If you are cringing at the thought of a colonoscopy, this is where my lack of shame comes in to play. You have to remember that this is what they do for a living. Your rear end is just one of the masses and I can assure you if they ran in to you at dinner, they probably wouldn't remember what you looked like from the other end. They've also probably seen bigger, older, hairier, smellier and more memorable in their professional careers. Besides, you're asleep so it's not like you're going to know what's really going on down there. These are the people that chose to go into the business of bowels. If anything, the joke is on them.

In the mean time, I set out to buy all the things I needed for the prep and dreaded the day that I was stuck at home with both kids, no coffee and nothing but clear liquids for the entire day and a half.

12.24.2011

Another Empty Toilet Paper Roll

I've always done everything right. I'm healthy. I'm fit. I eat all the right things and do all the right exercises. I'm a fiber junkie and love a well-oiled, predictable bowel! The people at Kashi love me and I love them.

That's why it was pretty easy for me to notice that something wasn't right in mid-September. I found myself suddenly going to the bathroom all the time. For the sake of practicality, I'm going to call it pooping. No medical terminology needed. You're not my doctor. I'm not sitting in an exam room, so I feel no need to refer to it as a bowel movement.

It wasn't diarrhea in the sense that we think of diarrhea. For us laymen and simple-minded folk, diarrhea is a matter of urgency and explosion and pain and sweat and tears. For the medical community, diarrhea is simply a matter of frequency. And I was frequent. It was solid, but it was frequent. So frequent that I started going through a roll of toilet paper a day. So frequent that I switched from the plush, pricey and highly recommended Cottonelle with Aloe to Target's Up and Up brand just to save money. So frequent that one of the lasting reminders of my last pregnancy reared its unattractive head: hemorrhoids!

For some moms, they can forever blame their children for the baby weight they never lost or stretch marks that will never truly fade. For me,  it was a belly button that never quite went back to normal and hemorrhoids. Petty matters really in the grand scheme of things and really minor reminders considering I actually looked like I was carrying twins (9 pound baby + extra amniotic fluid = very large belly).

I can distinctly remember going to my OB for my 35 week appointment in a vain panic and telling him that he had to do something about it because I was never going to be able to get a bikini wax again. It was scary. It was ugly. Imagine a large pregnant women in stirrups pointing down to places she can't even see any more and demanding a cure, all in the name of going to the spa again!

He just laughed and told me they weren't "that bad" while motioning with his hands as to how bad they can be and what he routinely has to deal with in office. And when he has to "deal with it" in his office, that means it's B-A-D. He also assured me that most women get them in pregnancy, they will get better but they will never go away. And if my esthetician had been bikini waxing for any length of time, she had seem them because they really are that common. I didn't believe him. I haven't been waxed since.

And with the "'roids" came blood. Just enough to be noticed, but not enough to write home about. As he promised, they did get better as soon as Lachlan was born. Something about removing a 9 pound bowling ball off your rectum can do wonders for those suckers! Any sighting of blood over the next year was infrequent and I always chalked it up to the 'roids, my new found friends for life!

I never had the urgency, but I did have the urge to go a lot. I could make it through errands and make it through my runs (which is a feat in and of itself for some runners), but it was clearly noticeable and it was wearing me out. I wasn't in pain, I wasn't bloated, I wasn't cramped up and I wasn't gassy (what women is?). I was going an inch at a time and what would normally take me one trip was taking 15. I was redefining "dropping the kids off at the pool." I was dropping one kid off at a time all day long, and that takes up a lot of gas and puts a lot of miles on my hypothetical minivan so to speak.

Being the self-healing type that I am, I started eliminating things out of my diet after a few weeks. I'd finally decided that this wasn't some weird flu or bug I'd caught, so it must be something I'm eating. Dairy was the first thing to go since I knew I was lactose intolerant. No compromise. No Lactaid pills. No Starbucks. I was in the prime of Pumpkin Spice Latte season and I was saying no to dairy.

Secondly, I stopped eating gluten. My mother has Celiac Disease, and given its genetic connection, I thought it might have come upon me as well. Pregnancy can do weird things to one's body, including triggering allergies and dormant DNA. I actually noticed a slight improvement, so hoped I'd solved the issue. I just needed to give my small intestine a few months to heal and I'd be good as new. Living a gluten-free life is actually quite easy these days and there's really nothing you have to deny yourself if you don't mind doing the cooking yourself or paying a little more for specialty food at the grocery store. It also kept me from finishing off the kid's snacks and eating a lot of junk I probably didn't need to be eating anyway.

Some of you are probably already cringing at the thought of a life without dairy or gluten (wheat, barley, rye), so you'll cringe even more when I tell you I also cut out sugar, my beloved Diet Coke and coffee. I was sure that something I was eating was causing this, and was willing to do whatever it took to find out what it was. I'm not someone who adores food. I mean, I like food in general. And there are a few things I love (like Rice Krispie). Don't worry, you foodies can blindfold me and peg with with rotted fois gras and spoiled endive later. I don't watch the Food Network, could not pick any of the popular TV chefs out of a lineup (with the exception of my beloved Rick Bayless) and don't cruise the cookbook aisle at Barnes and Noble (short of all the Rick Bayless books I own).

As I cut things out of my diet, I noticed the number on the scale continuing to drop. Granted, I had had a baby the year before, so losing weight was expected. And between running, Stroller Strides and nursing, I was burning some serious calories on a daily basis. But even I was amazed at the number on the scale and how quickly it was ticking down. And this is coming from a girl who grew up in LA, worked amongst the ultra skinny in Hollywood and had mastered the art of 5 spin classes a week while living on skinny lattes, Diet Coke and fat free microwavable popcorn. For the first time in my life, I had to buy a belt just to keep my shorts on. Any time anyone commented on my weight, I told them I was just as surprised, blamed running and nursing and told them I must have a tape worm. Turns out I did.

After a month off gluten, I wasn't seeing the drop in toilet paper usage I expected and finally broke down and went to Urgent Care. With a family history of gastrointestinal issues, I wanted to make sure that my days of a finely tune GI tract weren't over. I also wanted to rule out any lingering fears that I might have something seriously wrong. I knew something was wrong, but I wanted to get it fixed and was finally at the point where I knew I couldn't fix it myself.

Not only was our toilet paper budget out of control, but I was tired. Many a night it was all I could do to lay on the couch, crawl into bed as soon as the kids were down or cook dinner while sitting on a bar stool. I could go out and run mile after mile, yet by nightfall didn't have the energy to stand while cooking dinner. I blamed the pooping. It was exhausting.

Urgent Care is my version of a primary care physician. Don't think I was dribbling down my leg and desperate when I finally walked in. I just so rarely go to the doctor, it's not worth actually finding a PCP and developing a relationship. I've confessed this to them and they are happy to fill my PCP void.

Urgent Care was fun and I had to use big girl phrases like "bowel movement" and "soft, but formed" and "I just blame the hemorrhoids!" over and over again. I was sent home with a fun little test kit that made changing dirty diapers seem easy. God bless lab techs because there is nothing glorious and no paycheck great enough to make smearing fecal samples on a slide worth it for me. Then again, I've also said if it wasn't for all the poop, I'd love to be a nurse.

I dropped off my discreet little brown bag at Urgent Care the next day and would spend the next two weeks waiting for my scheduled appointment with the GI while you guessed it, continuing to poop all day long!

In retrospect, I had 4 out of the 5 top symptoms of colon cancer, except I was only 34 years old.

90% of colon cancer cases are found in people over 50.

I'm being very graphic and open about the details here because I think it makes an important point. It takes away the shame, but I also I think it's vital that we be in tune with our bodies in every way. The more we know ourselves, the more likely we are to notice when something just isn't right. This means we should know our skin, we should know our breast (or man boobs) and we should know our poop. And yes, we can eat all the right things and do all the right exercises and put on all the right sunscreen and use all the organics in the world. But nothing takes the place of knowing your own body and having no shame in talking about things that might be a little embarrassing but might save your life.

12.22.2011

The Least Sexy of the Cancers

I mean cancer isn't sexy, but it seems in our marketing and media crazed world, breast cancer is the most recognizable and most publicized with its pink ribbon and pink fundraising walks and pink everything. So I'm going to declare it "The Sexy Cancer."

Boobs are sexy, right?

Colons are not sexy, right?

So therefore it is safe for me to admit that I have colon cancer, the least sexy of the cancers. 

And by least sexy, I don't think I'll be slapping a blue ribbon magnet that says "I Survived Colon Cancer!" on my truck and I'm not going to be wearing a "Colon Cancer Survivor" shirt in any future races. It would totally take away from the sexy factor I've worked so hard to cultivate, you know? No amount of Victoria's Secret panties can make colon cancer hot!

Future cancer blogs will go in to some graphic detail because inquiring minds want to know. I think the details are important because they may make you aware of the importance of being in tune with your own body and noticing when things change or just aren't right. I've also been poked and prodded in so many parts of my lower body while awake and asleep at this point that I have no shame in talking about anything.

I mean, is there really any shame left after childbirth? 

I am currently 2 1/2 weeks post-op where I had an almost obstructing tumor removed from my sigmoid colon. Actually, the entire sigmoid colon plus some (about 10 inches) was removed (see illustration below). The surgery was performed laparoscopically, so my bikini days aren't necessarily over, and the whole healing process should technically be easier. Technically.

We now know that the cancer had spread into 14 of the 20+ lymph nodes that were removed, so this translates into Stage III cancer and chemo in my very near future. I've been told it won't be the hair-losing kind of chemo everyone expects, but it will be long and there will be plenty of fun side effects to disrupt my life.

You will never again see a photo of me without my eyebrows drawn in, so enjoy it while it last. This is a few hours after surgery, already out of bed and enjoying the comfort of my special "colon pillow." Be jealous, not everyone has a pillow with a colon on it and no you can't have mine. I also didn't grow a man bulge in the process. That was the ultra trendy fanny pack hanging out with my pain pump inside. Once I was more lucid, I moved it to my hip as to not draw attention to what was really going on under my gown.
Rather than send out mass emails with every appointment (and there are a lot of appointments), I'm just going to update the blog as we go along. I'll back track and tell you how, when, why, what and where, so don't start asking questions yet.  Feel free to bookmark, follow or just check back. Next stop should be with the oncologist after Christmas to discuss chemo.

Yes, this is surreal. Yes, we're still taking it all in. Yes, we appreciate all the prayers, support, encouragement and affirmation we can get. 

Sigmoid colon bye-bye. But that's OK, because there's still another 5 feet to go around!