I’m starting this blog on my first day of chemotherapy treatment, but in the interests of chronicling my whole experience, I’m writing a few posts that go “back in time”.  I’ll try to present things as clearly as I can remember them.  Given that this has all happened over the last few months, that shouldn’t be too hard. Also, I’m writing about colon cancer, which means that from time to time, I’ll be referencing things that I otherwise wouldn’t talk about in polite company (stool samples, bowel function, etc.). Fair warning…

Sometime in May 2012 I started having some pain in my abdomen. At first it was just a couple of times a day, but after a couple of weeks it was bad enough that I called my doctor for an appointment. By this time, I was feeling some level of discomfort or outright pain throughout the day, and there were times when it was acute enough that I needed to stop whatever I was doing and take a few deep breaths while the pain passed.

I’d tried to pay attention to my own body and habits a lot. Was it worse when I ate certain foods? When I didn’t get enough sleep? At home? At work? Nothing seemed to jump out at me, and nothing big had changed recently in terms of habits (good or bad). So, when I went into my doctor’s office, I felt like I was able to answer his questions well, but everything I had to say was a little non-specific. I had pain, but I couldn’t tie it to any specific events, foods, activities, etc.

My doctor is pretty conservative, and tends to treat the symptoms you have without going overboard. He’s not the kind of guy that hands out a super-strong antibiotic for every cold or immediately sends you for a bunch of unneeded scans or tests. Overall, I think this is a good thing, but it also meant that I was prepared for the conversation we had after I described my symptoms:

“So… what’s new in your life?” he asked.

“What do you mean?”

“Well, you’re describing symptoms of Irritable Bowel Syndrome, or IBS, which can often be caused or made much worse by stress. So, what’s new at home, at your job… in your life?”

We talked for a little bit, with me telling him that I’d been trying to look at those sorts of questions/factors as objectively as possible, but that I didn’t see anything relevant. Work was busy, but no busier than usual, and there’d actually been a few things that had happened in the last couple of months that were making things a little less crazy than usual. My diet hadn’t really changed. I was generally feeling okay otherwise… We also discussed possible food and environment factors that could be at play: lactose intolerance, gluten allergies, things like that.

Ultimately, I said something like “all I know is that this has been bad enough for long enough that I know I can’t have it continue like this. I need to do something.”

So, he ordered a few tests and sent me next door to the hospital.

There’s a lot of shorthand that happens when you go from one doctor to another or from one doctor to a lab. I encourage everyone to ask a lot of “so, explain to me what’s going to happen next” questions, because otherwise, things can get a little confusing. To wit…

I go next door to the hospital lab and they draw a few vials of blood. Then, the nurse asks “did you already schedule your lactose test?” “Huh?” I say intelligently, since I have no idea what she means. Apparently, the lactose test is done over two and a half hours, and is normally done first thing in the morning, since you have to fast for it. No problem, I say, even though it’s ten o’clock, I haven’t eaten yet today, so let’s do it now.

The lactose test consists of you drinking a gritty mixture that contains roughly the amount of lactose in a single meal, and then they draw blood every 30 minutes for two and a half hours. It was a heck of a morning.

My doctor also requested that I bring back a stool sample to the lab, and had the lab give me three “cards” for a fecal occult blood test (this has nothing to do with witchcraft, by the way). The cards each come with a flat wooden stick. You’re supposed to open each one up and use the stick to smear a small amount of your feces onto two boxes. Then you fold them up and bring them back to the lab. So, this is gross. Collecting ones own stool sample is also gross, and a bit complicated. Best left there.

A few days after I brought the stool sample back to the lab, I got a call from my doctor’s office. They found blood in my stool, and so they wanted to have me see a Gastroenterologist. They referred me to someone nearby who luckily had an opening just a few days away, so I didn’t have to wait long.

The consultation with the gastroenterologist was a relatively short appointment, during which I was told that I needed a colonoscopy. The blood in my stool was indicative of a variety of possible problems, and ultimately, there wasn’t any way to be sure exactly what was going on without one. I scheduled it for the following week.

If you ask anyone who’s had a colonoscopy about it, you’ll probably hear the same phrase repeated (I certainly did): the prep is the worst part.

So, let me tell you a secret about colonoscopies: the prep is the worst part. The prep basically involves drinking some amount of stuff that doesn’t taste great, and that makes you go to the bathroom. A lot. I do remember ingesting all of this stuff and then sitting there for a couple of hours thinking “nothing is happening… what happens if nothing happens…?” And then, it all kicked in, and I was running to the bathroom every 20-30 minutes, eventually wondering how there was anything left inside me.

Actually having the colonoscopy was uneventful. I showed up at the office, changed into a gown and had my info reviewed by a nurse, and then was wheeled into the procedure room. You’re given drugs to sedate you so that you’re not really aware of what’s going on, and I don’t remember anything about the procedure. Ultimately, I woke up in the recovery area feeling fine.

Once I was awake, the doctor came and reviewed the results with me. They’d found one polyp that they’d removed, and a tumor in my descending colon that they’d taken biopsies of. The doctor confirmed that this tumor was likely the cause of my abdominal pain, and that even if it was benign, it should be removed. Then, he dropped the bomb: “Based on its size, I’d be surprised if it weren’t cancer.”

It would be dramatic to say that “everything stopped” at this point, but it didn’t. I went into “one step at a time” mode instead. I asked a handful of additional questions and said thank you. The doctor said that he’d be following up with me in a few days when the biopsy results were back. While the word “cancer” definitely had me freaking out a little, there didn’t seem to be any point in worrying much until the test results came back.

Three days later, the doctor called me and told me that the biopsies had come back positive. Adenocarcinoma was the official medical term in the report, and it meant that the tumor was malignant and definitely needed to be removed.

At this point, I was more upset and worried, but was still mentally taking it one step at a time. From everything the doctor said, it was likely that I’d just need surgery to remove the tumor, and then that’d be it. A surgeon would be able to give me more details. So, the next step was meeting with a surgeon and scheduling the surgery…

Photo Credit

Photo by Alex Proimos and used in accordance with the Creative Commons Attribution license.