Monday, February 19, 2007

Plan of attack


We were to discuss our plan of attack with regard to this unexpected cancer diagnosis at an appointment with the surgeon at 3:10 pm on Friday afternoon. Long Suffering Spouse and I were early.

The surgeon was late. (He'd been doing 'procedures' all day -- and he had inevitably fallen behind.)

Eventually we were ushered inside. Dr. P. wasn't there just yet, but you can only sit in a waiting room for so long. Especially with daytime TV blaring.

To fill the time, the nurse decided to take my blood pressure.

When it ran up to about 210 over 100-something, the nurse said, "This doesn't look right." She took it again. This time it was much better -- 195 over 100-something. "Do you drink coffee?" the nurse asked. Long Suffering Spouse and I both laughed at that one.

"I think the blood pressure is high more because of why we're here than any amount of coffee I drink," I told her.

"Well," the nurse tried again, "why are you here today?"

"We're here to discuss the results of my February 2 colonoscopy," I answered.

"Do you know what the results are?" I wasn't supposed to know; my internist had spilled the beans not realizing I'd not been otherwise informed. At this point, the nurse was flipping through the chart.

"We have a pretty fair idea," I answered.

"Oh, it's not that bad," she said, scanning the page in front of her, but she did not wish to discuss the bases of that observation. Long Suffering Spouse and I were shown to an examination room where we eventually met the doctor.

----------------------------------------------------------------------

Dr. P. was very upbeat. The only thing he was upset about was that I'd heard about my diagnosis from the internist. I felt obliged to defend the other doctor: "He didn't know you hadn't told me yet," I said.

"I wouldn't tell someone this over the phone," Dr. P. said. "I always bring them in to discuss it in person. You're a professional man; you can handle this information. But some people throw themselves on the floor, cry hysterically, pull their hair out."

Well, just because I didn't do any of these things doesn't mean I didn't think about them....

But, given the unavoidable lapse in time between the colonscopy and our meeting, I was grateful for the 'heads up.' Bad as it was to get the news over the phone, I told him, the advance notice gave me time to prepare to deal with the consequences.

And that's what we discussed next: The cancer is in a very early stage -- it was only in one of the three polyps -- it's 95% or more curable at this point.

But those gently swaying fields of polyps? There are too many to harvest via repeat colonoscopies. And because the body has to heal up from each procedure... the chances of something bad happening during the wait were just too great. "If you were 80," he told me, "we might evaluate it differently. But you're not." (I just look like I am. But that's another story.)

So rather than harvest the polyps, Dr. P. recommended we remove the entire field: The whole colon must come out.

This took Long Suffering Spouse by surprise. "Isn't that like removing the entire arm because of repeat hangnails?" she asked. But the logic is persuasive: I have a very dubious personal history and an ominous family history. The alternative to doing something drastic now when it will do the most good may be doing something drastic later... when it may do no good at all.

If you think I'm scared, you're right. But, even though it sounds radical, this course of action makes sense to me. And Dr. P. got me through the problems I had in my late 20's without incident for 17 years -- whereas I'd had a miserable time, and recurring problems, with the doctors I'd gone to before. I have confidence in Dr. P.

And he was surprised that the cancer was found in the smallest of the three polyps. It's the big ones that are supposed to go bad. He promised he would go to the hospital and review the path slides himself... but, based on what we know, if it were him in my shoes, he'd have his colon taken out.

My wife's questions went to quality of life: To be delicate, will I be able to leave the house for any extended period of time?

Most people can, Dr. P. said, and if there are problems, there are medications to help maintain, uh, control. He said there are no guarantees -- but it seems to me there's a guarantee of what will happen if we do nothing or do too little.

The surgery is set for February 28.

I've got a CT scan set for tomorrow (just to make sure there's nothing else out of place) and I have a pre-op physical and blood work-up scheduled for tomorrow as well.

I'll not be blogging much -- if at all -- between now and the surgery; I expect to be confined to the hospital for as long as a week after the surgery. After that, I'll be at home for a couple of weeks while I learn to live with my newly configured insides. But I'm hoping to be back on line again before the Ides of March.

----------------------------------------------------------------------

After we got home Friday night, I had to call the kids and explain what was going on. Older Daughter didn't know about the cancer diagnosis; it was her birthday when we found out. Would you tell your daughter something like that on her birthday? I didn't think so.

Oldest Son was the most logical about it. "We don't need a colon to live?" he asked. I told him that the surgeon says we don't. "And you've had this problem and so did Grandma and Grandpa?" Yes, I told him. "So why," he asked, "don't we all have our colons out, just to be on the safe side?"

Sure, I told him, we can get them all plasticized and string them on the Christmas tree next year instead of the strings of beads. The immediate death glare from Long Suffering Spouse made me realize this attempt at lightening the mood had failed utterly so far as she was concerned.

Middle Son is leaving for Arizona and Spring Training right after the scheduled surgery date. "There's nothing to worry about," I told him. "I'm just trying to get svelte like I used to be. It's just a weight loss program. I'll keep removing non-vital body parts until I'm skinny like you."

Younger Daughter wasn't home when we returned from the doctor. We were just sitting down to schedule the surgery with Dr. P.'s assistant when my cell phone rang. "You're still not done yet?" Younger Daughter asked. "No, not just yet," I said. "Oh," she said. "Can I go to Karen's house?"

We let her go.

When she finally came home she did ask what the doctor told me: It's all good news, I told her, with one little caveat. The cancer is in it's earliest stages. It's very curable. It may even have been removed entirely. But the doctor is recommending that I have my colon removed.

The tests I'm taking this week may change things, for better or worse. Dr. P. may change his recommendation. Someone may yet talk me out of this. But that's where we're at right now.

31 comments:

Empress Bee (of the High Sea) said...

well alrighty then, we have a plan. it sounds reasonable to me, remember i read that do it yourself brain surgery book and all, but seriously, i believe in agressive prevention. i am not sure what will be your restrictions after but having a loving family will get you through it. and we will all be here for you. is there someone that can let us know how you are curmy? maybe one of the children? if someone emailed me i would put up a post and let everyone know, that is if you want and it's not too private. sending cyber hugs and prayers your way my friend...

smiles, bee

Linda said...

First off, I am thankful that the news wasn't horribly ominous and that Dr. P. is optimistic that the cancer is curable. I'm also glad that you have a plan of attack and that you aren't wasting any time in putting it into action.

I work with a paramedic who had his colon removed years ago due to some complications and except for the occasional bump in the road he does very well. Yes, he needs to be more careful than the average person but if he didn't tell you that he didn't have a colon, you'd never know it. No neon sign lights up across his forehead and he looks no different than anyone else. Even though you're going to feel quite different on the inside, you will still be you on the outside.

You have a great support system with the LSS and kids and that's going to make all the difference in the world. And also know that those of us who have come to know you here in the Blogosphere are going to be pulling for you in every way possible that we can.

Like Bee said, if there's some way that you can let us know how you're doing and you feel comfortable doing so, please keep us advised as we really do care.

Stay strong and stay positive.

Linda

East of Oregon said...

Ok. I'm glad you've got a plan. The news could've been worse - so that's great! One day atatime. Now to labwork and followthrough. Get some rest.

Claire said...

I feel like a right plonker now! I just read this post and realised i need to read previous posts!
So now i am up to speed.
I am glad you have a plan of action on the go and aggressive may be the way to go.
My mum would most certainly be dead if she hadn't put her trust in the doctors! They lasered a tumour out of her brain and that was twenty years ago now. Sure there are ups and downs but have faith in the fact that they know what they are doing.
They also removed her femur and replaced it with a donor bone, when she badly broke it (due to osteoporosis) and that saved her leg, also gave her back the possibility of walking properly again.
Hope you don't think i am jumping in on your situation and bombarding you with my experiences, its just my round about way of saying you can beat this, i am certain of it!

Smalltown RN said...

Oh Curmudge...first thank you for sharing your story....it takes a great deal of courage to even be able to put it to words. I know how I felt when my youngest daughter was diagnosed with cancer...my heart sank...my heart goes out to LSS and your children.

The new is good and there is a plan in place all that is good. And you have so many people rooting for you out here in the blogoshpere that we are all going to be sending good vibes your way.
Fill your mind with positive thoughts. You will beat this!

SQT said...

In a weird way it's good you at least know what you have to look forward to and you can plan for it. That said, it must still be scary. I hope you're okay.

I've actually known a couple of people who had to have large portions of their colons removed in their 20's. I don't know if you're doctor plans on leaving any of it or is taking it all but I know from my friends that you have to make dietary adjustments, but it's livable. One person I knew couldn't eat any fiber at all, it was just too hard on her system without the colon. She always joked that she lived on water and wine. But mostly she lived on a low carb diet and it didn't seem to bother her too much. But every once in awhile she'd make a discovery that would excite her. For example, sauerkraut doesn't have any fiber in it. That surprised me, but it doesn't; so she could have kraut dogs. :)

Lone Grey Squirrel said...

Well, the prognosis is almost as good as could be expected, so hang in there. I thought your attempts to lighten the mood were quite good efforts. Anyway, we'll be remembering you in prayer for that day on the 28th February.

CoralPoetry said...

Hi,

I was sorry to hear about your news.

The lady in the bed next to mine in hospital had a similar colon operation. When we met in outpatients a few weeks later, she was running around like a spring chicken, with renewed strength and purpose and mercifully having little or no pain.

Good luck and have faith. Remember: a stitch in time saves nine. It seems you have caught this thing in time.

Regards,
Coral

Ellee said...

I was truly saddened to read this, my thoughts are with you. I'm glad your op is booked soon. Is there any chance that you could ask for a second opinion? Would you find this helpful? Just a thought, though I am sure you have given this much consideration. I shall be thinking of you.

Jean-Luc Picard said...

Good luck to your, Curmudgeon. We'll look forward to you back in the blogasphere.

sari said...

Wow! This is shocking but makes sense. I even understand the Christmas decoration jokes, though if I were LSS I wouldn't have appreciated it much either.

You have my best wishes for your surgery and recovery. You and your family are in my prayers.

Chris said...

Best of luck Curmudgeon. It'll take more than this to stop you blogging, I'm sure they have internet access in hospitals these days ;-)

RUTH said...

Wishing you all the best in this worrying time. You don't sound like you're going to let it beat you. Fight the good fight...you have a lot of people rooting for you.

AMAZING GRACIE said...

With your family history, I'm sure the doctor is taking the best course of action. I can imagine it was shocking, though. I had an uncle who lived w/o a colon for years and it sure didn't keep him off of the golf course!
Your name is now on my calendar for the 28th and I'll be in prayer for you and yours.
~~~Many Blessings~~~

may said...

it is very natural to be scared at this time. when it is our body/health that is involved, there is no simple or small thing. if blogging about it helps loosen your fear a little bit, feel free to blog along and let us know. like all the rest, i'll be here to read.

my thoughts and prayers are with you and your family.

may
www.aboutanurse.com

Where fibers meet mud said...

Curmudgeon, You are in my thoughts and prayers. As I reread this blog for the umpteenth time to make sure I read it right - still in shock - as you are too - I saw that you let your daughter go do her things - that is an amazing sign of healing right there - to allow things to go along on a normal path.

You and yours will be in my prayers until we see you blogging again...

Anonymous said...

I wish you well and will be praying for you and your family. Take care.

Ben & Bennie said...

TC, I have no doubt you'll have a very successful surgery and a continued long happy life. I understand and respect your wishes to remain anonymous but I sure do wish there were things your blog buddies could do for you. By all means you've made the daily prayer list.

I'll be looking forward to a wonderful update in a few weeks. And I'll definitely put in a request for a personal nurse that resembles Sgt. Manhart.

Heather said...

I don't visit for awhile and all this happens while I am gone?

I am glad you have a good doctor and a supportive family. I admire your attitude.

Please be well. We will all be here waiting for your posts.

RUTH said...

Hope the tests are going well. Thinking of you and your family.

Skittles said...

I echo what everyone else has said.. my thoughts and prayers will be with you.

landgirl said...

The next best thing to not having this in your life at all is to have a good cure rate, a sense of humor and a doc in whom you have confidence. I'll keep you in mind and my prayers over the next weeks of healing.

No_Newz said...

My fingers, eyes and legs are crossed for you. Good luck with the surgery.

No_Newz said...

I just swiped this from my friend Michelle's blog thought it might make you a smile:
These are actual writings from various hospital charts.

1. The patient refused an autopsy.
2. The patient has no previous history of suicides.
3. Patient has left white blood cells at another hospital.
4. She has no rigors or shaking chills, husband states she was very hot in bed last night.
5. Patient has chest pain if she lies on her left side for over a year.
6. On the second day, the knee was better, and on the third day it disappeared.
7. The patient is tearful and crying constantly. She also appears to be depressed.
8. The patient has been depressed since she began seeing me in 1993.
9. Discharge status: Alive but without permission.
10. Healthy appearing decrepit 69-year old male, mentally alert but forgetful.
11. Patient had waffles for breakfast and anorexia for lunch.
12. She is numb from her toes down.
13. While in ER, she was examined, x-rated, and sent home.
14. The skin was moist and dry.
15 Occasional, constant infrequent headaches.
16. Patient was alert and unresponsive.
17. Rectal examination revealed a normal size thyroid.
18. She stated that she had been constipated for most of her life, until she got a divorce.
19. I saw your patient today, who is still under our car for physical therapy.
20. Both breasts are equal and reactive to light and accommodation.
21. Examination of genitalia reveals that he is circus sized.
22. The lab test indicated abnormal lover function.
23. Skin: somewhat pale but present.
24. The pelvis exam will be done later on the floor.
25. Patient has two teenage children, but no other abnormalities.

Here's to hoping you never run into the hospital staff who wrote these. :)

CoralPoetry said...

Hey No_Newz,

That's a really funny list, but not quite as funny as this one:

These excuses were on accident claim forms of a major insurance company. ere asked for a brief statement describing their particular accident.


The other car collided with mine without giving warning of its intention.

I thought my window was down but found it was up when I put my hand through it.

A pedestrian hit me and went under my car.

The guy was all over the place. I had to swerve a number of times before I hit him.

I pulled away from the side of the road, glanced at my mother-in-law and headed over the embankment.

The accident occured when I was attempting to bring my car out of a skid by steering it into the other vehicle.

I was driving my car out of the driveway in the usual manner, when it was struck by the other car in the same place it had been struck several times before.

I was on my way to the doctor's with rear-end trouble when my universal joint gave way, causing me to have an accident.

As I approached the intersection, a stop sign suddenly appeared in a place where no stop sign had ever appeared before. I was unable to stop in time to avoid the accident.

The telephone pole was approaching fast. I was attempting to swerve out of its path when it struck my front end.

To avoid hitting the bumper of the car in front, I struck the pedestrian.

My car was legally parked as it backed into the other vehicle.

An invisible car came out of nowhere, struck my vehicle and vanished.

When I saw I could not avoid a collision, I stepped on the gas and crashed into the other car.

The pedestrian had no idea which direction to go, so I ran him over.

I saw the slow-moving, sad-faced old gentleman as he bounced off the hood of my car.

Coming home, I drove into the wrong house and collided with a tree I don't have.

The indirect cause of this accident was a little guy in a small car with a big mouth.


Regards
Coral (the greatest comedy source)

CoralPoetry said...

Insurance Claim form quotes

True extracts from UK Insurance Claim forms; These were collected by Norwich Union for their annual Christmas magazine.

"I started to slow down but the traffic was more stationary than I thought."-----"

I pulled into a lay-by with smoke coming from under the bonnet. I realized the car was on fire so took my dog and smothered it with a blanket."-----

Q: Could either driver have done anything to avoid the accident?
A: Traveled by bus?

-----This Norwich Union customer collided with a cow. The questions and answers on the claim form were:
Q - What warning did you give?
A - HornQ - What warning was given by the other party?
A - Moo-----"

I started to turn and it was at this point I noticed a camel and an elephant tethered at the verge. This distraction caused me to lose concentration and hit a bollard."-----"

On approach to the traffic lights the car in front suddenly broke."-----"

I was going at about 70 or 80 mph when my girlfriend on the pillion reached over and grabbed my testicles so I lost control."-----

"I didn't think the speed limit applied after midnight"-----"

I knew the dog was possessive about the car but I would not have asked her to drive it if I had thought there was any risk."-----

Q: Do you engage in motorcycling, hunting or any other pastimes of a hazardous nature?

A: I Watch the Lottery Show and listen to Terry Wogan.-----"

First car stopped suddenly, second car hit first car and a haggis ran into the rear of second car."-----

"Windscreen broken. Cause unknown. Probably Voodoo."-----"

The car in front hit the pedestrian but he got up so I hit him again"-----"

I pulled away from the side of the road, glanced at my mother-in-law and headed over the embankment."-----"

The other car collided with mine without giving warning of its intention."-----"

I collided with a stationary truck coming the other way"-----"

A truck backed through my windshield into my wife's face"-----"

A pedestrian hit me and went under my car"-----"

In an attempt to kill a fly, I drove into a telephone pole."-----"

I had been shopping for plants all day and was on my way home. As I reached an intersection a hedge sprang up obscuring my vision and I did not seethe other car."-----

"I was on my way to the doctor with rear end trouble when my universal joint gave way causing me to have an accident."-----"

To avoid hitting the bumper of the car in front I struck the pedestrian."-----"

My car was legally parked as it backed into the other vehicle."-----"

An invisible car came out of nowhere, struck my car and vanished."-----"

I was thrown from the car as it left the road. I was later found in a ditch by some stray cows."



Coral

Lawfrog said...

I've been thinking a lot about you and am glad to hear there is a plan. For whatever it's worth, which is virtually nothing, I think your attempt at levity was quite successful. I laughed:)

Hang in there and know that you have a lot of people out here praying for you.

Linda said...

Just popped by to say 'hello' and send best wishes that everything is going okay for you and yours! Hang in there, better times are coming!

cmhl said...

ugh, curmudgeon, I'm thinking that you are having trouble fitting this into your social schedule..

the whole colon out? Well, .... better than having to go through it again in 5 years, 10 years, etc. right? right.

Now you have a plan, work the plan. thinking of you.

Overwhelmed! said...

So, this is my first time to your blog, I think. cmhl sent me.

I'm sorry to hear of your diagnosis, but I'm happy that you have a doctor that you trust so much. That's wonderful!

I'm keeping my fingers crossed for you!

Kim said...

CMHL sent me. What's quality of life compared to no life? I think it would be a different story if colon removal would be terminally painful. You're looking at a minor inconvenience on one hand and not having to worry about the future possibility of colon cancer on the other hand. I had a boss that had his removed. He kept working until his 80's.

Good luck.