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.