I'll CCU in my dreams.

On Saturday morning, I woke up with a headache that reminded me of the one that announced the hemorrhagic stroke I'd had 17 years ago. I called my brother, and he came and took me to U of L emergency room, where I'd requested to go, because they have all my records, and I like the staff there. From Saturday at 10:00 AM until Monday morning at 1:30 AM, I was in the emergency room with every sick, hurt, loony or druggy person within a 100 mile radius of the building. I did not get a room in the ER, because they were full, so I was in a corner with two other beds with curtains between us. It could have been worse, because there were others on beds in the aisles of the ER. 

In my little corner, during my 2 day stay, there was a woman who thought she'd had a heart attack but didn't, a man who threw gasoline on his gas grill and burned his face, a man who fell asleep on his motorcycle and apparently had no injuries because of the helmet and leather clothing, another man who came from Cincinnati to Louisville to "find himself" but apparently didn't, a man who fell off a roof and broke his ankles a few months ago and was concerned that he might have an infection under one of the casts, a man who thought he was having a heart attack but it was pancreatitis, a man who was camping in Mississippi and got bitten by fire ants, and more roommates whose issues I can't recall. The curtains between us didn't quite keep their voices from carrying. The guy with two broken ankles did not stop talking the entire time. He talked to his friend, and when the friend left, anyone who walked into his space was fair game for his electrifying monologues. I think he was either talking on the phone or to himself the rest of the time. I was more happy than he was, when he was released.

When my family and friends left to get some rest, I had to take my 80 pound purse with me to the restroom which was at the end of the hallway. I looked so fashionable with my big, expensive, leather purse (the one I got to carry my colostomy equipment in) hung over my hospital gown, my loose, black, workout pants, and the yellow no slip hospital slippers. The restroom smelled strongly of urine and had used band-aids, paper towels, and blood on the floor. After a few visits, I started wearing non latex gloves when I went in there. By doing that, I didn't have to wash my hands afterwards or worry about the door knob when I left. A few times when I went in there, the seat was up, too. That never happens at my house! 

They didn't give me anything to eat until Sunday morning around 9:00 AM, but no one woke me until a few hours later, so the food was cold, and bad, as usual. It consisted of two cold pancakes, some horrible cold coffee, and some warm orange juice. Even starving, I couldn't put those pancakes down. When my brother and sister-in-law came by that morning, they brought me Ghyslain coffee and croissants, a much, much better breakfast.

While in the ER, they did a CT and an MRI. Neither showed evidence of a stroke (yay!), but my troponin (enzyme) levels were raised, so there was a concern about a heart problem. They wanted to do a heart cath, which I was not excited about. The nurses came by and said I was going to get a heart cath, and then the resident doctor came by and said he didn't think I needed one. At 1:30 AM on Monday, a nurse woke me and said "I've got some great news!" and I expected him to say "You don't need the heart cath", but instead the news was that they had a bed upstairs for me, which was still pretty good news.  

Meanwhile, in the ER at different times during my stay, I listened to screamers, very dramatic and loud vomiting sounds all made by men, my neighbors talking on the phone or to their visitors or themselves, my roomies' TVs, and sirens. I saw a man being held down by two EMT guys, so the nurse could get his vitals. I saw a man with a really beat up face in a bed in the aisle. I saw young girls walk in with shorts, which was a big mistake, since the temperature in the ER is about 40 degrees. I had 4 blankets over me. At one point, the ER finally went into "diversion" mode, meaning no more ambulances could come to U of L hospital.

They monitored my troponin and blood pressure watching to see if the troponin would go down after they gave me some blood pressure meds. They also gave me a heparin drip which decreases the body's ability to clot. They said it can also cause an increase in troponin levels. So they continued to monitor my troponin, and it finally went down. They decided that it hadn't gone down quickly, because I may have been on the drip too long. They also wanted me to do a stress test, which I did. For a stress test, they lubed up some places on my chest, and took some images of it, by pressing a wand around my chest. Then I had to get on the tread mill and walk for at least 9 minutes or until I reached some magic number pertaining to my heart beat level. I didn't make it to 9 minutes, but I reached my magic number. I passed the stress test, too, which meant I didn't need the heart cath. They also could tell by how quickly the heart beat level rose when I got off the bed and stepped on the treadmill that I was dehydrated and needed water after the test. 

When the cardiology team finally appeared, after I got a room in the CCU, they said there was one last thing they wanted to check, and that was whether I had a blood clot in my lungs. If I had one, I would need to be on blood thinners for the rest of my life. I had a terrifying moment, when I thought they were going to give me an IV instead of using my port, but it turned out that the power port was good to use for the contrast needed for the lung CT scan. When the CT scan came back negative, I was finally told I could go home, which ended up being around 6:15 PM Monday.

I have to mention that all the nurses and doctors I had interactions with were great. Nurses need to know a lot about many different conditions, and most seemed very knowledgeable. I was especially impressed by my nurse in the CCU. Her knowledge, attitude, humor, patience, and empathy were all fantastic. She had been a nurse for many years and was still doing it right. I also saw my nurse friend, George, while in the CCU. He just happened to be coming to my floor to do a procedure on the person in the room next to mine. He was quite surprised to find me there. One of the cardiac doctors that I met there was also top notch. Being a doctor is about his 5 career move. One career was at the health insurance company where I work. He is doing his cardiac rotation now, but wants to be an anesthesiologist. He came back several times while I was in the ER and also when I was in CCU and told me what was going on and explained things to me. If he didn't know the answer, he told me he'd find out and he did. He was very kind and upbeat and had a great smile. It's too bad he wants to be an anesthesiologist, because they have limited contact with their patients, although his bedside manner will help put people at ease before he puts them to sleep.

When I was preparing to leave, I got on the potty chair. There was a knock at the door, quickly followed by a head poking in the door, and when the head saw me sitting there, he (the doctor who was discharging me) apologized and left. Next, I was sitting on the bed facing the door, getting dressed with only my pants on, when there was a knock, followed by another doctor opening the door, and suddenly sticking his head in. He, too, quickly apologized and left. He went back to the group and said he'd walked in on me while I was dressing, and the other doctor said he'd walked in on me sitting on the potty chair. Another example of how guys are always in competition and have to one up each other for everything. 

Finally, I got dressed and got home and went to bed where the only crazy person in the room was me. My three dogs and one cat were all there, too. I slept for 12 hours. Today, I rested at home and worked on eating more and getting my strength back.

I can only imagine what the bill for three days in the hospital will be. After multiple tests for a stroke, heart problem, and blood clot in the lungs, the final diagnosis was that I have high blood pressure. In all my recent visits to various doctors, my blood pressure was great, so why it's suddenly jumped, causing the horrendous headache, will remain an expensive mystery.     

No pain, no cane

It's been over a month since my last post, and I've been very busy. And my old plumbing has been working overtime. Sometimes, it doesn't give me adequate notice that it's time to "go," so I have to step on it and sprint to the bathroom. Sprinting has become more of an ordeal than usual. The usual ordeal involves my three dogs walking to the bathroom with me. One runs ahead, another walks slowly in front of me in my narrow hallway and stops and turns around from time to time to make sure I'm still coming, and the third one stays behind me. When I finally get seated, the one who walks slowly in front of me sits down next to me and assumes that this is the perfect time and place to be petted. He is delighted that I am in there as often as I am. Sometimes, the other two come in for petting, too, but mostly it's just my boy and me. 

The other reason sprinting has become an ordeal is that I now have peripheral neuropathy either from the chemotherapy or sciatica or something else. It's only affected my left leg which prompted my medical oncologist to say that it's probably not from the chemo, because it's usually bilateral and happens when people got more doses of the offending chemo drugs than I got. But my PCP said she has had lots of patients who had the same symptoms I had, and they had had Taxol like I had. I also read that Cisplatin, which I also had, can cause peripheral neuropathy. Both Taxol and Cisplatin were in the TIP chemo regimen that I had before the regular chemo and radiation started. The TIP regimen significantly shrank the tumor.

Regardless of what caused it, it is keeping my life from getting back to my "used to be." It started back in March or April. I don't remember when, but I do recall that for a time, walking felt the best, sitting was a little painful, and lying down was very painful. I used a heating pad at work on my back and hip. I was able to walk with my walking buddies at lunch time, but I was slower. While I was in the hospital for the colostomy reversal, I got the physical therapist to come to my room and show me some exercises. That was back at the beginning of May. I've talked to my colo-rectal surgeon, my medical oncologist, my PCP, a chiropractor, a massage therapist, and an acupuncturist about it. No one really knows where it is from, but they all have given me exercises to do. I am still seeing the acupuncturist and the massage therapist, and I've been attending classes on meditation. When I leave the acupuncturist and massage therapist, I get temporary relief and don't need to use my cane. But after a while, the mojo wears off, and I'm back to the pain and my cane. I wouldn't have had a cane to use, but I had given one to my Dad years ago, and when he died, I brought it home with me, never imagining that I'd need to use it. 

I'm on drugs for nerve pain and regular pain, but the nerve pain is able to rise above the drugs and surprise me with sharp shooting pain in my calf, shin, foot, and big toe. Basically, I've got pain 24/7, but sometimes the drugs are able to keep it at bay. It's worse when I wake up in the very early morning for a bathroom visit. Then, I have a hard time falling back to sleep. What's weird is the areas that get the sharp shooting pain are numb to the touch. Besides the pain, there is a feeling of heat, as if someone were constantly burning my skin. The top of my foot hurts after I wear shoes for a while, so I go barefoot a lot, at least when I'm home. Although I'm very careful moving around, sometimes the tip of my foot, which I can't feel, gets stuck on the end of the rug, and I'll trip, but I'm usually able to stay upright. Recently, after a massage, I was trying to straighten a rug runner that the dogs had moved while rough housing. I straddled it and fell, landing on my rear, and felt stabbing pains running through my calf and foot. I stayed on the floor for a minute surveying the damage, and when I saw all was okay, I got up.

A few days ago, I rammed my right little toe into the cane, because I think it's important to balance out the pain, although the left side is winning. Early this morning, when I got up for a bathroom visit, my cat walked in front of me, and I tripped, and my big toe curled under, and it has been hurting ever since. The intermittent, high frequency, stabbing pains I've had today in my calf and big toe are the kind that actually make me exclaim something appropriate out loud - from my meditation class, I've learned that the appropriate Buddhist thing to say would be "Hi pain. I am aware of you. Please come in and have some tea." I tried that the other night, but the pain took advantage of my kindness and is probably a fundamentalist of some sort. When the cat's tail brushes against my skin, it hurts. Sometimes, I'll think one of the dogs or cat is touching my leg, but there's no one there. At times, it feels like there's a hot vise around my foot below my toes. Right now, the arch of my foot is on fire and there's a pulsating pain there, which I don't want to serve tea to. 

My next step is to talk to a woman who was introduced to me by the executive director of the volunteer organization I have joined. She is also a volunteer who had cancer and now has neuropathy. I'm hoping to get some insights from her. I have also made an appointment to see an orthopedic doctor who may write a prescription for physical therapy. At some point, I'll run out of options and will either have rid myself of this miserable condition or have learned to live with it. If I must live with it, I reserve the right to yell curse words or kind Buddhist words if I become enlightened, when it's warranted. 

Now, if you'll excuse me, I've been dragging my feet, because I hate to cook, but I need to hot foot it into the kitchen and make some dinner. Until next time, remember to put your best foot forward and toe the line.

Holy shit!

While I was waiting for the day of the gastrografin enama test, I called my colo-rectal surgeon's office to find out what kind of surgery I would need if the fistula had healed itself. The nurse called me back and left a message that the only surgery I would need would be taking down the colostomy. This was great news, even though I was worried about how long it might take my "plumbing" to start working again. The only way you can leave the hospital after a colostomy is reversed is to poop. You know that old saying, "The proof is in the pooping."

After the test showed the fistula had healed itself, I met with the colo-rectal surgeon, and we discussed when the reversal surgery could take place. I wanted it as soon as possible. She spends a lot of time traveling the world doing research and teaching, but she had an opening right before Derby, on the last day of April, so I took it.

I had to be at the hospital at 6:00 AM, and my brother took me there and stayed while I went through pre-opp. The nurses and I had the same discussion that I have every time with them about using my port and not giving me an IV in my arm/hand. For the exploratory surgery when my doctor sedated me to probe around for the fistula, which was done in an outpatient area in the basement of her office building, they used my port until they sedated me, and then they put the IV in. They also took it out, before I went into recovery. In fact, I didn't know I'd had it, except for the bandage over the area where the needle was. This was ideal. However, the pre-opp nurses at the hospital would have none of that and insisted on poking me near my hand. They didn't seem the type to be swayed by tears, so I just went with the flow. I admit, she did a good job, and she did numb it first. 

We are now at another part of the story that I don't remember big chunks of. I know my brother had to leave to go to work, because he was the only one in his office that day, but I don't remember when he left, or when my sister-in-law showed up. Apparently, the amnesiac they put in the sedative works well. I do remember some of the dilaudid block (GI block). From what my sister-in-law said, I was in a lot of pain, and the morphine wasn't working well. I don't remember being in pain, but I remember the doctor being there with the ultrasound equipment. I think I had to lie on my side while he administered the block. After reading the description of it, I'm glad I don't remember it, because it was a 4 inch needle administered subcutaneously. Subcutaneously means in a fatty layer just under the skin where there is not much blood, so the medication can be absorbed slowly.

I guess once I was out of pain, I could concentrate better on making comments like "Let the poop begin" and offering ice chips to my sister-in-law and telling her it was bacon. I also told the nurse who said I should push the call light if I needed anything, that I would "let my love light shine." That dilaudid block was great!

According to my sister-in-law, I didn't get into a room for many hours. I don't remember this either. I did go to the floor where I had been when I got the colostomy, and my room had a decent view of the Pegasus Parade. My walking buddies from work showed up either Thursday or Friday and that was a nice surprise. I didn't end up with any visitors the night of the parade, because no one could get through the traffic maze downtown. 

As expected, I was given clear liquids for a few days, and I couldn't get much of them down, because they was disgusting and were foods that I don't like, like jello. Who wants to eat chicken broth and jello for breakfast, lunch, and dinner? I wasn't worried about not being able to produce poop, because I'd read that you still do or doodoo, even if you don't eat for a while. At some point, they switched me to a full liquid diet, which was a little better. I was able to have things like cream of chicken soup. 

Friday, I felt good enough to work on my laptop, which saved me from losing another vacation day. After having to stay in the hospital 6 extra days for the colostomy surgery, and after my doctor said I should plan on about a week for the take-down, I figured I'd be there at least a week. But on Friday, a little before the fillies were set to run at The Kentucky Oaks, this nag was sprinting to the bathroom in a bid for the real home stretch. When the deed was done, I was so excited. I pulled the help button next to the toilet, and as luck would have it, the CNA who opened the door was the cutest, 20 something year old male CNA I've ever seen. He said "Can I help you?" and I said, "I pooped." He responded, "Do you need me to help you?" and I said, "No, just tell the nurse I pooped, because that's what I have to do to go home." If I'd known they weren't going to ask for proof, I would have told them I pooped on Thursday after the surgery on Wednesday. By the way, without knowing the odds or who was the favorite, I picked Untapable for The Kentucky Oaks, just because of her name. 

Because it was so late in the day, I stayed in the hospital another night and was released around noon on Derby day. My neighbors came to take me home. It was so nice to leave the hospital without the waste around my waist. I felt good and strong and happy to have gotten over the latest hurdle. The next test would be whether I would recognize the signals to head to the bathroom, and whether I would make it on time. My first day home, the answer was "the old grey mare, she ain't what she used to be, many long years ago."

Unexpected good new

Almost a month has passed since I last posted here. A lot has happened and most of it was really good. 

When I went in for the gastrografin enema, I told the tech that I was concerned that it would hurt because of the radiation I'd had. He went and talked to the doctor, and the doctor decided to use a much smaller apparatus instead of the longer one with the balloon. I found out the balloon is inflated after the apparatus is inserted to hold the cannula in place, while they fill up the area with the liquid. The smaller apparatus didn't hurt at all, and the doctor told me while he was viewing my insides that he didn't see the fistula. He said he would need to review the x-rays, but from what he could see, the fistula was gone. The tech later told me that all the liquid went straight to the ostomy bag. Plus, I was told that I should wear a pad, because I was going to leak all day, but that didn't happen either, because the liquid went to the ostomy bag. 

I waited for the results and took them to my colo-rectal surgeon. She was very pleased that the test confirmed the fistula had healed itself and got up from her chair to give me a hug. She said she was so happy to be able to give good news for a change. I asked if it was very common for a fistula to heal itself, and she said it was very unexpected. While fistulas can heal themselves, they tend to grow even larger from radiation, and my radiation oncologist had told me early on that he was 100% certain that I would have the colostomy for the rest of my life. While I was discouraged from his statement, I decided to believe my colo-rectal surgeon who had told me that she would do whatever she could to reverse it. And she was true to her word - more about this in the next blog.

She and I had had a previous conversation about other surgeries that she could perform if the fistula were still there, and they were not easy surgeries or easy recoveries. One type of surgery was possible if the fistula were small enough and low enough in my vagina. This surgery is called graciloplasty and the gracilis muscle is a little used muscle on the inside of the thigh. "It can be turned upwards to be used as a living transposition muscle flap to cover or repair damaged tissue." The other type was even worse and involved two surgeries. First, I would have switched from a colostomy (large intestine) to an ileostomy (small intestine) and that would have had to be in place for two months while the area of the second surgery healed. The second surgery, called a colo-rectal anastomosis would have meant removing some of the rectum where the radiation had done damage, then pulling the colon down and creating a J-pouch out of the colon where the waste would go. Then the colon would have been sewn to the remaining part of the rectum. Fecal incontinence is not uncommon after anastomosis surgery and exercises to strengthen the anal muscle are needed. Dehydration is somewhat common with ileostomies. Also, with anastomosis surgery, because the J-pouch is where the waste goes, and the construction of the colon is different from the rectum, I would have had to learn new signals that I needed to poop. The rectum has a very sophisticated collection of nerve endings in it which send signals to the brain letting you know that you have gas, poop, or liquid. (Apparently, this collection of nerves isn't so sophisticated as you age, because sometimes, we seniors think we have gas, but it's poop. Surprise! Are you wearing your Depends?)

Luckily, I got to avoid those surgeries, because the fistula healed itself. The unexpected good news of the fistula's departure balanced out the unexpected bad news that I had cancer, which I might not have discovered in time had it not been for the appearance of the fistula. Maybe it knew it was no longer needed and went away. I don't know what caused it to close up, but I admit to doing some visualizations of it closing, and I know many of you were saying prayers, sending good vibes, and healing thoughts my way, too. Whatever the reason it healed itself, I'm grateful. 

It's almost party time! I'll bring the balloon!

It's been a while since I last wrote. But it's a sunny, warm, Spring evening and that makes me want to stay indoors and write. Actually, I've already had two walks today, and I'm enjoying a breeze in my sun room, so I'm not as nature deprived, as I pretend to be.

Since I last wrote, I have seen my colorectal surgeon twice. The first time was regarding reversing the colostomy. She did a brief exam of my lower orificia (that's the medical plural for orifice). I have been on this type of examination table more than once. I laid on my stomach, bent at the waist with my knees on a shelf lower than the table. Then they pushed a button, and my head went down and my rear went up, and she did her exam, apologizing the whole time because of the pain she thought she was causing. Actually, it was not bad, because she was being very careful. She also looked at the report of the PET scan and seemed pleased with what she read. Because she didn't want to hurt me by doing a more extensive examination, she set up an appointment for me to be sedated. During the next exam, she also scheduled another biopsy. 

So my brother took me to the outpatient surgical center, and we met some very nice nurses who covered me in warm blankets and connected a tube to my port (I love my port!) and dripped some saline in there, while I waited for the procedure. The anesthesiologist came and asked me a lot of questions, and then my colorectal surgeon showed up and checked what the nurses had written down. I told her and the anesthesiologist about the pain I'd been having (and am still having) in my left buttock and down the side of my leg and in my shins. After a few questions, I think they were convinced that it was not a sudden recurrence of cancer. I had thought it was sciatica, but now that I've read some things about it, I am not sure what it is. It hurts most when I'm lying down and has been interfering with my sleep. It feels best when I walk, and it hurts a little when I sit. I will see the radiation oncologist next week and tell him about it. Maybe it's a side effect from radiating my pelvic area.

Okay, so finally it was time for the exam and biopsy. Two nurses rolled me back to the operating room (in my bed) and one told me that what they had just pumped in me worked very fast. I told her I was still awake, and that's the last thing I remember. My neighbor came to pick me up and took me home. My throat wasn't sore from the anesthesia this time, but I did have some bleeding from the biopsy and probing. I wasn't groggy and was actually able to work from home for 5 hours that day. Since I used up 5 weeks of vacation time during the surgery, chemo, radiation, and side effects, I have been trying to make up the time I miss, so I don't lose any more vacation days. 

The results of the exam and biopsy were surprising. The biopsy showed no cancer, which was not that surprising, since that was what the PET scan showed, but the exam showed no evidence of the fistula. According to my doctor's nurse, she had really poked around while I was anesthetized trying to find the fistula. What is odd is that not only can radiation cause a fistula to form, but if you already have one, as I did, it can enlarge the opening. But mine was nowhere to be found, which was unexpected, good news. 

So now, we get to the party part of this posting. There's yet another test to see if the fistula is hiding somewhere. On 4/22, I will get a gastrografin enema. You may not know what gastrografin is, but I'll bet you know what an enema is. Gastrografin is a "palatable, lemon flavored, water-soluble iodinated radiopaque contrast medium for oral and rectal administration only." I'm sure my rectum will be delighted with the lemon flavor. I hope it doesn't sting the radiated tissue. The nurse mentioned that a balloon would be put in my rectum (party, party!), and then the liquid is pumped in and x-rays are taken. I asked the nurse if I would be sedated for this procedure, and she told me that I would not be, because it doesn't hurt, it's just embarrassing. Whenever someone in the medical profession tells me that something does not hurt, I wonder if they have experienced whatever it is that doesn't hurt. But don't you worry. I will soon have first hand, or first ass, knowledge of this procedure and will tell you whether it hurts or not. As for being embarrassed, I think all the previous experiences have made me immune to embarrassment. But if I walk into the procedure room and see Sybil's mother at the piano, I'm outta there! (If you haven't seen or heard of the movie "Sybil," check out http://moviebuffs.livejournal.com/2047467.html.)

I can see clearly now, the cancer's gone

I met with the medical oncologist today, and he was more upbeat and confident this time than he was the last time I met with him. He said the news was good, and that I appear to have some scar tissue from the radiation, but the cancer is gone. I read the radiologist's report, and it sounded much better than the first PET scan I had in August. My tumor had been 5.3 cm x 5.6 cm and the standardized uptake value, SUV, was 11.8.  

SUV refers to the level of activity in a specific area compared to activity elsewhere. Cancer cells are the fastest growing and show the highest SUVs. The baseline of 1 is normal activity while anything higher that 2.5 can indicate metastatic cancer. It can also indicate inflammation which can be the result of radiation, surgery, or injury. Now, the "mass has significantly decreased in size and intensity of FDG uptake." What is now seen at the site of the cancer appears to be about .9 cm x 1.9 cm and the FDG uptake is similar to the background tissue and is "likely representing treated disease with mild post radiation inflammatory change; however, continued attention on followup is recommended to exclude small volume residual disease." My limited understanding of the FDG uptake is that there is glucose in the radiotracer and cancer likes sugar, so where there is cancer you will see a lighter, brighter shading on the scan. The metabolic activity of cancer cells causes them to appear "hot" on PET scans. My SUV is now a "maximum of 2.0," and my lymph nodes also looked good. 

So, I feel pretty good about this and am hopeful that the next PET scan in 3 months will show the same or better results. Maybe by then, someone will develop a better tasting pre-test liquid, because what I had was awful. I don't even know what it was for, because they injected the radiotracer in my port. I did get a nice surprise when I started drinking the second glass, because it tasted like water. After several sips, I realized it was water. Things are not always what they seem.

I'll take "radiation side effects" for $400, Alex.

My good news from Dr. BigHands was followed by some other news from the MRI and CT scans. Apparently, there is still something at the site of the cancer, although it's smaller than the cancer was, and it hasn't been determined if it is cancer. It may be scar tissue or radiation reaction or granulomas. The radiology doctors who read the scans did not come out and say it was cancer, but they hinted that it could be. At least, I think that's what they said. It was in some foreign language, or it may as well have been. I could barely pronounce some of the words, much less understand them. Here is a sampling. Marcel Proust would have been proud of the first sentence:

"Again noted is positive treatment response with persistent thickening and irregularity of the rectal wall approximately 9 cm from the anal verge along the omental aspect from approximately the 12:00 to 6:00 position, measuring approximately 2 cm x 1.4 cm with persistent areas of restricted diffusion as well as scattered patchy enhancement." 

"Adjacent blooming artifact in this region is noted."

I don't know whether to be proud or nervous.

On Valentine's Day, I will be getting a PET scan to see if it picks up cancer there. I think my medical oncologist said that it would be definitive, if it found cancer, but if it did not, I would need further testing, such as a scope to see what is actually there.

So, I'm not out of the woods yet. I'd like everyone to say a prayer or send good vibes or visualize that there is no cancer remaining and that whatever is there is something I can live with. My guts tell me that it's not cancer, but my guts forgot to tell me when the cancer first showed up, so I'm not sure how reliable they are. 

I'll post again after I get the results of the PET scan which should be on 2/17 after I meet with my medical oncologist. I'm hoping that the PET scan shows nothing, and that the subsequent scope will also show no cancer and that all systems will be a "go" for a colostomy reversal. 

Hand jive or Dr. BigHands gets down and dirty

I met with Dr. BigHands today, and he earned his name again. He warned me during my first exam many months ago that this exam would be very painful, and he was right. Thanks to the radiation, my vagina and rectum are apparently smaller, narrower, and less supple. I had to be physically (manually) examined in both my vagina and rectum. I almost broke his nurse's hand when I grabbed it and squeezed it, while he was doing his exams. First, was the vagina and he did a forceful 365 degree exam, then the rectum with the same process, then both simultaneously, but without the 365 degree turns. What fun! What glee! I'm pretty sure that for part of the exam, my ass totally lifted off the table. When I left, I asked the receptionists if they heard me yelling "Ouch, ouch, ouch!!!" during the exam, but apparently, the doors were thick enough to muffle my screams. 

I mentioned to him that I didn't think I'd be able to have sex again, so he told his nurse to get me some dilators which I had read about. You get varying sizes of these things that look like dildos without any curves (hallelujah!) and some lubricant and insert them for 10 minutes 3 times a week, trying to undo the radiation damage and increase the size of the vagina. She gave me two sizes and a tube of lubricant in a small brown bag, so that it looked like I was carrying a bottle of beer when I left. As I laid the brown bag down in the car, I was thinking about how it would look if the police pulled me over and wanted to see what was in the brown bag. I was hoping I had the instructions handy, so I could show them what they were for. 

After the painful exam, Dr. BigHands announced that the cancer was gone, and that he was very happy. I was happy, too, and I'll be even happier if the MRI scan in a few days confirms his findings. I will also get a CT scan later this month - the CT scan will show the lymph nodes and the MRI will show any mass that is there. And in mid-February, I will meet with the colorectal surgeon to see if she can reverse the colostomy. Dr. BigHands still stands by his prediction that I will have the colostomy forever, although, he said the fistula was actually smaller. I told him I still wanted to meet with her to see what she says. He said he would be delighted if she could reverse it, because then she could help a lot of his patients. 

My first trip to the bathroom when I got home was electrifying. When I started to pee, it felt like I was being stabbed, similar to what happened when my skin broke down during radiation, and the uric acid went in the open sores. So, I'll have to put some prescription cream on the "wound" and pour water between my legs when I pee to dilute the acid and reduce the pain. But, it's a small price to pay for the good news I got today.  

Hurry up and wait!

My last radiation treatment was on December 4, 2013. Because the radiation keeps working after the treatments end, I must wait to get the CT scans done. I am also waiting to meet with three of my doctors. I'll see Dr. BigHands, the radiation oncologist, on 1/20 for a physical exam. On 1/29, I will get the two CT scans and will meet with my Medical Oncologist to go over the results on 2/3. Then on 2/11, I will meet with the colorectal surgeon to discuss whether the colostomy can be reversed. Radiation can cause the fistula to enlarge, which might make the reversal difficult or impossible. I am reeeealy hoping that the colostomy can be reversed. 

Not much else is going on, I'm just in a healing and waiting mode. I have gone back to the office and am working full-time there. I prefer working from home, but I like being back at work, because there's a group I walk with at lunch, and now I'm able to join them and get some exercise. Last week, I got in 5 days of 10,000 steps/day (5 miles), which I haven't done since I first was diagnosed back in July. This is also good because I get a lot of laughs during our walks. One day, I laughed for about 5 minutes straight, to the point of tears. Even now, when the key words "Come, Follow Me" are spoken, we all laugh. (You had to be there.)

I'm eating okay, but food has lost its appeal. It's nothing to do with the taste, because everything tastes okay. I just have a hard time coming up with foods that sound good. Salads, fish, and beef are on the short list of appealing foods. My sweet tooth has not come back, but I think that's probably okay. 

My hair is coming back, but at a painfully slow rate. I wear a hat most of the time, just because my head gets chilly otherwise. I must have heard 1000 times how lots of people's hair grew back a different color and texture after they had chemo. I can't tell the texture yet, but mine is grey which is what it was before it all fell out. I was hoping for curly red hair. 

I still haven't gained all my weight back, but I'd like to not get to the weight I was previously anyway. I think I'm within 5 pounds of my desired weight. 

I've started reading for pleasure again. After my brother's suicide, I started reading books about suicide and death, and when I was diagnosed, I started reading about cancer and healing. Now I'm reading light and funny novels and would love some book titles, if you have any to suggest. 

I ended the year with another trauma. I was walking my three dogs on our regular route, and we were walking down a small hill when Finn, my Golden boy, decided to do his stop, drop, and roll at my feet. He does this 5 or 6 times when we get to the grassy area, but usually, he is on my side or far enough in front that I can stop. This time, I couldn't stop, and I also had some momentum from the other two dogs pulling me downhill on their leashes. So, I catapulted head first into the ground - my arms were out at my sides holding the leashes. I landed on my nose and was wearing sunglasses which dug into the bridge of my nose. I heard a crunching sound in my neck. I had grass in my mouth. After I composed myself, I rolled over and sat up. I felt my teeth with my tongue to see if they were all still there and in one piece. My teeth were fine. I sat there for a bit and saw the three dogs in front of me, still on their leashes. Finn was behind Shelby and his expression said "I have no idea what just happened." Shelby came up and licked me on the face. I think she "got it." Tess also looked bewildered. We continued on the walk. I wish I had a video of the free fall, because I am sure it was funny. 

I was happy to see 2014, although I didn't ring it in. I'm hoping for a better year and getting good CT scans and reversing the colostomy would be a great start. Wish me luck!