Tuesday, January 13, 2009

The Joy of Barium

Visiting a hospital for tests is always something of a transformational experience for me. As you can probably tell from Saturday’s entry, I was feeling just a mite sorry for myself. Foolish, that. Fortunately, visiting a place where people face – and overcome – genuine challenges and threats, helps me to put my own life into better perspective.

The University of Texas M.D. Anderson Cancer Center, to use the full name once in a while, is a fantastic place, where thousands of the most dedicated and motivated medical professionals in the world fight a never-ending battle against cancer in all of its forms. Front to back, this place is incredible, operating at a level of care and compassion I have seen at no other place. It’s not just the doctors, you see, but the nurses, physician’s assistants, even the volunteers and phlebotomists are very, very good at what they do. While there are some patients that MDA must turn away, every patient accepted at MDA can count on a conviction that their doctors and staff will refuse to surrender, that every effort will be made not only to beat the cancer, but to provide a comfortable life for the patient. Hey, I know I sound like a commercial, but you have to see this place to believe it. And to understand why so many cancer patients desperately hope to be admitted there for treatment.

And why I am always a bit depressed when I go there. You see, I have been very, very lucky. My cancer is formally known as Pseudomyxoma Peritonei, an abdominal cancer where the cysts form as free-floating cells in the abdominal fluid, going unnnoticed for years in almost every case until they reach a certain size, around 2 millimeters in diameter. At that point, two things start to happen. They start to seriously block the flow of fluid into and out from the abdominal cavity, increasing pressure on internal organs and eventually choking them off, and at some point they metastasize, and attack all the internal organs they can reach. Up to that point there are usually no warning signs, so that the overwhelming majority of PMP patients are discovered only at Stage IV. There is no known cure for PMP, and Stage IV PMP has a survival rate ranging from 10 to 25 percent, depending on a variety of factors. Me, I got really lucky, because I passed a kidney stone.

In October of 2006, I passed a kidney stone, and it hurt like nothing I had ever experienced. My doctor told me to get a CT scan to be sure there was not another one waiting to have a go, and that was when my doctor discovered I had ruptured my appendix, and ordered emergency surgery. That surgery produced its own surgery, as the surgeon taking my appendix out found a mass of mucus-like material in my abdominal cavity, removed every bit he could find, and sent off the stuff for tests. From there, the tests came back malignant and more tests were done, and after a few referrals and more tests PMP was confirmed. So, odd as it sounds, passing a kidney stone and rupturing my appendix saved my life in a way, because it caught the cancer at a very early stage. You just never know how things are going to work out.

Short version from there, they cannot cure it but they can control it. So long as the little cells stay really small, I’m good. So no more surgeries, at least not for now, not even chemo. The downside of that, though, is that I didn’t do a single thing to deserve that good fortune. So every time I go to MDA to get more tests done, I see people who have not been so lucky. I was chatting with a guy yesterday who was fighting lymphoma, and he joked that the cool thing about the chemo he was having, was that he only had to shave every 3 or 4 days. That way of putting things to the good is not uncommon there. Because of the radiation and drugs and so on, the floors I go to do not have any children under 12, who are treated in a different place (just as well – I do not think I could stand seeing a child go through some of the things the adults have to endure, and I know that some of the kids do have to take that), so I see folks from their late teens and up, in various stages and types of cancer. Having an abdominal cancer, I tend to see the colon and rectal cancer patients, we’re a special kind of grotesque club. Sometimes we discuss what we do when the ‘plumbing’ shuts down, or which doctor we’re going to. Seems like the men here outnumber the women about 60-40 in abdominal cancers, for whatever that means.

Things are getting to be a steady routine now with the tests. After the tests, my wife wanted to know what I wanted to eat, and was surprised that I was not hungry; she’s forgotten what the tests are like. All that barium, you see. The barium shake is one thing, but the IV makes you feel glowy in a weird way, and all I will say about the rectal contrast is that you won’t want to be active below the chest for a while, OK? I was reading a bedtime story to my daughter last night, and I joked that I could read it with the lights off. Meh, if that’s the worst I get I should be fine. I thought about not blogging about the tests, but it stays on my mind while everything tastes funny, which usually lasts a couple days.

As you’ve probably figured out by now, my thoughts are less than well-organized today. I feel fine about the tests, guilty about not having as tough a time as so many other people fighting cancer, I appreciate the spirit and outlook of the fighters, and I am still immature enough to get bothered by all the needles, chemicals, Ivs, and other accoutrements of going to the hospital, even just to check up on how things are going. I’d like to say there was a point to this, but I cannot really think of one except it’s what’s on my mind, and maybe your Monday was not so bad when you think about it.

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