Wednesday
Aug292012

22. Cancer Again?

Christmas 2011 was a great milestone to meet. One, it meant time with my extended family and friends. Two, it meant I was still alive. Both pretty good things. But just as God giveth...

After coming home from a lunch with my friend Tricia, I sat down on the couch and noticed something odd. My right leg felt very hard. I wish it was all that muscle I was busy rebuilding. But I knew better. I lifted up my sweatpants and saw that my leg below my knee was much bigger. Not necessarily a problem. For a long time, my right leg has been bigger than my left. Years ago, a back injury caused severe atrophy in my lower left leg where, for all practical purposes, I have no left calf.

So, I thought, this is bigger than usual, but is it something to worry about? Since I already had experienced a pulmonary embolism, I wondered if blood clots were making a return visit. I picked up the phone and called my primary care doctor. Lynn, my favorite nurse, told me not to fool around with this and head straight for the ER. Sigh, another trip to the hospital. Well, at least I knew the way by now.

First order of business: have a sonogram to check for blood clots. It would take a little while to get everything ready. So I just laid there and tried to relax. Then it happened. I looked down at my leg again. I could see my leg literally shrinking before my very eyes, back to its normal size. Must be the healing powers of the ER. Or maybe God really was watching out for me. Or both. Still, I needed the sonogram. So off I went.

When you go through as many serious medical procedures as I had, you hope and pray you have access to the best medical professionals in the business. We tend to think of the doctors and nurses in this regard, and God knows they're absolutely critical to your care. But technicians matter, too.

For example, performing my ultrasound was BJ, who has a big, warm smile. He grew up in Virginia, moved to Nigeria for several years, then came back to the States to join the Navy. After his service was up, he settled in San Diego. But, get this, he found life there filled with TOO much leisure. To improve his skills as a medical technician, he moved back to Virginia and has worked at Loudoun Hospital since 2007. And because he did, he was able to help me.

His verdict on my leg: all clear. What a relief! BJ gave me a high five and his finding was confirmed by a doctor. Got through that one, I thought. I headed home...again...to prepare for the clean-up operation on my bladder.

Thinking that this surgery would be minor, I asked my son Stephen, home during the winter break from James Madison University, to drive me back and forth to the hospital. I thought it would help him emotionally to see that some surgeries are pretty straightforward and devoid of trouble.

We dutifully reported to Loudoun Hospital on Friday, January 6, 2012, met with the same nurses who had prepped me a few months before, and saw Dr. Schenk. "Ready?" he asked. Since this surgery was designed to remove obstructions that had forced me to use catheters on a daily basis, boy was I ready.

The procedure: Schenk would expand the opening from my ureters to my neobladder, which were healing in a constricted manner since the radical cystectomy a few months earlier. He would keep the openings, well, open by dialating them. And he would remove other obstructions that had popped up along the way. All this would radically reduce my dependence on catheters. The downside? He might to have to perform this surgery every so often. Kinda like getting an oil change, I thought.

The surgery wouldn't take long. Stephen could grab a meal in the cafeteria and I would see him in recovery. He did grab a meal. And I did see him in recovery. Nothing else went as planned.

When I awoke, I saw Schenk's face. It looked depressed. And worried. "We've got a problem," he said. Oh God, don't tell me... "See these pictures?" referring to photos taken of my bladder during the surgery. He didn't need to say another word. I knew. The white material looked a lot like the tumor he had biopsied back in April. We talked a bit more. "I'll need to send these to pathology." Words you don't want to hear.

"I really wanted you to urinate normally, without a bag..." as his voice trailed off. I got the point. My neobladder's life span was about to be cut radically short. And maybe my life, too.

Then I looked at Stephen. He was shaken. Given the unexpected news, I now felt terrible for asking him to be with me in the hospital. This was supposed to be a reassuring experience for him. Not even close. He heard Schenk's words, and was stunned. The nurse next to him said, "You didn't know about this?" Tears filled his eyes.

Later, he told me, "I felt guilty that I hadn't been there for you as much as the others during your big surgery. So I really wanted to be there for you for this one. But I didn't expect this to be..." as his voice tailed off, too. Terrible? Awful? Choose your word.

Schenk wouldn't know the results of the pathology tests until Monday. This being Friday, Stephen and I headed home. It was to be the longest weekend of my life.

You can imagine the thoughts that went through my head. Cancer, again? Will I be able to survive it? Do I have the strength to go through all the treatments and surgeries all over again? After all, my body had barely survived the first go around. And that was starting from the strongest I had been in years. Even more importantly, what am I going to tell Kate?

Friday turned into Saturday. Taking my mind off the propsect of Cancer II: the catheter that had been inserted after surgery. It would need to stay in there until Tuesday. And the attachment was loose. You don't need to have worn these things to know that loose is bad. The slightest movement...ouch! Safe to say, I wasn't terribly mobile on that particular weekend. But at least it was a distraction. Kate had no such luck. "All I could think about was being scared," she said.

On Sunday morning, I awoke to intense abdominal pain. It felt like I had a football in my stomach. And it really hurt. Then I noticed that my catheter bag was almost empty. I put two and two together, and concluded that I must have an obstruction in my bladder. Pain turned to nausea and I threw up. As unpleasant as that was, it solved for my pain.

I guess the brute force the body expends when you throw up created enough pressure to push the obstruction through the urinary tract and into my catheter bag. And my bag suddenly filled up to the brim. Had I not thrown up, I risked bursting the neobladder. That would have been bad.

Later that day, the same pressure built up, the pain returned, and the bag was empty again. This time, I didn't mess around. Kate and I headed straight for the ER. There, the nurse wasn't sure how to address my problem. So she called Dr. Schenk, who walked her through how to irrigate my bladder.

She took out a syringe, dsconnected my bag, and inserted the syringe into the catheter tube. No sterile water to inject; just air. On the very first pull, the nurse removed a massive obstruction. It was frigging huge! She connected the tube back to the bag, and once again fluids gushed into my bag, filling it once again. Even better, the pain was totally gone.

The procedure was so simple that I felt stupid for needing to come to the ER to have it done. I should have known how to do that. This was a crappy way to spend a day, obviously. But at least I didn't have much time to think about whether cancer had returned.

Monday night arrived, and I was in the family room with Kate when the phone rang. Schenk's name appeared on the phone. I stared at the phone for a moment. "Dr. Greg Schenk," it read. What he was to tell me would determine my life. Should I really answer? Was I ready to answer? I walked out of the room, twinged as the catheter moved back and forth, took a deep breath, and swiped the phone.

"Jim, it's Greg." Yes, and...? Another deep breath. I closed my eyes. Then he spoke: "It's all good news." Oh, thank God. My body collapsed in relief. Greg went on to say that the material we both suspected was a tumor was, in fact, something else. He gave me a technical term for it. I hadn't heard it before, didn't care, and I don't remember it.

What I do remember is that Greg Schenk -- who started out as Dr. Doom to me, gave me blunt assessments along the way about my condition and odds, spoke words that haunted me during the night, but who I had turned my life over to survive -- just gave me a clean bill of health. He sounded as joyous and relieved as I was. I rushed to tell Kate, and we collapsed into each other's arms.

I was going to live.

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