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dcnovice -> DC's Latest Oncology Update (1/11/2014 9:06:52 PM)
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January 11, 2014
“At the gate of the year”
Dear Ones ---
“It’s been so long since last we met.”
Those words open the Georgetown fight song, and it seems apt to quote them as I’ve twice been my alma mater’s guest since last writing. I really do apologize for the radio silence. I’ve crafted all manner of updates in my head, but it’s been hard to summon the mental focus to actually write then. Difficulty in sitting didn’t help.
Between my Facebook posts and text messages, I’m not sure at this point who knows what. So apologies if I’m repeating myself.
In our last episode, our hero was lodged at his brother's house in New England—basking in familial love, learning to cope with an ileostomy, battling the stench of my rectal discharge, and escaping bodily woes by “binge viewing” the first three seasons of Downton Abbey.
My ever-kind parents fetched me in late November, and we trekked south, stopping in Pennsylvania for a follow-up visit with my surgeons. The docs were concerned that my lingering discharge might signal infection, so they sent me off with a script for oral antibiotics. I returned gratefully to my home and looked forward to returning to work after a lengthy absence.
Everything changed on November 26th—my fiftieth birthday. The folks joined me at Georgetown for what should have been a routine check-in with my oncologist. Turns out nothing on Planet Cancer is routine. He looked at my battle-scarred bottom, sniffed the bouquet of le nouveau dischargé, and broke the bad news: “I know this isn’t what you what to hear, but we need to admit you for IV antibiotics.” So I toasted the start of my second half-century with oral contrast for a CT scan.
The scan revealed a large, infected abscess—a “big zit,” as my docl later described it. Georgetown waged a two-front war on the invader. In addition to getting IV antibiotics, I underwent a surgical intervention. The team lanced the abscess and inserted a drain. Cultures revealed that the infection was E. coli, which helped doctors refine my cocktail of medicines. Exactly how the bacteria, emigrants from my digestive system, invaded the rectal region is unclear. They may have snuck in through a leak or loose stitch. Or the colon walls may have weakened to the point of permeability.
Several days after my birthday, I celebrated Thanksgiving in the oncology ward. I did have turkey, but my diabetic/ostomy menu included no pie. Oh well. I was struck by the realization that, even in that setting, my blessings overflowed. They included an incredible family, friends worth their weight in gold, an amazing church community, a compassionate employer, skilled medical care, and the insurance to pay for it. Strange as it sounds, I truly had a happy Thanksgiving.
After a week or so, Georgetown sent me forth, bearing an abscess half its original size and prescriptions for both oral and IV antibiotics. Visiting nurses taught me how to administer the latter in my bedroom, which now looks like the warehouse of a medical-supply company. I’m rather proud at how adept I became and wonder if I should include this new skill on my resume.
Meanwhile, I returned to work half-time. I was greeted like a long-lost son and still marvel at how good and gracious my emplouyer has been to me. Work was harder than expected. Several days, I caught myself eyeing the clock and despairing that I still had two or three hours to go. And my concentration, never great, was still substandard. But I slowly got things done, and I reveled in the acclaim given my latest project.
I spent a magical Christmas with beloved cousins and aunts in Maryland and noticed with delight that my discharge was diminishing. I was even—Deo gratias!—able to stop stuffing pads into my underwear. Unfortunately, I learned later, that was not the hopeful omen I’d thought it was. Discharge returned with a vengeance on New Year’s Eve, and it included an alarming new ingredient—blood. That was enough to spur even me to call my doctors, who unsurprisingly sent me to the ER where, also unsurprisingly, I was admitted. It was my seventh hospital admission of 2013 and the fourth special day (after Easter, my birthday, and Thanksgiving) spent in Mother Georgetown’s embrace.
A new CT scan revealed that the abscess had grown slightly larger since I’d last left campus. So back on the IV antibiotics I went. The persistence of my bacterial buddies alarmed the surgical team—and me too. The sawbones prescribed a “drastic intervention”: eviction of the E. coli, removal of dead tissue, and a permanent colostomy. Nothing else, they argued, would halt the biological warfare in my butt. I refrained from making a decision till the surgeons had a chance to talk to the Pennsylvania wonder-worker who’d removed my tumor back in October. To my keen relief, he argued against any surgery till he could see me in person.
That happened yesterday. The news was neither as good as I’d hoped nor as bad as I’d feared. The surgeon counseled against rushing into surgery and advised continuing the oral antibiotics I’ve been on since my last Georgetown stay. He directed me to return on the 20th, when I’ll be sedated for a more thorough look. What he sees then will help us chart the course ahead. Whether that will include the dreaded permanent colostomy is unknown. That outcome, after a year of struggling to evade it, would be one bitter pill.
So I’m taking a chance on hope. There are, I confess, moments when I think, “Oh hell, let’s just get the blasted colostomy and be done with it!” Then I remember emptying my bag in grungy restrooms and aboard a moving train as well as discovering, in my exhaustion, a leak last night, and my determination hardens anew. As I was typing this, I cracked open a fortune cookie, which promised “You are heading in the right direction.” City Lights of China can’t be wrong, can they?
As some of you know, my companion in recovery was originally meant to be the Queen Mother—no stranger to boosting morale in rough times—via William Shawcross’s official biography. Well, the thousand-page book weighs more than my cat, so hefting it in the early weeks after surgery was impossible. I’ve finally regained enough strength to enjoy it, and tonight’s reading brought a lovely passage from King George VI’s Christmas broadcast in 1939, just months after World War II erupted. Mind you, I well realize that one guy’s nonlethal tumor is nothing like the horrors of warfare, but the words give me hope for the next rounds of the song that never ends.
A new year is at hand. We cannot tell which it will bring. If it brings peace how thankful we shall all be. If it brings continued struggle, we shall remain undaunted.
In the meantime, I feel that we may all find a message of encouragement in the lines which, in my closing words, I would like to say to you.
“I said to the man who stood at the gate of the year. ‘Give me a light that I may tread safely into the unknown.’ And he replied. ‘Go out into the darkness and put your hand into the hand of God. That shall be to you better than light and safer than a known way.’”
May that Almighty hand guide and uphold us all.
All the best,
DC
PS: The lines quoted by the king came from God Knows, a poem by LSE professor Minnie Louise Haskins. You can hear the king delivering the message on YouTube.
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