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Part 3: Consults and CT Scans

Semicolonthebook.com promo photoLast Wednesday, July 29th, I went for my consultation with my GI surgeon. In a nutshell, the tumor has grow into the wall and he’s recommended radiation and chemotherapy to shrink the tumor prior to surgery. On Thursday, the 30th, I had a CT scan on Thursday. For a more detailed depiction, read on.


The Look

I checked in for the appointment and was soon after ushered inside where I underwent the “height, weight, temp, oxygen level and blood pressure” routine. Everything was more or less in the normal range. My weight was slightly down (again). Then it was into the exam room where I donned the infamous “gown that ties in the back.” The doctor, you see, would need to examine me himself.

I still don’t understand why, with all of our technological advances, there is a need for repetitive (not to mention invasive) examination of one’s “final frontier,” but the need was there. I could almost buy the surgeon’s rationale: “I need to see for myself what we’re dealing with.” Well, he is the one who’s going to be opening me up and cutting out the rotten pieces, so to speak. I supposed it wouldn’t hurt to humor him, if only to stay on his good side.

So I knelt before the half-length table with my chest on the top. He then activated a switch that hoisted my back end upward, pointing it toward the top of the far wall like some sort of human field artillery piece. I was tense and apparently the assistant could tell this (maybe because I grunted and buried my face in the pillow) so she came over and started rubbing my shoulders. My initial reaction was indignation, which was quickly replaced with gratitude.


The Talk

The examination was brief, thank goodness. I got dressed and the three of us (me, Margaret and Dr. Roe) met in the consult room where he laid it out for us. Here’s what we learned.

First, the tumor is very low in the colon, however. It’s so low that it’s actually in the area called the rectum. So, technically, I have rectal cancer. The cancer has grown into the wall of the “colon” (it’s still hard to bring myself to say or write “rectum”) and may have spread outside of it. This has yet to be determined.

Medical advances allow them to remove a good portion of the rectum and reattach the colon to even a short piece of rectum, thus avoiding the need for a colostomy bag. This was his goal in my case. Quite frankly, any time someone wants to save my ass – either figuratively or literally – I feel a certain indebtedness to them.

Prior to the surgery, however, he wants me to undergo radiation therapy, coupled with chemotherapy for the first and last treatment. The goal is to shrink the tumor and minimize the amount of tissue (read “rectum”) that he will need to remove, thus avoiding the need for the bag. Big thumbs up for this.

The radiation and chemo treatments would be done five days a week for four or five weeks, followed by four to six weeks of recovery before the surgery. This is to allow the inflamation to go down and give my body a chance to recover.

I think Marge took the news a little harder than I did. I confess this whole thing scares me a little but I had already accepted the situation and some of the various possibilities so nothing really came as a shock to me. I was still treating everything rather matter-of-factly. Marge, on the other hand, was rather sober about it all. I remember feeling bad for her, though I tried to cheer her up a bit. I think I failed.


Something For the Pain

The doctor said one thing that did surprise me.

“I’d like to prescribe you Vicodin for the pain,” he said.

“But I’m not really experiencing any pain,” I replied. That didn’t dissuade him, thankfully.

“You’re having frequent urges to go to the bathroom that aren’t productive, aren’t you?” he asked. He had me there.

“Well, yes,” I said.

“That’s a form of pain. Pain you shouldn’t have to go through. This will help.”

Well, Hell’s bells, I thought! Bring forth the Vicodin!

The doctor gave us some literature to take home and made a referral to the radiation and oncology clinics for consultations, the next step toward the aforementioned treatments. He also wanted an ultrasound. The latter was too simple-sounding so I assumed it would be another uncomfortable procedure. (I would later be proven right.)

After gathering the materials and our thoughts, we left. I remember thinking that I was still happy to be able to eat solid food following the previous day’s colonoscopy. We went to the pharmacy and picked up my prescription of Vicodin. I quickly downed one. Within 15 minutes or so the discomfort was gone. I felt better than I had in months! No more scooting to the bathroom every 15 to 30 minutes. No more pressure in my lower abdomen. I felt as though I could return to a more-or-less normal daily routine.

I’d found my new best friend and her name is Hydrocodone.


Banana Smoothies

Wednesday night I had to drink a bottle of barium sulfate suspension, which was flavored with banana. In fact, the elixir had “banana smoothie” on the label. The barium sulfate would help generate greater contrast in the computer tomography (CT) scan so that all of my bits and pieces could be seen clearly, or something like that.

I have to say that compared to the gallon of Colyte I had to drink a couple of days before, this barium sulfate tasted like a, well, a banana smoothie. Actually, it was like an ultra bland yogurt smoothie with enough banana extract to smell like a banana smoothie without actually tasting enough like one. Even so, it was tolerable. So down it went.

The next day, Thursday, I was scheduled for my CT scan. I could not eat anything that morning nor drink anything after 10 am. This was easy as pie, having endured several days of clear liquid diet over the last week or so. Then I drank the second bottle of barium sulfate an hour before the appointment. I was all prepped and ready for the scan.


Hey Now, You’re A Rock Star. Get Your Game On

Marge and I went to the hospital, checked in at the radiology clinic and waited a short while. We had yet to wait an inordinate amount of time, which was odd for an HMO. We go to the South Sacramento center, however, which may have something to do with it.

I was escorted back and told to change into a strange hospital gown I had never seen before. It looked like some sort of Bedouin robe with multiple arm and neck holes and more ties than I knew what to do with. I tried to figure out how to put it on but was unsuccessful. Swallowing my pride I opened the door of the dressing room and asked the technician how to put it on.

The technician, a Hispanic male in his late thirties, looked all the world like the lead singer of Smashing Pumpkins. He talked a little fast and I was concerned that he would be the “all business,” zero empathy sort of guy who dripped testosterone. I felt anxious, vulnerable and somewhat insecure. My first impression was way off, thankfully. He seemed perplexed as to why I was given the arachnid robe and fetched me another, simpler one to wear.

With the new robe on I walked out of the dressing room and was ushered onto the table. We chatted a bit as he was setting me up. Turns out he was a radiation technician in the Air Force and retired from same. I mentioned I had been a Security Policeman in the Air Force, if only to establish some sort of commonality and rapport with the guy who was about to insert an IV into my arm. I haven’t had good luck with IVs of late, you see.


You Might Feel Like You Peed On Yourself

The technician went on to explain the whole process to me, along with what to expect throughout the entire procedure. First there would be an IV inserted into my arm, which would introduce radioactive dye into my blood.

“You may feel a sensation of warmth in your chest, throat and, when the dye makes it’s way to your bladder, you may feel like you just peed your pants,” he told me.

What the hell? Great. I could hardly wait to feel stifling warm with a lap full of piss.

“You won’t actually pee your pants, so don’t worry. It will only feel like it,” he assured me. “It’s normal. You’re young enough, though, that you may feel very little.” Okay. That made me feel a little better but I was still anxious.

He started the IV and asked me how I was feeling.

“Fine,” I said, experiencing none of the effects he had described.

“Good. Chances are you won’t feel anything, then.” And, thank the stars, I didn’t. The scan itself lasted only a few minutes and soon I was dressed and headed for the exit. Before I left the technician said something that caught me by surprise.

“Good luck, sir. I hope the test comes back negative. Our prayers will be with you.”

I didn’t know what to say. I already knew I had cancer. Prayers, I decided, are always welcome. I walked back to him and shook his hand.

“Thanks,” I said. “I appreciate it.”

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