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Archive for August, 2009

I’m heading over to St. Vincent’s Hospital in just a little while.  This time it’s for out-patient surgery to have a “port-a-cath” installed in my chest so they can administer the chemotherapy more easily.  For whatever reason, I’ve been pretty nervous about this procedure. The idea of having a longish tube running from my collar bone up into my neck and down into an artery in my chest is just a little bit daunting.

Nearly everyone I’ve spoken to who knows about these things says it’s a good idea.  It not only makes getting the chemotherapy easier, it also helps avoid complications from having chemo injected directly into a vein.  Last week during my “Chemo Orientation” at the Cancer Center, I met a man in the treatment room who was having his third chemotherapy session.  I was able to see his port “in action” and he assured me it had been no big deal to have it installed.

It helped ease my fears to have someone who’s actually been through this tell me not to worry too much about it. Nonetheless, I find myself unable to shake the nervous feeling this morning as I’m getting ready to go over to the hospital.  It would probably be a good idea to spend the next few moments doing some breathing exercises and trying to calm myself, so I guess that’s what I’d better do instead of typing away…

I trust that this afternoon I’ll be able to report that all went well.

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Meeting with a Surgeon

I had a much better day today. Although it started out a little rough (had to give myself an enema upon waking in prep for the Flexible Sigmoidoscopy, then had some anxiety when we were kept waiting in line at “registration” for half an hour past my scheduled appointment time – I imagined Dr. Rajput’s office didn’t know I was even in the building yet), but soon all was made well by a very good meeting with Dr. Rajput.

He was exactly what you would hope a medical professional might be: warm, personable, compassionate, understanding and seemingly unhurried. What’s more, when I questioned him, he assured me he was the most experienced colorectal cancer surgeon in New Mexico, having done hundreds of surgeries similar to what I would need, and managed to get that information across without a trace of arrogance. Pretty impressive in my book.

After he reviewed my records and then examined me, he surprised me by saying he didn’t think it was necessary to do the Sigmoidoscopy after all. The point of the procedure was to “tattoo” the area around the tumor so he would know where it once was in case the chemo/radiation treatment successfully reduces it down to nothing. But in my case, because of the location and size of the tumor, he felt marking the area wasn’t going to be helpful.

He went on to very gently tell me what I dreaded but suspected (my other doctors have been non-committal about this, but have prepared me for the possibility): when it’s time for surgery, he would not be able to save enough of my rectum to avoid a colostomy. He’ll need to have a “margin” around the area where the cancer was, and in my case it will involve taking a portion of the sphincter (the ultrasound revealed that it was already partially invaded by the cancer), which would effectively make me incontinent.

This wasn’t what I wanted to hear, but it also wasn’t brand new information. I had been hoping something might make it possible to avoid a colostomy (a miracle?), but Dr. Rajput kindly reminded me that the first priority is “cure” and the second is “function.” In order to have any chance at “cure” he’s going to have to sacrifice “function” in my case. (There’s a lot more information about this topic, but I’ll save that for another time when I’m ready to get into it.)

So, there was no need to “tattoo” around the tumor today. Despite getting the news I really didn’t want to hear, I was also relieved not to go through another procedure and sedation. And, although I’m not overjoyed at the prospect of being a patient at UNM Hospital for any length of time, this consultation left me feeling very comfortable with the choice of Dr. Rajput being my surgeon.

As we left the hospital and walked to the parking garage, Shawn and I both agreed we were really impressed with how Dr. Rajput had handled the meeting. At one point early on his phone rang and he apologized for needing to interrupt our conversation to take the call but said it was an emergency. I said, “I understand. I realize I’m not the only patient in the hospital.” Then, before he picked up the call, he said, “Yes, but I want you to feel like you are.”

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Rollercoaster Continues

It seems the ups and downs of this rollercoaster ride are getting more dramatic. Yesterday, I was feeling mostly “up” – even after a very full and somewhat overwhelming day at the Cancer Center.  Today – well, not so much.

This morning, I was smack in the middle of writing a very upbeat post for the blog about yesterday’s “Good News” (PET scan all clear, including lymph nodes) when I got a call from Dr. Rajput’s office at UNM.  He’s the surgeon I was referred to after my ultrasound. Dr. Fekrazad told me during yesterday’s appointment that he’d reviewed “my case” with Dr. Rajput and they both wanted me to see Dr. Rajput right away regarding a procedure he wants to do before the chemotherapy and radiation starts!  It seems he would like to “tattoo” the area around the tumor so that when the chemo/radiation treatment shrinks it, he’ll be able to identify where the tumor formerly was when I have surgery later…

So, I was expecting a call from his office, but not this bombshell: I need to be at UNM in Albuquerque at 9:00 AM tomorrow (Friday) to meet with Dr. Rajput for the first time, and following that I will go directly to out-patient surgery for a Flexible Sigmoidoscopy, during which he’ll do the tattooing.  Oh, and no solid foods today in preparation for tomorrow’s procedure. Clear liquids only until midnight, and an enema in the morning.

I hate this!

I’ve mentioned before how I dislike having this stuff sprung on me with no notice, so I won’t belabor it again now. However, I had to cancel a nice lunch appointment with Simone, who’s here visiting from Key West, since there’s no point in torturing myself by going to a restaurant when I can’t eat.  And I had to call around again to see if someone could drop everything and spend six or seven hours tomorrow driving to Albuquerque and hanging out in a waiting room while I get sedated again.  Thankfully, angel Shawn said she was available (“I’ll see you at 7:30!”). 

But, to add insult to injury, the Cancer Center phoned, too.  They needed me to come back over to pick up some prescriptions they forgot to give me yesterday. Oh, and, there’s the minor issue of getting the oral chemo drug through a service called MedBank, and you’ll need to fill out a bunch more paperwork over at their office across town.

There’s more. But I’ve spent most of my day running back and forth all over Santa Fe with nothing to eat, and I’m exhausted and emotionally spent (I cried in two government offices today, too). When I’m feeling a little better, I intend to write a post about how difficult and time consuming it is to simply manage the administration of having cancer, not to mention the actual appointments or procedures or treatments.  Merely keeping up with the paperwork is a full-time job, but I’ll save that for complaining about later!

A few weeks ago I said something about hoping not to whine too much on this blog.  But tonight I’m feeling pretty low and that seems to be all I can muster. I’m bummed that my “Good News” from yesterday got overshadowed before I could even get it posted!  Maybe I can get back to that topic soon…but, first, I’ve got a date with a wanna-be tattoo artist bright and early.

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Prayers

In early summer, when I first had symptoms severe enough to send me to a doctor (who then recommended a colonoscopy), I let a few of my dearest friends know I was beginning to have concerns about my health. Right away each of them, in their own way, said they would keep me in their thoughts and prayers. What began then as a handful of the people dearest to me focusing their intentions on my behalf has somehow grown into a wide river of countless people, many of whom I’ve never met, all offering their love and thoughts and prayers for my healing.

Now, every day, I receive messages, comments, greeting cards, phone calls and hugs from many people, all telling me, in some form or another, that they are praying for me. It’s astounding and humbling, and often brings me to tears. I am extremely grateful. I know there truly is healing power in the combined energy of all these expressions of love.

There are many, many individuals who’ve told me they pray for me daily. In addition, I’m aware that several people have asked their family members and their churches to add me to their prayer lists. I’ve also heard that some of my fellow yoga students have dedicated their yoga practice to me.

One dear friend, Celine, who spends part of her time at a Buddhist retreat center (Tara Mandala, near Pagosa Springs, Colorado), wrote to me asking if she could give my name for prayer request to “the long term retreatants who live on this sacred land in solitude for one to three years.” How could I ever have imagined a scenario in which someone who made a vow to live in meditation and solitude for three years might be praying for me?

All of these, and so many more I haven’t listed here, fill me with awe and gratitude.

Another of my lovely friends, Jody, has also recently created a “virtual healing circle” in my honor. She’s asked if I would pass along an invitation for anyone who wishes to participate with them to add their energy to the circle. Jody writes:

A “virtual” healing circle assembles every morning at 5:30am EDT in honor of Karen. Bring your love, positive energy, healing intentions, spirit guides and whatever feels appropriate to you.

If you already have a different dedicated prayer/meditation time, you may still join us by setting the intention with your higher self to be present in lieu of your body during the specified time. Another idea is to visualize your intentions just before you go to bed at night. Assign a window of time, for example 5:30 am to 5:45 am (or whatever coordinates in your time zone) and give your higher self permission to participate on your behalf.

Visualize wholeness, happiness and peace!

I really don’t know how to adequately express how moved and honored and grateful and awestruck I am at all the ways you’ve each shown me love and compassion. Thank you everyone. Thank you.

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PET Scan

I won’t have the results of Friday’s PET scan for a few more days, but my intuition tells me it’s not going to reveal anything that we didn’t already know.  Had last week’s ultrasound found more lymph node involvement, I might have been concerned about the PET scan finding cancer in some other organ, too. Since they couldn’t say for sure that any lymph nodes have cancer, I’m confident they’re just not going to find it elsewhere. We’ll soon know if my hunch is correct.

Several years ago, when I was in the thick of a different crisis, someone told me that I had the option, everyday, to choose “fear or fascination.” Since being diagnosed with cancer, I’ll admit it has been a big challenge to choose fascination over fear. But with the PET scan, I can honestly say I was able to do just that. It’s not an invasive procedure (unless you consider being injected with radioactive material invasive), and you don’t have to be sedated (unless you tend to panic in one of those tube-like machines). So, compared to the various rectal probes and surgeries I’ve endured, hanging out in a tube for a while didn’t seem like a big deal. I can report that I successfully managed to view this test with fascination.

First, I had to avoid glucose for 24 hours prior to the scan, which turned out to be kind of hard. I ended up eating eggs and cheese and sliced turkey most of the day. For my other procedures that require only clear liquids (no solid foods) the day before, I’ve grown accustomed to drinking lots of fruit juice. Well, juice is nothing but glucose, so that was off the list. I usually like to eat a lot of yogurt, in part because it works well with my digestive system. That was out, too. It seemed everything I looked at in the fridge or pantry had some amount of glucose in it! So, I drank lots of water. After midnight that was all I could have anyway.

The next morning, Shawn drove me over to X-Ray Associates, about ten minutes from my house. At 10:00 AM, they took me into a tiny room with a big recliner in it. I changed into a hospital gown (I’m getting really good at that!) and a young woman named Andrea began inserting an IV into my arm. When it was ready, she left the room to “get the isotope.” She returned carrying a small lead box about three inches square with a little handle that she held with her two gloved fingers as if it were something she’d really rather not touch. She set the heavy little box down next to my arm and attached my IV to a port on the box. She then attached a syringe to the opposite side of the box and squeezed, apparently forcing the radioactive isotope out of the box and into my IV. It struck me as comical that they would so carefully keep this “thing” protected in a lead box, and go to great lengths to make sure Andrea didn’t come into contact with it, only to deposit it directly into my veins!

Before she left, she dimmed the lights and asked me to sit quietly in the recliner for an hour. There were also two cups of water containing “contrast” that I needed to drink before the hour was up.  Although the liquid was clear and tasted like water, somehow knowing it contained “contrast” (whatever that is) made me sceptical each time I took a sip. I closed my eyes and relaxed in the darkened room, meditating, praying, saying affirmations and doing breathing exercises.

Surprisingly soon, it was time to go to a different room where the scan would take place. I was immediately shocked by how freezing it was in there! Andrea explained that it had to be kept colder for the machines. I laid down on a very narrow, concave bed and she put a blanket over me. I wasn’t shy about asking for a second blanket. I had to raise my arms above my head and stay in that position without moving for 30 minutes. I got situated, closed my eyes and said I was ready (although a little concerned about how I would stay completely still like that for half an hour).

I could feel the narrow bed moving in and out of the tube. I kept my eyes shut, but I could tell the tube must be very close quarters because I could feel the blanket being jostled slightly as the bed went in and out. I began to realize that this was definitely going to be a “mind over matter” exercise. I could imagine how, if you thought too much about being in the tube, you could panic and then not be able to stay still.  I started doing some breathing exercises and then began saying prayers and affirmations again.

Andrea had told me that the bed would move in and out of the tube a few times in the beginning, but then it would stop inside the tube and only push me a bit further out every five minutes. As I was meditating, I tried also to keep track of how many five minute intervals there had been. I was feeling really proud of myself for not moving at all and not opening my eyes by the time I counted five of these intervals. Then I felt my arms falling asleep overhead and I started to get restless. Instead of moving, I opened my eyes and realized I was in a futuristic, glowing environment that was very close on all sides. I shut my eyes again and starting counting to distract myself. I had just reached 24 when a voice said, “Okay, you’re done.” The bed moved completely out of the tube and I wiggled my fingers and toes for the first time in 30 minutes. My arms had indeed fallen asleep, so I moved them like heavy rubber down to my sides. It took a moment before I was able to get up and get dressed.

Unlike other procedures where it took me a little while to regain my appetite afterwards, I realized as Shawn drove me home that I was starving. She had other things she needed to do and was apologetic about not being able to go to lunch.  But I managed to convince Tim to take a break from pottery to go out for a bite. We went to Harry’s Road House and I had a watermelon juice and their delicious Blue Corn Turkey Enchilada with Green Chile, Cowboy Beans and Guacamole. I don’t remember food ever tasting so good – particularly the glucose part!

That was the extent of my rather uneventful experience with the PET (Positron Emission Tomography) scan. Fascinating, huh? I’ll post the results as soon as I get them.

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The Rainbow

It was raining lightly as we got in the car and headed out to the Opera. About twenty minutes later as we approached the entrance, I saw the sun emerge through the clouds near the horizon. The Santa Fe Opera is a gorgeous open-air theatre with a huge panoramic view to the west and north, and I was thinking how nice it would be to see a great sunset from our seats. 

The parking attendant directed us to a space toward the edge of the parking lot a pretty good distance from the theatre. As we started walking in the direction of the Opera, I happened to look back over my shoulder and caught my breath as I suddenly saw the most vibrant and spectacular double rainbow I have ever seen. Both inner and outer rainbows were complete from end to end. Everyone around us was halting in their tracks to stare in awe at it.

The green hills of Tesuque were bathed in a beautiful golden light within the inner rainbow. In the space between the two rainbows, the light was markedly different – almost a dark purple. The sky outside both rainbows was a pale twilight blue and it even looked like it might still be raining lightly all around it.  But the rainbows themselves were incredibly brilliant, with each color entirely distinct from every other color.

Everyone was stopping to gape and take photographs. Looking on, it was impossible not to smile from ear to ear. In those moments, seeing such an awesome sight, I felt completely happy and blessed. I was still thanking God for such a miraculous gift as we took our seats and the orchestra began playing. What followed was a beautiful evening of world class singing, amazing set decoration and costumes, and a fun (if slightly thin) story of a love potion gone awry. But, for me, the rainbow had already stolen the show.

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Back to Plan A

I’m beginning to realize that this journey will often feel a lot like a roller-coaster ride. Tuesday’s experience had me pretty down. Then, after expressing my disappointment and anger in yesterday’s post, things slowly began to look up again.

Dr. Fekrazad immediately made time for me to come in to see him. Tasya was able to drop everything and meet me at his office (I know better than to go to these meetings without another set of ears). He brought in his P.A. Cynthia, whom I hadn’t met yet, and they both listened carefully to my concerns about all that took place at UNM Hospital. Since Dr. Fekrazad works there as well as here in Santa Fe, he nodded compassionately and agreed that it’s a much more impersonal environment than that of Santa Fe. He also let me know that the doctors who performed my ultrasound were not oncologists, and he was not surprised that they were recommending surgery first. He went on to clearly explain why he believed it was still a good idea for me to begin with a treatment of chemo and radiation, followed by surgery later. Cynthia echoed this as well.

He also went over the findings of the ultrasound in detail. I had heard the doctor at UNM say simply “it’s Stage 3.”  But the reality is a bit fuzzier. They were not able to conclusively determine if there was cancer in one of the lymph nodes. And only one lymph node was in question. Because I’ve recently had surgery, it’s likely there’s still inflammation that could show up looking like cancer in a lymph node when it may not be. So the actual finding was: T3  N1 / N0. Meaning it’s either T3 N1 (one lymph node involved and therefore Stage 3B) or T3 N0 (no lymph nodes involved and therefore Stage 2A). Since the only way to know for certain if the lymph node has cancer in it is to do surgery, they will treat me as if it’s Stage 3B – but it might not be. The one thing the ultrasound did make certain is that I will eventually need surgery no matter what (had it been Stage 1, I might have gotten away without it).

Dr. Fekrazad also wanted me to meet Dr. Shina, another oncologist at the Cancer Center. Dr. Shina spent some time with me confirming all that Dr. Fekrazad said and assuring me that the original plan of chemo and radiation first, followed by surgery later, was indeed the best choice for me. In addition to all that, he also gave me the name of the woman who is the head of patient services at UNM Hospital.  He suggested I write a letter to her detailing my experience there.

So, I left the Cancer Center feeling like I was back on more solid ground. I felt like they really pulled out all the stops to make sure I understood everything and didn’t go home as upset as I arrived. I even managed to get some work done later in the afternoon (something of a miracle for me these days).

Today, I’m prepping for tomorrow’s PET Scan. I’m only able to eat things that don’t contain any glucose (sugars). Do you know how hard it is to find something to eat that doesn’t contain sugar? Just look at any label. You’ll be shocked. So, it’s meat and cheese and eggs for the most part. And lots of water.

But tonight! I’m going to the Santa Fe Opera! My belated birthday present from Tim (who isn’t nearly as excited about seeing the opera as I am) is taking me to see The Elixir of Love. I can hardly wait!

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Stage 3

I came home from UNM in despair. I was still drowsy and feeling the effects of the sedation, but I was alert enough to be despondent. The entire experience at UNM Hospital was upsetting and unpleasant.

So far I’ve been pretty happy with my health care experience in Santa Fe. I’ve gotten personal attention by people who seemed genuinely concerned about me. I’ve been especially impressed with the level of communication among the various professionals involved. And their communication with me has been mostly clear and compassionate (even if I didn’t like what I was hearing).

Yesterday’s experience in Albuquerque was a sobering contrast. UNM has a large hospital that’s hard to navigate. Mary Anne and I wandered around and eventually found where I was supposed to go. I immediately felt like “just another body” in the medical machine. They took us to a room with dozens of beds, mostly full of folks awaiting or recovering from some procedure. They pulled a curtain around my bed so I could change into a hospital gown. I was told to open the curtain again to signal when I was done. The nurse who prepped me for the procedure was polite but distracted. She was called away at least three times while attempting to get and give me info. I expressed my concern about the kind of sedation they would use since I’ve had varying results recently. She said I could talk to Dr. Parasher about that when he came. Soon I was getting an IV and being covered with wires and tubes. There’s also a clamp they put on your index finger to monitor pulse (and something else?). There’s the blood pressure cuff that stays on you throughout, automatically inflating every few minutes to take your blood pressure whether or not anyone is around to read the results. And they put oxygen tubes in my nose.

There were other little indignities that are hardly worth mentioning, but two monumental ones have left me angry and confused. The first is: I never once laid eyes on Dr. Parasher much less got the chance to speak to him.  A different doctor came to discuss the procedure with me beforehand. Again, when I asked about the sedation, she said I could talk to Dr. Parasher when we got to the procedure room. Meanwhile, I was asked to sign her consent form (about the possible risk of death from the procedure) even though I didn’t have a free hand to use. I never did see Dr. Parasher – before, during or after the ultrasound. Yet, ultimately, he would be the one to throw me the big curve ball (more on that in a moment).

The other thing that really messed with my mind was this:  they wheeled me to an incredibly small, purple procedure room and left me there alone.  Alone!  I was already a little agitated and nervous, covered in tubes and wires, barely able to move, and now I was lying by myself in a f—ing purple room the size of a cell. On a table next to me was a long, thick, black tube marked off with centimeters at various intervals. Next to that, a tube of lubricant. I was starting to panic, but tried instead to imagine four people squeezed around the gurney performing an ultrasound. It would have to look something like clowns jumbled into a Volkswagen. There were monitors everywhere, including one that reported all my vital signs. I kept watching the numbers go up as I became more distressed. Soon I was crying and trembling.

Then Jesus walked in. He introduced himself and said he would be assisting Dr. Parasher with the instruments. (Well, I guess having somebody named Jesus assisting is about the best you can do.)  Then he asked me to turn onto my left side with my knees pulled up to my chest. I heard him squirt a big blob of lubricant out. A nurse arrived and said she would be giving me the sedation. I asked about Dr. Parasher again and was told I could talk to him afterwards. Before I could collect myself, Jesus informed the nurse that I’d already given consent so they could begin the sedation.

The next thing I knew, I was waking up back in the bigger room with all the beds full of people. I was very groggy and having trouble keeping my eyes open when the doctor whose name I didn’t know came in. She told me rather coolly that it was Stage 3 and Dr. Parasher wanted to refer me to a surgeon named Dr. Rajput. I asked if they would get my friend Mary Anne in there so she could hear all this. In my haze, I tried to explain that I was supposed to start with chemo and radiation first before surgery, in the hope that I might not even need surgery. She said, well, we’re referring you to Dr. Rajput. You have an appointment with him on the 26th. I was grateful when Mary Anne arrived and heard the whole thing again since I was confused and upset. I’m supposed to start my chemo and radiation on the 19th, I told the doctor…Are you saying we aren’t doing that now?

I wanted to leave. They removed all the tubes and wires and said I could go. Although still really wobbly, I got dressed and somehow walked the many miles out of the hospital complex to the car. Mary Anne asked if I wanted something to eat. I thought a milkshake would taste good. She drove us to the Flying Star Cafe and, like a zombie, I went inside with her so I could order what I wanted. While we waited for the milkshakes to be made, I went to the bathroom and nearly passed out. Eventually, I came out, found Mary Anne, and told her I needed to get to the car. But suddenly I was sitting down at a table that needed busing, holding my head (which was ringing loudly) in my hands.

I slept most of the way home. Once in the door, I collapsed on the couch. Before Mary Anne left, she and Tim went outside to talk. I began crying again.

I feel like a ping pong ball. I’m angry and confused. I’m especially mad that a man whom I’ve never met, and who doesn’t know me, has decided we need to change my entire treatment plan.  I’m also miffed that over the past week his office called to change my appointment twice, which affected not only me but two friends who both needed to alter their plans so I could be driven back and forth, all so that Dr. Parasher could “make his plane on time.” I’ve been pretty damned accommodating. It seems like the very least he could have done was actually speak to me in person.

I also feel burdened by the task of having to referee the various doctors now. I suppose today I will call Dr. Fekrazad’s office and find out when I can talk to him about all this. I’m so distressed. I wish I hadn’t spent all the hours and appointments getting prepared for the idea of having chemo and radiation only to be dealt this blow. I know I will calm down eventually and find a way to navigate this, but at this moment I’m very much wanting to give up.

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Change of Plans

This morning, just as I was getting ready to have my first bite from a nice bowl of fruit and yogurt, I got a call from Debra at Dr. Prosher’s office at UNM. She wanted to know if I could possibly come for the ultrasound on Tuesday (tomorrow) instead of Wednesday. I quickly realized that agreeing to move the procedure up a day meant beginning the cleaning-out process today.  In fact, it meant starting immediately. I put down my spoon and told Debra I would have to see if I could find someone to drive me there and back on short notice (they’ll be sedating me and won’t allow me drive myself home) and I’d call her back.

A few phone calls later, Mary Anne graciously agreed to be my driver, and I confirmed with Debra that I would begin clear liquids right away in prep for the procedure.  But it wasn’t long before I noticed I was feeling really agitated and grouchy. I think generally if I’m given enough time to process something, enough time to “wrap my head around” it, I can usually find a way to get on board and accept a situation. But often I don’t do well when I’m forced to shift gears too rapidly, when I have to jump too quickly to make a choice or do something differently. With time I’ll nearly always come around, but in the instant when I’m being pushed I tend to resist strongly.

This was one of those times. For days I’ve been fully prepared to do the cleaning-out process one more time – on Tuesday! I was kind of attached to having today to eat whatever I wanted, get some work done, and attend to chores before being preoccupied on Tuesday with no food and having to drink that horrible “Go-Lytely” (a cruel joke of a name if ever there was one). But, as I said, with time I was able to let go of my plans for today and do what needed to be done.

I realized I hadn’t gotten the prescription for Go-Lytely filled yet, so I headed out to Walgreens. While waiting for the pharmacy to get it ready, I went across the street to Trader Joe’s to buy some Organic White Grape Juice (I’ve had to do this clear liquid thing enough times, you’d think I’d just keep a case of the stuff on hand). When I got back to Walgreens to pick up the Go-Lytely, the clerk stapled my receipt to the bag, and smiling wryly as she handed it to me, said, “Have a nice afternoon.”

By 3:00 my stomach was grumbling loudly, and I was getting shaky.  I distracted myself for a few moments with a mug of Organic Free-Range Chicken Broth.  But soon it was time to start drinking the really offending liquid. Every ten minutes. Eight ounces. And ten minutes later. Eight more ounces.

I’m not going to describe the rest. I’ve already been graphically open with various physical details in previous posts. Besides, I could never do as good a job as Dave Barry has in his Colonoscopy Journal. If you haven’t already read his outrageously funny description of this experience, I highly recommend it. Anyway, I’ve just now downed the last eight ounces of Go-Lytely so that tomorrow at noon, Mr. DeMille, I’ll be ready for my close-up.

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I’ve just gotten a few friendly messages along the lines of “more blog posts please” and “ok, how are you doing now?” I was about to reply that there isn’t much to say as I’m currently in a kind of calm before the storm – but I guess that’s exactly the thing to write about.

It’s been about ten days since my last medical appointment. I’ve been grateful to have some time to get work done, tend my garden, and organize my life a bit. (Oh, who am I kidding, that’s not nearly enough time to actually accomplish organizing my life!) In a few days I’ll begin a series of procedures and appointments in preparation for the daily chemo/radiation treatment that’s scheduled to start on August 19th. Since I don’t really know what to expect once I’m into the full-fledged treatment, I’m trying to make the most of my time now – while I still feel pretty good.

This Tuesday I begin the cleaning-out process for the Trans-rectal Ultrasound on Wednesday. It’s a special kind of internal ultrasound that will determine the extent of the tumor and help “stage” the cancer. It requires prepping almost exactly as you would for a colonoscopy. So, I’ll be back on clear liquids for the third time in a month and drinking that delicious “GoLytely” once again. My dear friend Shawn is driving me down to UNM in Albuquerque early Wednesday morning where I’ll be sedated for the procedure. I don’t expect to be given much info about the results immediately, but I should hear something within a few days.

Then, on Thursday, I’m on an all new diet plan! In preparation for Friday’s PET scan, I’ll be deprived of glucose for 24 hours beforehand. An hour or so before the scan they’ll inject me with glucose. Apparently, cancer cells really like glucose and will suck it up rapidly after lacking it for a while. The PET scan will reveal “hot spots” wherever glucose is concentrated. So, if the cancer has spread to other organs or tissue (besides where the known tumor is), the scan will reveal those areas. I’d appreciate your prayers that there’s no cancer elsewhere, please!

Those two tests are supposed to give Dr. Fekrazad the info he needs to determine what stage I’m at.  The stage will tell us what the prognosis is. I’ll meet with him on the 12th to review everything and to discuss the protocol for my treatment. That same day, I’ll have a “Chemo Teaching” session with one of the nurses at the Cancer Center. I assume I’ll learn all sorts of things I never wanted to know during that hour. Following that, I have a “CT Simulation” which I understand is when they make a mold of my pelvis for use during the radiation treatments. I’ll sit in the mold for each treatment so that I’m in the exact same position every time. And I’ll get these nifty little tattoos that they’ll use to aim the radiation at the correct location.

The following Monday, the 17th, I’m scheduled for out-patient surgery to have the chemotherapy port installed. For some irrational reason, this is the thing that terrifies me the most. I guess it’s because it requires inserting a tube in my chest that will go directly into an artery – and leaving it there for the duration of my treatment! Plus it means another anesthesia (which we all know didn’t go so well last time I was supposed to have an “out-patient” procedure!). But nearly everyone who knows anything about this stuff has said, “Yes, get the port.” And, after the difficulty they had trying to draw blood from me recently, it could be a fiasco if they have to stick me each time I have a chemo injection. Not to mention the very unpleasant problems that result if the vein collapses and the chemo gets into the tissue in your arm (apparently it’s very painful and the affected arm tissue will die).  So, I’m getting the port. Dear Natasya has agreed to be with me for that ordeal.

Two days later, on the 19th, I’ll experience my first chemo and radiation treatment. They’ve blocked out 4 and 1/2 hours for that first treatment since I’m “chemo naive” and they’ll be administering it very slowly.  My friend Mary Anne has bravely accepted the challenge of spending nearly that whole day holding my hand.

My long-time pal Alison is flying in on the 20th for the weekend following that first treatment. I hope I get to spend some time with her that doesn’t include leaning into the toilet. But I know she’s coming to hold me and help me through this…

So, as I said, I’m in that calm space before the hard stuff begins. One thing I’m doing with this time is saying many, many prayers of thanks for all the amazing people who have reached out to let me know they care, who have offered their help (both near and far), and who are saying their own prayers on my behalf. I am filled with awe at the many ways I’m being shown how much I’m loved.  Thank you to each and every one of you.

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