This Week (Just Medical Stuff)

Fourth of July at the baseball game. We got a free hat!

Surgery was moved (as previously mentioned) to Monday, July 24.

However, this week is not procedure free. Tuesday (7/11) I am having a stent placed: it’s like a straw to keep the tube between my bladder and left kidney open. If all goes well, it will be quick and easy. If the cancer is hugging the ureter too tightly, I’ll have to go to a different department and they’ll go in from a different angle (through my kidney, as I understand it). That could happen the same day or a different day.

Afterward, I may feel nothing, or I may be uncomfortable… like having a UTI…

So let’s pray for the first approach to be successful and for minimal discomfort afterward!

I may see my medical oncologist this week, too. I’ll call Monday morning to see what they think. I’ve struggled with increased pain, nausea, and fatigue for the past several days. That’s frustrating because it interferes with my plans. And it’s concerning because it might mean the cancer is growing. But then I remembered something that happened Wednesday that could be responsible instead of cancer growth.

(If you get queasy, I’m about to give you TMI involving my visit to the colo-rectal surgeon, and you can skip to the next paragraph.) While delaying my surgery was upsetting, it does give me time to get a colo-rectal surgeon in the OR on surgery day to repair the hernia at my colostomy site. I’m meeting with two surgeons, just to be sure I have a better chance of the schedule working out. (Here’s the gross part.) My hernia has allowed some of the bowel into the space between my abdominal muscle and my skin. It’s not uncomfortable, but let’s get that fixed as long as I’m in the OR, right?! Because that’s gross. Well, on Wednesday I met with one of the surgeons, and he massaged the bowel back to where it should be. Weird! But I think that would have made the area around my cancer a little more crowded, so maybe that’s why there’s pain, rather than more cancer.

OK. Gross stuff is done.

My friend/former oncologist suggested updated imaging based on my symptoms so there aren’t any surprises during surgery. She’s probably right, but I just want to get to surgery, get in there and take out as much as possible. Plus - so many scans!

Meanwhile, I’ve self-doctored by adjusting my pain med, which helped a lot. This isn’t quite as rogue as it sounds since my doctor and I discussed this option awhile ago in a different setting.

All that to say, there are lots of balls in the air in preparation for this surgery and I don’t want to be in charge, but I think I need to stay on top of everything to make sure it all comes together. Good thing I have all that project management experience on my resume…

That’s it, I’m afraid. No inspirational thoughts because I’m tired. Tonight I had six lovely thirteen year old girls over for book club, and there was a moment when I said something like, “OK, I can be done now if you’re done paying attention.” Followed by a few uncomfortable seconds of silence before moving on. Always effective, but I hate pulling that one out. It’s pretty rare. But, needless to say, those munchkins I love made me work hard tonight!

Have a good week! May YOU be the inspiration to someone! 

Soul Retreat

Surgery Update

My surgery has been pushed out to July 24th. Why? My surgeon wants to have a vascular surgeon in the OR with him because the tumor is pushing against the common iliac artery (the main pathway for blood to travel to the legs). Just in case things get tricky, he wants the vascular expert there. So when “surgery day” is Monday and doctors take vacations, things get pushed out further faster.

Fortunately, this also gives me time to get a GI surgeon on board. There’s a hernia at my colostomy site, so I figure, while I’m under and open, we might as well get that repaired, too.

Naturally, there’s a level of panic that sets in, knowing the tumor nearly doubled in the 10 weeks between CT scans, and now we’re giving it two MORE weeks to grow unchecked. 7/24 is six weeks from the last CT. More opportunity for things to pop up elsewhere. More opportunity for the tumor to get more complicated with the surrounding structures (it’s also wrapping around my left ureter - the tube from the kidney to the bladder - so I’m getting a stent put in to keep it open and make it easy for my surgeon to identify the ureter during surgery and avoid complications).

So we pray that the tumor stays put. Preferably no growth. But definitely keeping its hands to itself so there aren’t complications either before surgery or when we finally get to surgery. And we pray that when the surgeon opens me up, he doesn’t see cancer anywhere else. It’s possible he will see things that aren’t visible on the CT.

FAQ

How can this still be ovarian cancer if my ovaries were removed back in 2012?

I don’t get asked this often, but I suspect it’s a common question, especially based on comments my patients make about their family history.

Think of a patch of dandelions in one corner of your yard. They pop up overnight, don’t they? Imagine the yard is your body and the dandelions are cancer. These dandelions are in your wildflower garden, and they’re ALL OVER it. So pulling out the dandelions ends up pulling out most of your wildflowers - kind of like how removing my ovarian cancer involves removing my ovaries.

After some time has passed, even though the wildflowers are gone, those dandelions might pop back up in the same place. Because even if you used weed killer, you missed a persistent root or two. 

Worse, if one or more of those dandelions went to seed, you may find dandelions elsewhere in your yard.

So even without the tissue of origin (the “wildflowers,” or ovaries, in my case), the ovarian cancer can come back. It’s still ovarian cancer because it is part of the original cancer - microscopic cells that survived all the forms of treatment. Radiologists and pathologists look at imaging and actual cells and can tell from the appearance of the cancer what kind it is - even if it’s far from the original location.

Cancer can come back at the original site, or it can come back further away - like the dandelion seeds that travel across the yard. When it comes back further away, it has traveled through the body, usually through the blood stream, and settled in a new location. We call this metastasis - or just “mets” for short.

Different cancers like to go to different places. Ovarian cancer most commonly stays in the chest and a abdomen and makes its new home in organs like the bowels, liver, and lungs. Breast cancer tends to gravitate to bones, brain, lungs, and liver. At work, it’s common for me to hear that a patient’s relative had breast cancer, and also liver and brain cancer and then passed away. Most of the time, what they’re really saying is that the breast cancer metastasized - or traveled - to the liver and brain, and the death was due to the effects of the breast cancer on those other organs.

Helpful, I hope!

Soul Retreat

For many months, probably over a year, I’ve been wishing for an opportunity to get away for a few days on my own to dig through three boxes that have remained largely unopened for more than 20 years. They contain old journals and letters from my high school and college days. I even kept copies of some of the letters I wrote, thinking they’d be valuable someday when it was time to tell my life story (even in the days before YouTube, did all teens dream of fame??).

But I hadn’t mentioned my idea to anyone - not even Mike. 

Well, a couple weeks ago, a friend offered me a few days at Lake Chelan (in central WA) since her family wasn’t going to stay for the entire week and they couldn’t get a refund.

The view from my morning walk.

WOW! Mike had to work, so this was the retreat I’d been wanting! What a wonderful gift! I went earlier this week: Tuesday through Friday.

I was a little worried that I was opening Pandora’s box: no doubt embarrassing moments, hopefully past memories to me laugh and feel all the best feels, things I’ve forgotten and don’t want to remember, potential disappointment in my young self…

Overall, it was a little weird, but not as bad as I thought it would be. I got through most of my journals and none of the letters, but now the ball is rolling and I’ll carry on in my spare time. Once I’m done, I’ll probably share the highlights with you. Just wait!

In Summary: Prayer Requests, Please

1) That the cancer stays in its well-defined mass until surgery. No growth, no messing around with nearby structures.

2) That the planning and advance procedures go smoothly.

3) Both my cousin and my friend’s brother were in very serious accidents this week and are in ICUs fighting for brain function and mobility (respectively), so please direct some of your prayer time for me to their healing and their families’ peace and endurance.

Thank you! Have a safe and happy Fourth of July!