I sat in disbelief, the answer to the question still ringing in my ears.
“Not great, man.”
I had asked the colorectal surgeon for a prognosis. In May of 2015, I had been diagnosed with colon cancer which had metastasized to the liver. Stage IV. The tumor had been diagnosed during what I thought would be a routine colonoscopy. I had read the report of the CT scan, myself, just minutes before I was scheduled to undergo colon surgery. Metastasis. Not something you ever want to read or hear about yourself. The surgeon was blunt, which I dreaded then, but later came to appreciate.
After the surgery, the surgeon had referred me to a Clinical Oncologist. After my initial visit, I asked her how long I had. Her response had been, “if you respond well to the Chemo therapy, 18 to 24 months”. I was stunned, to say the least. Bad news travels in packs. I asked her how she felt about seeking a second opinion. After all, we lived in Houston, where MD Anderson, a World-renown, premier cancer center was located. She encouraged it, and thought it made sense.
But, let’s rewind the story a bit.
I hate everything about modern medicine. I hate doctors and specialists of any kind, blood work, any and all medical procedures and tests. I abhor being prodded, poked, stabbed, scoped, x-ray’ed, weighed, measured, probed, and scanned. I dislike waiting in the waiting room, waiting in the examination room, in the procedure room, waiting, waiting, and more waiting. I detest pills, shots, ointments, salves, bandages, even band aids. I can’t stand even taking an aspirin or other over the counter meds. Get the picture?
As a result, I didn’t even have a PCP (Primary Care Physician). I couldn’t remember the last physical exam I got. Prostate exam? Are you kidding? Colonoscopy when I turned 50? Seriously? Checking my blood pressure, and Blood Sugar? Surely you jest. I did not take care of myself at all. Ate what I wanted (all the wrong things), when I wanted, ignored any symptoms, drank like a fish, did not exercise, and, being the world-class procrastinator that I am, put off everything until “tomorrow”.
So it was no surprise that I felt as bad as I did, just before my 63rd birthday. Tired, weak, irritable, frequent colds, up 4 or 5 times a night to urinate, dry mouth, thirsty most of the day, and, there was no denying, blood in my stool. I was also at least 40 pounds overweight, and had a number of other ailments that I will not mention here.
My wife had reached her boiling point. With great reluctance, I agreed to make a doctor’s appointment.
The doctor’s office is near our home, a 10 minute drive. It’s a stand-alone modern building, with a large, pleasant looking waiting room. I had filled out all the required forms on line before arriving (yes, the medical field is slowly arriving into the 20th century), so it was pretty quick after I got there, that I was called in to see the PA (Physician’s Assistant). You rarely get to see the actual doctor these days, but, I have to say, the PA seemed to be very well qualified, extremely professional, and had great interpersonal skills. Good thing, because she would be the one who would be prodding, poking, stabbing, squeezing, probing, listening, and, performing the dreaded prostate exam.
The long and the short of the results:
- High Blood Sugar – 297 reading, Diabetes Type II
- High Blood Pressure
- Enlarged Prostate
- Overweight by about 40 pounds
- Blood in the stool
- And a few other more personal ailments that I will not elaborate on
I was prescribed medication for the first 3 issues, put on a restrictive diet, and given referrals to 2 specialists, a Urologist, and a Gastroenterologist, for a colonoscopy and endoscopy.
After a consultation with the Gastro, I was scheduled for a colonoscopy and endoscopy. This was to be a bookend exercise, getting it from both ends. Let me first say that it was nowhere near as bad as I had expected. The worst part is the preparation the day before. A clear liquid diet and copious amounts of a fluid that thoroughly cleans you out. Oh, and did I mention the self-administered enema? Yep, an enema.
The day of the procedures, I was prepped at the center where these bad boys are performed. After paying a $500 co-pay (ouch!), I was given Propofol, (the one and the same King of Pop stuff), administered by an anesthesiologist, but, in a proper and professional way. Out like a light in no time, and I came to quickly, clear as a bell, with both procedures complete. Well, sort of. The good news was, the endoscopy was clean, but the colonoscopy could not be completed due to a large doughnut-shaped tumor in my sigmoid colon. The doctor declined to provide any prognosis, advised me to consult with a surgeon, and that the tumor had to go (really?). So, the PA that had referred me to him, referred me to a Surgical Oncologist.
I was then scheduled for a battery of tests, including a CT scan. The scan revealed the Metastasis to the liver. 4 lesions. Stage IV Colon Cancer. Even though the cancer had spread to the liver, it was still considered colon, not liver cancer. Nonetheless, this felt like a death sentence, but realizing that I had to take this one step at a time, I went through with the colon surgery.
After a $1,000 co-pay (double ouch), the surgeon, cowboy boots and all, (after all, this is Texas, and what self-respecting surgeon would operate without wearing cowboy boots?) performed the Sigmoid Colectomy using a Laparoscope, an instrument that requires very small incisions. He removed 8 inches of sigmoid colon, and stapled the two loose ends back together. I was good as new colon-wise, and my recovery was quick.
Have I mentioned what a rip-off the American health care system is? I won’t get started ranting about Insurance companies. There is something most definitely wrong here. But I digress. It’s beyond the scope of this blog post, so I won’t get into it.
Referral to a Clinical Oncologist, an extremely competent lady with a great bedside manner, resulted in the prescription of 12 Chemo and Biological agent infusions, one every 2 weeks. Standard protocol for colon cancer. She would monitor how well the Chemo was acting on the lesions, and would then decide further action based on these results. This is where I requested a second opinion, not because I didn’t trust or agree with the Oncologist. I just wanted every opportunity to live longer than 2 years. Besides, a voice inside me (God) was telling me to go see the doctors at MD Anderson.
Enter MD Anderson. What a world-class place this is. You have to see it to believe it. You have to meet the doctors, nurses, PAs, blood techs, specialists, orderlies, receptionists, cafeteria workers, valets, and janitors at MD Anderson to see it for yourself. Everyone exudes competence and confidence. They have a mission: to eliminate cancer. Yes. Eliminate. Blow up. Eradicate. Kill. Their Logo is
CANCER. Strike it out. No more cancer. And they all firmly believe in this mission. Everyone is engaged in your care and well-being. If someone spots you walking the hallway with a confused look on your face, they stop you. “Can I help you? Do you know where to go? Can I show you how to get there?” And a close look at the patients, the calm serene look on their faces, gives you all the hope you would ever need. You could not be in better hands than here. Period.
To cut to the chase, after meeting with several oncologists and being subjected to a battery of tests, including blood work, several CT scans, and a MRI, they confirmed the diagnosis. But their conclusion as to the way forward was markedly different. Real hope.
As I mentioned earlier, The colorectal surgery was performed in June of 2015. After this surgery, and the consultation with MD Anderson, I underwent 5 of 12 planned chemotherapy and biological agent infusions. A little bit about the infusions. The treatment is tolerable, but literally, you are poisoning your body, and those poisons are supposed to attack the cancer cells. Unfortunately, they also attack normal cells, and cause side effects that you have to deal with. For this particular protocol, the side effects include nausea, cold sensitivity and pain in hands and feet (neuropathy), the inability to drink anything cold (neurotoxicity), diarrhea, and a few other assorted symptoms. Other than that, chemo is great!
The plan from MD Anderson was to look at how well the chemo had worked against the lesions. Shrinkage would be great. Staying the same not so great. Growth terrible. And before each infusion, my blood would be tested, and the Tumor Marker monitored. The marker is what is referred to as Carcinoembryonic Antigen, or CEA. A normal range is 0-3. My initial CEA reading was in the high 80s.
After the 5 Chemo infusions I had another CT scan and more blood work. The verdict: CEA in the teens. The scan revealed that the lesions had indeed shrunk. A HUGE blessing. So the surgical oncologist, a brilliant young man referred to as “The Boss” scheduled me for liver surgery. He would go in, remove 65% of my liver (he told me I didn’t really need that 65%. Huh?) and those nasty lesions along with the liver. He would have the removed liver biopsied, to verify the shrinkage and effectiveness of the chemo. Again, shrinkage would be good.
So I awoke from the surgery feeling better than a body has a right to, considering a 5 hour operation, a 10″ incision from sternum to belly button, a considerably smaller liver and no gall bladder. Seems that where the right lobe of the liver goes, the gall bladder must follow.
I was supposed to be in the hospital 7 days. The Boss cut me loose after 4 days. He walked in on me the day after surgery, and I was sitting up in bed, banging away at my laptop. “Hey!” he exclaimed, “Look at this! I’m taking a picture of you and sending it to all my patients. Nice recovery!”
And the biopsy? Shrinkage. Significant shrinkage. Blessings abounded. More than I deserved, but gladly and gratefully accepted.
As I write this today, 2 and 1/2 months after the surgery, and still undergoing the remaining 6 Chemo infusions, I am feeling fantastic. My last CEA reading was 2.7. Yes, 2.7 where the range is 0-3. Down from a high in the 80s. The doctors are really pleased. No cancer. And, oh by the way, I am 40 pounds lighter. They plan on monitoring after the Chemo treatments are done. Periodic CT scans, colonoscopies, blood work, and then we just keep on keeping on.
So, if there is no recurrence, and I am hopeful and have faith that there will not be, we killed cancer.
I am reborn. God gave me my life back.
Take it from me, you can overcome nearly anything that life throws at you. Of course there are a few simple rules. You need to do YOUR part, keep your Faith, believe in God (if I can’t convince you of this, at least believe in a higher power), look for those that have the skills, expertise and experience to help you, and maintain an excellent attitude. Life can and will be good again.
And, oh yes, NO MORE NEGLECT…