This is autobiographical, referring to my life in the time starting a couple of weeks before Christmas 2000, until April or May 2001. I had three operations. For 7 or 8 weeks in January and February 2001, I believed that I had cancer.
In December 2000 my bowels stopped working. I produced slim stools, and then I stopped shitting. I became bloated, and started to burp frequently – little gasps of gas kept coming out. On Christmas Eve, we went for dinner at my wife’s brother’s wife’s parents house. I got sick and went home. I stayed at home, eating broth and crackers for the next few days. My symptoms weren’t that bad for a few days. I didn’t get better but I didn’t get worse except for bouts of unproductive cramping. Jan went to her brother’s house in Kenora with her family for a week. Claire stayed home with me.
After Jan came home from Kenora, I went to the primary care desk at the Misericordia – a local facility that used to be a hospital, now called an urgent care facility. X-Rays showed trapped gases and festering matter. I was transferred to the St. Boniface Hospital. I don’t recall an ambulance, so my wife must have picked me up and driven me over. I had further X-rays. I got an NG tube which was hooked to a pump that suctioned digestive juice and semi-digested food that was backing into my stomach from my intestines. I got an IV line for fluids. I went up from the Emergency unit to a surgical ward. I had a few roommates over several weeks of hospitalization. The first was Reuben, who became a friend. We didn’t talk much at first because we were both having problems. Our medical problems were similiar, or so we thought at the time, and we were getting same treatment.
I found it hard to sleep while I was in hospital. The nurses and nurses’ aides are as quiet as they can be, but they are always coming and going, sometimes with a cart on rollers or an IV stand. Many nights, they have to take vital signs. There are electric motors humming, and every once in a while the alarm on someone’s IV pump starts beeping. The building is noisy in itself. There are constant reminders of being frail and vulnerable.
Over the first couple days, I went down to radiology for more X-rays and an MRI scans. For some of the X-rays, I received a barium enema. That was an undignified experience – a strange fluid shot up my ass, bent into and odd shape lying on a plastic mat at an odd angle, struggling not to explosively spray the fluid all over the room, desperately waiting to be disentangled from the machine, and then having to get to the toilet while wheeling an IV around the machinery. It would have been humiliating but the technicians were capable and compassionate.
My first few days in the hospital were devoted to locating the blockage and decreasing the pressure inside my intestines. I had no food or water, just a few ice chips to keep my mouth from getting dry. The diagnosis was a circumferential tumour of the colon. The large intestine has basically 2 sections, the colon and the rectum. The colon is identified in ascending, transverse, and descending sections. The rectum is the section that descends through the pelvis to the anus, the aperature that people incorrectly call the rectum. A surgeon working on a rectal tumour is working in a tight and sensitive area. My obstruction was colo-rectal. Because it was circumferential and obstructive, it was considered to be a stage stage T3 or stage IIA or stage III tumour. The doctors were soft about the information. My surgeon made a point of saying that my liver had been clear on the MRI scan, which showed that the cancer had not spread from the colon. For whatever biomedical reasons, colo-rectal cancers tend to spread to the liver, and liver cancer is basically untreatable. I didn’t ask a lot of questions in the hospital. There were a few informative posters around the ward, and some pamphlets and booklets. I did some research after I got home, before my second surgery. Bowel blockages are generally caused by tumours, by inflammatory processes associated with inflammatory bowel diseases – Krohn’s and colitis – and by post-surgical adhesions. I had not had previous surgery. I had always had a troubled gut which I blamed on bad eating, anxiety and stress, and I had not believed that I had suffered from an inflammatory disorder. At this point I wanted to believe that I had been ignoring one for years and toughing it out.
Near the end of the first week, I had my first surgery, a colostomy. The ostomy opened the transverse colon above the blockage to allow the bowel to empty and settle into a less stressed condition for surgery. The plan was to be to get me home, so that I could eat and rest and get in shape for the next surgery, scheduled in the third week of February. I learned the routine of surgical preparation, the last undressing, the warm blankets and the trip into the surgery. I learned about pain control. I had an odd reaction to morphine, sweating and retching. I handled demerol better but it made my very groggy, and I was prone to snap to wakefulness with the sense of having had a small convulsion. One of the delights of surgical recovery is coughing. There is a concern to clear the lungs of congestion, and the nurses insist on seeing you cough. You get a pillow to hold over your incision and you cough – which isn’t fun when your abdomimal muscles have been sliced and stretched. The first walks are remarkable. It isn’t as much a direct sensation of pain as a terrible weakness. The handrails in a hospital ward have a purpose. For the first few days, it was one hand on the rail for balance and one on the IV pole. Getting in and out of bed, or in and out of a chair, presents problems. There are ways of minimizing the stress on the abdomen, but abdominal muscles are big part of most movements.
For the first few days after the colostomy, a nurse’s aide came to empty the bag. My output was measured. After a few days, I was able to empty the bag into a container in the wash room, and rinse it, but the aides still had to measure my output. There had been a lot of material trapped, and I had a little shit volcano going for a couple of days. It was still a few days before I was able to start taking hospital meals. It had been so long since I had eaten that I got a PIC line, but in the end it was not used for nutrition. Towards the end of this session in hospital, my surgeon did a colonoscopy. She didn’t see any polyps or visible evidence of further cancer sites. She didn’t see clear evidence of inflammatory disease. She saw a number of diverticuli which can be a source of discomfort and aggravation, but are not associated with bowel blockages.
My days in the hospital were slow. I looked forward to my wife’s visits, even though we began to fight when she tried to get me to explore alternative health care – the vitamins that she was marketing in a Network Marketing scheme. She wanted me to read the marketing literature of the USANA company, and research papers by one of a USANA distributor and promoter – Dr. Ray Strand. My doctor didn’t support it. I know how to read a research paper, and Dr. Strand’s papers were full of speculation and rationalizations for disregarding the consensus views of the oncologists on the subject. My resistance to her ideas was going to cost me in the future.
My parents visited a lot. I walked up and down the halls. After several days, when my IV was gone I began to go up or down a flight of stairs. I read newspapers, magazines, even some novels. I talked to my roommates. I was still responsible for office administration for my firm. The senior partner was on his annual holiday in a warm place, and I still had to approve and sign cheques. My assistant and his assistant visited a few times to help me take care of business. Fortunately for my senior partner, they were capable of taking care of day to day business in the office.
When I went home, I wasn’t sleeping much. I would waken early and read. I had my assistant send files and letters home. I had a dictaphone, and I dictated some letters, and my assistant sent me electonic drafts by email for proofreading. I caught up on my correspondence. I wrote some briefs and letters in my wordprocessor. I thought about the next surgery, and cancer treatment, and leaving my life behind.