Friday, August 22, 2008

Good MRI Results

To my concerned neighbors, friends and caregivers,

I just met with my MGH oncologist to discuss the results of my latest post-chemo MRI study. A CT scan two weeks ago showed some anomalies in my liver that could have been metastatic cancer but were not typical of metastasis. To confirm this, an abdominal MRI study was performed on Wednesday night. The radiologist interprets the objects as likely cycts and not cancer. This is great news. Even though I was prepared for the worst, bad news would mean a completely different pattern of therapy (more chemo, surgery, etc. ) and a much lower chance of survival. Happy as I am about these results, I would never declare myself cured at this early stage. The next few years are ones of intense monitoring and recurrence is possible. As with many like me, the memories are fresh and we are traumatized. For some, me certainly, the fear will never fade. The end of chemo is not the end of fear and anxiety.

Here is a link which explains some of the emotions that can occur after cancer treatment.
http://www.mayoclinic.com/health/cancer-survivor/CA00071

There is a tendency to not care about the body which has already let you down. Earlier habits of exercise, healthy eating, weight control, self care, etc. need to be reprogrammed. It's easy to fall into a self-destructive pattern and I don't see this as irrational at all. It's a choice and a daily struggle. After all, why die of cancer when you can die of something more fun like vodka poisoning. :-) or skydiving .

--Dave

Thursday, August 7, 2008

Colonoscopy Through Stoma

My gastro doc uses the Half-lytely bowel prep. It's two liters (1/2 gallon) of water containing an osmotic laxative. It's designed not to dehydrate the user nor to add fluid to the body. So you can drink a gallon without (usually) any hydration issues. The effect is called "colloid osmotic pressure" or Donnan pressure after the famous British chemist Frederick Donnan, FRS.

Yesterday morning, I filled the plastic jug with tap water and mixed it until all the powder had dissolved. I added the lemon-lime flavor packet. The prep kit comes with two bisacodyl tablets (stimulant laxative) which I did not use since I have IBS. My gut needs no prompting to get moving.

I switched to a drainable bag which is absolutely needed since the liquid exits quickly and without warning within an hour or so. I drank one glass of prep every 15 minutes - about 8 glasses total. My bag filled up about ten times - each about 200ml, so the total out is a close match to total in. Ain't science wonderful. After about four hours things calmed down and the bag stayed empty.

This morning I had the colonoscopy. I brought some appliances with me. I was invited to change into the obligatory patient garb. I lay face up and a nurse placed an IV line into a hand vein and began a saline drip. I was wheeled to the endoscopy room where I met my red-headed lady gastro and the anesthesia nurse. The happy juice cocktail was Versed (midalozam) & Demerol (pethidine). Versed is short-acting relaxer and sedative and Demerol is a opioid pain med which sedates. I am pretty sensitive to this combo and it turns me off very well - no memory at all of the procedure - amnesia is common with the cocktail.

I woke up to an offer of juice and cookies. I was still under the influence of the happy juice. The Versed wears off quickly but Demerol wears off over several hours - I can still feel it. Whoopie.

I found that they did not remove the flange - only the bag of my 2-piece. It's convenient for the staff but there's a small chance they could miss something by leaving the flange on. A nurse told me that some docs work right through the bag. I think something could be missed that way as well. Overall, it was an easy and painless procedure.

Utility Pole Replacement in Cambridge (Riverside)

Last night a wooden  utility pole  cracked at the base and fell toward the neighboring pole across the street. This caused the wires to d...