Friday, January 9, 2009

Part of the Story....

I've been quiet for awhile. I didn't have much to say. I started this blog about my experience with cancer at a young age...and I thought that story was over. However, there has been a small new chapter that occured during the past month. Let me explain....

It started the day after Thanksgiving when I was shopping (what else would I be doing on 'Black Friday'?) My stomach felt a little funny that morning, but nothing that was going to keep me from shopping! After an hour or so, I started to get severe abdominal cramps. I tried to ignore them for a short while until they wouldn't let me, as they almost brought me to my knees. After some debating, my mother and I made a trip to the emergency room. They quickly gave me relief with some IV pain medicine and abdominal xrays were obtained. The xrays didn't show anything definitive, and we opted not to do a CT scan due to my previous radiation exposure and the fact that my pain was relieved. The doc thought that I might be starting a bowel obstruction, and sent me home on a clear liquid diet for 24 hours, hoping that it would resolve itself. This is what I did...and thought I was doing better. My belly continued to hurt if I pressed on it, but besides that, I felt fine.....

Until the following Wednesday. I woke up at 5:15am with the cramping again. I took a shower to get ready for work, and decided that since I couldn't stand up straight, I needed to call out for the day. At 9am I was back in the ED. I spent the day there recieving pain medicine every 2-3 hours, and this time they decided to do a CT scan. After the second scan, it was determined that I had a partial small bowel obstruction. The ED doc gently told me that obstructions were common following abdominal surgery due to adhesions/scar tissue that naturally develops, and that this was the most likely explaination for my problems. He also told me that he could not promise that this wasn't a cancer recurrence. This freaked me out for a second...then another helping of pain medicine put me back into my mindless sleep. I was admitted to the hospital that night, and spent a sleepless night with a crazy roomate and screaming neighbors....buts thats another story! I stopped requiring pain medicine that night...and spent the next day with a migraine. When that started to resolve (after finally figuring out that they actually do have excedrin migraine in the pharmacy), I went home at 7pm with the same instructions to stick to a clear liquid/bland diet, and schedule an appointment with a surgeon as a consultation.

My life returned to normal, though I quickly learned that food didn't settle so well. I stuck to rice, cream of wheat, and yogurt....and really ate those rather infrequently because I was scared to hurt again. Again, I lasted another week.

The following Wednesday, after working 2 12-hour shifts and feeling fine, I started to get the cramps at around 10pm. I tried to ignore them and fell asleep. I woke up 30 minutes later with extreme cramps. I had a bowel movement (gross...but necessary to know...as if you have an obstruction you would think that you couldn't have any BMs...but you actually can with partial obstructions....). Then I started to throw up. I started to seriously wonder how I was going to get to the hospital because I couldn't get off the bathroom floor. Finally, I was able to move to my phone and call my roomate to bring me to the hospital. Luckily, he remembered a puke bucket for the ride! This was a short ED stay...and I was promptly admitted. I spent the next two days there...and continued to be nauseous and need continual nausea and pain medicine. I met with the surgeon while inpatient, and he explained that we would give it one more chance to fix itself (as this is what usually happens), but that if it didn't happen, surgery would be the only option. He reminded me that I could not live the way that I had been, and that nobody should determine that their day was a 'good day' by if they were able to eat or not.

I convinced the docs to send me home Friday morning, as I had to pick friends up at the airport at noon for a weekend of fun. This time, they sent me home with pain medicine...just in case. My friends came and I had a great weekend with them, despite the fact that I didn't really eat and was using my pain medicine a couple of times a day....but distraction is a great tool for me! However by Monday morning, I was really hurting (I had eaten a couple of bites of soup the night before). I brought my friends to the airport, and started doubling up on my pain medicine. I called the surgeon, and we scheduled an appointment for Wednesday, with the understanding that he would directly admit me to the hospital at any time before that if needed. I continued to take pain medicine frequently until we met.

The surgeon went over the scenerio again, stating that the small bowel obstruction was most likely due to adhesions from my previous surgery, however, he could not be sure that it wasn't due to cancer until he got in there to look around. He reassured me that there was no evidence of cancer on any of the scans, but wanted me to know that it was an option. He then told me that prior to scheduling surgery, they needed to take some labs to check on my electrolytes and nutrition status since I hadn't been eating. He gave me the option of being admitted again, or going home and continuing on pain medicine. I had labs drawn and high-tailed it home! He called me later that night to let me know that my electrolytes were fine, and though my nutrition status labs were low (pre-albumin), they were still going to put me on the surgery list as an 'add on' for Friday.

So I spent the next day trying to convince myself that I needed surgery. I was very scared that this was in my head, and that I had made it worse than it was because of anxiety that it could be cancer. I actually didn't feel deep down that it was cancer....but I still thought that this pain could be in my head. I was very nervous that they would open my up, and find nothing. Would it be worth the recovery of major abdominal surgery, if there was nothing? Luckily, my family would put things back into perspective again. ("Kelly, you've aren't able to stand straight up, and haven't been able to for days...you are in pain!")

Friday morning at 7am, I got a call telling me it was time. I was at the hospital shortly after and being prepped for surgery. Of course, as I was getting close to being ready, there was an emergency surgery, so I was postponed. That was okay with me, as the pain team came in to give me an epidural, which included a little versaid in my IV (medication used for conscious sedation). I was again loopy and happy (even as they attempted 3 times to place the epidural).

They wheeled me in a couple of hours later, and I was asleep before we even got into the OR room. Next thing I knew I was in post op and very sleepy. I really woke up on my way up to my room, when the bumps of the transport had me writhing in pain. The bumps hurt my belly, but I couldn't take a deep breath (or normal breath for that matter) because that really hurt too. And...to top that off I had a NG tube (tube down my nose into my stomach). This tube was the MOST uncomfortable. I couldn't swallow with it in because it hurt and made me feel like gagging. Which was difficult when I started to tear up because of the pain, as the post nasal drip from crying made me want to swallow. By the time I got to the floor I was miserable! I was hitting my pain button every second trying to convey the depth of my pain and rating my pain 10/10. The pain team was quickly called and gave me an epidural push of pain medicine. RELIEF! I then didn't move the rest of the night.

The next morning, I woke up and realized that I couldn't move my left leg. This was fine with me, as I wasn't in pain. I knew that it probably had to do with the placement of my epidural PCA (pain pump). I needed two people to help me stand-pivot to a chair. It was a very wierd sensation. That night they changed the concentration of numbing medicine and decreased my dose, and the next morning I could move again.

*Just a note here on the epidural pca vs and IV pca. The first surgery that I had I had an IV pca. This worked well for pain control, but I was out of it during my recovery. I know I had lots of visitors, and am slightly embarrassed now of my behavior...because I don't remember much and continued to fall asleep on people. This is because the IV medication is systemic, meaning it flows through my blood stream and works on my entire body. On the other hand, the epidural pca was wonderful (besides the whole leg thing). This is local...meaning that it only worked on my abdomen area. I was conscious and knew what was going on throughout my entire recovery. My only problem was that I got bored one day and wanted some IV medicine to put me to sleep and pass the slow moving hospital time. :)
So.....was it worth it? ABSOLUTELY! I, in fact, did have a small bowel obstruction...it wasn't in my head! There was scar tissue that had wrapped itself around my small intestine, and was therefore strangling it. This made it difficult for anything to move through it. The surgeon snipped the scar tissue, then tested the intestine to make sure that it still worked! Since it did, nothing else needed to be done. However, I got an added bonus. First, he took my appendix out...so it won't cause me any problems in the future! But here's the great news.... He also inspected all of my abdominal organs (liver, lg and sm intesting, ovaries, uterus, etc) to make sure there were no signs of cancer.....and there weren't.
This is fabulous news!

On top of this, I was able to make it home early and be home for Christmas...and my recovery period has been smooth. I didn't really need pain medication after they took my epidural out, as the pain prior to my surgery was much worse than the post surgical pain. I continue to 'recover', as I don't go back to work until the end of January per doctor's orders....but I feel great!

So....there is my long winded rendition of my past month. As I stated...this was just a part of the whole cancer story. On that note, however, I've decided that its the last chapter. I'm ready, both physically and emotionally, to leave cancer in the past. I was unsure that I'd ever be here, but now that I am...it feels great! I am healthy and happy, and plan to remain here. I know that this new found confidence may just be left over gratitude from getting an internal clean bill of health, and that the anxiety may return during scan times, but thats okay....and expected. It's the anxiety in between these times that I'm letting go of.

I'm done with being sick. Period.

So...thanks for reading....and from the bottom of my heart, thank you for your continuing, unwavering support.

Much love and happiness to you......