23 July 2014

Prepped and Ready

"I saw my doctor and surgery is next week Tuesday."

I stood in my manager's office and nonchalantly uttered this frightening information as if nothing major was about to occur.  Working at a Level I Trauma Center has taught me to keep my cool when things feel out of control.  I was merely....staying cool.

M's eyes started tearing up.  She was not just my manager, but my friend as well.

Oh crap...  I can't fall apart now...  No...  Not gonna do it.

She hugged me and reassured me that I had her support.  I was relieved to hear it, but weight of what was about to happen to me kept me from breathing easy.

* * * * *

Preparations for my leave of absence had already started.  The entire leadership team was ready to cover for me.

"Don't worry," they said.

Before I knew it, the week of work was over and my leave officially began.

* * * * *

My luggage lay on the floor of my bedroom while I piled clothes and toiletries on my bed.  It felt strange to be packing for something other than a road trip or a flight out of the city.  Business or pleasure?  This was definitely business - as in the business of staying alive and healthy.

Please, God, let me wake up from this crazy dream...

Alas, this was real.  Too real.

When I finished gathering my things for a couple nights at the hospital and a two week stint at my parents' home, I stuffed Maggie's toys, food, and treats in a shopping bag.  Thoughts of how long I had to be away from my pup was more than I could handle.

Finally, the tears came.

I don't know why I held back from crying for as long as I did.  I've never faced the possibility of having cancer before.  The fact of the matter is that there is no right or wrong way to handle serious news.  I remember how hard I cried when I heard the news of a close family friend's death.  Finding out that my boyfriend of two years had been cheating of me during our entire relationship left me tearful, hurt and angry, but determined to leave him in the dust.  And I can recall how I put on a brave face when I found out my mom had a stroke.

So here I was facing the possibility of cancer.  It wasn't a diagnosis yet.  I still had a chance.  There was still hope.

I don't deserve to fall apart when I've seen others courageously face a cancer diagnosis, I thought.

I quickly dried my tears and finished cleaning up my home.

* * * * *

Maggie was dropped off at my cousin N's apartment, familiar territory for this Labbe.  She was excited to visit her Tita and Tito.

On my way to my parents' house, I picked up two bottles of magnesium citrate as part of my prep for surgery.  All day, I was on a clear liquid diet and then my gastrointestinal tract was cleared with the magnesium citrate drink.  While I felt lighter and skinnier, I still would never choose to do this on purpose!

I wished I could fast forward to the day after surgery.

08 July 2014

Sooner Than Later

"Are you SURE you didn't feel anything over the last six months?"

Bloody hell...  Here we go again!

"Yes, I'm sure," I insisted.

The resident continued to palpate my abdomen, pushing down on every quadrant until she came to the giant burrito hovering near my right ovary.

In nursing school we were taught to look at patient's face while we assessed the abdomen.  Gentle pressure sometimes reveal expressions of pain or soreness.  The tables were turned in this case.  I could tell by the resident's look that this mass was so big that I shouldn't have missed it.

As she continued to quiz me, I confessed that I was not alarmed by the size of my belly.  It is a well-known fact that high stress jobs increase cortisol production which often results in a large girth.  In case you didn't know, smarty pants resident, being a nurse manager in surgery is VERY stressful!!!  Also, it happens to be the one place that people on both sides of my family store fat.  I come from a clan of skinny arms, skinny legs, and big bellies.  That's how you can tell that you are part of my genetic tribe.

After a thorough examination by the young doctor, the gynecologic oncologist stepped in to verify her findings, do a pelvic exam, and continue the questioning.

"So...  You didn't feel this growing?"

Sweet Jesus, Mary, and Joseph, save me!

"Nope."

I reiterated what I said to the resident and added, "I also thought that my weight gain was typical for a woman over 40.  Honestly, I was just trying accept the fact that this is my body."

Which, by the way, I think is a healthy attitude, I thought.

Dr. P. scratched his head while he considered my rationale for not noticing the 21 centimeter long mass that had taken over my belly.  He took his turn at the gentle pushing of my abdomen.  Then without warning, he tried to grab the mass and found it to be mobile.  That's a good sign that it's probably not cancer, he said.

Is this what it feels like when you're pregnant and they have to move the baby around?  Ummmm...  OK, now I'm REALLY noticing this mass!!!

When he was done, he told me to change and meet him in the consult room next door.

* * * *

I was so happy to have my cousin N with me during the discussion of next steps.  The news of what had to be done next made my head feel like it would explode.

Dr. P ran through everything like a professional - pleasant yet straightforward.  He did not speak down to me, knowing that I am an O.R. nurse.  I appreciated that he remembered that I am the patient and still needed the extra explanation just in case I was overwhelmed.

Yes, I was overwhelmed.

He drew pictures, wrote out the possibilities, and comforted me with the idea that most likely it is NOT cancer - 85% positive that it was not the Big C.  That was great, but it still has be extracted as if it might be cancerous.  This means that the incision will not be a bikini line wound due to its location.  Since I'm not a super model it's not that big of a deal.  He said that if he can make the incision smaller, he will.

When it came time for me to ask questions, I froze.  It took me a second, but then I thought of a couple...

How long is recovery?  Dr. P was optimistic and told me that four weeks would probably be good enough for me since I'm "young and healthy."

How soon can we do this?  Next week was the answer.

Wow.

Well, I was done with my questions!  It was time for the scheduler to come in.

We settled on date for next week.  Her first suggestion, July 31st, was out of the question.  She checked with Dr. P and they figured out a way to get me on the surgery schedule.

Get this thing outta me!!!

She handed me some papers to sign and instructions to keep.  In addition, I received orders for bloodwork, an EKG, and chest x-ray.  I was able to get all tests done that afternoon, plus obtain surgical clearance.  Amazing!

Next on the list --- breaking the news to my manager and colleagues...

07 July 2014

Curve Ball

"Didn't you feel it?" asked the doctor during my annual exam.

"No," I said, wondering how I could have missed this.

Apparently, there was a huge mass in my abdomen.

"I'm going to order an ultrasound, then we'll go from there," she stated matter-of-factly.

Dr. J, my gynecologist, didn't mince words, something I appreciated about her.  As the heaviness of the news thickened the air, I wondered how many masses she found in her patients today.  I know I'm not the first woman to hear such a diagnosis, but at that moment I felt alone.

Just breathe, Marj, I told myself.

The following week, I had an ultrasound.  I imagined that this is what it felt like to be kidnapped by aliens and then probed.  If I wasn't a clinician myself, the violation of my private area would have scarred me for life.  Has any woman been diagnosed with PTSD after a pelvic ultrasound? I wondered.

After the ultrasound, Dr. J sat down with me again.  She described the findings as a large mass encompassing my right tube and ovary.  The measurements didn't sound real.  I mean, 21 centimeters long?  Holy crap.  I'm not sure what the expression was on my face, but I'm guessing it was shock.  Gently, she stated that it was most likely NOT cancer from the way it appeared on the ultrasound.

Yeah, right, lady...  I thought.  How can you tell by a flat image and no specimens?  I mean, tissue samples are more conclusive.

At that moment, I hated that I was an O.R. nurse.

She proceeded to hand me an order for a CT scan with and without contrast.  This would give her a better picture on what was going on with me, then we could talk about next steps.  Most likely, surgery was in my future.

"That was I figured," I sighed.  I resigned myself to the idea that this is going to my future for the next three months.

* * * *

A week later, I went to my appointment for the CT scan.  As entered the facility, I felt surprisingly calm.  The minimalist nature-influenced d├ęcor was reminiscent of a Gold Coast spa.  It would have been appropriate for them to pipe in some music from Enya.

After a few minutes of waiting, a nurse walked me to a dressing room where I would change into a patient gown.  Finding my way to a semi-private waiting room, I sat down and wondered how I was doing.  I know that sounds funny, but I have a tendency to compartmentalize my feelings, especially during times of excessive stress.

Am I stressed?  I don't think so...  Boy, I'm doing great!  The gown is comfortable, the facility is nice, and everyone is very professional.  Yup, I'm fine...  I think.

Just to be sure that I was coping, I called one of my best friends.  K and I laughed about the Berry Barium Smoothie, which tasted like the berry-flavored Tums I kept at my desk at work.  It's not so bad, I told her, as a I sucked it down.

After a long wait, another nurse brought me back to another area so I could get an IV placed.  She was very concerned about hurting me, which I greatly appreciated.

"I have a high pain tolerance," I confessed.

She looked surprised, then carefully installed the IV.  Softly she said, "You didn't even flinch."

I was proud of myself for putting on a brave face, but wondered how long it would last.

More waiting and then a young East Indian man took me back to the CT machine.  It was a large O that looked like a piece of equipment we use in the operating room.

This should be a piece of cake.

I laid on a cushioned platform that would slide through the large O several times. Throughout my experience, he instructed me when I should take a deep breath, hold it, and then let it out.  He kept asking if I was OK.  I must have looked like I wasn't OK, but in my mind I was handling all this like a champ.

The IV was hooked up to a bag of contrast dye.  I could feel when they released it into my bloodstream.  Earlier, I was warned that I would feel a flush of warmth and that I would think I accidently wet myself.  Of course, they were right.  I was relieved when the urge to pee diminished.

I survived the actual experience of the CT scan, but the worse part for me lay ahead:  the waiting.  I had all weekend to worry about my results.  It would be a battle between my positive self versus my negative self.

What if it's cancer?  What if it's all over?  What if they have to take everything - my uterus and my other ovary?  I'll never be able to have children...  What if there is more than just an ovarian cyst?  Could all those years of partying leave me with liver damage too?  What if I have an abdominal aortic aneurysm?

STOP.  Don't get ahead of yourself.  One day at a time.  Be grateful for what you have.  There are so many people who love you and who are there for you.  You are so lucky.  Don't be afraid to reach out to them.  You don't always have to be strong...  You can handle this.  Stay in the moment...

There was no winner to this battle, but only because it is ongoing.

* * * *

My CT scan was on a Friday.  By Monday, I received a phone call at work.  I happened to be at my desk when Dr. J's office told me that she wanted me to get additional blood work for my CA125.

What the heck is CA 125?

While the assistant was on the phone, I ran a quick internet search.  CA 125 are the markers for ovarian cancer.

Ovarian cancer.  Holy crap.

I could feel the blood drain from my face.  I stayed calm while I was on the phone, but after I hung up I sat at my desk stunned.  Thankfully, my officemate and fellow O.R. nurse, C, was there to give me perspective and comfort.

Getting those instructions felt terrible, but what was worse was that I was going to wait until the end of the week to get the blood work done.  C reminded me that I was doing it again - putting myself LAST and letting my work be the priority.  Honestly, that's my real sickness.

I called Dr. J's office to see if I could get this done that afternoon.  After an affirmative answer, I raced out of work.

* * * *

The waiting seems to be the worst part for me because I am a thinker.  I will analyze something until it can't be picked apart anymore.  This is both a strength and a weakness --- good for work, bad for my personal life.

At 1:30 AM the day after my CA125 blood test, I opened my eyes as if I had a full night's rest and it was time to get up.

Nooooooooo...  Go back to bed, Marj!  You have to be at work in 4 1/2 hours!!!

As I tried to fall back asleep, the "what if's" kept knocking at the door.

"How could you sleep at a time like this?" they wondered.

By 3:30 AM, I gave up on the idea that I was going to fall back to sleep.  I called work to tell them I wasn't coming in.  Who knew when the exhaustion would hit?  I could not be a responsible nurse with the distraction of my situation as well as lack of rest.

It was good thing I was home, because Dr. J called me herself.  She told me about the CT scan results which confirmed the mass.  Luckily, my CA125 results were low, so the likelihood of ovarian cancer is low.  Next step was to have surgery.  She explained everything about the procedure, explaining everything as if I was not an operating room nurse but a patient.  Dr. J stated that they will take a "frozen section" specimen to confirm diagnosis.  Pathology will process this specimen and test it for evidence of cancer while I am still on the operating table under anesthesia.  If there is no cancer, they would just take the mass and the right tube and ovary.  If there was evidence, then my uterus, left tube and ovary would be removed.  Yes, that would be EVERYTHING.

This is scary news for anyone.  But for some reason, I was holding it together.  I guess that's typical of someone who has been a witness to life and death.  We take our feelings, put them aside, and then deal with them when we let ourselves actually feel.

Having discussed possibilities with my physician mother, my next step was to transfer care to a hospital that was closer to my support system - my family.  I thanked Dr. J and told her about my plan.

"You gotta do what you gotta do," she said.

I was glad she understood.  She reminded me that I would need copies of my results to take with me to the gynecologic oncologist.

Immediately, I researched doctors out of the surburban hospital.  After finding one that was recommended by a former co-worker, I made an appointment.

And now more waiting...

05 June 2014

More Than Alive At 45

This week I have been on vacation and celebrating my 45th birthday.  Yesterday was my actual birthday, but I figured I would take the whole week off to think back on the past year and get excited for the next one ahead of me.

So far I have

....celebrated with my immediate family.
....visited the dog beach 4 times this week.
....worked on house/personal projects that I have been putting off.
....visited my doctor for my annual checkup.
....lunched with my little cousin who more like my sister.
....enjoyed a Cubs game.
....treated myself to a deep tissue massage (which was really painful, but necessary).
....dined and blew out the candles with my Puppy PlayDate friends (and dogs).

And there is more to come.

It is hard to believe I am actually 45.  I mean, FORTY --- plus FIVE more years.  Other than some random joint pain, I don't feel old.  I know I don't look my age.  I never realized it before, but part of me keeps looking for hints from other people/society/etc. on how my life "should be" at 45.  I know better now.  My life has never been on schedule according to the way society thinks.  In fact, it really hasn't fit in any kind of mold.

And you know what...  I'M OKAY WITH THAT.

At 45, many people have given up and resigned themselves to being overweight, over-the-hill, and over the idea that life gets better.

NOT ME!!!

I'm looking forward to the year ahead...  There is so much left of life to be tasted!  I'm determined to stay the course...  I'm casting off whatever baggage has been weighing down my vessel.

Anchors away!

13 April 2014

Cleaning House

Back in January, I started Project Mind Cleanse.  So far so good.  I have not really missed regular television.  And now on to the next step...

Step Two:  Declutter

One City Girl plus City Dog can make a pretty mean mess.  I've started to go through papers and other "stuff", filling bags and bags with ready-to-donate goods.  I'm not sure why, but I am actually feeling lighter.

When I was a kid, my father always asked me this question when I begging him to buy me something:

Do you WANT it or do you NEED it?

Most of the time, the answer was "want."  If I insisted that it was need, then he instructed me to wait 24 hours before buying it.  Usually, I found that I really didn't want it anymore.  I ask myself this same question as go through my stuff.

And it's not only my belongings that I'm looking to clean up.  My decluttering phase also includes so-called friendships and social networking sites.  I have an unnatural attachment to these things.  We'll see how much I can purge!!!