The Evolution of My Ass Part 6

Well, I made it through the surgery. Since April 2014, I had lost my corporate job, became increasingly more and more sick, dealt with excruciating pain, radiation, oral chemo, two bouts of c-diff, a total APR (abdominoperineal resection {removal of tumor and portions of my buttocks and a couple abdominal muscles just for kicks}), colostomy surgery, a complete hysterectomy, a second surgery to fix a bowel obstruction, and more tests, exams, needles, and labs than I can even count. But I wasn’t done yet. The first month or so after surgery was spent at home in recovery. After a three week long hospital stay, being at home, in my own bed, was pure heaven.

Next on the “to do” list was to prepare for chemotherapy. I have decent looking veins, but as soon as they see a needle, they become very persnickety and try to run away. They roll like the tide. It was decided it would be best for me (and future medical personnel) that I have a port installed. So, I headed in for yet another surgery. This one was very minor compared to others. I now have a power port located in my upper right chest, allowing access for IV drugs or when I need to have blood drawn. It doesn’t hurt, although if pressure is put against it, it does. I just hug more from the other side now.

After my port was installed, I began the next round of chemo. And oh heaven have mercy; it was PURE HELL. I don’t mean a little hell, I mean full on some of the worst misery imaginable. The type  of chemo I had was called FolFox. It’s administered by starting an IV with anti-nausea meds, steroids, and some other stuff, then the chemo itself is given. The process takes a couple of hours. Then they give me a fanny pack with the chemo drugs inside, and and IV connected to my port. I would wear it home and for the next 48 hours get a continuous drip of poison. The first dose was merciless. I threw up for 24 hours straight. I lost about 8 pounds in three days. I ate nothing but a handful of saltine crackers and tried to drink enhanced water as much as I could. I was taking anti-nausea meds about every two hours.

The next round we adjusted my nausea medicine. I was still sick but didn’t throw up quite as much. All in all, I had 11 total treatments. I was scheduled for 12, but number 11 I thought would be the end of me. Even though the vomiting wasn’t as severe, the other wretched side effects were becoming worse and each treatment was harder than the previous one. I didn’t have one more in me. So I took my final chemo treatment (at least the hard stuff anyway) on August 25th.

During the midst of all this, I was scheduled for another CT and MRI. Thanks to the close eye of the radiologist, he noticed two tiny spots on my liver that had appeared to have changed/grown since the last CT I had. My oncology surgeon reviewed them and we decided the only way to know for sure was to have a liver biopsy. Now, let me say something about that. So, I go in for the biopsy in Memphis and meet with the nurse and the doctor who would be performing the biopsy. He seemed to think it was an easy procedure, they would go in and numb it and I might feel a little “pressure”. Ha! Hahahahahaha! So, what happens is you are put on a flat table, and you get sent in and out of a CT scan (in, out, in, out, in, out, repeat). In the CT they take an image that pops up on the doctor’s computer screen. I come out and he pokes me with a needle. Repeat, repeat, and repeat some more. The thing is, you are not allowed to take deep breaths, only very shallow breaths so as to not move anything in your body even slightly. He starts with the numbing needles. I feel each one, going in deeper and deeper and deeper. Then comes the needle that snips off a piece of liver to be biopsied. Holy shit. A little pressure, my ass. I start crying from the pain. The crying causes my breathing to become heavier. The doctor yells at me because it’s causing his needle to jerk around. I yell back. I hear the nurse mention my blood pressure in a concerned tone. I’m sure it was skyrocketing from the pain and now the whole “I can’t breathe and am about to hyperventilate” thing going on. The doctor instructs her to inject me with something, stat. She does. I immediately feel very, very relaxed and the pain has subsided. Now, why the hell didn’t they just give me this magic medicine BEFORE the procedure and this could all have been easily avoided? Note to medical staff - drugs are good. Always. And before the pain and panic sets in is preferable. But, I made it through. Bad news. It was indeed metastatic cancerous lesions in my liver. I was officially upgraded to stage 4. Previously it was thought I was only a stage 3, even though there were some concerning lymph nodes in my groin they removed in surgery “just in case". It’s amazing how the odds go waaaayyy down from stage 3 to stage 4. The five year survival rate for stage 4 colorectal cancer is around 12%. Now, granted some of those stats may be old, and each case is different. And so far, my cancer has not played by most of the rules anyway, so who knows. I have been told twice by my oncologist at the West Clinic that she doesn’t know just exactly what to do with me, and that I’m a difficult case. I told her this wasn’t the first time in life I’ve been told this.

See, here’s the thing. The spots on my liver didn’t look like cancer. Not to the radiologist, my surgeon or even to the doctor who performed my biopsy. Until the results came back they were convinced they had to be something else. They just didn’t look like your typical cancerous spots. And at my last PET scan, not a single thing in my body lit up. Nothing. Zilch.

My oncologist started me on Avastin. It’s different than chemo, in that it works to cut off the blood supply to the tumor, essentially starving it. It seems to be working. Since starting Avastin, my CEA levels have decreased over 80% and are close to the normal range. So, that’s all good. BUT, there’s always a BUT these days, during my last CT and MRI which was just a few weeks ago, something else showed up. The good news is that it appears that one of the spots on my liver has disappeared entirely and the other spot has shrank (or is it shrunk?) by over 50%. That’s good news. It means the Avastin has been doing a good job of what it’s supposed to do. Bad news, a couple of spots on my lungs have also shrank/shrunk. Wait, I didn’t tell you about those perhaps? Well, that’s because they weren’t supposed to be anything significant. Way back when this all first started and I was initially diagnosed they noticed a couple of tiny spots on my lungs, most likely some type of fungal something or other that most everyone that lives in certain areas get from time to time. However, it appears these spots have also decreased in size along with the spots on my liver. What does that mean? Well, most likely it means they were also cancerous. It means that damn tumor that they declared was very aggressive and quite unusual for someone at my age and my history, was in fact, exactly that - very aggressive. It means this tumor meant to kill me, and rather quickly. The only way to know for sure is to have another biopsy - this time on my lungs. Let me make this clear up front - I want drugs. Lots and lots of happy, happy, la, la, la drugs, before they ever even get close to me with a needle.

As of now, my surgeon is supposed to be presenting my case to the tumor board, and get the opinion and expertise from other members of the council on the best course of action henceforth. My oncologist has postponed any more treatments for the time being, until after the board meets. If I do have a biopsy, or possibly ablation to burn off the remaining lesions in my liver, then I need to be off the Avastin for a month at minimum due to risks of complications and bleeding that occur because of it.

So, here I am. Over a year later. Overall, I feel much better than I did a year ago, and am quite lucky and damn thankful to be alive. For now, I wait. I wait to see what my brilliant medical team determines is the next best step for me. In the meantime, I am trying to stay positive and focused on the present and plan optimistically for the future.