Cancer survivor – Oncologist followup Dec. 12 2017

Cancer SurvivorCancer survivor. I have been very fortunate to be able to say I have survived cancer and am indeed thriving. Questions asked when I was in for my Oncologist followup Dec. 12 included how I was feeling and how was my weight. Standard questions asked each and every time. My weight is actually up a couple pounds to 227. I did just get back from vacation, so I am sure that has much to do with that 🙂

As for how I am feeling? I spent 3 hours raking leaves and another 3 or 4 hours splitting firewood this weekend. I feel great. In general, I would have to say that if it wasn’t for the regular doctor visits and my medical reports (and the plastic bag glued to my belly), I wouldn’t know there was anything amiss at all. In the world of the cancer survivor, that is huge.

Cancer survivor followup with the Oncologist

The followup appointment itself lasted mere minutes. My Abdominal Aortic Aneurysm remains the same size with no notable increase in size. My blood work is still good, my good, but good. The only thing of note was my left retroperitoneal lymph node had swollen further. Last CT showed it at 11mm, this one has it at 14mm. Still not large enough for immediate alarm, but it is something we will have to keep an eye on. The information is inconclusive as to whether this is related to the bladder cancer, or the small lymphatic lymphoma, or exactly what. I will be having another CT Scan and followup in April to see what it is doing. At this time, there is nothing to be alarmed about and we are in a wait and see mode.

LIfe’s distractions

I jokingly commented, “Well that was 2 and a half hours well spent” referring to the drive down to the appointment. It was meant as levity. Dr. Joanne Vergidis suggested that perhaps in April we could just do a telehealth to avoid the drive. I immediately declined. I truly believe it is time well spent. The information of the appointment itself was a definite bonus and reinforces my cancer survivor feeling, but I find the drive to and from the BC Cancer Clinic in Victoria an important part of the process.

Yes, it is two and half hours each way, but it has the effect of pushing everything else going on in life to a back burner and putting the entire focus on cancer, treatment, and the process. The drive gives me time to think of anything I want to comment on, any questions I may want to ask, and to look into myself and think if there has been anything of note since our last meeting that I should bring up.

I find that valuable time of introspection and focus. This would be a time I would otherwise not have. I have had telehealth conferencing in the past and it is definitely convenient, but I did notice myself distracted by everything else that I needed to do in the day and what I needed to get done when the appointment was over. The drive to and from Victoria pretty much eliminates the possibilities of planning other things in the day and forces the much-needed self-reflection, prioritizing, and helps ensure a productive appointment.

Additional Reading

Managing stress, both the normal day-to-day stresses of life, but also the specific stresses of being a cancer patient and cancer survivor, can be a challenge. However, it is possible to turn those forces into tools one can use to their own benefit. Training the mind to do so is a process, but one that can dramatically improve one’s outlook on all things. Some excellent titles mentioned by Dr. Rutledge in his webcast (view it here) can help train the mind to work for you even when it seems it is trying to work against you, (You can review the titles by clicking on their name).

Buddha’s Brain: The Practical Neuroscience of Happiness, Love, and Wisdom by Rick Hanson, PhD.

Hardwiring Happiness: The New Brain Science of Contentment, Calm, and Confidence by Rick Hanson, PhD.

The Upside of Stress: Why Stress Is Good for You, and How to Get Good at It by Kelly McGonigal, PhD.

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Herniated Stoma consult with Surgeon

family vacation in CaliforniaMy herniated stoma caught the attention of my oncologist at my last appointment. I was referred to a general surgeon to review and see what, if anything, needed to be done about it.

A couple weeks ago now, I was in to see the general surgeon. He confirmed that it was indeed herniated, and my belly button region was as well. A hernia stoma is when the ligaments surrounding an area tear thus allow what is behind it, internally, to push outwards.

Around my stoma, a hernia had developed resulting in bulging of my belly. This is a common occurrence with a stoma. The stoma is the part of the small intestine that is routing the waste from the kidneys out through the abdominal wall. A hole in the abdomen is required for the stoma to protrude. A common effect of that hole is tearing of the muscles and ligaments in the area; a hernia.

Things like the ileal conduit that is meant to remain inside, start to push out. The natural response is to fix it. Surgery would be required to repair the tears in the muscle and ligaments. The reality of the fix is that there isn’t a foolproof method to fix these types of tears. There are a number of different procedures that can be employed, but none have yet proven to be permanent. The result is a need to go back in and fix it again.

With a conduit and stoma, there are few places the stoma can exit the body. The ureters from the kidneys are picky and don’t like to be moved around much. Any fix that would essentially be temporary is, therefore, the last resort.

The decision was to not do anything about it at this time. Nothing internally is currently in jeopardy and I am not in any discomfort, so a critical need doesn’t exist. If my herniated stoma becomes an issue in the future, then we will look at doing something. For the time being, however, we will just leave the status quo. Naturally, I asked how I would know when something needed to be done. He simply smiled and said, “Oh, you will know.”
I laughed. Good enough. Onwards and upwards.

I am in for my next CT Scan on the 5th of December. We’ll have a good look at the herniated stoma then and see how it is doing. We’ll also be looking at the abdominal aortic aneurysm as well as looking for any overt signs of cancer developing anywhere else. I am in to see the oncologist again on the 12th to review the blood work and scan to plan where we go from here. Hopefully, I will be graduating to the annual check-ups. That is the goal. One goes from 3-month follow-ups post-cancer to 6 months follow-ups and then on to the standard annual checkups. Graduation, for lack of a better word, is when one hits the annual check-up routine.

Family Vacation

I just got back from vacation in California with my family. It was the first real vacation I have had in years. Over the last several years any vacation time I had was used up with medical procedures, appointments, tests and the occasional hockey tournament, and with my previous job, work. This was the first vacation where I actually didn’t have anything to do other than relax and spend time with family. Needless to say, it was great. We are home again and back to our daily routines, looking forward to the next vacation.

While in California I read a book by Randy Pausch called, “The Last LectureThe Last Lecture”. An excellent read and would recommend it to anyone (You can view it hereThe Last Lecture). Randy had terminal cancer and the book was all about perspective and the life lessons he wanted to leave behind for his kids. Both of his kids at the time, were of an age that neither will remember much of him when they got older.

Stories like these do help put life into perspective and to help one learn that some things, in the big picture, just don’t matter. I read and hear people go off on tirades about this or that. All I can do is shake my head; How nice it must be that such a minor, insignificant things can be such a disaster in their life. Perspective.

Helping others

When I was going through my email after I got home, there was a notification from a woman I had been talking to on (a website by the Canadian cancer society that facilitates cancer patients interacting and supporting one another) asking me to reach out to another woman that was just starting the process of having her bladder removed.

I wrote that woman immediately offering to talk to her about life without a bladder. It was that communication that renewed thoughts about what it was truly like living with a urostomy and a reminder of what cancer had taken from me. It wasn’t a hard thing to think about, but it was a very definite reminder of just how far I had come.

Living with bladder cancer and having a urostomy is annoying, inconvenient, frustrating at times. One has to deal with it every minute of every day, it never leaves your mind. There are leaks, there are complete failures, there is the planning of everything one does around the urostomy and the needs it presents. But at the same time, these things do become simple routine parts of life.

In some ways, the thing is almost a badge of honor. Yes, it is annoying, no question, but because of it, I get to live. I get family vacations in California, and I get to see my wife, and I get to watch the kids living their lives, and I get to watch my grandson learning about the new world in which he finds himself. It is a constant, daily, non-stop reminder that I had cancer, it took a lot, but I won. I beat the bastard and I get to live. It is a constant reminder, don’t sweat the little stuff.

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New issue from follow-up – 06/16/17

New issue arrives, but it will pass. It will be addressed and it will passJune 16 was the follow-up review the spot noticed in my lung 3 months ago. As always, making the trip down to Victoria was overshadowed by the usual concern as to whether I would be getting the all-clear once again, or if this would be the time I get an expiration date.

Prior to these visits, I am usually able to view the results of the blood tests and CT Scans before the trip and am able to prepare somewhat for the conversation that will take place. This time the results hadn’t been posted ahead, so I arrived at the appointment with no chance to prepare for what I might hear. Naturally, there was a new issue that we need to address.

I have been feeling fine all along and had no reason for concern, but the doubt was there anyway. The appointment lasted all of ten minutes. After the appointment, we hooked up with my step-son for lunch. All told, an hour and a half, however, it was still a seven and a half hour day. It took the usual two hours to get from home to the Cancer Clinic, but the actual drive home took four hours. There was construction all the way back with the delays usually associated with that. It was indeed a long day.

The spot on the lung is gone

As for the appointment itself, the spot on the lung that had initiated the three-month follow-up instead of the usual six was gone. There was no sign of whatever it had been. That in itself was a huge relief. The Abdominal Aortic Aneurysm that had been steadily growing seems to have now stabilized. The swollen Lymph nodes are still swollen, but stable. Those will still need to be watched. The blood work was normal, well, my normal. Overall, everything that had been of major concern, while most still present, are behaving. There is never a time I go to the Doctor these days where there wasn’t at least one new issue that needs attention.

The oncologist did note, however, that it appears the area around the stoma is herniated, a new issue. That is a concern and she has referred me to a general surgeon in Nanaimo. It is something that has the potential to be serious, and it will require surgery to repair. As soon as I am contacted by the surgeon, plans will be made to have that addressed. It is funny how the mind works though. This, with all its inherent danger, we consider minor. There is nothing minor about being opened up for repairs, but we are of a mindset these days, where if it isn’t cancer it’s minor. A little cavalier granted, but in our minds, it is so much better than the other things that could have been on the table at the appointment.

Meet with the surgeon soon

I expect that sometime in the next few months I will be meeting with the surgeon and we will be setting a date for the surgery to address the “new issue”. I have no idea how long the recovery from this surgery will be. That is another thing we will learn as we progress through all this. My next follow-up with the Oncologist is in six months. I am back to the normal follow-up time frame; still looking for the ultimate goal of only annual checkups. Onwards and upwards. One step at a time, one day at a time. Still fighting, and bladder cancer free.

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