I'm sorry to have to grab your attention with a basic post and forcing you to click over here, but I really only wanted to have to type this out once. Anyone who uses Twitter knows that it can take a while to write out a lot of tweets. I can promise you, however, it wasn't a gimmick for attention.
So, a little background first: back in April my job role changed to where I was spending a lot more time sitting and a lot less time moving. It became more difficult to sit as time progressed, and as most you know I'm not exactly the most active person, nor am I the healthiest eater. Put those together and I just thought I had a bad case of hemorrhoids. I was gutting through it, until we took our trip to Texas for SIL's baby shower. The plane ride was torture, and I finally decided to schedule an appointment with my PCP.
Modern access to medicine being what it is, I had to wait a month for that appointment. The hemorrhoids diagnosis was confirmed, but on the exam, she found something that seemed to be a little too deep for just a hemorrhoid, and she couldn't get a good grasp of what it was. This earned me a colonoscopy, which I had to wait another month for, though to be fair that was because it needed to be when Kathleen had a day off so I had someone reliable to come home with me. Thus, we celebrated Kathleen's 40th birthday with this hanging over our heads.
Let me tell you something: I get why people hesitate to get colonoscopies, but it's not because of the procedure itself. Three bottles of Magnesium Sulfate within twelve hours and the colon was REALLY cleaned out.
The actual procedure was painless, thanks to the sedative. The staff at Beth Israel clearly knows what they are doing, as the process of getting me ready was quick, efficient, and easy. I had the first IV of my life, and was rolled into the room with two TVs on the wall. After answering a few questions, the nurse advised me that the sedative was being administered. The next thing I remember is the physician performing the procedure telling me that a 2.5 cm mass had been found, and that I would be speaking to a colorectal surgeon before I left, but that I was in a good place and should have a lot of hope.
While waiting for the surgeon my wife also spoke with the physician who performed the colonoscopy, and we were both left with the same impression: a biopsy had to make it official, but he had no doubt that this mass was cancer. Within a short time, the surgeon was by looking at the photos, telling me that there were additional tests that were needed, but on first impression I was probably looking at chemo, radiation, or both to shrink this mass first, and then surgery due to it's location, then further treatment.
To say I left the hospital in a daze and not fully realizing what just happened is an understatement. It wasn't until the weekend, really, that the full scope of weight of what's about to occur in my life started to sink in. I started to bring people in, let my new supervisor know, and then just laid down for the rest of Wednesday. On top of all that, it's not like your system instantly recovers after being told it has to expel everything currently residing inside and then being sedated. Anything consumed the rest of the day quickly exited the way it came in, and I was thankful I had taken a half day on Thursday.
By the time I sat down at my desk on Thursday, I had an appointment for an MRI of the colon and then a CAT scan of the abdomen for Tuesday (Sept 25). I also had to go by Beth Israel to get blood draw to examine cancer markers and white cell count. All of this would help determine the stage the cancer (which at this point still wasn't technically confirmed) was in, and then on Wednesday I would sit down with the oncologist, surgeon, and radiological oncologist to put together the plan of attack. All three are on the teaching staffs of Harvard Medical, so it's probably fair to say I at least have some confidence in their abilities.
If there were a day where all of this started to hit home, it was Friday. That's when the Google searches happened, the learning about stages, survival rates, trying to figure out if it spread, and so forth happened. It was also on Friday that I got a call from the physician who performed the colonoscopy. I didn't recognize the number so he left a voicemail, simply saying "our suspicions have been confirmed, so you need to keep those appointments you have set"
With that, I officially have cancer.
Friday wasn't all bad. One of Kathleen's friends had been a Broadway in Boston subscriber and landed a ticket for Hamilton, but she couldn't go. The ticket was offered to Kat, but she had an early day at her clinical and then had to work a closing shift for her part-time job, so she couldn't go either. She offered the ticket to me, and so at least for Friday night, I got to be distracted with the sounds of the Founding Fathers.
After a weekend of mostly mulling this over, I was back at Beth Israel on Tuesday for the MRI and CT scan. The MRI required the bowels to be cleaned. Again. This time with a laxative and enema 1-2 punch that I'm pretty sure has my large intestine ready to just pack up and leave. If that didn't do it, the ion water I drank for the contrast on the CT scan had to have done it. I'm actually surprised my large intestine is still with me right now, to be honest. I get a tumor in my rectum and it has to suffer.
It should be noted I originally had to wait between the MRI and CT scan, just because of when the coordinator could get an appointment. The tech for the MRI was amazing, and despite being cloistered in a loud metal tube for an hour, the procedure was a lot easier than it could have been. Once done, she asked if I had a CT appointment, and I mentioned it was set for 6 hours later. She told me to wait, and about 10 minutes later told me they had room to take me earlier while I was still there. I still had to wait for an hour while the contrast water worked its way through, but the communication there to work together and make the process easier for me was amazing.
Thus, we get to today. I met at Beth Israel with my team. Yes, I have a team! And then the team wanted to see the tumor for themselves.
It's at this point where Cartman comes to mind.
Anyway, after a few uncomfortable minutes, the wonderful team laid it out for me:
- The cancer is Stage 3C rectal cancer
- It has spread into the lymph nodes around the tumor
- The MRI and CT scans did not show evidence that it had spread into the abdomen/liver
- The tumor is 3cm and located low in the rectum
- As had been first mentioned, with the size and location, we will have to do chemo, radiation, then surgery
- Generally, the 5 year rate is about 65%, but for someone with my health/lack of symptoms they pegged it closer to 75-80%. They stressed how treatable it was, and made it a point of letting me feel optimistic.
After the initial information, I sat down and discussed more specifics with the oncologist and radiation oncologist, the majority of the time with the oncologist. The chemo is going to be a lot less invasive than I had feared, and hair loss isn't even one of the symptoms of this particular cocktail. There are others, the biggest will be an instant numbness when I touch something cold. The good news is that I'll only have to get treated once every two weeks, and I can schedule a round for the end of a week so the majority of it pumps in during the weekend, minimizing the time I miss at work. Depending on how I respond to the first round, another drug may be added just to provide an additional blast.
The plan is to do this for two months, then scan to see where things stand. If it works like they expect, do it for a another two months. Then, we'll take another scan. If still good, then we move to the radiation. The radiation will be daily for 4-6 weeks. After that, we will take a two month break to allow the body to heal, and then the surgery happens.
So, a rough outline would put the radiation around February and it being completed around March, thus the surgery happening around May/June. The really good news is that if this works out the way they think, once the surgery is done I'm done (aside from the usual check ups, etc).
Thus, there's a real reason to be optimistic here. I know once I walked out of Beth Israel today I felt a lot better than I did this time a week ago. I feel confident in the team over at the Cancer Center, especially after spending an extended time talking to both the Oncologist and Nurse Practitioner who is the main patient contact for the whole program. First off, I'm not being managed by just an oncologist but one who specializes in colorectal cancer, as does the radiational oncologist. They explained their process of collaboration and communication inside the hospital, and most important the Oncologist offered to assist me in setting up a second opinion, if I wanted. "It's your cancer, and any doctor should be willing to do that for their patient."
The thought is appreciated, but I'm ready to fight.
I not only have a great team inside the hospital, but one outside. I've spent the afternoon and early evening bringing family and friends up to speed, and it truly felt like I've been on the phone all day. It really shows how lucky I am that I've had to spend this much time catching people up, and that I still have to do this to make sure everyone knows where I stand.
So, if I haven't reached out to you before now and you're hurt in any way I am truly sorry. I just hope you understand that the past week has been a huge whirlwind, and between getting the process set up with appointments, soaking in the news, and looping in some people, at some point I had to take time to keep from saying the same thing over and over again. The support I've gotten already has been nothing but outstanding, and what's gotten me so optimistic is that I know I have this great support structure behind me.
It's part of this support structure that has inspired the video above. When I informed one of my circles about this, they quickly came up with two hashtags: KACA and MAAGA. Originally, that was Kick Ass Cancer's Ass, and Make Al's Ass Great Again. When I reported this to some other friends, the suggestion was to change "Great" to "Glorious." So, Kick Ass Cancer's Ass (KACA) and Make Al's Ass Glorious Again (MAAGA) will be prominent in my mind during this process. Of course, once Glorious is invoked, you have to listen to Bobby Roode's entrance.
Seriously, listen to it.
GLIORIOUS!
No, I won't give in
I won't give in...
'till I'm Victorious
And I will defend
I will defend...
It's cheesy, it's meant to be an ear worm to bring thousands of fans to their feet, and it's meant as nothing more than to accompany someone as they walk down to the ring before they fight. Yet, it's perfect for so many reasons.
If all goes according to plan, I'll be getting the port implanted next week, and the first round of chemo will be at the end of the week.
No, I won't give in. I won't give in..till I'm Victorious.
Game on.
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