take care of yourself

Life has gotten bus(ier) and time has slipped past me and suddenly it’s been a while. This weekend Thomas will be 8 months old. I’ll do a “quarterly” update on him then – a 6-8 month update.

Recently my husband joined the local volunteer fire department while also functioning as the only technician in his work exchange, as his fellow tech had gotten a promotion and the replacement hadn’t been hired yet. Needless to say we saw very very little of eachother at the beginning of the summer – he had fireman’s classes 2 evenings per week and was working late the other nights to keep up. He’s now passed his written exam and we have another couple months before the practices start up again for his fire training. And, finally, the new tech was hired and took some of the work strain. Now I see him at a relatively decent time most nights. Anyway, long story short, I was  basically single-momming it for a couple months and couldn’t sqeaze in blogging. But that’s not what this post is about. This post is about cancer. Again.

Previous to my oncology job I did family practice – very general wellness, acute, and chronic care. In my training I learned there are certain times you go hunting for cancer. Luckily, our country has some decent cancer screening processes in place – mammograms, colonoscopies, even low-dose CT’s of the chest for long-time smokers. We know that typically finding cancer before it displays symptoms will lead to a better outcome. Sometimes this isn’t true, but commonly it is. We also know that cancer breaks the body in some common ways. It causes weight loss, fatigue, changes in lab values of the blood, persistent cough or unusual pain or bruising. When we have patients come in with these vague symptoms, we sometimes go searching for cancer, hoping we are wrong.

A little over a month ago my mother in law had been complaining to us on a phone call about her headaches and fatigue – she had just retired from her long-time job as a customer service rep and had been working part-time in a green house. She felt like the new job was just too hard on her and mentioned she was going to go to the chiropractor for her headaches. Now, I know my MIL well enough to know that she doesn’t go to the doctor very often. I also know she has a history of high blood pressure, so I told her that she should probably go to her doctor instead, since her headaches could be from uncontrolled BP. She sorta agreed. I felt like she wasn’t going to listen to me. I saw her a couple weeks later at a family reunion. She looked tired, pale, and grouchy. I was busy chasing kids and didn’t broach her health with her. 3-4 days later my husband’s sister mentioned in a text message that her mom was not very talkative at her daughter’s birthday party, but that her “iron was low.” I replied, “good, she must have went to the doctor.” My SIL said, “No, she went to the chiropractor, but she tried to give blood and they wouldn’t let her because her iron was an 8 or something.”

Now, let me pause and speak to the fact that the common person is fairly medically uneducated – my MIL especially so. She goes to the doctor about once per year to get her pills refilled. She can’t tell you the names of the medications she takes. She doesn’t seem to care AT ALL what type of diet she eats or if she ever exercises. And I had to badger her into a mammogram a few years ago after she turned 60. I told her to have a colonoscopy, too, but that was far too much for her.

Back to the text message convo with my sister in law. After I read that my MIL’s hemoglobin (they don’t measure your “iron level” routinely, FYI) was an 8 (it should be at least a 12-13 for an adult female), I promptly panicked. I explained with successive quick messages that she needed to get into the clinic NOW, that anemia is not a solo disease, but the symptom of a disease and that she needed a colonoscopy ASAP because in someone her age colon cancer was a very common culprit.

She went to the clinic. She saw a nurse practitioner who she had never seen before, but who prayed with her, which meant so much to my MIL. The next week she had a diagnostic colonoscopy – she did NOT want to. She asked me why, what they were looking for. Again, speaking to the medically uneducated nature of the common person, she wasn’t even sure what this was for and so I told her, but I didn’t say the word cancer – she was already worried, no reason to make it worse. Last Wednesday my husband and I waited in the room with her husband, who is not the most supportive person in any situation to anyone. And the surgeon confirmed what I already knew deep down – she has colon cancer, and the tumor was the source of her blood loss. She had scans completed that, THANK THE GOOD, GOOD LORD, did not show metastatic involvement to the liver or lungs, but that lymph nodes are likely involved. She has a colon resection scheduled next week, and if there is cancer detected in the lymph nodes she will be recommended to complete chemotherapy, which she will HATE and probably not tolerate very well. Anyway, please keep her in your thoughts in prayers next Friday – pray for a safe surgery and a good path report, or at least grace and mercy in acceptance of whatever the results show.

And for the love, take advantage of your annual physical exams and labs and get a colonoscopy starting at age 50 (these wellness things should be included at no additional cost with most insurances with the ACA changes). She’s 64 and never had one. This cancer has likely been there for at least 2 years, as it turns out she’s been losing weight and having symptoms of anemia for that long. Colon cancer grows slowly most of the time, I just wish we could have caught it sooner. But, like I said, it’s not metastatic now, so we’re counting blessings for that. Life is short, take care of yourself.