Tuesday, January 12, 2016

Part 10: The End of The Beginning

So I was back on the regular Chemo Maintenance regiment- infusions every other week and then a pump for two days. The side effects from my “Adventures With Xeloda” were still lingering but getting better. Now it was time for a new adventure- marriage. We knew this was something that could survive the “better or worse”- though I will admit I hoped to get to the health part of “in sickness and in health” sometime soon. When we first started talking about marriage I joked about doing it in Vegas- and she agreed. So we planned our Vegas wedding in June (someone’s bright idea to get married in the desert in the summer!). We decided to have the ceremony at the Excalibur, and upon the suggestion of a friend, stayed in the Monte Carlo. Of course Cancer doesn’t care what plans you have, it does it’s own thing. My body, which had been valiantly fighting this disease for over a year started having issues again- incredibly painful bowel movements. Unfortunately this happened while my Oncologist was on vacation, so his office referred me to a gastrointestinal guy- the one I had used in the past couldn’t see me for two weeks, and I was in a lot of pain, and didn’t want to wait that long to be seen and get to the bottom of the problem. The oncologist’s referral got me in right away and he diagnosed me with an anal fissure, gave me a cream to apply, and told me to take Sitz baths twice a day. A Sitz bath is where you sit in hot water for 10-20 minutes and soak. After about 10 days things still weren’t getting better. I had an appointment with my back from vacation Oncologist and he told me to go see my surgeon. The Oncologist told me that he knows fissures are painful and that women have told him that having a bowel movement with one feels like giving birth.
The surgeon confirmed the fissure, but told me that part of the problem with a fissure is that the sphincter muscle goes into spasm, and that makes it even more painful. He gave me a different medicine to be applied internally and told me that 90% of the people who have a fissure get better with this medication. I wasn’t going to apply it barehanded, so I went off to find finger cots. Just picture something that looks like a condom for your finger. So I started applying the medicine 3 times a day. It’s in the middle of this that we went to Vegas to get married. The wedding was great with family and a few friends attending- small, intimate, and perfect. While there I also got to play poker at the World Series of Poker- just in the room at the Rio, not a bracelet event- though maybe someday… Despite everything I don’t think I’ve ever been happier than I was marrying my amazing and lovely wife.

When we returned from Vegas things were not any better for me physically- as a matter of fact they were getting worse. I went back to the surgeon, and he told me that with the chemo and stress I was under that a way to relieve the spasms that were causing the pain was to have a sphincterotomy. This is a “minor” surgery where they cut the sphincter muscle, which prevents it from going into spasm. It’s an outpatient surgery requiring one small cut and one stitch. The only risk was for fecal incontinence, which I was told is more common in women (whose sphincter muscle is not as large) and old people (whose muscles don’t work as well to begin with). The surgeon went on to tell me that he had not seen this happen to a man my age. I decided to have it done. It was a quick procedure with no huge preparation like my other surgery. I was in and out in a few hours, and told to rest for a couple of days afterward. For a few days, maybe a week, things got better; the pain was less, and my body seemed to be getting back to “normal”. Then the pain started again.

I went back to see the surgeon. A quick side note; it doesn’t matter how many times it happens, having a colo-rectal surgeon examine you is never fun or dignified. He said the problem I was having now was a skin irritation- basically an adult version of diaper rash. I asked him if there was something else I could call it since I didn’t want to go around and tell everyone I had diaper rash. He told me it was Moisture Associated Dermatitis, to which I replied, “You mean I have “MAD Ass?” He found this highly amusing (got to love a surgeon with a sense of humor) and asked if he could use that. I told him he could as long as I got credit. I got prescribed another cream to apply- this time externally over the irritated skin. I was also told no more Sitz baths as the moisture was the problem, and to use Desatin as needed to keep the area dry and try and prevent more irritation. Also, sweating was a problem, as that would also cause more irritation. Living in Florida, that did restrict things I could do, which is frustrating to say the least. The problem continued to come and go (alternating with extreme itching) for the next several weeks. It mostly got worse after chemo and the pump.

 In October I got my next CT Scan, and it showed that everything cancer-wise was stable. There was one lesion left on my liver, but it had not grown. With everything continuing to be stable the Oncologist discontinued the pump- I was down to infusions every 2 weeks and that was it. With this, my bowels and my ass started getting better temporarily which I am very grateful for. Unfortunately my CEA numbers were slowly, but steadily rising…