Thursday, January 21, 2010

The First Time I Knew I Had Cancer

Alison and I were buddies in the 1950's. My family moved to California. Hers stayed in Iowa. It never occurred to either of us to write to each other, so for over 50 years we never heard from each other. A few months ago, Alison found me on the web, and we've been writing ever since. Here is her latest:

Why Me? Why Not Me?
The First Time I Knew I Had Cancer
By Alison

The first time I knew I had cancer was when a short nurse in teal scrubs whose name I did not know explained I would not be seeing the doctor for my scheduled appointment, because they had found atypical cells in my urine. It took a while for me to compute that. “Atypical cells.” …..Ohhh, aTYPical cells.

I had arrived for my second appointment with this doctor, whose specialty was “Uro-Gyn,” pretty nifty I thought: ladies’ urinary problems. At our first visit I had explained my symptoms. For the past few months sometimes I would suddenly need to go to the bathroom—so suddenly that “suddenly” doesn’t really cover the sensation—and when I would head for the loo, odds were about even that I wouldn’t make it. This was bad enough at home, but at work it was unacceptable. When I realized it wasn’t going away I started wearing pads. I also had to go more frequently, especially at night. Often there would not be much to show for it.

All this sounded like a bladder infection to my officemates, nurses all, and so the first thing I did was go to my regular doctor. He took a urine specimen and called a few days later to say I did not have an infection. He sent the full results to me via email and I noted that the specimen was positive for blood. The doctor said the sample was contaminated. I asked, well, if I don’t have an infection why do I have all this urgency and frequency? He offered to write me a script for an antibiotic. I don’t remember what I said, but I hung up knowing I would not fill that prescription. I wanted to know why I was having this trouble—never had it before in my life—if it wasn’t an infection.

What I didn’t tell my doctor was that I had smoked for 30 years. That is, the information is in my chart, but I am sure he never thought of it. I thought of it though. Thirty years of tars and nicotine and other byproducts wafting into my body through my lungs—sliding into my blood stream—intestines—kidneys—and out my bladder. Poor bladder, the final place for all that poison to come to rest, all that time. Bladders don’t like tars and nicotine. They get cancer when they are too stressed with toxicities.

So when I saw the Uro-Gyn, the specialist, I made a point of telling him about all the smoking. I stopped fifteen years ago, but I am over sixty. It was time for some chickens to come home to roost, I suspected. Or at least, I wondered.

He was a sweet, jovial man who said he would humor me by scheduling a cystoscopy – that is, take a look around inside my bladder with a light and a camera. That was exactly what I wanted. He did a brief exam and also asked me to produce a urine specimen, which I did. The cystoscopy was scheduled for one week thence. He also prescribed something for “overactive bladder” which, he was sure, was my only trouble.

After seeing him I actually didn’t have the symptoms for a few days—I have quite a placebo response—but then they came back. I filled the prescription he gave me, added it to my medication regimen, and sure enough it worked quite well. I had time to get to the bathroom in the daytime and I could sleep at night for hours at a time without having to go.

Something was still odd, though. There were unusual sensations. After, say, 58 years of having a certain peeing experience, it was now different. Hard to describe, in fact so hard I would not even try to describe these funny feelings. I just knew that even with the nice new medicine, something was not right.

So I was more than ready for the cystoscopy, but when I got there I was told by more than one person—receptionist, nurse—that it had been cancelled. “We tried to call you.” “We scheduled you for an appointment with someone else.”

Then the short nurse in teal took me into an examination room and told me it was because they had found atypical cells in my urine. The Uro-Gyn doc, it turned out, despite his certainty about the “overactive bladder,” had sent it to cytology for an entire additional layer of analysis.

When I processed what she had said enough to understand that I have cancer, my main feeling was one of excitement. “What do you know! I really have cancer!” Like—I was right! One doctor tries to blow me off by offering me antibiotics for a bladder infection even he knows is nonexistent; another “humors me” with the promise of a cystoscopy, and here I was right all along!

The vindication was more than that, though. I have long been a bit of a hypochondriac. Quite often, I would think I had something awful and serious and then see a doctor and it would turn out to be either nothing or nearly nothing. I would feel somewhat relieved, but in a perverse way, disappointed. Nothing Serious THIS time.

Except now, THIS time, there is definitely some drama. They found cancer cells right in my urine. Something Serious is Going On. NOTE: I would definitely not have felt this way if they had said: “You have stage 4 (fill in the organ) cancer with metastases.” When I say Serious I am thinking just of the import of the word, “cancer.” Still, I knew starting out that bladder cancer, as cancers go, is not such a ruthless killer. I knew people who had bladder cancer and lived long enough to die of something else. Caught early, it is very treatable.

So they told me that the next doctor to see is a Urologist, the appointment set for January 18, 2010. This was mid-November of 2009. “I am sorry,” I said, “but I cannot wait that long, through the holidays and all. I really need to deal with this much sooner.” “Oh,” said the nurse—such an emotional snag had perhaps not occurred to her. She indicated she knew this doctor and his staff, and that she could probably manage something. She certainly did, bless her heart, because I got an appointment for the very next week.

Next time: Cystoscopy Art

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