Category: Food/Nutrition

So Far, So Good – Post-Op Report

(Getting a full colectomy, and the first days of recovery.)

Last Thursday we woke up bright and early… or dark and early I guess, since the sun wasn’t up at 3:45 am. I took my last shower with special anti-germ chlorhexidine soap, and we headed to the UCLA Ronald Reagan Medical Center for my 5am check-in.

There’s a conveyer belt of pre-surgery rituals: I signed in at an admin area then reported to a curtained pre-op room, where a nurse handed us packets with six pre-soaked chlorhexidine wipes and instruction sheet for wiping my entire body down again, as well as special swabs to clean out each nostril (not a Covid thing, apparently, just standard). I changed into a hospital gown, reassured multiple folks that there was no chance I was pregnant, signed consent forms and got hooked up to an IV. Everyone was very kind and nice. The “team” all introduced themselves, etc. A second surgeon working with my surgeon reassured me that their surgery plan prioritized two things: 1) a successful operation that would remove any cancer, and 2) preserving as much as possible of my colon, per my request.

Then they wheeled me in to the operating room. I wanted to to see the “robotic” equipment, since my surgery was to be robotic if needed. It was a little disappointing because the arms were retracted, and there weren’t any Transformer-looking appendages—which makes sense as they probably keep those sanitized and wrapped until the very last moment. But here’s a couple of images stolen from the internet of what things might have looked like after I was knocked out:

Then the drugs hit my bloodstream and I was out. I woke up in recovery later in the afternoon, and was very happy to hear that the surgery had gone smoothly: They were able to do the surgery laparoscopically (as opposed to open) and had been able to keep about six inches of my sigmoid colon.

A few other interesting (to me) details: 1) Along with having (had) a longer-than-normal sigmoid colon, I also have a slightly longer-that-normal rectum. I’m hopeful that this extra length will be helpful as my body adjusts to its new normal functioning. 2) During my first surgery, in Australia, years ago, the surgeons opted to make the small-to-large-intestine connection (the anastomosis) behind my stomach, which is apparently quite unusual. This made the present-day surgery a little longer and more complicated for my doctors, as they had to reach around behind the stomach to do some of their work.

I stayed the night in the hospital and was able to have some visitors, like Paul, my mom and my brother. Everything was pretty painful, but I know how important it is to move in order to get my digestive system working again, so I ate some broth and and a bite of mashed potatoes, and got up to walk around the area, pushing my IV pole.

Currently, I’m at my mom’s apartment, enjoying the quiet, and the luxury of having food cooked and dishes taken away when I’m done. The first couple days was mostly pain management (Tylenol and Oxycodone), very slow walking and resting. But now I can (in limited fashion) read, write and watch TV in the evenings. For the next 4 weeks, I’m supposed to eat a low-fiber diet, which is pretty much the antithesis of everything I normally try to eat, i.e. meat, not veggies, white rice not brown, processed breads and crackers, not nuts or seeds or grains. I’m not supposed to lift more than five pounds or do abdominal exercises — even though I end up doing those inadvertently just getting in and out of bed. I asked my surgeon a litany of questions like, “can I sleep on my side? what if I twist around? can I lie on my stomach? can I do yoga?” and he pretty much said that it would take blunt force trauma to pull apart what has been sutured together. That doesn’t really jibe with the idea that lifting five pounds would be injurious… so as my energy returns I’ll have to figure out some of that out. For the moment, I’m happy to have other people do the lifting!

My least favorite part of the day is when I have to take an anti-coagulant medication called Lovenox —through a needle jammed into my belly! I’m lucky though, because instead of having to self-administer it, Paul does it for me—best husband ever! Apparently cancer patients are more prone to blood clots for longer than most people after surgery, so instead of two weeks, we’ll be doing the shots for 30 days.

For those who are waiting for the “poop report,” so far, there have been no toilet emergencies (though, TMI, my surgeons “oatmeal” example is proving apt)! At the moment, my entire digestive tract is recovering, and, somewhat counter-intuitively, I am taking a prescribed stool softener because the painkillers tend to slow everything down. I’ll have a better sense of my new normal as time goes by, but so far… so good!

Weekend Excerpts

SATURDAY:  My mother-in-law, in town for the weekend, holds my arm as we stand at the L-shaped buffet at her friend’s new Thai noodle shop.  She wears jeans, a floppy tee-shirt and tinted glasses with white rims studded with Swarovski crystals. Her friend, on the other side of the sneeze-guarded trays of food, has on a floor length skirt, and lots of purple.

The food in trays are aren’t the familiar dishes listed on the English menu of the restaurant my husband and I usually go to next door. She suggested for me lumpy squares of pumpkin sauteed in spices and I agree.  I point to a curry with basil, chicken and bamboo shoots, and when she looks hesitant, assure her I will like it.

We travel to the short side of the L,  where in one tray balls and cubes of unidentified meats  float in a brown broth, next to another tray of potato-sized slices of  a starchy root that isn’t a potato soak in a bright orange bath. What’s that? I ask, intrigued, but she doesn’t answer, either because she hasn’t heard me, or, more likely, because she can’t figure out a way to translate it.

“Or that?” I point to cut green stems drifting in what could be a familiar combination of coconut milk and red curry powder. Her friend on the other side of the counter comes over to check on us. “Is it morning glory? “Is it bok choy?”

“Not bok-choy,” says the friend.

My mother-in-law, looks seriously at the whole section of offerings and says, “Not for you, I think. These not for you,” and steers us toward the register.

SUNDAY: On Sunday mornings I try to counterbalance a week’s worth of muscle-stiffening sitting at desks by going to a yoga class that meets at 9:45.  I leave the house at 9:43 and arrive at my class at 9:55–a serious breach of etiquette at some yoga studios, but this is a gym, so nobody cares. When the class lets out at 10:45, if I see my friend Gina, we go the the little snack stand inside the gym and order two fresh juices made of mixed veggies, and drink them at one of the little cafe tables along the wall with a partial view of child care area where toddlers play with colored balls, push wheeled objects, and occasionally shove into each other so that one falls and cries.

When my friend has not come to class, I go straight to my car, usually run some errand, like buying gas for the car or stopping at the grocery store.  At 11:AM the radio announcer introduces the Moth Radio Hour, a collection of real people tell five-to-ten minute stories from their own lives.  This morning I emerge from the Vons in time to hear a woman with a Sarah Silverman voice tell about the birth of her youngest sibling when she was twelve, and being told they did not share a father. “My father always took us to get ice cream to tell us bad news. If you don’t want to find out that your grandpa’s been diagnosed with cancer, or that your dog has been put to sleep, don’t go to Cold Stone Creamery with my dad.”

Arriving home with my groceries  I park, but  turn the key in the ignition only enough to kill the engine but not the power, so I can hear the rest of someone’s story before I go upstairs to fold laundry and write stories of my own.

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Super Ninja Neck Snap

I see my chiropractor on Mondays.solid-snake-neck-snap_2632

He bounces his fingers along my spine, lightly, barely pausing as he presses

the offending vertebrae, muttering,

“L4, T12 C7, C4, C3, C2,”

He stands behind me, cradles the crown of my head in one hand, my jaw in the other

and twists.

The CRACK resounds, and leaves me shaky.

I think about highly trained assassins and wonder

what the difference is

between the angle of relief and the angle of death.

10 degrees? Less?

I ask my chiropractor, and it turns out

they never discussed this at chiropractor school,

It was assumed there would be no death snaps,

like in hair-cutting school they assume no one will get stabbed in the eye with scissors.

Fair enough.

Still.

That crack is loud.

Subsequent internet research reveals that ending a person with a single swift twist of the neck, is much harder than one might think

from watching Die Hard, multiple episodes of Buffy the Vampire Slayer, and that scene in A Long Kiss Goodnight where Geena Davis kills the deer.

According to one website (with no listed outside sources), it takes between 900 and 1500 Newtons to fracture a C2 vertebrae.

According to another website, a Newton—a term of which I have no recollection from high school physics—is the amount of force needed to accelerate one kilogram of mass at a rate of one kilometer per second squared.

Another website—referred to since it’s hard to visualize those words that start with kilo—says a Newton might be compared to the weight of a single quarter-pound hamburger.

Which is also difficult to visualize. 900 quarter-pounders torqueing a neck? Is that 300 McDonald’s paper bags? does three burgers per bag seem reasonable? could four fit? or would  the bags no longer fold securely and spill open as you tried to stack them on the side of someone’s face?

In terms conceptualizing speed and force it might be more helpful to know that most C2 fractures happen as results of car accidents.spine

My chiropractor is not so speedy or forceful as a car wreck.

My inner wanna-be-poet likes the idea that the difference between life and death is only a few degrees.

But this is not the metaphor for it.

There is also the matter of some 1400 Newtons.

 

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Chemo–What we expect versus what we get…

Was browsing this blog that I really like, and saw this report;

Most falsely believe chemo is curative
According to a study in the New England Journal of Medicine although chemotherapy is the primary treatment for patients with lung and colorectal cancer, it is not curative.

In an American national survey of 1193 advanced-stage patients, 69% of patients with lung cancer and 81% of those with colorectal cancer misunderstood the intent of chemotherapy, mistakenly believed that chemotherapy might cure their disease.

This seemed a little crazy to me, so of course I looked up the original New England Journal of Medicine article.  If you are feeling geeky, you can read it here:  NEJM Article. (It should download as a PDF.)

As you might expect, the rate of misunderstanding was greater within non-white ethnic groups. I’d guess perhaps there were some language barriers (doctors often throw around the term “palliative,” and for a long time, I wasn’t sure what “palliative” really meant). Also, the way serious illness is treated varies by culture.  BUT the rate for white (and I assume English as a first language) patients who thought chemo might cure their Stage 4 colorectal cancer was still 74%, which is high.  Consider: For every demographic, more than half of patients with a terminal illness mistakenly believed chemo treatments might cure them.

And, as you might also expect, the rate of misunderstanding among patients who had lower levels of education was slightly greater…but here again, even among patients who had a college degree or higher 75% still thought chemo might cure their Stage 4 colorectal cancer.

The article brings up several issues to consider and the researchers offer up ideas why this might be. I was interested in the idea that while the oncologists do communicate the truth of the situation to the patients, there tends to be a very quick transition from discussion of the prognosis to discussion of treatment.  I have experienced this myself, where a doctor–I think with all good intent– quickly steers away from the emotionality of a diagnosis, and toward the logistics of treatment.  As soon as we can start talking about the pros and cons of various options and setting up a schedule etc., it starts to feel like we are “doing something.” This can be comforting and work as a coping mechanism to get you through that first appointment, but the authors here (based on yet another study ) propose that this focus on treatment can lead to false optimism–and I have a tendency to agree.

I can imagine there is a great temptation to bolster a patient’s morale. And I even believe that good morale can help extend someone’s life…but this kind of misunderstanding ultimately takes control from the patient. 

If a chemo is going to extend your life by a few months, but you’re going to feel terrible for much of that time, do you want to it?  It seems like people should get to make that choice.  People should also have time to come to terms with the end of life, to do what things they can to put their affairs in order.  Finally, for those who are truly committed to trying to beat the odds– given the information that conventional means are not likely to cure they might want to try alternative means to prolong life–be it diet, meditation or whatever. And regardless of outcome, it could be argued that a by-product of these alternative practices could be a better life–or a more peaceful end of life.

Flailing

As this is a record of sorts, of my creative progress, it bears mentioning that I have been flailing lately in my creative life, and well, just my life. I haven’t posted much about it, not because it’s an emotional topic (though it is) so much as it is one that is difficult to capture in writing, because, by its nature, flailing goes off in many directions, and while that might be good for a twenty-page essay, or a semi-autobiographical novel, a blog post, if it is not to be tedious, best accommodates one direction, two if you’re crafty.  If I were up to writing a twenty-page essay or a novel…well then I would probably be flailing less than I am.

Instead of trying to capture everything, I will just mention one aspect of the flailing, and that will probably give some idea of how even one thing can split into multiple directions.

For much of April and May I really tormented myself about whether to take this summer TV Writing Class that was offered. I had seen the instructor on a panel and been really impressed by her and so was super excited when the class announced, and even when I signed up for it.

But as last semester started to come to an end and the class loomed closer, something changed.  I started to ask “what is this all for?”  What sparked this feeling? Maybe it was attending an informational session for one of the TV Fellowships and having it dawn on me that it just never going to happen.  I’m not the droid they are looking for.  A diversity program is never going to think that my voice is diverse. That’s nobody’s fault, but nothing can change that.   I’m getting too old to climb the ladder from the bottom, to be a PA, then a writer’s PA, then a writer’s assistant, then a writer. I’m sure  someone could cite a case where a woman my age made that work and became one of the 14% of TV staff writers out there who are  female,  but it’s not the low-hanging fruit. Even rung one is not the easiest gig to get.  (I was offered it once, right when I graduated, but it didn’t have any health insurance, and my job had to support myself and Paul, since he was shooting his movie, so, I didn’t take it, and, I guess, since I had one of my cancer “episodes” the next year, I made the right decision, since with no health insurance we would have been completely screwed. But still I have to wonder if it was a mistake. I get that I’m rambling here, but rambling is kind of like flailing, so we’ll just go with it.) and second, even all the full writers I know, who have been on several TV series, seem to live with constant uncertainty and workplace dysfunction.

I also am getting really scared that if I keep taking different classes, I won’t ever finish the screenplay and the book that I already have drafted, I’ll keep putting them to the side, and I’ll die–or just get old with a drawer full of half-finished dreams that never get to come out into the light.  And one of those half-finished things would be the new TV script, because you never come out of a class with a polished draft of anything.

So after two months of deliberating in this way I dropped the class before it started.  I’m still not sure it was the right decision.

And now I’m really worried that even if I don’t take a class I won’t ever finish the screenplay and the book that I already have drafted, because, I really don’t fucking feel like writing right now .  A bad poem now and then, a blog post, sure.  But something that will take concerted and continuous effort an extended period of time. Sitting down at my desk and opening the document feels like a trip to the gallows. All I feels is this “don’t want to,” and I don’t know when that will change.

And this brings up a bigger question…if i don’t even like to write anymore–why in the hell am I existing in this financial situation?  Why are we selling our car for a thousand bucks because we can’t afford to spend two thousand to fix it?  Why do I only buy clothes about twice a year, and then at the Ross or Goodwill? Why do I live in a house that makes me homicidal because everyone who lives here likes to act artistic and not clean anything but no one has money to pay a maid?  And why do I seem poised to live like this for the rest of my life?  It’s one thing to have a dead-end job because I’m driven write some opus, and another just to have a dead-end job for no reason at all, because the act of opening a Final Draft document feels like walking to the gallows.  My job is not bad.  It’s benign, but it’s the definition of a dead end.  The maximum raise I will ever get will be something like 38 cents a year.  My salary will never pay my school loans. Not even close. And until Paul gets a job, it can’t really pay our current expenses either.

So then I’ve starting to look at “real” jobs. With two and half Masters degrees, and quite a bit of work experience, it  seems like I could have something to offer in a more lucrative field. But that begs the question, why do I need to live in one of the most expensive, traffic ridden cities in the world to do a job that has nothing to do with the industry that the city is known for?

And then again, so much is so close. It’s possibly the exact time not to be looking at other jobs, but the time to bear down. It might be tragic to pack up and go now.

I decide I should wait, just push myself through this one script that I’ve promised to someone.  But of course, because of the not-wanting-to-write, it would be helpful to have a push.  I ask about taking an independent study with an instructor I like in the my program. The department doesn’t do independent studies with adjuncts.  I reach out to an old-mentor. His summer is full.   My writer’s group is on hiatus…

Flailing is what you do when you’re in deep water and you feel like you’re going under.  You just grasp and any random-ass object that passes. “Hey, piece of disintegrating driftwood, can you support me?  Please save me.”

Rotten driftwood can’t save you.  And there’s no one else here. You have to start swimming. But swimming only helps if you can figure out what direction to swim.

Therapy, you say?  Yeah, I’m going for the first time this week. Will let you know how that goes.