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Actually, Arnold, it WAS a tumor.

June 3, 2011

Since my recent diagnosis of colon cancer, the question everyone (friends, family, coworkers, nurses, doctors, strangers!) wants answered is, “How did you find out?”  Good question.  How does an apparently healthy 26-year-old discover that she’s been living with a tumor in her colon that has grown to the size of a ping pong ball and spread to six nearby lymph nodes?

In the early days of Colorectal Cancer Awareness Month this year, I wasn’t feeling well.  But I guess I should go back even farther – I hadn’t, in fact, been feeling well for some time and had seen a gastroenterologist last May with symptoms I no longer recall.  Beginning in late January, I started to experience abdominal pain.  My fiancé, visiting from Spain, begged me to go to the doctor; I wasn’t as concerned.  Besides, since I hadn’t (and still haven’t)  established myself as a regular patient of a primary care physician, I knew it would be difficult to find a doctor who would see me before March or April.  So I decided to ignore it.

Over Presidents’ Day weekend, things got worse.  The pain was more frequent and more severe, and I lost my appetite.  I was visiting my aunt and uncle at the time, and declined their offers to take me to the ER (which at the time I thought were mostly in jest; they told me later that they had feared it was something serious).  I was feeling much better by the time I returned to Washington, D.C. that Monday, but I promised to make an appointment to see a doctor as soon as possible.

I was in luck – after calling at least 15 different clinics in the D.C. area and asking for the next available appointment for any internist or GI doctor (which on average was in June – an only 3.5 month wait!), I finally found a gastroenterologist who could see me the following week, on March 2.

He was stumped by my symptoms (which were likely vague, since I wasn’t experiencing many at the time of the appointment).  He ordered blood work to check organ function and to test for things like celiac, prescribed an acid blocker, and scheduled me for an endoscopy (upper GI) that Friday.  If we didn’t get answers, he said, the next step would be a CT scan.  After the appointment, since the weather was nice and I was feeling better than I had in a few weeks, I decided to walk to Georgetown (about 1.5 miles) and do some shopping.  When I arrived home a few hours later, I had a large dinner and went to bed.  I wouldn’t eat a meal again for more than two weeks.

The next day, I was Sick.  The pain in my abdomen was suddenly excruciating, and I spent the day throwing up.  I called in to work to let my supervisor know I wasn’t feeling well, and that I would see her Monday (I was already scheduled to be off that Friday).  I set an Out of Office response in my Outlook, announcing I would be back on Monday, March 7.  I didn’t return to that office, where I was supposed to be on temporary assignment until the end of June, until early April, when I went to clean out my desk (I went back to work at my regular position the last week of March).

By Friday I could barely walk.  I took a taxi to the hospital for my endoscopy, which was completely normal – the doctor brought out squeaky-clean pictures of my esophagus, stomach, and small intestine.  He also had the results of Wednesday’s blood work, which were also completely normal.  Still stumped.  But there was still hope for the acid blocker, which I hadn’t yet begun taking.  If things didn’t improve in a few days, said the doctor, I’d need to see him again.

My memory of the rest of Friday and that weekend is a blur.  I couldn’t move, couldn’t eat, couldn’t sleep.  I derived my only amusement from taking videos of my stomach, which had begun to undulate.  In a matter of seconds, it would inflate like a balloon on one side, slowly move to the other side, fully deflate, and then begin again.  I began to be convinced that I had an alien baby living inside of me.  What other solution was there?

On Sunday I finally called the hospital and asked to speak with the GI fellow on-call.  I had never been to an emergency room before and wanted to know the protocol.  What should I do?  How do I know I’m sick enough to warrant an ER visit?  She had no answers for me.  I hung up, frustrated, and decided to make another appointment with the GI doctor first thing in the morning.

It took a few hours to get in touch with the doctor, but he finally called at noon with clear instructions:  Go to the ER for a CT scan.  He would call ahead and tell them to expect me (they didn’t, but I have a feeling that the breakdown in communication was on the ER’s side, not my doctor’s).  I called my aunt, who was waiting to hear whether she needed to come pick me up to take me to the doctor, and told her the plan.  (She had been on high alert since the night before, when, in an unprecedented move, I declined a dinner invitation.)  I packed a small bag, thinking I’d end up either in the hospital or at my aunt’s house overnight.

The ER was not busy, so I didn’t have to wait long before they put me in a bed and gave me Zofran and Dilaudid.  After answering what seemed like endless bouts of similar questions from various nurses, medical students, and doctors, I was scheduled for a CT scan.

Several hours later, the on-call ER doctor came to tell me they’d found a large bowel obstruction in the scan, that I would need at least a colonoscopy and possibly surgery, and that I was going to be admitted to the hospital.  At that point, I was so grateful to have some sort of answer to my days/weeks/months of problems that I was much more relieved than scared.  An obstruction – that sounded benign enough.

This “obstruction” became a tumor the next day.  After the colonoscopy, one of the doctors paid me a visit.  My aunt was present, and we called my mom and put her on speakerphone.  Based on the type of tissue composing the obstruction (I believe she called it “bloody” tissue), all signs pointed to cancer.  Surgery was scheduled for that Friday to remove the portion of my colon containing the tumor, but we needed to be prepared for the almost certain diagnosis.

The pathology report came back on March 16.  The tumor was malignant.  Six lymph nodes also tested positive.  Chemotherapy would be in my future.

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One Comment leave one →
  1. June 10, 2011 3:27 pm

    Rachel, I have been thinking about you almost daily. I know I was always closer to your sister, but I’ve also always felt a connection to you because of our shared interest in diplomacy. You were actually in one of my dreams several nights ago. We were just out to dinner somewhere like Bordino’s, but I remember how lovely and bright you were in the dream. Anyway, I just want you to know that you’ve got people who love you all over. Power and energy be with you!

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