So it’s been a year since the last peek inside my colon.
Time for another. At this point I’m a prep pro, having done four bowel preps in
the last two years. If anyone needs any pointers give me a holler. Cottonelle
Wet Wipes (**Pointer #1**), after pooping for 2-4 hours wiping with regular TP
starts to feel like wiping with sand paper. Anyways. After a successful prep I
hit the sack as we had to get up pretty early to get to the appointment. Get
the earliest appointment possible (**Pointer #2**). Why? Because a just like
the early flight leaves on time, the early colonoscopy gets completed on time.
I actually was not scheduled first. But, I got their first because I follow
directions (**Pointer #3**), health care professionals love the patients that
follow directions. My nurses must have liked me (oh and I may have said I
followed directions and got there and hour early and the other guy didn’t. I
actually got there before he did and his appointment was 30 mins before mine. I
didn’t pull out the C card, but they knew I had cancer, so maybe that helped.)
because they successfully lobbied the doc to look at me first. Be nice to the
nurses (**Pointer #4**), they have the power to make your stay better.
So after the most uncomfortable IV placement I’ve ever had
(15 IV placements in the last two years and numerous other sticks, so I’ve got
some experience in this regard), I was wheeled into the endoscopy suite.
***Side note: So the nurse pokes it in and I feel her hunting
around for the vein (you feel the needle wiggling around and some pain, not my
first rodeo). So, after grabbing a straw and sucking it up (**Pointer #5**,
don’t say a word or start wiggling when they’re placing an IV. Why? I don’t
think it’s the best idea to start putting pressure on a nurse trying to stick a
needle in your hand/arm), she finally gets it placed. As she tapes it up she
mentions to the other nurse that she hates these new catheters. I guess they’re
using new IV catheters in the endoscopy center that the nurses aren’t big fans
of. At that point I tell her that I wasn’t a big fan of them either and told
her that was about the worst IV stick I’ve had. She apologized and said that
they should talk to the powers that be (likely some bean counter got some deal
on cheap IV catheters from China or something). I told her no problem it wasn’t
the worst thing that’s been done to me under this roof (you get near me with a
foley catheter you’ll likely end up with a black eye).***
After the nurses took my vitals, I rolled onto my left side
they pushed some Midazolam and Fentanyl into my IV. The last thing I remember
is the Doc asking me if I was ok. Sleepy time. I remember waking up just as the
doc was pulling the scope out, but it’s all a bit foggy. She found one 7mm
sessile polyp that she cut out. All else was good. The path came back and it
was an adenoma (not malignant, but cancer can form from these suckers).
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| Location of where the surgeon connected me back together. |
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| Polyp that wasn't long for the world. |
Now it’s somewhat strange that she found a 7mm polyp one
year after she only found a 10mm polyp. Polyps aren’t supposed to grow fast
with the average being around 0.5mm a year. But, there’s some data that has
shown rate in excess of 2mm a year. So maybe she missed it (5-10mm polyps are
missed nearly 15% of the time). Maybe it was smaller and hiding in a fold and
I’m abnormal (I think most would agree this is the case), so polyps grow a bit
faster in me. What does this mean? Well it means that in a year she’s going to
take another trip into my large intestine. Had it been clear we probably would
have pushed it to 2 years. Oh well. Colonoscopies really aren’t that bad, a lot
easier than cancer.
So, it’s been a little over a year since I finished
treatment and we are looking at growing our family. I’m not sure I can count
the number of times total strangers ask if we plan on having another child. Honestly,
it’s a common question when small talking about families with others. Should it
be? For most people the question is easier, but for the few it’s not the easiest question
to answer.
Dude, you’re about to feel really awkward... I’m open about our situation to really anyone, so the unfortunate
person that asks me the question gets to feel really awkward. “Are you and your
wife thinking about having another kid,” someone asks? Dude, you’re about to
feel really awkward, I think to myself. “Well, about two years ago I was
diagnosed with cancer…,”I say. Then crickets. I suppose I could be cruel and
leave it there, but I continue talking about it reassuring the person that they
didn’t just pee in my Cheerios. Moral of the story, be careful. What seems like
an innocuous question may not actually be one.
The recommendation from most authorities is to not to
conceive a baby until a year post treatment. I guess the chemicals that kill cancer
cells aren’t good for swimmers. I also did lot of research on my own to check
into the effects of cancer treatments on baby making hardware. Unfortunately
there is just about zero information on the effect colorectal cancer treatments,
which isn’t surprising since it’s mostly an old person cancer. But, the
research did seem to indicate that the conception process is extremely
selective. I made some swimmer deposits prior to treatment in the case that
something happened to my fertility, unfortunately due to the stress the cancer
was placing on my body they were not the highest quality swimmers. We actually tried
three rounds of inter-uterine insemination (IUI) with the best banked swimmers early this year, but nothing
took. We were hoping that we could just try the old fashion way in June. When we
got back from France we had my swimmers checked. “No sperms seen in pelleted
sample, confirmed by IVF Lab,” read the results. Damn.
We then checked my Testosterone. The initial test found it
low. So, I’m a 36 year old with low T and shooting blanks. Sweet. After some
research it’s seems both Oxaliplatin and Radiation does a number on the old
testes. I found one scientific paper on irradiating the testes. Turns out a
single 4-6 Gy dose of radiation does a number on sperm production with a dose
over 6 Gy likely causing permanent azoospermia (that’s a fun word huh? Means no
measurable level of sperm). How did they find that out? “The effects of a
single-dose irradiation on spermatogenesis have been documented in a population
of healthy prisoners.” Oh I see medical testing on prisoners…sounds kosher.
Anyways. Well that’s fine there’s no way my testes saw 4 Gy of radiation. But,
reading further on turns out if one received fractionated doses much less
radiation dose damage. Well my treatment was 25 fractionated doses…shit. What’s
the number? Somewhere around 1.5 Gy can cause permanent azoospermia. So I got
on the phone with my Rad Onc (Radiation Oncologist). I asked him what the treatment
plan said my testes may have gotten shot with. Docs tend to shy away from giving
detailed info about the tools they use define treatments. I think they’re
worried being too detailed, rightly so, since most patients can’t handle
information. I tell him that I’m just curious about the order of magnitude. Was
it 1 Gy or 0.1 Gy? I tell him I know that fractionated is worse than a single
dose, blah, blah, blah. He realizes I’m not a normal patient and says that
plans are just that, plans, and just estimates of the dose received. I say of
course and joked that if it was cold one day in the treatment room my testes
would have seen more radiation than if it was warm. Ha laughed and says that
the plan says my testes could have seen about 1.6 Gy. Shit. Now that doesn’t
mean I’m officially sterile…but it doesn’t look good.
The last 21 months have been hard. Lindsey and I were literally
going to start trying for kid #2 the weekend I was diagnosed. Not a day goes by that both Lindsey and I
don’t think about my cancer or the fact that growing our family may not be
possible. Part of that is my own doing as I’m active in online colorectal
cancer communities. But, I feel a duty as a survivor to share my story to try
and assist others through their journey (one of the reasons I write these blog
posts).
When no news is good news, the only news is bad news. Many survivors disappear into their lives (I get it, why would you not
want to try and forget about an awful time in one’s life) and the majority of
stories being told are the poor outcomes. When no news is good news, the only
news is bad news. I remember how uplifting it was to see the stories of others
with similar diagnosis that were successfully beating this shitty disease. I
want to be that light for others. I do feel some guilt, about feeling upset
about our fertility issues. Shouldn’t I just be happy that I’m still alive?
That I’m not in active treatment? That my body tolerated treatment so well?
That I have a son? That I have a wife? There are so many others that follow
similar journeys that are not as fortunate. It's easy to be scared into inaction, but as a well regard member of the Colon Club, Brownbagger puts it, "Live your life like it's going to be a long one, because it just might, and then you'll be glad you did."
So it looks like our only option may be IVF to get a brother
or sister for Oliver. IVF was something that Lindsey and I said we would not do
6 months ago. After a second opinion on the quality of my deposits not being high enough quality for IUI, 3 failed IUI attempts, and what looks like (today)
my sterility, we’re reconsidering. I have an important scan at the end of
September, a CT scan with contrast to look for metastases locally, in my liver,
and/or in my lungs. Something like 80% of recurrences occur within 18-24 months
from surgery (with that said stats don’t mean anything for singular cases…so…).
I’ll be at 20 months come scan time. If the scan comes out good we’ll make some
decisions.
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| Cartoon by www.XKCD.com that is soooo true. |
Cancer...the gift that keeps giving.
