Chapter 7: White Lies and HPV

 

I told a white lie while writing my last chapter. Sorry, but I suspect we all speak an untruth now and then, maybe a couple. But in all fairness to me, I think mine was a pretty small one in the scheme of things.

I lied when I said I wasn’t all that worried about having a feeding tube surgically inserted into my stomach. And there really was a part of me that wasn’t all that worried. But that part was pretty small.

The larger part remains horrified by the thought of laying semi-naked on a metal gurney in a sterile, brightly lit white room while some stranger and company cuts me open. That particular fear will likely always be my truth even though I know they’re trained professionals, even though I know their highly experienced, even though I know I’ll be fast asleep and unaware of any pain, and even though I know that hardly anybody checks out from feeding tube complications. However, I have since learned from talking to friends and acquaintances, it must be a primordial fear because a lot of people seem to have it. And as I heard the elderly female patient in the pre-op room next to mine tell her nurse, you just never know when something will go wrong. Comforting words to ponder as you’re being prepped for surgery.

I arrived at the Hospital around 6:45 having been driven there by one of my closest friends. I got checked in, he took off, and then I was led to a pre-surgery room where I got undressed and laid on the bed. It’s a room where you go before surgery to be prepped and then later returned after surgery to be monitored for complications. It comes complete with all the whistles and bells they use to track your progress.

Next, the nurse gave me a gown, checked my vitals, hooked up an iv, and then collected a bunch of blood vials. We chatted a bit. For those of you who don’t know me, I’m a chatterer. I’ve always liked to talk to people. However, this chat was more interesting than most idle conversations because it turns out she’s been a nurse for over 40 years specializing in cardiac surgery.

For some odd reason I remembered the name of my father’s heart surgeon from decades ago and asked if she knew him. Turns out she worked alongside him for years. She went on to relate she assisted surgeons during Fort Wayne’s first heart transplant. She spoke a little about the experience as she fiddled around on her computer making notes about me. My hunch is she didn’t pick up on my fear because I pretty much acted like nothing big was happening. Fooled her. She left and another nurse appeared dressed in surgery garb.

This particular nurse was obviously the rock star of the operating room. I could sense that from the moment I first saw her. The tall, blonde, attractive middle-aged woman introduced herself by laughing saying something about how my last name was as cool as her first name. I never considered my last name as being particularly cool, but then again, I never thought about it. It’s always been just a name to me. Her first name was Roxanne. Admittedly, that name is kind of cool. And she wore it well.

She grabbed my bed and wheeled me down a few sets of hallways in much the same way kids and their friends play with wheelchairs when they’re forced to hang around hospitals for very long. When I was a young kid, hospitals ranked right up there as one of the most boring places to spend any time. It seems like you were always too young to be allowed visitation so you got stuck in the waiting room sorting through a stack of Reader’s Digests and watching old people hanging out. Back then, the old people I saw wore suits and dresses. Today us old people wear jeans and sweatshirts. Thus far, I’ve not seen any kids hanging around during my many visits so I don’t know what they do these days to pass time. My hunch is they stay glued to their phones like they do everywhere else.

After Roxanne and I flew around the final corner, she backed me into the operating room which was filled with a bunch of nurses and technicians. She placed my bed directly under an x-ray type machine that hung from the ceiling. Next, she bounced around the room getting things prepared while joking with all those present. It was readily apparent that she was very well liked and respected. I suspect she was the leader of the group ranked in stature right underneath the surgeon who had yet to make his appearance. When she learned I was a lawyer, she spoke a bit about her son who was also a lawyer. When the L word was spoken out loud, it caused most of those present to smile and boo in unison. But she shushed them like some favorite friend’s mother calming the troops and then patted me on the shoulder assuring me she’d have me sleeping like a baby in no time. I’m pretty sure Roxanne picked up on my fear. 

And that’s the very last thing I remember until I awoke in the comfort of my pre-op room which was now my post-op room. I never saw Roxanne again but if I had, I would have thanked her and the others for putting me at ease. Again, huge kudos to our local hospitals and their staffs. I've been extremely impressed by their compassion.

I read up on feeding tube surgery beforehand and figured I’d be up and about the next day. Turns out I was mistaken. There was a considerable amount of discomfort that lasted well into the next morning, so much so I called in sick telling them I’d be in later in the afternoon. I rarely call in sick. I think my middle-class guilt kicks in whenever I take time off. But a sharp pain kicked in every time I tried to roll over in bed the night before making for a miserable evening of sleep. I probably woke up five or six times. The following morning my stomach was extremely sore and the site of the incision prevented me from bending over. Dressing was a very tortured process and putting socks on was simply out of the question.

By the way, I rarely wear socks unless it’s real cold outside.

Nevertheless, I made my way to the office in the early afternoon and spent a couple hours getting caught up before heading back home. By late afternoon I showered and took off my bandages revealing a long tube attached to a hole northwest of my belly button. I then spent some time on the phone talking to a nutritionist on how to clean it because even though I won’t be using it for a few weeks, water has to be put thru it a couple times a day so it doesn’t get clogged up. 

The clogging culprit is brown stomach stuff that flows into the tube. Apparently, it’s propelled into the tube by stomach gas, the same gas that makes you fart. If the tube is allowed to rest below the incision point, gravity can also cause it to fill with stomach stuff. And if stomach stuff is allowed to remain, it gets hard and makes the tube impassible.

So, the nutritionist and I had phone-tube. He talked on the phone as I practiced putting water thru my tube with a big plastic syringe. It seemed to be working okay so we made plans to meet next week. But that all changed the next morning.

I woke up Wednesday morning feeling pretty good. Dropped off the dog and got to work around seven. Reviewed a few files and headed off to court to attend some hearings. Nothing huge, just small stuff. Before I left the house, I washed my feeding tube as instructed but when I unplugged the tube, brown stuff started shooting out from my stomach. I grew worried that something was wrong so I placed a call to the nutritionist who called me back around 10:30. I’m sure he sensed my concern so he made himself immediately available and I left work to go meet.  

It was around that time I started feeling worn down. Since the feeding tube was now an appendage to my body, I found myself feeling anxious about its presence. Actually, I think I was struggling, in part, with a serious wave of depression. In retrospect, it isn’t all that surprising since I now had an open hole in my gut shooting out nasty stomach gunk from a plastic tube. Like I said in an earlier post, everything is becoming real. And it's becoming more and more real with every passing crisis. The feeding tube was further confirmation that yes, I really do have a life-threatening disease. It was a very sobering moment in this boy’s journey through cancer.

Turns out everything with my feeding tube is just fine. He showed me a couple of practice tips to help me grow more acquainted with its use. I’ll meet with him next week to get further instructions on feeding. I suspect I’ll be using it to supplement my nutritional needs towards the end of November. Until then, I’ll be eating my normal meals with my mouth. As for the tube, it’ll just take some time for me to recognize this is the new me. If you haven’t figured it out yet, cancer brings with it a whole bunch of changes.

After leaving the hospital, I went to the store and bought some loose-fitting sweatpants. I never wear sweatpants, only jeans and shorts. But I now own a couple pair because I have a sneaking hunch, I’ll be laying around the house a bit in the weeks to come.

Thursday came and I actually felt great. The feeling lasted all day. The soreness subsided and I began feeling a little more comfortable with my feeding tube. I can actually bend over to put on socks and tie shoes. And as I’ve stated before, I don’t experience any pain directly associated with the cancer. I have some trouble swallowing but nothing has changed in that department. My speech is still impeded but it hasn’t gotten any worse. Again, small blessings, but I’ll take them.

I think this week’s lesson for me is that I need to better understand that there are going to be moments ahead which will activate all of my stronger, darker feelings. When those moments arrive, it’s time to remember that this too shall pass. Once again, it’s a whole new relationship with time. Time will soon bring me radiation and chemo. It will unquestionably lead me into more miserable moments. But it will also lead me through this mess into healing. And in between, there will be the better days as well as the others. Not to sound too cocky, but I got this. At least I got this so far. Another small blessing.

So, since I have some time, this is good opportunity to talk a little more about the HPV virus and its relationship to cancer. I say this because I’m the first patient in Fort Wayne who will be administered a new blood test which will track the disease using my DNA. The thought is this blood test may be able to predict HPV activity in a person’s DNA and become some type of test alerting those potentially affected as to their future risks for oral cancer. At least I think that’s what this test is all about.

I’m not exactly sure how the whole thing works but they’ll take my blood before treatment begins and then monitor it throughout the course of time after treatment ceases. The hope is my DNA will be able to demonstrate the likelihood of cancer returning once I’m into remission. I think that means my doctors believe I’ll be making a successful enough recovery that my blood will be around for a while. Translated, that means they expect me to be around for a while. And again, that’s more good news in a way.

This new test is in response to a dramatic rise in HPV cancers. Apparently, there are a multitude of different HPV strains. It is contracted primarily through sexual contact and can be activated through a single sexual encounter. Sometimes the virus goes away on its own. Other times, it lays dormant and surfaces via cancer, oftentimes manifesting itself in men as a tumor at the base of the tongue. Women are also subject to the virus’s cancer-causing propensities. In fact, almost all cervical cancers are caused by HPV.

I spoke briefly with a cancer radiologist who says this type of cancer is definitely on the rise locally. His comments are mirrored by national medical journals which assert that it will soon become the predominant cause behind head, neck, and tonsil cancer. Not surprisingly, the age of its victims corresponds loosely with the age group of those around during the sexual revolution of the 60’s, 70’s and 80’s. So, I guess the lesson is if you were a wild child during those years, you might want to talk to your family physician and get his or her thoughts on diagnostic testing. Too late for me.

By the way, the virus itself is extremely prevalent today. This year alone, almost 3 million new cases will be diagnosed. I would add you might want to talk to your doctor about having you or your children inoculated because there exists an extremely effective vaccine which can eliminate the chance of any infection.

By the way, as I'm editing this chapter CBS evening news is reporting on HPV prevalence and cervical cancer in women. Again, I'd urge all of you to talk about this with your family doctor. 

So anyways.

I want you all to know how much I appreciate your thoughts and prayers. But again, I don’t want you to think I’m writing this to solicit sympathy. My purpose is to give me something to do, you something to read, and others somewhere to go if they’re experiencing the trauma of serious illness or disease. The truth is I have always loved to write, it gives me great joy. And this event is the perfect opportunity for me to pursue my passion. Again, you take your blessings wherever you can find them. 

As for my own prayers, they've been answered. I don't have to have surgery. However, the downsides of answered prayers is that I'm now obligated to God to keep all those promises I made him. I hate when that happens. It’s a lot like making commitments when you’re drunk. But the good news is that most of them were small anyway.

Friday, I meet my chemo doctor. After that, the show should begin very shortly.