March is for medical appointments

My cancer surgery was at the end of February 2020, so I did all my first annual follow-up screenings in March.

All the results have been good! The blood work shows my white blood cell counts have mostly recovered. They’re on the low end of the “reference range” but still within what would be considered normal, which is an improvement.

My CEA (Carcinoembryonic Antigen) is up slightly from the last couple of tests but still very low, which is good. That one needs to stay low! It is a protein that can be found on some types of cancer cells, including colorectal cancer cells. So it can act as a cancer marker.

Unfortunately no one ever measured my CEA before my surgery (and we didn’t know to ask for it), so we don’t know how high it might have gotten during the time my tumor was active. That would have been interesting to have for comparison. With this marker, we want it to stay below the reference range, and we don’t want to see it steadily going up regardless of where it is in reference to the reference range. The amount it went up recently is very minor and probably not indicative of anything other than natural variation or noise in the test accuracy.

My CT scan was good. All my various liver cysts (which are numerous), all seem to be stable and not growing, so we’re continuing to believe they are benign. There is one large cyst that just showed up new since my last scan in October that is probably an ovarian cyst. Ovarian cysts are very common, usually harmless and usually go away on their own. But I am scheduled for an ultrasound next month just to keep an eye on it. The new cyst is huge! Over 5 centimeters! That could account for my lower back/abdominal ache, although I’m pretty sure that ache showed up before this cyst did, but I don’t remember.

I also did a colonoscopy. This is the first since the surgery that they’ve gone in there and taken a look at everything. It all looked very good. The juncture where they reattached the colon to the rectum looks all healed up well. The tumor was right at that juncture, so they had to remove some rectum as well as some colon. That made my surgery a bit more tricky and my recovery time quite a bit longer than if it had just been a section of colon higher up. Anyway, they found nothing wrong at the juncture, and there were no new polyps to remove either.

I really like my gastroenterologist (colonoscopy doctor) here in Albuquerque; he seems competent and kind, and very straightforward. I’m glad I did my follow-up in Albuquerque with this same doctor. I’m sending the results to my Tucson oncologist, who is a specialist in colorectal cancer and seems more knowledgeable than the oncologist in Albuquerque who is not a specialist. She seemed in over her head when I was reacting badly to the chemotherapy last summer, so I’m glad to have the oncologist in Tucson now.

My gastroenterologist says I won’t need another colonoscopy for 3 years, which is excellent news. I was expecting to have to do one annually for a couple more years. But we’ll see what my oncologist says. I will do it more frequently if my oncologist says I need to. But if he agrees with my gastroenterologist, I’m off the hook for another 3 years!

Quick bit of advice regarding getting a colonoscopy. It involves fasting the day prior, and then drinking laxative powder mixed in 64 oz Gatorade. First of all, if you hate gatorade, you can use a different electrolyte drink. Also don’t bother ordering the fancy recommended “kit” (which includes useless things like jello); just get what you need at the grocery store.

Regarding the timing of your appointment – if you hate fasting, and don’t mind staying up until midnight or later, then schedule your colonoscopy for first thing in the morning. If, on the other hand, you don’t mind fasting and don’t mind being awake from about 3:00 AM – 5:00 AM, and want a slower, more gentle cleanout process, schedule your colonoscopy for around 11 AM. Then you’ll take a “split” dose, half around 5 PM and half around 3 AM, rather than all of it between 5:00 PM and midnight.

Because I don’t stay up late very well, and I am frequently awake around 4:00 AM and then fall asleep again around 6 AM, the late morning scheduling works well for my sleep schedule. Also, the laxative dose is harsh, and the one time I had to do it all at once (surgery prep), I ended up with a migraine and vomiting. But I do fine with the split dose.

For me, being able to take the dose in two halves rather than all at once is definitely worth fasting an extra couple of hours with the later appointment time. I fast for 36 hours every week anyway, so that part wasn’t hard for me. Also you don’t have to do a full fast. You can have jello and broth and hard candy and anything translucent. (If this all sounds impossibly miserable, let me remind you once again that cancer is so, so, so very much worse. Just do it already.)

I’m scheduled for my next blood work and CT in September. So once I get my ultrasound done next month, I should have an appointment-free summer! Knock on wood!

Although actually that’s not true – I really need to find a primary care doctor and a dentist in Tucson. Cancer overshadowed everything, but I still need to keep up with the rest of my health. I’m going to run out of blood pressure meds soon, and my teeth haven’t been cleaned in ages, and I’ve been ignoring a chipped tooth. One of these days I’m going to get a haircut too. What a year it has been! I expect many of us are behind on our routine maintenance, am I right?

To top off a good medical month, I got my second covid shot on March 19, and John got his first shot today!

To send Kristina a comment, email turning51bykristina@gmail.com