I didn’t think I’d ever recover from the shock & awfulness of the Republican Convention. I could barely watch it, but heard the drones of hyperbole, bombs of deceit, missiles of accusation, and explosions of radioactive hatred as I scooted past the TV in pursuit of mundane chores and palliative distractions. I felt the contamination of a toxic mix of enmity, inanity and false patriotism clinging to my psyche even when I turned off the TV. But the searing, 100+ degree afternoons since the event’s grandiose finale are starting to cleanse my soul. And I think the gape-jawed expression in response to that cataclysmically historical convention, captured so perfectly by Gary Trudeau on all his Doonesbury characters’ faces, is starting to disappear from my own.
Certainly the first few days of the Democratic Convention are helping to displace the dread and dismay I’ve been feeling. What a contrast! Reality vs. reality show. Humanism vs. hubris. Mutuality vs. mob.
I suppose the new symptoms I’ve been experiencing from my own physical cataclysm play a part in obscuring the national & global angst I should be feeling in response to the tyrannical trajectory of Trump’s GOP. It’s hard for me, though, not to conflate the mayhem caused by the metastasis inside with the hideous dissemination of malice and distortion by the GOP. So the threat I feel from the one seems to compound the despair I feel from the other.
Almost two years ago, at the beginning of my campaign against ovarian cancer, at a time when Donald Trump was merely a blustery perpetrator of a nefarious conspiracy theory, I described my pre-treatment abdominal symptoms which were, initially, so easily dismissed as a bad case of irritable bowel syndrome. Now, in spite of tumors deemed “stable” in response to my current chemotherapy drug, certain effects of the cancer and surgery have conspired to create symptoms somewhat similar to, but more ominous than, those first inklings that something was wrong. The symptoms, which started suddenly just over two months ago while we were on our road trip, have persisted, wavered, worsened, and waned, flared up every morning and lingered into the night. This is not constipation; this is different. Since I started it in December, Doxil has resulted in the opposite of constipation. I’ve been describing my current condition as diarrhea with no exit strategy.
The past two months have been spent, in part, trying every remedy suggested by every medical professional on my team. Metamucil, Miralax, ducosate sodium, senna, Fleet enemas, glycerin suppositories, and something called Lynzess, intended to be used for IBS. I pleaded with my doctor and my medical oncologist for a sigmoidoscopy to determine where the blockage might be. That, as well as a colonoscopy, is too risky, I’m told. I asked about surgery and stents. My problem is too advanced and complex for that. After about a month, I was finally referred to a GI specialist, who basically shrugged and said, “There’s not much we can do that you’re not already trying.” Since bowel obstruction can be a predictor in ovarian cancer that weeks to months remain, I asked my medical oncologist and primary care physician if this was a sign of imminent decline. You’ll beat the months, they both assured me. The GI specialist wrote a response to a question I had about stents, repeating various options that aren’t really options for me, saying if I’m in significant discomfort I should go to the emergency room and explore the options.
That’s when I called the Stanford Cancer Center. I made an appointment for an assessment, 2nd opinion, and evaluation for possible clinical trials. I decided to pay for it myself, but asked my medical oncologist if Kaiser might authorize it. She said she doubted that it would, but she could refer me to any doctor within Kaiser, or to doctors outside Kaiser. I decided to move my regular appointment up with the Kaiser gynecologic oncologists to see if they had anything else to say about my prognosis/treatment before I went to Stanford.
Marc and I met with the chief of gynecologic oncology at Kaiser Sacramento. He was much better than the medical oncologist, my PCP and the GI specialist in explaining exactly why there’s not much they can do about my intestinal issues, even at the palliative level. He emphasized a difference between ovarian cancer and other cancers – that it doesn’t usually travel around and end up in the brain or bones, rather stays in the abdomen and lands on various parts of the intestines (as well as other organs), creating bowel dysfunction which results in a person eating less & less, leading to malnutrition & starvation. It starts insidiously and destroys cynically and dishonestly. It doesn’t care about the evident health and resilience of the system; it strangles by obstruction.
Using visual aids of X-ray and CT scan, he described the three factors involved in ovarian cancer and its treatment that affect mobility in the intestines. He explained that each of those factors affects multiple parts of the intestines, so can’t easily or safely or effectively be addressed by surgery, radiation or stents. One factor is the tumor burden here & there, which is unpredictably transient. It wanders and attacks erratically, and can have a detrimental impact with fewer than 140 characters in the form of resistant cells. Then there’s the restricted blood supply to intestines due to tumors on lymph nodes pressing against the abdominal aorta, which inhibits peristalsis and causes the digestive system to balk and falter. The third factor is a result of the treatment necessary to provide any hope of survival in the first place: adhesions and scar tissue resulting from surgery which render the intestines chunky, bumpy & less pliable. So stuff is kind of stuck in various places, presumably for all three reasons combined.
The gynecologic oncologist seemed sincere when he said if he thought he could fix anything with surgery, he would do it. Consistent with everything I’ve read and been told, he was unequivocal when stating that in a case such as mine, surgery wouldn’t help and would probably harm. He clarified what it means to wait until I have “significant discomfort” (as in the case of complete obstruction) and then go to ER. While in hospital, my intestines can get a rest and I can be on IV while they regain their composure. And if they don’t…that’s ovarian cancer, folks.
In the meantime, there’s fiber, fluids and food. So with that, I’ll try to shift some of my energy from my own physical antagonist, which grew out of my own personal cellular structure, to the national menace who grew from the reactionary polemics of right-wing extremists, which have metastasized to the entire Republican party.
I can only hope the prognosis is better for our country. Hillary Clinton may not be a cure, but we're talking palliative care here, and we can trump Trump with our votes for Hillary.