The Sign

I saw the sign and it opened up my eyes, 
I saw the sign
Life is demanding without understanding
I saw the sign and it opened up my eyes, 
I saw the sign
No one's gonna drag you up to get into the light where you belong
But where do you belong? - Ace of Base

Let's talk about signs. Not just regular signs but the signs or symptoms of Bowel Cancer. Sorry if you thought this was going to be another upbeat life update or something about rainbows and sunshine. No, no, no. We are going to talk about butts, poo, and probably colonoscopies. A lot of people don't like to talk about their butt or poo or having scopes put up their butt, its considered pretty taboo.. But its time we started and break the taboo because if we don't, more and more people will die from Bowel Cancer.

New Zealand has one of the highest incidences of Bowel Cancer in the world. Each year about 3,000 people are diagnosed with Bowel Cancer and more than 1,200 people will die from it. This is why it is important to know what the symptoms are. The earlier Bowel Cancer is caught, the easier it is to treat and the better the chances are of curing it.

"75% of Bowel Cancer is curable if caught early"

For those who aren't well acquainted with human anatomy, the bowel is part of the digestive system and is a long tube made up of the small bowel and the large bowel. Food and liquid are passed into the small bowel to be digested. The remains are then passed into the large bowel. The large bowel is made up of two parts: the colon and the rectum or butt hole as I like to call it. The colon removes liquid from the digested food leaving poos which is then passed into the rectum/butt hole and held until you go to the toilet. Who doesn't love a good poo yarn!

So, now that is out of the way, what the heck is Bowel Cancer? The most common form of bowel cancer occurs in the large bowel (colon or butt hole) and is sometimes called colorectal cancer. It can also occur in the small bowel, but this is unusual. Most bowel cancers start as benign (non-cancerous) innocent growths - called polyps - in the lining of the colon or rectum. Polyps are like small spots that for the most part don't produce symptoms and become pretty common as we age. Its important to note that polyps are not pre-cancerous - you can have polyps and never get bowel cancer. So just because you have a few polyps does not automatically mean you will be diagnosed with bowel cancer. However, it is always better to be safe than sorry. When left undetected, cancer cells will multiply to form a tumour in the bowel and if left untreated, the cells can travel into the bloodstream or lymph nodes, and can travel to other parts of the body. The most common places for bowel cancer to spread to are the liver and lungs. This is what happened to me.... This is why it is so important to catch bowel cancer early.

"The Doctor will see you now"

There are a number of symptoms that could mean bowel cancer, so it is important to know your body and be aware of when things change. The most important symptom of bowel cancer is bleeding from the butt and this can usually be paired with straining, soreness, lumps and achiness. The other important symptom is changes in bowel habits that continues over several weeks or longer. These changes could be constipation or diarrhoea, or feeling that your bowel doesn't completely empty, going to the toilet more often, or blood in your poos. Because blood loss goes hand in hand with bowel cancer, anaemia or low iron is a symptom of bowel cancer. Alongside this is unexplained weight loss, weakness and fatigue. You may also notice abdominal pain and lumps or a mass in your stomach. And just to make you feel even worse, you may even have persistent abdominal discomfort such as cramps, gas, bloating and stomach pain. 

SPOILER ALERT: you could have bowel cancer and never experience any symptoms. Or, the symptoms could be explained by other conditions or medication. Whether or not you suspect or are concerned about bowel cancer, it's still important to have these symptoms investigated. REMEMBER: just because the statistics say bowel cancer is more common in the 50 years and older age group, bowel cancer affects people of all ages. DO NOT accept "you're too young to have bowel cancer" as an explanation for your symptoms. Ask to be referred for further investigations and if you are still concerned, seek a SECOND OPINION! Don't settle for "it's just women's problems", "you're too young" or "you don't have a family history". Early detection is key to survival. 75% of bowel cancer is curable if caught early, which is why it is so important to know the symptoms, and get yourself tested.

Now for those of you who don't know, I am a prime example of someone who had bowel cancer and never experienced any symptoms. Well that's not entirely true. I had symptoms but didn't really notice them until I was going through the process of being diagnosed. And the symptoms I did notice, I was able to explain them with something else. I was on pain medication which explained the changes in my poos. I have endometriosis which explained the stomach pain. I was quite stressed out due to work and had just left a stressful home environment so thought my weight loss and decreased appetite/vomiting was due to this. Also from what I knew about bowel cancer, I thought I was too young to have it. And anyway, who notices some symptoms and automatically thinks "OMG I HAVE CANCER". When I was diagnosed, the symptoms I had been experiencing and the ones I failed to notice, totally made sense. I was a walking time-bomb and didn't even realise it. This is why it is soooooo important to me to make the people I care about aware of the signs and symptoms of bowel cancer. If I can save one person from having to go through what I am going through then my journey will be worthwhile. 

If I had just opened my eyes and saw the signs, then maybe I could have been diagnosed earlier. But I didn't know the signs, and I didn't think I was old enough and quite frankly, I didn't think I would get cancer. So maybe you can open up your eyes.....

And see the signs!

You Can't Always Get What You Want

You can't always get what you want
You can't always get what you want
You can't always get what you want
But if you try sometimes you might find
You get what you need - The Rolling Stones

Its been two weeks since I went under the knife to have the cancer removed from my liver and I am slowly beginning to recover with the help of some amazing pain medications. While the safety of being in hospital was great, I must admit, there is nothing like recovering from a major surgery in your own bed.

"Surgery didn't go as expected"

I woke up from surgery feeling pretty good, until I realised just how many needles I had sticking out of me. I had gone to sleep with an IV line in each arm and an epidural in my back for pain. But I woke up with two IV lines in each arm and a central line in my neck, I couldn't feel anything from my chest to the top of my legs and to top it all off, they had placed a catheter in while I was sleeping. At least I didn't have to worry about going to the toilet... I was supposed to spend at least 24 hours in the High Dependency Unit (HDU) but because I had responded well to surgery and woken up feeling like I was walking on sunshine, they didn't think HDU was necessary. I lay in recovery happily chatting away to everyone, while also nagging at them to take me back to my ward. It wasn't until I got back to my ward and saw my relieved mother, that I was told just how long I had been away for and that things hadn't gone as planned. I was wheeled into theatre at 8am, was in surgery for a few hours and sat in recovery until 3pm. My poor, poor mother, I'm still surprised that she had any hair left.



It wasn't until Dr Bartlett had opened me up that he saw just how damaged my liver was from chemo. My liver was BLUE!!! Apparently one of the chemo meds, Oxaliplatin, had made my liver really fatty and increased the pressure in my liver making it really hard to work with. He managed to cut out the cancer in the left lobe, but due to how much I was bleeding, it was too risking to try and do anything with the right lobe. Plus, they found a new lesion by one of the main arteries and had to stop surgery. They got it tested, not cancer but still cause for concern. So had he gone further with surgery it is highly likely I could have bled out... So it was still too risky for Dr Bartlett to do the second surgery a week later, so liver surgery number two has been postponed six weeks. Hopefully thie will be enough time for the liver to heal, and the pressure to subside. In the meantime, Dr Kennedy has decided that its to risky to be off chemo for too long and I have already had another cycle of chemo. This chemo regimen is different however. Dr Kennedy has taken the Oxaliplatin out and I only have the Folinc Acid and Fluorouracil. By taking out the Oxaliplatin, it wont increase the pressure in my liver and will give my liver time to heal. So I have this chemo regimen for three cycles, then get an updated CT scan and undergo a test called a Wedge Pressure test. This test involves inserting a catheter either through my arm or groin into my liver, place a balloon inside and blow it up and it will test the amount of pressure that pushes back on the balloon. So long as the pressure has subsided, surgery will go forward. If not, then D Kennedy, Dr Bartlett, and myself will be having a major discussion about what is next...

On the bright side, I finally got my wish... A porta-cath was inserted during surgery and is already in use for this cycle of chemo. It is accessed by numbing up the skin, and piercing the skin with a rather large needle with an IV line attached to it. You can feel it underneath the skin and can see a slight bump on my chest where the port sits, but otherwise you wouldn't know it was there. Apart from when the chemo pump is attached of course... In terms of pain, the first few days after surgery were fully pain free, thanks to my amazing friend the epidural. If you are ever having surgery and this is offered as a option for pain management, I highly recommend it. It makes those first few days after a massive surgery easier to get through and allows you to get up an moving around much more quickly. I was going for walks less than 24 hours after surgery, granted it was only to the shower but at least I was up. On the Monday, the catheter and the epidural were taken out and my pain was managed by oral medication instead. There was a massive difference between the epidural and normal pain meds. I went from feeling absolutely nothing to feeling everything. It took a bit but we managed to sort out the right way to manage the pain. I easily became the nurses favourite patient on the ward. No complaining, no unnecessary buzzer pushing and the most eager to get home. Another plus, no stitches! I was actually looking forward to seeing how many stitches I was going to have, until I remembered having to take them out. Instead, Dr Bartlett just glued me back together. The incision is looking pretty tidy so I wont quite look like Frankenstein's monster..

Coming home after a major surgery is never easy. I was in a lot of pain and angry at the world for surgery two not happening. While I understand why the second surgery couldn't happen, I'm still annoyed that I will have to go through all of this again in about a month. But at least I'm home, in my own bed and have mumma bear to help me. She's a real trooper. You really can't always get what you want, I've learnt that with this experience. But at least.....

You get what you need!