Saturday, September 21, 2013

Colon Cancer And Warning Signs That Can Mimic Other Illnesses

An alien world was revealed to us after what proved to be a fortuitous incident that left my mum void of memory for a 24 hour period. After this incident, constipation came on suddenly along with lethargy & cognitive decline. What was to ensue within the next 4 weeks was a rigmarole of memory assessments & blood tests to find the cause, which eventually was believed to be related to her anemia.

It was only upon investigation into this foreign world that I was to discover that anemia in the elderly can be symptomatic of internal bleeding that needs to be investigated. Many Google searches revealed what I did not want to believe - the link between Colon Cancer and those with anemia (low iron stores in the blood). After consultation with a Colorectal Specialist we were advised to have a Gastroscopy and Colonoscopy. At the time, it was explained that mum was a Category 1, yet the waiting list at the public hospital could not be guaranteed within 6 weeks, therefore we chose to utilise a private clinic. It took us 2 weeks from the initial consultation.

During this period we were also to stumble upon the fact that mum had been taking a well known statin drug - Lipitor, which was recently linked to new FDA guidelines issuing a warning as to having some severe side effects. These include cognitive decline and anyone with suspected renal & liver conditions to be cautiously monitored. With mum's blood tests revealing moderate renal dysfunction & the cognitive decline, I wondered if there could be a correlation? After speaking with the doctor, we decided to wash the drug out of my mum's system, even though it was doubtful as to the cause of her memory decline. (For anyone taking this drug, see FDA guidelines & consult with your practitioner prior to ceasing medication).

It was interesting to note the improvement in mum's memory throughout the period that she stopped taking the drug, irrespective of the fact that she was still classified as anemic. The recent memory lapses appeared to reduce dramatically as crosswords began to make sense again, with her even joking that she had also found her long lost sense of humor. I watched on as a silent observer as to the re-awakening of her thought processes and continued to wonder?

I will digress for a moment here and reveal the substance of an Aged Care assessment to further support how imperative it is to question and continue to seek advice and support of trusted open-minded professionals. Interestingly, my mum had formed a diagnosis of Dementia (honestly, we all had!). This was not supported by the assessment process and a clinical diagnosis of Depression was offered with a recommendation of antidepressants given. Not wanting to add another tablet to mum's regime of daily medication, our family doctor supported the decision that we would intervene and deal with the episode with family support. The pieces of the puzzle were somewhat foggy in all areas as to the cause of the memory dysfunction and mum's future.

Our conversations took many forms and were open, raw and honest as to if the inevitable was to be faced. In a matter of weeks, we traveled the road of low care Nursing Homes, Independent Living Villages all the way through to Palliative Care options. At this time mum felt that she was no longer capable of looking after herself and showed little self confidence and low self esteem. On top of it all, she had recently instigated the sale of her home after many years of procrastination. It seemed as if a hidden part of her psyche propelled her to make changes and slowly piece by piece it all began to make more sense.

I make the pun slowly, as Colon Cancer is the "slow killer" and quite often does not make its presence known until it is of adult like nature. The testing is not as intrusive as one might believe, with quite often the worst part being the Glycoprep mixture prior to the procedure, which produces a laxative effect. A tedious 48 hour period to prepare is that of low fibre dietary requirements and monitoring of blood sugar levels for those with Diabetes.

Another interesting part of this process was that my mum had little or no idea as to the terminology used, preparation required and relied upon me as her "interpreter", even surrendering to the process as I was given Medical POA. Most doctor's visits throughout this time consisted of the relaying of information between all parties. I have been given a new appreciation for any elderly person navigating this process alone or someone of foreign speaking background. If you have an elderly parent, I cannot stress enough the importance of having "an advocate" to help decipher the process with them.

Finally, a diagnosis of Bowel Cancer was given and we were told that from now on "things will happen quickly". Over the next week, more CT scans were performed to see if the cancer had metastised to any other organs. The next step was to see a Colorectal Surgeon and we were given the treatment options. The scans revealed no secondary sites. The tumour was in the caecum and a Hemicolectomy would need to be done as soon as possible. Basically, removal of the contaminated part of the bowel and then a rejoin so that a colostomy bag would not be needed. My mum often joked that she had "a good cancer" as it was on the right side, instead of the left, therefore this procedure was a more comfortable outcome. Either way, I think they both pose their own challenges to the individual and the more information primary carers & those diagnosed have to support recovery is imperative. Ask questions and if you don't remember write them down and take them to your appointments!

Surgery was booked within 4 days and the following week we arrived at the hospital. I felt as if the tables had been turned as our parental roles seemed to be in reverse. The surgery time took approximately 3 & 1/2 hours including post-op recover time. After surgery mum was groggy, yet she gave that beaming little smile of hers with a thumbs up and I immediately knew that it wasn't her time to go.

Back on her feet the very next day, I behaved like an overprotective mother as I ensured that her stockings had been put on, massaged her legs & rang friends/family to keep an ongoing support crew at her bedside (thank god for phones). Due to the high risk of clotting, patients are encouraged to walk around as soon as possible, deep breathe regularly and wear stockings when in bed. Within days mum was ready to come home with approximately 15 staples in her belly and a working bowel that she said felt little different to before. As the surgeon explained with this type of surgery, the patient finds their "new normal". Mum found hers after the first bowel motion!

Our house has now turned into an interesting daily phenomena of poos, medication and memory programs (thank god for crosswords, scrabble & resourceful teenagers). Throughout the whole journey, I have maintained an optimistic expectation and tried to visualise the outcome; the right surgeons, nurses and a speedy recovery. I even sent out prayer requests to every denomination I could find on the internet as I believe in the power of prayer to help heal!

By facing the inevitable, a magical process happened as time merged into the most important moment to moment memories. The laughter throughout this time was almost constant, support never far away and tears let go as needed. We spent many hours dealing with the process of our very own family sitcom as a multitude of synchronistic events played out. Laughter is definitely a healer!

Being of a holistic nature, I believe that it is imperative to address all facets of one's disease & lifestyle. In my mum's case, we addressed lifestyle and social support (she now lives with my daughter and I) In addition, with the doctor's support we have modified the statins as we do believe based on observation that they were partially responsible for the memory decline, in conjunction with the low levels of iron in her blood. She now takes iron tablets and will have blood tests to rule out any future onset of this disease, further scans and a Colonoscopy in one year's times to check that no polyps (small lumps in the bowel) have formed. In conjunction, I believe the key factors are: proper nutrition, regular exercise, ongoing monitoring and social support. Ironically, mum has no signs or symptoms of Depression anymore.

I believe in looking at the process of dis-ease as a journey, forget the destination and life can take on new meaning. It is simply as the word states, a dis-ease within the body that needs attention. Avoid powerful words of suggestion and speak in positive realistic terms, internally and externally. The mind is a powerful tool that can and will talk itself into and out of anything. I am not advocating living in denial but simply mapping the journey as positively as you can with limited stress to all involved. If you have an elderly parent who is over 55, it is worthwhile to screen for Colon cancer periodically, as it is the number one cancer in the elderly that is curable, if treated early.

I wonder if I had not asked questions and just accepted the waiting list for testing as to whether this outcome would have been so positive. Thankfully, the tumor was removed along with 14 lymph nodes; all of which were negative. The follow up was with an Oncologist who advised that there is only a 10% chance that it will return and given mum's age she has a higher chance of dying from other unrelated illnesses. If chemotherapy was to be used for 6 months it would only reduce the chance by 1% & reduce quality of life, therefore we have decided to continue on this journey with a light heart, lots of laughter, support and gratitude for what we have right here and now. I'll keep you updated.

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