Monday, September 22, 2008

Post-Surgery Update from Nina

I wanted to update Di's Blog as soon as possible because I know how many of you are anxiously awaiting news of the outcome of surgery. Di's doctor was able to give her the ileostomy instead of the colostomy. This means she will NOT wear the colostomy bag for the rest of her life, but only for a minimum of 3 months while the resectioned portion of her colon is healing. After her agony of being faced with two such extremes for several months, we are relieved to tears and overjoyed that she received the best possible fate today.

While Di was being rolled off to the surgery, our dad walked behind her bed and continued to follow her past the allowed point for family according to the hositpal rules. Having lived through losing his mother, his only sister and the mother of his 5 children to cancer, it didn't seem like much would stop him from walking with her as far as he could or beyond if he wished. As we walked out to the family waiting room for surgical patients, he turned and said to me in half Vietnamese and half English, "Our family, last time, we lose. We don't lose this time."

Though we are still waiting for the pathology in the next couple of days, we are filled with more hope than ever, that he is absolutely right.

Di has woken up and we have just given her the news. We are trying to keep her comfortable and she is groggy, yet her mind is as sharp as a tack. She didn't react to the news, so much as ask twice. Then, in a tired voice, she says "Rowan and Spencer." Regardless of how much pain she is in or how doped up she seems, she still says thank you to the nurses everytime they complete a task for her. They seemed shocked that someone just hours after major surgery remembers her pleases and thank yous, so they give her a little laugh and say " You're welcome." Those who know her are not at all surprised.

Though she is extremely worn out and heavily medicated, and her awareness is fuzzy, she still managed to comment that her hospital room was pretty and not shaped weird like the last room. We wanted to get her a back scratcher for her itchy legs that were driving her absolutely crazy, and coicidentally, however strange, our dad quickly offered the one he already had in his car.(!) (If you have an Asian dad, it's more funny than it is weird.)

When asked if she wanted anything else, she replied, with eyes closed and half asleep, "Kentucky Fried Chicken." Di had to fast the day before her surgery and was starving by end of day. So our dad brought home a bucket of KFC for dinner. In hindsight, they probably should have gone out to eat that night. She continues to tell me, through her sleepiness, that I can share her toiletries and asks if they brought me a cot to sleep on. Even after a life changing surgery, nothing stops her from being a big sister.

I sit here, updating her blog in a chair next to her hospital bed, amazed once again by her bravery, her determination, her love for her boys and her kindness that reminds us all so much of our mom. We are so grateful for this gift, the gift of her future that is unfettered by a daily reminder that cancer took a part of her. She is free to claim that she's beaten it and when that day comes very soon, it'll be a sweet day. You did good today, Sis. We love you.

Sunday, September 21, 2008

Hungry for Happy Hour

Tomorrow, I head to Overlake Hospital in Bellevue for my abdominal surgery. Not allowed to eat anything today except water and clear liquids (no solid food, no milk, no soy, no red dyes). At 6pm tonight, I have to start my MoviPrep regimen which involves drinking two canisters of very nasty-tasting powder mixed with lukewarm water. It kind of tastes like liquid lemongrass and is supposed to "clear me out" so that my colon will be prepped for surgery. There's no end to the fun and glamour. I am trying to keep my spirits up, but it's especially hard when you're hungry too. This morning I got some strawberry yogurt on my hand while feeding Rowan and Spencer their breakfast. I had to stop myself before I licked it off! For lunch, the boys shared a Quarter Pounder with Diane, but only after we told them it was a Krabby Patty. The ruse worked beautifully since they love Spongebob Squarepants so much. They ate it all, except for the pickles. I was tempted to even eat those cast-offs from my toddlers' meal- that's the pitiful, hungry state I'm in....

Speaking of food, my friend Jenny and I had a few delicious hours last week to hang out and catch up. We had lunch at a new Vietnamese restaurant in Tukwila called The Lemon Leaf. It's right off the same exit as IKEA, but its interior decor reminded me of The Tamarind Tree in the International District. Very chic and upscale, but the menu was exceptionally affordable like most Vietnamese eateries are. She did find a live bug in her fresh herb/veggie plate (not in her main dish), but the staff was suitably embarrassed and gracious about removing her meal from the tab. We talked so much about our kids, work, life and ideals of happiness. We were so engrossed in our conversation that we pulled our party over to Anthony's Home Port in Des Moines during Happy Hour. I had a fresh, hot espresso shot poured over three scoops of vanilla ice cream, float-style. SO GOOD! My brother Jeff joined us since he lives just down the street, and the three of us contentedly polished off calimari, pan-fried oysters, and shrimp salsa & chips as we watched the sunset over the marina. I realized that I used to do this sort of thing all the time, and now, it seems like these moments of blissful relaxation, good conversation, and excellent appetizers are stolen moments.

It's only been 4 months since my diagnosis, but my world has become more somber. In that moment with Jenny and Jeff, enjoying food that I hadn't been able to eat in a long while, I truly savored and enjoyed it while I could. Today, I am still thinking of that food, but more importantly of the conversation we had. We all get dealt a rotten hand sometimes, but life is what you make of it- even if you have to go to a place that labels it Happy Hour for you. This week, my friend Gina wrote to me of her mom's and her grandmother's struggles with cancer. I know it must have been hard for her to dredge up those memories because she suffered along with them during their illness. I also spoke to my friend Joni, whose mom has been battling metastatic breast cancer (now in her liver) for the past 7 years- when they originally told her she had 6 months to live. I had a good conversation also with my friend Lynnett, who is having a hard time of her own and didn't want to bring it up because she was worried it would add to my burden. In sharing your sad stories, you also shared with me important lessons, and my spirits have been lifted by your gift.

What I realized is that I have a lot of STRONG WOMEN as friends. This includes my 214 friends, my amazing cousins, childhood friends and even many co-workers over the years who have demonstrated their integrity and good character time and again. They face adversity, raise their children, juggle a career, and still find a way to prevail. But we can only do that with a strong support network and friends that we can rely on to vent with, share lessons with, and hope with. We all have sadness and struggles in our lives, but we must also have each other to help us through it. My friends Kimchi and Tina are both pregnant now, and expecting their first child soon. I want to be there to celebrate with them as they join an even greater sisterhood.

As I head into surgery tomorrow, I'll be thinking of my sons and what I want to teach them about my experience long after it's over. They won't remember any of this, but I still want them to know it happened. They need to know that their mother was strong for them long before they could ever see it for themselves, and she could only get through it with the combined strength of so many women who have been, and remain, her friends and allies. I hope to teach them how precarious life can be, and the only defense is strong and resilient friendships. I will also teach them to treat the women in their lives kindly and with respect. As women, we bear our children and we continue to bear so much in life just to ensure that our kids can grow up safe and healthy. We love them, protect them, and teach them- sometimes at great sacrifice to our own health or sense of happiness. But what I wish most for my girlfriends out there is many Happy Hours to come. Please know that you deserve to smile and to be happy, no matter who or what in your life is bringing you down. Know this so that you can raise daughters who become happy, strong women themselves and sons who know how to treat women. To the good men I know, continue to honor the women you love. Take a moment to recognize and appreciate how much they do for you before it's too late. Teach your sons well, for they will look to you as an example of what a man should be.

To ALL of my friends, thank you so much for your support and continued friendship. When I come out on the other side, I will be calling you for coffee or Happy Hour- Count on it!!!

Thursday, September 18, 2008

The Bag Lady

Yesterday, I had my third and last appointment prior to day of surgery. I had to meet with the specialist, Molly Price, who will train me on how to use my ileostomy bag and mark the placement location of the stoma. In addition to removing the diseased section of my colon during surgery, Dr. Biggers will also create a "stoma", a surgically-created opening on my abdominal wall through which a section of my small intestine will be drawn out and sewn onto the skin surface in order to allow the body's waste to empty into a man-made bag. This procedure is necessary in order to allow the re-sectioned portion of my colon to heal by allowing waste to instead be eliminated through the stoma temporarily. If I end up getting a colostomy instead, then I will have to wear the bag for the rest of my life, but it will save my life. If I'm lucky, I won't need the permanent colostomy instead, but Molly will show me how to use both since it can go either way as determined during surgery.

Envisioning an older woman with years of experience, I met instead with a young, athletic-looking brunette who seemed like she was already having a long day as evidenced by the frequent exhalation of sighs during our appointment. Molly had so much information to go over, but she was also cognizant of the fact that most patients have much on their minds prior to surgery, so she was careful not to overload or task me with too much. Like a traveling salesman might do, she brought out a range of bags, appliances, brochures of different types of ileostomy and colostomy bags available on the market. It's not a one-size-fits-all world, she said, so she will meet with me in hospital after surgery in order to customize a system that will work best for my body and lifestyle. Chief in my mind is that I have two little sons who will want to be hugged, held, and lifted a lot, so she will find something that works just for me. There were clear bags, opaque bags, different openings, varying sizes, some with built-in charcoal odor filters! Evidently, there were disposable bags, bags with clamps or velcro fasteners, and even bags that were conducive for intimacy. My face must have betrayed some kind of emotion after hearing the enumeration of products that would serve to replace my normal bowel function for the next three months, or possibly the rest of my lifetime, because Molly suddenly changed gears.

Molly couldn't be a day older than me, but she must have felt sympathetic in that moment because she stopped her stream of professional-speak for a moment and instead offered me a moment to take it all in. She said, "I know this is a lot to process right now, but remember to take a moment to grieve. These medical devices work great with few chances of failure, but the biggest thing my patients face is the issue of body image and self-esteem." After hearing those words, I wanted to bite my lip to keep it from trembling and to keep from letting any tears fall, because I hadn't really wanted to think about it at all. Sure, I can regurgitate everything the doctor discussed with me about my diagnosis and treatment regimen, but have I really let any of this sink in? Have I been grieving adequately or have I been hiding behind a false front of bravado and denial? I have to wear a bag to poop! Molly might have read something in my face or sensed some apprehension, and the way she was looking at me made me feel that she could see right through my skin. Maybe she saw the cancer from inside-out or maybe she was staring at the person carrying it, and stopped a moment to empathize.

My friend Phuong is an oncology nurse at the Seattle Cancer Care Alliance and I was wondering at that precise moment if she dealt with this everyday while at work. She once told me it was a "privilege" to be doing the work she does with cancer patients, and I know she is sincere because she is one of my dearest friends and everything about her personality and demeanor speaks to compassion and benevolence toward others. Doctors and nurses are consummate professionals who must deal with the reality of sickness and death in those they treat; but when a patient sees a glimmer of compassion or senses that their health care professional really cares, it makes being treated bearable and humane. Phuong has been my champion and my advocate ever since my diagnosis, and no one needs to remind me how very fortunate I am to have her as a real life guardian angel.

Brought back to the discussion at hand, the tears dissipated before they had a chance to surface, and I regained my composure and took to writing down more notes in the little memo pad I've been carrying around. In order to mark the precise location of the stoma for surgery, Molly had me lie down, sit up in a chair, stand up straight, bend over, and also show her the waistline of my pants in order to determine the flattest and most suitable stoma site. Because of the loose skin on my belly and the distension of my abdomen after having the twins, my case was more challenging to mark. She marked four locations on my belly with her pen before she inked the final site in permanent marker and covered it with clear medical tape so that it won't fade before the day of surgery. Armed with books and brochures, I got up hesitantly to leave and Molly assured me that she will visit me in hospital to get fitted for the right bag post-op. I wanted to believe that she really cared, but she was already on her way to the next appointment. I wonder if she will even pronounce my first name correctly next time she sees me...

Tuesday, September 16, 2008

Countdown to Surgery

Today I met with Dr. Biggers, my surgeon. He went over the game plan again and clarified other points. After an anuscope, he determined that the tumor had indeed shrunk significantly after chemoradiation. So, all the torture of treatment did result in some measure of success. Instead of the 4cm lump that was there before, he felt "puckered tissue" where the tumor had been. This news is hopeful because that means the surgical procedure will be much more manageable since the tumor has receded, and there's a chance that he can cut out the diseased section of my colon without sacrificing any part of the rectum- which would have necessitated a permanent colostomy. However, only on the day of surgery can he determine with the greatest amount of accuracy whether or not he can adequately remove the tumor site, 2cm on each side, any involved lymph nodes, and the watershed area that feeds it without losing permanent use of my normal bowel functions. If he discovers that there is not enough room, or if the cancer has spread beyond the original site, then he will do whatever is necessary to save my life and ensure that there is no recurrence of the cancer. At that point, he will also be able to "stage" my cancer to determine the extent of the tumor's penetration into the tissue wall. The section to be cut out will be sent for biopsy and testing as well. My white and red blood cell counts are within normal range now, and my CEA level has dropped from 4.3 at the start of treatment to -0.5 as of today, a vast improvement and a hopeful sign. The carcinoembryonic antigen (CEA) test measures the amount of this protein that may appear in the blood. CEA levels may be measured both before and after surgery to evaluate both the success of the treatment and the chances of recovery.

I listened intently, asked all the right questions, took copious notes, but still felt a kind of weary resignation peppered with cautious optimism that I might actually come out of this ok. I thought again of my sons and how I will be around to spend years and years with them to come. A kind of calm and warmth spread through me like an opiate. I saw myself hovering above my own body on the operating table; an observer in a dream. Or it might have been an involuntary flashback to the hazy memory of my C-section when the twins were born. Someone will be digging their hands into my guts again; cutting, removing, rearranging my innards. Of course the thought of major abdominal surgery is creating some measure of calm hysteria, but I must fight the first instinct of fear and accept that serenity and composure will benefit me most as I prepare myself psychologically, rather than physically, for my operation. It could really be possible that I will be cancer-free by year's end. As a mother, and as someone who desperately wants to live for my young sons, I let the idea take root even as I process the fact that any of this is happening at all. When hope is offered, you feel the fight rising in you again, battling the morbid thoughts that run rampant, each taking its turn for possession. I will prevail, I will survive. But if I don't, please make sure my sons know that I fought for the chance to be with them for a lifetime.

Monday, September 15, 2008

Insomnia & Hospital Paperwork

I haven't been very good at updating my blog lately. Not for lack of conscious-stream thought, but because I've had so much weighing on my mind that it falls out of my head at night instead of through the tips of my fingers on the keyboard. Insomnia has had a powerful influence on my frazzled mind and frayed emotions lately. My surgery is less than one week away and there seems to be no end to the details that must be attended to before I go under the knife. Kids, paperwork, finances, house, etc. Tired but sleepless every night; worry consuming my waking hours. Even if I do manage to snooze, I'm frequently awakened by my bladder and remain in a state of feverish thinking long after I've emptied it. By the time sleep claims me, morning has broken and everyone in the house is stirring when I most want to sink under the blankets. They say lack of sleep ages you most next only to sun exposure and smoking cigarettes.

This weekend, longtime friends came to visit me from San Bernardino, California. They've known us since our childhood in Colorado. Now their own kids are in their mid- to late- 20s, all with careers, some with kids of their own. They have been incredibly good to me. I think back on many friendships nearing the three decade mark, and many others of comparable quality that have been nourished in shorter spans. I think also of many friends who have been lost over the years; some who have died and others who are ghosts all the same. So many have come through for me, even some from unexpected corners. Still others I thought I could count on are not heard from and nowhere to be found. But I have no grievance because each person and each family has its own measure of trouble and grief, none of which is truly relative because it strikes us all differently and hurts us in ways only we can feel. Friends can help to mitigate our pain, but we must carry the load ourselves.

I went to my first pre-op appointment today to fill out paperwork and get blood work done prior to surgery- it helps to cut down on the number of tasks that make the day of the operation hectic. They took three vials of blood to test my counts- white and red blood cells, and verify blood type in case of transfusion during surgery. Although both nurses were very nice, I sense that they see many, many patients and I'm just another person with cancer and this is where they show up to work everyday. I've spent so much time in hospitals with my mom, when I had the babies, since my diagnosis and treatment, even to visit friends when they were in need. It is both a scary and comforting place to me, and I will be spending 5 to 10 days here after abdominal re-section. I am meeting with my surgeon tomorrow to go over the test results and discuss the plan of action for surgery. This week will go by fast and I am trying to keep my fears at bay as the date approaches. If only I could sleep........

Friday, September 5, 2008

Stand Up To Cancer!

Friends,

If you read this in time, please watch the televised cancer awareness telethon on all three major networks this Friday night at 8pm. Stand Up To Cancer is a fund- and awareness-raising organization that is putting on a major TV special for cancer research. Hollywood Producer Laura Ziskin (who has been battling cancer herself since 2004), former Paramount Pictures chief Sherry Lansing (who established a namesake foundation for cancer research and awareness), and Katie Couric (who lost both a husband and sister to cancer) organized this star-studded event. It will feature many celebrities who hope to raise awareness and money for "translational research," as described by Laura Ziskin, "which encourages scientists to collaborate rather than compete, translating basic science into applicable therapies for patients." They hope this project will bring greater awareness to cancer research in much the same way Al Gore's "An Inconvenient Truth" raised awareness of global warming. Their aim is to find faster, better, less toxic treatments for cancer patients. Over half a million Americans die from cancer every year.

Celebrities such as Christina Applegate will share their personal experiences with the disease and will help answer phone calls from donors during the telethon. Other stars set to appear include Halle Berry, Forest Whitaker, America Ferrera, Jack Black, Salma Hayek, James Taylor, Carrie Underwood and Rob Lowe among many others. The hourlong show also will include a performance of "Just Stand Up," a charity song featuring Mariah Carey, Mary J. Blige, Beyonce, Rihanna, Fergie, Miley Cyrus, Leona Lewis, Carrie Underwood and many other musicians. Couric and her fellow network news anchors, Charles Gibson and Brian Williams, are set to host the show.

For more information on the televised event or the organization, please go online:
http://standup2cancer.org

Tuesday, September 2, 2008

The Painted Veil

Only 3 weeks left until surgery and my head is hurting more than my guts at the moment. The past few weeks have been about recovery, healing and preparation for the operation to remove a section of my diseased colon. I desperately needed to salvage my summer, most of which has been spent in treatment or convalescence. The twins and I stayed at my brother Zhivago and Toni's house for a few weeks and there was no end to the comedy! We had a townhouse stuffed with 3 adults, 3 kids, 2 cats, and a toy rat terrier to make things merry. I came out of the bathroom early one morning and Toni asked me, "Did you go poo?" A split second later, I arrived at the realization that she was talking to one of the babies, and not me- even though she was inadvertently looking directly at me when she said it. Considering all the problems I've been having lately, it really was a valid question so I didn't fault her for the startling inquiry into the success of my bowel movement. The very next day, Toni told me authoritatively to, "Go outside and go potty!" Again, she was looking at me, but talking to Doe, their little dog. But Toni does not have a monopoly on ill-timed, yet hilarious one-liners. Feeling obligated to eat a Gardenburger the other day, I tried desperately to swallow the first bite. My carnivorous brother quipped, "That's your first mistake- your lunch does not have a soul." These hapless moments keep things jovial in a house packed full of people and pets.

But trying to stay positive and actually feeling good about things are sometimes mutually exclusive. The very phrase "staying positive" denotes an effort to find comfort in an uncomfortable situation. This is what I call The Painted Veil. The picture of happiness you present in order to put everyone (including yourself) at ease, and the truth behind the curtain when you stand alone with your thoughts. There are times when I can truly savor things like a great moment spent with family or a brief surge in my energy level. But it's not the same as being able to enjoy it as I once did when I was fully possessed of my good health. And when you are already slowed by illness, there is no worse nag than worry. Sometimes, trouble comes upon us so thickly that unbidden tears slip and burn before we can stop ourselves; extinguishing joy, snuffing it out like a light. The world is full of friends, but we all feel at times that crushing loneliness that blights the happiness that we might otherwise feel. We are sometimes solitary in our sorrow because sympathy carries you only as far the painted veil you put up for others. The company of friends and family can be a salve to our wounds, but we can still bleed under the bandages.

When I can't sleep at night, I roam the halls like a ghost or lie in bed staring at the walls hoping that deep slumber can make me forget everything that is troubling my waking hours. After my mom passed 12 years ago, my dreams consistently revealed dark, quiet rooms where she would lay in her sick bed. I could never talk with her- or at least she would never answer me, and she always looked pale and gaunt as she did in those final days of her struggle with cancer. These dreams usurped my nocturnal sojourns for years, until one night I had a visitation dream that finally assuaged my abiding grief. I looked across the length of a moonlit pool of clear water. On the other side, my mom and my long-deceased grandfather sat at a table playing cards together! My mom actually smiled and waved back at me. I woke up choking with tears, truly knowing that she had finally crossed over and was no longer sick, in a better place, reunited with her own father. She looked radiant, healthy, no longer emaciated and tired-looking, her hair was full again. And best of all, she had acknowledged my presence in this dream so I knew that she was telling me that she was ready to let us go and she was finally happy now. The remembrance of this dream still reduces me to racking sobs, even as it lifts me up and frees me from the grief I held inside for so long after losing her.

So when I am feeling down or troubled, I remember that dream because nothing can ever make me feel as aggrieved and elated at the same time. It would be unrealistic to think that we can be happy all the time, even if that's how we front to the world. And even though our life may be filled with good things and loved ones, there is a lonely corner that sorrow reserves for you behind the painted veil. Be kind to everyone you meet, because they may be facing a harder battle. -Plato