Symptom Check

The below post I wrote in January 2020 while awaiting scans at MD Anderson in Houston. 

This week I am back at MD Anderson in Houston for follow up appointments and my first round of surveillance scans post surgery.  Being back here in Houston and at my aunts house brings up so many emotions.  The last time I was here was the end of August for surgery. I think about the physical and mental state I was in right around surgery. That was tough.  Not only was I physically uncomfortable and in pain but I think about how riddled with anxiety and fear I was right before surgery.  I recall sitting in this exact room a little less than four months ago guzzling down bowel prep in between my tears.  My husband, sister and sister-in-law huddled around me assuring me it would be ok.  Unimportant things I was worried about regarding surgery: anesthesia (very worried about this, turns out it will likely not kill you), the catheter (very sure this was going to cause immense pain both going in and coming out – spoiler alert- it doesn’t), stitches from surgery (again, very concerned about pain -spoiler alert-they dissolve on their own).  Can you tell I had never had surgery before? Things I should have been worried about: clear margins (got those), colostomy bag (got that too), more organs coming out than expected (happened).  But alas, everything turned out ok!

All of this has got me in serious retrospective about the years leading up to diagnosis and what my symptoms actually were.  Of course I had symptoms where the cancer reared its ugly head; however, I was pregnant and postpartum so it was easy for me to brush them off.  First off, let me remind you I had stage 3C RECTAL cancer.  I had to do so many physical exams and scans and getting undressed and being uncomfortable about talking about my most intimate parts that I think I could walk down the street naked now and not care.  So if anything surrounding rectal cancer and bodily functions makes you squeamish, exit now! Don’t worry, I’m going to spare you my most intimate stories (I save all those mortifying stories for my husband) but there is your warning.

1. Urgency/Constipation – This is one of the symptoms that sticks out the most for me because I definitely remember it to the year prior to diagnosis.  I know it seems odd to have these two sensations together.  Know how when you’re pregnant you have to get up and pee multiple times a night? Well, I had that except it was to poop. I would frequently get up at night and feel urgency to go and then wouldn’t be able to empty my bowels all the way.  Again, I was pregnant so I chalked this up to pregnancy constipation.  It was mostly an annoyance because the last few months of pregnancy it really began to disturb my sleep.
2. Change in Stool  – Somewhere along the way (I can’t exactly recall) I did notice my stools begin to change shape. They were longer and thinner.  But HELLO, I was constipated, doesn’t that make sense? It’s not like my stools morphed into some seriously weird stuff, they were just a little…different. The change wasn’t alarming to me, I just chalked it up to constipation.  I recall a few times there being blood when I went to the bathroom but never enough to be alarming. I had always thought that bright red blood was a sign of hemorrhoids.  After the birth of my son in December 2015 I did complain about hemorrhoids to my OB but no one ever did a physical examination to check.
3. Weight Loss – With both of my pregnancies I gained about 30lbs.  After I gave birth to my daughter in July 2018, I noticed I was steadily losing weight. Not in an alarming way but every time I got on the scale I had dropped a few pounds.  However, breastfeeding was going so well (unlike my first), so I figured this was the weight that just “fell off” from breastfeeding.
4. Anemia – In December 2017 I went to a new OB in Florida when I found out I was pregnant with my daughter.  Took them about 1-2 months to call me back and tell me my routine bloodwork showed I was very anemic.  If I recall correctly, my hemoglobin level was at an eight or six, which is extremely low.  Oh, I don’t eat meat I told them! I had been feeling extremely run down and tired, but I was pregnant and running after a toddler, of course I was tired! I was put on an iron supplement and my iron levels came up to normal and stayed that way throughout pregnancy.
5. General Change in Bathroom Habits – I don’t really know how to categorize this one so we’ll leave it at this.  If I really think back I can trace to beginning to notice something being different summer 2017. I felt like I was beginning to deal with more gas, urgency , something was just different. During this time I was also smack in the middle of serious postpartum depression and drinking heavily so I also chalked these changes up to lifestyle at the time.  (Honestly, I could write a book about this period in my life, its very much a hard thing for me to talk about because I am ashamed of it).

Of course typing all this out I feel like the biggest idiot for not going to a doctor with these symptoms. What the hell Catherine?! Everything  came on gradually and by the time I was diagnosed (thank you access around my tumor for saving my life, you can read more about diagnosis here) I was suddenly dealing with an onslaught of these symptoms all at once.  I think it was a case of knowing I had this tumor so all the sudden these symptoms I had been dismissing were magnified. When I look back at this timeline of my life I can clearly see the storm brewing but at the time, I couldn’t.

I don’t write this to scare anyone at all. I just write this in hopes in helps someone else in the future.  Never in a million years did I think I would get cancer.

I was healthy!

I worked out regularly!

I was a vegetarian!

I didn’t have a family history of cancer!

I had no risk factors for this type of cancer!

My genetic testing showed I had no irregular gene mutations!

I didn’t have a complicated medical history at all!

I had never even had a surgery before for God’s sake! Nonetheless, I had cancer.  It happened to me.  Somewhere along the line my body started making these cells at an excessive rate.  Was it because I drank heavily during my depression? Was it because I drink tap water? Was it because my diet wasn’t healthy enough? Was it from chemicals in my food? I have beaten myself up over this for over a year. What could I have done differently to prevent this? Why did my body betray me? I guess I’ll never know. Maybe I will. Who knows. I’m trying my best to not live in the past.

The only advice I can even offer is that in the end YOU know your body.  I didn’t have to deal with doctors dismissing me; however, if a doctor ever does dismiss you or your symptoms, find a new doctor! Since being diagnosed with rectal cancer, every colorectal doctor I have seen has told me they are seeing more cases of colorectal cancer in patients younger than fifty years old. (I mean, maybe it has to do with all the glyphosate they allowed into our food system in the 80’s but I digress…). People younger than fifty years old are generally not getting colonoscopies so by the time the cancer is found it is often already at advanced stages. Like mine. Be your own advocate. My brother (who is a doctor) told me once that’s why they call it practicing medicine, no one knows it all. All doctors are not created equal, search out the best team. Pay attention to your body. It might just save your life if you listen close. I was lucky enough to find a team of doctors that helped save mine.