01 – Time To Worry

Where shall I begin? Yesterday or several months ago with subtle signs that we do not wish to entirely see.  A rather sudden onset of constipation with no change in diet or exercise patterns.  Maybe it’s an aging thing.  I mention it to my doctor during my annual physical in September.  A family history of polyps.  We decide to consider a colonoscopy to be done some time soon, but let’s wait until the new partner with the endoscopy experience joins the practice. Weeks later, bed, my wife thinks that she notices enlarged lymph nodes.  They are non-tender and I don’t connect the two symptoms.  The constipation continues.  I become a bit anxious but it is a fairly innocuous event, constipation, part of the gradual process of growing older.  Of course, I am a cancer nurse so I start speculating about colo-rectal cancer, stomach cancer, something sinister.  But we oncology nurses are always thinking that we might have cancer.  The smallest symptom suggests itself to our pysche.  It is worse when we first start working in cancer.  Later it settles down in our minds but never quite leaves, embossing itself on how we come to look at the world.  Neurotic me. I shove these thoughts to the back of my mind.

The week before Thanksgiving is hectic.  Four of the five days are spent doing 12-hour shifts at the hospital.  I also have a long list of chores and projects to perform at my house and my mother’s house.  My brother and his family are coming from South Carolina to share Thanksgiving, to see my mother, my sister, myself and my family as well as my 104 year-old Grandma.  This will be their first visit here in three years.  I am fixing windows, installing a new front door, installing floor trim, keeping up with my emails, shopping for a new stove.  A few nights I get only 5-6 hours sleep.  On Thanksgiving I spend nine hours constructing a complicated, gourmet dinner.  There is way too much food.  After the feast, while everyone is sitting at the table relaxing, I return to the kitchen to finish preparing a sour cream pumpkin pie and a cranberry-apple, crumb-top pie.

For much of the following week I am really, really tired.  I overdid it.  Too much holiday.  I even feel a bit sick – my body is achy, a couple of days I have a low-grade temperature.  But this is how I frequently get when I am rundown and my immune system is compromised.  I still do not even connect to all this to the baseball-size bruises that appeared last month on each of my upper arms several weeks apart.  My constipation persists.  Thanksgiving dinner didn’t help that a bit.  On Friday morning, the last day of November, I am laying in bed when a sharp cramping in my lower left abdomen awakens me. I had taken Senekot, a laxative, the night before.  I roll onto my back and reflexively massage my abdomen.  It is hard and feels solid.  I vaguely noticed that hardness a few weeks ago – constipation I thought.  But this time I palpate more carefully.  This hardness has definite shape – it runs straight down from my ribs to my naval, left of midline, about 4 inches across.  It’s quite hard and a little tender.   I lay there for a few minutes, staring at the ceiling.  Maybe now it is time to worry.

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