One lily pad at a time.

Jaunty frog says
"Ribbit."

Ever seen a frog sitting on a lily pad on a pond? Okay - how about a cartoon frog on a cartoon lily pad?

I bet you're hearing that frog singing "Hello My Baby", aren't you? Honestly, I'm not sure he was ever shown on a lily pad.

Again, I digress. Lily pads.

Once upon a long, long time ago I completed a certificate in project management. In one of my seminars the speaker showed a slide of a frog on a lily pad and explained that if a pond is too big for a frog to jump across in one go, they will hop from lily pad to lily pad until they get to the other side, breaking down an insurmountable task into a series of smaller tasks that are easier for them to achieve. "The same thing goes for projects; sometimes the whole concept is too big or the work involved is too great to do in one go. Just focus on the next lily pad. Jump there, get stabilized, and then set a new goal of the next lily pad."

He was a pretty good instructor and the metaphor is solid. He was clearly not a biologist though, otherwise he would have realized that frogs are not only amphibious, they are freaking awesome at swimming. Sure, frogs sit on lily pads... but I doubt one has ever gone pad to pad to pad across a pond. Even if they did, they would have to come back to the pond sooner rather than later or else they'd dry out. A frog's gotta be a frog, right? So the metaphor breaks down when applied too literally... but I think the idea is still pretty valid.

Being diagnosed with cancer is one HUGE pond.

Even with my healthcare background, understanding the ramifications of my diagnosis is too much sometimes. I feel overwhelmed. I feel exhausted. I feel confused. I go through all five stages of grief, sometimes over the course of a couple of days and sometimes in what feels like a single heartbeat. Grappling with my diagnosis on both an emotional as well as an intellectual level is too big to be done at once, so I have to jump to one lily pad and rest there, gather my wits (such as they are) and then jump to the next lily pad. Sometimes I don't know I am going to jump, but the pad I am on starts to sink or move or turn into something completely different. Since the moment I was diagnosed, I have tried - and still actively try - to just feel my emotions rather than to try to push myself to be always happy or always positive or always engaged.

I get sad and I cry. Someone opens up to me and tells me how sincerely sorry they are and my heart swells and I tell them how important it is to me that they care. I get scared of what I am facing in the next few months and I tell my wife and she holds me and I feel safe. I look into her eyes - the same eyes I've looked into lovingly for thirty-seven years now - and I tell her how much I love her. I fully intend to have a tomorrow and a day after that and so on for another thirty-seven years, but I can't live that life now. The only life I can live now is here, right now, happening all around me.

I'm not sure everyone would agree that it's a good thing but I think I've become even more honest with people since I was diagnosed. I focus on my emotional lily pad and don't worry too much about what the next one will hold or when I will find myself jumping to it.

Just like coping with my diagnosis emotionally, the actual path from not having cancer to finding out I have it to being treated so I can never have it again is a pond too big to jump across.

Hop!

See my GP for a regular physical. She orders a FIT.

Hop!

I eventually remember to go to the lab and pick up my kit and bring it home.

Hop!

I eventually remember to poop on a piece of paper and jab the FIT test stick in it. I do not delay taking the sample back to the lab. After all, who wants to hang onto a sample of their own poop?

Hop!

My GP schedules an appointment to talk about the results. I don't put it off, but instead I go and listen to her as she interprets the result for me. I consent to be referred for screening colonoscopy.

Hop!

A nurse from the colonoscopy screening program calls to schedule a time for me to have about five feet of camera inserted into my colon. I pick the earliest possible time.

Hop!

I buy my first of what seems like way too many bowel preps, change my diet for a week, and then stop eating anything solid on the day before my colonoscopy. I drink half my CoLyte and spend more time on the toilet than almost anyone would want to. I go to sleep and do it all over again in the morning.

Hop!

I take my health care card and a piece of paper with my wife's phone number, wear comfy clothes, and have her drive me to the surgical clinic. I fill out their forms and go into a pre-procedure area and put on one of those ridiculous gowns that do a reasonable job of covering your shoulders and little else. I talk with the nurse who starts my IV and explains what I'm about to go through when they wheel me into the suite.

Hop!

A different nurse wheels me into a room with subdued lighting and a huge monitor and a great big machine that probably goes ping. My gastroenterologist comes into the room and does a double-take before they realize that they know me. They ask if I want analgesics and benzodiazepines.

I do.

A nurse injects 75 mcg of fentanyl and 2 mg of midazolam into my IV. I feel nothing. I'm not even sure that it works. THey ask me to turn on my left side and I do.

Hop!

My gastroenterologist tells me what he's doing and then slides a relatively thin, flexible tube into my anus and all the way up and around to where my appendix used to be. Then he inflates my colon and shows me the scar that used to be my appendix on the great big monitor in front of me.. I introduce myself to another nurse who comes into the endoscopy suite.

I've already met them. I can't remember that. I can't remember how many of the nurses are male and female, what their names are, or whether they are in their twenties or sixties or somewhere in between. I still remember the name of the nurse who started my IV and the fact that, like me, she owns a miniature dachshund.

The midazolam is working.

Hop!

My gastroenterologist shows me two polyps near where my appendix was, then shows me that there are no more in my ascending or transverse colon. As they reach the spot where my transverse colon becomes my descending colon I see what look like shallow craters in the wall of my colon.

"Huh. Have you ever been diagnosed with diverticulitis?" he asks.

"No."

"Oh. Well, you do, but it's pretty mild. Do you try to maintain a high fibre diet?"

"Yes. Always," I tell him.

"Good. Keep it up," he says.

Hop!

He finds the tumour. "Looks like a benign polyp," he tells me. "This might be a little uncomfortable," he says. He has to retroflex the scope and have one of the nurses who I still can't remember help to raise the polyp so he can snare it and cut it out. It bleeds. The camera is only a few millimetres from it so the amount of blood looks truly alarming on the huge scope; the gastroenterologist calmly uses the heated snare wire from the scope to cauterize two large vessels and irrigate the area. The bleeding stops.

The fentanyl has done its job. I feel a mild discomfort and nothing more. He pulls the scope out and tells me everything looks good.

Hop!

I get my diagnosis. Everything is not good, but honestly, it could be a lot worse. I start to rapid-cycle through emotions.

Hop! I get a call from the surgeon's office to set up an urgent appointment.

Hop! I see my gastroenterologist. I talk to my GP. I go for relatively routine bloodwork.

Hop! I have my initial consult with my surgeon.

Hop!Hop!Hop! Flexible sigmoidoscopy. Pelvic MRI without contrast. Chest/Abdomen/Pelvis CT with Contrast for staging.

Hop! See surgeon to get results of CT and MRI and decide on a LAR with total resection of my rectum and anastomosis of my sigmoid colon to what's left of my lower rectum.

Hop! Get surprise phone call from the Ostomy clinic to set up a preop appointment to discuss the ostomy that they say I am going to have after surgery.

Hop! Immediately freak out because my surgeon said there was less than a 10% chance I would need an ileostomy. Hop! Get myself under control when I realize that seeing the ostomy clinic is just being cautious in case I wind up with an ileostomy. Hop! Feel a little embarrassed when I remember that I told my surgeon I was totally fine with having an ostomy.

Hop!

Write my blog post.

Yeah. Writing this blog is one of the series of lily pads for me.

I'm not writing this blog for sympathy - I have no time or interest in that! I'm writing it because the people who matter may not even realize they have questions about my journey until they get the answers in my blog or they might feel awkward asking questions for perfectly valid personal reasons. I'm mostly writing it because it's therapeutic; it helps me process my thoughts and emotions and figure out what lily pad I'm currently on. Finally though, I'm writing this blog because if I can convince just one person to get their mammogram or have their Pap test or do their FIT, I will be happy.

Think of the benefits to that one person if the results come back positive. Early diagnosis leads to better outcomes, so the earlier you undergo the minor indignity of these screening processes - like me - the greater the chance of full recovery. Even better than that, imagine the incredible peace of mind in the majority of people for whom the result will come back negative!

Hop!

On to the next lily pad...

PS - Midazolam apparently works like a charm for me. Did I already tell you that?

PPS - several months after my colonoscopy I realized that I couldn't remember getting dressed after my colonoscopy. AT ALL. I was wearing my peek-a-boo gown, and then I had my clothes on as I held my wife's hand and got on the elevator to the parking lot. To this day - now almost eight months after my colonoscopy as I write this PPS - there is nothing but a pleasant, fuzzy blur between those states of dress.