(Title courtesy of my new friend Joselyn, from the Podcast "Breast Cancer is Boring")
I spent the wee hours of Tuesday morning in the emergency room (ER) doubled over in pain. It started Sunday morning when I woke up with a stomach ache. Between my routine hot flashes that woke me up and the steady belly ache, I tried to suck it up but couldn't sleep it off.
"Its just a tummy ache, get over it. It'll pass."
I chalked it up to my healthy appetite that returned a few days earlier post-chemo #10. Was it the parmesan-crusted sole I had for dinner? The sip of my husband's old fashion? Was it the extra spicy kimchi that I couldn't get enough of during lunch? Whatever it was, I thought, stupid tummy ache; I don't have time for you. Despite the dull ache that continued throughout Sunday and Monday, I went about my scheduled plans. I went to a drive-through baby shower. I met up (COVID-19 style) with a dear friend for coffee. Monday night, I prepped my chemo bag for Tuesday's session and planned the family meals for the week.
Tuesday morning, shortly after midnight, the dull ache I had been having turned into a stabbing pain in my upper abdomen that would not let up. It intensified every half hour. I couldn't find a comfortable position. It hurt, and I felt a bit panicky at the possibility that it would worsen. I have given birth to three kids without epidurals. I've also had gallstones, which I thought was more painful than childbirth. Many people would put those experiences "way up there" on the pain scale. Although this belly pain wasn't "up there," it was creeping up to that pain level, and it most definitely didn't feel normal. I called the medical oncologist on call, and she quickly sent me to the ER. My live enzymes had been creeping up during the last month of my chemotherapy, and she was concerned about my liver and pancreas. So off we went for a 5 am drive to the ER.
A physical exam by the ER Physician. IV fluids for hydration. Anti-nausea medications given (even though I didn't have any nausea.) IV Dilaudid to relieve the pain. Blood work. CT scan. The Physician told me there was a "suspicious spot" in my stomach on the CT scan. "It could be nothing. It could be inflammation like gastritis or a stomach ulcer, and or it could be cancer. With your cancer history, we need to investigate further." Ugh. Sigh.
Certain phrases trigger fear in cancer patients. One of those is "a suspicious spot." The phrase is ambiguous and, I dislike it for that reason. In my story, the words "suspicious spot" lead to further testing, ending with a biopsy, and the eventual devastating confirmation of my breast cancer. It's traumatic.
Hearing those words again, I immediately thought the worst. I thought, "metastatic breast cancer." With stage 3 and confirmed lymph node involvement, it's always a possibility for me. Breast cancer cells are not confined to the tumor(s) in one's breasts. You can have breast cancer in your liver, lungs, brain, bones, and anywhere along your gastrointestinal tract. Once it is in those areas, cancer is considered terminal. The 5-year survival rate for Stage 4 breast cancer is 22%.
I left the ER still in pain, a bit stunned, and sad. I didn't get any answers or relief from my pain, only more anxiety over the possibility of something worse than "just stomach ache." I got out just in time to make it to my 10 am chemotherapy appointment. As I was sitting in the infusion chair waiting to get hooked up for #11 of 16 (yes, I'm still counting down), my Oncologist, Dr. T walks in.
"Jasmine, I'm worried about you. We need to figure out what's going on with this pain."
She proceeded to tell me that she felt it was best to cancel the chemo infusion. Her concern was that it could be a stomach ulcer that could perforate my stomach and lead to an infection or worst. Up until now, I had lucked out on the most severe effects of chemo. I've had no hospitalizations or complications. My body was responding well to this Taxol drug. Other than extreme fatigue, anemia, and a low white count, I was feeling way better than when I was getting the Adriamycin/Cytoxan combo. According to the Physicians I saw, the weekly steroids and chemotherapy I was getting could have been wreaking havoc on my gut. It could be the reason for the acute pain. Or, the "suspicious spot" could be something worse, like a clump of cancer cells. A gastrointestinal (GI) physician would need to perform an endoscopy to look directly into my upper GI tract and perform a biopsy for us to "really know." While we wait for more answers, they would treat my abdominal pain as if it was a stomach ulcer. Only time will tell if this treatment plan will help.
I thought, "Great, more waiting", yet from that point, things moved quickly. The same day, a GI specialist contacted me, and I got an appointment. He expressed the same concerns and was quick to add me to his last appointment slot on Wednesday for the endoscopy.
The fact that things have moved so precipitously worries me. Is everyone thinking the worst, or is it just me? As I write this, I am in the hospital lobby waiting for my procedure. My stomach is growling because I haven't eaten a proper meal in 16 hours. My mouth is dry because I'm nervous but also thirsty. I'm also fervently praying that my CT scan's "suspicious spot" will be confirmed as a stomach ulcer that we caught early. Please let it be an ulcer! If you have ever struggled with stomach ulcers, you don't wish it on anybody. But who prays for one? This cancer patient does. People, I want answers! Having a normal/negative endoscopy exam would be the worst because that would mean
#1 I'm a wimp who can't handle a stomach ache or
#2 That there is no obvious reason for my pain
Even more importantly, I'd prefer an ulcer diagnosis because I don't want it to be cancer cells. Can you say a prayer for me too?