14th March 2020
I appreciate I only have myself to blame for how it happened.
It was Sunday the 24th November 2019, Sh** Sunday, as it has come to be known.
I’d found the mass the previous Monday. I’d had a niggly pain in my right side so decided to examine myself on my couch at work, as you do. I’d had no reason to examine myself before then – I’d had no pain, no weight loss, I felt fine. I got the shock of my life when I felt it.
It felt so odd, like an orange sized mass that was firm and shifted upwards under my fingers as I palpated my abdomen more deeply. I had examined myself during a break between patients. I don’t really know what possessed me. This was clearly not good. What the hell do I do?
I carried on my morning surgery. What else was I meant to do? I got back on the couch after every subsequent patient, just to confirm my findings – I wasn’t imagining it was I? I debriefed my registrar and then saw my colleague. He’d known the saga from the start, been aware of every investigation and every outcome. He’d tried to reassure me initially, way back in December, nearly a year earlier, that common things are common – young, fit, no symptoms other than the anaemia– far more likely to be angiodysplasia than anything else.
“I’ve got a right sided mass”, I burst in to tears. His face dropped. He’d known I’d been worried about cancer from the outset. “I hate to ask but can you feel it?”, needing the confirmation that I wasn’t imagining it. “Of course”. I got up on the couch.
“I don’t need to feel it, I can see it”. I fast tracked my bloods at work, left early, my colleagues covering the back end of my afternoon surgery and I saw my own GP. Another 2 week wait referral, appointment came through for 10 days later.
I went to work that week. It was better than the alternative, sitting at home, worrying. At least I could be distracted at work.
That Sunday morning, I woke at 4.30 am with quite severe right sided abdominal pain. I was worried about possible bowel obstruction and laid in bed thinking “out of hours, or A & E, out of hours or A & E…”
I do a weekly shift in our local Out of Hours centre and figured that if I was on the receiving end of the phone call, I would more than likely advise A & E. So I showered, dressed and called a taxi. I explained to my husband what I thought might be happening and set off for A & E. Having three young children meant this was going to be a solo trip – certainly at that ungodly hour.
The dregs of the Saturday night crowd were still in the waiting room, but it was pretty quiet.
I processed through the system fairly quickly – triage, bloods, first given a chair in a bay before being assigned a cubicle.
The registrar was lovely. She felt the mass. Decided on an ultrasound first to rule out ovary problems with a plan for CT after.
Needless to say the ultrasound was clear. I knew it would be. Then on to CT and transfer to the Clinical Decisions Unit.
“There’s a bit of narrowing in the ascending colon and another polyp, so we’re going to ask the surgeons to see you”. I guess it wasn’t her job to give me the diagnosis.
My husband arrived soon after, having dropped the children off at friends.
Off to Surgical Assessment and then we saw the surgical registrar. He took my history, examined me and then discussed the scan. The talk was that the lesion was suspicious. It could be cancer, couldn’t say for certain. I’d need another scope and MDT. No specifics. Non-committal. I guess it’s how we are all trained to do it…give nothing more than a warning shot until you have the confirmation of histology.
I always knew they’d need tissue confirmation, but given the slightly vague nature of the discussion I had assumed that the CT scan might say something along the lines of “suspicious looking lesion but need biopsy/further assessment for confirmation”. Perhaps hope over expectation.
Plans were made, I needed another scope, but the wait would be as long as an in-patient as an outpatient. Given this was going to be my 4th lot of bowel prep in a year, I’d sooner have the prep at home thank you very much.
The registrar left and the foundation doctor came to sort my discharge out. I asked for a copy of the CT scan report– simply because I was seeing my friend the following day, a colorectal surgeon – and thought it would be easier for me to ask her questions knowing what the scan showed.
I asked if it would be possible to have a print out, or to take a screenshot of the report with my phone. “Of course.” He was so kind, and obliging, and took my phone.
Would I have asked if I wasn’t a doctor? Probably not. Would he have been more reluctant or hesitant had I not been a doctor? Probably.
I don’t know if he’d read the report before giving me back my phone with a smile, “Here you go”.
I didn’t bother looking at it straight away, but after a few minutes I read the report. My stomach dropped. I felt sick.
“…5cm segment of ascending colon…significantly narrowed lumen…constricting mass lesion…bowel wall thickening/mass…2.3cm polypoidal lesion…” “Comment: colonic mass, highly suspicious for malignancy. Please refer urgently to the colorectal MDT.”
Well there it was. There was no sugar coating it. Full on, in your face. No two ways about it.
And that is how I found out I had cancer.
And then armed with this information, I broke the news to my husband.