As It Turns Out, You Can Feel Healthy and Have Great Checkups, and Still Have Cancer . . .

June 15 - Julie receives a forwarded email, an animation of a woman walking from one woman’s house to another’s, spreading the word about the symptoms of ovarian cancer. Julie reads the symptoms, and calls her doctor and makes an appointment. (More on her symptoms at the end of this post. If you’d like the email to be forwarded to you, request it from Diane at jakipp@comcast.net.)

June 18 – Julie is examined (internal exam) by a nurse practitioner who finds nothing to be concerned about, no tumor is detected, her ovaries feel fine, but the NP gives Julie the option of having the CA125 blood test. (From http://www.medicinenet.com/: “CA 125 is a protein that is a so-called tumor marker or biomarker, which is a substance that is found in greater concentration in tumor cells than in other cells of the body. In particular, CA 125 is present in greater concentration in ovarian cancer cells than in other cells. CA stands for cancer antigen.”)

June 22 - Julie has the CA125 blood test. Her number comes back as 225, definitely elevated (under 35 is preferred) but not necessarily alarming; some people have numbers in the tens of thousands, and the test is known to have a high rate of both false positives and false negatives.

June 25 – Julie has an ultrasound which shows a tumor. Her doctor says she will definitely need surgery, cancer is a possibility but not a given, and the doctor wants Julie to see a gynecological oncologist in Spokane, Dr. Melanie Bergman.

July 10, Friday – This was the soonest Dr. Bergman could see Julie for an exam and consultation. The doctor has a rare cancellation in her surgical schedule, only three days away. Julie takes the spot; she’s had enough of waiting. She tells the doctor to take out everything that can be taken out.

July 13, Monday – Those waiting at home and at Deaconess Hospital begin to fear that the “benign” outcome that we were so sure of is not going to happen as the surgery takes longer than expected. Finally, the doctor tells Joe and Rob (Julie’s brother) that Julie has stage 3C ovarian adenocarcinoma, that surgical “debulking” was done (removing as much of the cancer as possible), and that Julie will need intraperitoneal chemotherapy as well as “regular” intravenous chemotherapy, so a port was installed during surgery to facilitate this. (Intraperitoneal chemotherapy delivers chemo drugs directly to the abdominal cavity.)

July 13 through 18 – Julie recovers in the hospital. She does well physically, and her attitude, unfailingly, is very positive. She is the favorite patient of all her nurses. On Friday a second port is installed for the intravenous chemotherapy. She goes home Saturday July 18 and continues her recovery there.

July 31 – Follow-up appointment with Dr. Bergman; everything looks good.

August 5 – A port check is done on the abdominal port pre the first chemo treatment. Bad news – the port is not functioning properly; scar tissue evidently formed after the surgery and since the chemo can’t go everywhere it is supposed to within Julie’s abdominal cavity, that therapy will not be done. Quel désappointement! (French doesn’t really make this any better.)

August 11 – First chemotherapy. Carolyn (one of Julie’s sisters) accompanies Julie to Cancer Care Northwest in downtown Spokane. Julie initially has some reaction symptoms (understandably, her body is not thrilled with being poisoned; reactions are common) but they subside. Chemo goes smoothly.

August 14 – Julie has typical fatigue for some days after chemo. The third day is the hardest, she has “achy bones” – in particular, her feet, ankles, and legs hurt. By the next day, the worst is over, just the fatigue remains but it lessens daily. Initially it looks like Julie’s hat collection (courtesy of talented friend Kathy) won’t be needed quite yet as there is no hair loss, but after a week to ten days, strands begin to fall out in large numbers. Julie has very thick hair – she can lose quite a bit before it becomes noticeable. She had her hair cut short a few days before, a transition step to help everyone get used to her looking different, before the anticipated complete hair loss.

August 21 – The neck pain starts, as detailed in August 25th’s post, “The Fun Never Ends.”

Note about Julie’s symptoms: Of the dozen or so typical symptoms of ovarian cancer, Julie had only 1 ½ - she had had a gassy, bloated stomach for a couple of months, and very mild constipation. Both are very common for many, if not most people, at least occasionally – see the “Warning Signs/Symptoms of Ovarian Cancer” post. In addition to the symptoms usually listed, Julie had two others, both of which indicate the presence not of cancer but of a tumor. For a couple of weeks, she had felt a “hardening” in her abdomen; at the time, she wasn’t even sure there was a change and it was only in retrospect that she realized the significance. She also felt some discomfort when bending over to tie her shoes, but she attributed that to (actually non-existent) weight gain. In the earlier stages of Julie’s cancer, she had no symptoms.