Category: cancer

Craig’s Colorectal Cancer Crisis: Part III

I had lost my ass. Not in the colloquial sense, like when a chronic gambler loses at the casino. I mean in a literal, inside and out sense.

The rectal resection surgery took most of my rectum. How much, I can’t say exactly, but when I asked my surgeon he said, “Most of it.” The reason they took so much was because no one was sure if the cancer had spread to the lymph nodes surrounding the tumor, so they took as much rectum as they could without my losing it completely.

To add insult to injury, because I was in the hospital with the ileus for so long and unable to eat, I lost 40lbs in just about four weeks. The weight loss stole my best feature–my perky butt. I was aghast when I went to shower, looked in the mirror, and saw that I now had a flat ass. It really drove home just how much cancer was going to take from me. Unfortunately, over the coming months this wouldn’t be the worst of my ass-related trauma.

Losing that much weight in such a short period of time has significant repercussions. Stupidly, when I was finally allowed to go home on January 14th, I thought that as long as my ileostomy continued working I would recover and start getting back to normal within a few days. Nope.

The weight loss had weakened me severely and exacerbated other issues, like the neuropathy in my left leg and both feet. For the first week or so I had very little energy and spent most of my time in bed. Stairs were a challenge, and I was often left winded just climbing the 13 steps between our first and second floors. When I tried to help with chores, like dishes, I needed to take frequent breaks because of fatigue and pain in my back and legs. Even showering was difficult.

Taking care of my son in a way that included more than sitting on the couch and watching him play or, if he felt like interacting with me, reading to him was a non-starter. I was home, but in some ways I still wasn’t able to be with him like any parent would want.

Elijah took some time to adjust to my return. While he’s always preferred Hanh in certain ways–kid is a mama’s boy–he had understandably come to rely on her for everything over the month I was gone. I wasn’t a stranger to him, not exactly, but there was definitely some distance there that was tough to acknowledge. Bedtime was especially difficult. I couldn’t help because I couldn’t lift him, and he became so reliant on Hanh helping him to sleep that if she left his room before he was in a deep sleep he would throw a tantrum. Basically, we had entered sleep training all over again.

Gradually I was able to increase my movement, then start helping with chores and child care, until my strength and energy returned to the point where it wasn’t a tragedy if I was unable to get a two-hour nap in during the day. After a month or so, maybe around mid-February, I generally felt pretty good day-to-day. The neuropathy hadn’t gone away (it never will), but I was able to do chores and even some light exercising with an elliptical and exercise bands.

I was also able to take care of my kid again. Honestly, the best exercise I have available is carrying around my 30-pound son. As my legs got stronger, the pain I felt in my left leg dissipated. It’s still there if I focus on it, but I rarely notice it on most days. Before the reverse ileostomy I was able to spend entire days with my son on my own, something that was unthinkable in January.

Caring for and adjusting to my ileostomy was a more difficult challenge. I’ll write a more detailed post about what it’s like living with an ileostomy somewhere down the line. For now, I’ll just say that it took a while for me to adjust. Not only seeing a section of my small intestine protruding from my abdomen, but learning how to manage my output. Diet is tricky with a stoma, especially if you want to live an active lifestyle and not be tied to a bathroom all the time. Eventually I learned enough about my stoma that I could sit through John Wick 4 without bursting a bag. Aside from my anxiety over the reversal surgery, there was never a time when I wasn’t counting down the days until the ileostomy was gone.

And that brings me to the story of what I came to call “Butt Stuff March.” It started with a late February check-in with my surgeon. After the health issues I’ve experienced for the past year, I’ve become a firm believer in radical transparency. If something seems weird, I’m going to mention it. Even if something doesn’t seem weird, I want my physicians to have a full understanding of what’s going on with my body just in case something is wrong that I wouldn’t know to recognize. It was with this belief in mind that I told my surgeon I was still having some bloody bowel movements.

I use the term “bowel movement” loosely, here. With an ileostomy you technically don’t have bowel movements. Food can’t make it that far into your bowels for any movements to take place. That said, your bowel does still produce mucus that needs to be flushed. In that sense, you still have to sit on the toilet and move things from time to time. In my case, sometimes I was only moving blood.

My surgeon was concerned about this. Early on it was expected that I would have blood sloshing around in my colon because of the surgery, but that should have been gone by now. He worried I had somehow developed a leak in my anastomosis. If we reversed the ostomy while I had a leak, it could kill me. At the very least I would get very sick. “I’m going to do a digital exam,” he said. I’ll spare you the details, but I did text my wife afterward to say 0/10, would not recommend.

The digital exam didn’t result in anything conclusive, which was actually encouraging because if there was something conclusive it would have meant something was terribly wrong. My surgeon outlined a plan for the next few weeks. A sigmoidoscopy with a stiff camera to see if anything was wrong up there, and then a barium enema that would show if there were any leaks.

The following Monday I had the sigmoidoscopy. I was put under general ansthesia and nothing seemed amiss, but I was quite sore afterward. The Monday after that, March 13th, was the barium enema. You aren’t given anything for enemas. You just go in, they shove a tube up your ass, pump your colon full of fluid, take x-rays, then send you home. I assumed that it would be easier than the digital exam. I was wrong.

I laid on a hard, cold table on my left side, with my right leg pulled up toward my chest. Before they started the procedure I caught a glimpse of the enema catheter and was surprised at its size. In hindsight, perhaps this was a mistake. It probably made me tense up. The nurse started the insertion and I was in immediate discomfort. The doctor, bless his heart, tried to help me relax by talking me through it, but I was in genuine pain. The nurse struggled to insert the catheter, even asking if I’d like to do it (I assume because sometimes people either have some experience doing at-home enemas or at least know their own bodies well enough to navigate the insertion process–at the time I had neither). I declined.

After an excruciating minute or so they gave up and said they were going to try a foley catheter, which is much smaller. The problem we faced was that with a small catheter I wouldn’t retain the fluid that helps x-ray clarity, which means the results would be suspect. They successfully inserted the smaller catheter, started pumping the fluid into my colon, and I almost immediately felt it coming back out and spilling down my leg. They asked me to clench. No dice. This wouldn’t work.

The doctor came to me and said they were going to try the full-size catheter one more time. If I was in too much pain, or they couldn’t get it in, they’d give up and my surgeon would have to figure out another way to check for a leak. He explained that for most people, the initial discomfort goes away after 30 seconds or so. The nurse rounded on me again and this time was able to insert the catheter and inflate the balloon that was to keep all the fluid inside me.

Unfortunately, the discomfort did not dissipate after 30 seconds. In fact, I was in quite a bit of pain the entire time. But I got through it. Afterward, I voided the liquids that were in my colon and asked if it should have a red tint. The nurses replied that the fluid should be clear. Apparently I was bleeding. Again, I spent the rest of that day and the next quite sore.

A few days later my surgeon gave me the results of the enema. It was a good thing I had stuck it out, because they found a leak. My ileostomy reversal would need to be delayed at least two months. I was also to go in for another colonoscopy with the intent to find the leak and patch it in the hopes it would heal faster. That Friday, March 17th, I met the specialist who would do the patching. She explained that with leaks as small as mine there was no guarantee they would even find it, let alone be able to patch it.

“Butt Stuff March” continued the following Tuesday, March 21, with two at-home enemas and the colonoscopy. The at-home enemas were easier on me than the barium enema, although I also don’t think I did them 100% correctly. I did them well enough that my colon was clean for the specialist, but only barely.

As you can imagine, I was pretty down as I headed to the hospital for this next procedure. Nothing had gone my way over the last several weeks, I was in a lot of discomfort from weekly plundering of my backside, and the specialist seemed pessimistic that they would even be able to do anything about it. I was put under general anesthesia expecting the worst and telling one of the nurses how much I missed my cat in the moment. The adorable demon below, specifically.

I awoke some time later already resigned to the fact that my ileostomy would be with me for at least two more months, if not longer. I had read stories from other people on ostomy forums that had their ileostomies for years before getting them reversed. A nurse approached and told me that they didn’t find any leak. They had shot fluid into my colon and it didn’t go anywhere.

I started to cry, then had to explain to the nurse that they were happy tears. The specialist eventually came by and explained that my anastomosis (i.e., where they had stapled my insides together) had formed a pouch that caught the fluids they shot up there. The x-ray misinterpreted that as a leak.

I was good to go forward with the ileostomy reversal.

Craig’s Colorectal Cancer Crisis: Part II

This is probably the best I looked during my hospital stay.

If radiation and chemotherapy were bad dreams, I was about to walk into a full-fledged nightmare.

On December 16th, 2022, my wife dropped me off at the hospital before sunrise. I walked in alone, stripped down and changed into a gown, and was met by a small parade of doctors and specialists. I don’t remember what order they came in, but I spoke with my surgeon, an anesthesiologist, an ostomy nurse, a urologist, and various other nurses who took vitals and stuck me with needles. We were delayed starting the surgery because the computer systems were down, which meant that any orders for medicines like pain killers weren’t being filled. My surgeon gave me the choice of delaying the surgery for another day, or going through with it (the surgery itself wasn’t reliant on those systems) and betting that the system would be back up by the time we finished the procedure. Considering that I knew the surgery was complicated enough to last at least six hours, I bet that the systems would be back up. Perhaps this was an omen for what was to come.

They wheeled me through the hospital into where I assume the surgery happened and knocked me out. I remember very little going into the next day, but from what my surgeon told me afterward my anatomy was a little harder to work with than they expected. Apparently, some of my organs stuck together, which led to more manipulation of my insides than is normal for this type of abdominal surgery.

When I finally gained some semblance of consciousness again (anesthesia really fucks me up, apparently), I had six new scars around my abdomen and a stoma covered with an ostomy bag. After they fully heal, the scars won’t be that large because the surgery was robot-assisted laparoscopic surgery. The incisions were painful for a few days, but healed pretty quickly. The stoma, on the other hand, is a physical and emotional challenge.

Because my tumor was on the upper end of my rectum, close to the colon, my surgeon removed a good chunk of it and then reattached what was left. This type of surgery can take up to two years to heal, though everything is able to function again after a few months. But, since I’ve lost the ability to use my rectum while it heals, I need another way to pass waste from my body. To do that, I was given a temporary ileostomy. The end of my small intestine was pulled to the outside of my abdomen and manipulated so that it has an opening to pass waste. I have an ostomy bag to cover the stoma and catch the waste. It’s as inconvenient and gross as it sounds. I’m lucky that my ileostomy is temporary. If my cancer was lower in my rectum, they may have had to remove the entire thing and the ostomy would be permanent.

That said, adjusting to having a stoma (CW for a picture of a stoma at the link) and watching waste pour from it into a bag is difficult, mentally and emotionally. The surgeon, ostomy nurses, and a few other nurses talked to me about how many people with new ileostomies can’t even look at it for a long while. They need help cleaning the stoma and changing the bag. I didn’t have this problem. Not because the stoma and bag don’t bother me, they very much do, but because I’ve always had a “deal with it and move forward” mindset. Within my first few days at the hospital I met with the ostomy nurses who showed Hanh and I how to clean and care for my stoma and change my ostomy bag. At first, I needed help from Hanh or a nurse to change the bag, and I still need help sizing the bag’s opening to my stoma (I suck with scissors), but now I prefer to do it on my own. It’s messy, embarrassing business, and I think it’s best I handle it myself.

Despite all that, the surgery can be considered successful. Even though I ran into myriad problems while recovering over the next month, the surgery accomplished some important things:

  • The cancer was totally removed with good margins. While doctors don’t like to say “cancer free” because there is always risk of recurrence, there is high confidence my recurrence rate is very low.
  • There is no leaking from where my rectum was reattached to my colon. That’s good, because it could kill me.
  • My bowels didn’t become twisted or anything else that would lead to another surgery. Everything is in its right place.

What I did have was a nasty ileus. For the link-impaired, an ileus is basically when your intestines stop working. That means they’re not pushing anything through, which leads to bloating, distension, cramps, and eventually vomiting. In most cases, an ileus will resolve itself within a few days. For me, it took weeks. Weeks of being unable to eat without cramping, nausea, and vomiting.

The first few days, maybe even the first week, is fuzzy. I was in a lot of pain, unable to eat because my stomach was distended. I slept as much as I could. I have flashes of memory in this time–briefly waking from my anesthesia stupor to hear the nurses commenting that I still didn’t have room (from what I can piece together it took the hospital over eight hours to get me a room after surgery); when I was finally in a room, a nurse asking me if I could stand, trying to help me, and the room spinning out of control; apparently answering some texts and a phone call with a friend I don’t remember; and having my urinary stents and catheter removed (felt weird!).

I had multiple catheters during my stay. Because of my bloat, plus a hematoma resting somewhere below my bladder, there was pressure on my bladder that made it so that I was retaining urine. The worry, then, was that the urine would backup into my kidneys, causing even more problems. The first time I had a catheter put in (while I was awake, anyway), I warned the nurse I was going to be a big baby about it. I laid flat on my back and held onto the rails of the hospital bed for dear life, not sure what to expect but assuming it wasn’t going to be pleasant. The nurse pinched the tip of my penis, then inserted the catheter into my urethral opening (a.k.a. my pee hole), sliding it up through my shaft and into my bladder. It felt weird, but wasn’t painful, and I thought that wasn’t so bad. Little did I know how bad it could get.

The second time was similar, if a bit more unpleasant because the nurse had a harder time moving the catheter past my prostate. The third time wasn’t even supposed to happen, which was mistake number one. See, I had an agreement with my surgeon that as long as the urine in my bladder didn’t exceed 600mL we wouldn’t use a catheter. At this point I was peeing okay. Not great, but well enough to keep the levels down. Every six hours I would be given an ultrasound on my bladder and most of the time there was around 550mL of urine sloshing around in there. Not great, but below our agreed-upon threshold. One morning, a urologist I hadn’t met before visited me and we talked about my issue. No big deal, lots of random doctors and specialists would come talk to me. She left and I thought nothing of it. Later that day, I was given another ultrasound. The numbers were as they usually were, but this time the nurse said the threshold documented in my charts had been lowered to 300mL. She would have to give me a catheter to empty my bladder. Hanh was with me at the time and we were both confused. But, I figured, it was better to empty my bladder and maybe not have to worry about it for a while than to keep playing this game. Perhaps I was too trusting of the urologist and this nurse, but I consented to having it done.

We went through the same process as usual, but when the catheter was inserted I felt the sharpest pain I’ve ever felt in my life. I tensed and the nurse told me to relax. For those that don’t know, that is the worst thing to say to someone who is in pain. She kept pushing the catheter through and I cried out, “I’m in so much pain!” to which the nurse replied with another relax, once again making the situation worse. Finally, the catheter reached my bladder and the pain stopped. She only kept the catheter in as long as it took to drain my bladder. Even as she removed it, I knew there was no way I was going to allow that to happen again.

About an hour later, I felt the urge to pee. I went into the bathroom with the container they wanted me to pee into in order to measure my output, and struggled to go. I couldn’t see what was happening beneath my gown, but what was coming out felt thick and warm. Finally, I lifted my gown to see what was going on. There was blood all over the container. The catheter had cut me somewhere.

I called to Hanh to find a nurse. She ran into the hallway and, after one failed attempt, found one. The nurse came into the bathroom, begging me to stay calm and not pass out (I wasn’t going to–I genuinely wasn’t panicked about it), and checked me for a cut. They had me bleed into a container until it clotted. Afterward, I had to wear special underwear with a pad until we were sure the bleeding was over. Word of what happened eventually got around and a few doctors apologized for the trauma, and advised me not to consent to another catheter. I whole-heartedly agreed.

In time, it became clear that my ileus wasn’t resolving quickly. That’s when we had to start the gnarly treatments. Because my digestive system wasn’t moving anything through, there was a build-up of fluid and gas inside my stomach. Cramping, a truly disturbing amount of vomiting, etc. To relieve this, a doctor gave me a neogastric (NG) tube. It’s a long plastic tube that goes into your nose, curves down your throat, and rests in your stomach. It’s attached to a suction device that pulls excess fluids and gasses from your stomach into a container to be measured and disposed. While “tubed,” you can’t eat or drink anything. All of your nutrition comes from IVs.

As I had this first tube inserted, I gagged and vomited all over myself. Panicked, unable to breath, I wanted the doctor to stop and come back to it. To his credit, he remained calm and finished the procedure, then helped me to clean up. Embarrassed, I actually later apologized to him for panicking. He took it in stride and said it was a natural reaction. I would be “tubed” three more times over the next several weeks. The longest I had a tube in, meaning the longest I couldn’t eat or drink anything, was about a week.

At one point, while with tube, my surgeon ordered x-rays that required contrast in order to see what my digestive system was actually doing (spoiler: not much). They gave me the contrast via the NG tube. It was a strange feeling to feel the liquid going down my throat and into my stomach through a tube. The x-rays themselves weren’t too bad, outside of the annoyance. They brought the machine right into my room (most of the time), rolled me over, put a hard plastic square under me, and then took the x-ray. It was a five-minute process, but when I had the contrast they had to take x-rays every hour or so, which meant I got no rest.

Rest is a problem in hospitals. All day and throughout the night you’re dealing with noise like alarms going off (my IV especially liked to shriek randomly about bubbles and blockages); light from the hallway; and frequent intrusions to get medication, take vitals, or be looked in on by a nurse or doctor. For a light sleeper like me, that meant I’d be lucky if I could string together two hours of solid sleep before being awaken.

The 4:30-5:00am blood draws were most annoying. The doctors need the results when they come into work, so the lab draws your blood at this time, which means being woken up. My surgical team would typically come in between 6:00 and 7:00am to check on me and give me updates on the recovery plan. Breakfast (if I was allowed to eat) would come at 8:00am. Vitals would be taken every one to two hours. In short, solid blocks of sleep were almost impossible. Early on, during my first hospital stay, I would go to sleep not long after dinner. After I was readmitted to a different hospital, I tried to take naps in the mid-morning, after my doctors visited, and sometimes in the afternoon.

Yes, I said readmitted. I was initially discharged on January 1st. My ostomy had been producing (perhaps too much, in hindsight, since I burst bags overnight twice) and I was able to eat solid foods without getting bound up. We all thought I was finally in the clear. I went home, greeted my cats, and we finally opened our Christmas presents. I sat on the couch, watching Elijah open his gifts, and felt exhausted. Exhausted from everything that had gone on in the hospital, but also an overwhelming fatigue. I went upstairs to the spare bedroom, which Hanh had set-up with a TV, bar on the bed to help me get up, and a tea station. Eventually, Elijah came upstairs to visit. After not seeing him for weeks, I lost it. I held his hand and cried. He wasn’t quite two years old, yet, but I think the weight of everything became clear to him in that moment. He patiently waited for me to finish sobbing before he took his hand back, and then he stayed with me a bit longer. Everyday afterward he would ask Hanh to come upstairs so he could “check if Daddy is okay.”

While home this first time I only ate two meals–chicken and white rice for dinner, and toast and eggs for breakfast. My ostomy was producing, but very slowly. I started to feel full and had a lack of appetite. We called the surgeon and was told to try a liquid diet. I still wasn’t able to take much in. On Tuesday, January third, I had cramps and vomited that night. We again talked to my surgeon and he told me to come into his office. He said the sooner the better, but I wanted to wait overnight to see if I felt any better. The next morning we went in.

I wasn’t readmitted right away. First, my surgeon saw me at his private office and digitally penetrated my ostomy to check if it was too tight for food to move through. That wasn’t the case. At somewhat of a loss, he recommended I go to the hospital across the street and readmit myself through the ER. I took his advice, and my wife and I sat in the waiting room for a room to open up. I cried again, frustrated that we were starting this process over again. Eventually, I was put on a stretcher in a room in the ER. I was given another NG tube (I vomited again, but this time the tube caught it before it came all the way up–how fun!) and a PICC (peripherally inserted central catheter) line.

I had a PICC line at the first hospital because it was the only way I could get nutrition. The PICC line is used for many things, but primarily ingesting a total parenteral nutrition (TPN) bag. It’s basically a minor surgery done right in your hospital bed. A specialist comes in, sets up an x-ray machine, numbs your arm, then inserts the PICC line through your arm and into a vein near your heart. It’s mostly painless, but getting it a second time clued me into the fact that this stay wouldn’t be a short one. I wouldn’t be discharged again for another ten days, on January 14th.

Aside from the NG tube, this stay was a bit easier. The hospital was nicer, with a private room, and I was already on the mend so my discomfort level was less. I had to keep the NG tube for nearly a week, which sucked, but by the end of the stay I was able to eat full meals. My ostomy bag was producing consistently, maybe even too much, and I was eager to go home. I had spent enough time away from Elijah and Hanh.

My saving grace throughout this ordeal was Hanh. She visited me nearly everyday, staying hours so I wouldn’t be alone. She acted as my nurse when I needed her to, helping me to change my ostomy bag, cleaning my hair since I couldn’t shower, and getting me water. She even brought in a mattress pad because the hospital bed was so uncomfortable and let me borrow her iPad to buy a bunch of movies to pass the time. The reason she was able to spend so much time with me was twofold: 1) lucky timing meant she was on winter break from work for the entire time I was hospitalized and 2) my sister, Marisa, drove up from Virginia a few times to watch Elijah. Without those things, I would have had a lonely stay.

I’ve spent this entire long-ass blog post describing how traumatic my hospital stay was, but I also want to recognize that the medical professionals I dealt with were largely great. I trust my surgical team completely, and all of the nurses that took care of me (apart from two I had to side-eye) were great. Hospitals are inherently uncomfortable. Many medical procedures are inherently uncomfortable, painful, or traumatic. It’s no one’s fault. It just is what it is. And, to be more objective, things like the NG tube are legitimately helpful. Rationally, I understand all of this. Emotionally, I’m not looking forward to my next surgery in March to reverse the ostomy. But, until then, I’ll work on getting stronger.

Craig’s Colorectal Cancer Crisis: Part I

My attempt at adding some sex appeal to radiation treatments. I think I was successful.

On May 11th, 2022 a nurse woke me up from my anesthesia-induced sleep, waited as I scrambled to regain my wits, and then told me that the colonoscopy had found a tumor. I started to cry. She assured me it could be benign. I knew the chances of that were slim. Five days later, on May 16th, my gastroenterologist called me to tell me that my biopsy results were what we had feared. I had cancer. I cried some more.

What had brought me to that point was months of consistent blood in my stool. It started in late December of 2021 and, at first, I didn’t think much of it. Rectal bleeding is common and often clears up on its own. Wasn’t the first time in my life it had happened. Except, this time, the bleeding only got worse with time. In March, 2022, I was finally able to see my primary care doctor. The initial thought was hemorrhoids. However, my doctor recommended a colonoscopy just in case. After another month, I had a consultation with the gastroenterologist and was given a choice: a 30-day prescription for suppositories or a colonoscopy. I figured if I had to shove something up my ass, I’d prefer for it to be for one day and know exactly what was going on rather than 30 and still being unsure. It was the right choice.

There’s a strange type of liminal space after receiving a diagnosis, but before getting a prognosis. I had no idea what stage the cancer was, what my chances of survival were, or anything else. In a situation like that, how can you not expect the worst? I thought about my ambitions. I had just finished the first draft of a novel I was excited about and now knew the chances of my finishing and publishing it were slim. I had the entire year planned out with projects to further my writing and filmmaking ambitions. I never thought 35 would be too old to pursue your passions. I wasn’t filled with regret, my life is truly too good for that, but there was a disappointment and frustration that I might not be able to accomplish my goals. That said, as my feelings evolved, I realized that there were plenty of other things I had accomplished.

I thought of my then 15-month old son, Elijah, and my wife, Hanh, and how I might take care of them after I was gone. I wrote letters to Elijah and documented my favorite poems and songs in a notebook. I made Hanh the beneficiary on everything I own. I did what I could to continue providing.

And that’s when I started to realize that, if we have any purpose at all in such a cold and random Universe, they were it. I’ve come to believe that there are two types of people in this world: 1) doers and 2) facilitators. Doers are those people that make tangible change in the world. They accomplish great things and affect lives positively. But, they can’t do it alone. They need facilitators. Those people that support them while they’re in school, or do the chores while they’re running events or working, or myriad other things that keep our lives together even when time is tight.

Hanh is a doer. She’s out there in the world getting degrees, changing lives, and being a leader. My purpose, if I ever had one, was to help her get to that point. I did that. We also had Elijah, who I know is going to accomplish great things. He’s already shown so much potential, is so smart and has so much love in his heart, that it’s inevitable. If my purpose was to support Hanh as she finished school and started her career and to bring Elijah into the world, then mission accomplished. My life was worthwhile. That change in thinking helped me cope a bit easier while I lived in that liminal space.

Once we knew I had cancer things moved more quickly. I consulted with multiple oncologists, radiologists, and surgeons from Crozer-Keystone and Fox Chase. I wasn’t eligible for any experimental or novel procedures, so the process for fighting the cancer was the same between both institutions. I chose Crozer-Keystone because their facilities were much closer to where I lived. In this time, we learned that I had Stage III and that my prognosis was good. I was young, relatively healthy, and the cancer hadn’t spread. All reasons for optimism.

I continued to work. My employer has been extremely supportive throughout this process. They’ve given me time off as needed, helped me to navigate our fucked up healthcare and insurance system, and my coworkers have sent me gifts and professed their support. I’m extremely grateful to have that. Many people don’t.

I went down to part-time work in July, when I started radiation treatments. Every day I stripped naked from the waist down, put on a gown, then lay facedown on a giant machine that shot lasers at my bare ass. After each session I would feel nauseous and tired. I would go home, try to eat, and rest. It was all I could do in the latter half of the day, until I had to pick Elijah up from daycare. I got used to the routine, but it was also exhausting. By the end of the process, I had permanently lost most of my pubic hair but was assured the radiation missed my testes, so I hadn’t lost the possibility of having another child in the future. Unfortunately, surgery may have taken that choice from us.

Radiation ended on August 15th, my wife’s birthday. When we looked at the latest scans, it looked as if the tumor had shrunk by about 2/3rds. That part of the treatment was successful.

I met with my oncologist and told him I wanted at least two weeks off before we started chemo. He agreed, and in hindsight I should have done three. Two wasn’t enough. In that time I went in for my first surgery–port placement. The port is how the chemo is delivered to your body. It’s a small, circular plastic piece that is implanted just under your collarbone. A catheter connected to the port is attached to a vein near your heart. I’m still not used to it. Every time my hand brushes by it when I scratch my chest or wash myself in the shower I shiver a bit.

Chemotherapy began on August 30th. I should have had the port installed earlier, as I was still bruised and healing during that first treatment, which led to a lot of pain as my port was accessed. Little did I know, the pain felt on that day was nothing compared to what I’d be in for a few months later.

The hair on my body has been a major problem when accessing my port or doing anything, really.

For three out of every 14 days (in other words, three days on and 11 days off), I would be poisoned with the hope that the chemo would kill the cancer before it killed me. There were days, particularly the days following the chemo treatment, where I wasn’t sure we would win that race. The fatigue was all-consuming. I often felt sick. This was a difficult time. I did my best to carry on normally, unable to face the fact that things were no longer normal. I wanted so badly to be better already, to just return to the way life was before the cancer, but the journey was so long. As we neared the end of my six treatments, my white blood cell counts kept dropping. I was given a shot to stimulate their production. Part of me hoped that my body wouldn’t be able to keep up and we would end this part of treatment early. It’s a weird compulsion, I know, but by this point I was so tired of treatments and needles and drugs. I wanted it to be over.

Chemo finally ended on November 10th, nearly five months to the day from when we initially found the tumor. By the end, I was glad to be past chemo and sincerely thought that would be the most difficult part of the process. Through chemo I had developed two blood clots, one in my leg and one in my lung, that put me on blood thinners. Otherwise, to steal a phrase from every mid-2000s pop punk band, I was just sick and tired of being sick and tired.

There were more tests and imaging to do, but I had a brief respite before going to surgery. I increased my hours at work, spent time with my family, and did my best to relax. In my head, I figured surgery would be the easiest part of this whole process. My understanding was that after surgery I’d be in the hospital for three to five days, on a lifting restriction for two weeks, and then from there I would be in the clear. What I didn’t expect was the sort of complications that would keep me in great pain and discomfort for nearly a month.

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