Hindsight is 20/20

As one of my clients, an economist, might say, “2020 continues on brand.”

The past couple of weeks have been a whirlwind of medical tests, waiting for results, and doing my best to focus on work. Yesterday I had a biopsy that appears to confirm a diagnosis of pancreatic cancer. (I am well aware of the seriousness of this diagnosis, so please keep your dire warnings, etc. to yourselves.)

Several friends and family members have asked what prompted me to have these tests. I’m sharing the following in the hope that it may help someone else avoid getting to a place like that where I now find myself, whether with this or some other disease.

A bad snapshot of the kitchen cabinets I was working on in October, 2019, with Jack Patrick’s lower half. (He was setting tile.)

I began to experience vague abdominal discomfort in October, 2019. During a doctor’s visit at the start of 2020 I described it as a sensation similar to what I felt in 2006 when, as it turned out, I had an ovarian cyst. (The cyst was removed laparoscopically and proved benign.) Based on this description, my doctor ordered a pelvic ultrasound in February. It showed up nothing unusual.

The discomfort continued. I tried eating smaller meals and exercising more, not drinking beer, then not drinking any kind of alcohol. I still felt the vague discomfort and mild bloating. Over the summer I had a couple more visits with the doctor; my back had also begun to hurt, and it wasn’t the kind of back pain I’m used to — the kind I’ve brought on myself by 25 years of carrying heavy materials alone in the shop and on jobsites, digging thousands of holes for plants in hard-packed soil, shoveling and carting acres’-worth of topsoil, gravel, and mulch for my gardens, and building limestone paths and retaining walls around the homes where I’ve lived.

Beginning in July, I started seeing a bodyworker who specializes in treating athletes through myofascial release; after several weeks of getting no lasting effects, I went to our friend Dan Selvaggi, a licensed masseur. The massage felt wonderful, but the back pain persisted, and the abdominal discomfort was turning into something I could, by that time, describe as low-level pain.

One of this year’s October/November jobs.

In September or October my mother-in-law, who lives in northern Indiana, was diagnosed with lung cancer — this, after many months of perfunctory tests and balls dropped by her medical care providers, as she found it harder and harder to breathe, her blood oxygen level was so low that she could scarcely stay awake for half a day, and she had to go to the emergency room twice to have fluid removed from the area around her lungs.

After hearing about Jo, I decided it was time I became more assertive (not that I’m generally a shrinking violet; nor would I begin to compare my GP, who respects her patients’ intelligence and genuinely cares about our welfare, with the doctors who have been treating my mother-in-law). I scheduled an appointment with my GP; the earliest available was six weeks out. A week into that wait, I said “to hell with this” and went to the walk-in clinic, where I described my symptoms. I had a battery of blood tests, all of which came back normal, other than revealing a slight vitamin D deficiency. When my doctor received the results, she called me in for an appointment right away — not because normal blood test results would warrant an immediate consultation (that would be illogical), but because it seems to have taken my proactive step to impress on her the depth of my concern. There’s a fine line between being seen as careless about your health and being seen as a hypochondriac. Apparently I haven’t negotiated that line very well.

Based on my updated description of the discomfort, she ordered an abdominal ultrasound. That revealed a mass on my pancreas, as confirmed by a CT scan the following week and a biopsy yesterday.

The point of this post

In retrospect, I wish I’d been more assertive with my GP back in February. The pelvic ultrasound showed nothing abnormal, but the discomfort persisted. I should have insisted on further screening to find out what was wrong.

And even though I can’t think or speak as a medical professional, I do think my doctor should have recommended further screening. I say this not to blame her, but to encourage whoever is reading this to be more assertive than I was in February. My tumor could have been discovered eight months earlier. We all know the importance of detecting any kind of cancer as early as possible.

A late-summer job this year.

The thing is, most patients are not medical professionals. It’s exceedingly difficult, even for someone who writes professionally, to articulate the kind of discomfort I’ve been feeling — and even more, to pinpoint its location. In my case, the sensation feels like it’s immediately under my left lung — not farther back, where the pancreas is actually located. How did it feel at first? It simply felt “amiss.” Something was out of whack, and it was accompanied by mild but noticeable bloating. Another sign: if I had just a few sips of beer or wine, I sometimes experienced a sharp pain in my mid-back. Sugar. Pancreas. The connection didn’t even occur to me. Most of the time the vague, unfamiliar feeling defied description.

I’ll be writing more here as things progress — far less blow-by-blow chronology of symptoms and such than thoughts and observations about sickness and other insufficiently-discussed matters that have interested me for as long as I can remember. I have a meeting with an oncologist next Tuesday at which I’ll get a better picture of where things stand and what kind(s) of treatment may be possible.

Don’t hesitate to speak up for yourself and your loved ones.

Thanks to @magdahiller and @wyattwilson for the “cat cap,” which provoked the greatest laugh I’ve had in a long time.