Cancer - The Great Complicator

Cancer. Some people call it The Great Complicator. Never heard that? Well, some people do say it. In Canada. The North of Canada. No the Northern part of the North. Whatever, the point is, to say that cancer complicates things would be an understatement. Even if you are in remission, it always has to be thought of, and that is especially true when it comes to surgery.

Cancer complicates upcoming ankle surgery

If any of you follow my articles over on RheumatoidArthritis.net, you’ll know that I have an upcoming procedure on my right ankle, the third one, actually. Third time’s the charm, hopefully, and when I finally go under the knife later this year, I’m hoping it will be the last time. At least for this joint – the list of joints in my body that need a tune-up is longer than a CVS receipt. The thing is, now that I’m a “cancer survivor,” it makes things eminently more complicated.

Now, normally when you go in for surgery you have to go through a battery of tests to make sure you are healthy enough so that if you die on the table, they can say it was God’s fault. Ha, ha – no, wait, that’s actually true. Yes, they make sure you are in good enough shape to be able to shirk all responsibility for your doom should the worst happen, which means things like blood tests, physical exams, cardiac workups, etc. etc. etc. It’s a huge pain and possibly the worst part of getting a procedure done.

It’s complicated and a mess and it usually takes all day. Now, add cancer to that bouillabaisse of  medical checkups and you have the perfect recipe for a game of medical Jenga the likes of which the world has never seen.

Every specialist needs to have their say

Normally, for surgery, each member of my basketball squad of doctors has to weigh in. This dream team includes a cardiologist, a rheumatologist, a pain specialist, and a nephrologist, as well as a representative from Boston Scientific, the people who make my defibrillator. Can’t have that going off during surgery and accidentally saving my life, so they have to enter the kill code.  Like disabling the nuclear missiles on a submarine, only they have the passphrase to do it and it almost always comes down to mere seconds before surgery starts.

Needless to say, getting all of these people to come together at the right place at the right time is a feat of herculean fortitude and patience that only those with chronic illness can imagine. Now, add cancer. Yeah, welcome to my nightmare.

Cancer is the biggest co-morbidity

There are only a few things you can say to a nurse or PA when listing your co-morbidities that really makes them pause – HIV, Hepatitis, and the big one – cancer.

As soon as you list that among your “also hads,” the ears perk up, the eyes actually look at you instead of the computer screen, and the questions begin. What kind? When? How long? What chemo did you have? What is the airspeed of a coconut-laden swallow? The list goes on and on, and suddenly your surgery has now become “complicated,” because, you know, it was such a piece of cake before.

Cancer complicates medical tests

Yes, cancer complicates. Shocking, I know, but it’s true.

Now, for the surgery, I’ll have to see my oncologist, get extra blood tests, and get in that God-forsaken metal donut for eighteen minutes and try to ignore the excruciating pain of laying still for almost half-an-hour.

Seriously, did the people who designed the PET scan machine even think to themselves for one second, “hmm, who is going to be using this machine mostly?” “Oh, probably people who are already sick and ill and can’t move well.” “Well, then we certainly can’t put one shred of padding or shaping on it, those people have been coddled enough!”

In addition there’s a cardiac stress test. This is where they make you run a mini-marathon on a treadmill in your cardiologist’s office to see if your heart will explode. Of course, since I have RA I can’t really run on a treadmill but they have a solution to that too – drugs. Lots of drugs. Drugs that make your heart go boom boom boom. Weird feeling that – sitting reading a book and having your heart race like you are running from the police. But… I digress, the point is already the pre-surgery checklist has become more complicated.

Cancer complicates medications

The actual surgery isn’t the only area of life that gets more complicated after cancer. Cancer also complicated medicating, especially if you are already taking meds for a chronic illness. I’ll never forget they wanted me to stop my RA meds when I was on chemo because “it’ll probably do the same thing.”

Well, for me, “probably” isn’t a ringing endorsement of certainty so I said no, I want to take my biologic and do chemo at the same time. After a lot of head scratching and hand-wringing, the doctors told me that it was “uncharted waters,” and I’d have to sign a waiver that says if my head turns purple and I grow a third arm out of my bellybutton they can’t be held responsible. I said fine, and that I always wanted an extra hand to help when I’m playing The Legend of Zelda anyway.

In the end, everything worked the way it was supposed to, and my RA was kept at bay while I went through chemo – oh, and guess what? I tried it their way for a few days and the RA wasn’t controlled by the chemo at all. Surprise, surprise.

Anyway, as you can see, cancer really is the great complicator. It adds a new level of difficulty to what is probably already a tough situation, and it stays with you pretty much for the rest of your life. As if we needed another reason to hate this illness! Talk soon.