Colon Cancer One Year Later

It has been just over a year since I was diagnosed and operated on for colon-rectal cancer. Fortunately the cancer (stage I) was discovered early. It was revealed after I had my first colonoscopy at age 51. I had several more tests to determine the extent and location of the cancer. The doctors determined that the cancer was located just a few centimeters from my sphincter muscles. Luckily my surgeon believed he could save my sphincter and I would not require a permanent colostomy pouch. Instead I would have a temporary ileostomy bag. After I healed from the surgical removal of my rectum, the ileostomy would be taken down and I would be hooked back up “normally” again.

On November 13th 2009, I had my rectum removed at Kaiser Permanente Hospital in San Francisco. The surgery went well but I had a number of complications over the next several months dealing with an infection and abscess. I was in and out of the hospital a several of times. I spent close to a total of four weeks in the hospital between November and January. For the next 5 months I had an ileostomy bag hanging from the right side of my belly. The end of my small intestines was pulled through my abdominal wall so that waste could be discharged without passing through my healing colon. The care and management of this was time consuming and required lots of fidgety work. It was not as uncomfortable as I feared but it was really bizarre to have a piece of my insides hanging out. Finally in mid April I had my last operation to restore my colon to “normal”.

This so called “normal” was a totally new reality. One does not usually think about their rectum and its function. I learned that the purpose of the rectum is to be a temporary holding area for your poop. When it fills up, it sends a signal to your brain telling you it is time to go. If all is well, you don’t think about it more then once or twice a day. For the first month out of the hospital I found myself going 60 to 80 times a day. My colon was doing its job of pushing food waste along (peristaltic waves). But there was no rectum at the end to collect it. I felt like a rabbit pooping little pellets all the time. Although the surgeon has shaped the last part of my colon to act like a small rectum (transverse coloplasty pouch), I was going to have to train it to act like one.

Fortunately, a friend of a friend came to may aid. He had a similar operation a couple years back and had a strategy that worked for him. He had found a bowel-training program that worked with a combination of Metamucil (psyllium, a dietary fiber supplement) and antidiarrheal medications such as Lomotil or Immodium.

If you are interested, the bowel-training program can be found HERE. My new regimen consists of starting off the day with a large meal. I then stay close to the bathroom for a couple of hours. When I am ready to go out I take an Immodium or two. Lunch and dinner consists of very, very small amount of food - no more than a cup or two in size. It is followed by a very concentrated shot of 3 teaspoons of Metamucil dissolved in a couple ounces water. I don’t have any food restrictions. However, I have learned some foods are no longer easy to digest, especially beef and corn for example. Other than at breakfast, I can’t have hot liquids such as coffee or soup. Rich and sweet foods (cakes, cookies, chocolate, etc.) also are limited to mornings. Some days are a real challenge and I can’t go more than a few hours without thinking about and physically clenching and squeezing my butt muscles to hold it all in.

Things that are a challenge:
- Can’t take for granted that I can always control when I poop.
- If I don’t stick to my eating and Metamucil program, there are unpleasant consequences. Gone are the days of eating whenever and whatever I want.
- Eating, drinking, sex, going out to a movie or a play are no longer spontaneous activities. They now require planning, organizing, and preparation.
- Wherever I go, I need to carry a bag of supplies: Metamucil, Immodium, spare underwear, extra toilet paper and underwear pads.
- Keeping a sense of humor when my body betrays me.

When I start to get overwhelmed or depressed about the situation, I try to remember the positive outcomes:
- I am alive, active and productive. I am working part-time. I can travel (we spent the month of August in Scandinavia). I started running again.
- I didn’t need radiation or chemotherapy or a permanent colostomy bag.
- The procedures didn’t make me impotent or have erectile dysfunction or urinary incontinence (all possible side effects).
- I have lost 15 pounds from my high point. My clothes fit better and friends say I look healthier. I would still like to lose 7 to 10 more pounds.
- I have the most wonderful and supportive husband. He has taken great care of me in a multitude of ways.
- The doctors, nurses and staff at Kaiser Permanente have been first rate. I could not have asked for a better health team.
Previous entries about my surgery and recovery: : 1, 2, 3, 4, 5.

Heart Healthy Hanukkah??

Latkes on the griddle. Mmmmm.

Eight tips for a Heart-Healthy, Low-Fat, Low-Cal Latkes for Hanukkah:

1) Cook latkes on pancake griddle, spraying with olive oil spray instead of frying in oil.
2) Oven baked the latkes. Place them on a greased baking pan and bake them in the oven. They can be finished under the broiler or on the griddle.
3) Use egg whites or egg substitutes instead of whole eggs when making the latkes. This will reduce the fat and cholesterol.
4) Serve low or no-fat sour cream as a topping. Non-fat yogurt, light Greek yogurt or cottage cheese can be substituted too. Use applesauce with no added sugar.
5) If your recipe calls for regular flour, replace it with whole-wheat flour. This will increase the fiber content.
6) Don’t use salt. High sodium intake contributes to high blood pressure (hypertension). Other spices to consider: dill, parsley, sage, rosemary, black pepper, white pepper, garlic, cinnamon, nutmeg, and onion.
7) Think far wider and more creative than just starchy potatoes. There are delicious recipes for sweet potato, butternut squash, zucchini, celery root, carrot, cauliflower, broccoli and turnip latkes. See our list of 21 types we made this year.
8) For Gluten-Free latkes use rice flour in place of the matzah meal or flour.

Tonight, I am making my 15th, 16th, and 17th varieties and probably will flip my 850th latke tonight. Two more nights with two more sets of guests (friends and family) after tonight.

That's a Lot of Latkes

My husband says, "Even though Hanukkah is a relatively minor holiday on the Jewish calendar, it is one of my favorites. Each year, we invite friends & family to join us during the 8 nights for various latkes dinners. (This year, we have about 20 people coming throughout the week-plus.) I don't do just potato latkes but instead explore lots of varieties, planning meals where 3 or so kinds of latkes combine for a fun and delicious time."

"The Complete, Planned List for the 8 Nights"
- Tuna Latkes
- Carrot Latkes
- Crispy Cod Latkes
- Cottage Cheese Latkes
- Butternut Squash & Sage Latkes
- Sauteed Mushrooms & Onion Latkes
- Herbed Spinach Latkes with Feta/Yogurt Sauce
- Italian Apple Latkes
- Sweet Potato Latkes with Spiced Maple Syrup
- Cheese/Rice Latkes
- Garlic/Rosemary Potato Latkes
- Sweet Potato/Apple/Carrot Latkes
- Spinach & Zucchini Latkes with Smoky Creme Fraiche
- Wild Rice and Vegetable Latkes
- Jerusalem Artichoke and Parsnip Latkes
- Fish in Potato Latke Crust with Horseradish Cream
- Tuna Steaks on Potato Sage Latkes
- Vegetable Latkes with Dill Sour Cream
- Ricotta Cheese Silver Dollar Latkes
- Apple Latkes (different than above)
- And Just Plain, Traditional Potato Latkes

From The Regulars Comic. By the funny and talented Karl Hampe. "The Regulars is a fun, snarky take on what might happen if a gay, urban attorney burn-out wound up running a coffee bar."

A Festival of Light and Warmth

We have over a dozen menorahs or hanukkiyot (the plural of hanukkiyah) that we will rotate lighting over the next eight nights. E is planning some where between 12 to 18 different types of latkes recipes he is going to prepare during the holiday. E goes way beyond the traditional fried potato pancake. They are delicious.

Wishing you a very bright and happy festival of lights!

Today is also World's AIDS Day. I am remembering several very talented friends and co-workers that died of AIDS. I worked with them at San Jose Repertory Theatre and American Musical Theatre of San Jose (aka San Jose Civic Light Opera) in the 80's and 90's. David DeLong, David Lemos, Ken Holamon, Jeffery Struckman and Peter David Heth.

Hanukkah is also a festival of freedom. In so many countries in the world, being gay, lesbian, bi or transgendered is still criminalized. U.N. member states recently voted to remove sexual orientation from the list of recognized grounds on which people should be protected from extrajudicial execution. On this Hanukkah, please let Secretary Clinton know how you feel about this.

Next week, a critical international summit-the first in 11 years-is bringing together dozens of world leaders to discuss security and human rights. It's time to rally international support against homophobia and anti-gay violence on the world stage!

Please consider sending your letter to Secretary Clinton with a simple click here:
http://actions.humanrightsfirst.org/p/dia/action/public/?action_KEY=2843