Good Luck to All Homes (My Dear Cancer – Part VI)

I never suffered from constipation before, and I always had difficulty understanding people who suffered from it. That is, until I experienced it myself…

Due to the chemotherapy, I was noticeably dehydrated, but I thought it was only affecting my skin and could be compensated for with creams and oils. Unfortunately, I also started spending more time in the washroom each day. Constipation was one of the most striking consequences of my dehydrated condition.

Whenever I asked my oncologist about it, he continuously repeated the same mantra: “It’s to be expected. Eat some dried fruit and high-fiber food and drink plenty of water.” Inan would always bring dried fruit for me and force various high-fiber foods down my throat, but none of them worked. One time, my visit to the washroom became unbearably long. Here’s the scene:

Location: Home – Scene: The washroom (again)

The sixth day of constipation

Me: İnan, I’m in the bathroom. Don’t wait for me with dinner.

Inan: But you should eat high-fiber food, honey. I bought some dried apricot for you. Come and eat some.

Me: My God! Damn all those doctors.

The eighth day of constipation

Me: What now? Who moved my bed to the washroom?

Inan: We thought it would be easier for you. We can put a partition up and move the bookcase there. Nice, isn’t it?

Me: I guess.

The tenth day of constipation

Me: İnan! İnan! Come here!

Inan: Yes, what is it honey?

Me: You know my friends are visiting me tomorrow. Why don’t we take the bathtub out so we can fit a sofa in here?

Inan (confused): Funda?

Me: What’s wrong with that? It’s not too much to ask, is it?

The 15th day of constipation

Inan: Funda! Take this, honey.

Me: What is it?

Inan: It’s a cure. Don’t ask me what it is. Just take it.

Me: Well, you must think I’ll do anything to get rid of this!

The next day

Me: Inan! Great news: It’s over; it really is.

Yes, it was finally over. Inan, my hero, had come home with a bottle of liquid glycerin, which helped me to get over the constipation. I was happy beyond words, but I was scared this happiness might be short lived. As it happened, those beautiful days ended sooner than I expected.

I was sitting one day when I felt something strange in my stomach. It was as if something was stuck there. I waited to see if it would pass, but it didn’t. I later discovered that it was a hernia. During my period of constipation, I had strained so hard that the suture in my belly had partially opened, causing the hernia. After going through such an important and risky surgery, I was annoyed that I had to live with a hernia because of simple constipation. However, the cause of my anger was neither my body nor the hernia.

When I thought about this hernia, some thoughts grew stronger. The operation had been successful, but the surgeons had left the task of closing the wound to a young and possibly inexperienced junior surgeon. In addition, my oncologist had not realized the significance of the constipation, which had resulted from the chemo, and failed to give me proper advice. Specifically, he never warned me about the risk of my stiches opening.

In conclusion, I came to understood that this hernia had resulted from negligence hidden behind the expertise, so it deserved my anger.

The hernia heralded another difficult period for me. Movements like bending down and lifting heavy objects put a strain on my hernia. Based on past habits, I initially forgot I had a hernia. Fortunately, my hernia was smarter than me: It reminded me of itself whenever I did something inappropriate. In time, my hernia and I became an inseparable couple. A new situation, a new Funda, was part of my life now, and I had to accept it.

The hernia did not prevent further chemotherapy, and I was happy that this was working well and not causing nausea. It was too soon to rejoice, however, because after the fourth or fifth cure, I finally encountered the famous nausea. I was so shocked when I first experienced this effect. I patiently hoped the nausea would fade, but the situation developed differently. Severe back pain, an accumulation of water in my stomach, and a poor appetite accompanied my nausea each day. I could even hear the water sloshing around in my stomach when I tossed from one side to the other.  My oncologist informed me that it was a frequent side effect of chemotherapy and tried prescribing some medicine for this and my nausea. However, the medicines did not help get rid of the water, which was neither being urinated out nor absorbed by my body.

One night, I decided that the best solution might be to vomit, so I tried to trigger it by pushing a spoon to the back of my mouth. Inan was shocked to see me like that and rushed me to the hospital the next day. The doctors inserted a pipe into my stomach and drained the water out. I then learned that the nausea was not caused by the chemotherapy but rather an intestinal obstruction.

They took me to the intensive care unit immediately. I was expected to urinate within twenty-four hours, because this would mean the obstruction in my intestines was gone and not require surgery. If not, I would need a new operation in addition to the one five months ago. Moreover, there would be a serious risk of infection.

All of the beds were occupied in the intensive care unit. It was disturbing to realize that I was the only rational person there. An old man in one of the far beds was singing in a terrible voice. An old lady near my bed shouted about her need to pee, and I could hear others noisily breathing. I felt even more terrible because of all the mechanical sounds coming from the equipment, the strange odor of medication, and all the unconscious states I felt.

My inner voice told me, “I need to run away immediately, and the only way out, is to go to the washroom. I need to shake the weasel loose somehow.” I told one of the nurses about my need to go to the washroom. With a sour expression, she removed the various tubes and wires from my body. Although it was very hard for me to stand, I continued to the washroom. The patients’ washroom was there in the intensive care unit, and as I approached it, I detected a strong odor of urine. Gingerly, I looked inside and decided it was unwise to step inside that dirty place. I wanted to wash my hands and return to my bed, but there wasn’t any soap. When I told one of the nurses that I wanted to wash my hands, she reluctantly showed me to the staff washroom, where I found water and soap.  On seeing me leave the staff washroom, another nurse lectured me about patients not being allowed to use that washroom. If I ever got strong enough, I decided I would enjoy pushing her head into that toilet.

By midnight, the surgeon came in and told the other staff to prepare me for surgery the next day. That was enough for me. I grabbed my cellphone, which was hidden under my pillow, and called Inan. The last I remember about that night was telling him  to come and get me out of there.

They told me I slept with a smile on my face that whole night. I was home, so what else would you expect?

An intestinal obstruction is not something to overcome alone at home. It is a dangerous and tricky problem, so the next morning, we went to the hospital at my university. The doctor told me he would take me into his care and administer a treatment to clear the obstruction. I was not allowed to eat solid food, so I was drip-fed instead. The doctor did his best to keep me in that room for a month by telling me things like “Funda, today’s serum is fried egg with sausages” or “You are lucky. Today it’s stuffed grape leaves.” I saw how all his patients were positively affected by his affectionate, meticulous, and humorous approach. I am grateful to him.

My intestines recovered after the treatment, so I could leave the hospital. I was very weak at that point, as I had been in bed for so long and been drip-fed. For a while, I struggled to stand up and walk. In addition, there was no break from my chemotherapy sessions, and those sessions topped it all off.

I learned that my intestinal obstruction was related to the operation I’d had, and this was a risk with all open abdominal surgeries. Incidentally, I can’t recall my doctors warning me about this risk, otherwise I would have been more suspicious about the nausea I’d endured for a week before realizing what the problem was. It was Inan’s heroic response that saved me from getting much worse, yet he’d also had difficulty realizing what was happening, even though he is a doctor himself. However, some simple information could have saved my life without the need for a hero at home.

Due to the overlapping traumas of surgery, the hernia, and the intestinal obstruction, I was so weak. I lost my grasp on the things I used to do, and all I could do was watch everything go by. My independence, my self-confidence, and my identity had been seriously damaged, and I didn’t know how to get them back. To compensate, I either had to ask for help or issue commands. Needing help made me crazy, and Inan and Kardelen felt the same whenever I made commands. I was unable to find a balance between these two approaches. There were so many things to do in the flow of daily life, but I was unable to do them, and they could not do them adequately. As I felt they were insufficient, they regarded me as an impatient control-freak. In fact, we both failed to see how those judgements were two sides of the same coin. My physical recovery was the prerequisite for reaching an acceptable serenity, but this took a long, long time.

There were many possibilities for trouble during the treatment process, and they all happened to me. Inan’s timely interventions prevented things from becoming much worse. I was lucky to have such a hero at home, but why did I need to attribute my continued survival to luck and my partner, especially with so many competent actors being involved in my treatment? Does every patient need luck and an “Inan” to pull through?

Actually, everything that contains contrasts is a system, and any system is open to problems. The more perfect a system becomes, the more complex the problems are. Consequently, people devote a great deal of effort to predicting, measuring, and compensating for the potential problems that might arise from a theoretical system. This is just as important as setting up the system itself. We can say that if the possible problems of a system are well documented and measured, and if it is possible to compensate for these problems, then we do not need to rely on heroes or good luck.

This should also be based on something fairer than giving a lotto ticket to each person.

Considering the modern system for cancer treatment, we can talk about two main features. The first is the common and generalized character of the treatment. The second feature is how this treatment is supervised by public authorities. The treatment protocols that are used were approved by academics. They identify the standards that should be applied and the controls on the treatment processes. On the other hand, they also supervise the cost of these treatments.

Non-standard individual variances invite problems. If a system is equipped with a talented prediction, measurement, and compensation mechanism, such problems can be addressed quickly. On the other hand, this incurs a “cost” that must be paid.

Individualized treatment systems, rather than generalized ones, have now gained momentum through some innovations in the medical discipline and interdisciplinary cooperation. Tailor-made data can now be used efficiently in the analysis, diagnosis, and treatment phases. For instance, the DNA structures of cancer cells and their mutations can be observed. In addition, undesirable effects are minimized by avoiding incorrect or inadequate drug use and the use of the latest personalized agents. Such developments in the individualized treatment approach are closely related to the corresponding developments in technology, which in turn come at a cost.

Speaking of public cost, however, there is also a cost associated with incorrect diagnosis and treatment, although no one knows the magnitude of it. We will never know the true cost while the zombie-like lives resulting from incorrect treatment are omitted from the statistics and stories.

This all leads to one simple truth: What makes the existing system sustainable is the intensive cooperation between the patient, doctor, and family. In this cooperation, the parties are forced to take on burdens and costs they are not responsible for. This is unfair not just for the patients but also for their families and the doctors.

So, shouldn’t we ask this: If the affectionate support from doctors and loved ones is not enough, what else is there?

Each answer to this will be a mirror for the reality of health.