Gifted

  

She told him once that she wanted a gift. Something tangible, that she could hold onto when he wasn’t there. Something that showed she meant something to someone. That she meant something to him, after all of those intimate moments together.

Her body and her love.

Valuable.

“We are no longer compatible,” he said. 

There would be no gift. 

Only emptiness. 

She wanted to die.

She clung to his memory, holding it dear, keeping him close to her heart.

Now all these years later she has this bit of him eating a hole through her soul, its fingers reaching into all of her secret places. Places where he had once been and apparently never actually left.

His gift to her.

This cancer.

Her life.

We are no longer compatible. 

Only now, she wants to live. She finally understands he is not worth dying for. 

Except now, she has no choice.

For all of the women suffering from cervical cancer.

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116 thoughts on “Gifted

    • It is based on an encounter I had a few years back with a woman who came in complaining of urine leakage. She was in her twenties so it was an unusual complaint. On the exam I could feel the bladder catheter bulb through a hole in her vagina. Advanced cervical cancer. She asked me how she could have gotten cancer. I had to explain the HPV virus to her. That was when she told me her story…. Terrible, terrible situation.

      Liked by 3 people

  1. Do the things that rot our soul turn to cancer? In the end, I guess we do just wish we could have let the ugliness go so life would have been sweeter. This is a post to ponder, that’s for sure.

    Liked by 2 people

    • In this case it is technically a virus that caused the cancer but I know she wished that she could have spent all of those intervening years living free. Such a waste of time and energy. Too bad we cannot just flip a switch.

      Liked by 1 person

  2. One of the things about working for an American company was their medical health policy, which included a Well Woman check every year. In the twelve years I worked there, I never missed one.
    Cervical smear tests for me are every five years until the age of 65. I hate them, but feel they are necessary. I have only 2 left to go now.

    Liked by 1 person

  3. Wow Victo…having survived early cervical cancer with a hysterectomy I can truly relate to the concept of ‘gifts’ left behind and the tragedy that can come with them. When I received my DX my very first thought was HPV. This was after many years of marriage, but my first assumption was a gift given from one of the 4 men I slept with during the time after my first long term relationship ended and meeting my now husband. I was told no HPV…but have to admit that lurking has always been a doubt…

    Liked by 1 person

    • I am so glad yours was caught early! The virus can linger for years before it causes trouble. The body can also get rid of the virus. Whose does what is a crap shoot. There is not really a test for it in men so you almost have to assume if you are having sex that you have been exposed. I have no idea what your specific cytology showed but kudos for you going to get that check up!

      Liked by 1 person

  4. Oh god, that realization must have all but knocked you over Victo and then to have to organize your thoughts and tell her. Dear God – You couldn’t pay me enough to be a doctor. I’m OK with my own pain – it is having to tell and watch others as they realize what it means.

    Sigh.I have a radiation fistula between my b,ladder and rectal stub (I have a colostomy). When this developed it was a few years after the cancer treatment and I was getting a urine leakage. I went to the urologist and he scheduled a cystoscopy. He called me into his office very serious a few days after the procedure. He told me he had bad news, and he explained about the fistula. He was very serious.I asked if he did biopsies in the fistula and he said he had and they had come back negative. I burst into laughter and I could have kissed him.He was quite indignant and kept saying – This is serious,this is serious Paul. I told him I didn’t give a damn about the leakage or the fistula – it was a mechanical problem and I would find a solution – the important part was that IT WAS NOT THE CANCER! I danced out of his office – probably the first patient he ever had do that after news of the fistula.

    Liked by 1 person

      • I was pretty much left to my own devices, mostly because that’s the way I wanted it. i could have gotten help, but I wanted a more personal solution. One of the really interesting characteristics of life, in general, is that if you have a problem that is bothering you, that is a a sure sign that you don’t have enough problems – for a truly engaged person has enough problems that the problems begin to solve each other. First of all,any time i do have leakage, it reminds me to thank God that the fistula was not cancerous- that removes a lot of the stress from the issue. that’s half the problem right there.Here’s the somewhat eerie part: my Dad died of exactly that problem – an enterovesical fistulsa while i was discovering my very own enterovesical fistula caused by radiation. it appears to have an epigenetic connection and mine was hastened by the radiation treatment. My Dad was 75 and his colon was still connected to his rectum – as most are – and he developed septicemia from the fistula which caused his death before they could operate. To put it flat out – my colon cancer saved my life when it caused my colon to be disconnected surgically from my rectum by way of a colostomy. Again I thank God for the cancer. that factor also reduces the emotional impact of the fistula and makes any leakage a reminder of how lucky I am to be alive.

        The above mentioned neatly solves any emotional impact and converts it from a huge negative to at best a positive and at worst a nuisance. The physical side of the solution also bears the stamp of having enough problems that they solve each other. I am a dialysis patient and so have very little kidney function (about 10% on one side only and none on the other). This means that very little fluid actually gets to my bladder – however the little I do have allows me to have a relatively free limit on fluids – unlike those who have no function. It is a nice balance that keeps a lot of fluid from my bladder. If i dialyze every two days, I only get significant fluid in the second half of the second day..That will give me about 2 kg of fluid to lose in dialysis. Between the internal and external anal sphincters, I can control about 250 mls of fluid before leakage occurs. In other words, with fluid intake control, the sphincters can handle enough to allow me to operate normally except having to go to the toilet every 2 hours or so – which can be managed by carefully choosing my itinerary. Believe my when I tell you that those who have a colostomy make a mental note of the bathroom facilities wherever they go and they rate those facilities (single user is .preferred). That knowledge greatly helps in dealing with the anal leakage issue – giving me a mental map of available facilities wherever I go. In an emergency, all shop downers, facility owners are very understanding (just mention cancer and they jump)- although I prefer not to go that way. Again this is an example of how one problem helps to solve another – the knowledge of facilities developed in dealing with a colostomy is applicable to the leakage issue.

        Then there is the colostomy itself. It turns out that when kidney function is reduced, as mine is, the human body will do what it does best – adapt. I can tell you to within 100 milliliters how much excess fluid I have aboard .by the consistency of my stool. My body will void fluid through the colon when the level increases above normal. This again reduces the strain in the sphincters. I can and do reduce fluid levels with natural diuretics – like coffee – when I am in controlled environment, like home, so the fluid levels are lower when I go out and there is less need to be worried..As dialysis time approaches, I can tell by my fluid output.

        Finally, there are adult diapers. This sounds much worse than it is – and in fact emotional issues are the biggest hurdle in the use of these. With the changing demographic of the population growing older, the manufacturer have stepped up to the plate and done an excellent job. They are not noticeable by anyone looking at your ass – as they have a very slim line. They are available in many sizes at virtually all stores – Walmart, or any pharmacy. They fit well and are reasonably priced at about $1.00 each (about $15.00 for a pk of 12 -20 depending on size). I only need them if I skip a dialysis or drink a whole lot – like a holiday celebration. If i am careful of the mix,I can drink alcohol straight (hard alcohol and wine only- beer is a no-no for dialysis patients) all night and it acts as a dehydrator and lowers fluid output. The diapers feel just like regular underwear and are very absorbent. I can wear one for two days easily – but my output is low. i use a pack about once a year. If you have any patients who are reluctant you should ask them to try them – once they do that they will never worry about it again. Because I am on disability, I can get the diapers reimbursed as a medical device cost.

        Sorry about the long answer Victo. Basically dealing with the enterovesical fistula just means an increased awareness of fluid intake and output and some small amount of planning. .

        Liked by 1 person

      • This is fascinating! Thank you so, so much for sharing this. It did not sound like you had it repaired so I was curious how you addressed the issue yourself. Do you have much difficulty with infection? (If you don’t mind my asking?)

        Liked by 1 person

      • I don’t mind you asking at all. If anything I can say has a possibility of helping your patients (or even just satisfying your curiosity), I;m more than pleased to discuss it all day. For quite some time – far too long if you ask me (about 1.5 years) – I had a pair of nephrostomy tubes in. God Victo, they had to be the most annoying poorly designed medical devices I have come across. The valves leaked regularly and the pigtails popped out of my kidneys at least once a week – even when I was careful.I was told that the problem was my height as the kidneys floated and the neph tubes were in the kidney and attached to my skin where they came out. The distance between the two points was constantly changing as i moved and the pigtails would pull out of the kidneys. I had a direct number for Interventional Radiology. and during business hours i could just give them a call and they would take me right in and replace the tube that pulled out. honest to God I knew the whole crew by their first names. anyway, when in had those tubes in I had continuous UTIs. It was so bad that they ran through all the available anti-biotics and were concerned about creating a super-bug. Eventually they just told me to live with the UTIs as they could not be controlled. That left me with cloudy urine and a constant dragged out feeling that basically suppressed any happiness i may have encountered for over a year. The most effective anti-biotic for me was ciproflaxin but that soon became useless. When it worked though it was like magic.I had a bad reaction to vancomycin and ended up with red man’s syndrome – whoooos that one is very rough, God i looked horrendous and you could easily mistake me for an alien. Yikes! It was terrible and itchy too.

        Anyway when they got stents in my ureters, they removed the neph tubes (rather I did not go back to have them replaced when they fell out – the doctors wanted to keep them but that is like keeping a flea infestation when you have the choice to get rid of it – not going to happen). After that the UTIs dropped off to almost nothing within a year.I was infection free for sometime and then we discovered the radiation fistula. They did a colonoscopy and did the stoma first and then the rectal stub = mistake. Any doctor scoping a colostomy patient should always do the stub first and then the stoma. Doing the stoma first results in blowing stool into the bladder if (on the rare chance) there is a fistula attached to the rectal stub. And so it did. I almost died from the infection and was in hospital (in intensive care for a few days) on intravenous for 10 days. Once we had that cleared, I have not had any UTIs and that was about 7 years ago. That said, since the radiation and chemo, my GI tract has been flaky. I get regular GI infections – at least one a month and my tolerance for many foods has changed. Ha! back to the many problems paradigm again, my tolerance for fat has been seriously reduced..I get serious issues if my fat intake is high and i actually will get nauseous and not be able to eat at all McD’s and KFC are but a memory and I will still get cravings but then if i buy it I will have a hard time eating it. This is good because my life has become more sedentary since the dialysis has caused peripheral neuropathy that makes walking hard. I will literally gag if I walk by a McD’s now.

        So,in a nutshell, UTIs – none; GI infections – monthly. The fistula does not seem to be contributing to any additional infections. But my rectal sutb, although it s alive and well and producing some digestive fluids, seems to be bacteria free as none are being transferred to the bladder.

        As an aside, the doctors had a large argument over re-connection of my colon to my rectum. Some wanted to do it ( my colorectal oncological surgeon who did the cancer surgery wanted to reconnect – they had left enough tissue to do so) and some were less enthusiastic (it is a quality of life operation and here in Canada with socialized medicine quality of life operations come with a high threshold – they have to make quite a difference to be approved) They all agreed that we should wait for two years to be sure there was no recurrence of the cancer before reconnecting. In the meantime the radiation fistula developed. My colorectal surgeon still, wanted to go ahead and he said the fistula could be “shaved” and removed at the same time. the other surgeons backed away (the tumor had abutted the bladder so the urologist was involved and there were other organs that had to be moved or adjusted and watched so there was a general surgeon involved as well) I pondered this Victo long and hard. My cells had demonstrated a sensitivity to radiation that was abnormal: the doctors had irradiated based on shrinking the tumor but instead it was gone; there were numerous other non-standard reactions to the radiation as well, including scarring of the ureters (which caused the kidney failure), scarring of the intestine (which means I have to limit non-water soluble fiber. i can eat all the water-soluble fiber I want but not the other or my intestine blocks). Add to that the fact that right around that time my Dad died of a enterovesical fistula – hinting at a genetic or epigenetic proclivity to fistulas, and I was seriously concerned that any fistula would reform. and if it did so while my rectum was charged with stool, it would likely kill me. All things considered, I choose to keep the colostomy and fistula – as much as my spirit screamed that I was wrong and my colorectal surgeon seemed dispirited that he could not operate once again. Give a man a hammer and everything looks looks like a nail; give a surgeon a scalpel and every human ailment can be cured with surgery. .Ha!

        That’s my story and i’m sticking to it. πŸ˜€

        Liked by 2 people

      • Ha! Very true. It is interesting that you have not had further infections from the fistula presence but it does sound like you have made the right choice, all things considered. Thank You!!!!! πŸ™‚

        Liked by 1 person

  5. It takes a special person to become a good doctor. I thank God for doctors like you, it is not easy to give someone horrible news about their life. I do not think I could ever do it. I cry too much.
    Eye opening story Doc, I hope many people read it. Thanks.

    Liked by 1 person

  6. When I was in nursing school in the mid-60’s I took care of a young black woman, just a little older than me, dying of cervical cancer. She was the sweetest person, I remember her still these days, many years later. She was so apologetic about the drainage & the smell. I wish we could have done more for her.

    Liked by 1 person

  7. I know Doctors must have many occasions when they must give a distressing diagnosis to a patient. It can’t be easy in any way at all, for either of you, and you created a really good story to illustrate such a scene. HPV awareness is so important, especially in young teenagers. In the UK, pre-teen girls (and boys, too, I think) are offered vaccination against it. Is this the same in the US?

    Liked by 2 people

    • In the Boston area where I used to live, the vaccine was quite popular and well-used. Good health classes talk about it. My (now-16-yo) daughter knew about it and expected it. So even though she doesn’t like shots she stuck it out and is protected now.

      Liked by 1 person

      • That’s good to hear. It’s a tragedy that young people should suffer this terrible disease, generally through ignorance of its causes! Education and readily available preventative vaccines are a great step forward. In the UK, the vaccinations are usually carried out in the schools for Year 8 girls (12-13-year-olds).
        Thank you for sharing your info. about this – and I’m glad your daughter had the shot!

        Liked by 2 people

  8. We can get a man hard, but we cannot create a test that could save women’s’ lives sooner. Same thing with breast cancer….they are just now figuring out that flat mammograms don’t work for every woman.

    Liked by 1 person

  9. I was with a doctor who had to go in and tell a young woman in the ER she had a huge lung mass. She came in because of a cough. She was in a hurry to get home because her husband was throwing her a “surprise” party. It was awful.

    Liked by 1 person

  10. Amazing and beautiful, and terrifying. Wow! It took me awhile to convince my sister to have her children vaccinated. Their morals and religion would protect them. Fortunately she came around. They will never have to worry about it, some of us are still waiting for the hammer to drop.

    Liked by 1 person

  11. I am religious about yearly pelvics, much as I despise the invasiveness…but one abnormal scan was all it took for me. Thank the pantheon that I never developed cervical cancer – I light a candle for everyone who wasn’t as fortunate.
    Excellent post.

    Liked by 2 people

  12. You have quite a talent at putting… terrible things in a few words.
    Don’t get me wrong. You have a way of driving readers to understanding in just a few words, when most spend pages and pages and don’t get to the point.
    Thank you for sharing, Victoire…

    Liked by 2 people

  13. After an unassisted traumatic delivery, then a heart attack-CABGx2, widow maker repair, stentsx2, now in 26 days I go in for a hysterectomy, rectocele/cystocele repair, and then some, at 45 this really moves me. Your story isn’t me, I’m dealing with ovarian,not cervical, but I have 3 daughters and it could be them. I lost an aunt to cervical cancer, she was only 31. Touching, sad, thoughtful and educational all at once.

    Liked by 1 person

  14. Pingback: Meet A Blogger: Victo Dolore | That's What Anxious Mom Said

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