accumulation

I received a frantic phone call one day from my mother-in-law. She was crying and hard to understand. I was finally able to calm her down enough to find out that while paying her bills she became so confused; she didn’t know how to write the checks. She asked me to come over to her house. She only lived about 15 minutes away, so I hurried over and found her sitting on the couch, eyes red and swollen and a dazed look on her face. This was not the first time that she became confused.

I suggested to her that I would come over every month and write her checks for her. We could sit together and enjoy a cup of coffee and some good conversation while we did the bills. She liked that idea and so we wrote checks for her bills together each month.

In the midst of her confusion with the checkbook, she began to feel very insecure and asked my husband, to become her power of attorney. He went to the attorney with her, and they she added him to her checking account in case he needed to pay bills for her. This all took place during the summer, and we thought things were working out fine but, the beginning of December brought a new symptom that landed her in the hospital. She awoke one morning so dizzy she could not stand. Her doctor admitted her to the hospital for tests. She stayed in the hospital for several days, but nothing was indicated that could explain her symptoms. She was treated with medication for her usual aliments of high blood pressure, angina and arthritis…

Christmas Eve was always spent at Mom’s. The entire family would gather, and the grandchildren would open presents frantically until there was no room to walk. Mom would have a spread of deli delights for family and friends that would drop in. Later in the evening, the family would gather around and sing Christmas carols. As we sat around the dining room table I looked over at Mom and she looked so frightened and confused, as if she did not know any of us. Her lips moved to the music, but her mind was not in the room. Before we left, we got her settled on the couch and she seemed to be a little more alert. Fortunately, her oldest son lived with her, and would be there if she needed anything.

Sometime in January, Mom had an appointment with her gynecologist. She had a hysterectomy thirty years before but kept up with annual visits. Mom was very short, only four foot eight, yet she weighed over two hundred pounds. When the doctor examined her she told her that she had a very large mass that she could feel across her abdomen. She wanted her to have an ultra-sound immediately. She never indicated what it might be, but as people usually do, we thought the worst.

When the results came back, the radiologist identified the very large mass in her abdomen as her uterus. We knew that wasn’t correct and so did her gynecologist. At this point the word, “cancer” appeared, and we followed the next steps to a sure diagnosis without hesitation.

For the next month, Mom was bounced from one doctor to another. Her primary sent her to a general surgeon who suggested that her belly was full of fluid and if it were cancer it was very bad. He sent her back to her primary. Her primary checked her again and sent her to an oncologist. The oncologist took a blood test, checking her for ovarian cancer with the CA-125 test. As we sat in the examining room, Mom joked and laughed about her belly being so large with fluid. The doctor returned with the results and the protein was very high. He concluded that she did in fact have ovarian cancer. The entire ordeal of going from one doctor to another was exasperating for her because she did not remember the visits. When she was confronted with the news that she could have cancer, she acted surprised, as if she was hearing it for the first time. When the oncologist told her she indeed had ovarian cancer, she said that no one had mentioned it before, and she began to cry. By the time we got home, she was fine and did not remember the visit.

The one thing that added to her confusion was the fact that she had a total hysterectomy twenty years earlier. She thought that meant her ovaries and tubes had been removed. Since her short-term memory was all but gone, the truth wasn’t in her mind long enough to sink in.

The oncologist sent her back to her primary and he told the family he was going to enroll her on hospice. What we thought was a case of Alzheimer turned out to be end stage ovarian cancer.

She finally understood. Her short-term memory loss did not take over, this time it was all real. It was still a shock to us all because she never had any pain in her abdomen. She gained a great deal of weight that turned out to be fluid. She complained about her legs hurting but she was carrying a lot of weight for her small frame so we thought nothing of it. Her mental symptoms gave rise to the thought that she was suffering from dementia. Her primary physician never suspected a thing. When the doctor checked for dementia, he said she was fine. This hidden disease was racking her body, and we didn’t know it. Hospice arrived on Friday, February 25, she died on Monday.

According to the Ovarian Cancer National Alliance, ovarian cancer is called the “silent killer” because by the time it is diagnosed 75% of women will already be in the advanced stages. Some early symptoms include bloating, pelvic or abdominal pain, difficulty eating or feeling full. Later, there may be an urgency to urinate, fatigue, indigestion, back and leg pain. A genetic predisposition to the disease can be an indicator for a more prophylactic approach by your doctor. Make sure he/she is aware of your family history. Some of these symptoms mimic a dozen other diseases which is why it is difficult to diagnose.

What steps can be taken to diagnose this disease before it reaches an advanced stage? Aside from a pelvic exam, we can insist on two other tests: the CA-125 blood test and a transvaginal ultrasound. Some physicians may not want to order these tests, but if you feel something is wrong, insist on it. A pap test does not diagnose ovarian cancer.

National Cancer Institute: Ovarian Cancer
http://www.cancer.gov/cancertopics/types/ovarian/

Medline Plus: CA 125
http://www.nlm.nih.gov/medlineplus/ency/article/007217.htm

(c) 2014 Vickie Van Antwerp