Autumn Leaves

I wonder why so many people like autumn. Long before we had heard of hygge and pumpkin spiced lattes, many of my friends would say things like “thank god for tights” and celebrate when the heating spontaneously sparked up on a random September morning. 

I think it’s because summer is just too much pressure. MUST enjoy ourselves. MUST get out in the sunshine. MUST be all golden and glowy and active and lithe. MUST HAVE FUN!!

We had quite a topsy turvy summer. 

It began with our youngest daughter being sicker than any child of mine has ever been before. She had a perforated appendix and we spent five nights in hospital. It was horrific. 

She’s better now, thank goodness. 

Her main concern was that her scars would be healed in time for our massive family holiday in Mallorca in July. A gathering of nearly two dozen Fitzgibbons+ in one place. Yikes. 

It was lovely – hectic, but lovely. We celebrated my mother’s 80^th birthday, in the same place we celebrated other family birthdays before, and it is humbling to think how lucky we are to still be able to come together in this way, without illness (or homicide) coming between us. 

I was feeling a bit off while we were there, because my belly had mysteriously swelled up in the few days before our departure. I had had my routine surveillance scan just a couple of weeks earlier, and that was stable, so I figured my guts were just reacting to the anticipatory anxiety of the big get-together. It didn’t stop me from swimming every day or clambering over the hot rocks, so I wasn’t too concerned. 

When we got home I assumed things would settle down. Instead my belly button kept bulging more and more – I have a hernia there since one of my operations, and it is like a little sentinel of bloating, a reminder to lay off the white bread. But this time it was staying stuck, and I started to worry that it might be incarcerated (which is not a good thing for a hernia). I have an inguinal hernia too, and that was beginning to bulge alarmingly. 

I decided I better do something, before my entire guts burst out of my abdominal wall. I went to the Emergency Department, which actually isn’t as bad as people make out. I met some lovely nurses and doctors, who very gradually and carefully let me know that my pregnant-looking abdomen was not due to an overdose of baguette, or a strangulated loop of bowel, but was in fact a result of litres and litres of fluid filling my peritoneal cavity. This is called ascites, and if you say that word to a medical person they are physically incapable of stopping their face from saying “oh shit”, even if they try to shrug it off and smile a fake smile. 

Ascites is generally a result of liver failure, or else a few other things that are even worse news. 

My liver was fine. 

The word “curtains” went through my head a number of times.

This was unlikely to work out well. 

I had a drain inserted to relieve the pressure, which was by now pretty excruciating. 

Many many litres of apple-juice-looking fluid came out of me. I felt, and looked, a lot better. 

None of the apple juice had any cancer cells in it. Weird. 

Still though, it was very likely to be from the cancer. 

I left hospital and entered full-scale denial. Off camping for the week. Lovely. 

I felt so good I declined the offer of returning early from our week away to have a permanent abdominal drain inserted. Sure wasn’t I grand? Not a thing wrong with me. 

A couple of days later I was bursting again. Unable to move in the bed without severe pain. Feeling about 50 weeks pregnant. I had to go back to the ED. 

This time my hospital stay was quite a bit grimmer, for a number of reasons. Mostly because I felt like an idiot for not pre-empting it by having the drain put in when it was offered. 

Anyway, the very kind people didn’t hold my stupidness against me, and gave me lovely drugs while they tunnelled a tube into my belly flesh. This device allows me to attach a bag to myself whenever my tummy swells, so that I can harvest another litre or two of apple juice and prevent the pain and waistband-bursting expansion. 

I’ve been doing this now every couple of days for 5 weeks or so. It’s a strange sensation, like a tiny vacuum cleaner swooshing around in my innards. The fluid even flutters and rumbles, very similar to the feeling of a baby moving around in there. But this time I have no idea of my due date. 

I had a PET scan which was expected to confirm that my cancer had spread to my peritoneum (the lining of my abdomen). This was the most likely cause for the ascites, and even though there were no cancer cells in any of the many samples of fluid that were sent to the lab, we still assumed that the PET scan would show little shiny white spots of metastases in my belly sac. It didn’t. 

It showed some bits of something that could be metastases, but they didn’t light up like my liver had last year. My liver is all calm and quiet now, subdued by my last round of chemo. And these peritoneal nodules are not “avid” (that’s PET-scan speak), they are more like Ferris Bueller in a chemistry class. Languid. 

Right now, I don’t really know where I stand. 

I will have a laparoscopy, where a learned chap will look into my abdomen with a camera and see if he can spot some nasties. And if he does, he is a dab hand at eviscerating them. Only thing is, that often involves excavating quite a few innocent viscera too. Peritoneal surgery is no walk in the park, and has to happen in Dublin which is an additional urgh for me. But of course I will be grateful and happy that learned chaps are willing to do what they can to continue to prolong my life. 

So autumn has begun with me regularly harvesting apple juice from my own tummy, and pondering the march of time. 

Winter is ahead. Let’s get those cosy pyjamas out.