When Emma Dowling notices something amiss with her health, she wastes no time in getting it checked out. It’s a far cry from a few years ago, when delaying a doctor’s visit led to a serious health issue and cost the Tauranga mum of two the loss of her large bowel.
Emma, now 41, found out she had bowel cancer in 2014 but for a year before diagnosis, she didn’t think her symptoms were anything she needed to ask her doctor about. Extreme fatigue could be put down to sleepless nights with very young children; and the obvious change in bowel habits – well, as a busy mum it’s all too easy to put yourself last and dismiss your own health.
The dermatitis on her hands actually plagued her more than anything else, but she still didn’t seek medical advice. By this time her bowel habits had intensified – loose, frequent and urgent.
“It was only when I talked to a nurse friend that I took action. She told me to get it checked right away and if I hadn’t spoken to her I don’t think I would have done anything urgently,” Emma says.
Because blood tests didn’t show anything unusual, she waited three months for a colonoscopy. The diagnosis was a stage 3, low rectal tumour. “I went to the consultation on my own and wasn’t prepared for that diagnosis. I was expecting something else, like Crohns Disease or IBS.”
Cancerous cells had been found throughout the bowel so Emma was advised to have a total colectomy – following 6 weeks of radiotherapy and chemotherapy – which removes the colon (the main part of the large intestine) and the rectum (the lowest part of large intestine) and means Emma has a permanent ileostomy*. The physical recovery from this major surgery, and the emotional impact has been huge.
* An ostomy is an opening created on the abdomen through the skin surface for the discharge of body waste through a bag, which replaces the usual system of disposal. In an ileostomy, part of the ileum (small intestine) is brought through the opening following the removal of the colon and rectum. Other ostomy procedures include colostomy and urostomy. Approximately 6500 New Zealanders have an ostomy, with colostomy being the most common.
“I can do most things as before but some things are not easy. One day after surgery I went shopping and bought a fitting dress, without thinking about what happens when the bag fills up. My jeans cut right across it and swimwear is really difficult, so it has been a bigger adjustment than I realised.
“It would have been good to talk to someone about it all, and that’s made me want to be available for other people who are going through the same thing, to offer a listening ear.”
Change in attitude
Emma feels stronger because of the experience and has noticed a big change in her attitude to life. In 2016 she was able to return to her work as a massage therapist and now works two days per week. She’s choosy about what she takes on and prefers to stick with remedial massage rather than more vigorous sports massage, and, before seeing each client, she uses a mindfulness exercise to protect her own energy and look after herself.
“I’ve grown a lot as a person and I’m way more relaxed and am much better at finding balance. When I hear people stressing about something, I find myself thinking that I just wouldn’t get worried about that now, unless it’s a health issue of course. I’ve learnt to just let things go.”
Good nutrition is really important for Emma and although she doesn’t analyse her intake, she’s careful about the amount she eats and not consuming too much sugar, or red meat because of her body’s reduced ability to digest. On the menu now are lots more green leafy vegies and plenty of fluid to keep her system moving. Blockages are not uncommon with an ileostomy, and when this happened to Emma a year after her surgery, she had to return to hospital to resolve it.
“A lot of foods can block the bag, like Brazil nuts, because they are really hard, and grape skins. Even mushrooms and mesclun don’t really break down so I couldn’t eat a whole plate of salad, but I’m lucky that I can still eat most things and just have to be careful about the volume, and chew my food for longer than normal – be more mindful about it. Previously I would be doing something else while eating breakfast, but now I sit down and take my time and don’t get distracted by what the kids want.”
Another challenge Emma had to contend with was falling instantly into menopause as a result of her radiotherapy treatment prior to surgery. Initially this was concerning but says so far she feels fine and hasn’t had to deal with the common symptoms other women endure.
Put yourself first
Like many people who are diagnosed with cancer, Emma will never know why it happened to her. Apart from her grandfather, nobody else in her big extended family has had bowel cancer and it is not thought to be hereditary for them.
“I thought I was healthy by eating well and keeping active but I think I was just unlucky. If I had been more aware of how I was feeling and how my body was working, I would have realised something wasn’t right and might have saved my colon if I had got onto it sooner. Now I tell people to get things checked out – anything you are concerned about, any changes in yourself or your body. Don’t put yourself last; you have to think about yourself more.”