as the pain worsened, dickson remembers wondering, “is this what childbirth is like?” the next morning she saw her family doctor in new jersey, who sent her to the hospital for tests. soon afterward, the symptoms disappeared, and when testing revealed nothing, dickson said she “moved on.”
for dickson, who now works as a book publicist in manhattan, the first episode was a surprise. she had felt fine on vacation and been generally healthy during the previous year she had spent in south africa on a college study program. because she had worked with orphans who had hiv , dickson underwent testing for infectious diseases after she returned to the united states from her year abroad. “i assumed if there was anything serious, i’d find out about it,” she recalled.
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he decided that dickson probably had food poisoning – she had bought fruit from a street vendor the previous day. although her pain, which was mostly on her left side, seemed somewhat lessened, the doctor told dickson’s parents that if it didn’t subside by noon, she should go to the hospital for an abdominal ct scan. one possibility was acute appendicitis , although that typically causes pain on the right side.
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the primary concern was that the obstruction was cutting off the blood supply to dickson’s colon; an operation to untwist the intestine and relieve the obstruction was the only treatment. causes of a blockage include a hernia ; crohn’s disease , a disorder that causes inflammation of the gastrointestinal tract; previous abdominal surgery, including a caesarean section , which results in the formation of scar tissue; and a tumour.
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goldman remembers wondering what he would find. “i’ve seen 25-year-olds with metastatic colon cancer ,” he said.
the pathologist found that the specimen contained abnormally shaped spindle cells – round in the middle with pointed ends. because such a finding is rare and its implications unclear, dickson’s pathology samples were subsequently sent to the mayo clinic in rochester, minn., for a second opinion. in the meantime, goldman decided that in case dickson did have an invasive cancer , he needed to remove enough of her intestine – about 10 inches – to ensure that no malignancy remained. dickson said she suffered no ill effects from the surgery.
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dickson said she underwent frequent monitoring the year after her surgery as well as a colonoscopy , which found nothing. she sees an oncologist periodically for follow-up, but so far the tumour has not recurred.
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“if pepto [bismol] doesn’t work after about 20 minutes,” she said, “i do get a little nervous.”
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