Blueberries

December 2022

“So how is it going?”

I’m sitting in an exam room at the radiologist’s office across from Dr. Mahadevan. His tie beneath his white doctor’s coat is impeccably knotted as always. Wire-rimmed glasses sitting atop the dark-skinned apples of his cheeks which look like they’re stuffed with ping pong balls when he smiles. When he asks, “So how is it going?” he emphasizes the how coming across as warm and genuine.

In the summer, I went through 6 weeks of radiation treatment to nuke and eradicate my rectal cancer. Every weekday morning at 8:30, I drove from my parents’ house in North Hampton, NH to Wentworth-Douglass Hospital in Portsmouth, arriving on time for my 9:00 appointment. A technician would meet me in the ladies waiting room and walk me down the sterile corridor past a door bearing a bright yellow caution radiation sign to the treatment room. There, we’d be greeted by two more techs. “Warm out there today, isn’t it? Name and date of birth.”

“Kristin Carlson.” I’d unzip my fly. Pull my pants and underwear down to my knees. “5/24/73.” Then mount the table laying my stomach in the hollowed-out area, placing my forehead and chin in the face rest. The techs adjusted my body’s placement, then retreated from the room. I lied there while a giant mechanical arm rotated around me making clicking sounds for about eight minutes. Then I was done.

The techs re-entered, “All set, Kristin. Let us just back you out. Watch your head.” I’d dismount as gracefully as one can with their pants around their thighs. Pull up and zip my pants as they removed the paper from the table, prepping for the next patient. “See you tomorrow.”

Between IV chemo treatments, radiation, oral chemo, and surgery, they killed the cancer. I just needed to have one more surgery in a few weeks to take down the ileostomy bag. So, I wasn’t really sure why I was meeting with Dr. Mahadevan again.

“So how is it going?”

“Good. Still dealing with some fatigue, but you got it. You zapped that tumor.”

“Yes, we got it,” he says, cheek apples popping.

“My feet are still blocks of ice from the chemo,” I shrug. Small tradeoff, I guess.

“The neuropathy. Yes,” he nodded. “That may lessen with time.”

“The only other thing, since the first surgery…” I pause. Am I going to go there? Am I going to tell the radiologist about my bathroom issues. It’s probably not his department, but he’s nodding. They can’t help me if I don’t say it. Get it out. “I frequently feel the need, the urge to go. To have a…” What’s that other word for poop? “a… B…M,” there we go. “…which makes no sense because I have the ileostomy bag still. Nothing comes out, but it’s like the muscles need to stretch, push. It feels better for a few minutes, but then the urge is back again.”

His eyes light up with excitement as if I just told him I was going to his favorite vacation spot. “Have you heard of pelvic floor therapy?”

Mmm, no. I shake my head slightly, cautiously.

“We offer it in the building next door. It’s not uncommon to have issues with those muscles from the radiation and surgeries. You likely need to retrain them a bit.”

Pelvic floor therapy. I immediately think babies. Maybe Kegels—those vagina strengthening exercises. Do I really want to see another specialist.?. I already have an oncologist, surgeon, and radiologist. Do I want more appointments?

That said, using the bathroom is important. One could say the need to visit one comes up regularly. And I am supposed to be focusing on my health right now. Fuck it.

“Ok.”

“Great! We’ll have them call you to set up an appointment.”

A few days later, I found myself in a tiny office lying on my side, fully clothed with Tina’s hands on my bottom. Tina was likely in her 30’s, dressed like your average physical therapist in workout gear and sneakers. Her sandy blond hair pulled back without fuss. “Bear down,” she said authoritatively.

I’m 49 and 100% certain this is the first time in my life anyone has ever told me to, “Bear down.” What muscle is that? How do you trigger it? Isn’t that something only pregnant people do to get the baby out?

I close my eyes and swallow my pride. “How?”

Tina was ready. “Like you’re trying to fart.”

I concentrated. I’m not certain if she felt my powerful trying-to-pass-gas muscles move or gave up on me. “Ok. Do a Kegel.”

My body went empty. Not a muscle in the place. Like a desolate, run down, grey office building of sad, grey, empty cubicle spaces. ‘C’mon damn it,’ I thought, ‘We’ve done these before. Hello?’ Nothing. Meanwhile, Tina waited like a quarterback having just called, “Hike,” for the ball.

I winced. “I know what a Kegel is. I’ve done them before, but I can’t figure out how to trigger that muscle now.”

“Imagine picking up blueberries with your vagina. I know it sounds weird, but it works.”

Picking up blueberries. With your vagina. First of all, that would be one hell of a squat to pick up blueberries off the floor with your vagina. Gymnasts have a definite advantage here. A simple split would do the trick. I suppose for beginners, a coffee table would be a better starting point than the floor.

Second, once I pick up a blueberry with my vagina, then what? Is it like lifting kettle bells? You pick up a blueberry, put it back down. Pick up a blueberry, put it back down.

She did say blueberries. Plural. I doubt I’m supposed to imagine picking up one blueberry after the other, tucking them in my vagina cheeks like a hamster. Once my vagina cheeks have reached capacity or my Kegel muscles give out… then what? Bombs away?

Tina asked me to sit up as she provided reassurance that we’d work on retraining my muscles. To start she wanted me to work on breathing to activate my pelvic floor. She directed me to take a quick deep breath in through my nose letting my stomach expand and chest rise. Then slowly exhale through my mouth like I was blowing through a straw. It was the same kind of breathing I did a few years ago when I took voice lessons. I was to repeat that ten times in a row and try to do the exercise a couple of times a day. No problem. That’s easy enough I thought.

Next up, we talked about proper “toileting mechanics.” A good friend of mine had a Squatty Potty. I knew you were supposed to lean forward with your elbows on your knees, feet on a stool like the Squatty Potty. But then she said, “You shouldn’t push or strain to urinate.” I locked eyes with her, my brow furrowed. Suddenly, I was suspicious of her expertise.

“What do you mean you shouldn’t push?”

“It should just come out.”

“But something must initiate it. Open the door. Give permission. Start it off.” I mean otherwise what holds it in, right? Anytime we sat down and leaned forward we’d start peeing. Think of basketball players, sitting on the bench, leaning in in anticipation watching the game. They’d need a trough under there.

“Nope,” Tina said with a slight head shake and even voice. “It should just come out.” She handed me a printout with BLADDER RETRAINING at the top. “One last thing,” she said. “When you feel the urgency to go after you’ve just gone, try heel raises. Just stand up and lift your heels up and down. See if that eliminates the urge. I’ll see you next week.”

We walked out front to the receptionist and scheduled 3 more appointments. Clearly, there’s a lot more to learn.