Kristen Lunden

September 2021

In April 2018 I started experiencing abdominal discomfort and other symptoms which gradually affected my job and personal life. I started having urinary urgency. I felt like I had to go often, but output was low. My abdomen felt slightly bloated on and off. This continued through May and into July. The urinary urgency was a constant, with varying degrees of bloating and occasional abdominal discomfort. I was still working between 40 and 50 hours a week, but having to find restrooms and dealing with the abdominal discomfort was making it difficult to work, and on the weekends I just wanted to nap. I sought treatment at the Veterans Administration Medical Center in Vancouver where I was twice misdiagnosed by a Nurse Practioner. This resulted a year later in a trip to the emergency room, a diagnosis of ovarian cancer, a complete hysterectomy, and 18 weeks of chemotherapy treatment.

From August through November 2018 my symptoms gradually increased. I would be hungry but after eating a few bites would feel full. Some days I would have dull pain under my sternum. I started to have digestive issues, both diarrhea and constipation. My abdominal pain increased and some days it would hurt to drive over rough roads. I often felt fatigued. At work I had to turn down a few large commercial jobs because the discomfort made it hard to do the physical part of lifting 18′ span ladder and running long spans of cable. At home I started to have to nap after work because of fatigue. In December I had a couple of dizzy spells at work. My other symptoms were still present. They did not get better, but they weren’t getting more severe.

On my birthday (Dec. 18th) I took my blood pressure at home. It was 160/100. I went to Zoomcare to verify. They got the same reading. Around this same time I started seeing a naturopath for feelings of depression and fatigue which I though were largely from job stress. I saw her about four times, and just talking to someone was helpful. However, she was only available on Saturdays and I had to use vacation to see her. I continued to work, but it was getting harder to get through the day. My symptoms had settled into a predictable pattern of urgency, bloating, abdominal pain that was uncomfortable but not intolerable.

On Sunday, January 13th, 2019 (day off) I was cleaning and doing laundry. I had my by now typical urinary urgency, and as I headed to the bathroom, I lost control of my bladder before I could get there. I found this extremely disturbing. The next day I drove to Veterans Administration Medical Center Vancouver and related my concerns to the person at the counter in the women’s health building. I asked if someone was available to see me as I had not been there for a few years and did not have a primary care provider assigned to me. She found that an NP had an opening. I described my symptoms to her. She did a basic physical exam of my abdomen and said, “I think you’re full of shit.” I was taken aback by the way she phrased it. She then went on to say she thought I was constipated. She sent me to have an X-ray and pointed to the upper abdomen where she said it showed that I was constipated. She prescribed lactulose (2 huge bottles). I asked her how long it would take to resolve my problem. She said not long, maybe a day. I took the lactulose for a week. My symptoms did not resolve; in some ways they got worse as the lactulose caused more gastric upset.

I called in for another office visit (January 30th). This time she told me I had Irritable Bowel Syndrome. She did not send me for any further tests, exams, or imaging. She did not give me any information about IBS or any suggestions on what I should do or not do. When I got home I started researching online. I started cutting potential problem foods out of my diet. I gave up coffee and dairy. At one point my diet was limited to about six things that seemed to not bother me too much. Through February my symptoms did not abate. During this time I did a lot of online reading about IBS, tried different supplements, diet changes, probiotics, digestives and whatever else I could find, hoping to lessen the discomfort. Work was still a struggle, but I kept at it, asking for help when the jobs were too big for me.

As instructed during the last visit to the VA (January 30th, I called the advice nurse line on March 9th because the symptoms had not abated. I told her my symptoms were not improving and that it was affecting both work and home life. She said, “We generally don’t do gastrointestinal consults until you have been in pain for six weeks continuously.” I said I had been in pain for six months. She then replied they would not do a gastrointestinal consult until I had taken fiber supplements for 30 days.

I went to the store, bought some psyllium husk, and started taking a daily dose. I also decided I was not getting anywhere with the Veterans Administration and called Providence Portland Medical Center to get an appointment using my work insurance coverage. The earliest appointment I could get was May 13th. At 3 AM March 22nd I woke up with extreme abdominal pain and nausea. It was so bad I could not lie down and just staggered around the house trying to walk off the pain.

My boyfriend offered to drive me to the hospital, but the pain was so severe I couldn’t even consider sitting or lying down or being jolted in any way. The pain increased to the point of nausea and lightheadedness. I knew if it was not stopped that I would pass out soon. At 0600 I called 911 and got transported to Portland Adventist Hospital Emergency Room and was admitted.

The doctor there sent me in for two CT scans and told me afterward I had a large growth on my ovary. I do not remember if cancer was mentioned, but he gave me an immediate referral to a gynecologic oncology clinic. He also wrote a note excusing me from work until March 27th, and prescribed some pain medication. I saw the gynecologic oncologist on March 26th. He confirmed the growth on my ovary and determined I needed a complete hysterectomy. He also prescribed stronger pain medication as I was still in a good amount of pain.

I remained at home until my pre-op visit April 2nd. A complete hysterectomy (ovaries, fallopian tubes, uterus, cervix) was scheduled for April 5th, and took place at Legacy Good Samaritan. My gynecologic oncologist took multiple samples from the ovary and elsewhere in my abdomen. The samples were sent to Stanford and took a long time to be analyzed. Abnormal cells were found. Based on the pathology report I was scheduled to have 18 weeks of chemotherapy. The treatments started June 11th, and were administered every three weeks through September 24th.

After numerous calls to the VA during my recovery and chemotherapy I was told to have all my providers submit the records to the VA and that the VA would cover the amounts that were not paid by my primary insurer (UMR United Health Care). On September 4th I started to get a series of rejected claim letters stating that none of my medical treatments were pre-authorized and that they were not considered emergent.

It has been a little more than two years since my treatment ended and I have been back to work for almost a year now. I just had a checkup last month and my doctor says everything looks good and that I don’t have to come back for another six months. I still have neuropathy on the soles of my feet and my stamina is not what it used to be, but I continue to improve each month.