Thursday, January 15, 2009

Date Dengan Radiologist

12th January was my appointment date with the oncologist. E-Ya and me arrived at HUKM on the dot at 10 am. After registering myself at the counter I waited for about 30 minutes before my name was called. As usual E-Ya followed me into the examination room. As I tend to sometimes forget details, so she will be there to act as my backup info storage. Sort of like my external hard disk lah mcm gitu, kata dia. Tapi kadang-kadang dia pulak yg terlebih-lebih teruja, tanya itu ini dgn Dr.

I was introduced to my new oncologist Dr Hayani. She started off with asking how I was to which I answered, “Doing well, TQ”. She then proceeds to ask me questions like, “Do feel any pain now? How’s your bleeding, has it stopped? How’s your appetite? Do you have any problem with your motion passing and urination? Is there any blood in your stools or urine? Is the skin being radiated giving you any problem?”, and so on.

Alhamdullilah, although two or three weeks after radiation I had to endure diarrhea, and fatigue but today as I entered the fifth week, it’s much better. Overall I am fit as a fiddle – but an old fiddle lah...

My bleeding has also stopped and it has been a week since the last. What’s left with me now are back, leg pain and yeah ... the itchiness. Oh God whenlah will this itchiness go?

Even though I followed the advice of the radiotherapist not to apply any ointment, cream, soap or talcum powder to the radiated area, I still find it dry and itchy. Luckily there are no abrasions or burn marks , just that it’s a bit darker than the other areas. However, I do notice my skin is getting a bit drier now and this is causing other parts of my body to itch slightly. I asked the Dr if she can do anything about this, but she said if she prescribed any medication it would either be some cream that contains a steroid or something that would make my skin even drier. Thus she advised me to just wash and bathe using water diluted with salt, a practice which I had actually done several times at home.

On top of that, to eradicate dryness I am also “learning” to consume a lot water now.. err.. before this I don’t think I had the proper 8 glasses per day dosagelah.. Mana taknya... sometime nak minum atau nak makanpun boleh terlupa... Yes, believe it or not, if I’m too engrossed with work I sometime forget to eat and I can be without food for hours. Tak human btullah aku ni...

Now, every morning I make sure I take my Prosure drink added with nestum or cornflakes together with either bread/biscuits/beehoon whatever is available. Kalau boring dgn Prosure I’ll have my strawberry flavored Ensure. Both drinks contained Omega 3 fatty acids (can also get it from cold-water fish) that is not only good for the heart but also inhibits cancer tumors. At least twice a day, I’d normally go for green tea added with a spoonful of honey and mint leaves. I am also trying hard to add variety and build up my vegetables intake. Before this I only go for leeks, asparagus and broccoli, but now cabbages, spinach, carrots - anything green or leafylah, I’ll try it. The word here is to go for veggies and fruits that are rich in phytochemicals. Surfing the net got me to know that such veggies and fruits are those rich in colors. Anything that is red, green, yellow and orange – go for it. Cuba jangan tak cuba kata org.

I also noticed that now I have to be more careful with my food intake. Before this I was a seafood diehard fan but now makan sikit seafood je badan dah gatal.. Uwah...! Betul, masa our BBQ tu kan aku hentam seafood? Esoknya badan gatal ssngt. Lg satu kalau makan makanan yg ada banyak letak MSG kepala aku boleh pening sikit. Pulak dah... Dulu berkilo-kilo MSG dah makanpun tak de apa-apa... sekarang pulak tak boleh. So off or slow down je (hehehe) with all the KFC, McD, Burger King and seangkatan dgnnya ... and what about my noodle eating crave? Ni lagilah doubly Uwah ... uwah ...! Dulu hari-hari aku makan noodles, nasi tak jumpapun tak pe, tp jgn noodles. I must have noodles at least once a day. Sekarang kalau makan boleh kembong perut...! Bagus tak bagus??? For example, just the other day E-Ya, Fizah and me stopped by to eat at this “Nasi Lemak Antarabangsa” restaurant near our house. They both had nasi lemak while I had curry mee. My God, masa makan tak pandang kiri kanan tp bila balik rumah, tersandar kat kerusi mcm buaya kenyang sebab perut rasa senak dengan angin. I quickly took my green tea and alhamdullilah, an hour later I was ok. Hey... I cuma burp kat atas, tak burp kat bawah, ok... so skrang kalau nak makan mee kenalah fikir berkali-kali nampaknya.

I just don’t understand why food that I used to consume before I was sick, is giving me problem now. Tp tak kisahlah. Most importantly I can still eat other things. Thus, my sickness is actually something like “a blessing in disguise” as it teaches me to now take more care of my diet and lifestyle.

Oh my... look at me. I’ve strayed from my original intention of relating what happened in the Dr’s room to something else. I’m good at this, ya? Hehehe...

Ok, where were we? Let me see.., I’ve done the part on the itchiness. Oh yes.. now, the back and leg pain. As anticipated the Dr said the pain is normal, its indeed part of the side effects of radiation therapy. If the pain is not too intense just bear with it. If not, taking pain killers would be fine. But she recommends taking low dosage pain killers first before going for higher ones.

With all pleminary questions settled she then asked me to lie down on the examination bed so that she can do a pelvic check on me. She seems satisfied as she found the pelvis is soft to touch. Before, it was a bit hardened especially at the location where the tumor was. Checking both my armpits also revealed that the area is lump free. It’s the neck that is still a problem...

Funny as it may sound, the cancer on the neck is also called endometrial cancer. This is because it is a metastasized tumor from the endometrium. In my earlier appointment with my previous oncologist I was told for the cancer to spread up to the neck, it has to go through my para aortic lymph nodes. Thus, logically this area has also been affected with cancer. The para aortic lymph nodes are located near the stomach. The oncologist did not carry out radiation on all three areas – pelvis, stomach and neck, as the area to be radiated would be too large and that is something unwise to do.

When asked what the next step in my treatment is, the Dr suggested that I try chemo. I mentioned to her about my failed chemo and she said if they do chemo for me now it would be a different drug and they’ll do it 3 cycles first. And guess what? She even mentioned to me that I should not have had the earlier chemo in the first place. She explained at that time I was still bleeding, so chemo shouldn’t have been administered at all. That’s why it failed. But now since my bleeding has subsided, that’s why she is thinking of giving me back chemo.

E-Ya asked the Dr if it is possible that I undergo surgery to remove the tumor altogether. After all earlier visits with the Dr at Gynae-Onco suggested that I will undergo all three treatments - radiation, chemotherapy and surgery. I remembered being told at that time surgery will take place once the tumor has shrunk.

Dr. Hayani explained if the Drs thought that I can be operated, they would have done that in the first place. Now since I started my treatment with radiotherapy all the veins, lymph nodes and others are in a mess inside my pelvis due to the intense radiation. In a mess, meaning some tend to be infused with each other thus it would be very difficult for the surgeon to separate which is which during operation. Hence that would be a problem that is too risky to take. Sounds spooky, huh? At that point of time aku dah imagined my veins and lymph nodes looking like mashed, soggy noodles ...

From that explanation I now come to a conclusion that my case is now a case of an inoperable cancer. What does that mean? I will do a separate write up on inoperable cancer in my next entry, insyaalah. If I include it in this entry then it’ll be like writing a journallah pulak... panjannnngggg bangat!

Dr Hayani nevertheless added whatever the decision is, it will be based on her discussion with her superior the oncologist specialist, Prof Fuad. With that she left the room to go see the Prof who was just a few doors away. I was left with E-Ya in the room.

E-Ya looked at me and said, “Acik, patutlah bila Acik kena discharged lepas chemo tu tak sapapun dr Gynae-Onco datang explain kenapa situation Acik jd mcm tu, dia org takutlah tu sbb dia org dah buat salah. Ni kalau dekat the West ni dah boleh saman dah ni”. Ke situ pulak bdak ni...

Aku: ”Alah... syukur jelah Acik masa tu cepat developed side reactions. Kalau ditakdirkan lg lama chemo tu berjalan, ntah apa jadi ntah? Tapi jgn cakap ngan Ucu (my bro) nanti Ucu sure mengamuk punyalah”. Definitely, dahlah masa aku duduk lama kat ward tak buat apa-apa tu dia dah pissed off, lepas tu dngar pulak mesin radiotherapy rosak, lagi dia geram and now this.. kalau info ni dapat kat dia, hemm.. alamat ada yg kena kang...

15 minutes later Dr. Hayani came back into the room. Behind her was Prof Fuad. Prof Fuad asked me to again lie down on the examination bed as he himself now wants to check my pelvic and stomach area. After 3 or 4 minutes of tekan sana, tekan sini he then asked me to sit up as he wants to check my neck pulak. Then both of them converse in English about what they want to do with me.

Naturally, during their conversation itself I already know what the next treatment is going to be. The deal is like this:

Since I’m inoperable and since they see that radiation works well with me they are going to continue with radiotherapy, but this time it’s for the para aortic lymph nodes. For that they have to re-stage my condition. Re-stage means that I have to have a new chest X-Ray and CT Scan. So I am given appointment for both procedures on the 21st January at 8.30 am. The next day, 22nd I’ll have my appointment with the gynae-onco Dr. I have yet to hear their side of the story but I think after what had happened, they’d probably just go along with the oncologist’s suggestion.

Then come 29th January I’ll have my simulation at the radiotherapy unit. Hopefully one week after i.e early February, I’ll start my first, out of 10 sessions of radiotherapy. Actually this time around, the radiotherapy frets me. Radiation to the stomach area gives more side effects like nausea, vomit, appetite loss, fatigue and epigastralgia. Epigastralgia includes feeling of burning, cramps, heaviness, painful hunger, something similar to a person who has gastric. Meaning I will most probably feel like I used to feel before I went for treatment. This really bothers me as I can still recall how agonizing that was. I am thus, praying for that not to happen.

Upon completion of all that, ehem... ehem... if all goes well, early March Insyaalah E-Ya, Fizah and me will be off holidaying to Penang and Langkawi (jerrr...) We’ll be away for 5 days. Accommodation for this is free because of that Carrefour lucky draw win, remember? We have to go before 11 March 2009 or the vouchers will be void. Tu yang TERPAKSA pergi holiday tu... hehehe

Oh, Oh ... guess who just entered the room? No lah.. Its not Angelina Jolie lah.. Its Jessica Alba wannabe aka E-Ya lah siapa lagi... (Dey... in your dreams lah you Jessica Alba... uwekkks!)

As expected dia start dah membebel kat aku, “Hee... Acik ni tak de keje lain asyik tulis blog je...” I turned to her and asked, “Well, what do you expect me to do then?” Sebenarnya dia jeles tu, mcmlah Acik dia ni tak tahu ...

“Pergilah mencangkul ke” she replied. Tak de modal de lah tu...

“Cangkul apa? Kepala kau?” jawab aku. Hahaha ... yelah rumah aku rumah teres tanahpun dah tak de sbb semua kwasan dah ditileskan. Nak cangkul apa? Sebelah rumah akutu adalah taman permainan tapi takkanlah aku nak pergi mengcangkul kat situ pulak? Tak patut, tak patut ...

Oklah bdak ni dah nak start mengacau aku dah ni. Kang kejap lagi startlah dia suruh aku duduk memonggok dengar dia berceritalah, mengadap temankan dia makanlah, duduk sekali kat bawah tengok TV ngan dialah... bla bla bla... so aku pun ingat aku terpaksa blahlah. Cherioos!

1 comment:

D said...

It's very easy to blame humans and their 'mistakes' but in all, redha to the Almighty is essential. In my late husband's case, I too was advised by many to sue the National Health Service (NHS) for refusing further check-ups on him even as early as 3 months prior. Still, itu ketentuanNya... Semoga tabah yea!