More cancer? …. Stage what!?

Prior to starting chemotherapy, several additional tests were required. I allude to this in my last blog, which could be found here. Apart from all the bloods drawn, X-rays and scans, a positron emission tomography (PET) scan is to done. Unlike other imaging tests, such as CT or MRI, PET scans show problems like cancer spread, at the cellular level.  The scan uses a special dye that has radioactive tracers. These tracers are injected into a vein in one’s arm. Organs and tissues then absorb the tracer over about an hour. When I had the a PET done I was comfortable in a lazy-boy chair with minimal movement so as to not attract muscle activity as this would result in a glucose rush to that muscle and a possible incorrect result.

When highlighted under a PET scanner, the tracers help doctors to see how well one’s organs and tissues are working. The PET scan can measure blood flow, oxygen use, glucose metabolism (how your body uses sugar), and much more.

When PET is used to detect cancer, it allows a doctor to see how the cancer metabolizes (processes), and whether it has metastasized (spread) to new areas. PET scans also shows how the tumor is responding to chemotherapy.  credit: healthline.com

So here I am after an overnight fast.

Diagnosed with breast cancer.

Dressed in a green hospital gown and comfortably awaiting an injection of dye in order to have a PET scans done.

As the radioactive dye gets into my bloodstream, I feel nothing. The dye continues to fizzle to every part of the body and takes about an hour to do so. After an hour, I’m ready to have the PET done. This means lying still on my back. Doing nothing but breathe for another hour whilst this table slowly maneuvers through the donut-looking tunnel.

For someone with an active mind like me, this takes serious switching off and fortunately I did.

One has to exercise patience with all these processes; it’s extremely time consuming, demands your everything, to go-slow and affords a lot of ‘thinking time’. I have great respect and admiration for anyone undergoing these tests and treatment in our current, South African public healthcare system. (I hope to talk to the need for the National Health Insurance (NHI) in future.)

The PET scan results would be available in about three days or so but since I’m only seeing my oncologist in about a weeks time, I’ll actually only have feedback then.

Fortunately, I’m offered colour, printed copies of the scans, which with the help of Dr Google, I’m able to fairly accurately interpret by myself. After studying the scans and comparing it to my Internet findings pertaining the matter, I realised there’s trouble.

Since the start of this journey and up until now, I have not feared a thing but by grace I have had an irrevocable conviction – God’s got this; He has my best interest at heart and He will accelerate my life-victories – even through and with cancer.

Now, PET Scans are interesting, nuclear medicine and works as follows:

IMG_0097Before the scan, one receives an intravenous injection of radioactive glucose. Many cancer cells are highly metabolic and rapidly synthesize the radioactive glucose.

In a nutshell, glucose shows up as bright white areas on the scan results. This bright whiteness should only show up in one’s brain, lungs and other areas where glucose normally exist. Any other area indicates cancer because cancer cells feed on glucose and would have “attracted”/ rapidly synthesized the radioactive glucose, thereby exposing itself.

When I looked at my scan results, I noticed bright white areas in places where it should not be.

For a moment my heart raced.

Like fear knocking on my heart.

I refused to let it in.

I reminded myself of my initial conviction and peaceful state as detailed in a previous blog.

Within seconds I felt normal and thought: If this scan were true, I’m sure God’s got even this. Let’s not be naïve – nothing under the sun surprises God. He’s neither caught off-guard by our conditions, our future and concerns. Like a GPS, He’s intentions for us are only good and therefore for our benefit and finite minds, He’s “recalculating the route”.

Given that I’m empowered with knowledge about my condition, I was eager to test my findings against my wife’s knowledge on the matter. Ronwyn however refused to look at the scan print-outs. Little did I know she wasn’t ready for more bad news and probably knew something was wrong given my eagerness.

The day finally arrives when we meet the oncologist to face the music.

Her feedback is short.

“The cancer has spread to the lining, top and bottom sections of your lung”.

She draws a basic image to indicate the locations. She further explains the spread, discuss root causes, treatment plans and the way forward.

Since I had dealt with this feedback before with help from the Internet, this news was a bit shocking but I was somewhat prepared for it.

Critical to the treatment plan was taking a more radical approach in chemotherapy and probably over a slightly longer period. In my mind I’m thinking ‘just cut it out like with the breast’. I therefore engaged the oncologist on the possibility of surgery.

She agrees to discuss this with her colleagues, as surgery would mean opening my chest to access the lung and cutting away parts of it.

This is hectic stuff!

The oncologist further explains that their decision to do surgery would be based on improved longevity of life verses the expected results of chemotherapy.

We leave it at that for the day.

The sun sets over our balcony like any other late Autumn day.

The cancer has spread to my lung.

It’s rated stage four (IV) because it’s advanced (in staging) and metastatic (spreading).

I’m still UNSHAKEABLE.

I’m propelled by desire to represent. Create awareness. Contribute to life and society.

My HOPE is sure.

GOD’S GOT THIS.  He’s faithful and can be trusted.

In memory of my late mom, Catherine Isobel Venturini (nee Deschamps) who trusted God for total restoration of her body until the day she closed her eyes. These lines accurately describes her attitude:

17 Though the fig tree does not bud
and there are no grapes on the vines,
though the olive crop fails
and the fields produce no food,
though there are no sheep in the pen
and no cattle in the stalls,
18 yet I will rejoice in the Lord,
    I will be joyful in God my Saviour.

19 The Sovereign Lord is my strength;
He makes my feet like the feet of a deer,
He enables me to tread on the heights.

For the director of music. On my stringed instruments.

extract from Habakkuk 3:17-19 – New International Version (NIV)

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Scars Tell Stories – accepting my new normal

I was scheduled to be in theatre exactly a week after my diagnosis. I generally do not fear theatres; I actually prefer general anesthetic over local – for just about anything. My reasoning is simple: (doctor,) do what you have to do whilst I’m “out”.  Then clean up the mess and let me wake up.   And that’s exactly what was scheduled to happen – or so I thought.

The original plan as discussed with the surgeon was to do a total right mastectomy, then, together with other specialists, see what the extent of the cancer spread to the lymph nodes in my armpit was.  We already knew from preliminary tests that the sentinel node (nodes closest to the tumour) was infected and that its removal was inevitable. We however did not foresee major spread; maybe two or three other lymph nodes but certainly not more than that.

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Within private healthcare (an area I’m connected to for most of my working life and which I hope to write about later) we are fortunate to have specialists and superior healthcare facilities readily available in all major cities. As a result,  I was fortunate to have a pathologist in theatre that was able to immediately test the malignancy of lymph nodes as it was removed.  Upon removal of the sentinel lymph node and four other nodes, the specialists realised the cancer had spread beyond these and therefore continued to remove more lymph nodes. A total of 12 were removed – that’s just about the whole lot located in my armpit. Doctors refer to it as a radical axillary excision.  This additional surgery therefore resulted in a longer than usual theatre time. Two and half-hours later I’m wheeled out of theatre, oblivious to what had just happened.

Now, regarding the removal of my total breast – my reasoning is similar to bidding farewell to a deceased loved one at a funeral (I know, it’s a weird comparison, but hear me out):

That which was, is no more. I appreciate the role it had played but since it is no more and I still have breath, it’s time to adapt to the new normal, and move on.

Now don’t be fooled, it is easier said than done.

The challenge with not adapting means one is stuck in the past: longing for, weeping, not accepting, and ultimately regressing.  The blessing of accepting the new normal may mean new horizons, scope to grow, opportunity and possible fulfilled purpose.


Scars 1I remember taking off my oversized t-shirt in front of the bathroom mirror and being shocked at the sight of no breast. This happened a few times. The sight of stitches across my chest and armpit, was weird to see. I would genuinely skrik at the sight!

Whilst getting dressed one morning, my nine-year-old son, Eli, asking me: “ …but dad, was it really necessary for them to remove your nipple; could they not put the nipple back after removing the cancer?” His younger brother Zach, who heard the question, retorted quickly before I could. His response made me laugh. “Would you rather have a dead dad or one without a nipple?” This chirp reminded me not to under-estimate the intellectual capacity of kids.  It further made me aware of the importance of discussing and involving our children in this life-altering occurrence.  Someone once said: “life lessons are not taught to kids, they are caught by kids.”

Now back to my post-operative recovery:

I always joked about wanting to be admitted to hospital. But my intention then was to rest, chill, watch TV and so forth – as if hospitals are hotels!  So here for once,  I had all that I joked about plus a menu of food to select from.

On my first day of recovery an elderly cancer support group volunteer visited me. Her words were warm, her smile beautiful and she carried a gift and loads of brochures for my education. Little did I know, the gift – a little blue pillow which one places in the armpit for comfort – would come in very handy during my recovery (my “baby” as I was teased for carrying it all over with me). This brief, yet warm encounter with a total stranger reminded me that I’m not alone in this battle.

Balsam KopivaThe days ahead, both in hospital and at home, meant bathing without stretching, tons of resting, slow movements to avoid jerks and sleeping on my back. It also provided loads of time to read, research and consider where this journey would take me.

Weeks prior to the diagnosis I believe God had placed a confidence in me to trust in His guidance, supremacy and favour.  It was at this rather tumultuous juncture in my life where #GodsGotThis resounded in my bones.  Little did I know that this very confidence and declaration of faith would become my anchor in weeks to come. I hope to speak about this soon.

In the meantime, the scars across my chest and armpit continued to heal. Healing as if it was readying to tell a story.

The grabbing feeling in my armpit started fading.

A treatment plan was approaching – chemotherapy.

More tests…

Tests to check for cancer spread to other parts of my body.

Was it going to be a time to face the facts and fear?

…or continue in confident hope?

I was being prepared to tell my story… the story I did not know I’d tell.

“…tribulation produces perseverance;  and perseverance, character; and character, hope. Now hope does not disappoint…”

CANSA Mens Health Infographic - 2016 Social Media.cdr

To read more about my story, please see: http://www.godsgotthisweb.wordpress.com

The Balloon Effect – People make People fly

My aim with blogging was to tell the clinical, cold detail of my journey with cancer but as I write I realise there’s a softer, warmer, very encouraging part I must write about.  This “must tell bit” I was only going to share much later but the last mountain of support from different people, has encouraged me to write the following sooner.  If you’ve encouraged me in anyway, please read this.

If this is your first time reading my writings, please read the rest here:  https://godsgotthisweb.wordpress.com/

mood-balloons-bulbs-girl-silhouette-nature-grass-green-sky-background-wallpaper-widescreen-full-screen-widescreen-hd-wallpapers-background-wallpaperI have been fortunate to receive tremendous love, support, comradery, ubuntu, care… from both family and friends on this journey as.  I call this “The Balloon Effect”.

As children, we played with balloons.  The aim was to keep the balloon airborne for as long as possible.  It must not touch the ground.  We would jump, run, kick and scream in our efforts to keep the balloon afloat.  Now, the balloon itself has some ability to keep itself up in the air, but it cannot do this forever, by itself.

People are like balloons.

I’m like a balloon. 

My life experience has toughened me to a great degree to weather storms. This is not unique to me; we all face and have faced great personal storms.  As a result of us overcoming past challenges, we have a certain capacity and tenacity within us to overcome life’s challenges and stay afloat… like a balloon.  I particularly like thinking about the life of a biblical character, David. At an early age whilst he tends sheep, he is able to overcome a bear and a lion in protection of his family’s valuable livestock. On another day, he stretches forth and takes food to his brothers whilst they are participating in war. There he offers to fight Goliath on their behalf, a powerful, fear-inspiring chap in the opposition army. 

David takes Goliath down, largely because of the confidence and courage he’s built in previous battles.

Our previous battles prepare us to be greater conquerors later. We have a great degree of courage within.  Then, when others come beside us in encouragement, our courage is given a boost, and our balloons stay afloat.

Let me get back to the balloon effect:

There is something indescribable when those around me – friends, family, colleagues and even strangers – assist in keeping “my balloon afloat”.  The words of encouragement, prayers, little gestures and assistance from people is like a group of kids, stretching themselves to help keep my balloon in the air. 

The further effect of this process is that life just seem so much more liveable for me; the challenges are less challenging, and HOPE is kept alive.

I’ve often been on the giving end in life. I don’t say this boastfully.  I love giving.  Giving to make life more liveable for others gives me great joy. We should never underestimate the power of giving to others.  It’s personally liberating.  Winston Churchill said it this way: “ We make a living by what we get, but we make a life by what we give.” 

Now that being said, I am thoroughly enjoying being on the receiving end of this process.  I am often left speechless by the length and breadth people have gone to support me and to keep me afloat. These efforts by others has enabled me to fly higher.  It has also encouraged me to tell my story and in so doing, encourage others.  See, there’s a beautiful cyclic effect in all of this. And I’m loving it.

Be encouraged friends.

Whenever you can – stretch forth and be that person who will bump up someone else’s balloon… like kids do. The balloon bump you are about to do may seem small to you but the effect on the recipient may be indescribable.

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“…sorry, you have breast cancer”. The day my head went zim zum

In my previous blog, Finding C50.9 – Tests, tests and more tests, I detail the various tests I had undergone in order to provide doctors with specimens to make a conclusive diagnosis.  That Thursday, 16 February, ended like any normal working day.  In fact, on that day, after all my tests, I reported to office and went along doing stuff as usual with colleagues oblivious to the morning’s drama.  I had a bandage strapped across my nipple and armpit area, and this provided me enough comfort to go about life.

Days passed and the usual, hectic office life took over.  I was expecting a call from the surgeon to discuss results any day.  I was not bothered in the least, even cracking an odd joke with Ronwyn about the possible results.

On Tuesday, 21 February I receive a call from a number which had become familiar in the last while – the surgeon’s rooms.  Margaret, his right-hand lady, then confirms that doctor wants to see me to discuss my results.  Given that he is in theatre most of that day, I’m given an appointment to see him on Wednesday.  In my mind, I’m thinking this doctor is keen to make more money by seeing me for something he could just discuss telephonically – this is how nonchalant I was.  I however obliged and committed to the appointment at a time convenient to both Ronwyn and I – after work. 

My wife likes to hear things first hand so I resultsrespect that.  Also, I tend to not ask questions and she has the ability to ask all the right questions.  So, I prefer having her beside me.

I arrive slightly early for my appointment with the surgeon and he is able to see me almost immediately as I walk-in.  Ronwyn had not arrived at the rooms at this stage.

The surgeon sits me down.

His words I remember as if it was uttered yesterday. 

“I’ve received your test results of the biopsy and FNA.  I’m sorry, you have breast cancer.  It is confirmed…” 

At this moment, my head does cartwheels and I feel zim zum.  It felt like I’ve been knocked against the head with a pan.  For a moment, I hear nothing else but the doctor’s words.  I quickly bring myself back and continue listening to him explaining the way forward – further tests to be done, surgery and and and…

I’m left speechless at this news, but my entire being is at peace.  I find this peace so strange as I’d expected to become emotional. Let’s face it – a positive result crossed my mind and I’ve had to consider how I would respond to it.  But despite there being a 50% chance of a positive result, one hopes for the opposite.

The doctor continues talking to me but my mind wonders away ever so often. 

It’s as if life slowed down. 

I’m more observant. 

Awake. 

Alive. 

My state of peace at this stage grows into an optimism; a curiosity as to what possibilities this diagnosis could bring.  A quiet excitement starts to grow within me.  I have a knowing that this is a turning point for many things in life.  I have a knowing beyond a shadow of a doubt that this is going to work together for my good.  And I can’t wait to see this pan out!

Now, I’ve mentioned earlier that I’m not the question asking type.  Ronwyn is.  And since she had not arrived, I have nothing to ask.  The doctor then beckons toward his reception area to have Margaret assist with scheduling additional tests.  I follow him to the reception and at this moment, Ronwyn walks into the reception area with a “I missed the bus” look on her face. 

The moment is quickly and silently awkward –  I have a straight face and the surgeon has a look of “are you not going to tell her?”  I’m a poor communicator for myself.  At this opportunity, I’d probably communicate the facts in the shortest possible way.  The surgeon realises the uneasiness and therefore offers to see Ronwyn privately to provide her with the feedback.  I’m happy he obliged as I was not going to break the news gently.  To me, at this instance, it is what it is and life goes on.  I have learnt over the years that how I accept and process information is different to how my wife does.  Or maybe it’s a woman thing in general.  Men tend to be doef daf; women not. 

Moments later both Ronwyn and the surgeon emerge from his rooms.  During this time Margaret and I had some or other chit chat. 

I’m too eager to have the additional tests done and given the time of day, we dash to the lab two floors under.  Apart from providing more blood samples, I’m seen by a radiologist for a sonar of my key organs.  This sonar could immediately tell whether there is any further cancer spread.

Night falls.

I’m on my bed.

Gazing into darkness.

Thinking about the journey I’m about to embark on.

Considering where this road would lead.

Hope leaps within me!

 As if it had become exited at the possibility of it becoming.

know

Finding C50.9* – Tests, tests and more tests

I’m writing this blog, assuming you’ve read the previous one.  If not, I’m sure you won’t be entirely lost.

bloodsHaving seen a surgeon who was as eager as I was to diagnose this breast lump was a good thing.  As soon as I left his rooms, we sped to the xray and pathology labs.  Here, without appointments but because of the referring doctors influence, I am able to have a CT scan and x-rays done as well as bloods taken.  I’m happy this could be done so quick as it would eliminate me coming to sit in a queue the next day.

In fact, the next day has its own challenges.  Upon the surgeon’s recommendation, I planned to gate-crash the radiology rooms for a mammogram, sonar, FNA test and biopsy.  These tests are usually done by appointment but if I had showed-up at the radiologist’s rooms by 07h30 and as a male request a mammogram (with referral)  the reception staff would squeeze me in.

Little did I know my early arrival happened to be perfectly timed as my “squeezing in” would be before any of the scheduled patients arrived.

I had no cooking clue how these tests were going to be conducted. 

Needles and I are not friends; we’ve never been.  I therefore preferred to remain ignorant pertaining the detail of the tests because sometimes knowing little about a matter is better.  After all, given the little I knew about a mammogram, how on earth was I to grow a breast overnight!?

The tests turned out to be an interesting experience.

For the mammogram to be done, I had to stand infront of the mammogram machine (or whatever it’s called) and lean forward slightly. Then I had to make my body ‘pap slap’ so that the technician could move me as she wills, pull/stretch the little breast I have and place that between two plastic squeezing stuff (very much like a snackwich toaster, less the heat). Then I had to remain still in that position, long enough for her to run and take the x-ray.  For the men reading this, especially the skinny guys, grab your boob with one hand (yes, the little boob you have) and hold that grab tight for 10 seconds…. that’s what a mammogram feels like.  But imagine a total stranger doing it to you 🙂

The mammo was followed by the FNA. Vader van genade! For this part I closed my eyes because even though my breast area and armput was numb (because of local anaesthetic) a needle was to be used to extract fluid from a lymph node in my armput.  In order to know the exact location of the node, a sonar is used and the doctor watches on a screen as she navigates the needle to the correct node.  I’d be lying if I said I did not feel the needle prick, but once the needle was in, I was fine.

Then came the nasty one, the biopsy.  The radiologist had to zap a piece of the tumour tissue which is to be sent to the lab for microscopic testing.  In order to do this, she inserted some or other zapping device through an incision made next to my nipple.  I recall seeing a long, niddle-like thing in the corner of my eye.  I preferred not seeing anything and therefore shut my eyes. The radiologist is once again guided by the sonar to ensure she gets to the correct tissue.  Then, suddenly, without warning, I hear the sound of a big stapler which cuts a piece of the tumour.  OMW! The stapler sound coupled with the zap is something I won’t forget.  I was extremely grateful to the radiologist for not explaining this process in detail (as I just did) because if she had, I’d probably run away.

Once this was over, I was offered a seat in a recovery area coupled with tea and a snack.  It was at this point where my eyes fell on the basket beside me containing knitting.  This basket brought so much fond memories, I could 16797271_10155005768402232_9057525195750575965_onot resist demonstrating my knitting skills to Ronwyn and in this moment, managed to forget about my recent trauma.

These tests, coupled with the ones done the day before, would be the specimens the various doctors would use to confirm my diagnosis.

*C50.9 is the International Classification of Diseases (ICD) code for unspecified malignant neoplasm of the breast.

Deceived for my own good

I’m a fair-skinned bloke so having moles seem pretty normal; in fact, I have a good few across my body.  One particular mole on my back changed in colour and shape (yes, as if I could see this) and this is apparently not a good sign.  A visit to my GP resulted in a referral to a dermatologist who found the mole to be benign (a nice word for not cancerous) but I opted to have it removed by way of a quick, painless, in-room procedure.

As we’re about to leave the dermi’s rooms, Ronwyn, my wife, who happens to be a biomedical technologist and who majored in histology (the study of cells of body tissue), asks the dermi to take a look at my right breast and particular, my nipple.

This specific nipple had been inverted (turned in, instead of showing out) for at least three months.  It did not bother me at all as it was painless, and I recall seeing it showing outward at some stage.  So having a doctor check and touch my boobs was no big deal.

Upon closer inspection, the dermi confirmed that an inverted nipple was abnormal but more than this, there was a lump of sorts right behind the nipple.  Haaibo, I thought! A lump, from where, how….   True’s Bob, I could feel it for myself.  It was there.  Painless, lumpy and there.

Despite me feeling the lump, I was not bothered at all.

At this stage of the consultation my wanting to leave the rooms is stalled by a question: where to from here?  The dermi then clearly explains his expertise and suggests that I see a surgeon who knows lumps and stuff.  At this stage, I’m still very content and happy to be referred for an opinion.

With a specialist surgeon appointment scheduled within three or so weeks’ time, I get back to work and life continues as normal.

My appointment day arrives and given that my plate is relatively full back at the office, I opt to go to work and then in the afternoon, Ronwyn and I meet at the surgeon’s rooms.  I hate avoiding work for what seems petty or mundane and so I’d rather kill an appointment of this nature in the afternoon and once I’ve managed to get some work done.

The consultation with the surgeon follows the usual pre-inspection conversation during which time we unpack family and medical history.  Upon inspection, the doctor tells me what I already know (i.e. lump behind nipple) but in order for him to make an informed diagnosis, I’m referred for tests.  I’ll speak about these and other tests and its findings in my next blog.

With tests confirmed, we go about our usual, everyday lives.

As the day draws to a close, I am still not aware this entire process has been a set-up.  From a GP to a dermatologist to a specialist surgeon. 

I’ve been deceived for my own good.

A journey of a month was a long-way-around for my own benefit, orchestrated by my wife who loves me too much to give me the potential facts because she’s not sure how I would process it.

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