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WHEN YOUR HELP GOES OUT OF ACTION..... The joy of becoming Director, Breast Surgical Oncology, dissipated into thin air when my help did not turn up for work citing an excruciating back ache. And then all hell broke loose, at least for me, as I realised that a whole new vista of mountains of work had piled up in front of me. My mother in law who is past 75 did her best to restore order but at that age, speed is not on your side. The morning hours between 6 and 7.30 am is nothing short of high speed roller coaster with three people with contrasting needs, rushing off to their respective places of work. One of these people is also me but I was the only one riding the roller coaster. Now I know why the goddesses have multiple arms, symbolic of the multitasking geniuses women are. I had exactly an hour and a half in which to don the cape of Superwoman! I would have to conjure up six dishes. Each of us would eat a different thing and carry yet another thing for lunch. Spoilt brats, each one of us 😯but blame it on the ever complying help. If this variety in dishes was not enough, my obsessive mind with a fetish for cleanliness would go about setting the house right, ironing out the last crease on the bed and cleaning the bathroom, till the tiles gleamed and the arms hurt. 😱My husband and daughter would look on trying to tell me that my obsession was not their problem-meaning, they would not help!🤨 Out of breath and sweating, I would now get ready for that job, I am trained for and love doing.I would arrive in hospital, without a trace of the battle that I was embroiled in not too long ago. Nobody wants to know that you have just completed a day’s work before coming to the hospital. I am not looking for compassion but this is my tribute to all the women who strive endlessly to make the lives of their loved ones better and then go to work and excel there as well. Breathe ladies and take good care of yourselves!While I love being a woman, I really hope my help comes back soon!
Early breast cancer does not usually announce its presence with pain. The most common presentation of Breast cancer is a PAINLESS LUMP! Please do not ignore such a lump and see a Breast surgeon to make sure it is nothing sinister!
Never too old to make choices Last week, I met this lovely lady, pushing 80 years. I’m reluctant to call her old for her lively demeanour would put the chronologically young to shame. How I met her was because she had been diagnosed with breast cancer. Fortunately for her, she had early breast cancer. This is a delight for a breast surgeon like me, who is used to seeing advanced breast cancer. After going through the investigations, it was decided that she should have surgery. I started discussing the surgical options and just as I would do with all my patients amenable to all the options, I discussed breast conservation surgery, mastectomy ( surgical removal of the breast)and mastectomy with reconstruction. She was quick in making her decision and said she wanted to have a breast conservation surgery. I liked her firmness but her daughter was not so sure. When the time came for her to be admitted, the daughter came up to me and said that she and her brother thought it would be better if she went ahead with mastectomy. It was surely concern for their mother. They wanted her to be disease free and also thought that at her age, it did not matter if she lost her breast. At the same time, they were not sure that breast conservation and mastectomy yielded the same results. I spoke to her again and said that her mother had made a choice, which was scientifically tenable .Ten years ago, my warped mind might have encouraged her to go for mastectomy. Now I know, choice has nothing to do with age.The instances when husbands, brothers, parents, relatives and anyone else( read neighbors!) influencing surgical decisions have been too many and every time, my heart has gone out, especially, to the young ladies who have had no say in the choices imposed on them.Losing a breast is a self esteem, body image issue- the loss and its impact is borne only by the one who loses it.The lovely dame stood by her choice and it was executed. Choices are not about being right or wrong. Choices are about the freedom to make a decision and stick by it. The comfort of having made one’s choice is a confidence booster and can bring about unexpected results. I do know that, for a fact!
ATTITUDE IS TRULY EVERYTHING The picture one would conjure up on seeing this beautiful old lady is that of a loving ‘dadi’ or ‘nani’ full of stories, weaving magic with her deft fingers as spools of thread became exquisite pieces of crochet art.She is all of 86 years old and continues to do all her chores without any help. She does not believe in stopping. And believe me she is quite extraordinary! I have known her for the last 8 years and every meeting with her is inspiring. At the age of 78 years, when many would will themselves to die at the simple pretext of a minor illness, this lady was diagnosed with pancreatic cancer. She had deep jaundice and she needed a Whipple’s procedure to get rid of the cancer. This surgery is one of the most challenging to even an experienced surgeon. She and her family were explained the pros and cons in view of her age and frail self. She was determined to see this through. The surgery went to plan but the postoperative period was stormy. She had a bloated abdomen, for which she was re-explored and found to have a twisted bit of intestine. It took her a month to recover and finally, she walked out of hospital, recovered fully.She refused any further treatment and said she felt fine. She would meet me every 3 months for a year and then she stopped coming. I had almost forgotten all about her, when she resurfaced again after almost 1 year. This time she came with an ulcerated mass in the right breast. She was 80 now. She did not want any other treatment except surgery. She had a surgery to remove the breast and the lymph nodes in the armpit. Fortunately, the disease was hormone sensitive. She said no to Radiation and accepted hormonal treatment. What does one say to this except that I was fortunate to witness this most wondrous display of an old lady’s grit and determination, willing herself to live on, in the face of not one but two cancers! She came to meet me five days ago. She is disease free. Her smile lit up her wrinkled face and her eyes sparkled as she said she had come to bless me. I, honestly had nothing to offer her. Did she even realise how inspiring she is? She wanted me to share her story with everyone and so here I am! Important lesson learnt..Attitude is truly everything!!!!
Having been closely associated with the care of cancer patients, I do certainly know that we cure some and we lose some. There is nothing like a 100%. However, when I see patients who have undergone alternative treatments and were assured 100% cure, I can only wonder where this confidence comes from.The number of times I have seen a Stage 1 or 2 Breast cancer on alternative treatments, going on to become Stage 3 or 4 is quite substantial.Anecdotes call for applause but that is not the entire story. And that brings me to Mrs U’s story. I met U, a retired teacher, 10 years ago accompanied by her husband and her daughter, a doctor herself practising in the US. During my conversation with U, she would not make eye contact. She was angry because she did not want to come to see me and her husband and daughter had almost dragged her to the hospital. She had a lump in the left breast of 1 1/2 years duration and was on alternative medication offered by a popular seer.I examined her and was shocked to see a large mass in the left breast occupying about 3/4ths of her breast and bleeding from an ulcer on it.I advised a biopsy and U got up and walked out of my room, explicitly declining my proposition. Her daughter said she would bring her around and went after her. She returned after 4 days and got a biopsy done on her daughter’s insistence and the bleeding from the ulcer was getting her worried too.She muttered and mumbled throughout the procedure, accusing doctors of doing tests to make money and deriding alternative medicine practitioners. The biopsy confirmed cancer and her staging work up fortunately did not show cancer anywhere else in the body.She was offered chemotherapy followed by surgery, radiotherapy and hormonal treatment.Her daughter and her husband stood ground and got her through treatment. It was not an easy ride but she completed treatment. The chances that disease would come back was pegged at 50-60%. Two days ago, she came for her 10th year follow up. Her husband has been rock solid in his support for her. He has ensured she is very regular with her follow up. She continues to be disease free. However, this time was slightly different. She held my hand and apologised to me for her bad behaviour 10 years ago and was grateful for how life had panned out since. I did not know what to say. While what I offered as treatment did help her recover, her husband played an equally important role by ensuring she took her medication on time, ate well and led a healthy life. I complimented him on that and could see tears roll down his cheeks. We do what we can!Blind faith may have serious consequences. Sincerity of purpose, backed by evidence and the support of loved ones can truly move mountains!
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