Early Symptoms: Hollow, Tired, Lost Focus
I still remember calling an urgent meeting with Fiza and Anis (who were my two very able assistant) and Yanti (a colleague who knows me very well) sometime in September 2oo8. It was approximately 2 months after I came back from my confinement leave after giving birth to a cute and healthy 2.7 kg baby girl, which I named as Faiqa on 29 April 2008.
I started the meeting by thanking them for coming and blurted out my frustration. “I have a confession to make and I need your views on the matter. It’s been about two months since I came back but I must tell you, I feel so hollow and lost. No matter how much I try to accelerate (for your information, I’ve always been a top performer at work), I just can’t. It is worst when I am not having a meeting; I feel my brain refused to work and every time at the office, I try to appear busy when inside me I could not focus on anything but rest and go home. I can’t stand pretending anymore. I am ashamed to be a useless member of this organization so I am seriously considering tendering my resignation.
Blessed
Everyone empathized and started probing questions to try to understand what I was going thru. And eventually, these were some of the comments and suggestions made. Fahiza, we know who you are, how workaholic and passionate you are about your work. No way could you live without working, so resigning will not be the solution. Secondly, we also know that you have just came back from birth and it was less than a month gap from your previous birth (on 8 June 2007 I gave birth to Muhammad Fayed a 3.3kg baby boy who since inside tummy look as cute as Tweety Bird). Our guess your body may be tired or you are going through a post-natal depression. Thirdly, you don’t look that bad at all during meetings because you still give good inputs. In view of all these, the threesome wanted me to give myself some time to heal and pick up my steam again. While Fiza and Anis offered themselves to cover my work until such time I am able to buck up again, Yanti on the other hand promised to snarl at me whenever I look dreamy.
What Happens When You Ignore Your Body?
A week after that, during a short rendezvous with hubby (he was going for a business trip to Labuan for 2 days) he commented about a UFO (unidentified object) which he had discovered on my left breast. I dismissed his concerned by saying it could have been caused by the swelling of my milk gland (but frankly, I never did check and realised the UFO. But after he went to sleep, I run my fingers on my left breast, and to my surprised I could feel a big lump about a size of a 20 cents coin. I couldn’t sleep till the morning thinking what that lump could be. That morning, on the way to the airport hubby suggested that we went for a check-up as soon as he comes back from his business trip.
After sending my hubby off to the airport, I went to work as usual. But boy, it was tough keeping my mind off the lump discovery. So, I decided to go for a check-up instead.
At the Hospital
I asked the receptionist at a specialist hospital (APSH), who I shall see regarding breast cancer examination. The receptionist suggested Dr. K and so I went up to his clinic. I didn’t have to wait long. There were only two patients before me. I told him about the discovery earlier and so he asked me to lie down for a physical examination. The examination was brief because the lump was easily identified. Dr. K asked, why didn’t i come earlier caused the lump’s size is big. It looked like it has been there for at most a year (this is in consideration of my earlier pregnancy). Anyway, Dr. K asked me to go do a mammogram check and once report is ready, I need to come back and see him. Please note, a mammogram will not be performed unless you fit in certain criteria (i.e. aged above 40 but in my case because a lump was discovered and I already have four kids an exception had to be made. Mammogram below age of 40 is not encouraged as it may activate your cancer cell. Output of a mammogram is in an x-ray film format.
So I went for my mammogram test at the same time updated my husband by sms about it. I know he was on the flight and will only be able to read it within next 30 minutes? Mammogram done and I was waiting for my report. My name was called and I was asked to go for a short ultrasound scan. At that moment I knew something is not quite right because Dr. K never mentioned about an ultrasound scan. An ultrasound scan is like a pregnancy ultrasound scan. Doctor will put on a gel on your skin and roll to spot any changes on your tissue). Still calm, I went to see the radiologist Dr. A. He was friendly and maybe to ease my mind he started asking questions including how I discovered the lump. I said it wasn’t me but my hubby; a good teamwork eh teased me. He smiled and suddenly I saw a changed on the look of his face. He didn’t look pleased with the ultrasound. I asked him the outcome of the ultrasound. All he said was let me prepare a report for you to discuss with Dr. K. I asked again, is everything ok? He repeated, discuss with Dr. K ok. At that instant, I knew something isn’t right.
While waiting for the ultrasound scan report to be ready, my hubby had touched down at his destination and was upset as I didn’t wait for him before going to see the doctor. Well, we always do things together especially when it concerns health. I apologized and explained that I had to go because my heart and mind wasn’t at ease till I know what the lump is. Hubby was still very upset, maybe because he already suspected the worst?
A Beginning to a Bumpy Journey
While waiting for Dr. K, I took a peek at my mammogram film. I contra my film to a breast cancer wall poster hanged on Dr. K’s clinic wall. As I compare, my heart dropped. The image on my mammogram looked exactly like the image on the poster. I know then what to expect.
Dr. K explained the results. I have a lump a size of a 50 cents coin. While the mammogram helps showed where, ultrasound confirms the depth and width of the lump. Dr. K suggested I do an excisional biopsy. An excisional biopsy is procedure where an entire lump or suspicious area is removed. I will be put on a General Anesthesia and a surgery to take out the whole lump was performed. His argument was that the lump is already big and whether it’s a benign (non-cancerous) or malignant (cancerous), it would grow and should be removed. I asked him about how my mammogram looked like the poster outside. He dismissed my thought and say, let us do the surgery first before we make any conclusion. I guess he was trying to comfort me. He asked me to come the next day (Friday) for the surgery.
Quite frankly, I think Dr K was a bit unfair as he never explained my option well. He presented me a solution that maybe was right for him but not necessarily for me as a patient. You see there are other types of biopsy that could be done on me (you may researched it yourself but an option that was never presented to me was A Needle Aspiration Biopsy; in this type of breast biopsy, a needle is used to aspirate (draw out) fluid or tissue from a breast lump. Needle aspiration leaves no scarring, is less invasive and quicker than excisional biopsy, and usually does not require stitches or a recovery period. The patient can resume regular activities immediately. This being the case, cost for performing the test is definitely lower. Additionally, Dr. K never told me the overall picture i.e. what is next if my lump is confirmed to be cancerous. He kept on asking me to take it easy and go for the excisional biopsy the soonest possible.
Agreed, there have been cases where people do biopsy and because the lump was so small, the tissue sample taken was inaccurate and you could be misdiagnosed. But in my case, the lump was big enough hence the risk of misdiagnosed is extremely low. A surgery has it cost implication and I was a business for him? I don’t know.
But what I was more upset about other than the cost was, I had to unnecessarily undergo double surgery. For your information, once you have been cut-out you only have about two weeks before your next wide excision surgery.
Breaking the news to my Hubby and Parents
Immediately, I updated my hubby about the news. He was still upset that I didn’t wait for him to go to the hospital he is obviously more upset now as I will be undergoing surgery when he was not around. He asked me to wait till at least he comes back. Adamant, I argued my way to proceed with the surgery and he was kind enough to bless me.
At that point of time, I thought hubby was being unreasonable. Hubby wasn’t effective at expressing his views I kept on hearing him being concerned over what will my mom said when I undergo a surgery without him. I was annoyed because I feel at this point in time he should be more concerned of the bad news in hand. Believe it or not, it takes me years to finally understand it wasn’t the trip to the hospital alone that upsets him, it was him not being there with me and for me when I needed him the most that was killing him. Duhhh, how can I not see that? Sorry hubby dearest, for my failure to understand you then.
After dinner that night I told my parents about the discovery and surgery. Parents were shocked and worried. The news sort of spoilt my parent’s mood to prepare for the Raya Open House which is taking place on Sunday.
Friday, the Biopsy Surgery
Everything went well. I didn’t know what to expect but having gone through various surgery in the recent years, I would say it Dr K’s work wasn’t that impressive. After the surgery I went home and was greeted by a big hand bouquet from hubby (Thank you Sayang that was gorgeous and nice). On Sunday I was busy at my parents’ house Raya Open House. My discovery episode becomes one of the day’s hot topics.
Hubby was still upset. Told hubby I would like him to go with me to collect the Biopsy Report on Tuesday. He said since you could handle it before, I’m sure you don’t need me now too. (heheheh merajuk betul ni). But Alhamdulillah, he was finally ok.
Tuesday Appointment, Result Day
Nervous both hubby and I went to the hospital that morning. Dr K greeted us and started with an icing on the cake kind of questions. Immediately I told the doctor, let’s cut the chase doctor just tell us the outcome. He looked at us both and said, I do not have good news for you. The lump proves to be cancerous. I need to perform another surgery to scoop out wider margin to see if the cancer has spread. Additionally, I will also take out your lymph node to see if there is any spread there too. We need to determine your staging and grade of your cancer cell. Since you are young, I don’t recommend mastectomy. Both my hubby and I were speechless. We know we were prepared for the worst but we never thought we really have to face it. It was daunting and we were numb by the news. Hubby asked Cancer? What does it mean doctor? How long? Dr. K said there are many advance treatment now compared to older days so chances of survival are better now. She is young. Hubby asked when is the latest we can do the surgery. Doctor gave us two weeks maximum. The Doctor explained that since APSH do not have cancer division he recommended us to see his friend who is an oncologist at TSH (another specialist hospital) for chemotherapy and radiotherapy.
We told the Doctor we would like to use the two weeks to seek second opinion and at the same time go for a short break to try digest the news that was just presented before us.
My quick lesson’s learned
Few things I’ve learned from this episode and I wish you to share it with as many people as you could:
- PAY ATTENTION TO YOUR BODY CHANGE, do not dismissed any changes so easily, look for signs or symptoms; learn to do your breast self-examination, see doctor if unsure. For your information, I used to do a regular breast check-up but stopped after doing it in four consecutive years because the Doctor said I was healthy. Good report made me complacent and complacency is costly. Three years I stopped and a lump discovered?
- DO NOT DO MAMMOGRAM UNLESS NECESSARY; assuming you happen to meet up unscrupulous doctor (doctors are human and private hospitals are business driven entity, so you know what I mean. On separate topic, if you go to government hospitals, if you have a malignant on your breast no matter how big or small it is, I heard the doctors will recommend an automatic mastectomy as they need to manage the long-term cost of treatment).
- TAKE UP AN INSURANCE POLICY FOR CRITICAL ILLNESS TODAY; once you are diagnosed with cancer no policy insurance can take you. Treatment costs are high. There are good policy around which pays you a lump some money so that you could manage the cost of your treatment.
- ASK FOR SECOND OPINION FROM A REPUTABLE DOCTOR; ask for second opinion before you let anyone cut you (this is not a stroke, so it doesn’t need immediate decision. Few days wouldn’t hurt so please ask for professional and reliable opinions before making your final decision). Don’t blindly let the doctor decide everything for you. You must do your own research and list down questions you need to ask before you make your final decision. Questions such as what are your options, what are the cost differences, how accurate will the results be from various options, etc. Cheap solutions may not be the best and vice versa.
- CAREFULLY SELECT THE DOCTORS YOU WOULD LIKE TO WORK WITH; Check their credentials from other good doctors that you know, ask friends and finally the doctor him/herself e.g. how regular do they handle this type of cases, failure and success rate, etc. You need to work with a doctor that you are comfortable with. You really do not want to go through the pain i went through.
- TREATMENT COST MANAGEMENT; start working out your treatment and cost plan. Treatment is expensive!
So friends, learn from me. We are talking about your health and life here. If you don’t care for yours who else will and can? Your hubby, children, parents, families and friends can empathized you but what can that do to take away the pain, agony and shortened life? If you have RM300,000 (an estimated cost of direct and indirect breast cancer treatment I’ve spent so far) would you rather spend on fixing your broken health or enjoying life? MAKE THE RIGHT DECISION YA!!
Love, Midget