Deciding on an oncologist

This entry is part 18 in the series Victory in the Valley
Surgeon taking notes

Image courtesy of photostock at FreeDigitalPhotos.net

Start at the beginning of the story

Now read on . . .

Talking to the oncologist

As Dr Meiring, the oncologist recommended by my sister-in-law Denise, explained the various ways a malignant tumor is classified, I began to understand the seriousness of my situation. I had an aggressive, fast growing cancer, with a number of negative factors. It was far more advanced that it would have been had it been caught earlier. If I’d had a mammogram when I first requested it, the tumor would have been identified in its earlier stages. Nothing could have stopped it developing, but I had my gynecologist’s stubborn attitude to blame for facing the rigors of chemotherapy.

M.E. history

Dr. Meiring grew concerned when I mentioned I had been ill for months two years ago with M.E. (Myo-encephalitis) or as it is also called, CFS (Chronic Fatigue Syndrome). I hotly avoid the nickname of ‘Yuppy Flu’, which is lightly bandied around by those who don’t believe in this debilitating condition. It is neither ‘yuppy’ nor is it ‘flu’!

Fortunately for me, Dr. Meiring did believe in M.E.  “Chemotherapy will depress your immune system,” he explained. “When that happens we could face a further flareup of the virus. I need you to have a minimum of three intravenous drips of Polygam which will boost your immune system.” He wrote carefully on his notes. “I will try and motivate with your medical aid to pay for this. It is pricey.” 

Further tests

sonar for tests ordered by oncologist

Image creative commons

He gave me a long list of blood tests to have done at the laboratory, including tests for the Coxsackie virus which had caused the M.E. I confidently expected this to be negative, as I had fully recovered my energy and strength, prior to my breast cancer operation.

“We also need to check out your heart before we embark on the radiotherapy and chemotherapy.” He made an appointment with a cardiologist at a private hospital some miles from my home. 

“I want him to do a MUGA scan which will measure how well your heart pumps with every heartbeat, and an echocardiogram to ensure that there is no serious heart damage as a result of the Rheumatic Fever when you were seven,” he added.

He assured me that he would spend time looking at my situation, and discuss it with some of the other oncologists before he saw me again the next day. Before we left for home, he called his radiotherapist and assistant, and together they laid hands on me and prayed for wisdom, and for healing.

The decision I didn’t want to make.

We spent the hour that it took us to drive home, talking about what we had learned that day. We spoke about Dr. Meiring. Was he the right man? Rob was totally convinced.

When we got the home, we sat together in the lounge with the inevitable cup of tea, and prayed.

“Lord, is this the oncologist you want to use in my life? He’s nice, and he’s supposed to be good—but I’m just not sure.”

“I think he’s the right man.” Rob was unusually positive as he spoke. “If you are really not happy then we need to try one of the others, but really, I think we’re wasting precious time; and who will we go to?”

Who indeed? With me being in the medical field, I received plenty of advice.

“You must go to Dr. X,” I was told on several occasions. “He’s a lovely person; a truly dedicated oncologist.” Then I heard that he was so busy he never had time to sit and listen to his patients. This would not suit me. I knew, even then, that I was going to have lots of questions.

The cancer patients I had known up until this point, either in my role as minister’s wife, or through my nursing, were usually at one of two stages. They had either just been diagnosed through tests or surgery, or they were dying. When it came to the outpatient treatment, I knew no more than the man in the street; nor did I know any of the oncologists, except the one whom I had already rejected. The oncologist who took me on had to be prepared to give me time.

This is my life

This is my life! I am taking control wherever I can, I reminded myself. I needed an oncologist I could talk to, who would explain things in ways I would understand, and who would see Rob as part of our team.

“Dr. Y is the best man in his field,” I was advised by a number of people. He held down a very high position in the cancer field so was obviously highly qualified. A member of our congregation and a good friend, was exactly one year ahead of me, and this was her doctor. She couldn’t speak highly enough of him.

“He is such a nice man,” she assured me. “He listens to me, and answers my questions. However, he only speaks to the patient. He totally ignores my husband.” That was no good for me either. Rob and I were in this together. I needed Rob, and Rob needed to be a part of my treatment plan.

So we decided to listen to my sister-in-law and accept Dr Meiring as my oncologist.

“After all, I don’t need to commit myself to him if I’m not happy,” I reasoned aloud. “We can always change our minds and go to someone else if we don’t like him.”

This was easy to say. Where could I go? Would I really be happier with someone else?

Next chapter in ongoing story of cancer journey, In the Valley by Shirley Corder. #cancer Click To Tweet

Over to you:

Have you ever had to make such a decision?

Or were you automatically assigned to an oncologist?

Please leave a comment, and if you leave a live URL in your comment, I’ll get back to you. 

NOTE:
These events occurred between 17 and 20 years ago. I have tried to recreate events and locations as accurately as possible, but in order to maintain their anonymity, in some instances I have changed the names and identifying characteristics of individuals and places.

Strategies for World War III

This entry is part 17 in the series Victory in the Valley

World War III machine gun

World War III

“I must warn you that I do not believe in fighting World War III with World War II weapons.” After a few words of introduction, the oncologist made this opening sentence.

I sensed my heart go into overdrive. What a way to start. If this was a book, the man in front of me had me hooked. Dr. Meiring leaned forward, his arms folded on the large untidy desk. His gray hair was neatly in place; the slightly crumpled jacket of his suit hung open to show a conservative shirt, with a cheerful tie.

A Friendly Room

The tiny consulting room, attached to his home in an upgrade suburb of Johannesburg, had no outside window. A warm breeze came in through the open door leading to the tiny examination cubicle. A small shaft of sunlight shone through a porthole in the roof, adding to the heat. Behind me, an assortment of medical and Christian books spilled out of a too-small book-case. A friendly room, even if rather claustrophobic.

This was the first of two comments, uttered during that initial appointment, which would have a profound effect on my life.

The other was, “When the cure makes you sick it is no longer a cure. The cure should not be worse than the disease. Then it will be time to stop.”

To my mind came the words, 

God is faithful; he will not let you be tempted beyond what you can bear (1 Corinthians 10:13.) Click To Tweet

Many times over the next year I realized God had different ideas to me of how much I could bear. I also often wondered how bad things had to be before Dr. Meiring considered it worse than the disease.

No Death Sentence

His confident manner, however, reassured me and totally won over my husband. This man saw cancer as something to be fought and overcome. He had not offered me a death sentence. By classifying it as World War III, it was a war we could fight.

weapon-999_640

He shared with us some of his family background. There were so many cases of cancer that he said,  “It’s not IF I get cancer – it’s when. The secret is in finding it before it finds me!” What an unusual approach to a dreaded disease!

That first appointment lasted the full afternoon. The three of us drank coffee together – several cups – and talked. We talked about cancer. We talked about the Lord. He was a devout Christian and expressed his encouragement over the ‘team’ that we would form. He saw my husband Rob and I, together with him, as the ‘principal players’. But he expressed enthusiasm over the ‘back-up team’ consisting of a supportive family, a united congregation of God’s people, and many other Christian friends and colleagues, all praying.

That afternoon Rob and I sensed a new friend in Dr. Meiring.World War III viruses

Simple Explanation of Cancer

“The human body is made up of billions of microscopic cells, each with its own role to play,” he explained, drawing a dot the size of a normal full-stop on the paper in front of him. “Some of these are so small that 250,000 could fit into that space. They grow and reproduce in an orderly fashion.” He continued to doodle as he spoke, sketching out a complex diagram of circles and lines.

“Sometimes, something goes wrong with the reproduction process, and a cell is produced which contains incorrect genetic information. If this cell becomes a ‘mother cell’, it produces ‘daughter cells’ with the same faulty data. Normally the defense system of the body, the immune system, mounts an attack on these intruders and destroys them. When this does not happen, for whatever reason, these cells start to multiply rapidly, and a cancerous tumor begins to develop.”

Bewildered and feeble

For the first time, I began to understand what my cancerous tumor really was; a mass of bewildered, feeble cells, incapable of carrying out their God-appointed task.

“Healthy cells know which organ they belong to, and remain within the established limits. However, cancer cells are undisciplined, and they invade adjacent tissues, even traveling throughout the body.”

This, he explained, was the reason I needed radiotherapy and chemotherapy. According to the pathology report, the sentinel gland under my arm was ‘brimming’ with cancer cells. The cancer had already spread from my breast. World War III was about to begin.

READ ON: Next Chapter – Choosing an Oncologist

Operation Mobilization

This entry is part 16 in the series Victory in the Valley

EXERCISE REGIME:

action-Public DomainOnce the clips were out, I no longer had an excuse for avoiding the prescribed exercises. I had attempted to do them in the past, but the sling made them almost impossible. I pumped my stress ball almost continuously, shrugged my shoulder up and down, and twisted my hand back and forwards. But that had been the limit to my workout. It was time for Operation Mobilization.

“You only need to wear the sling at night or when traveling in the car,” Dr. Prinsloo had said. “Start to mobilize your arm now. You cannot start radiotherapy until you can lift your hand above your head.”

Until this point, I had told everyone how relatively easy this operation had been. “Sure, it’s a bit painful,” I would say. “But it’s really nothing like I had expected.”

Now the picture changed. I soon realized why the Physiotherapist in the hospital had been so negative about the sling. Because of my incredibly good cosmetic result, I do not, to this day, regret wearing it, but the pain of trying to use my arm again was unbelievable. It seemed to be anchored to my chest, and the slightest effort to move it was torture.

“The best exercise of all,” assured everyone in the know, including my physiotherapist, my surgeon, and Beulah from the Cancer Association, “is to stand close to a door, and allow your fingers to ‘walk up and down the door.’ Just push yourself a little further each time and in no time at all, you will be back to normal.”

It sounded simple. It probably was—if I could reach the door. My arm stayed frozen in position as I desperately tried to force it away from my body.

“I will never be able to move this arm!” I moaned at Rob, tears streaming down my cheeks. “And until I can move my arm over my head I can’t have radiotherapy. I don’t know what to do.” I returned to my efforts with gritted teeth. 

The words from that television show floated back into my mind. Time to get back on the beam!

INVENTING NEW EXERCISES:

After a few days of battling to move my arm, I started to panic. It was taking too long. That is when I remembered what I’d read. Make your own decisions where possible. If the prescribed exercises were not going to work, I would have to invent my own.

I found if I lay flat on my back and totally relaxed my left arm, I could grip my wrist with my right hand. Then I could slowly move the stiff arm away from my body. Because I wasn’t using my muscles, it didn’t hurt as much. I soon devised a number of exercises, which I called ‘passive exercises.’ Every hour I spent ten minutes working on my arm in this way. Within a few days, I could reach the door.

Then started the agonizing process of trying to move my fingers a little higher, a little lower. I did this exercise against a polished wooden sliding door which had knots in the grain. Each day I would strive to go one mark higher. My goal, the top of the door, seemed way out of reach, but every excruciating little step was a battle won.

“I can do this,” I would mutter regularly, through clenched teeth, often with tears streaming down my cheeks.

CHOOSING AN ONCOLOGIST:

The time had come to choose the man who would control my life for the next year or two. The city where I lived boasted many well-known oncologists, but no one seemed to have heard of the man my sister-in-law recommended. How we prayed the Lord would lead us to the right person. Should I go to the one I had told my surgeon I wanted to see? Was he the one who would give me God’s choice of treatment? After much prayer, we made an appointment with Dr. Kurt Meiring, Denise’s recommendation.

Read on: Next Chapter: Strategies for World War III

NOTE:
These events occurred between the years 1997-2000. I have tried to recreate events and locations as accurately as possible, but in order to maintain their anonymity, in some instances, I have changed the names and identifying characteristics of individuals and places.

Getting Back on the Beam!

This entry is part 15 in the series Victory in the Valley

—Victory in the Valley – Chapter 13—

Start at the beginning of the story

Now read on . . .

FALLING OF THE BEAM

Gymnast on balance beam

Gymnastics_2015 European Championships

It was the day after we’d watched the TV show where the young gymnast fell off the balance beam. My husband suggested the message for me was to get back on the beam. He didn’t get it. I hadn’t fallen off the beam. For someone doing battle with cancer, with a poor prognosis, I was doing well.

I awoke uptight and irritable. It was one of ‘those days’! Nothing went right.

Halfway through the morning, I walked past my younger son’s bedroom. I noticed he hadn’t opened his curtains before leaving for his college. I shoved angrily at his door and stalked into the room. The door boomeranged off a pile of books on top of his bookcase and slammed back into my left arm. The handle punched me on the breast, at the exact point of the wound.

“Ow!” I wailed in agony and kicked the door. Real mature!  I lowered myself onto his bed, sobbing helplessly.

Rob came racing through the house. “What on earth’s wrong?” He sat next to me and held me while I cried and cried. All the pent-up tears and emotions of the last two weeks poured out.

“It’s going to be all right!” he assured me repeatedly. “You’ll see. We’ll get through this.”

He passed me a handkerchief.

“Come, blow your nose. You’ve got to stop this. You’ve cried enough.”

“Rob, I’m sorry, I can’t go on,” I muttered into the sodden handkerchief.

After a moment of quiet, he answered. “Shirl, the Lord is saying to you, ‘You’ve got to get back on the beam!’”

FOLLOW-UP VISIT

It was time for the follow-up visit to Dr. Prinsloo.

“This is really healing beautifully,” he remarked with a near smile. As he prepared to remove the clips, I attempted to hide my fear. As a result of my arm being strapped to my body for ten days, I had difficulty moving it even slightly. How would he reach the wound? Since my experience in the hospital with the wire, my pain threshold had become just about non-existent.

As the last metal clip fell into the receiver, I looked at him in amazement. “Wow! I hardly felt that.” Then I took him by surprise. “Please, may I take these home? I want to show them to my nephews.”

“I don’t think that’s a good idea. They need to be properly disposed of.”

“I’ll take them to the laboratory where I work and throw them into the ‘sharps’ box,’” I pleaded. “Promise!”

“See to it you do.” He folded them into a paper towel and handed the little parcel to me. “Well, you seem to be doing very well so far.” 

He explained again his reasons for doing a Quadrantectomy and not a Mastectomy. “The tumor was so deep, there was little point in taking the entire breast,” he said. “In any case, this gave a better cosmetic result.”

I jerked when I heard his next words. “Of course, there would have been less likelihood of a recurrence if I’d done a Radical Mastectomy.”

Inwardly I screamed at him, Then why, oh why didn’t you?

Outwardly I smiled. “What are the chances of a recurrence?” I made it sound like such a minor issue.

PROGNOSIS:

Surgeon taking notes

Image courtesy of photostock at FreeDigitalPhotos.net

The doctor avoided my question and eyes, as he drew out the Histology report. He went through it with me, and I learned that the cancer was an aggressive, fast-growing type. My prognosis was not good. I noticed he didn’t say how long I had, and suddenly I didn’t want to know. I sensed that a time limit might just become a self-fulfilling prophecy.

During my student nursing days, patients were sometimes given a placebo (a capsule with no medicinal effects) instead of a sleeping pill. Many times, they settled down and had a really good night’s sleep. I feared that knowing the doctor’s estimate of my life span would have the same effect. If he gave me an estimated life span it might just prove prophetic. I didn’t want statistics, I wanted to conquer Goliath.

LOOKING AT THE FUTURE

“You are going to need a full course of radiotherapy, followed by chemotherapy.”

“Yes, you told me,” I replied, and took a deep breath. “But Dr. Prinsloo, I would like to go to Dr. Meiring.” Through my work, I had met the oncologist Dr. Prinsloo normally referred his patients to, and I didn’t like him at all. I had never met Dr. Meiring, but my sister-in-law had worked for him, and she thought he was wonderful.

“Shirl, please give Kurt a chance,” she had pleaded on the phone. “After you’ve met him you can choose to go to someone else if you like, but please give him a try. He’s a wonderful oncologist – and he’s a strong Christian man.”

A look of extreme annoyance flashed across Dr. Prinsloo’s face. He did not like patients to make suggestions. Tough! I thought. This is my life! I am taking control wherever possIble.

He reached for his script pad and started to write a referral letter.

“I am not happy about this decision,” he stated flatly. “And I want to see you regularly myself.” 

NOTE:
These events occurred between the years 1997-2000. I have tried to recreate events and locations as accurately as possible, but in order to maintain their anonymity, in some instances, I have changed the names and identifying characteristics of individuals and places.

Read on: Next Chapter – Operation Mobilization