Archive for the ‘diagnosis’ tag
Another hospital visit, and no running
The Royal Marsden phoned yesterday. Apparently, I’m very anaemic–which explains why my training has turned so crap recently. It’s so bad they want to give me a transfusion some time next week. Ho hum.
From what I can work out, they suspect I might be bleeding internally. The most likely culprit is a melanoma metastasis to the small bowel, which has ulcerated and is bleeding into the bowel. But I haven’t experienced any intestinal pain or obstruction, and I haven’t been (excuse me, this is gross) passing melena (bloody number two). Or it could be that I’m bleeding from another ulcer. I had a tube down my neck in January that showed my ulcer had healed, but I could have developed another. I’ve certainly been getting enough stomach pain for this to be the case. I thought it was just reflux, but could be another ulcer, I guess. But again, there’s been no melena.
Another possibility, and this is what I hope it is, is that the combined doses of Ranitidine and Lansoprazole I’ve been taking have affected my uptake of iron from my diet. Stomach acid is needed for digestion of many nutrients, and long term use of antacids is associated with iron-deficiency anaemia. Added to this is the fact I’ve been taking iron supplements for a week now, and I’ve been feeling better. I’m going to stop taking Ranitidine for a month or so, and see if this has any effect.
Unfortunately, because of my history, the Royal Marsden want to make sure I’m clear of a stomach/intestinal metastasis. This means tests. And that means cameras down the mouth and cameras up the bum. Hopefully this won’t happen at the same time, because that would really suck.
They’ve also forbidden me to go running. Which also sucks.
Introduction (second surgery)
When I found the lump under my armpit, I knew immediately it was melanoma. It was hard, and fixed in position (both signs of tumours rather than inflamed nodes). I don’t think I truly understood the odds I was facing until that point. So I went back to the hospital and spoke to a nice female Australian resident (and just why are so many of the junior doctors in the cancer unit from the antipodes?), who didn’t seem particularly worried about it. She scheduled me for an ultrasound, then a possible biopsy–but only if it looked ‘suspicious’.
I had to wait a week for the ultrasound, during which time I managed to convince myself that it wasn’t melanoma after all (this is why ‘positive thinking’ for cancer is bullshit). Read the rest of this entry »
Introduction (The NHS maze)
Back in Blighty, the first hurdle was getting registered with a GP. NHS care is only free to UK residents–NOT citizens. So if you’ve been living overseas for a while, the NHS wants to see proof that you’re actually now living in the UK, rather than just coming back to get your whatsits clipped, or whatever. The amount of documentation they needed was . . . intimidating. (Visa for my wife, school registration documents for the kids, etc. etc.) It really was jolly exciting dealing with all of that and preparing for the operation. Read the rest of this entry »
Introduction (second misdiagnosis)
In April I was working out when I noticed a lump in my groin. I thought at first I’d given myself a hernia during the workout (I’d been doing some very heavy lifts, so it wasn’t a completely stupid thought). I went to see a doctor at the same hospital, who felt around and said it wasn’t a hernia (wrong place, too hard). He thought it was an enlarged lymph node, and said I should wait and see if it went down.
I waited a week, and it didn’t go down. SO I went to see him again. He then said I needed a biopsy to find out what it was. I asked him if it could be cancer, and he said “from what primary?” (Tumours in the lymph nodes are secondary, or new tumours caused by cancer cells splitting off the main mass and growing somewhere else in the body). I pointed out that I’d been biopsied for melanoma, and he waved his hand and pointed to the pathology result in my file. “Look,” he said, pointing to a line in the report, ”it says benign features. So it’s not melanoma.”
Apparently the possibility of the pathologist being wrong had never occured to him. Read the rest of this entry »
Introduction (First misdiagnosis)
So there I was, being told by an A&E doctor that I had melanoma. I should add at this point that the hospital I was in (Mahachai 2) was a small private hospital near my house. If I had melanoma, there was no way I was getting treatment there: medical treatment in Thailand is . . . variable. The best is world-class, the rest is rather dodgy. Anyway, while I was thinking of where to go to get my skin cancer treated, the A&E doctor told me that I needed to get a biopsy to confirm the diagnosis, and that Mahachai 2 hospital had a consulting dermatologist from Chulalongkorn University hospital who came in a couple of days a week.
Now, Chulalongkorn University is Thailand’s equivalent of Harvard. Its medical school is reasonable, so I thought I could save myself a long trip into Bangkok by going to see this doctor. I made the appointment for the next Thursday, then went home.
Introduction (first signs)
I found out I had cancer in September of 2009, when I’d been living in Thailand for eleven years. I walked into the dermatologist’s office, saw a CT scan film clipped to a light box, and knew immediately what he was going to say. He handed me the biopsy results (amelanotic metastatic malignant melanoma), then pointed out the large mass attached to my spleen. All I could think of was the 5-year survival rate I’d found when googling for melanoma–around 15%.
And what really sucked was that I could have caught it much earlier, only I was an idiot. Read the rest of this entry »
