29 April 2007

Battleship babe



After the biopsy I had to recover for another hour before I was aloud to get up. All went well and I made my way over to Dr. Luykx office.


She showed me that the part of the bone was missing on the inferior pubic ramus. This was what was causing the instability of my back. In the vicinity of the bone lies a tumor of about half an inch. This has been eating away at my bone, perhaps the last 8 years or so as I have felt pain there since the pregnancy. This lack of bone is presently a main reason for worry. Seeing as the cancer is eating away at different areas of the pelvis, there is a fear of me fracturing the bone near the sacroilliac joint. In that case I would become an invalid. (It chills me to think back at the many hours which I took therapeutic walks when I was stuck home with my back injury. I am not to take any such risk.)
my own pelvis
After pointing out this spot and reallizing that I had felt it, I consecutively pointed to spots on my body that have been hurting me. (This was supposedly a case of Lyme disease). Each spot I pointed out was like naming the coordinates in a battleship game. Each time I named a coordinate she would check her scan, and I had 7 hits in a row. I was always very good at that game! Actually this gave me goosebumps. She was suprised to find out how well in touch I am with my body.

Despite the fact that I still do not have the results of my biopsy, she told me what the bottom line is up to now.

I have cancerogenous cells in my pubic bone, at my hips, in the hipjoint, on my spine on several diffent spots, under my ribs, and in my lungs. We are assuming my head is clear. More testing will follow. The doctor could not believe that I have been carrying this pain with me since september 2005. She litterally told me that me being this tough was my biggest enemy. (So F all those people who thought I was so feable!)

All in all...we are still not sure what the source of the matter is, which is crucial in order to be able to determine the type of cancer and the matching treatment.
Why is this? Apparantly in 30% of the cases they are unable to determine the source because at the time when the first tumor appeared, the body was still strong enough to fight the cancer.
After a recovery one or two cells managed to get away and embed themselfs in another area of the body. So for instance if a breast cancer cell embeds itself in the hip and a tumor grows there...then the cancer is called breast cancer. It is very often the case that there are no longer any signs of the source when the disease is discovered. This is why the biopsy is so important.

The plan for the next days was to get my first radiation therapy A.S.A.P.. There are two reasons for this: One is to strenghten the bone so that the risk of breaking my hip deminishes, the other is pain relief.) Contrary to most people I have been given a status of high priority. A great feeling to know that everything is being taken care of ...but a horrible feeling when you realize how severe your own situation must be. I was told that I would be treated in the Anthoni Van Leeuwenhoek Clinic (cancer clinic in Amsterdam). At least this will please my sisters who want nothing less than this for me.

28 April 2007

D-day


D-day was brutally disturbed by a call from the oncologist on tuesday.
A diagnosis had not been made because nothing had been found in the tissue of the first biopsy. It is protocol to give the beast a name, only after getting a positive result from the biopsy. Before that, they are not allowed to call the tumor: "cancer", hence the second biopsy.
The doctor had already made it clear that I was dealing with a case of malignant cancer and that treatment was going to have to take place in the future. I weedled this information out of her, as this is not the normal procedure. When I heard the news I had told her I had expected to get the full blown treatment. She was relieved and told me that for most patients this was the time that they would feel the shock. In my case I had already been through the shock and was ready for the next step. The acceptation of the disease had now become a fact.
The biopsy took place on wednesday morning.
I have become a routined guest at the hospital now. The other cancer patients don't scare me anymore. As I walked into the department the nurse was standing in the hallway, with her typically healthy Dutch look about her. When she saw me she said, "Mrs. Hunkar, you are early today!". I was, and my mother and I decided to have our habitual glass of water out in the recreational area.
My mother came with me for my tests. First they took an X-ray of my pelvis, and later on they brought me to the area where the biopsy took place.
As I lay there waiting for the radiologist we both watched the door, hoping it would be another doctor than the first time. In walked doctor Van Keulen. A middle aged man with glasses so thick you couldn't even imagine he could see a thing. However, doctor Van Keulen has become my hero...he was certain he could do the biopsy without too much pain and he was also certain that he would get the right tissue this time. I relaxed! And he did precisely that which he had promised.
Hail doctor van Keulen!

Frankly, the biopsy scares me more than the radio or chemo therapy. The first time was so extremely painful!
Whilst being rolled out to the recovery area, the nurse ran after us. The doctor wanted to make an extra sonogram of my liver.
He startled me. I could not have cancer of the liver! It turned out that my liver was not affected by malignant growths. What a relief. I immediately asked him if he knew if my womb was affected. He said that my womb was also clean. By this time I was happy it was almost time to go to the oncologist who had a meeting with me to explain what they had discovered so far.

27 April 2007

One for sorrow


Since I had the knowledge of the presence of a tumor in my body...a single magpie has been making frequent visits to my backyard. It makes you wonder how it can be that these things happen simultaneously. I can't help but think of the child's verse:


One for sorrow,

Two for joy,

Three for a girl,

Four for a boy,

Five for silver,

Six for gold,

Seven for a secret

Never to be told.


Well, I watched carefully...everytime it was just the one.
(For those who do not know; this verse is said when counting Magpies.)

Speaking of sorrow...well, if I tell you that I had my first radio therapy today, you can easily conclude that the last 2 days have been a practical and emotional rollercoaster. I have plenty to write up on now ...because I have had so many impressions. But for now.... I am going to bed to rest.

More info in the morning.

25 April 2007

Biopsy of the back


Yesterday the oncologist called me in the afternoon. The biopsy showed no signs of bad cells. Well...that does not mean:good news.
The scan showed malignant cells (they are not allowed to say this for certain) and I will be starting radiation therapy next week. In the meantime they will have to repeat the biopsy which to me is the scariest thing out.
They put a hollow needle in your back (in my case). Then they insert this device in your back through the duct of the needle. This little device then takes a bite out of the tumor. Yes, it does hurt! And somehow or other I am more scared of this stupid intruder than any therapy to follow. This morning they will be conducting this test once again....just to pester me before I get the full-blown (if I am lucky) news-flash. I only slept 3 hours. I am scared.

24 April 2007

Lunch with the ladies


What a difference a lunch makes! In the midst of all these goings-on it would normally be hard to forget about work. In a normal situation your job is a life-line and an absolute priority. When one is away from work for a significant length of time, there is a realistic reason for being worried.

In my case I have been ever so lucky. From the start of this mess, which is now already 9,5 weeks ago, I have had the most incredible support from my co-workers and managers at PwC. There was never a moment of doubt on their end and even more so...they did not forget me as time progressed.
It is so easy to get used to someone's absence! After having only worked there for 6 months, I feel so incredibly valued. I have every security they will not let me go.
Yesterday afternoon, I spent my (extended) lunch time with my dear colleagues: Anita and Willemijn. We had a most valuable, normal afternoon together on the Mauve Restaurant terras in Laren. Even though the pain followed at night, I feel charged up to face D-day.

The day before


Tuesday morning. Tomorrow is -so to speak- the big day. The oncologist will be telling me the bitter truth. Then later that day I can tell Kiara (my 7,5 year old daughter) the same wonderful news.

Right now my hope and expectation is that I have a Hodgkins Stage II diagnosis. All this would be great news as it has become obvious that Hodgkins Lymphoma is a treatable disease. (90% chance of survival after 10 years).

It is now precisely a week since I heard that I have a tumor in my back
. The next couple of days I will tell you more about what has happened since my life has become an upside-down pineapple cake.

How I heard it


April 17, 2007.
My next appointment was at 12.15. I hurried back to the waiting room. Whilst taking out my snack I realized that I had made a mistake. I was one hour early.
I decided to eat my snack and stay there, but just as I was about to take a bite…the neurologist came out to call me. I guessed that I had not been mistaken after all…but in the process of getting to him there was no time to look at my watch.
As we entered his office I saw seriousness written on his face. I realized something was wrong.
“Mrs. Hunkar”, he said, “I’m afraid that the problem is entirely different".
I replied," It is? I already thought so".
"The situation is very serious".
"But I have a 7,5 year old daughter".
"Let me show you, this is L5 where you are having a problem. There is an object in that area which is a tumor, you really must be tested today".
"Can't I come back tomorrow?"
"No I can not let you leave".
"OK then...can I make some calls?"
"Yes you can. Come back afterwards and I will arrange a meeting with the oncologist".