Unwritten~*

Friday, May 19, 2006

being "sick"

You know how you always feel as though the Fates have been too kind to you and then you keep expecting this good luck to come to an end? And yet somehow when it really does screech to a sudden halt it leaves you reeling in shock and wondering if you can handle it. That seems to describe aptly how I feel these days.

I have always thought that I have a good life, you know the usual my parents-love-me-my-sister-and-i-are-great-pals-who-have-enough-$-to-be-comfortable-i-get-good-enough-grades-and-fabulous-friends kind of life. And maybe sometimes I do wonder if I deserve it (being Capricorn seems to mean that I am a devout pessimist) but of course, no complaints for having an easy life.

So of course the long-standing arthralgia which to date has lasted for 6 months and 10 days seem just like a stroke of bad luck. Even though I have been shunted from one doctor to another it doesn’t seem to warrant much worry. I mean, its not like one can’t get a bad sprain which takes months to heal anyway.

So when the “insect-bites” start to proliferate and take over my entire legs I was thinking, oh hey, what bad luck. Such ugly mosquito bites! And then simply shove the matter into the back of my mind. It helped that my sports medicine doctor seems to agree that they were innocent mosquito bites too. But of course, it got more worrying for the vainpot in me when it didn’t go away after 2-3 months. It was disfiguring! You can hardly blame a girl for wanting unblemished legs. It’s bad enough to have fat legs without having weird marks on them too.

When the hair loss came on, I was horrified. In the my-goodness-what-a-young-age-to-drop-hair-i-arent-even-attached-yet kind of way. Yep, purely vanity. And I thought it was probably due to exam stress, even though I never did experience hair loss of such great proportions before.

The arthralgia seems here to stay. Enter good friends rashes and hair loss. And so I casually consulted my teacher after the family medicine end-of-posting-test to see if the rash was something to worry about.

It’s the last thing on my mind to be told it seems to be this thing called erythema nodosum. Of course I was scared. I was a medical student who had vaguely heard of this big term and yet can’t remember if it’s something to worry about or not! And yet having the rash branded seems to mean that something was wrong. Being referred to the rheumatologist only seem to shout out to me that all may not be well.

I still harbour the hope that everything is coincidental.

And now it seems like maybe that’s too much to hope for. I got my test results one week ago and it showed increased levels of ESR, CRP, rheumatoid factor, ANA, pANCA. Now before you jump to conclusions let’s just say that ANA does not equal SLE. At least that’s what my doctor told me. And hooray, SLE usually does not present with increased CRP and patients usually have lymphopenia which I don’t. small comfort eh? Maybe I am grabbing at straws, or maybe she was being kind and trying not to frighten me, but yep I heard enough and I am frightened enough.

I realized it’s very surreal, to look on when patients are told that they have certain diseases and when a role reversal puts you into the hot seat instead. It’s a terrible terrible feeling. No amount of empathy you have for a patient can prepare you for the day when you yourself become the patient. ESPECIALLY if you are a medical student with enough knowledge to recognize the repercussions of certain markers.

A lot of things just seem to flash past my mind. It’s all rather melodrama, even to me it seems very extreme. But suddenly, I just felt as though I am no longer normal. How am I going to pay for everything? Am I going to be able to finish my studies? Am I going to be well enough to take care of my parents? Is this going to be an added financial stress to them? Is it fair for them to pay for my extremely expensive studies when I can’t be sure I can go on to be a doctor? Do I even think I should get married and saddle my husband with a burden? What about my kids? Would I pass this thing to them? Would I have to grow old alone because I would be balding and walking around with ugly legs and would be fat from steroids hence no one would want me? Would I have to wear a wig? What are the treatments that may help my hair loss? Would my friends laugh at my thinning pate? How am I going to face the world with no hair?

Very stupid thought I know. It sounds extremely stupid just writing them down. But these are really the fears that come uppermost to my mind. It’s weird I know, to be so pessimistic when I haven’t been diagnosed yet. These are but the preliminary results what, some may say. But it’s really different being The One with abnormal test results. A doctor I saw at the skin centre who biopsied my rash told me straight in the face: your results doesn’t look too good.

Frankly, I prefer the way he speaks to me, very matter-of-factly and yet not treating me as if I was a fragile porcelain figurine, still joking and poking fun at me as if I was just another normal person. It exacerbates the sense of impending doom when patients get the feeling you are being extra nice and soft-footing around us so that you would be seen as being empathetic and nice. It just adds to the feeling of hopelessness.

My encounter with the rheumatologist started but 3 weeks ago. I have been poked countless times for countless tubes of blood, did 2 urine tests, had weird antibodies-tests done and even what cryoglobulin what-nots done, had biopsy (it was darn painful and horrible) and have been started on steroids. In summary, I feel like a sick person. Yet the ironic thing is that have I not approach my teacher, I could have gone on living my old life happy as a lark, with the occasional fretting about my hair loss and ugly legs. The psychological impact of branding is great. Its makes you blue, roller-coaster between trying to feel brave and strong and wanting to break down and cry for all the uncertainties that now lie ahead. There are times I just feel so angry, then times I feel so guilty for making my family worry and having to fork out so much money for all the tests (for your information I have paid about $1000 just for my 2 visits to the rheumatologist and 1 visit to the skin centre. This is excluding the $800 or so my parents paid for acupuncture, bone-scan etc for my arthralgia). And then I feel so frustrated that I am paying for all the investigations as an A-class patient, since I was referred directly from a doctor. This arrangement stinks big time. And I can’t even downgrade ‘cos my dad’s salary is deemed “too high”. Hello… something is seriously wrong with this arrangement. My family is nowhere near rich. Middle-class families can’t afford to pay $1000 plus a month for medical treatment ok… (I have this sudden urge to write to my MP).

So now I wait. Please don’t feel sad or sorry for me. It would only make me feel worse. But please do pray for me. I hope it’s nothing serious after all. I don’t enjoy the idea of life-long steroids making me fat and alopecia necessitating a wig. *shudder* but of course I don’t think I can be brave all the time so bear with me if I need to whine and wail once in a while.

I wonder how these extraordinary people in the news do it. battling diseases far worst than mine, being brave, getting on with life, calmly accepting their fate, living life just as they have always wanted. I wish I can borrow a little of their spunk.

And please, if you don’t know me well and happen to read this because you are bored, don’t go spread the news as if it were some juicy gossip. I am writing this because I need an outlet. And I need to write it on one of those days when I feel rather calm and collected. So that I can put things into perspective for myself.

Thursday, May 04, 2006

Yes, it is a weekday. Yes I am really tired and I need to reach the hospital by 7am tomorrow which means I have to wake up at 6. yes I am still sick and flu-ey and feverish but lo and behold! Here I am am blogging again!

Ah well. Never did mean to blog today. But the events that unfolded today made me want to blog.

My surgical electives started almost 3 weeks ago. It was of course a rather interesting experience to follow a new team of doctors which were previously strangers to us all, and we all took some time to settle down. And yet, what strikes me was how these surgeons can work tirelessly around the clock and yet remain smiling, calm and considerate towards their charges.

You see, my previous surgical posting had given me the false impression that all surgeons can scoot off home at 5 pm and hey! I thought that wasn’t so bad after all. Maybe ‘cos SGH is definitely one of the busiest hospitals around, but the number of surgeries scheduled are crazy. I really have no idea how the surgeons can simply stand at the operating table for endless hours, without so much as the occasional toilet-break and a rushed gobble-everything-within-ten-seconds lunch. A peritonectomy can lasts for as long as 12 hours. And yet it may not be the only operation scheduled.

Contrary to popular layman’s beliefs (which was mine too a long time ago) that surgeons recommend operations so that they earn more moolah, these people show me the different side of the coin. They squeeze patients in for operations, at their own expense of rest and an easier life, because it is the best thing to do for them. Patients who have been misled by rogue doctors into trying alternative medicine who only visit the clinic when their cancer have spread, worried family members who take a long time to deliberate over safety and cost issues… these are the people we see everyday. And knowing there isn’t a moment to lose, the surgeons do the only thing they know they can: operate as soon as possible.

I remember my first day of electives. Having heard rumours that elective postings are slack, I sort of expected myself to be comfortably perched on my sofa lazing the afternoon away by 5pm the LATEST. To my horror, I only left the hospital at 7.30pm. more than 12 hours spent in the hospital. And this is just yet another day in the life of these surgeons. I remembered I was soooooooooooooo exhausted that I could hardly bear to wolf down my dinner. I almost didn’t want to bathe. (ALMOST. But I did anyway. Hah)

But I learnt a lot. Maybe not so much in terms of knowledge and those regurgitable textbook info we always have to bash our heads to remember by heart, but it was awe-inspiring tagging behind these surgeons.

We were attached to Prof Soo Khee Chee, as he had been highly recommended by our classmates who had been taught by him. He was gruff but very lovable in his own way. Of course, he was too busy to really meet us much but he is such a good doctor that you can’t help but wish you would grow up to be like this too. When we presented our first case to him in tutorial, he listened and then proceeded to give us a illuminating tutorial. At the end of the session, he concluded that the patient “had cancer of the pancreas, probably in the body of the pancreas.”

We were totally stunned. Five heads whipped up simultaneously, five wide-eyed gazes torn from our feverish scribbling to look at him, gape-mouthed. Never ever had I seen a doctor who can localize the lesion just from the history alone, with no prior knowledge of him and without ever setting eyes on him.

If I ever had any problems (choy! Touchwood!!!!) he would be the surgeon I know I would be safe with.

And our main tutor Mr Tan Hiang Khoon was another awe-inspiring surgeon. Mind you, we didn’t get his jokes earlier on and it took us some time to adjust to his mode. Haha but he’s really nice and lots of fun. Always treating us to drinks, and blatantly calling us sticky students who always seemed to be hot on his heels. (can’t blame him, we are REALLY practically glued to his back. Almost followed him to the Gents once, hahah) I guess he must be pretty “scared” of us, the way we follow him around, 5 in a row.

What strikes us the most is his rapport with his patients. The young the old the ladies and the gentlemen all seem to like him immensely. He is the kind of doctor one would be very comfortable seeing. And of course, we liked him a lot too! Especially after today (where he lambasted us for being apathetic young voters who don’t care two hoots about the elections— we like him cos we are sadistic I guess) and also waxed lyrical about Chinese poems and even sang them to us.

FWAH. Impressive man!

And Ah Ma secretly recorded down his singing for “future refences”. *grinz* read: blackmail. Ahahaha

And now my respect for him has grown hundredfold after chancing upon an article which made me realize that Mr Tan is none other than the chairman of the Children’s Cancer Foundation! Despite the heavy workload, a wife to accompany, he still had the time to contribute to these poor little kids. It’s really incredible. I have always respected doctors who really genuinely seem to care. And he seems to be just one of them.

It is because of fine surgeons like those I have met in AH and now in SGH that really draws me to surgery. Although I highly doubt I am cut-out to be a surgeon, it’s still very encouraging to have tutors who inspire me and show me how it can all be done. If only the electives were longer. *gloom*

P.S: thanks to Miss Alice Bennett for your nice comment! Although I can’t find it anywhere on my blog currently… =)