Sentinel lymph node incision still healing

After more than a month from surgery, the incision made for the sentinel lymph nodes is still healing. Its strange to have an open wound for more than a month, but slowly it is getting better.

After surgery I got 5 stitches in the incision where they removed the two lymph nodes. I had to visit the hospital regularly to drain the accumulated lymph liquid, that would accumulate beneath the skin and create a huge bulge. The incision broke on a few occasions and the liquid leaked out between the stitches. Since the pressure from inside didn’t seem to subside, together with an indication of infection, the stitches were removed and a drain was put in. While I had the drain, about 150 to 200 ml of lymph fluid was released daily, but as the wound healed from inside, this slowly reduced to about 25 ml a week later. That was enough to get the drain removed and since then I have been using a large adhesive bandage which needs to be changed regularly since it is still releasing lymph fluid.

Its down to just a trickle that keeps the wound wet, but it will be a relief when it finally closes and starts to dry.

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HOLLY BUTCHER: 1990-2018

Quoting from her letter:

“It’s a strange thing to realise and accept your mortality at 26 years young. It’s just one of those things you ignore. The days tick by and you just expect they will keep on coming; Until the unexpected happens. I always imagined myself growing old, wrinkled and grey- most likely caused by the beautiful family (lots of kiddies) I planned on building with the love of my life. I want that so bad it hurts. 

That’s the thing about life; It is fragile, precious and unpredictable and each day is a gift, not a given right. 

I’m 27 now. I don’t want to go. I love my life. I am happy.. I owe that to my loved ones. But the control is out of my hands.

I haven’t started this ‘note before I die’ so that death is feared – I like the fact that we are mostly ignorant to it’s inevitability.. Except when I want to talk about it and it is treated like a ‘taboo’ topic that will never happen to any of us.. That’s been a bit tough. I just want people to stop worrying so much about the small, meaningless stresses in life and try to remember that we all have the same fate after it all so do what you can to make your time feel worthy and great, minus the bullshit.

I have dropped lots of my thoughts below as I have had a lot of time to ponder life these last few months. Of course it’s the middle of the night when these random things pop in my head most! 

Those times you are whinging about ridiculous things (something I have noticed so much these past few months), just think about someone who is really facing a problem. Be grateful for your minor issue and get over it. It’s okay to acknowledge that something is annoying but try not to carry on about it and negatively effect other people’s days. 

Once you do that, get out there and take a freaking big breath of that fresh Aussie air deep in your lungs, look at how blue the sky is and how green the trees are; It is so beautiful. Think how lucky you are to be able to do just that – breathe. 

You might have got caught in bad traffic today, or had a bad sleep because your beautiful babies kept you awake, or your hairdresser cut your hair too short. Your new fake nails might have got a chip, your boobs are too small, or you have cellulite on your arse and your belly is wobbling.

Let all that shit go.. I swear you will not be thinking of those things when it is your turn to go. It is all SO insignificant when you look at life as a whole. I’m watching my body waste away right before my eyes with nothing I can do about it and all I wish for now is that I could have just one more Birthday or Christmas with my family, or just one more day with my partner and dog. Just one more. 

I hear people complaining about how terrible work is or about how hard it is to exercise – Be grateful you are physically able to. Work and exercise may seem like such trivial things … until your body doesn’t allow you to do either of them. 

I tried to live a healthy life, in fact, that was probably my major passion. Appreciate your good health and functioning body- even if it isn’t your ideal size. Look after it and embrace how amazing it is. Move it and nourish it with fresh food. Don’t obsess over it. 

Remember there are more aspects to good health than the physical body.. work just as hard on finding your mental, emotional and spiritual happiness too. That way you might realise just how insignificant and unimportant having this stupidly portrayed perfect social media body really is.. While on this topic, delete any account that pops up on your news feeds that gives you any sense of feeling shit about yourself. Friend or not.. Be ruthless for your own well-being. 

Be grateful for each day you don’t have pain and even the days where you are unwell with man flu, a sore back or a sprained ankle, accept it is shit but be thankful it isn’t life threatening and will go away. 

Whinge less, people! .. And help each other more. 

Give, give, give. It is true that you gain more happiness doing things for others than doing them for yourself. I wish I did this more. Since I have been sick, I have met the most incredibly giving and kind people and been the receiver of the most thoughtful and loving words and support from my family, friends and strangers; More than I could I ever give in return. I will never forget this and will be forever grateful to all of these people. 

It is a weird thing having money to spend at the end.. when you’re dying. It’s not a time you go out and buy material things that you usually would, like a new dress. It makes you think how silly it is that we think it is worth spending so much money on new clothes and ‘things’ in our lives. 

Buy your friend something kind instead of another dress, beauty product or jewellery for that next wedding. 1. No-one cares if you wear the same thing twice 2. It feels good. Take them out for a meal, or better yet, cook them a meal. Shout their coffee. Give/ buy them a plant, a massage or a candle and tell them you love them when you give it to them. 

Value other people’s time. Don’t keep them waiting because you are shit at being on time. Get ready earlier if you are one of those people and appreciate that your friends want to share their time with you, not sit by themselves, waiting on a mate. You will gain respect too! Amen sister. 

This year, our family agreed to do no presents and despite the tree looking rather sad and empty (I nearly cracked Christmas Eve!), it was so nice because people didn’t have the pressure of shopping and the effort went into writing a nice card for each other. Plus imagine my family trying to buy me a present knowing they would probably end up with it themselves.. strange! It might seem lame but those cards mean more to me than any impulse purchase could. Mind you, it was also easier to do in our house because we had no little kiddies there. Anyway, moral of the story- presents are not needed for a meaningful Christmas. Moving on. 

Use your money on experiences.. Or at least don’t miss out on experiences because you spent all your money on material shit. 

Put in the effort to do that day trip to the beach you keep putting off. Dip your feet in the water and dig your toes in the sand. Wet your face with salt water. 

Get amongst nature.

Try just enjoying and being in moments rather than capturing them through the screen of your phone. Life isn’t meant to be lived through a screen nor is it about getting the perfect photo.. enjoy the bloody moment, people! Stop trying to capture it for everyone else. 

Random rhetorical question. Are those several hours you spend doing your hair and make up each day or to go out for one night really worth it? I’ve never understood this about females 🤔.

Get up early sometimes and listen to the birds while you watch the beautiful colours the sun makes as it rises.

Listen to music.. really listen. Music is therapy. Old is best.

Cuddle your dog. Far out, I will miss that. 

Talk to your friends. Put down your phone. Are they doing okay?

Travel if it’s your desire, don’t if it’s not.

Work to live, don’t live to work. 

Seriously, do what makes your heart feel happy. 

Eat the cake. Zero guilt. 

Say no to things you really don’t want to do. 

Don’t feel pressured to do what other people might think is a fulfilling life.. you might want a mediocre life and that is so okay. 

Tell your loved ones you love them every time you get the chance and love them with everything you have. 

Also, remember if something is making you miserable, you do have the power to change it – in work or love or whatever it may be. Have the guts to change. You don’t know how much time you’ve got on this earth so don’t waste it being miserable. I know that is said all the time but it couldn’t be more true.

Anyway, that’s just this one young gals life advice. Take it or leave it, I don’t mind! 

Oh and one last thing, if you can, do a good deed for humanity (and myself) and start regularly donating blood. It will make you feel good with the added bonus of saving lives. I feel like it is something that is so overlooked considering every donation can save 3 lives! That is a massive impact each person can have and the process really is so simple. 

Blood donation (more bags than I could keep up with counting) helped keep me alive for an extra year – a year I will be forever grateful that I got to spend it here on Earth with my family, friends and dog. A year I had some of the greatest times of my life.

..’Til we meet again.

Hol 

Xoxo”

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Meetups for rare Melanomas

Quoting from the link:

“Melanoma is a cancer originating from melanocytes, the body’s pigment producing cells, and is mostly found on the skin. However, on rare occasions, Melanoma can also occur in the eye (Ocular/Uveal Melanoma — approximately 4000 new cases across Europe each year), the inner surfaces of the body (Mucosal Melanoma — 1000/ yr), on hand and feet (Acral Melanoma — 5000/ yr) and in children (Pediatric Melanoma — 1000/ yr).

Patients with Rare Melanomas face unique challenges: Rare conditions are often diagnosed late or incorrectly, with limited access to specialists and centres of excellence. Genetically and clinically distinct from adult cutaneous (skin) Melanoma, existing treatments are either less efficient or have not been systematically tested in Rare Melanomas. Small patient populations mean slow recruitment for clinical trials and the general scarcity of clinical data is causing restrictions in access to potentially effective treatments in many countries today. This leaves patients with rare forms of Melanoma with few options, in particular in the metastatic setting.”

 

Meetup for patients with rare melanomas

First appointment after diagnosis

My first appointment to started just a few days before Christmas. The appointment was with a Dermatologist who is also a specialist in Melanomas. I remember that I grew more anxious in the week between the pathology result and as the first appointment came nearer. The first few days after receiving the biopsy results, I didn’t really react much to it. I understood it was serious, but since I have been blessed with health, I didn’t make much of it and maybe had no references of what I was facing. The anxiety slowly starts growing because inevitably you start doing research online from credible sources and avoid opinionated forums. You get to the conclusion that maybe this is more serious than what you gave it credit for. This starts creating a list of questions, which no one can really answer until the whole process begins. That wait is tough and you yearn for the first appointment so that you can address this head on.

The hospital is an old building, built in 1945 on a campus where other buildings were added over time. I am an architect and I notice these things and felt that the place needed some work. On the other hand, I also found myself thinking that I am fortunate to live in a country that not only treats cancer, but does it on the national health system for free and has been doing it for some time. What I later discovered was that the brick and mortar is really superficial. I found a team of incredible human beings working in these buildings that no architecture could surpass.

When I met my doctor, she had a look at the pathology report. She asked me to see my toe, but I was surprised when she asked me to strip to my underwear. Didn’t know what that was needed but soon found out. She asked me to lie down and started examining my lower leg, touching and pressing along the lymphatic route and searching for any swollen lymphatic nodes. She pressed under my armpits, around my neck, behind my knees and around the groin area. That was the moment it hit me that this was more serious than anything I have dealt until now. It never occurred to me that this could spread and the fact that she was searching for traces of that, put everything into perspective. From that initial examination, there didn’t seem to be any evidence of swollen lymph nodes to the touch which I guess was good and that gave me some assurance to that multitude of questions that maybe it hadn’t advanced to a critical stage.

After my examination, I was referred to a Surgeon who would perform the surgery and remove the tumour from my toe. In the mean time, I was booked in for a series of exams to prepare me for the surgery.  Basically chest x-ray, blood and urine tests and a CAT scan. Besides the appointment with the Surgeon, I was also booked for one with the Anaesthetist. Everything was lined up to happen within the next few days and was a bit overwhelming looking at a list of things to do.

If on one part, the appointment had served to answer some of my questions it also felt good that the process to solve this had started, which gave me a small sense of relief. I also left the appointment with the feeling that this was more serious than I had expected. I also think I was in a state of disbelief and still processing everything. I breathed in deeply, took it in and walked with my wife to get the chest X-ray.

Getting the chest x-ray was an eye opening experience that I will never forget for the rest of my life. I was taken to a waiting room with maybe 20 or 30 people. A nurse came and called few names and walked us to the x-ray machine. In the group that was called, there were elderly who walked slowly and lagged behind, there were people my age, some men and some woman. I looked at them and wondered what they were there for. I also saw that this disease chooses randomly and still thought it was bizarre that I was in the middle of these people. Cancer is not for me, it happens to others and I am a spectator and not a participant. Clearly in denial to what was happening.

When I arrived at radiology, I was asked to wait until my name was called out. I sat down and noticed a beautiful toddler boy on my left. He had light green eyes, light brown hair and was not older than two. I had just been a father in October, about two months ago and thought how proud his parents must be to have such a beautiful baby. Even now when I write this I get super emotional and my eyes cloud. I felt sorry for his young mother who was probably in the same predicament as me, I looked at her and I could see in her expression she had had better days. I wondered what she was there for, when I noticed that the toddler had a bandage on his hand from a drip. When he turned, I noticed another bandage on his neck!

I was shocked! I couldn’t believe it, in fact I can´t describe in words what I felt. It never crossed my mind that he would be the patient and not his mother. I immediately thought of my own son and it hit me, that never in my wildest dreams, had I ever contemplated that anything bad could happen to him. I thought of this kids parents who probably thought the same, putting their baby to sleep every night, enjoying that phase and never imagining that something like this could happen. It starts making you question a lot of things that I can’t even write down. The first thing I understood is that I have been living in a bubble all my life. I have had bountiful life, because its been blessed with good health, for me and for my loved ones. The toddler was on my left and when I looked to the right, there was a young boy, probably the age of my oldest nephew, not more than eleven, in his pijamas and next to his father. I am speechless…a sense of disbelief, I know what it is to deal with this when its me, but if it were to happen to my son, I think it would be worse to deal with. I pray and ask that God protect him, but so do these parents. It takes thought and a lot of processing, to work through that and make sense of it. There is a lot of suffering in this world, more than I imagined. The hospitals are full, the x-ray boxes are lined with patients, only to be refilled a moment after, each person dealing with his predicament and making sense of it all.

I have been at the poker table, and I have been given a good hand every time the cards are dealt. I was naive to think that I would continue on this winning spree and never imagined that I could be dealt a bad hand. It looks like the cards I am looking at the moment, are not that great. The irony, is that I never rejoiced and celebrated the good hands given to me until now, but rather I bitched about petty things and really lost site of the big picture. I have been extremely fortunate and naive, in more ways that I could imagine and never truly understood by just how much. You only appreciate something when its taken away from you or almost taken away from you. I always convinced myself I would die an old man (I am still hoping for that), but its only when you are really dealing with a life threatening episode that everything is put into context and you see everything in a new perspective.

When someone passes away, we question our own mortality and think about how we are living our lives, but in todays society you get pulled into the rat race very quickly to the point that those experiences are distant memories and you forget the lessons learned.  Thats why I started this blog. I did it for me, to register this in some way, because I cannot afford to lose the lesson learnt and the changes I need to make to live the life I want to live. It is a very private blog, I have only told 2 or 3 people about it, but its open to strangers who might find an echo in it.

When I became a father and I held my baby in my arms and he looked at me with his squashed distorted nose, slanted eyes and his mouth moving like a little goldfish, I remembered one predominant feeling – that my life from that point would never be the same again. I felt energised and felt like wanting to do even more. The fact that I am mentioning this, is because I have heard so many times people describing to me the feeling of what it is to become a father. I tried on many occasions to imagine it, but the fact is that as imaginative as I already am, that you can never truly understand it without experiencing it. Its like cancer, we think of mortality and think about how we should be living our life, but its only when you are put in a real situation, that the experience becomes so much more real.

In the little journey that I have been on, I have understood that I was over investing emotional suffering on petty things in life. I would lose sleep over work related issues. Since I knew I had cancer, I started sleeping a lot better. What kept me awake at night, was no longer a subconscious reason for it, especially at a stage where my practise is going through a difficult period, accumulating debt and having key architects leave after being with me for almost a decade. My sister sent me a post by Holly Butcher who passed away to cancer at a young age. Her words resonated so strongly with me, because it is exactly that (I need to post that for future reference).

Its made me rethink a lot of things. Its really difficult to know how to live life. To be honest with yourself, to have the courage to do the things you enjoy and reject the things you don’t, even if that comes at a financial cost to you. I need to change myself for better, I need to respect myself more and be more healthy, to enjoy the time I am here in the best possible way and be a father to my son and a husband to my wife as long as I can be. I f I am not true to this, then I am not be true to this experience and will have learnt nothing from it and it will have been a waste. I hope that I will beat this, but I fear that some time in the future that I will not remember this and will be caught in the trials and tribulations of daily life.

What I do want to do is to have more time for my family, because that is the most precious commodity, more than any material or financial substitute. I also want to restructure my practise, so that it is not only centred on me, but draws value from the potential of individuals and creates an atmosphere where they can grow. I have no clue how I will do this, but I need to do it. I will keep you posted on my attempts in that regard

The drawing below is the toddler in the waiting room, I did it to remind me of that life changing moment.

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Is there an elephant in this room?

I have never had cancer before, but I have found that people in general react in really strange ways when you tell them. This is a sensitive topic, but so many times I have felt like there is a huge elephant in the room and no-one is talking about it.

Partly I understand that people want to respect your privacy and don’t want to raise the subject to make you feel uncomfortable. I am also not sure if it is a cultural thing, but many times it would be nice if people ask me how I am? By saying this, I don’t want to be the centre of attention, but I recall when a friend of mine who was not that close to me was diagnosed with cancer. I recall asking him how he was, wishing him strength in his battle and mentioning that if he needed anything that he could count on me. People haven’t asked me that…I don’t know why. It’s usually me that raises the issue and mentions that there is an elephant in the room. A bit of conversation later and everything feels lighter and the elephant has left.

On a professional level, when I have mentioned it, I have got some mixed reactions. Silence is common, followed by the subject being hushed and the topic of conversation changing very quickly, only making me feel like I should have not even mentioned it. I don’t feel that people are un-polite, but maybe they are caught off guard, are shocked and not know how to react. I have chosen not to talk about it, because in part I feel that people don’t understand it and seem to misinterpret it. I don’t know if they see weakness in me when I mention it, or if they think that an ill architect is not in the best interest of their project.

If you have or had cancer, did you feel this as well? This kind of strange silence around you? I find it very uncomfortable.

Tomorrow is the big day

Its Thursday night and I am at home with my son who will be four months old in a couple of days. My wife went to the theatre with a friend and was feeling guilty for having accepted the invitation, but al the more reason to not let things like this get in the way of our day to day.

My appointment has been rescheduled twice now because the pathology results were not yet ready from the lab. Since this appointment has not been cancelled, I am hoping that tomorrow with be the day that I know. In part I have not invested too much thought into the results, probably because I really feel strongly that this was solved with surgery. I am aware that that may also not be the case, but if it comes to that, I am sure I will find a way to deal with it…although I would really prefer not to. The other part is that I have had the tremendous support of my wife and priceless smiles from my son that just make me forget everything!

On the other hand, being an architect and not someone in the medical field may help. Cancer is something you need to understand, especially in ways that it relates to you, but I confess that I still feel like I am in a bad dream and that I am going to wake up and find out that nothing like this actually really happened. It is still difficult for me to understand that this has actually happened to me. I have always downplayed it and convinced myself that this is a more simple cancer and that I was lucky with the one that was given to me. In part that is true, I am aware that there are very aggressive cancers out there but I have also recently become aware that this can potentially be quite nasty.

Since losing my big toe, I have been searching for information of people that have been in a similar situation. To be honest, I haven’t found much. Most toe amputations are related to diabetes and I found a few cases of mountain climbers who lost toes to frost bite. Only recently I found some posts of other people who had this tumour and the topic was not about the lost toe, but rather the treatment to deal with the cancer having metastases in other parts of the body like the vertebrae in one case and in the brain in another case. The sense of despair and urgency in the conversations caught me off guard. People younger than me, with children… It still doesn’t make sense to me. I could see this tumour! I still can’t imagine that the black stripe on my toe nail could be so lethal. I have mentioned this before, but I still can’t get my head around it.

I have been watching a TV series and there was a prisoner who had cancer and was told by the doctor that she had a few months to live. I know it will not be my case, but I felt a chill go down my spine, imagining that soon it will be me, in real life hearing the news from the surgeon.

I am sure I will be ok. So wish me luck. My friends and family have been awesome, praying for me from different creeds and giving me strength. Even tomorrow, an architect and friend that works with me cancelled her dental appointment to babysit our little one while we go to the hospital.

So lucky to be surrounded by so much love!

24 days after surgery

I am back at the hospital today to change my drain that’s been leaking the last couple of days. I didn’t think much about recovery after surgery and in part it’s been quick, but quite slow in other aspects. Four days ago I got the last stitches taken out of my toe, but the part around the sentinel lymph nodes near my groin has been a slow process. I had stitches there, but last week they were removed due to the beginning of an infection. I was put on a course of antibiotics and the wound was opened and a drain was attached. Until then, the liquid was trapped underneath the skin and caused a large bulge from the accumulation. That liquid was removed at the hospital and I would need to do it every couple of days. It meant spending as many hours as possible with my legs raised up to help my body absorb these fluids naturally.

Since the drain was attached and I started antibiotics, the liquid is captured in a bag and it seems to be speeding the healing process. It’s also allowed me to work more which is a topic for another post about working under these conditions when I should be resting – but that’s what you get when you work for yourself. When I thought about people that have bags glued to their body for strange fluids, it always made me feel quite squeamish and now I have one myself! It’s actually no that bad. It’s a bag attached to an adhesive that is glued over your wound and has a little plug for you to empty it out. When they attach it, they put a metallic mesh in the wound which is made of silver nitrate or something, that prevents infection and helps the liquid flow out.

Looking forward to not having a bag on my leg and to start recovering and learning to walk again. I thought losing the toe was no big deal, but it is. I get really tired from walking and my feet and legs hurt probably because I am compensating incorrectly. I have tried to read up about people in my condition that have lost a toe and what their recovery was like, but didn’t find anything. I have read that losing a toe does not impede you from walking, but it doesn’t say if you will walk again without limping. The thought of running seems like an impossibility at the moment. It feels like the remaining toes are just too fragile to take the weight and feel like they will snap if I bend them. I guess it is all a question of time, but I will be very happy if I get to run again!

Band aid day

Back at the hospital to check on the bandages. I come here every 3 to 4 days. My toe is healing well but is super sensitive while the stitching around the lymph nodes is taking longer to heal because it keeps swelling. It has a tendency to accumulate liquid which forms a large bubble under the skin that ruptures occasionally. Not painful but just uncomfortable.

Needless to say, that the progress is inspiring! Our body fights so much to get well it’s incredible! I limped out of here on crutches and today I walked in unaided! Still limping slightly, but what a difference and better is how happy you get just to be able to walk again!

I should have gone on that last run before the surgery! It will be a while before I can do that again. That’s the thing about this…I was always making excuses for myself why I wouldn’t run on a particular day. Today I look back and think….how silly….you can run! I never thought that that simple truth can be taken away. Life is about rejoicing and being thankful that you have legs, lungs and a heart that function to run! Next time I run, I will remember just how something so simple is such a massive privilege And how fortunate I am to just…run!

Between diagnosis and my first appointment

I don’t remember when exactly, but a thin grey well defined stripe appeared under my big toe on my right foot. It was perfectly parallel and ran the length of my toe nail. It was about 4mm wide and I didn’t make much of it. It looked like I had taken a wide marker pen, and ran a stripe along the length of my nail.

When I noticed it, I thought that something must have dropped on my toe, or I must have kicked something without noticing it and got the dark stripe which I associtated to a bruised toe nail. I think everyone has at one stage banged the car door on a finger or accidentally hit it with a hammer. You usually get a bruised nail and over time as the nail grows, it gets pushed up and goes away. That is what I thought I had, so I made nothing of it and let time pass by, thinking it would go away sooner or later. I do recall, that the perfect stripe also made me think that it might not be a regular bruising, for being so well defined, but once again made nothing of it. I didn’t photograph it at the time, but I found a picture on the internet that looked very similar to what I had when I first noticed it. It’s the perfect stripe, mine was slightly wider and more towards the right side of my toe.

Some time did go by and it didn’t go away. I thought it was strange but ignored it and also didn’t think that it warranted a visit to the doctor. It didn’t hurt, looked slightly different but no reason to get it checked out as it seemed to be purely cosmetic. That is the problem with Acral Lentiginous Melanoma. It is a very rare form of Melanoma and more aggressive and with porter prognosis than common skin melanomas. It isn’t caused by sun exposure and usually appears on soles of feet and on skin that is hairless and also appears under your nails. It’s dangerous because it goes undetected for long periods of time, many times being misdiagnosed and when you do get to do something about it, it may be too late. Late in the sense that this is a malign tumour, a sheep in wolves clothes, looks harmless, but then spreads to other parts of your body through your lymphatic system.

It’s dangerous, because there is a risk that you look for help once it has already metastasised to other parts of your body and be more complex to treat. Apparently this tumor has a tendency to Metastasise on organs like liver, lungs and brain. How crazy is that? You would never think it would have started on a grey stripe marked on your toe nail! The irony and fragility of life…how can something apparently so innocuous be something that could actually cut your life short?

Anyway, one day while getting out the shower, I pressed on my toenail and a bit of blood seeped out below. I still thought it was a bruised toe nail, so it wasn’t until the summer of 2017 that my wife who had been insisting with me before, insisted even more that I see a dermatologist about it. By now the mark under my toenail was starting to look darker and the toe nail had begun to soften around it. That seemed to convince me that maybe it was just a fungus I had caught somewhere*. I kept forgetting to call the dermatologist and did it more because my wife insisted. When I did finally remember to call him, he only had an appointment in late November which for me was ok, since I wasn’t dealing with anything that was urgent. It’s a good thing I did call and that I listened to my wife…like a very dear friend of mine says “married men live longer” and I hope to be a testimony to that phrase!

When the appointment finally came around which was Wednesday the 29th of November 2017, the doctor suggested I come back on the following Monday for a biopsy. Since a biopsy sounded serious, I asked him what that meant and he told me that there was no reason for alarm. I was told it would be important to understand what type of cells were under my nail so that the doctor could know what we were dealing with. I came out thinking it was a type of birthmark that had started growing under my toe nail and that there was no reason for alarm.

The next week, on that Monday 4th of December, I went in for the biopsy. Feet and toes have a lot of nerve endings and are pretty sensitive so it wasn’t a pleasant experience at all. The samples were sent to the lab and we waited for a few days. The dermatologist mentioned in his request to Pathology what his suspicion was, but I shrugged it off, thinking that it was just protocol, didn’t apply to me and frankly didn’t lose any sleep over it.

On the 13th of December 2017 I got the results from pathology. I received the email confirming Acral Lentiginous Melanoma. I showed it to my wife and when she read it, she burst into tears. Probably because being a Doctor herself, she understood what that meant while me on the contrary had no idea what I was dealing with. The following days went by pretty quickly between getting referred to between Doctors and ending up at the Portuguese Institute of Oncology in Lisbon. If it wasn’t for my wife insisting that I get this checked out by a proper specialist in this area, I would never have gone to the doctor for this. I would still be here, oblivious to what was going on in my toe, while the tumour would keep growing and likely spread to vital organs that are key for survival. How screwed up is that? I know I am going to beat this and get well.

From here, things started moving quickly, but literally felt like an eternity. The first two or three days you are still in denial and caught by surprise while taking in everything. It slowly starts sinking in that you are dealing with something serious. You start searching for photos to understand just how long you have had this for, since it is a determining factor foro a good prognosis. When you look at the photos, there aren’t many summer pics with flip flops and at an angle that you can see your toe nails. We worked out that I have probably had this for about about a year and half as we don’t recall having noticed it on our honeymoon. As the days go by, so does your anxiety level, you start looking for answers to the gizillion questions running through your mind. That first appointment took forever to happen and it was just a week away!

I have been blessed with health. I am a 45 year old male and between having had my appendix taken out, I have never had any health problems. I am an architect and run a successful practise in Lisbon and my only ailment until now was working too much. I live in the city of Lisbon in Portugal and consider myself fortunate to live in a country with free healthcare. I was referred to the IPO (Portugueses Institute of Oncology), a hospital that deals exclusively with cancer and where my first appointment took place.

My wife is a doctor, currently specialising in Pulmonology and during her training she spent a few months at the IPO in the lung cancer division. On a few occasions I picked her up from there at the end of her day or to take her out for lunch. While I sat in the car and waited for her, I saw patients going in and coming out of the hospital. I thought of them and imagined how challenging it must be to be diagnosed with cancer.

I never imagined that I could get cancer….it was something that happens to everyone else. It is still difficult for me to say it today that I have it. I push it to the back of my mind like it doesn’t exist or it doesn’t apply to me. But it does. Unfortunately it does. It changes your perspective of things. I sat in my car at the gates of the cancer hospital and as much as I could have tried, I truly couldn’t relish that moment that you appreciate that you are healthy and fortunate you are. You do, you inadvertently think how lucky you are to be healthy, but it is only when that is threatened to be taken away from you, that you understand just what a big deal it is.

Little did I know, that one day it would be me, walking in through those same gates to get treated for cancer.

Notes:

* it wasn’t a fungus but in actual fact, it was the tumour increasing in thickness below the toe nail. That thickness is key in detecting the state of the tumour, where the thicker it is, the worse the prognosis is. I will know what thickness my tumour was on the 30th of January and understand how far it developed.