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Breast cancer can catch anyone by surprise. Why I say that is because the usual history is a lump felt in the breast over a few weeks to a month or two or more. Apparently innocent as it caused no pain or upset the rhythm of life. It was just there! I identify with this extremely unpleasant feeling of being caught out or cornered or ganged up against, when this innocuous lump is declared cancer, almost everyday. How could a lump which was just there till yesterday change life indelibly? The grief that accompanies the diagnosis is unfathomable in most. The denial that follows and the unfairness of the situation is quite hard hitting. I, as a Clinician, after so many years of being witness to this familiar response, still find it hard to say something sensible to console, especially if the affected is young. It is almost as if I am on their side, a part of their family, going through this heart- wrenching sequence. When I am at a loss, the best I do, is hold their hands and say everything will be alright. I want it that way and no other way, as every doctor would. And it works! I liken the situation to being in quicksand. If you struggle too much with the situation, you get pulled in, the brain gets clouded and wrong decisions are made. If you reach out to a helping hand, gently ease yourself out with coaxing and cajoling coming from your loved ones, you make it! How one handles the situation has a large part to play in what the final outcome would be. We do not choose situations in life and some situations do catch you unawares. What you can choose, is your response to the situation- accepting it, making light of it, taking it in your stride and going through treatment with the desire to heal and bounce back, is usually what winners do!!
Cancer is often viewed as the end of the road in many ways, especially for the young afflicted with cancer. While the diagnosis of cancer, in itself, can be devastating for them, the consequences of treatment can actually push them further into a corner. One such situation arising out of treatment is infertility, a topic which was rarely broached with the young and old alike, till the recent past. With due care and sensitivity to these needs of the patients, it is possible to reverse a lot of wrong that treatment can bring in its wake! That brings me to the story of this young Champion I wish to share with you.The main protagonist of this story is a young Doctor diagnosed with breast cancer aged 26 years about 6 years ago. She was devastated! She was engaged to her sweetheart- a young Doctor training to be a surgeon. She was looking forward to a beautiful life when she was struck by breast cancer. This was more than what any girl her age could take. But she was different!She had spunk and was not willing to let go, of the life she had dreamt of. She soon collected herself to ask the right questions of her doctors. She wanted to preserve her fertility and after consulting an infertility specialist, had her ova preserved. She underwent treatment, thereafter and had breast conservation surgery followed by chemotherapy, radiation and 5 years of hormonal treatment, supported by her fiancé who stood by her like a rock.She was married to him soon after treatment. She is on follow up and all is well. The story doesn’t end here. She called me last week to share a piece of good news. She had given birth to a healthy baby boy two months ago. I was besides myself with joy and both of us laughed merrily over the phone. She came over two days ago with her bundle of joy cradled in her arms, her eyes overflowing with the selfless love of a mother. I could imagine what it meant to her. And this had happened naturally!! However bad the situation, life does turn up trumps on many occasions. These Champs give a new meaning to hope and I am wiser for it. If I am optimistic, you know where it comes from!! #health #breast cancer # breast conservation surgery #infertility #Max Hospital #Patparganj
Yesterday I visited my niece and was on the phone talking to my patients, sorting things for them. When I finished, she asked me, ‘Isn’t your profession stressful?’ I was quick to say NO. The conviction in my tone has taken many years to come. I recall my early days as an oncologist and in particular, this vivacious young lady who had a relatively advanced colorectal cancer with involvement of her ovaries. She had undergone surgery elsewhere, 4 weeks prior to coming to our unit. Her abdominal wound lay open and was pouring out fecal matter and abrasive intestinal juices, consuming her skin.I could not come to terms with the unfairness of the situation, then. Why was this young lady with the most sparkling, hopeful eyes dealing with this horror? I wanted to pull her out of this mess and diligently did my best to improve her nutrition, take care of her wound and her medication. She and I would talk a lot- her dreams, her aspirations, her twins, her loving husband, her family...we became good friends! Her surgery was planned and executed well. She was recovering well and she wanted to be home to celebrate her twins’ birthday. I assured her she would. And then that day arrived, when she walked. She walked for the first time after 8 weeks. I was thrilled and went home thinking she would be out of the ICU the next day. I was going up to the hospital the next day when I got a call that she had had a cardiac arrest. I thought I had heard wrong. I ran up to the ICU and before I reached, she was gone. Pulmonary embolism had taken her away. I was distraught and I cried, rather howled, like I had lost one of my own.An elderly physician put an arm on my shoulder and said, ’ This is certainly not the last time you will have to deal with this. Don’t get attached to the outcome of what you do. Do your best but remain detached from the outcome’. Those words have stuck and I have grown since. My focus is entirely on what I can do for the person who sits across the table and entrusts his or her life to me. I do my best to understand the problem, execute treatment, handhold them and try and do whatever I can to make the experience as seamless as possible. Cancer outcomes are never a 100%. You do lose some at the end of the day but if I have contributed to making their life easier through their suffering, I have done something worthwhile. While it is easy to be overwhelmed by these difficult situations, I need to remain detached from them so that I can do more for those who need help. I have come a long way since, but it is not as if I am not affected by what happens to my patients, anymore. It is just that I have taken better charge of the emotional me and replaced it, not entirely, with the professional me!
It was Breast Support Group meeting on Thursday, 18.12.14.The Champions who had been through the journey of breast cancer had come in to encourage the ones who had just started treatment. What is exceptional about this interaction is that the conviction of being able to go through treatment goes up manifold when the ones who have gone through the process and have recovered completely, counsel the new kids on the block. I believe it is the fear of the unknown and the feeling of isolation that puts you on the back foot. The interesting methods of coping with the situation related by the champions, is very encouraging. The smiles, laughters, jokes...... all give the impending process of treatment, the much desired sanity!!! For more information on breast cancer, please contact Dr Geeta Kadayaprath, Delhi, India
Today Max Patparganj and Vaishali conducted C4 - Challenging Case Capsules in Cancer. What was unique about this event was that it was for and by Oncology trainees. What they brought to the table was oodles of energy and the ability to discuss situations in Oncology with aplomb. They stayed on till the end and the learnings from this endeavour were truly humbling! The experts and the Supreme Panel of judges gave more dimension to the exercise. The energy remained till the very end! The interactions were another level and could not agree more when one of the judges said that the future of Oncology is in safe hands! Thanks a lot to all those who believed in us!! Till we meet again, Adios!!
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