Our marvel of a survivor!

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“What??!!” was my bewildered reply to the nervous voice on the phone line. I stood silent for a minute, holding tightly to the phone on my ears and staring blankly on the corridors of ward 8. Feeling the cold sweat engulfing my consciousness, the world around me suddenly turning into a gyroscope of blurred images. The universe went dark.

Doc? okey ka lang?” came the ward nurse’s faint voice. “I need you to sign this” handing me a patient chart needing an RIC’s signature. I cleared my throat and mustered enough energy to sign the chart with my hands shaking. “Sigurado ka okey ka lang doc?” She asked again. “Thank you” I said, motioning her to go away and making a gesture I’m answering a call.

I haven’t turned off the phone yet.

I’m seeing her face- short, gray hair that was always kept tidy by constant rearrangements. Her cheerful face look a bit weathered but is still wittingly sharp, beaconing years of endless struggle to survive a harsh, defiant world. Lately, wrinkles appeared in her forehead and no matter how she ‘tucked” those with make up, age seem to catch up with her indomitable spirit.

She use to wake me up in the morning with “kain na!!!!“and then bang my door.

She was just fifty and I just finished med school.

She went into the provincial hospital without informing anyone about it. Not even us. I only found out when she called after the operation.” My sister’s nervous voice collapsed into sobs of frustration. Dumbfounded of the events unfolding, I can neither summon enough energy to console my sister nor think clearly about the situation we were in. It was a chaotic tug of war between uncertainty and frustration. I am totally dazed.The mixed emotions of grief, fear, anger and love, all bursting up front.

What if we lost her? Are we prepared for this? Is she prepared for this? I shiver at these possibilities.

A marvel of parental control and survivorship, she lost her husband while in her early forties. She took the cudgels of single handedly supporting their four children, sending them to through college and produced four top caliber professionals in their fields. For the longest time she was the family’s beacon, the passion, the inspiration. And now the danger of suddenly “losing her” lurks just around the corner.

She is Helen.

Helen is my mom.

Well differentiated uterine adenocarcinoma,” came the histopath. Silent panic. The sudden gush of adrenaline made my heart thump louder I could hear them between my breaths. The phone almost slipped my hands while I froze in disbelief. Now, losing my mom is a grim possibility. What now?What shall I do? What shall we do? Med school had trained me for situations like this. But not if your mom (or any other close person) is the patient.

Med school even made it more painful for us doctors. We often have an idea how disease progress and how it eventually ends.

Sir can I file a leave starting tomorrow?” I told my team captain and chief resident. “My mom have uterine CA and will undergo surgery in our province“. My chief resident looked at me for a while and sensing some desperation said “Ok. You can file your leave and go home a soon as you endorsed all your patients. But come back !” He too can sense the frustration and hopelessness in me.

Yes sir” I subconsciously answered . I was busy thinking about my mom.

I’m still lost in “what ifs”

Arriving early in the airport next day, I went directly to the hospital and into my mom’s room. Asleep with IV lines jutting out of her forearm she looked pale from the blood loss of prolonged menstrual bleeding before. She is cachectic and visibly weakened . “She lost this much…” I whispered. I looked at her teary eyed. I wanted to hug her tightly, but never had the courage to do so. Her sunken, gray rimmed eyes suddenly opened. She was surprised to see me there and hugging her. My mom is not used to this hugging thing and she hates being pitied upon. “Bakit?” was all she said. I didn’t answer. I just sat in the chair beside her bed.

We’d be doing a Total Hysterectomy tomorrow. She won’t need her ovaries too so we’d take it as well. Problem is she has diabetes.” Her OB Gyn told me. “Diabetes???” I remembered my mom siblings got diabetes too, so it is really possible my mom has diabetes but she was mum about it. My heart melt in pity for my mom. She couldn’t just take all these diseases in one single hospitalization! If she is lucky enough to survive the CA, she has to contend with another equally debilitating chronic disease!

After all she had done for us?? This is all she will get??! It’s not only unfair but entirely painful!

I sprang into a robotic action, called all the MDs I know, asked for advices and called a family meeting. That family meeting seem like eternity. I could feel the tons of weight that stood on our shoulders. “I am the doc and I know what to do.” That’s what is expected of me and that what I’m hypnotizing myself with. Hopefully it will work out.

My brother and sisters all waited silently, visibly grief- stricken. We abruptly “lost” our dad before too. Such sudden turn of events not only traumatized our poor souls but made us grappling for lifelines too. The fact that none of them has had any medical background added more to their uncertainty. The burden is so heavy. “You decide because you are the doctor and you know what to do” said our eldest. I always dread this phrase. It makes me feel like dying too.

We will all suffer and grieve, If we will all just cry here and do nothing ” I said in a crackling obviously pretending voice. But we’re ready to strike a deal with fate just to extend my mom’s life. She was our lifeline.

Hiding the panic in me, I went organizing a support group for my mom. “We have to adapt to the current situation or we will suffer. “ I made roles and schedules for each of my siblings- preparing food, relieving hospital watch, even informing contacts. I was busy arranging for the OR, finding the necessary meds, medical needs and preparations. I pretended to be the “in charge guy” but deep inside I’m cracking up in panic and fear.

I’ll advised” said my friend.

I decided to scrubbed in the OR next day. My mom’s surgeons let me in and used my “surgical” hands too. It was an all star surgery for a routine hysterectomy. An OB gyne doing the surgery, a general surgeon assisting and an orthopod on the second assist and another MD on third assist. We have an internist watching over my moms medical condition the whole OR There two anesthesiologist working behind the bags and machines. Outside the operating theater were hordes of close friends watching the show.

I don’t know, but whenever I went into the surgical room, my panic temporarily stops. I feel as cold as any steel as the scalpel I’m holding, perhaps a result of years of training. The team went into robotic precision the entire surgery. I distracted myself not to think about the patient on the OR table, so I don’t clutter or be jerky assisting. The surgeons were meticulously well oiled and systematic. After swiftly removing the uterine and ovaries, we inspected all the nodes and noted for gross metastases. We did the routine inspection three times. None were suspicious. My mom’s appendix is “inflamed” so the surgeon removed it also. I was totally engrossed in the procedure I didn’t notice we were already an hour into the surgery. “Wash!” Woke me up and made me realized the surgery will soon end. After final last minute check of organs, bowels, instruments and sponges, we closed the incision. It was an uneventful procedure and we were all happy the team is through these emotion filled surgery. I made a little speech to the OR team thanking them for helping my family all out and making this surgery safe and succesfull for my mom. I was surprised by the round of applause the team gave each other.

Two days after, my mom was already walking and taking her bath alone. She was visibly rejuvenated but is still weak to walk unassisted. Her blood sugar stabilized and she was eating quite well. There is this smile on her face already. My pamangkins were all around her playfully tagging their lola. Helen is all smiles facing and talking to all those visitors she had like nothing happened.

We were happy too. She went to live another lifetime we believed. Perhaps several years more who knows. For once we were suddenly reminded of our moms loving presence. That in the process of us growing, we never had noticed she was getting old also. And as me and my siblings looked at each other, we knew right then we’d be better off showering our mom with love or we won’t have time for that at all!

The tumor margins were negative for mets. The review of slides were the same adeno CA initially diagnosed in our provincial. I brought my mom to a well known gyne-oncologist in Manila for another follow up check up. He said that my mom luckily survived the ordeal. He advised yearly abdominal CT Scan. For 8 years now, my mom has been symptom free. She had her swings of glucose intolerance but this can be adequately controlled medically.

She still hates being pitied upon or being thought of as weak. If my dad “thought” of everything he wanted us to become, my mom carried the four of us to an unbelievable life struggle, never hinting for  moment about quitting or saying “I can’t”.

My mom is a marvel of a survivor.

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Dr. Remo-tito Aguilar co-founded #HealthXPh. A board certified orthopedic surgeon, he is previously Chief of Clinics at St. Louis Hospital in Tacurong City and a consultant in Orthopedics at the Southern Philippines Medical Center in Davao City. Dr. Aguilar is a healthcare social media evangelist and writes his medical musings at The Cast & Curious (www.remomd.com).

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