Saturday, June 15, 2013

Nose Cancer? Getting a biopsy.

continued from previous post

Following the news of nose cancer, and the stunned reaction of all of us - me, my brother who was there, and family and friends..I decided to just go have lunch. Let's go and eat sashimi. It will put me in a better mood! Perhaps..

I called a good friend who has some connections with some medical specialists and told him that my GP was going to scope my nose and do a biopsy to check for cancer. A red flag was raised immediately.  Is he a specialist? No. What if I can get an ENT specialist to see you today? Would you go? Hell, yeah, if I can get in today because I have a ticket to fly home to Kelantan tomorrow. (I don't want to stay here and be away from Zoe). Let me see what I can do.

Not 15 minutes later, a call back confirmed an appointment for me at 3pm. I trekked down to the Subang Parade area with my brother who is driving in KL traffic while on a conference call with me holding a laptop for his reference. Insane...

I am greeted by smiling faces at Dr Puravi's clinic that is on the first floor of a row of shophouses, next to an Eye Clinic. They were clad in purple blazers, all of them. Many of them!! A girl with what look like burns on her face asked me,

What's your name, why are you here?

Gigi, I have nose cancer. Here's the report.

How long have you known?

The scan is from this morning, I say calmly with a wry smile.

A look of sympathy flashed across her face.
From the way you are talking, it sounds like you've known for a while. But it's just this morning? You mean today?

Yes. The scan was done this morning. I am OK. I have taken it all in already. I am ready.

Registration continued and I find out the only guy behind the counter is from Kelantan. A connection is made immediately as we started speaking our local dialect, a form of Malay very unique to our area and it commands a lot of respect when Chinese people don't sound like Chinese people trying to speak Malay. The girl with the scars who had warmed to me instantly is even more in awe now. You don't speak like a Chinese.  I laughed, acknowledging the compliment.

The Indian doctor showed up shortly after I arrived. He is bespectacled, tall and slender and slightly balding. He has kind eyes.

I was second in line. The patient before me is an older woman who has had two bouts of nose cancer and is back for a check up. She had arrived about an hour ago and was just tired of waiting. Complaining loudly because she waited so long, she went in to see him. My brother is still on his conference call.

Eventually it was my turn to see the doc. He sat me down. He'd already been briefed by my good friend about my condition and diagnosis from earlier in the day. He stepped me back through some history and I have a better grip on telling my story since I have had to tell it several times already. This time I'm doing things chronologically. I walk him through. He explains that in his experience a lot of times these things that show up red in the PET/CT scan are not cancer but something else, but he will look at me.

After explaining different parts of the nose and pharynx to me, he ushered me to a chair where he can examine my nose with what looks to me like a 6 inch probe  with a camera on the end. He said Look at the screen and showed me everything inside my nose.

I don't think you have cancer. In my experience, this looks to me like an ulcer. You have narrow nasal passageways, enlarged adenoids and tonsils....blah blah blah...

But please take a biopsy anyway, just for my peace of mind.

Are you sure? I really don't think it is.

I am sure. I need to know. And really for my peace of mind. The radiologist said that he was nearly 100% sure I have nose cancer.


Several of his assistants busied themselves and loomed over me. He sprayed some Afrin into my nose to numb me for the procedure. I had to wait for a few minutes before it was done. One nostril was probed with the 6 inch thing from earlier and the other was probed with slim looking pliers. Snip! He pulled something out and decided it wasn't enough. I wasn't relaxed enough and he couldn't get a good sample size for biopsy. Another stronger numbing agent was introduced.

This is going to taste really bitter.

I can take it. Let's go.

The spray was incredibly bitter and as he sprayed it in my nostrils, I tasted it in my mouth and it trickled out and also down my throat. Yep, it was bitter.

Wait 10 mins, and then spray more Afrin. And then, let's have another go at it. Dr Puravi instructed his assistants.

I started to bleed from my nose and cough up some blood clots. And apparently it was totally normal.

Before long, I was up for another try. As the probes reentered my nose, I started to cry involuntarily. The tear ducts are so close to my nasal area that this was bound to happen. And the thing bloody hurt. It was super uncomfortable to have to breathe through my nose (which is already small!) with a probe in one nostril and a pair of pliers, albeit a slender pair, in the other. Still I breathed through my nose, took a deep breath through my mouth and SNIP!  Remember my high pain threshold? Still intact, but still bloody awful and painful.

A big chunk was taken out for biopsy. I've got a huge sample size, the doc declared. I am given a handful of tissues and blood started coming. I tasted blood in my mouth as well. Totally normal.

I get out of the chair with a smile and thank him. All his assistants have kind faces and they are all constantly smiling reassuringly. I sat down opposite the doc and he gave me a bit more advice on what to do going forward. After all was said and done, I told him I was really happy to have seen him on such short notice, and that he had amazing staff who were so incredibly kind and always smiling. He looked a bit perplexed, like no one had ever bothered to say something like that to him. He just nodded his head and smiled, not sure how to respond I guess.

I was truly impressed by his demeanour and calmness, his willingness to not gloss over everything and his patience to explain to me exactly what was the matter with me and how to treat what I had, assuming it wasn't nose cancer. He really changed my day around from the 100% nose cancer declaration I had got in the morning. I felt like I had some real hope when I left his clinic. But I will wait to celebrate when I know the results of the biopsy.

I wanted to tell him but I feared that my being so honest would embarrass him or make him think I was just trying to flatter him unnecessarily.

Those of you who read me here and know me will know that I am not into flattery, in whichever direction. I don't like to be flattered (when it is clearly untrue) or lie and flatter others. But I wasn't sure how he would take my sincere and heartfelt comments. So I left it at just complimenting his staff.

I now hang on to the next few days while I wait for the biopsy results with some hope that I really don't have cancer. I hope I really just have bad inflammation of my nasal pharynx area.

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