No news is good news, the rate at which I’m blogging has subsequently declined. The latest blood tests the liver function tests and the LDH (the marker of disease activity) were both normal, so it’s very likely the C is not doing anything. I spoke of this in a previous blog, and being back to work has been very positive, as it really has given me a chance to “move on”. The difficulty however is that it is not a problem that will go away, at least not any time soon. However there has been the odd reminders of it, the most difficult was recognising the SHO Doctor who clerked me in at the Marsden. I very artfully avoided eye contact with her, however compared to how I looked then to now, it may have taken her a long time to recognise me. I’m actually 7kg heavier, my eat-as-much-as-I-like diet with a lot less exercise may have to change. Although weight gain is extremely reassuring*. Bizarrely I’m even slightly taller, perhaps I was hunched over the last time. So this is more of a blog about some snippets of wrestling melanoma since MalTOUR.
The weirdest moment was from an autistic girl in clinic. She was clearly very bright, studying biochemistry at uni, she had a lot of support to do this – a psychiatric interview we go into a lot of detail – with her own room with a computer for the exams. The thing is, she said “oh biochemistry is so boring having to learn lists of proto-oncogenes” then started listing them starting with “P16 – goes to CDKN2A”. What did she say? It is only my dastardly gene. For the uninitiated a proto-oncogene is a gene which “A proto-oncogene is a normal gene that can become an oncogene (a cancer causing gene) due to mutations or increased expression”**.
I quickly slotted back into the routine of weekly FY2 teaching after everyone was especially nice to me in the first week back. It is weird, in a nice way, when someone is pleased to see you simply because you’re looking so well. Maybe, after reading this, spend the next hour thinking how great it is that the people around you are looking so well. Anyway, by the 3rd week of teaching I was well into the flow of things, during a talk I had a particularly loud sneeze, rapidly most of the people near me turned to look, maybe it was in my head but they looked more concerned than usual, I grinned “don’t worry I’m ok”. The second teaching is loosely related to the theme of this blog but it was a week where FY2’s were presenting cases** to the group, for my sign off at the end of the year this is mandatory, I thought I had some more time, but this happened to be the last week. I had actually made the slides only a few days before becoming unwell as in all the way back in February as I was due to present a couple of weeks later. So I had to blindly present these slides, some of the slides were completely blank! Fortunately I had a very sympathetic audience who were aware of my plight, it was too long ago for me to remember what I intended to put in them. Thankfully I really knew the patients story well if you are reading this or your daughter is, like we told you at the time, we will be presenting your X-rays for years to come.
*weight loss occurs partly because the cancer uses up energy reserves and I had a few days where I barely ate. In my case it was because I was running long distances all the way up until I was diagnosed.
**if I’m going to reference anything it’ll be wikipedia.
***patients who are particularly interesting this can be for many reasons, for example, if their disease is particularly rare, if they responded well to treatment, if they offer a learning point to the audience or if they presented in a strange way. Hopefully I’ll be the latter three.