The 'testing' several weeks I've had...

10-14 November 08
i. Was doing my Infectious Disease placement, when I spoke to my colleagues about the neck lump. Hmm, non-tender, tethered to the skin. It's been there for almost 3 weeks now. Better get it checked (being medical students do make you think of all those possibilities...)
ii. Arranged for a GP appointment, got one for the 21st November.
iii. No signs of neck lump resolving by itself.

21st November 08
i. Addressed all my concerns to GP, who agreed and immediately arrange for blood tests and chest x-ray. Referred to Consultant Haematologist (pakar darah).
ii. Chest x-ray finding (for those interested to know): Perihilar shadowing. Hmm.

26th November 08, 130pm.
i. Appointment with Consultant Haematologist. History and examination findings made him slightly concern, thus leading to immediate investigations.
ii. Had more bloods taken, in fact the most taken from me ever.

27th November 08, 230pm.
i. Had my first CT scan ever. Had to drank a litre of contrast, which, suffice to say, was unpleasant. CT scan took 30 minutes, analysing my head and neck, chest, abdomen and pelvis.
ii. At least I knew my kidney's working well though, given the increased frequency of visiting the loo afterwards to excrete the contrast.

28th November 08, 10am.
i. Ultrasound-guided fine needle biopsy of the neck lump. Sounds scary, but being a medical student really helps to comfort you a bit. Especially when you know the exact manner in which the procedure is being done.
ii. The biopsy is the diagnostic investigation, so this is definitely an important one.
iii. 3 biopsies taken. Alhamdulillah, wasn't too painful, the lignocaine (ubat bius) that the Doctor injected did its work, with Allah's will.
iv. Sore neck all day long.

04th December 08
i. Got a call from the Hospital. Being told to come and see the Consultant Haematologist for biopsy result.
ii. Knew straight away that the biopsy result is not normal (again, being a medical student, you know bad news are not conveyed via the phone).

05th December 08, 0930am.
i. Time to break the bad news. Diagnosis given. SubhanAllah.
ii. CT scan conducted previously gave it a stage 3; which basically means involving the neck, and both sides of the diaphragm (ie chest and abdomen). Quite aggresive.
iii. Chemo to be started soon, for 6 months. Regimen : ABVD (go and read it up guys).

10th December 08, 115pm.
i. Arranged for a PET-CT scan. Almost similar to a CT scan, except that I didn't have to drink that unpleasant contrast. Rather, they injected a radioactive sugary compound an hour before the scan commences.
ii. Being told not to go home by the public transportation, as I remain radioactive 8 hours post-scan, thus posing risk to small children and pregnant ladies. Wow.

12th December 08, 0930 am.
i. Probably my biggest test so far, bone marrow biopsy. This test is essential, to ensure that Mr 'X' has not messed around with the bone marrow yet.
ii. The experience of observing a bone marrow biopsy myself a few years back didn't help. It looked traumatic to the patient back then. Now I need to go through it myself.
iii. Even with the lignocaine, this is definitely a not so enjoyable experience. Ya Allah, may this pain cleanses my sin!
iv. To be fair, the doctor who performed it was very experienced and didn't spend long to get the biopsies from the marrow. Alhamdulillah.
v. As I was about to leave the hospital, a nurse held me and kindly requested that I have a blood test taken before I leave. Aiyo.

A very eventful few weeks it's been. The wonders of medicine. SubhanAllah, never had I imagined going through all the investigations I've learned inside out via the medical textbook myself!

p/s: Thanks encik wikipedia. Owe you a lot for this entry.