THE SCARIEST THING
It all started when I fainted in the subway. The ambulance took me straight from there, and after that there was no end to the number of ambulances.
On one of the calls I was taken to the hospital where I was diagnosed with a tumor. I was even glad that they found the cause of my condition. I could not sleep or talk. I was tormented by a strong cough. The tumor was in the chest, in the mediastinum.
What scared me was not so much the word "tumor" but the unknown. When faced with such an incomprehensible, rare diagnosis, you do not know which doctor to contact, where to find him, what kind of research to conduct. It was frightening. I didn't know what to do. Later, as it turns out, many patients face this dilemma.
WHAT KIND OF DOCTOR IS A HEMATOLOGIST?
Before the diagnosis, I was treated under a voluntary medical insurance contract (Additional medical insurance. — Ed. note), provided by my employer. As part of this agreement, I was given a consultation by a thoracic surgeon at the Vishnevsky Institute of Surgery.
According to the results of the computed tomography, the doctor recommended that I contact a hematologist-oncologist.
I didn't even know there was such a doctor, and I had to go and find where one worked.
I had recently arrived in Moscow and began to make inquiries through friends.A separate story is how I enrolled at the Institute of Hematology. It was necessary to wait for the registration to open for the next two weeks, then wait for the appointment. A friend helped me sign up.
My condition was getting worse every day, and my friends and I began to look for other options on how else I could get to a hematologist who knows how to treat me, who would be able to alleviate my condition and help me get chemotherapy or other treatment. We found him in MEDSI. Right from work, my boss put me in a taxi and sent me to the clinic. The doctor explained to me that I needed to undergo a biopsy, and only then could I start treatment. I was offered a laparoscopic biopsy under general anesthesia, and the next day I went to the medical center for surgery. The biopsy was performed under compulsory health insurance, so I only had to pay for my stay at the clinic. I was given a preliminary diagnosis — Hodgkin's lymphoma, stage 4.
When I came to pick up the slides, I was offered treatment in the hematology department of this clinic by Alexey Fedorov.
TO DEFEAT THE TUMOR
I took the slides for analysis to the NMRC for Hematology. Then there was a long wait for the results. My appointment with Tatiana Solovieva was coming up. I understood that I would come to the appointment with ready-made immunohistochemistry and get the final diagnosis, but it so happened that the analysis was ready on that very day, but in the evening. Even before seeing the results, the doctor assumed that the most aggressive protocol would be used for treatment. The tumor was progressing, and it was impossible to postpone treatment.
In addition to the tumor itself, there were aggravating factors — broken ribs, fluid in the lungs, fluid between the heart and the surrounding membrane.
I decided to undergo chemotherapy at MEDSI. The course was completed in January 2020. It had to be interrupted ahead of schedule due to a severe infectious complication.In April, during the pandemic, radiation therapy was prescribed. It had to be carried out in a private clinic for a fee. It was not far from home. I could walk there. It was very scary, after chemotherapy, with reduced immunity, to deal with the coronavirus, this new, incomprehensible infection. Would I be able to survive it? I did not use transport, I went only for treatment, and only on foot.
Now I am being observed by Tatiana Solovvieva at the NMRC for Hematology. I always go to her for the final opinion on the main disease.
HOW TO SURVIVE THE TREATMENT?
I underwent five courses of chemotherapy, between which I was discharged home for two weeks. In between courses, the ambulance recognized me by my voice. At first, during the most difficult stage, my mother moved in with me. She took care of me the entire time I was undergoing treatment. I couldn't have done it alone.
When I needed to recover, my colleagues helped me a lot. During the pandemic, I was afraid to leave the house. They came, brought medicines, and went to the clinic to close my sick leave so that I could return to work. It was good that it was possible to work remotely at this time.
I had moved to Moscow recently, and my colleagues were my friends. I am grateful that they did not abandon me in this situation. Each course of chemo lasted eight days, and thus, my stay in the hospital always took a weekend. Every weekend they came, brought delicious food to please me, took me out for a walk, and they also picked me up from the hospital.
My friend and colleague lives in the adjacent building. He took garbage bags, brought groceries and prescription medications. There was support.
There is nothing worse than physical helplessness. You used to live your life like an ordinary person. You could do anything, but now you feel so bad that you can't even get dressed on your own.
The support of family and friends is also a part of treatment.
I've had a lot of breakdowns. I would say: "Why am I going through treatment, why did I agree to all of this? I can't stand it anymore. I'm going to die anyway. How long do I have left?” Each time, my relatives patiently, time after time, got me out of this emotional low. They persuaded me to be treated, to not quit, and supported me. It would be very difficult for me without them.WHY IS A PSYCHOLOGIST IS NECESSARY
I also worked with a psychologist while I was being treated. This is also an important part of treatment. At the moment when it hurts, it's scary, it's hard, you want to give up on everything and say, "Come what may." It is necessary not to lose your strength and your inner resource, in order to survive the treatment.
In Russia, it is somehow not customary to turn to psychotherapists. I always say this: if we have a toothache or a stomach ache, we consider it normal to go to the dentist or therapist, and when our soul hurts, for some reason we consider it shameful to go to a psychologist, as if this is some kind of faux pas.
In a situation with severe treatment, the help of a psychologist is very important. I know that there are even oncopsychologists, and their consultation can be obtained by CHI.
There is an institute of "equal consultants,” where people who have been through treatment and illness act as a consultant.
They can provide help and support to those who have just been diagnosed and are just starting treatment.I'm also thinking about becoming an equal consultant. I remember how many questions and fears there were when I heard the diagnosis, and there was no one to ask. The reaction of ordinary people can be unpredictable. They don't know how to communicate with people like us who have an oncological diagnosis. Everyone who is faced with a serious illness and complex treatment should have the opportunity to receive psychological help.
A COMPLICATION THAT NO ONE EXPECTED
I had a very toxic chemotherapy protocol, and I was given large doses of hormones. One day I couldn't bend down to put on my shoes. Then I began to limp and the pain intensified.
I didn't understand what was happening to me and which doctor to go to. It was April 2020, and because of the pandemic, everything was closed.
It wasn't until September that I found out what was going on with my legs. It turned out that this is aseptic necrosis, and such a complication after toxic chemotherapy is not uncommon.
For a year and a half, I walked on crutches. My legs had almost stopped moving and there were constant pains.
RESCUE OPERATION
I couldn’t have imagined that there are traumatologists and surgeons in the hematology center, but when I once again came to see Tatiana Solovieva, she scheduled me for an operation at the NMRC for Hematology. I was surprised. Then we met with the orthopedic surgeon of the NMRC for Hematology Vasily Mamonov. After looking at the X-ray, he immediately said: "You are our patient, we will take you."
I understood that only an operation would relieve me of pain, raise my quality of life, and restore my legs.
I was very scared, because legs are not a tooth, not hair, and new ones would not just grow back.
I was looking for all sorts of ways to delay the operation. This was at the end of May 2021.Vasily E. Mamonov said that no conservative methods would help me. I asked him about two billion questions, and he patiently answered all of them. When the doctor suggested an operation in early July, I immediately agreed.
“Can I have two at once?” I asked
“No, you can't have two at once. It will be too difficult and rehabilitation is needed. We will do it in turn.” Vasily Mamonov replied.
"IT’S OK, DON'T BE AFRAID"
Before the first operation, it was very scary. I was literally shaking. I was almost bouncing on the operating table. The nurse could not install the catheter for a long time. I had had chemotherapy, and everything dripped through my hands. The veins suffer very much from this. The nurse would put it in, and the vein would tear. They put it in only on the third time. We had such a hitch with the catheter. And until the catheter is in, nothing starts.
Nikolai Prasolov, the anesthesiologist, had already arrived. He sat at my head jokingly giving instructions and explaining how and what would happen so that I wouldn’t feel scared.
Mikhail Pisetsky entered the operating room and saw that we were not yet ready. “Well, okay,” he said, “I'll sit here on the bench for now.” As I was lying on the operating table tied up, Mikhail Mikhailovich came up to me, looked into my eyes, and asked me how things were and about my mood.
"It's scary, we'll finish with the catheter now, but in general, it's scary.” I say.
“It’s ok, don't be afraid.”
I looked into his eyes and realized that everything would be fine. They would do everything as promised.
I calmed down, and the catheter immediately stood up. Then they gave me anesthesia, and I passed out. They really did everything as promised. It's great that they can both encourage and treat their work very simply, as something taken for granted.THE FIRST STEP
After the first operation, I was taken to the intensive care unit, where I was monitored for a day before being transferred to a regular ward. On the same day, another woman underwent surgery. We were lying next to each other on neighboring gurneys without clothes, everything in sensors, tubes, and drainage. At about nine o'clock in the evening, the doctor on duty, Ardavazd Vartikyan, came in.
“What are we lying down for, ladies?”
“What do you mean we're lying down? And what should I do?”
“Get up.”
“How do we get up? Just a few hours ago…”
“We're getting back on our feet.”
And he didn't leave until we got up. It's impossible to even imagine! In the morning we had an operation, and in the evening Artavazd Arshakovich lifted us to our feet. Lifted us to our feet! Of course, with a walker, but I got up and took one step.
"LIVE A FULL LIFE"
When the first leg was done, I immediately asked, when is the second? They said no earlier than in six months. Three months later I came to the follow up appointment. The operated leg felt fine, but the second leg became very bad. I was ready to do the operation for money. I couldn't stand it at all. It turned out that there were quotas, and that the operation could be done in the near future. Three months later, I was taken for a second operation.
I am still grateful to all the orthopedic surgeons of the department. I thank them every day when I wake up in the morning without pain and stand on my own feet.
The other day, a year had passed since the second operation. I had another follow-up appointment and Vasily Evgenievich said that everything was fine and that everything had grown as it should.
“I'm waiting for you next time in five years.”
“What do you mean in five years?!”
“Earlier is not necessary. A year of observation has passed, everything is fine. Please live a full life. We work for this, and I'm waiting for you at the next follow up appointment.”
TO THOSE WHO JUST FOUND OUT THEIR DIAGNOSIS
I had stage 4 and there was little chance. You will be told a lot that you need to fight. But still, fighting is not the best term in such a situation. The one who fights is wasting his valuable resource on destruction, not on creation.
You don't need to fight the disease. You need to accept it and learn to live with it. I was able to negotiate with it. A psychologist taught me this, and it helped me a lot.
Doctors cannot cure us completely. The disease falls dormant and remission occurs. No doctor can guarantee that the cancer will not return. We always live with this risk.I would like to encourage people to try not to fight, because no one comes out of this fight victorious, but to accept their illness and learn to live with it. It's hard to comprehend, but it's worth a try. I will be glad if my story inspires someone and helps someone to not quit treatment. We have millions of chances and thousands of opportunities to look differently at our illness and life itself.
"80% WITH HODGKIN'S LYMPHOMA CAN BE CURED"
Tatiana Solovieva, hematologist of the NMRC for Hematology, Candidate of Medical Sciences:
Hodgkin's lymphoma is the most common lymphoma among young adults. The disease is a malignant tumor of lymphocytes.
More than 50% of patients, at the time of the initial visit to a hematologist, have a widespread stage of the disease, often with damage not only to the lymph nodes, but also to various organs (lungs, heart and others) and skeletal bones. Treatment is carried out according to chemotherapy protocols in accordance with Russian clinical guidelines. In some patients, radiation therapy for residual formations is required in the future.
Currently, more than 80-90% of patients with Hodgkin's lymphoma can be completely cured if adequate induction therapy is carried out.
Due to the intensity of chemotherapy regimens, many patients face various complications. In particular, against the background of the use of high doses of glucocorticosteroids, it is possible to develop such irreversible complications as aseptic necrosis of bones, which subsequently leads to the development of secondary arthrosis. This significantly reduces the quality of life of patients and leads to their disability.
Correction of such complications is possible only surgically by performing endoprosthetics of the affected joint. Orthopedists of the NMRC for Hematology have extensive experience in performing joint replacement, which allows patients to avoid disability, significantly improve their quality of life, and maintain their ability to work.
