She died. I knew that the chances she had neither in Russia, nor in Israel. It took so much time, and I'm there, he reminded the woman he had never seen. Internet - a great hoaxer, we never know who is actually located on the other side of the monitor, but I believe - no, I know - it was just that: a strong, energetic, bright.
A woman crying
The question online consultation:
"I have a bloody discharge from the vagina . I have put a preliminary diagnosis -Disfunktsionalnoe uterine bleeding menopause . Hysteromyoma . Pelvic ultrasound from 02 . 07 . 2011 - 132h92h133 uterus, uterus enlarged to 39 mm infiltration front and rear walls . The appendages are not clearly visualized . Right surround education tubo-ovarian volume 102sm3 left 163 cm3 . Changed parametrium l / nodes . Conclusion: The pathology of the endometrium, education appendages . Wedge . blood from 02 . 07 . 2011 Hb 113 g / L, erythrocyte-4, 9, Lake 13, 5, 15 fell, ESR, 15 mm / h . X-rays of the chest of 02 . 08 . 07- pathology is not revealed . Common analysis of urine from 02 . 07 . 2011- 1026, acid, protein, 0, 4, sugar-otsuts, Lake 60-64 in sight, erythrocytes 80-85 unchanged . Coagulation of 02 . 07 . 2011 prothrombin index 83%, INR, 1, 19, PTT-45, 7, 20-thrombin time, 5, fibrogen, 3, 0, fibrinolysis, more than 5 hours . Biochemical analysis of blood from 02 . 07 . 2011: urinary-8, 6, creative-152, glitch-5, 7, protein-83g / l, albumin 49g / L, AST-16E / L, ALT-9E / l AP-411, Fe-3, 4, total . Bill 14, 1, 8-cholesterol, 18 . 03 . 07 . 2011 attempted WFD, the operation is not technically possible due to severe infiltration of the anterior vaginal wall . Biopsy tissue from the anterior vaginal wall, the material is sent for histological examination, cytological smears taken . Histology showed (6 . 07 . 2011): Macro-loose dark brown and grayish convolutions kroshkovidnye tissue fragments . MICRO: Among individual blood found very small fragments of tumor tissue in its structure the most appropriate stromal sarcoma . Endometrial stromal sarcoma . CA125 at a rate of 35 I 94, in addition, I have been suffering from obesity . What are my chances? "
"You have a lot of hard work. In no case do not pull - pull long been nowhere. Much depends on you - your spirit of recovery, how you tolerate the treatment. It ochayannaya disease, and it requires a desperate means - the treatment of cancer pathology requires the mobilization of all the resources of your body, and help loved ones. You will find like-minded people and experts in the Russian Oncological forum. Good luck, stay :)) "
The issue:
"You did not answer me. Approximately what awaits me? At the hospital I was put on the following Monday. Is it true that Jewish susceptible cancer most often and why? I'm just the doctor said, "Oh, my dear, you are a Jew! It's hard you have to. "
Answer:
"No, not associated with Kaposi's nationality, although proven that Jewish women of Ashkenazi in the genotype are common alleles for pathological VDKN, breast cancer and ovarian cancer. I do not want you as a properly orient (by your description, it IIIC), but I hope that you will operate (volume - hysterectomy with appendages, resection of the greater omentum may resection 2/3 of the vagina), and then - chemotherapy. Perhaps a chemo-radiation therapy, or as a separate step - beam. May propose to start with a few courses of chemistry, and then go to surgery. This is a very long and multi-step process. "
The issue:
"Then, doctor, my chest is too problematic. The results of mammography, "skin, nipples, areola not changed. The structure shows a pronounced glandular, fibrous, fatty and connective tissue components. Against this background, both breasts are determined by multiple focal shadows of 0, 3 and 1, 0 cm d, with equal precise contours. The left breast is determined by the formation of 4 cm d, with irregular contours. Conclusion: diffuse fibrocystic breast disease, suspected cancer of the left breast. " Just do not know how to be a mood of eerie "
Answer:
"Bad. It is not clear - whether primary multiple cancer (two different cancers at once), or metastasis. Unfortunately, most first. "
The issue:
"I once again stuck. But what predictions in my case, as I have left? "
Answer:
"Forecasts in oncology - a thankless task. I have too little information to somehow evaluate your chances. A comprehensive survey, the volume of surgical intervention, the results of histological examination of all removed material, comorbidity, tolerance of chemotherapy and radiotherapy - all this seriously affects the prognosis. Most important is your attitude and faith in a favorable outcome. Survival of those who are willing and able to fight. "
The issue:
"Thank you Doctor. You are my ray of light and hope. I'll be happy when your words come true. Let us pray and fight. Two more questions: 1. I was put in the center of Blokhin. Who would you have advised me there of mammalogy oncologist and cancers? Should I be treated there, or go to Israel? 2. How to protect three daughters from this horror? In older have found ovarian cysts, operated on. "
Answer:
"Methane in any case it is not necessary! RCRC - the most solid institution in the Russian Federation. You necessarily look for a consultation and all decisions are made collectively. In relation to girls - the only reasonable method of prevention is regular monitoring. Annually - colposcopy cytology + + + OMT ultrasound mammography / breast ultrasound. Today it is possible to make the molecular genetic study on the carriage of mutations in the genes BRCA 1/2. These mutations are responsible for hereditary ovarian cancers and breast cancers. BUT! In case of detection of mutations, an adequate measure of prevention is prophylactic mastectomy and oophorectomy (removal of the ovaries and mammary glands) immediately after the implementation of the reproductive function. If the mutations have been identified, that does not preclude the likelihood of tumor localization data of a different nature. Hold on, strength, and good luck to you. "
The issue:
"Thanks, I'll try not to limp. My girls I taught youth receptions of self, and launched himself. Jobs such, I have a large construction business. There's no time at all. But preventive operations do very scared, they are too beautiful. Whether it is possible in some other way? Do I have what they have cancer? "
"BSE does not improve the early diagnosis of - just an observation with the use of modern equipment: mammography, ultrasound, etc. Prophylactic surgery - a step of despair. This selection is done by women, burying his mother, grandmother, aunt, sister ... "
And again, she again:
- "The terrible thing to say. But the analysis we do, but we'll see. How will they live then as sex life and how to lead their husbands to say? Tomorrow I go to the hospital. Nerves to the limit. Not slept all night, the pressure of 170/90, the head is in a vise, abdominal pain, chest whining. In the brief moments of sleep dreaming about any nonsense. What is that to me it would do. Just to get out for four months at least. Is there anything in an Internet forum where you can chat with people like me? I rummaged everything, one nonsense. Fearfully. I cried all morning. "
- "If I survive, we will meet again, I'll come to you at the reception. You calmed me, gave me hope. Girls adult male around. We love each other. Today, imagine, I terribly wanted sex. Experience the stunning orgasm can last in life, who knows.
- I look forward to our doctors, "...
- "In general, as you said. I looked at a council headed by the manager. Branch. We looked at all of my examination, ultrasound done in two projections, and they decided to carry out an operation on Wednesday. The volume: removal of the uterus, vagina 2/3, omentum appendages and ovaries. When operate chest decide tomorrow. I have been told that the breast can try to preserve. Head. department said it is good that paid doctors to work in a day and not waited for everyday life, we are calm and work productively. So, do not so bad ?! "
- "Today the issue resolved with the breast. I do lumpectomy left breast in the lower outer quadrant with preservation glands. My dignity will be saved. Tell me, please, when you remove 2/3 of the vagina, uterus and ovaries, sex generally is possible? And how much he brings fun? I understand that you're not a sexologist, but just too shy to ask your doctor. It is strange to hear from La Juive questions about sex? I'll probably go to hell. "
- "Thank you for your support. Today I was told that the chances of a long and active life I have more than 70%. Very strong body. Yesterday came a daughter. Walked around the clinic. Prophylactic mastectomy - the removal of the breast completely? And is it possible, after her doing reconstructive plastic ? "
And it is not She wrote:
"Hello! I rose, daughter Myra Isaakovna. My mother had an operation, the state is now stable, moderate. Doctors say that everything went well. Mom just asks me to write to you about this, because you are very cool its support during the difficult days. Almighty bless you. "
I am often asked what I think about the online consultation. Miscellaneous think. Medicine - not an exact science. Not seeing the patient, not knowing the full scope of information that can be such nakonsultirovat that oh-ho-ho. To offend patients. Frustrating that nothing concrete has been said, the treatment is not appointed, the board of given some uncomfortable.
One of the basic tenets of medical ethics - Primum non nocere (first do no harm). It is this correspondence remember consultant, looking at issues of nuggets of information, sifting husks of emotions.
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