Primary Mediastinal Diffuse Large B Cell Non-Hodgkin’s Lymphoma
This is my story
For as long as I can remember, I have wanted to study medicine. My mom has me on video at just three years old announcing that when I grow up, I am going to be a doctor.
In February 2018, I was a final year medical student. I was completing my clinical rotations at one of the biggest public hospitals in South Africa, fulfilling the future that my three year old self had prophesised. I was exhausted all the time, but I just blamed that on my difficult call schedule. I was losing weight, but I attributed that to too few snack breaks. I was covered in bruises, but I just assumed I was just clumsy.
It wasn’t until I started experiencing severe facial and upper limb swelling, migraines and episodes of loss of consciousness, that I considered that there may be actually be something wrong.
After visiting numerous doctors within various specialities, my mom found a physician who was able to give me a diagnosis (with the help of a few scans). I was diagnosed with Primary Mediastinal Diffuse Large B Cell Non-Hodgkin’s Lymphoma, with my primary tumour sitting in the space just above my heart and constricting all my major blood vessels. Due to the placement of that tumour, I was not in a healthy state. To put it plainly, I was functioning on borrowed time.
I had naively thought I’d be in and out of that hospital in a matter of weeks and would be able to return to my degree in the second semester. I had no idea what the next two years would entail.
After eight rounds of intensive, inpatient chemotherapy, I assumed I had conquered the terrifying lymphoma and would be able to begin the healing from the “cancer chapter” in my life. However, it soon became apparent that I had more to learn about the fine art of survival.
In October 2018, just prior to my post-chemotherapy PET/CT scan, I was diagnosed with chemotherapy – induced congestive cardiac failure. I was admitted to the CT-ICU department and placed on the heart transplant list. At this point, my heart was functioning at only 15%. The only delay in my transplant surgery was that I had not yet had a cancer free scan, and cancer is a direct contraindication to transplant.
There were so many days (ones that I was conscious enough to remember) during which I had to actively choose to breathe. It would have been so easy to slip away, but I’m stubborn and I had already decided that it was not quite my time. And then something happened – be it the magical combination of medication I was placed on to keep my heart pumping, or my active decision to continue to LIVE – but my heart started getting better. So much better in fact, that I was taken off the transplant list and I was allowed to go home. And as though the universe had collective decidedly to allow me a chance to breathe, a week later I had my first cancer free PET scan.
However, life was not quite finished with its curve balls. In January 2019, I started having difficulty walking. I was diagnosed with Avascular Necrosis of both my hips – specifically the heads of my femurs – caused by the massive amounts of cortisone that I had received during chemo. As you can imagine, this did not bode well for my return to medical school. After two failed orthopaedic surgeries and eight months in a wheelchair, I was deemed a candidate for bilateral hip replacements. Towards the end of 2019, I underwent the bilateral hip replacements (a few weeks apart) and I have never been happier with chunks of metal than I am with my two new hips.
I am now back in medicine, and en route to receive my MBBCh at the end of 2021. I am still trying to find my feet, both in life in general, and in medicine. I have learned so much over the last three years, but the most important lesson is one originally said by Dr Viktor Frankl:
“Those who have a why to live, can bear with almost any how”