I should have followed this up sooner, but very little happened over the next 14 months! I struggled to get my blood sugars down while in Peru, and it was consult, more pills, blood test, consult more pills, and so on, with the biopsy not happening, so eventually I asked outright whether they thought it was malignant or cancerous, and though they wouldn't commit themselves, they did say it was "unlikely" at this stage - so I decided to leave it, as it was not causing too much bother at this stage.
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| Chip March 2019 |
Returning to Brazil September 2019 I decided to see if I could get it looked at, as by then it did appear to still be growing, and I decided to give "it" a name - so Chip was christened - "Chip on the shoulder", get it? The dentist in the little town I live in in Brazil rents out a consulting room to various medical professionals, and one was an Osteopath, so I booked an appointment, and he took a cursory look and said I needed a biopsy!!! He recommended a hospital in Salvador, some 400 kms away, but when I contacted them they told me they only dealt with SUS (Brazilian Health Service) patients. A friend suggested I contact a Day clinic in the next town, some 70 kms away, as they might be able to help, or at least suggest a viable alternative, so I made an appointment, and after a short wait was ushered into a doctor's consulting room. I explained that I had tried to get a biopsy done in Peru, but they were concerned about my sugar levels (which were still considered "too high"), but he asked me some health questions and agreed to do the biopsy himself - later that day!!
I had to wait a month for the results to come back from Salvador and went to see the doctor again, and the report (not that detailed) said it was a benign lipoma. He told me that he could not do the removal surgery there, and that there were no hospitals nearby that could either, so I would have to get it done in Salvador, the city 400 kms away, but that if Chip was not really bothering me then maybe I should leave it alone for now.
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| Chip March 2020 |
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| March 2020, biopsy scar visible |
By the time I was due to return to Peru in March 2020, Chip was still growing and beginning to cause more discomfort. The "lump" itself was not painful, but was exerting pressure on surrounding muscles and nerves, and causing occasional pain in my right arm, but mostly was making it difficult to sleep comfortably. The place I stay in Peru is close to a very large city, with excellent medical facilities, so I resolved to get Chip treated properly upon my return.
Unfortunately 4 days after my arrival in Peru the Coronavirus pandemic caused a State of Emergency to be declared, and Peru went on lockdown! That meant that people were only allowed out for essential shopping, non-urgent operations were cancelled, and many clinics and hospitals refused to attend to high risk patients, and due to my age and diabetes I was one of those! So that meant I just had to try and sit things out, but Chip kept on growing!
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| May 12, 2020 |
Chip also starting becoming more painful - I couldn't carry my shopping in a backpack using my right shoulder, and even just walking at times resulted in pain down my right arm, and sleeping became much more difficult. I contacted some hospitals but unless it was cancer, they didn't want to know, and with the country still under the State of Emergency international borders were closed so I couldn't even return to the UK for treatment there!
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| August 13, 2020 |
Towards the end of September, when I should have been leaving Peru, some of the controls here had been relaxed, and some friends here found a surgeon who was prepared to consider surgery, so sent him the picture above. I had an online consult with him, and he sent me for blood tests, which returned incredibly high results, so much so that he immediately referred me to another doctor (a specialist in internal medicine), further blood tests, another online consult, and being prescribed insulin and other meds to bring my sugar levels down. I was also tested for liver, kidney and heart functions, as the sugar levels were high enough to cause further complications (they were all fine!).
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| September 22, 2020 |
Throughout all this Chip continued to grow, and continued causing me problems, and the costs were mounting up! Public transport does not run into the centre of Trujillo, so I was having to use taxis to go for tests, and usually that meant a second trip the same day to collect the results! Eventually my blood sugar levels were low enough for the surgeon to consider surgery, but I needed a "surgical risk assessment" from the other doctor, requiring a "face-to-face" consult, and a whole raft of additional tests, which fortunately could be done at the clinic where he worked, though the blood work had to wait until the next day as had to be done "fasting" - no food for 8 hours - and then I had to wait a few days for a follow-up consult!!
I passed the assessment, though on the day of the blood tests my sugar levels were the highest they had been for days, and 30% higher than my own finger-prick test taken just 40 minutes before the full blood work! I then had my first face-to-face consult with the surgeon, so for the first time he actually "met" Chip, and was rather surprised at how "solid" it was. A lipoma is fatty tissue, so should be fairly squishy, but Chip is rather hard, and he voiced concerns that maybe it was not a Lipoma but something more sinister! He still agreed to attempt the surgery and it was scheduled for 4 days away, at yet another clinic! But first I needed a negative rapid Covid test!! I found out that the "rapid" test here takes 24 hours!
The following Monday I checked into the clinic and was shown to a room with two beds where I could undress, and put on a gown (with broken ties so I could not fasten it closed), and wait to be taken to surgery. I had to wear a mask all the time, and the staff all had masks and face shields, as well as vinyl gloves, but what surprised me was that I was placed on a gurney (hospital stretcher) and covered with sheets and a blanket, and taken up to surgical reception, where they transferred me onto another gurney, where I was covered with different sheets and blanket - but a patient waiting to be returned from surgery was then transferred onto my recently vacated gurney, covered with the same sheets they had used for me, and taken away!!
The surgery was to be done under local anaesthetic, and I was wheeled into surgery and they started work on my shoulder, but after about an hour the surgeon said that they could not remove Chip, as he was extremely solid, and appeared to have a blood supply, so possibly was a Liposarcoma, which is a cancerous tumour! But they had taken samples for biopsy and this would confirm things, so I was returned to the ward/bedroom, and kept in overnight!
