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On being there
ROADMAPS
On Being There Laura E. Wilwerding, MD 44
Y
EEOUCH!” 1 had been pummelled by a 12-year-old girl three times my size. What started as a friendly seventh grade soccer game, ended in agony for me. I was convinced she had broken my leg in two. The x-ray revealed no fractures, just a small bone cyst on my fibula. I used crutches for a couple weeks, mostly for sympathy. Six months later, my right leg started hurting again. After an ice storm prevented my initial visit to the doctor, I finally had an appointment with an orthopedic surgeon. One look at my swollen right knee, and I was scheduled for a biopsy. My biopsy was on a Monday, my amputation was the following Friday. Yes, I was the proud owner of a very large mixed blastic/lytic lesion of my right tibia: Osteosarcoma. There was not much discussion about limb salvage at that time, amputation seemed to be the only practical option. I was initially devastated. I could not imagine walking again; I had never known anyone with one leg. I have very vivid memories of the day I first met my oncologist. I had been told that I would have to take “medicine” for a couple years, but I had no idea what chemotherapy involved. My doctor explained that I would not only be bald and very sick, but that it might not even work and I still might die. For a moment, this did not seem like a very good deal at all. I kicked him out of my room and cried. Luckily, both he and my parents were very understanding. I soon realized this was the only deal I had, fair or not. From that point on, I focused on survival. From the University of Nebraska/Creighton UniverJoint Program in Pediatrics, Omaha, NE. Address reprint requests to Laura E. Wilwerding, MD, University of NebraskaKreighton University Joint Program in Pediatrics, 7721 Grover St, Omaha, NE 68124. 0 1998 by Association of Pediatric Oncology Nurses. 1043-4542/98/l 502.0010$3.00/O sity
Journal
of Pediatric
Oncology
Nursing,
I remember waking up from surgery to see my “little” leg for the first time. I was alarmed that the cast was bloody, but it still did not really sink in that this was me. When I had the cast removed, however, reality hit me. Somehow, seeing my own skin on this “little” leg really upset me. I almost passed out. Luckily, one of my favorite nurses was there holding my hand. I subsequently managed to get through 2 years of grueling chemotherapy. I remember every episode of vomiting. I weighed a mere 75 pounds at one point, losing more than 20 pounds in 1 month. Amidst it all, I managed to have fun. I loved to play practical jokes on residents and medical students. Laughter definitely helped to pass the time. The hospital became a second home to me. All of my treatments were on an inpatient basis, so I missed a lot of school. Consequently, I was really “out of touch” with my friends and peers at school. Also, 1 was no longer interested in “normal” kid things. I could no longer relate to my peers; we had little common ground. I was, however, finding close friends among my nurses. In the hospital, I would stay up talking with the nurses until I had to excuse myself to puke. My nurses were really an excellent support system for me. I still see many of them and hope they know how I value their caring and support. After high school, I went 700 miles away for college. I was a vocal performance major on scholarship. I did well, but something just was not right. As corny as it sounds, I had a dream one night, and awakened knowing I had to go to medical school. I changed my major to biology that day. In medical school, I managed to assimilate quite nicely. In fact, by the end of my first year, only a handful of people knew I had a prosthesis. This was comfortable for me. Vo/ 15, No 2 (April),
1998: pp 103-l
04
103
104
Laura
E. Wilwerding
Body image has been an issue for me since the first day I saw my “little” leg. I use that term because “stump” sounds like something a troll would sit on. As I grew older and was more comfortable with my improved prosthesis, I was able to blend in with others. I started avoiding situations such as swimming where 1 would have to go “legless.” Throughout college, 1 really tried to be “normai.” I actually dated a guy once who would not let me take my leg off because the idea disgusted him. That was truly a blow to my already fragile self-image, and perpetuated my desire to appear “normal.” Ultimately, my body image was improved when I started down-hill skiing while in medical school. The ski slope is one place where I can truly excel. I ski on one ski with skis on my poles. I ski faster than my friends and people watch in awe. Unfortunately, 1 still need help with my body image at times. I worry about going to the pool with my kids
and being stared at. 1 know, however, I gain strength every time I am forced to accept myself as 1am, “little” leg and all. Now I am on the other side of the fence. Patient turned doctor. It was easy for me to choose my specialty. Having been sick as a child and knowing many ill children, pediatrics seemed the natural path. Seeing these children suffer, get well, or even sometimes die, keeps me humble. They remind me of where I have been, where I am now, and where I have to go. My experience with cancer was short lived, but its impact on me continues. My struggle with body image is ongoing, but it does not defeat me. Everyday, I look down at my “little” leg and am reminded of my struggles as well as my triumphs. Life is not static. The only sure thing is that after overcoming one obstacle, there will be another. With each challenge, you can either give up or gain strength, there are no other options.
On Being There Laura E. Wilwerding, MD 44
Y
EEOUCH!” 1 had been pummelled by a 12-year-old girl three times my size. What started as a friendly seventh grade soccer game, ended in agony for me. I was convinced she had broken my leg in two. The x-ray revealed no fractures, just a small bone cyst on my fibula. I used crutches for a couple weeks, mostly for sympathy. Six months later, my right leg started hurting again. After an ice storm prevented my initial visit to the doctor, I finally had an appointment with an orthopedic surgeon. One look at my swollen right knee, and I was scheduled for a biopsy. My biopsy was on a Monday, my amputation was the following Friday. Yes, I was the proud owner of a very large mixed blastic/lytic lesion of my right tibia: Osteosarcoma. There was not much discussion about limb salvage at that time, amputation seemed to be the only practical option. I was initially devastated. I could not imagine walking again; I had never known anyone with one leg. I have very vivid memories of the day I first met my oncologist. I had been told that I would have to take “medicine” for a couple years, but I had no idea what chemotherapy involved. My doctor explained that I would not only be bald and very sick, but that it might not even work and I still might die. For a moment, this did not seem like a very good deal at all. I kicked him out of my room and cried. Luckily, both he and my parents were very understanding. I soon realized this was the only deal I had, fair or not. From that point on, I focused on survival. From the University of Nebraska/Creighton UniverJoint Program in Pediatrics, Omaha, NE. Address reprint requests to Laura E. Wilwerding, MD, University of NebraskaKreighton University Joint Program in Pediatrics, 7721 Grover St, Omaha, NE 68124. 0 1998 by Association of Pediatric Oncology Nurses. 1043-4542/98/l 502.0010$3.00/O sity
Journal
of Pediatric
Oncology
Nursing,
I remember waking up from surgery to see my “little” leg for the first time. I was alarmed that the cast was bloody, but it still did not really sink in that this was me. When I had the cast removed, however, reality hit me. Somehow, seeing my own skin on this “little” leg really upset me. I almost passed out. Luckily, one of my favorite nurses was there holding my hand. I subsequently managed to get through 2 years of grueling chemotherapy. I remember every episode of vomiting. I weighed a mere 75 pounds at one point, losing more than 20 pounds in 1 month. Amidst it all, I managed to have fun. I loved to play practical jokes on residents and medical students. Laughter definitely helped to pass the time. The hospital became a second home to me. All of my treatments were on an inpatient basis, so I missed a lot of school. Consequently, I was really “out of touch” with my friends and peers at school. Also, 1 was no longer interested in “normal” kid things. I could no longer relate to my peers; we had little common ground. I was, however, finding close friends among my nurses. In the hospital, I would stay up talking with the nurses until I had to excuse myself to puke. My nurses were really an excellent support system for me. I still see many of them and hope they know how I value their caring and support. After high school, I went 700 miles away for college. I was a vocal performance major on scholarship. I did well, but something just was not right. As corny as it sounds, I had a dream one night, and awakened knowing I had to go to medical school. I changed my major to biology that day. In medical school, I managed to assimilate quite nicely. In fact, by the end of my first year, only a handful of people knew I had a prosthesis. This was comfortable for me. Vo/ 15, No 2 (April),
1998: pp 103-l
04
103
104
Laura
E. Wilwerding
Body image has been an issue for me since the first day I saw my “little” leg. I use that term because “stump” sounds like something a troll would sit on. As I grew older and was more comfortable with my improved prosthesis, I was able to blend in with others. I started avoiding situations such as swimming where 1 would have to go “legless.” Throughout college, 1 really tried to be “normai.” I actually dated a guy once who would not let me take my leg off because the idea disgusted him. That was truly a blow to my already fragile self-image, and perpetuated my desire to appear “normal.” Ultimately, my body image was improved when I started down-hill skiing while in medical school. The ski slope is one place where I can truly excel. I ski on one ski with skis on my poles. I ski faster than my friends and people watch in awe. Unfortunately, 1 still need help with my body image at times. I worry about going to the pool with my kids
and being stared at. 1 know, however, I gain strength every time I am forced to accept myself as 1am, “little” leg and all. Now I am on the other side of the fence. Patient turned doctor. It was easy for me to choose my specialty. Having been sick as a child and knowing many ill children, pediatrics seemed the natural path. Seeing these children suffer, get well, or even sometimes die, keeps me humble. They remind me of where I have been, where I am now, and where I have to go. My experience with cancer was short lived, but its impact on me continues. My struggle with body image is ongoing, but it does not defeat me. Everyday, I look down at my “little” leg and am reminded of my struggles as well as my triumphs. Life is not static. The only sure thing is that after overcoming one obstacle, there will be another. With each challenge, you can either give up or gain strength, there are no other options.