Stay the Fuck Home!

It would take a really huge thing to get me back on this blog.  I have been living my life, minding my own business, waiting for breast cancer metastases to get me back on here. But here I am, and this is my gorgeous high school friend Nicole. Say “Hi Nic!”

We met way back in 1987 as four foot nine, pre-pubescent, eleven year old schoolgirls. In this same student cohort was our other girlfriend, our genius, friend Melissa Baker who I have written about many times before in this blog. Incredibly, the three of us, Mel, Nic and I joined the cancer club in our thirties. Go us! As a forensic pathologist, Melissa used to say, “Pathologists are the Gods of medicine” and I used to giggle, not really understanding what she mean’t.

Devastatingly, Mel left this Earth in an eerily coincidental way given our current world predicament with COVID-19.  You see, back in December 2019 and with little immunity, Mel caught an unknown virus that lead to pneumonia, which irreversibly damaged her lungs after a stem cell transplant for refractory Hodgkin’s Lymphoma. She was taken off ICU life-support after 58 days, despite care with the best technology, from the best specialists and wonderfully attentive nursing staff. In the quiet ward of one of our best Melbourne hospitals, they tried many times to bring her out of it. Mel passed peacefully surrounded by her loving family, a couple of days past her forty-fifth birthday.

I was forever grateful that her family allowed me to visit and kiss her goodbye. I thanked her for her thirty-five year long friendship and everything she did for so many of us in a personal and professional way in her short 45 years.

I wept for her beautiful young kids and everything she endured in order to maintain her life. Including sacking her haematologist after he said there was nothing more he could do, she sought a whole new team at another hospital. In doing this, she gave herself another five-odd years with her kids.

Her specialists had never seen someone endure so much treatment to beat a disease that is supposed to be so highly curable. And all of her specialists had never been challenged so much by a patient who knew her stuff. She saved countless lives with her advocacy and fundraised a shit load of money for many cancer research charities. She got patients access to drugs that saved them by lobbying to have them placed on the PBS. She researched trials and shared with patients with no hope. She helped fund the first lymphoma specific nurses in Australia. She committed to making the greatest memories with her kids. She was the toughest, smartest, no holds barred, tell it exactly like it is chick ever!

Every day since, I carry the weight of a dumpster load of survivor’s guilt on my shoulders because I’m still alive with my kids, when she isn’t. Mel was one of the most exceptionally brilliant and giving humans to walk the Earth. We need people like her in this world.

Mel was a great support to Nicole and I with our breast cancer diagnoses. We both found the lump ourselves long before access the age of post-fifty Medicare funded mammograms. We shared the same breast cancer pathology, same grade, same hormone status and our tumours where even the same size.  Despite being diagnosed seven years apart, we had the exact same treatment pathway. Lumpectomy, axilla clearances, mastectomies, chemotherapy, radiation, hormone therapy, reconstruction.

After her early breast cancer treatment back in 2006, Nicole got on with living her best life as a healthy, sassy, fun-loving, go getter woman. She continued to be a kick-arse auntie, girlfriend, and friend. A model daughter and sister.  She offered me so much support when I was diagnosed with breast cancer in 2013 after many years since school.

Then after nine years in 2015, Nicole was having trouble with one of her eyes. A simple eye test with her optometrist revealed her breast cancer had metastasised to her eye.   With cancer then found to be in many places in her body, Nicole continued to live. She married the love of her life. Built a house and continued to work. All while living with the continued treatment regimens to give her more time. She has continued to raise much awareness for stage four breast cancer patients and has always maintained a positive outlook despite her predicament which I have always envied.

Yesterday Nic visited her oncologist as she very often does. Normally, the routine checks and scans are mundane and predictable.  Cancer in a lot of places, some of it stable, proceed with treatment and go and live your life. Travel with your doting hubby. But yesterday she was shocked to the core! Not because of the cancer, but because of the threats of COVID-19.  This is what she had to say…

Yesterday I was handed ‘Advanced Health Directive’ forms at 45 years young. I was  told that due to my chemo treatment and my compromised immune system that my chances of catching this virus are EXTREMELY high. Holding back tears, my doctor also told us that due to my stage IV diagnosis, if I do catch this virus then my chances of surviving are basically nil and that’s why I need to consider my wishes for end of life.

I would very likely die alone, no husband or family would be allowed near me. Should we resuscitate or intubate when there is no chance of me, being terminal, coming back from that final stage? This also puts trauma on our family.

My only option at this stage is to be in isolation with hubby because unfortunately people don’t feel the need to take this seriously! Eighty percent of the population will get through this with minimal health affects of the virus, twenty percent will end up in the ICU (if there is even a bed for me)…. and will not walk out of ICU.

We discussed some other avenues of me receiving treatment so I don’t have to attend my hospital, which now has two confirmed cases of COVID-19. Unfortunately I still have no choice but to have parts of my treatment at hospital. Should my treatment stop working and my cancer again begins to spread, I now cannot travel interstate or overseas to take part in life saving clinical trials, I’ll have to start another toxic chemo which will deplete my immune system even more.

The ‘she’ll be right’ attitude is what is going to seriously impact those of us that cannot fight this virus.

YOU KNOW WHAT YOU NEED TO DO….so PLEASE DO IT! 😊 

Much love and may the force be with you 💜👩🏻‍🎤

Nicole Kawalko-North

This is people living with chronic conditions all over Australia and indeed the world are facing. They are having advance directives slapped in their faces. We know that many of us are high risk for death from COVID-19. Cancer patients and the chronically ill are clued into what this means with not enough intensive care beds in Australian hospitals and a rampant viral deadly pneumonia spreading across the globe like a cancer. For cancer patients and survivors, there’s a kind of solace in the much greater solidarity. For the first time, most of the Western World understands what the threat of having cancer is actually like.

It’s the impenetrable fear and uncertainty in having the world as you know it turned upside down. The complete medicalisation of your world and reliance on health-care workers to save you. The loss of jobs and the fear of going backwards financially. The potential of the sickness and the worry that your body will never be the same. The anxiety over getting sick and leaving your friends and family behind. Your changing identity and standard of living. The feelings of being isolated. The metastatic spread seeding its way out of control. Being without treatment options. Having to face your mortality.

It’s all there. Such striking similarities between Covid19 and cancer. But unlike COVID-19, cancer rarely makes you die on your own.

And here’s another NEWSFLASH people, it’s not just about the published risk factors such as your age, cardiac issues, diabetes, lung diseases, cancer status. It’s not even just about those who are immunocompromised.

The shocking point you haven’t even had time to think about, is that many of you don’t know you are HIGH RISK because you have yet to be diagnosed with the disease processes that are swirling inside you. So perhaps in light of COVID-19, ALL of us should be sorting out these end of life affairs; our wills, executors, power of attorneys, advance directives etc. Who will care for your pets? It’s confronting yes.

Nothing is more important NOW than protecting our society! Not your Bondi Beach day, not your shopping mall spree, not your pub sesh, your aged-care home visit, nor your supermarket hoarding practices. We must shut down, physically isolate and suppress this virus in order to give us all more time. Time to develop and execute more tests, and essential time to develop the vaccine. We are all stage four cancer survivors. grasping for MORE TIME.

With this time, Governments can stimulate aspects of the economy and they must. We must be innovative in our consumer choices to support our existing local business through this difficult time. We must maintain solidarity in spite of uncertain times and dithering leadership. We must trust the scientists and ignore misinformation. We must take time out to protect our mental health and seek safe ways to maintain our physical health. We must protect, support and applaud the health care workers. We must be thankful for the pathologists that Melissa would call these “Gods of medicine”.

One day, our grandkids might come and ask us, “what did you do in the FIRST COVID WAR?” and we could reply, “well, we physically isolated but still used technologies to connect, we practiced good hygiene and distanced ourselves in essential public places, we supported our local businesses by safe shopping to ensure their survival, we assumed we had the virus already and acted to stop the spread, and we didn’t behave like selfish gits, and it was those things that helped us get through it and learn from it”.

Kudos to my friend Melissa, I finally understand her when she often reminded me that pathologists ARE the gods of medicine.

Stay safe everyone!