First Post

01:45 August 6 2015
Maddie's Birthday 

Background:
I am a 64 year old male. Retired, but physically active. I walk about 40 km per week. 
In 1981 I was stung by a scorpion on my left foot. I was far away from any medical facility, and only got treatment at a clinic, after about 3 weeks. 
For the last 34 years my lower left leg has been very swollen with lymph-edema. The scorpion sting apparently destroyed the lymphatic system in my lower left leg. 
About 15 years ago I developed a sore on the leg above the ankle. It never hurt, never grew, but never healed. 
In April 2015 my lower leg erupted into many sores. They weaped, and bled lots. I went to my GP and she prescribed creams and wrapping to reduce the swelling.

On 21 July 2015 my local GP referred me to a vascular surgeon. 

On 24 July 2015 the Vascular Surgeon decided to do a biopsy and a lymphogram to determine the cause of the new sores.

On 27 July I was admitted for about 36 hours into Unitas Netcare hospital in Pretoria South Africa. At 12:00 on the 27th I was put under a general anesthetic without any muscle relaxers. I had previously had strange reactions to general anesthetic muscle relaxers. Previously I was very slow to regain control of any muscles. I was conscious and awake, but just could not move for much longer than the anesthetist was happy with, so no muscle relaxers were used this time.
The Vascular Surgeon Removed 5 open sores surgically, and sent the tissue away for analysis. 3 of the sores were stitched closed, but 2 were bigger cuts, and left open. 

I was assigned a wound care lady that would clean the leg every other day, and wrap it tight to keep any swelling down.
On the morning of the 28th I went to the nuclear section of the hospital for the lymphogram. They injected some fluid between the toes. Twice on each foot. The I went into a CAT scan machine every thirty minutes to see how far the fluid was traveling. The good right leg had a steady progression of the fluid up past my groin. The bad left leg had a very slow progression, and the fluid stopped about 3 inches below the left knee.

I was discharged the evening of the 28th. 
I saw the wound care lady every 2 days until I met the Vascular Surgeon again in the morning, 5 August 2015.

 Doctor Fernandes told me there was a total lymphatic blockage 3 inches below the left knee, but the bad news was that the the biopsies on my leg sores were malignant. All 5 of them.
 
 The four new sores were reported like this:
 The tumor cells show large pleomorphic hyperchromatic nuclei with brisk mitotic activity.
 The immunohistochemical profile together with morphological features are compatible with a poorly differentiated epithelioid type angiosarcoma.
 
 The sore I had had for 15 years was reported like this:
 Ulcerated basal cell carcinoma, and is probably unrelated to the other four sores.
 
 With my friend Google, I was able to learn more about what all that meant.
 Angiosarcoma is a malignant neoplasm (cancer) of endothelial-type cells that line vessel walls. This may be in reference to blood (hemangiosarcoma) or lymphatic vessels (lymphangiosarcoma).
Its origin typically readily permits metastases to distant sites. Most tumors of visceral blood and lymphatic vessel walls are malignant. 

Epithelioid sarcoma is a rare, highgrade, soft tissue tumor that has a known propensity for local recurrence, regional lymph node involvement, and distant metastases.

That was bad news, because it means that the cancer will spread (metastases) easily.

It is 02:30, and I just can't sleep. Today I am supposed to go to a plastic surgeon that specializes in cancer skin operations. Dr. Andri Neuman. Then day after tomorrow I will see an oncologist.

Dr. Fernandes said that they usually remove all skin from the calf, and replace it with skin from the thigh. That means I will need to be hospitalized for 10-14 days, and must keep the leg held upright during that time. I fear my lower back will suffer greatly, as I must always sleep on my side at night, or my back pain keeps me awake.

I feel like I have been shat on by a Black Swan.