Craig O’Grady’s darkest moment was turning neutropenic for the second time undergoing chemotherapy for a rare cancer.
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Locked in a hospital room alone, the 28-year-old contemplated giving up on a five-year fight with synovial sarcoma.
“Being neutropenic means the chemotherapy kills your immune system,” he says.
“You have to admit yourself into hospital in a room by yourself, and be on a drip for two hours, every six hours.
“I’d never experienced that before, and I was at that point where I was wondering if the fighting and sickness would be worth it.
“Do I die in five years or do I just die now? It was terrible.”
The Wodonga man has been diagnosed with cancer three times – first in 2011, prompting surgery and radiotherapy, then in 2014 in the lungs, and back in his right leg in 2015, leading to chemotherapy.
At one point when he and now wife Rebecca were living in Canberra – when household income was $460 and rent $500 – they relied on food vouchers to eat.
While Craig is reluctant to ever call himself ‘cancer-free’, he has been in the clear since moving to the Border in July 2015.
But he is facing a new battle, with lymphoedema.
“The chemotherapy had shrunk the cancer quite well and I had a surgery in April 2016, where they had to take a vein out and tie a knot in it, making sure they got everything out,” he says.
“After that, my right leg started to get gradually bigger.
“It wasn’t until my GP told told me to get it checked out, and I was put in garments, that I knew it was lymphoedema.”
Secondary lymphoedema, the most common form of the condition, is often the result of cancer treatment and occurs in approximately 20 per cent of susceptible cases.
It is swelling that develops when the lymphatic system has failed or becomes overloaded, causing a culmination of fluid and protein.
Since April, Craig’s right leg has gradually ballooned to a circumference of 90 centimetres at the thigh, double that of his left leg.
Decreasing that measurement has been the goal of lymphoedema therapist Sue Butcher for the past three months.
Sue has been treating lymphoedema patients for five years at her business, Back Straight Massage, but Craig’s case has been her most challenging yet.
“We have garments and equipment to decrease the size of the limb,” Sue says.
“When Craig came to me, he was in a stabilised garment and now we’re trying to get that limb size down.
“Looking at it, you think he has a swollen leg, but the fluid has gone fibrotic, and the density of that tissue is very hard to get rid of.”
In a bid to get him the best treatment available, Sue has approached companies for trials and support – currently, Haddemham and Medi-Rent are providing wraps and pumps for him to use.
The garments he is using have to be custom-made and cost up to $500 each, which must be replaced every few months.
Sue’s passion for treating lymphoedema extends beyond Craig’s particular case.
“In 2004, I had an ovarian tumour removed which left me with lymphoedema in the left leg,” Sue says.
“No one said to me after the surgery, ‘You could run the risk of lymphoedema’.
“I had to put the pieces together myself … so being a massage therapist, I went off and did training and came back a qualified lymphoedema therapist.
“In the last five years, I’ve been very passionate about making sure everyone gets the chance to have good wellness and quality of life.”
The reason Craig’s case is so extreme is because it was identified late – he was not aware he could develop the condition if he did not keep garments on the limb, and before he knew it, he couldn’t tie his shoes.
Many of Sue’s other clients – particularly breast cancer survivors – were able to get on top of the swelling much earlier, as the risk was communicated clearly in their after-cancer care.
“(Breast cancer) patients are sent to nurses, given their packages, and told to watch out for arm swelling,” she says.
“I have ladies come in who just want to have their arms checked, but when it comes to surgeries like what’s Craig’s had done, it’s just not on the radar.
“You could talk to a dozen people and no one will know what lymphoedema is.”
Lymphoedema therapy and garments are not covered by Medicare either – the reason Jenny Jensen, as an acquaintance of Craig, has stepped in to sponsor his treatment.
“These bandages aren’t funded; the treatment Sue’s doing is not funded, the pump he uses is not funded, and the health system is too poor to be able to fund it,” she says.
“So let’s look at prevention.
“Someone who is not careful looking after their leg can face issues like cellulitis, hospital stays, and all the emotional side of it where they just want to hide away.”
The Lymphoedema Action Alliance estimates 13,400 cellulitis hospitalisations in NSW could be prevented by early detection of lymphoedema, saving $60 million.
In five months at one hospital, lymphoedema patients spent 975 days in care.
Above the strain on the health system is the emotional impact of lymphoedema, something Craig is still grappling with.
“The biggest thing is not being able to do what I used to be able to do – I can’t go for walks with my wife and dog down the Murray River,” he says.
“What I’ve been told is something like this could take up to two years to go back to a partly normal stage, and it will always be bigger than the other leg.”
In the grand scheme of things, surviving cancer is most important to Craig.
It’s also something his wife, Rebecca, comes back to when the lymphoedema becomes overwhelming.
“It's tough – I get up an hour early to put Craig’s stocking on and he gets up even earlier to put his pump on, but in our minds the lymphoedema is secondary,” she says.
“Craig’s not in remission yet and he may never get into remission.
“We’re just so grateful to everybody that’s helped us along the way.
“Craig’s stubborn and he’s optimistic – we got through it.”
There’s no doubt Craig will get through lymphoedema too.