Bronwen Karovsky opens up about how she managed Parkinson’s disease during breast cancer surgery.
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Bronwen Karovsky (69), a widow, lives in Parkmore, Gauteng.
It was in 2020 that I received two devastating diagnoses: Parkinson’s disease (PD) and breast cancer, only four months apart. I was widowed during the same time frame.
The Parkinson’s disease diagnosis came in February, after a sudden job loss because of the insolvency of my employer. I was 65 years old, retired before I was ready, and nowhere near prepared for what was about to unfold. Parkinson’s disease is a neurodegenerative disease of the central nervous system which effects muscle control, balance and movement. Unfortunately, there is no cure and no diagnostic tests. Diagnosis is done through clinical observation and response to medication. There was no known cause for my diagnosis, which came as a relief. Early May 2020, my husband died. He was eighty years old, fifteen years my senior. He had been fading for several years and didn’t adjust easily to lockdown.
In May 2020, I received the breast cancer diagnosis. I previously had breast cysts and vainly hoped that this was another one to be aspirated and then forgotten. But, no I had the Big C and PD; this couldn’t possibly be true.
Breast cancer treatment
I didn’t have medical aid at the time, so my breast cancer journey started at a public hospital. Surgery was planned but the pandemic put a stop to all but the most necessary surgeries. Fortunately, my cancer was slow-growing and endocrine medication was holding things steady.
The oncologist suggested that I have radiation which I declined, feeling that it wasn’t yet necessary. So, I was closely monitored over the next two years. During that time, I joined a medical scheme. Then in October 2022, my mammogram results were concerning, and surgery was now a must and planned for mid-October.
Managing Parkinson’s disease during surgery
In general, Parkinson’s disease isn’t well understood, even though it’s second only to Alzheimer’s in number of diagnoses. In the time since my Parkinson’s disease diagnosis, I had done research and became my own Parkinson’s disease advocate. I told my cancer care team that Parkinson’s disease was as important as the cancer and surgery.
My first concern was the interaction of drugs, specifically the interaction of one of the Parkinson’s disease drugs with commonly-used anaesthesia. My second concern was access to my Parkinson’s disease meds in hospital, on schedule, and the length of the surgery affecting the interval between doses of my Parkinson’s disease meds. The dosing interval is critical. Apart from the danger of messing with the meds, Parkinson’s disease symptoms could be confused with post-surgery symptoms or problems, giving a false reading of my condition after surgery. The progression of the Parkinson’s disease could be adversely affected by so many little things that even experienced medical personnel might not be aware of.
The cancer care team was magnificent; before being hospitalised, I met with the anaesthetist and an anaesthetic was found that wouldn’t interact with my PD meds. My surgery was scheduled first on the list to accommodate my dosing schedule, and strict instructions were given to allow me to bring my own PD meds in, and to be in charge of dosing.
To conclude treatment, I had radiation, 15 consecutive days, 15 minutes per session. Radiation wasn’t my finest hour. My skin became chapped and felt like fine sandpaper. A special silicone dressing was applied to my left breast to help prevent more damage.
Side effects
It’s now over a year since surgery. There is fat necrosis, but it will resolve itself over time. I developed a small ulcer at the intersection of two cuts under my left breast. I have lymphoedema possibly caused by removal of the sentinel node, radiation and a family history of swollen extremities and water retention.
It’s been a four-year rollercoaster ride. There have been ups and downs, frustrations, loss and deep sadness. Parkinson’s is a life sentence with no reprieve, and cancer is no walk in the park either.
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Laurelle Williams is the editor at Word for Word Media. She graduated from AFDA with a Bachelor of Arts Honours degree in Live Performance. She has a love for storytelling and sharing emotions through the power of words.
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