Big K's discovery of Teratoma

Saturday, October 17, 2020


Never had I expected that things would turn out this way. Nothing could mollify those devastating moments of despondency that would remain forever etched in my mind. I demanded justice at the start of the year when I was torn by a miscarriage. And today, on the fateful day of Children's day, I lay shattered like a broken China once again. Tears marred my vision and it felt like I was elevated onto the gallows. 

8th October. Mom was scheduled for her surgery. To remove the tumour in her rectum. I haven't quite shared, but mom was diagnosed with Stage 4 rectal cancer in November 2019. She went through 3-4 cycles of chemotherapy and finally, the doctor gave the go-ahead for a surgery. After seeing her enter the operation theatre, I headed off to work. Yes, I was still working that day. Instead of packing up and down the corridors of the hospital or standing outside the OT, feeling absolutely helpless, I might as well work for 2hours right? Midway through work, the deliveryman called asking me if anyone was at home to receive a parcel. There should be. Before I left home, Big K was sleeping, Small K was due to be home and the hubs was working from home. So yes, they should be at home. But they weren't. 


I texted the hub, only to find out that he brought Big K to the hospital to see our Pediatrician again as her tummyaches intensified till her face turned as white as sheet. A month ago, we admitted her due to constipation. We initially thought that it could have been a muscle strain as papa made her do some leg raises which might have pulled a muscle. What ensued over that weekend were episodes of vomiting and acute pain. So painful, she couldn't stand or walk well. We took her to the GP and it was inconclusive. It wasn't food poisoning, stomach flu or UTI. So the GP suggested that we monitor the pain and gave us a letter for A&E as she suspected HERNIA! Say what nia? I had to google and it freaked me out. Her nauseousness and acute pain persisted and we zipped her off to A&E. The PD had a look at her concluded that she had severe constipation. The condition wasn't because she wasn't pooping. On the contrary, she was. Everyday. Xrays and Ultrasound showed that her large intestines were all clogged up and there were hardly any pockets of air to push the poo out. The PD explained that this could be due to the fact that she pooped too quickly and over time, the remnants built up. It needed time to clear. Probably a month she said. So we gave it time. Despite Big K's complaints, we still insisted that it could possibly be constipation. However, that afternoon, our PD felt something different. She felt a lump at the tail end of her large intestine and instantly ordered for a CT scan. 


It was at a time when my daughter was in the hospital waiting for the time to do her CT scan and it was also at that moment that my mom was already wheeled out from surgery. Who should I go to? Mom or dot? It was a tough call which was probably why the husband did not inform me there and then. He knew I needed to settle mom and didn't expect things to be so bad for Big K. So I headed down to Tan Tock Seng Hospital to have a quick check on mom. She was awake and grumbling despite having a slight fever. I knew she was going to be well (Since she could grumble), so I zipped down to my baby girl. 

7pm I arrived at East Shore Hospital.

830pm CT Scan. 


By now, Big K was already in immense pain. She could not lie or sit well. She seemed to be searing in pain. She was made to drink "contrast". Something which would aid the CT scan and even then, it made her want to vomit. She entered the room herself but minutes later, the radiologists came out asking me for help. Baby girl was in so much pain, she couldn't lay straight to facilitate the execution of a proper CT Scan. They needed my assistance. With a lot of coaxing and me decked in a lead vest to protect myself from the harmful radiation, she finally did the scan. 

930pm. Results were out. 

My world collapsed when I heard the news. a 10.3 x 6.6 x 6.0cm  tumour was found in her ovary. It had tiny calcifications, fat-attenuation appearance which is suggestive of a mature cystic teratoma/ dermoid cyst. Her left ovary was also not discretely identified. Meaning to say that the cyst was so huge, it covered it and we do not know if the ovary was still healthy. One complication of this was ovarian torsion. I was speechless when the PD announced it to me. I was alone (due to covid, they only allowed one parent to be with the child) and I knew I had to stay strong. But it was so tough. It was a double whammy for the day! The day my mom went for surgery was the day I discovered that my child had a tumour? I couldn't even say the word out loud. Those moments of anguish and agony lay like broken mosaic tiles, forming the picture of hell on Earth. It hit me like a bolt from the blue and once again, I demanded justice. I knew that I am viewed as a resilient woman. From all my recent episodes. Every single episode did help me surmount countless moments of desperation. But the reality of the situation was that I was assaulted by multitudinous arrows that struck and agonised my heart. I called the hubs who was trying to settle Small K and his own work matters. He expected the result to be yet another sign of constipation but when he heard the news, he too turned silent. The words spun round and round, destroying our mental faculty, grinding it to an ominous stop. We had nothing to say to each other for that few seconds. My world of happiness came to a cataclysmic collision with the world of reality. 

1015pm PD suggested we get transferred to KKH

KKH is known to be the forefathers when it comes to children's condition. Our PD said Teratoma is rare and in her years of practice, she probably saw it once every 10years. Say what? Why were we so unfortunate then! Why can't this translate to a lucky draw instead? The thoughts continued to swim in my head. My inner screams rose to an unbearable crescendo of screams. She gave us an option for us to go in an ambulance of I could drive her there myself. I wanted to zip us down immediately but the hubs was concerned with my mental health. Plus I only managed to clock 2 hours of sleep the night before. Hence, he insisted we call for an ambulance. The hospital assisted us on this and our PD was really nice, coming in constantly to check on us. To check on me, in particular. The blow was bad. I didn't look that badly shaken to be honest. But it was all a facade. A part of me had collapsed. In that instant, I really did not know what to do. 

After what seemed like eternity, the ambulance finally arrived (after almost an hour). By the time we arrived at KKH and got ourselves checked in, it was already 1am. Once again, due to Covid19, only one could accompany Big K. Though badly shaken, I needed to be the one. The hubs understood and stood outside the A&E, waiting for further news. We were brought to a waiting area where the doctor asked us some questions. Meanwhile, the hubs got admission done and we were pushed up the ward. By now, Big K was knackered. Her spirits were still high though. Afterall, it was her first experience (and only one I hope) in an ambulance at the age of 8+. It was also exciting that she got to sleep that late. Truth be told, she was already dozing off in the ambulance as she looked around curiously. Seeing her indifference due to her ignorance pained me even more. 

That night, I couldn't sleep. I was shivering in cold and gasping for air. I had no one to turn to. I ranted on social media because it was late and I needed an outlet. Friends I have, but it was late and I knew better than to impose. I refused to be placated even after the hubs texted to say that he is optimistic all is going to be well. He is always the happy-go-lucky one. The optimistic one in the relationship. To the extent, I sometimes feel, he is unfeeling. 

930am Dr Ong Han Lim, Associate Consultant of the Department of Paediatric Surgery came to Ward 75, Bed 12. 

Together with his team, he went through the possibilities and after an internal discussion with the team, they concurred with our PD, that it was indeed Teratoma and it had to be removed asap since it was causing her so much pain. They were calm. Too calm. They probably have seen several more cases but still I was told that it is something rare. In fact, they have been trying to gather participants for their research in this area and their aim was to attain 150 participants for their study. However, to date, they only managed to get 60 in a span of 3 years! That is how rare this damn cyst is! They put us on priority and managed to get a slot for the operation theatre for that day. Laparoscopic Cystectomy kiv oophorectomy. Gosh, the jargons scared me. 

9th October 2020. 430pm. Operation. Children's Day.

Like a bolt from the blue, right after lunch, we were told that the surgery would be scheduled for that afternoon. Once again, I was hyperventilating and tears flooded my eyes. I hugged Big K tightly, telling her to be strong and brave. She was baffled and thinks perhaps I should be the one who needed to be strong and brave. My kids are the sole impetus behind the perseverance. They give me courage. Courage was the essence of what impelled me to accomplish each day. No matter what construed over the past few months: Mom's cancer, my grandfather's passing and my miscarriage. But now, one child's health is at stake. I felt like I had been slapped. It felt like someone up there was playing a prank on me and this is was breaking the camel's back. Big K was extremely brave and I tried keeping her occupied with happy things. She missed her brother so much, the two of them kept video-calling each other.

Thud. Thud. Thud. 

My heart palpitated wildly in my ribcage as the hours ticked by. As we drew closer to 430pm, my heart pumped harder. at 2pm, I ensured that Big K was comfortable and tried to sponge her. I wanted to do everything for her. We prayed really hard and each time I prayed, tears rolled down uncontrollably. At one point in time, Big K hugged me, telling me she was sorry. She apologized as she thought it was her fault that she's ill. Oh my heart. It shattered into a million pieces. Oh my darling, it isn't your fault. It is no one's fault. We are just unlucky. I don't have the answers to why we are unlucky, but that's a fact we can't change. We could only pray for divine intervention. 

4pm. Operation theatre. 

She was made to change into a robe and strip off her undies. She felt tickled and was giggling all the way. She was still pretty clueless. I did explain to her that a monster is in her and that is the thing which is causing her immense pain. We had to take it out in order to feel better. She understood and even asked to see that monster after it was taken out. Such a brave girl! Someone please give her a trophy. The surgeons came to speak to us and told us of the option for one parent to go in with Big K to ensure that she doesn't go ballistic during GA administration. Once again, the hub knew I needed to be there and gave me the honour. I helped her tiny hand tightly as she was wheeled into the theatre. The cold white walls must have given her a different vibe. She looked all around her and suddenly realisation hit her like a sledgehammer. She whispered, "mama, I'm scared." I told her not to be. To focus on positive things, to think of the songs I sang with her. To pray and have God in her heart. But I was a wreck. I was tearing so badly, my mask was wet. Seconds later, the doctor started injecting saline. It made her uncomfortable but she did not cry. She never shed a tear. However, she exclaimed. This time I could sense her fear in her voice. She cried out to me" Mama, I'm scared, I'm scared!" I was so helpless, I could only continually scream for her to be brave. That I would be here waiting for her when she woke up. I screamed at the top of my lungs for her to pray and that God will protect her. She did no wrong. My poor child. I bawled my eyes out and the next moment, within probably 3 seconds, the aesthetician announced that Big K was asleep. That feeling of having your child hold you so tightly, shouting out in fear to the moment she fell into a deep slumber and let go of you. The feeling was indescribable and no parent should ever go through this. 

I walked out of the OT and ran into the husband's embrace. Cried buckets and I could have sworn he too, wanted to cry out loud. but he didn't. He once told me that if I'm in such a wreck and if he is also affected badly, who will hold the fort? He urged me to head home for some rest. The operation was going to take at least 2 hours and she has to spend another 2 hours in the recovery ward. Instead of heading back, I dragged him off to pray. My face bored the wretchedness that was swallowing my heart and soul. He couldn't talk me out of things and accompanied me. I bemoaned in tears and sobs, telling God the devastating news. Grief washed over me in tides but luckily masks were mandatory and that hid my woebegone expression. Following that, we went for a quick bite. I haven't eaten much. Midway, the husband announced that all should be good since there weren't any calls and it was already an hour into the operation. You see, we were told that should her ovary be damaged and that they had to cut it off, they would call us. This was something which caused me to plummet into the depths of despair. I tried to stifle my sobs as my husband tried to console me. 

730pm. The call came. 

Big K was out in the recovery ward and both her ovaries are intact and the prognosis based on the doctor's observations (they found hair --YES HAIR! FREAKISH and calcifications which might develop into TEETH if it carried on developing) and experience, it was indeed a mature dermoid cyst hence it is likely to be benign. Ohhh thank God! Someone up there was watching over her! The tumour was expanding in her ovary hence the left ovary could not be seen. Also, the doctor later revealed that her ovary was actually twisted 360 degrees but because it still looked pink and healthy, they were able to salvage it. Early detection helped. So please do not dismiss your child's pleas when they are in pain. Such a thing is so random. It isn't hereditary or genetic. The harrowing few hours of nervous anticipation that amalgamated with ominous fear finally vapourised! We zipped back to the hospital and called out to Big K. She struggled to keep her eyes open and managed a weak grin when she saw me. Guffaws of joy and relief choked in my throat. That night, she slept. She woke up midway wanting to pee. She underestimated her threshold and insisted on going down the bed and walk to the toilet. Bad move. She bravely walked to the toilet but on the way back, the pain surged through her. But being the warrior that she is, She lumbered back to her bed. Every step was excruciating and it pained me so much. I wanted so badly to carry her 23kg frame back to the bed, but I could not as I would cause her more pain. She could only depend on herself. She made it, but following that, she developed a phobia and refused to get off bed. It was so arduous to even pee on the bed pan. The whole process took possibly 20minutes as she was in immense pain. Think Cesarean if you have ever gone through it. Imagine taking out a 10cm tumour from a petite child. Proportionately, 10cm is HUGE. 

The black stuff was the tumour. It was as big as the bladder from the scans. 

The entire episode was like a whirlwind. Between diagnosis to surgery, it was only 2 days. Less than 48 hours. Ripples of disbelief still linger in my heart. We waited for almost a week before the histology was out. The immensity of the pressure was lifted with the assurance of the doctor to us that it was non-cancerous. It is such a dirty word, I can't even say it. Upon hearing that, all the muscles in my body eased momentarily. While we have successfully hopped over one hurdle, the journey ahead is still uncertain. Big K has to be checked periodically for at least the next few years. We have to continually pray for a non-recurrence. 

Thank you all for your support, prayers, love and encouragement in one way or another. We are deeply appreciative. A time-bomb is still in us. For now, gratitude triumphed over insomnia. We can only take one day at a time. Hope is what keeps us going.