Dr. Sowmya Siragowni is a hospitalist who provides care for patients at Emory Saint Joseph’s Hospital. She was diagnosed with stage 4 ovarian cancer five years ago when she was 43 years old and she shares her journey here.
In the summer of 2018, while working a shift at the hospital, balancing work, home, and two small children, I started to notice random abdominal pain and bloating accompanied by right shoulder pain. The right shoulder pain was particularly bad when I was lying down. I decided to make an appointment with a gastroenterologist and go from there. After examining me, my GI doctor felt my symptoms most likely were related to gallstones and we even talked about which surgeons I should seek out. A CT scan of my abdomen and pelvis was the natural next step.
I completed the CT scan one morning and went back to finish my clinical rounds. The nurse from my doctor’s office called and said “The doctor would like to discuss the results with you in person.” I knew right away that something was not looking good. I braced myself for the discussion and went back to see my doctor.
All of a sudden, I was sitting on the other side of the table from another physician, not a patient. I was not discussing my cholesterol levels, blood pressure, or anemia, but instead reviewing the implications of a Stage 4 ovarian cancer diagnosis.
‘Biggest challenge of my life’
I was born and brought up in Bangalore, India, and faced many challenges as an immigrant both before and after I finished my residency.
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After completing my training as a resident, I finally settled down with my family in Atlanta. Being away from family and social support, developing and understanding the cultural norms and adapting to a new healthcare system, practices, regulations, and technology was a steep learning curve. But in that moment, I realized I would be facing the biggest challenge of my life.
My doctor told me “You have metastatic lesions all over your abdomen and the primary seems to be ovarian.”
I couldn’t believe what I was hearing.
The dreadful word “cancer.” My mind was flooded with questions: How? Since when? and Why me? And so, my journey began. The inevitable “Why me?” hit particularly hard as I have no family history of cancer.
Putting the questions and emotions aside
I was then directed to have fluid removed from my abdomen for testing. This is medically called ascites which is the build-up of fluid in the space between the lining of the abdomen and abdominal organs.
A sinking feeling engulfed me as I saw the amount of fluid that was drained. I knew if this is fluid from cancer it was definitely stage 4. I knew I was facing a formidable battle. Tears rolled down my face.
But I quickly realized that I had to put the questions and emotions aside and assume the driver’s seat of my life, my motherhood, and my treatment. I moved forward with getting all the required scans and biopsies.
I needed to be my own advocate.
The scans were followed by chemotherapy. As we all know, the side effects are quite challenging. It was no different for me. Nausea, vomiting, intolerance to food smells, and a weakened immune system, leading to a tooth abscess and recurrent sore throats.
Above everything, the anxiety and fear of whether I would respond to treatment or not was overwhelming. I was navigating through so many uncertainties.
I chose to put my trust in my providers and the miracle of medicine.
Going back to work
While undergoing chemotherapy, I had the chance to come back to work when I felt well enough to do so. I am grateful that I was given the opportunity to work a few hours on some days when I felt well enough in between my chemo schedules. It was definitely difficult initially, just walking around the hospital seeing patients was challenging, sitting in front of the computer with a swollen abdomen was uncomfortable.
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But work helped me focus on other things and not just my diagnosis and treatment.
Three months into my treatment I underwent a follow-up scan that showed that my tumor burden (the size and the number of metastatic lesions seen on scan) was improving and I was responding to treatment. I was finally eligible for surgery. In January 2019, I underwent the removal of my uterus, ovaries, and cancer masses in my abdominal walls. Once I recovered from surgery, I underwent additional chemotherapy. Finally, in April 2019, I was told I was in remission.
Moving Forward: What I Learned
Once my remission was confirmed, I shifted gears to focus on cancer recovery.
My mind and body had gone through so many changes; at first, I felt like the ever-present exhaustion had become a part of me. Losing hair and dealing with skin changes was incredibly distressing but I had to put those feelings aside and focus on my ongoing maintenance treatment and sustaining physical well-being for my family and eventually returning to work. I had to balance home, children, and work in addition to my regular doctor appointments and maintenance infusion treatments.
I had to find time for walking three to four times a week and doing yoga. Little by little, this helped me regain strength. I particularly enjoyed working with a physical therapist. Just getting out of the house, and working with my therapist who helped me take small steps in regaining my strength was an important part of my recovery.
I have come a long way since that initial diagnosis. But I also had a relapse since then; I went back on chemotherapy and am now again in remission.
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Valuable lessons
Through this journey of five years, I have learned many valuable lessons, especially about making the most of our time when we are confronted with a challenging diagnosis like cancer.
When we receive a difficult diagnosis, being a professional in the medical field is in itself challenging: we sometimes know more about our diagnosis than a non-physician might, we get to read a lot about the diagnosis with our resources, but we still can’t know everything about the illness in its entirety. We, just like everyone else, have to simply trust the system, and medical providers and believe in the miracle of medicine.
I encourage you to be an advocate for your own health, learning how to seek and navigate good care for yourself. Never hesitate to ask your doctors and other providers questions.
Take time to read about the diagnosis and chemotherapy.
Many people advised me to have a positive outlook. As important as this is, you cannot ignore negative or painful feelings like fear, anger, anxiety, and sadness. These emotions are an unavoidable part of this journey, so instead of fighting them, you have to let them flow through you. Allow yourself to experience the emotions.
Once you have shed your tears and let out your frustrations, jump back to do whatever mundane task you need to do next, whether it be simply preparing a meal, making an appointment, or planning your calendar for the next day.
My strategy was turning the focus to my “to-do list”
There are a lot of things a mother who is also a physician has to juggle. This list was my motivation to keep moving forward. It kept me away from constantly worrying about the future. I found peace by just going on with life as it comes, but holding on to the hope that we have the power to forge our own path.
One unique challenge for me was navigating through treatment for some of my patients admitted to the hospital for complications of cancer when I returned to work.
While I have always empathized with my patients, I felt these patients’ pain and anxiety flow more intensely through me.
But again, I found ways of coping: I found that by sharing my own cancer story, in that moment, I was able to show them hope, positivity, and confidence in the medical world today. Those encounters gave me a sense of peace with myself and my profession.
Then came my challenges with COVID-19 and navigating through the dreadful pandemic. There came an additional layer of fear and anxiety being immunocompromised and an additional layer of exhaustion wearing masks and personal protective equipment at work. I had to adapt to a new circumstance, stay well informed, and be focused on each day as it came.
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Support and love
The support and love from my colleagues was something I will never forget. It was definitely challenging for the leadership to fill in my shifts, but the flexibility and thoughtfulness of my colleagues made my journey smoother and the workplace a better environment for everyone. Time and time again, my coworkers would take turns bringing a complete meal for all of our family members for which I am so very grateful. While there are so many who helped me through this journey, my spouse and my mother-in-law were the backbone of my recovery. My husband was always there to ride with me to my appointments and stay beside me for hours while I went through my chemotherapy sessions. My mother-in-law helped with caring for my kids and making homemade meals. My children never felt the void of their parents as she was always there for them.
The outpouring of love and kindness from my neighbors and friends also provided a strong support system which made all the difference during these challenging times.
Last but certainly not least was the joy of taking vacations with my family, which had become my priority during my treatment and recovery. To my surprise, though, I soon realized checking off places on my bucket list wasn’t enough to sustain my soul’s purpose. While downtime, travel, and togetherness with my loved ones is incredibly important, what I have realized is my purpose — and that’s to spread hope and healing through my journey and experience. The joy of giving back. I am grateful for the opportunity to give back this love and hope for others, especially my patients.
Advocating for them truly reflects that “life comes in full circles.”
My question “Why ME?”— is still a question I have, but I have found peace with myself.
How we got this story: Dr. Sowmya Siragowni reached out to Helena Oliviero, a health and enterprise reporter for The Atlanta Journal-Constitution about sharing her story. Oliviero helped edit Siragowni’s story for length and clarity.
