Trusting her gut may have saved her life

Amanda Arellano, a 35-year-old accountant in San Diego, believes in doing things the right way. She exercises regularly, eats a plant-based diet, has never smoked or used drugs, and rarely has a drink. She also listens to her doctor.

So when Dr. Jeffrey Sugar, an urgent care doctor with Sharp Rees-Stealy Medical Group, told her to head straight to the emergency room, she listened.

Arellano first met Dr. Sugar at the Sharp Rees-Stealy Downtown Urgent Care. A nagging voice in her head finally convinced her to seek treatment on a Friday night for the headaches, cough, chest pain and labored breathing she’d been experiencing. She went to urgent care an hour before it was scheduled to close, expecting to quickly be treated and sent home to rest over the weekend.

However, Dr. Sugar suspected that she might have more than a simple cough and ordered a chest X-ray. After reviewing the results, he told her to head straight to the emergency department at Sharp Memorial Hospital, where the charge nurse would be expecting her.

“Amanda came in on a Friday night at about 9:30 pm,” says Dr. Sugar. “Her symptoms were just not consistent with infection, such as bronchitis or pneumonia. Sometimes, as a physician, you just have to go with your gut level feelings, and sometimes, you get it right.”

Dr. Sugar’s gut was spot-on that Friday night. He showed Arellano the results of her chest X-ray to convince her of the seriousness of her condition and began coordinating her reception at the emergency department.

“I assumed I would be diagnosed with bronchitis and given medication,” Arellano says. “If Dr. Sugar had not acted swiftly, called ahead to the ER and told me that they were expecting me, and that I needed to drive straight there, I probably would have simply gone home.”

A CT scan, and a life-changing diagnosis
Once she arrived at Sharp Memorial, a CT scan — a series of X-ray images to create cross-sectional images of the body — of Arellano’s chest was performed and blood work was done.

By midnight, she was told the true cause of her cough, pain and breathing troubles — she had an 11-centimeter tumor pressing against her heart and lungs. She learned that she had lymphoma, a cancer that begins in the infection-fighting cells of the immune system, and she did not go home again for 11 days.

“I definitely didn’t expect to hear the word ‘cancer,’” Arellano says. “Most people have time to go home and at least get their pajamas after a diagnosis like this. But I went to the urgent care, was sent to the ER, received my diagnosis and was admitted to the hospital all on Friday night. I started my treatment by Tuesday and didn’t leave the hospital for another six days.”

Swift action and strong support
Arellano’s care team was optimistic about her prognosis and she was supported by loved ones throughout her treatment. Her boyfriend, Dustin, took a break from his own personal journey, a 3,000-mile run across the country to raise PTSD awareness. Her parents, sister and aunts also took turns caring for her as she went through six rounds of six-day chemotherapy treatments every 21 days under the care of former Dr. Meera Ravindranathan, known as Dr. Meera, an oncologist with Sharp Rees-Stealy Medical Group.

“I was consistently told that everything was going according to plan and that my cancer was very treatable,” Arellano says. “Dr. Sugar’s swift action likely saved me from progressing to an advanced stage, and Dr. Meera’s strong expertise and confidence in my treatment plan was the ultimate reason I got better after only one go-around. Supported by her hugs and encouragement after every single treatment, I found the energy I needed to keep going.”

A challenging journey, with a positive outcome
While Arellano, now cancer-free, is incredibly grateful for the exceptional care she received, she admits that the experience was difficult at times. She was overwhelmed by the sudden change in her life, and didn’t know what to tell people when they asked how they could help. Just talking about her illness made her upset, and she worried that her crying would distress her loved ones.

“Others felt optimistic, but I was so scared that I really couldn’t see the light,” she says. “It all happened so fast and I was just trying to get through one day at a time. I was weak and tired, and was hyper-conscious about germs because my immunity was compromised. It was traumatizing.”

However challenging the experience was, Arellano recognizes the positive consequences of her illness. Her relationships with her friends and family are stronger. She no longer sweats the small stuff. She’s learned to listen to her body and trust her gut. She’s also living in the moment more than ever before.

“There’s always going to be the time before lymphoma and the time after lymphoma,” she says. “I will no longer put off what I want to do. I will show up for my friends. I will keep myself strong and healthy to be prepared for anything that comes my way. Life has a way of changing plans and there is never a perfect time for anything, so I will ‘just do it.’”