Kelsie Dummètt is only in her 20s but she's already made a will.
She's spent the past decade dealing with a debilitating auto-immune condition, ulcerative colitis, resulting in the "traumatic" removal of her bowel, then last year was hit with another devastating diagnosis — melanoma.
The 26-year-old, who has a post-graduate degree in digital communications, has been unable to work this year as she copes with her dual health conditions.
"It's just been crazy," she said.
"I've had seven surgeries in the last nine months alone for the melanoma.
"I've organised my will. Just in case."
Melanoma 'link' to auto-immune condition unclear
Doctors first diagnosed and removed an early-stage melanoma in mid-last year, requiring them to cut out 7.5cm from one of her breasts.
During three-monthly skin checks and scans, another 21 early-stage melanomas and abnormal moles have been identified and later, surgically removed.
"My body is full of scars," Ms Dummètt said.
Because the melanomas have been in areas of her body shielded from the sun, and she has been vigilant about sun safety, medical specialists are unsure whether there's a link to her auto-immune condition.
That uncertainty has created a dilemma for doctors on the best treatment options going forward for the melanoma, a potentially deadly form of skin cancer.
Ms Dummètt was still a teenager when her bowel was removed as a treatment for severe ulcerative colitis and replaced with a surgically created internal pouch.
"I had a few good years after that," she said, wistfully.
"I went travelling … all over the world. I loved riding horses and adrenaline sports.
"I thought I'd crawled out of hell, and I was like: 'Oh good. That's great. I fought that.'
"I've now found myself straight back there."
Her life of hospital visits, medical tests, surgeries, illness, and medication differs markedly from other 20-somethings.
But she tries desperately to avoid comparing herself to others.
"What I would give to step into someone else's body that's fully able," she said. "It's just such a different world."
"Every time I go into hospital, I'm surrounded by 80-year-olds. It's just been really tough. The more I compare myself to others, the sadder I get. I try not to.
"I don't plan ahead more than one day."
Given Ms Dummètt's melanoma, her long-term gastroenterologist Jakob Begun, of the Mater Hospital in Brisbane, has changed the main drug she receives to treat her ulcerative colitis.
She has four-weekly infusions of an immunosuppressant medication, designed to prevent her immune system from attacking the internal pouch surgeons created to replace her bowel.
"I'm using a very gut selective medication right now, which shouldn't affect her immune response anywhere else in the body," Dr Begun said.
The big hope is that by switching to a more targeted drug, Ms Dummètt's own immune system may be better able to destroy the cancer cells.
But with more questions than answers about the underlying cause of her melanomas, the uncertainty is challenging for her, as well as her doctors.
"I try to give her reassurance," Dr Begun said, praising Ms Dummètt's resilience in dealing with two severe health challenges at such a young age.
"She's religiously going in for her skin checks, being very diligent about monitoring all of her freckles and moles to make sure nothing looks sinister.
"We do know if you catch it early, you do better, which has fortunately been the case for her. They've caught all of them early before they've invaded deeply."
As she tries to live in the moment as much as possible, Ms Dummètt is thankful for the good Samaritans in her life — people such as her neighbour who bought groceries for her and would not accept payment for them.
During a particularly hard time in her journey, her friend's stepfather, who would make her meals and drive from the Gold Coast once a week to drop them off, expecting nothing in return.
"I couldn't stand up to cook anything," she said. "Even cracking an egg into a pan and standing there to flip it, I couldn't do it."
The fiercely independent young woman, whose dad died in 2016, is learning how to ask for help as she deals with the medical unknowns as best she can.
"I worked so hard after I recovered from being so sick as a teenager, to create a better life for myself," she said.
"It didn't matter how great my career was or the financial freedoms I had set up for myself — all that's been destroyed being diagnosed with cancer.
"I find myself right back where I never wanted to be.
"That's just the nature of getting sick. There's nothing you can do. You just have to address everything that happens as it happens."
