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Day 10 – Twists and turns

I had an appointment to with my consultant to confirm my treatment following the lymph node biopsy. I had kind of accepted and got used to the idea of having a mastectomy with reconstruction, and was ready to do that (I had the surgery date as well).  But that’s changed now.

Due to the high probability from assessment since the lymph node biopsy that I may need radiotherapy, reconstruction at the same time as mastectomy isn’t a good idea. As the doctor explained, radiotherapy can spoil the reconstruction. It would be better to have the mastectomy only first, confirm if I need radiation, and then have reconstruction later. The type of reconstruction I’ve chosen will still be possible. I’m so happy about that!

On top of that, I’m having the surgery this week. Short notice, but the best thing. I wasn’t really expecting this outcome today. On the one hand I’m pleased – surgery will be over soon, and the recovery period is considerably less than having reconstruction, so overall it should be less of a stressful, uncomfortable time.

But, I then have reconstruction to contend with again, at a later date, rather than having it all over and done with at once. I also now have to adjust to having a prosthetic, ensuring I have the right fitting bras etc. And how will I deal with my body image? Right now I think I will be okay. I’m generally a confident person, but maybe when I see myself for the first time after the operation it will be more difficult than I imagine. It will undoubtedly be weird at first.

 

Silver lining of the Cancer cloud

Clouds by sidewalkflying_flicker

Image by sidewalk flying @flicker.com

In many situations there are both negatives and positives, sometimes without being obvious or readily tangible. I think as a cancer patient that applies too. I’m not for a moment dismissing the sorrow or pain that cancer can cause, but equally I think one has to try to see what it is that one can gain from the situation. It’s a situation we are forced into – no-one chooses Cancer by choice – so  we might as well make something positive from it, or recognise what positivity there may be…

Thinking about this today, I feel that:

  • Experiencing illness can enable you to empathise with others who have experienced the same, or similar circumstance
  • A cancer diagnosis will most likely make you think at some point about your life, what and who you love, and what is meaningful to you – things we might otherwise take for granted
  • In doing the above, the meaningless and unimportant may diminish as we embrace those things which are not
  • All the above can provide motivation to do more for others

These are no small things, but enhance and provide value and meaning where perhaps there was not before. Every cloud has a silver lining.

Finding strength in adversity

Butterfly image by mk* at flickr.com

Butterfly by mk* at flickr.com

I had a visit to speak to one of the nurses about the breast reconstruction operation and stay in hospital. I have been feeling pretty okay about my situation recently, but during my talk with the nurse she showed me some pictures of what breasts look like post surgery after different time intervals. The only pictures I had seen prior to this were in a book a different nurse had lent me showing images of women after all procedures had been fully completed. They looked really good, not what I was expecting, so that helped to allay me fears a bit.

But the post op pictures threw me. They weren’t what I was expecting and initially I felt they made me anxious again. They weren’t frightening, or gross – just not as ‘okay’ as I would have anticipated. Later procedures can reconstruct the nipple and get the breast looking pretty normal, but  I wasn’t sure how I would be dealing with seeing my breast in the early weeks.

After the chat my mind felt like mush again, the pictures had an effect on me.

My journey home was a thoughtful one, but I came to some conclusions. Firstly, I’m in this situation.  I think that’s the first thing to fully accept. It might seem obvious, but so often we fight against situations and don’t fully accept them.  My not liking it, being angry, wanting it to not be happening to me is irrelevant. The situation exists, I am in it. Only by accepting it 100% can I move forward and deal with it.

Once I had realised this, I found myself being able to think about how to make the absolute best of it. The key is, I believe, not to see an adverse situation as something negative, and dwell in sad, or self-pitying thoughts. It won’t  change the situation one little bit, just make the passage through it darker. The only thing you can do to get through it is say yes, this is what’s happening, but how am I going to react and be mentally and emotionally in this? How am I going to let it affect my life?

I think by going through this mental process,  in the space of a train journey, I have reached a place where I am okay with what’s happening, and I’m not going to let it darken my skies, or set me back. I’m lucky to not have a terminal condition, so my life will go on, and how that life will be will depend on how I make the best of it. It’s all up to me. And I’m determined it will be the best possible.

Day 9 – Axilla sentinal lymph node biopsy

So I had the biopsy. It had to be performed under general anaesthetic…and a lot of firsts for me: I’ve never had a stay in hospital before, never had general anasthetic . Basically I’ve never been in hospital for anything in my life other than a simple x-ray or blood test.

The experience was good though. The staff were fantastic, friendly, caring and that helps a lot.

First lots of health details were taken, and visit from the operating surgeon andanaethesist . Then it was a little time lying on the ward bed waiting to go in. First they took me into the anaesthesia room (it’s quite fun being wheeled around on a bed – though obviously without the surrounding causes). This was the bit I was so unsure about. I don’t like needles and assumed it would hurt or be uncomfortable, but the anaesthetic needle in the hand was fine! Whoopie! A fear dismissed.

My consultant also popped in to see me, just to say hello and see how I was – that was so nice. I am fortunate to be in good hands.

Next an oxygen mask was put on me and they said I might feel the anasthetic going in – that was weird. It was a cold sensation spreading up my arm , but it didn’t hurt in any way.

Next thing I knew my name was being called as I tried to rouse myself from a dizzy, foggy state. It was over. It’s interesting how you can’t remember the point at which you start  to drift under in anasthetic.

It took a good 45 mins to get to a state where I was fully awake, and then the nurses brought me back to the ward to rest, have a snack and a hot drink (I wasn’t allowed to eat from early in the morning). I wasn’t sure how I would feel after anasthetic, but I actually felt really good, and the wound was only slightly uncomfortable – no pain killers were needed.

I’m glad that’s over, but also glad for the experience as it gives me some idea of what to expect going in to the big operation. It’s awkard moving and sleeping, as every time I move the arm on the side of the wound it starts to hurt, so trying to keep above the elbow pretty still.

And today, I feel good in myself. I think part of this whole process is the unknown experience – we can fill our minds with fear and anxiety, but when it comes to actuality, reality, often things are not as bad as we dreamed up.

Day 8 – decisions, decisions, decisions

I had a meeting with the plastic surgeon to explain the various reconstruction options. This was great as she explained fully the pros and cons of each. For me, I had 3 options:

  • reconstruction using implant only
  • reconstruction using muscle and tissue from my back
  • reconstruction using tissue from my abdomen

The meeing lasted about 45 minutes. When I came out my brain felt like mush with all the information I had been given and the decision to make. It made me tearful and deciding this seemed hard to do – each of them have their own risks, and at the end of the day I want the one to me seems to have the least overall, weighing up different factors.

I’m fortunate in that I have very good friends around me who I could talk to about this and get different perspectives. It’s my decision, but being in the situation sometimes you need some objectivity.

I actually ended up deciding very quickly – reconstruction with tissue from my abdomen. Weighing up everything I decided I  really don’t want implants and don’t like the idea of messing with muscle and tissue from my back. I’m not saying these are bad methods, they obviously work otherwise they wouldn’t offer them,  just not the right ones for me for various reasons.

The only problem may be is that as I’m quite slim there may just be enough fat and tissue from my abdomen to make the right size breast….bring on the doughnuts!!!!:)

I’ll admit this was a difficult day. It’s a big decision because you want to be sure you are doing the right thing for yourself, and only you can make that decision. But I think I can comfortably say I’ve made mine, and it’s the right one for me.

Day 7 – More results and getting closer to treatment

So the scan results were back – I’m in the clear for any other cancer in my body. Good news! It means there is more possibility of having the reconstructive surgery at the time of the mastectomy. Even more good news! However ,just to be sure the doctor wanted me to have a lymph node biopsy – i.e. a blue dye is injected which indicates where any cancerous cells in the lymph node are, and removal of two or three lymph nodes for examination.

So..another hospital visit in store..not sure what to expect really again in terms of undergoing the whole experience, but I’ll say this much…despite the unfortunate situation I am in it’s kind of objectively interesting too.

 

Day 6 – Breast biopsy results and diagnosis

So today was D-day…my hospital visit to get the results of the biopsy and discussion with the doctor about the next course of action.

The results were a little worse than I expected. Part of me still thought (maybe denied the possibility) that the lump would be benign – cancerous lumps don’t usually hurt I kept reading, and I still couldn’t envision that I would have actual cancer.

But..I do. It’s been confirmed that not only do I have low-grade, non-invasive DCIS, I have some invasive DCIS too, plus the lump is cancerous. On the positive side, the cells taken from under my arm have not shown positive for cancer.

I can’t say I could have imagined these results, but on the other hand it makes the choice of course of action very simple and straight forward for me.  They can’t remove the lump alone or the DCIS without having to remove the breast – the would be too much risk of cancerous cells or calcification remaining. So…looks like I’ll be having a mastectomy.

I feel quite settled about it and calm, which I didn’t expect. Maybe because there are other steps to take before then: it’s been advised to have a CT scan and another scan (can’t remember what it’s called now – a lot of information in one day!) to check that I don’t have any cancer anywhere else in my body before surgery.  I’ll be having a biopsy on my lymph nodes before any surgery too.

The results of all these tests will determine the path of treatment, e.g. whether or not I can have reconstructive surgery at the same time as the mastectomy. It was suggested that there is a small chance I might need some radiotherapy too.

Wow, information overload today! I’m glad I had done some research on DCIS though as it made it easier to understand the diagnosis.

 

 

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