Friday, 3 June 2016

3 Is A Magic Number

Wednesday 1st June I finally got the results of my gene test, bringing to a close the longest three weeks I think I've ever experienced.

As a quick recap I was looking for a number under 18 ... I got a three!  I may have punched the air ... Dr Martin was almost as pleased as I was!

The combination of my score, lump size, negative nodes and a couple of other bits mean that have I have best possible prognosis for long term survival with no need for chemotherapy.

I have a couple more appointments to go before I start radiotherapy.  It seems likely that will start in July at this rate - four weeks of daily doses which will happen at St Thomas' so I'll have a new hospital to visit. 

Dr Martin was trying to tell me about the possible side effects of radiotherapy and tamoxifen, I was sitting there grinning like a loon.  I did explain to him that I'd been more worried about chemo than the cancer and he seemed to understand.

I have more leaflets to read (I quipped that I wasn't actually going for the full set) and more letters to wait for, but at the moment I'm back to full on positive mode.

  






Wednesday, 11 May 2016

Hmmm ...

I've just had my upbeat disposition given a bit of a knock.

I'd understood this afternoon's appointment was to sort out my radiation treatment, possibly a tattoo or two, a schedule of sorts, that kind of thing.

It turned out that this was actually my first meeting with the Oncology team.

Up until now I've been under the influence of the surgeons.  Not unnaturally they see their role as the main one, the bad bit has been cut out, no trace of any more bad bits, job's a good'un, a bit of a zap and some tablets and all will be well.

Things didn't start well when it took three hours for me to be seen.  They were a doctor short and of course these things happen, but it did make for a very long afternoon.

The charming chap I finally saw had a very thick accent, which meant I had to really concentrate on what he was saying - no bad thing really.

I got a summary of where we were at the moment, (operation, nothing in the nodes taken from my armpit, no history of this disease in my family - we came back to that a couple of times), there is no disease in my body.  But ... but ... this is Oncology, basically they always recommend Chemotherapy as well as Radiotherapy and tablets.

I felt the wind coming out of my sails (if that's an appropriate way to describe it) at every point in this process to date I'd been told Chemo wouldn't be necessary.  I had to piece together for myself that what I was really facing was the different disciplines beliefs about what is best for the patient.  I know it's all coming from a good place, but Chemo was the one thing I really didn't want to experience.

I focused back on what was being said.

The current tests show two markers, the one that's about hormones  is positive (bad - therefore the tablets are a given) the other one is negative, but I got the impression that this group of doctors always know better and would rather make absolutely certain with more chemicals.  (I'm probably being very unfair, his accent was very thick and I probably shouldn't be trying to read a subtext into someone else's discussion).  

In actual fact what is happening now is more tests.

Thank goodness the use of Chemo is subject to cost benefit analysis.  The tests are the gene therapy ones (that to be fair were mentioned as a possibility during the biopsy discussion) and the numbers will fall into one of three groups.  Less that 18, the cost outweighs the possible benefits and the decision is likely to be no.  Over 31 and the benefits outweigh the costs (2% increase in a long-term lack of return of the nasty) so that'll be a yes.  A number in the middle and it gets fuzzy.  So fingers crossed I'll have a low number.  And that I might get a say in what happens?  I sort of doubt that, but I can dream.

They like to do Chemo within two months of the operation so the clock is ticking.  They'll see me again in three weeks when they'll have the results of the gene tests and then the next steps will be decided (and they'll discuss side effects - cheers!)

I left in a bit of a daze and a bit upset - but I've had a chance to think and really I'm where I've always been - there is more to be tested, more results to get and further action to be taken when we know what we've got.  

Onward







Monday, 9 May 2016

It goes so fast!

It's been nagging at me that my last update was a bit miserable - a state that didn't last that long and only occasionally visits for a moment or two.

In fact the whole thing has been so quick I've not really had much chance to dwell, for which I am very grateful.

The latest news is that last week I started back at work (working from home for the first couple of days) and on Wednesday 4th May I went back to the PRU for my update with the surgeon.

It was actually the lovely and very tall Dr Dave I saw (he had assisted - he wasn't sure if I'd remember him and I told him he'd been in his scrubs when we met and of course I remembered - he seemed strangely pleased).  It's all good - which is how he started the meeting - bless him - it's the kindest thing anyone can do in these circumstances - cut to the chase.

smile emoticon
No cells in the lump margins, nothing found in the two lymph nodes taken from my armpit so no need for further operations. Now it's just radiation (as a lump was taken rather than the whole breast they need to sterilise the area to knock out any pre-cancerous cells) and anti-hormone tablets to reduce the risk of anything coming back.
I insisted he look at the girls ... On reflection I'm not sure he'd intended that but hey, they enjoy the attention.  smile emoticonAll looks good, healing well, another six weeks for the bruising to go down ... I do like a target.  I remembered to ask if I could wear deodorant again (I can) and I pointed out the odd things I wanted reassurance about.  His main response was that my joie de vivre demonstrated that I wasn't suffering from sepsis and that I was obviously fine.  He had been telling me about the next stages and that there would be literature from the oncology team - I'd explained I already had a pile of literature from my experiences so far and that actually what we needed was Cliff Notes on how the whole thing works.  Which lead to a fabulous little explanation to his colleague exactly what Cliff Notes are and about his experience of buying some in Foyles before their refit.

I went back into the office on Thursday and had a lovely mixture of greetings and enquiries after my health, along with more minimal 'nice to see you back', which was exactly what I wanted - I wanted to get on with my work.

The weekend just gone was gloriously warm and reminded me that it's easy to do too much without thinking you are - I spent a lot of time sleeping!  I did get in a long walk on Sunday and I'm finally starting to think I might be able to resume my normal sleeping position (on the side that's been operated on).

My radiation 'fitting' meeting is this coming Wednesday and I'll be a little quicker to share what happens this time.




Thursday, 21 April 2016

Random musings

The nurse came on Wednesday and took the dressings off the two wound areas leaving just the strips in place that will be washed off on Monday, hopefully with the stitches with them.  I ticked all the boxes, had a fresh strip put on the one in my armpit and was left to get on with things.

About noon a friend arrived for lunch - bringing with her so many things that I now have a fridge stuffed full - which is such a gift!  It hadn't even occurred to me how useful that might be - if ever you find yourself with a friend going through any event like this, don't even ask, rock up with food for the fridge - if I'd been asked, I would have said I was fine, that I didn't need anything - but suddenly I don't have to food shop or even think about it!

'Take it easy' is so much harder than you'd think!  When sitting at work the idea of just being on the sofa reading sounds divine.  Not really being able to gauge how much energy you have or how easy it is to just overreach slightly and find that you're in pain or crying from being tired - very annoying!

Today (Thursday) I'll be in pj's until after lunch (which is in the oven as I type) then I'll, slowly, be washing all the bits of myself I'm allowed to, putting on some real clothes and then getting back on the sofa.  Later I'll take a slow walk to buy milk.  

Planning and achieving small victories is important.

The nurse who told me the pain killing drugs put in me during the operation can last for five days was right ... and I'm being more diligent about taking the regular pain killers I've been given - they're nothing special, but it's worth keeping a steady flow going.

This is the first time I've found myself feeling a bit sorry for myself - it won't last, I just don't work like that, but it is very interesting the  bits that you realise you don't have control over and that you have to ride through.


Tuesday, 19 April 2016

Timeline

What happened when:

(seemed useful to have this in one place and I'll update it as I get my appointments)

8th March   Mammogram (part of regular screening programme)
29th March Referral to Breast Clinic where ultrasound was done and a needle biopsy for further checks
7th April     Results of biopsy showing cancerous cells, appointment made for surgery that day
11th April   Pre Op assessment
14th April   insertion of wire and radioactive dye
15th April   Operation (home the same day)
17th April   Nurse visit
20th April   Nurse visit for removal of dressings 
25th April   Remove stitches (in shower)
 4th May     Appt with Surgeon
11th May    Appt with clinical oncology (to discuss next steps)
1st  June    Result of gene therapy test (no need for Chemo)
23rd June   CT Scan
7th July - 27th July (weekdays) Radiotherapy


Monday, 18 April 2016

Persistence

Sunday afternoon I had just come back from shuffling down to the post box with my sick note for work when the door bell rang.  I really wasn't expecting anyone so I was pleasantly surprised to see a nurse on the doorstep.

Seems she'd been trying to get hold of me all weekend - I have another top tip for you - don't change your home phone provider (and then discover the new phone line doesn't work) the day before you have an operation. A Virgin lad had been round on the Saturday and put a new switch in my slot ... I didn't ask further in case I made him blush, but no one had the new Virgin number - and my mobile number had had a 3 replaced by a 5 in the notes she had.  So on the off chance that I was in and because she was in the area, she rang the door bell.

Quick check of the dressings (which meant drawing on one as there had been a bit of an ooze, but nothing serious and she was just marking it to check it didn't get any worse) and a general discussion on how things were going.  Which included her taking a monitoring pad off my back - it seemed I'd been wearing that since Friday, she also pointed out I was still orange from the stuff they cover you with in surgery and had developed a bit of a rash from something rubbing.  Goodness knows what she thought, I must have looked very grubby and like I'd not really checked my bits at all!

I was also warned that the general anesthetic and pain killers they gave me during the operation will be in my system for five days so I should expect to be a bit up and down and that it was worth keeping up a reasonable routine of taking the tablets I'd been given.  I can get a bit stupidly stoic over things like that so it was very useful to have a nurse tell me to take the pills.

Next set of important dates, I'll get another nurse on Wednesday (phone call between 8 and 9 - all the phones now work and she has all the correct numbers!) at which point they'll take off the dressings (slightly nervous about the ouch factor in that!) then the following Monday I'll be allowed to properly shower and pull out my stitches (if I want) (they're the ones that dissolve so actually it should be quite straight forward and I'm not particularly squeamish) or I can make an appointment for the nurse at my surgery to take them out.

I got permission to shower below the waist as I have a hand-held device (that sounds wrong ... but I'm leaving it there for the comedy value!) and bless her cotton socks she washed my hair for me.


Hearing that she had just come from an 80 year old lady who had announced that she was feeling fine and was off out I felt a bit guilty about being in my pj's so I washed the bits I could reach, wiped the rest of me and put on some clothes to venture to Tesco's for wet wipes (and other tip/obvious thing I should have thought of!  You need loads of wet wipes when you're not allowed to shower or use deodorant!) 

Monday I walked to the Dr's to deliver my surgery note and ask them to process my prescription application - another of the 'benefits' of cancer is that I'll have five years worth of free prescriptions.  I then caught a bus into Croydon to buy a couple of larger bras - which I did, deciding that maternity ones looked the softest.

All of which meant I overdid things a bit and I got home cold and tired; silly Lucy.  I fed myself, took painkillers and then cranked up the heating and the number of covers I had for a sofa nap - woke up bright red but feeling much better :-)


Tuesday will be spent in the house!

Oh and hoovering counts as heavy labour so I can't do any of that for the moment ... I didn't like to confess I only hoover if someone is coming to visit so that isn't going to make a lot of difference :-)





Saturday, 16 April 2016

Home

Friday started early, I had to get my light breakfast done by 7.30am - and more importantly my last cup of tea!

By now I was getting quite casual about this 'need to be on time' lark and I got on my bus at just gone 11am (appointment was 12.30pm but I'd been told so many times that I was last on the list and that I should bring two books to keep myself entertained with that I wasn't sweating this one too much).

by 12.10 I was in the hospital and being taken down to the ward - where I retained my obnoxiously cheerful demeanor while one of the ward support staff took me through the questionnaire (you are asked your own date of birth so often that after a while you start to doubt yourself!), followed very quickly by the anesthetist (who apparently had been looking for me at 11.30am!  If I'd known that I would have been on that early bus!) and then one of the surgeons who would be assisting (this one was a lady, which was nice to see) - I confessed about my early history of a heart murmur (nothing to worry about but I wanted people to know in case something happened - mostly so they would know it wasn't their fault ... I'd not taken any drugs, honest!) and my worries about a period that had been due to start the day I was given my diagnosis but had since vanished - scared off I assume by more important concerns.  

Oh yes, which reminds me about the first real laugh - you have to take a specimen in so they can do a pregnancy test (all women between 12 and 55 if being operated on need testing - which is a sobering thought) - the support nurse looking after me came back from having done the test with a slightly solemn look;  'it's negative, I'll retest it in a moment but it seems to be negative'.   'Thank goodness!' I almost shrieked in her ear, ' it's SUPPOSED to be negative!'

Having talked to three different people and received my completed set of paperwork (including a note for work - very efficient!) I finally got to the joy of taking off all my clothes to put on the infamous hospital gown and a pair of paper knickers ... oh and then the addition of a fetching pair of knee high pressure stockings to stop my blood pooling in my feet ... there really is no way to maintain your dignity when they're about to put you out cold and open you up!  I think it was about this time the surgeon and his assistant arrived - I managed to stumble out some words about him doing his best work and how beloved the rack is ... he managed to remember that it's the smaller one he'd be working on and made a joke about me giving him grief for that - so I think he knew who I was ...

All of this had taken about an hour, possibly an hour and a half, so I perched on my chair, trying not to flash anyone and got my book out.  Two pages in another man came over to say 'I'm here to take you down', to which I (quite naturally in my mind) said 'can I take my book?' and looked shocked when he said 'no'.

He was there to take me to the theatre ... 'but I'm last on the list', 'yes, that's now' - poor thing must've thought I'd completely lost it!

I put on my specially purchased robe and new slippers and was walked down to the anesthetists room - where a total of six men sorted me out (one of them had changed profession from electrician to nurse - good chap!)  ... robe and slippers off, gown untied as I lay on my back, discrete slipping of one arm out of the gown so a monitoring cuff could be put on, then the other arm, then a mask over my face with oxygen.  All beautifully done, not rushed but not much chance to think about anything, very respectful - and then I was out like a light.


Coming round was odd - I sleep on my side so being propped up on my back wasn't good for me - I'm afraid I might've been one of those moaners ... not in the good way, but in the whimpering way - just couldn't get comfortable.

I was dozy for a while and I'm pretty certain in that time the surgeon came round to say they'd got it all and that there had been nothing in the lymph nodes in the armpit - but I'm guessing that will be confirmed at the follow up in two and a half weeks - plus I was still pretty out of it so I'm not entirely certain what was said.

There is very little that can be more welcome, delicious and just generally great than the first cup of tea and a plain digestive.  It's when you finally start to feel human again.

There's more paperwork (including a note for my GP to explain what's happened 'Routine, clear Axilln, No concerns' magic words) instructions about what to do when I get home, a packet of drugs and then it's time to phone the friend who's picking me up.  (Oh and I put my own clothes on again of course!)

Poor love, she was just pulling into the hospital when they rang - so of course it rang out and they thought she was MIA.  She was actually about to come through the doors onto the ward with immaculate timing.

So I'm home now, a another friend stayed the night on my sofa to make sure I didn't do anything silly and generally ran around making me tea and food - bless her.  I'm taking painkillers and starting on the stretching exercises while watching a bit of bad TV.

Throughout this entire experience (eight days from the delivery of diagnosis to the operation) I can only praise and thank the amazing staff of the NHS - every appointment was quick and efficient,  every nurse, every doctor, kind, generous with their time, patient with their patient. 

And all my friends both near and far who have rallied round with support and kind words - you are all much loved and I'm a very lucky person to have you all in my life.


There will be follow up appointments, radiation treatments and generally time to heal - and I'll keep a few notes going on these pages as a record of what happens - but I absolve you all from the need to read any more if you don't want to :-)