Week 3: Thursday 08 - Thursday 15 December 2016
So my appointment was at 10.30am. Apparently this seems to be a crap time to have an appointment as there are literally no parking spaces at St Johns. Mum circled a few times before we gave up and parked at the Howden Centre and walked through.
In arriving at OPD 4, I was sitting scuffing my feet like a small child. I kind of felt awkward having both mum and husband with me - talk about overkill. Most people only take one person at most. But I didn't want to have to choose between them.
Anyway, when the surgeon called me in, I walked forward and joked that I had brought a posse with me. He said that was perfectly ok... and at that point I knew I was going to be told something I might not like.
(Not that the surgeon was in any way an ogre... I just got a feeling!)
Anyhow, we sat down and the surgeon started off by recalling the various tests that I had had, and then went onto say that the biopsy had confirmed that the tumour was cancerous, but that there was a plan to treat it.
At this point, I was actually ok. I just went into practical mode, and my previous research actually paid off. I think my mum was also practical but trying to be stoical, but my husband looked quite frankly stunned and grey.
I asked what that meant in terms of treatment plan, timescales, what kind of cancer, and my mum asked how big the tumour was.
So, we got walked through the fact that it was a Grade 3 tumour, which means it is abnormal (I laughed at this point, as I can't even have normal cancer lol). However what that actually means is that tumours are graded 1 as normal cells and slow growing, grade 2 is moderate, and grade 3 is abnormal cells which are fast growing.
I got told not to get that mixed up with the cancer staging, and my cancer was caught very much as at an early stage. (So if anyone looking it up it is stage 0 or 1, I think.)
In terms of treatment, the first thing would be surgery to remove the tumour. Then chemo, and then radiotherapy. He pointed out at this point that I am young, strong, fit and healthy, and he would still like me to be around in 40 years... and they take a balance of what treatment levels they could give me to give better sustained quality of life. So in essence, because I am young, fit and healthy, the trade off is that they can give me aggressive treatment in the short term for longer term benefit. (The sub text also being that I am probably going to have a really shitty 6 months!!!)
When asking about surgery I asked if it would be a mastectomy, and he said no, it would be a lumpectomy and we would wait and see what results showed. The lumpectomy is about breast conserving surgery, and has the same success with radio therapy, as a full mastectomy when it comes to removing cancerous cells.
At which point I nodded as that is a good thing. I had already jumped ahead to needing a double mastectomy and breast reconstruction to perhaps getting a perky D-cup, with fat used from my stomach to create a barbie doll look without the need for diet or exercise! (Wishful thinking on my part I know lol.... but silver linings 😀)
Anyway the surgeon did point out that he was hoping to get everything out without need for invasive surgery, and that there may only be a small dent underneath my breast once he was finished. I did explain that my sister had already adopted the nickname of 'wonky tit' for me.... but in all seriousness I was not sure how I would cope with being lopsided. He did say that we can always address any cosmetic issues at a later date.
He then explained that the operation would consist of taking out the tumour and injecting blue radioactive dye into me. This was to allow the identification of the sentinel lymph node, which was also going to be removed for testing.
Basically the tests on both would be looking at if all the cancerous cells had been removed, and also if it had spread, or indeed if it had the risk of spreading. (In my head I picture the cancerous cells as sparring robots or Artificial Intelligence bots who can create their own wee worlds in which to live in.... but I do have quite a vivid and overactive imagination - you should see my other blogs!)
Anyway, my results would be available after 3 weeks due to xmas holidays, and at that point, he would be able to tell me more about the cancer itself, and if he had managed to remove everything, including a healthy margin. If not, I may require a further surgery.
He also explained that it was just a day procedure, and that the following day I may still be a little groggy, but the days after that I may just feel a little bruised under my armpit and I would be given exercises to do to make sure that it didn't stiffen up.
He also went on to explain that the initial biopsy taken the week previous was also able to identify that my cancer was both oestrogen receptor-negative, and progesterone receptor-negative. This basically means that I cannot be given drugs like Tamoxifen to control the cancer - the only thing that will work is to cut the cancer out and to then have chemo and radio therapy. Part of the testing on the tumour after surgery was to see if I was HER2 positive - something else which may be controlled by drugs but I have to wait and see on that score.
I actually took all of this in my stride - as I said - looking up all possible scenarios and preparing myself mentally had really helped. However, I did have one moment of real distress. That was when I asked about potential hair loss. And I was gently told there would be no 'if'. And it would be the chemo. And actually, between the first treatment and the second one three weeks later, I should expect to have lost all my hair.
I mean. I am not even a vain person. I don't actually care what I look like normally. However there is something about being bald and wearing scarves which really screams out that I have cancer. That's the bit that's unfair. 😢
The nurse did tell me about the use of the cool cap - which basically works by freezing the scalp to stop the chemo working on the hair roots... however I also appreciated her honesty when she said that it worked best on people with thick hair, who sometimes still lose clumps. I have thin, fine and delicate hair, so knew at that point that it was never really going to work for me.
I tried again to look on the positive side of this, and said that at least the treatment may help kickstart my new year diet. Unfortunately... that would appear not to be the case either. 😢.
Supposedly I will also be on steroids, which will make me put ON weight. "Jings, I can't even catch a break on that!", I exclaimed.
So... instead, I have to give up my gym membership as I can't go anywhere open plan for the germs (I will have no immune system going through chemo), and I can't go swimming as I may be radioactive, but I have to eat healthily and make sure I have regular programme of exercise.
No more thinking I will be a lady that lunches, can eat cream cakes galore and the chemo will help me shift 2 stone in weight then!!!
Anyway... pulling myself back into practical mode, I then asked what the timescales were for everything. So, it was going to be surgery first, then allowing for no further surgery requirements after that, I would start chemo after 6 weeks (1 day every 3 weeks for 6 cycles = 18 weeks in total), and then radiotherapy every week day for 4 weeks.
In asking about date for surgery, the surgeon flicked open his diary and asked... "what about 23rd December?"
At this point I started laughing. Honestly. The reason being is that particular week, my mum was going for a liver scan on the Monday, my dad was going for a colonoscopy on the Wednesday, and my niece was having dental surgery on the Friday! (My family really are not the healthiest at the moment, and clearly we have lost whatever rabbits foot or four leaf clover which had covered us in previous years!)
Anyway, of course I said that was fine, and he added me to the end of what seemed a very long list of names in his diary. He explained that as I was the youngest, fittest, healthiest patient he had, I would probably be taken last on the day surgery, but I still needed to check in to the hospital at 7.30am that day.
So that was more or less it on diagnosis day. I had a further chat with the breast nurse after leaving the surgeon's office - they also needed to take my pre-op bloods to make sure I was fit for the surgery.... thankfully although I despise needles (bit of an issue given what's to come!), I apparently have good veins and they got all the blood required.
Upon leaving hospital I was still ok, but mum and husband I think were in shock. We decided to go to Dobbies for coffee and cake as yet again I decided I was hungry lol.
Trying to compose a meaningful text to friends and loved ones who were awaiting my news was really difficult. How do you tell people you have cancer?
I am conscious that even at the best of times, texts are terrible things to read cold - you can't put true sense of feeling into them, you can't be there to read reactions, or to put people at ease, or to reassure them that you are fine...
Anyway... what I ended up with was the following: (with some tweaks for some people like my boss lol)
"Hiya... just out.
Got breast cancer but caught early.
Operation scheduled for 23rd December as day op. Chemo and radiotherapy afterwards.
All signs positive as I am young and fit (and bolshy lol)
I am ok... out with mum and dave for coffee and cake.
Seeing this as free holiday from work.
So hopefully all done and dusted within 6 months and in time to go to Madeira hopefully 😄.
But I am doing ok. Research in advance helped! Xx"
After we were done there, Mum suggested that Dave and I went into town for the afternoon and maybe had a drink - she would take the dogs to her house and bring them back later. I actually wasn't fussed as I am not a big drinker at the best of times, but she did point out that actually Dave may need to do this to help him through with dealing with stuff.
Anyway, so that's what we did.
We went in and bought me 3 new bottles of gin from the Edinburgh Gin shop, and then went to the Whisky Society for late lunch and to buy new whisky for husband. (That actually happens on a regular basis, so really my diagnosis was just a good excuse to get whisky lol.)
Of course over the course of the afternoon and evening, many people texted back and everyone was lovely, but shocked. My own husband also admitted that he had fully expected me to be given the all clear.
Once home, I spent most of the evening on the phone to various people and my mum also returned the dogs.
Actually, funny side story. My dogs who who are tiny Yorkshire terriers, can normally sit on my car front seat, belted in, curled up and sleep when I drive. When my mum had them, the wee one had decided to become like Houdini, squirm out of her car harness AND her jacket, and had managed to stand on the window button to roll the window down whilst mum thought they were safely harnessed in the back seat of her car. Poor mum thought she was having heart failure as she thought my dogs were making a bid for freedom! Thankfully she stopped and put them to rights, but I have honestly never heard my mum swear so much about my wee puppies who look like butter wouldn't melt in their mouths!
My neighbours popped over too - I think this was the start of me trying to assure people that I was ok, I had not suddenly turned into an alien and that I was dealing with everything in my own imitable fashion 😀😀😀 - and actually I am eternally grateful to them both for coming over - as actually it genuinely proved to me that I am ok with this.
I have cancer. It's not a death sentence.
Don't get me wrong... It's not going to be a walk in the park either, but I am determined to beat this with a positive attitude and great support networks.
I will end this blog here although this only covers one day - as the next part is better chunked together (I have OCD about making sure things flow well together! 😀😀😀)
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