Tag Archive | breast cancer

A Rare Laugh

I woke up totally out of sorts yesterday morning, jumped on the computer and ended up being on it for hours before I completed the normal things one does in the morning like shower and dress.

Since the operation I have been wearing the special post surgery recovery bra I bought from Masterton (in the Senior Moments to Cancer Brain chapter). I laundered it once in the bathroom sink and dried it overnight on the heated towel rail, but I was desperate to give it a proper wash. So yesterday was the day, but I only had the one of those bras, so I had to try one of my normal ones back on for the first time since the surgery.

For all my angst over my changed shape, and I can see a definite difference, I put this bra on and the swelling is still such that I more than filled the old bra and I guess, outside my clothes, no-one would have noticed the difference, for a while yet anyway. I didn’t know whether to laugh or cry, so I had a laugh. Crying can come later, for this part of the grief anyway. I had already shed more than a few tears in the earlier part of the morning when I was feeling out of sorts.

So, fortified with the notion of a near normal shape, I ventured out, with Peter to do the supermarket shopping and then later in the afternoon to the local New Rags Market, a Christmas showcase for local arts and craft, and I enjoyed spending a little bit of money on entirely frivolous things, although there was a bit of Christmas shopping slotted in there too.

This morning I actually managed a sleep-in – two hours later than normal, although the last couple of hours were punctuated by pings from Peter’s Ipad as he played on his new Sudoku App. I guess he must have solved quite a few of them judging by the number pings ūüôā

Post-Op visit to Surgeon

Given the seriousness of the disease, “Cancer” and the enormous emotional upheaval with which a woman is faced when the word ‘Cancer’ is prefaced by the word ‘Breast’ everything seems to be over and done with so quickly at this stage anyway, but my mind still reels from it all.

Yesterday was the appointed day to visit the surgeon in Lower Hutt again and have the results of the pathology on the tissue removed from my breast – there, I’ve had to admit it and lose the word ‘boob’ – and from the Node Biopsy. After Peter and I had had breakfast I fiddled with the packet of things I had received from the Cancer Society which has now become intermingled with the material I received in the Cancer Pack from Boulcott Clinic. There is one booklet in there which I have not been able to face. Its called ‘After Breast Cancer Surgery – Looking Ahead’. I’ve had several attempts at reading it and the only part of it I can read without tears welling up as I try to read, is the part on Radiotherapy.

It’s an Australian Cancer Society publication I can’t fathom why I can’t face this booklet but even as I prepared to go to the post-op appointment I still couldn’t read it without great big tears rolling down my face and dripping onto my clothes. I had thought that the feeling of relief I felt after the surgery might have translated into a bit more self assuredness and a lot less of the tears and tissues. But no. I had to give up on it again and just go do something else to while away the time before we left to go to Lower Hutt. I had thought that I wasn’t even too worried or anxious about the visit but the tears and tissues might have indicated otherwise.

When we arrived at the Boulcott Clinic we were ushered into to see Carl Dowle after a short wait. Straight down to business, he told us that the tissue removed from my breast had about 2mm of clear tissue all around it and that the node biopsy had shown no evidence of Cancer cells. Hooray for something. It should have been a great relief, but it wasn’t, because in that message he also told us that he had, unknowingly, removed three tumours!! The biggest one, the frozen pea that grew into a chick pea, the one I knew about, was 18mm in diameter. But there were two others, one of 11mm and one of 2mm. I can easily see how one would miss removing something only 2mm in size and I can understand that it would have been easy to miss seeing it on one of the numerous mammograms I had had prior to the surgery. But what absolutely amazes me and frightens me is the fact that the mammogram machine and the surgeon both managed to miss the fact that there was another malignant tumour 11mm wide growing in there, when there had been all that kerfuffle about the two areas of calcification which turned out to be benign.

So while all that is running round in my brain the surgeon has moved on to the statistical probabilities of my likely survival with a 6 week course of radiotherapy and whether that should be followed up by Hormone therapy, and if so, which one. The favourable results in the pathology report rule out any necessity to consider chemotherapy as a treatment. I had expected that to be the case once I heard the results of the report but the relief I thought I might feel never eventuated. Those other two tumours are really bugging me.

Apparently I shouldn’t be worried. It’s gone now. Is there another rogue frozen pea growing somewhere else in my breast?

Cancer brain, all the logical and illogical thoughts that race unbidden into one’s consciousness. But am I being illogical? I don’t know. I guess I’ll have to find out in the 5 years of checks which will follow my completed treatment.

For the statistical analysis he used something called Adjuvant Online, a website to help health professionals and patients with early cancer discuss the risks and benefits of getting additional therapy (adjuvant therapy: usually chemotherapy, hormone therapy, or both) after surgery. (I’m learning so many new words throughout all of this. Adjuvant wasn’t ever something my limited vocabulary had come across before.) He entered data into the site on the size of the tumour, but only the biggest one because it’s most unusual, unheard of, not recorded for anyone to have three tumours, the grade and it was a Grade 2 tumour, and various other statistics from the pathology report that elude me now. The website throws back at him that I have a 78% chance of still being here in 10 years time. But of that other 22%, 14% will die from something else, other than Cancer. 7% will have a recurrence of Breast Cancer. My chances of sticking around a bit longer are enhanced by a measly 2% if I undertake 5 years of hormone therapy to repress the production of oestrogen which fuels the growth of the cancer cells, even though the radiotherapy is supposed to kill off anything and everything around the site of your recently removed cancer/s to prevent just that very thing. Yet 7% of women have a recurrence.

He discussed the options of Tamoxifen versus Aromatase inhibitors – more new words. Both of them have some pretty nasty side effects. If I choose to have the hormone therapy and he seemed to be angling towards the aromatase inhibitor treatment, mostly on the basis that the side effects were not quite as severe, but one of the effects is to weaken your bones and become more susceptible to Osteoporosis. Oh my goodness, that’s also something which can be a side effect of Coeliac Disease. I have already had one bone density scan, about 1 year after my Coeliac diagnosis. While I was in the next room having the dressings removed from my wounds by Robyn, Carl was picking up the results of that bone density scan from 4 years ago on his computer. I am stunned that all my records seem to be so readily available. But that was fleeting compared to everything else going on.

I had thought that removing the dressings would reveal the true shape of the new me, but all it really revealed was more sticky tape beneath. The only sutures I have are soluble internal ones. The two wounds on my breast are all held together with steri-strips, one long one on each wound with several more at right angles along the length. The wound where the excision took place is about 10cm long and begins to show that my shape will never be the same without re-constructive surgery, and over the node biopsy the wound is about 8cm long. Not a pretty sight, even covered up with steri-strips. Everything is still swollen and there is a lot of bruising too, but most of the swelling appears to be where the biopsy took place, strangely enough.

So back to the Bone Density Scan. Four years ago it was pretty good for a person of my age, but I have an appointment for another one in two weeks time. A copy will also be sent to the radiologist to consider in planning my radiotherapy. When the appointment with the radiologist will be is a bit in the lap of the Gods as the Christmas Holiday period intervenes in the normal sequence that it should be conducted. Carl, or someone, will also consider it, I guess, when the decision is made about the hormone therapy.

So armed with more information and another load of inner turmoil, well, on my part anyway, we left Lower Hutt and off we went to Wellington where I was to have the second fitting for my Mother of the Bride dress. It looks as if it will be lovely. Zowie had a mock up of the dress for me to try on and for her to tweak where necessary. As I looked at myself in the mirror, all I could think of was whether or not anyone would notice that some of my top half was missing. Its fairly detailed with ruching on the bodice and is a princess line style, so probably will hide the worst, but then when she came to the tweaking it needed pulling in under the bust. She’s about to emphasise what is now my least desirable feature I was thinking. Despite the lovely colour and lovely fabric I feel diffident about wearing it before it’s even made.

The Wellington skies had leaky eye syndrome when I emerged from the fitting. Peter had been off at Animates buying more supplies for the feline inhabitants of our home. Fortunately there was a shop verandah to wait under, but I didn’t have long to wait.

From there we went to the Office Christmas lunch at a pub near the office in Karori, which, last time I had seen it was called The Quiet Lady. Now it’s the Pickle Jar. And was I in a pickle. For the first time I had to confront my workmates with bits missing. Of course, nobody was crass enough to comment. Maybe they didn’t even notice. But I felt as if I had gone to lunch with a bunch of strangers. I don’t feel I am the same person any more, physically or mentally.

Post Surgery

Strangely enough in some ways it was almost a relief to have the surgery done.

A Wide Local Excision – strange terminology that, the verb ‘to excise’ meaning to charge a toll or tax but the noun ‘excision’ seems to be exclusively applied to cutting out a carcinoma, Latin derivations, the Oxford dictionary tells me. I suppose the demon cancer had not only been excised from my boob but exorcised from my mind as well.

I returned home from the hospital the next day with a little package of painkillers to help me through the succeeding few days and several pages full of exercises from the physio to be working on so that my shoulder would regain normal function, after the Sentinel Node Biospy.

The relief was something I didn’t expect to feel, given the disfigurement I know is sure to follow. I came home with the hospital dressings on the wounds. They look absolutely ghastly, having been applied immediately after the surgery. Fortunately they are showerproof so I can shower normally but each time I undress, that mess under the dressings is all to evident, as is the different shape of the post surgery Sylvia.

Whether it was the effect of the anaesthetic wearing off, the painkillers or the massive sleep deprivation during the past few weeks, I have actually managed to sleep again without my brain running off on journeys I would rather not travel, despite the fact that there is an element of uncertainty this week as I await the result of the Node Biopsy. Despite Carl Dowle’s reassuring words after surgery that he thought everything had gone very well, there is still an element of doubt which haunts me.

My days at home have passed quietly but punctuated with calls and messages from friends and family – and the arrival of two bouquets of flowers, always a guaranteed pick-me-up. I have followed orders and taken the painkillers as required, not done anything too strenuous apart from the prescribed exercises.

On Sunday, I finally felt able, emotionally, to reveal the mess of dressings and the new shape that was beginning to become evident underneath, to Peter. Because the whole nipple area has had to be removed I know there will have been no nice place to hide a scar, although the dressings still hide whatever the extent of that might be. I have been more than slightly aware of it ever since I came home and have to come to terms with the inevitable, either a prosthesis or reconstruction at some point – both probably. So as I dressed on Sunday morning I showed Peter the post surgery Sylvia. I expected the man I married, who has an almost pathological dislike of hospitals, to have been more drawn by the bloody mess under the dressings, but being a man, the first (and only) thing that came out of his mouth was, “God, they’ve mutilated you”.

November 28th

The cloud from when I arrived at the hospital this morning has dissipated into wisps of high cloud. ¬†It’s breezy but, for Wellington, quite a glorious day, especially for the Hobbit premiere, and altogether far too good to be in hospital recuperating from an operation

Ive had to many surgeries over the past 10 years. The pre-op procedure is almost becoming routine. ¬†With that done I was wheeled off at 9am this morning. They told me they were inserting a needle with a ‘light’ sedative and that was the last thing I remember till I woke up in Recovery. The surgeon is confident he has clean tissue all around the chick pea so that is good news. As for the node biopsy that will have to be put through all the tests and I will find out next Thursday what the results are from that.

i haven’t shed a tear since Peter left this morning.

So here I am in my hospital room writing a blog. ¬†There’s a little pain but the policy here seems to be to keep me well dosed up with painkillers to keep me as comfortable as possible. I am a wuss so I am quite grateful for that.

It’s actually altogether far too hot to be in hospital. ¬†Must be a good sign that I can sit here and complain about the sunshine rather than pain or the disfigurement that I can’t really see yet. (I am still in one of those horribly fashionable hospital gowns.

The Hiatus

After the rigours of the past weeks I decided that last week would be my pampering week. I had a facial, a pedicure, my hair done and my nails done. Just for good measure I also had my eyes tested. Reading things on my screen has become more difficult over recent months. I need new specs!!

On Friday I realised that only had a few days left to compete my Christmas shopping. So after some advice from Frith and Keri I spent the weekend shopping in Masterton, looking for toys I had never heard of before. I really ought to watch more kids TV or play computer games to be an up to date Grandma. I finished off with a trip to the Westfield Mall in Lower Hutt on Monday. So I have the grandchildren mostly sorted but as for the rest…………

My trip to Lower Hutt was punctuated by calls from the Breast cancer Nurse and Boulcott Hospital, the upshot of which was that my arrival time has been out back to 7.45. Even so it still means leaving home at 6.30am.

Yesterday I had appointments with the massage therapist and chiropractor and also to go back to the Cancer Society office to pick up their breast care pack. It was filled with yet more reading matter but also practical things to get me through the next few weeks and a small teddy bear hugging a pink heart with the pink ribbon symbol embroidered on it.

This time I managed the visit to the Cancer society without the demon that had accompanied me the week before, although the tears were ever at the ready.

Back home again my late afternoon was filled with calls and emails from friends and family wishing me well for the operation and treatment to come.

My good friend Cynthia had wisely suggested dinner out that evening. That seemed like a good idea and the last bit of pampering before the operation, to say nothing of the fact that it was also the last meal of any sort before the operation. So we made a trip to The Tin Hut at Tauherenikau for a very nice ‘last supper’.

Even though I refrained from alcohol, when we returned home I Felt I was running on adrenalin again and not at all ready for bed. Fortunately Simon called and whiled away another half hour with me on the phone. Shortly afterwards I went to bed and went to sleep sitting up with my book unread. However I was well awake nearly an hour before the alarm was due to make its early morning summons.

The frozen pea feels more like a chick pea now.

From Senior Moments to Cancer Brain

As young mothers, when the constant company of babies and toddlers and the endless chores associated with bringing up a young family, and when things start to go slightly awry, it’s often attributed to ‘Baby Brain’.

At my age when I start forgetting people’s names or where I put things, Baby Brain becomes a “Senior Moment’. ¬†Now that I have that dreaded diagnosis of Cancer, I think my senior moments are metamorphosing in to periods of Cancer Brain. ¬†I know I’m doing things that are just not me, but I feel almost powerless to change the particular chain of events I’m caught up in at a given time. And I know I would have behaved completely differently had I been faced with similar situations prior to diagnosis.

One of the comments made during my early morning Facebook chat with my friend in USA about her sister bursting into tears at her inability to do up a bra strap made me think twice. I know that at present, and before my diagnosis I can be irritable about not being able to find the right hook behind my back even without the extra bother of an incision and stitches in a wound under my arm to contend with.  Forewarned is forearmed, I thought, so I set off to Masterton to purchase a front closing bra without underwiring, to tide me over the recovery period after surgery.

I thought I could be strong, walk into the Lingerie shop, and tell the shop assistant I had been recently diagnosed with Breast Cancer and did they have a bra suitable for recovery after surgery. ¬†I might add that this particular store is on the Cancer Society list of recommended stockists of specialist lingerie for women with breast cancer. ¬†Well I walked into the lingerie shop, but then the strength I thought I had mustered together completely deserted me and I was in tears before I had even uttered my first sentence. Cheryl, the shop assistant was absolutely lovely. ¬†I’m sure she probably has a few idiots like me walking through her door on a moderately regular basis, and tissues were quickly produced along with hugs. ¬†Then she told me she completely understood as she has been in my shoes just last year. ¬†She had had¬†breast¬†cancer, radiotherapy and even chemotherapy as she had another medical condition which complicated the choice of drugs for her treatment. And there she was looking lovely and able to relate her tale with complete equanimity a year or so later. ¬†We chatted some more and she persuaded me that I should make contact with the people at the local Cancer Society, particularly the nurse. ¬†So with my purchase made I went back to my car and tried to follow her directions to the Cancer Society.

I eventually found the Cancer Society premises at the end of a short lane of purpose built office units occupied by various businesses. ¬†The Cancer Society Offices occupied an L shaped formation right at the far end from the street entrance. I parked the car and walked towards an office labelled ‘Information and Support’ or something similar. ¬†The other one was labelled ‘Office’, and with the two separate labels I thought perhaps one shouldn’t be bothering the office people and that the Information and support one was¬†definitely¬†where I should be going. But the door was closed, as in locked with no one visible behind the glass¬†fa√ßade. If my normal presence of mind had been with me I would have just gone and knocked on the door of the Office. ¬†But I didn’t. ¬†The tears welled up and flowed again. ¬†I couldn’t even move myself to go back to the car. ¬†I just stood in front of the door reading and re-reading an out of date poster with all of their programmes for 2012 listed on it. ¬†The slightly logical part of my mind thought that at mid November perhaps a 2013 list of events should have been promulgated by now. ¬†But all I could do was walk up and down past that closed door. ¬†I don’t know now, whether it was fear, shame, shyness, all of the above or more factors that I can’t even recall now, just a few days later, but I was rooted to the spot, well almost, and felt powerless to go anywhere else, even back to my car and down the driveway again. ¬† ¬†What was I thinking? ¬†I don’t know. ¬†Was I even thinking? ¬†Cancer brain, I can’t remember anything but being unable to move away from that door. ¬†Eventually someone from the office saw me and opened the ‘Office” door and invited me in. ¬†Even then I was still rooted to the spot.

I don’t know what eventually made me move but I did. ¬†The lady gave me a glass of water while I explained why I was there. ¬†She was savvy enough to realise that I already had information overload and just gave a bare minimum one slip of paper an the card of the nurse I had supposed would have been behind that closed door. ¬†And after I had, again, regained a modicum of equilibrium again I drove home.

I look back now, only days later, and can’t imagine myself being so stupid and acting so illogically and I can only put it down to the inner turmoil that I attribute to Cancer Brain.

Diagnosis part 2

On November 8th, it was another trip to Lower Hutt.  This time Peter came with me so that we could both hear the results of those awful biopsies from the week before. Talk about good news and bad news, well there was bad, good news and bad news.  The bad news was that the frozen pea was definitely cancerous, Invasive Ductal Cancer of the Breast, apparently the most common and the easiest to treat, if caught early, as are they all.  The good news was that the area of calcification they had taken biopsies from had all turned out to be non-cancerous.  However, that in itself, while a relief, was immediately tarnished by the fact that having established that, they wanted, now, to make sure that the other area of calcification was also not cancerous, or otherwise.

With the official notification that I had cancer, Robyn, Carl’s Specialist Breast Nurse, who sits in on all the consultations, handed me a ‘Cancer pack’. ¬†On top of Carl’s detailed explanations of diagnosis, prognosis and treatment there was a whole heap of paper to read as well, just to make sure that we were fully informed, in¬†case¬†one or other of us had glazed over during all the verbal explanations. One part that I didn’t glaze over for was the fact that now there was a non-cancerous part to the equation with one part still unknown the treatment could change from a straight out Mastectomy to a chance that there could be a Lumpectomy, or in their terms a Wide Local Excision, accompanied by a Sentinel Node Biopsy and followed up next year by 6 weeks of radio-therapy. ¬†And the bad news on that possibility was that,¬†because¬†the frozen pea was right on the edge of my aureola, I would have to lose the nipple.

To me that is almost as bad as losing the whole breast. ¬†That’s still quite a disfigurement that will be with me for the rest of whatever life I have left after all this. ¬†When Carl talked about the Mastectomy he talked in terms of an immediate re-construction being available if I wanted it,¬†because¬†of the unlikelihood of the cancer having spread into the lymph nodes. ¬†But with the lumpectomy and losing the nipple with it there is no talk of reconstruction, even though the disfigurement is almost as great I would have thought. ¬†In fact, I do think. ¬†OK, there will still be something to put in a bra, but it will be smaller and misshapen. ¬†In the cancer pack I read, somewhere, that the NZ government provides subsidies for prostheses in cases such as I imagine mine would be. That’s not what I want to define the rest of my life either.

Something I shall have to enquire more about on the next visit.

But meanwhile, back to November 8th. An appointment was made for me to go down to Lower Hutt again, the next day (9th) to have the extra biopsy on the ‘hard to find’ area of calcification. ¬†And, oh dear, was it hard to find. ¬†That day, I think I must have had the most photographed boob in the country. ¬†It was one of those nasty ones where I had to firstly stand up for a lengthy series of mammograms till they found a picture they thought they could work with. ¬†I think there must have been nearly 15 mammograms trying to get that far. ¬†Having obtained the right sort of picture, I was then put on the gurney again, on my side, with boob clamped into the mammogram machine while what seemed like another 15 mammograms were taken while they positioned me exactly, so that the Dr could reach the area of concern with all his needles to take the required samples. ¬†I ended up with my hips downward on the gurney, my arms over my head, and my whole top half almost completely off the gurney with my head between my arms, all but eating the mammogram plates and with one of the radiologists having to support my top half so that I didn’t fall off. ¬†And though all this I had to remain so still, so that they could do their positioning and eventually stick all the needles in.

I might add that all of this was taking place on a boob that was already showing a bright rainbow of colouring from the bruising of the previous week. ¬†plus there were two incision marks healing. ¬†(The biopsy needles were wide enough that they had to make small incisions to get them into my boob.) ¬†The incision from this biopsy was under my armpit and in the ensuing days both it and the new lot of bruising made for quite an uncomfortable time. The bra-less 60s beckoned, but I didn’t back then and nor did I that week.

I had had the foresight to bring a little lunch with me this time and ate in the car park before driving home over the hill again.

So then began another nightmare week of waiting, waiting, waiting, sleep deprivation and so on. ¬†On one of my periods of sleeplessness, in fact, it was November 15th, the day I was due to go back to Lower Hutt for the results of that horrible biopsy, I heard my Ipad ping with a Facebook notification. Not being otherwise occupied, I answered the message back and surprised one of my lovely friends in the USA who thought that all good people in NZ should have been asleep at that hour, 4am. ¬†But I had already been awake since 2.15 so I had no compunctions about picking up the Ipad and writing back, and so began a ‘chat’ that lasted over an hour. ¬†I was so grateful for the company, and the sympathy at that desperate hour of the day, and all this while she was supposed to be working. ¬†You have to love friends who love you like that. ¬†And for her it was a bit of double whammy¬†because¬†her sister in Christchurch had had a Lumpectomy (and the Sentinel Node Biopsy) for an Aggressive Lobular Cancer only a week before. ¬†In a way, I almost felt guilty, unburdening myself on her as I knew full well what her sister’s situation was, but I had no sister but her to ‘listen’.

So the day of my next appointment (November 15th) had dawned, rather early for me, and again we piled into the car and drove over the hill for the news that the second (‘hard to find’) area was benign. ¬†I almost felt that it should have been cancerous or at least pre-cancerous, just because of the ordeal I had been though to get any sort of result at all. ¬†But that result certainly simplified the treatment options. ¬†Although I could still have the Mastectomy if I wanted to, the lumpectomy followed by the radio-therapy sounded like the least invasive option, surgically anyway. ¬†So I have been booked into Boulcott Hospital in Lower Hutt for the surgery on November 28th. ¬†I have to be there at 7am and nil by mouth since midnight on 27th. ¬†That means I shall have to leave home, at the latest, by 5.45am. Ye gods and little fishes. ¬†Another time when good New Zealanders should still be in their beds.