Scan fear...

The pessimist complains about the wind; the optimist expects it to change; the realist adjusts the sails.

William Arthur Ward

 

 

 

I have in the last couple of weeks outlined my 2 year journey with breast cancer. Obviously I have been fairly concise,(believe me there was a lot more I could have said) but I'm confident that readers have got the picture. It's not as straight forward and "curable" as recent media hype would have us believe. It's complex and dangerous and yes it kills. For these reasons women should be acutely aware of what they may be facing should they end up with this horrible illness. With this awareness they can "adjust the sails".

 

 

 To come completely up to date this post will look at what's been happening in the last few months.

After my recovery from surgery I went back for another scan in March. Part of me ( a very small part of me) was wondering if there was any chance that these nodules could be benign. There had been no biopsy done and they had remained the same size during chemo whilst the breast tumour had grown! I know that many people close to me were wondering( and hoping for) the same thing. There is nothing whatsoever wrong with hope but preparation for reality not being what you wanted is equally important. I was fully prepared for such reality. I found out in April that my lung tumours had grown and that there were new ones. So it was time to talk more chemo. It was decided that I should go onto weekly doses of a chemo called paclitaxel. It was thought best to go for weekly doses as the doctor didn't think that my body would cope with larger doses every 3 weeks. So far so good. I have been very active and have felt really good in the last couple of months. My white blood count has not always recovered and I have missed a few but on the whole, if this is chemo then I can live with it. I am a bit bored with the head scarves but again I can deal with it.

I am almost half way through the 18 week regime and am now awaiting the mid way scan results. I had my scan 12 days ago and am most likely getting the results tomorrow. The best outcome will be shrinkage and the worst will be growth and spread. I would love to say that I am living the words of F Scott Fitzgerald and Buddha but it would be a lie. I am a wreck. For people who go through these scans it is probably the worst time of their lives. The rational side of the brain copes, the other bit is a minefield. In the last few days I have self diagnosed multiple tumours in all parts of my body and I have the pains to back it up. The mind is a powerful thing. I found out today that a woman I have become friends with at the chemo clinic and who has the same type of cancer as me, had a very positive scan result. Great news. It should give me strength and hope. In my rational mind it does. Janette is receiving the same drug as me for the same type of cancer and it is working. It may well be working for me. But today I am in not in possession of rational thought. Today I am crazy and lacking in intelligence. Today my head tells me that Janette got all the good news, there's only bad news left for me. This is the power of the mind and this is the reality of living with cancer. My next step on this journey is to find ways of coping with these days. They will be here again. I am starting a meditation class on Wednesday and I am intending to explore other avenues which could preserve my sanity (and energy) in the future. These are the things that are not explained to you when you are diagnosed. These are the things that we need the most help with. I will be sharing my findings and I am hopeful that there are measures that I can take which will help me and then, through this blog help others.

SO, just in case Janette didn't really get ALL the good news, keep your fingers crossed for me.

Living with cancer

The secret of health for both mind and body is not to mourn for the past, worry about the future, or anticipate troubles but to live in the present moment wisely and earnestly.
       - Buddha



Coming to terms with having incurable cancer was pretty hard. I doubt that will come as a surprise. I was put forward for a clinical trial. As I have triple negative breast cancer, this means that drugs such as Herceptin and Tamoxifen don't work. Researchers are now looking more closely at triple negative cancer. As it affects roughly only 15% of breast cancer sufferers it has not been as well researched as others, which is understandable. For women who may be diagnosed with this rarer form of breast cancer I would recommend finding out as much as you can about it and using your knowledge to take more control of your illness. I pray that I can survive long enough for them to come up with a wonder drug for my type of cancer. In the meantime I will continue to take chemo. Anyway, I was put onto Carboplatin, a chemo commonly used to treat primary lung cancer but recently discovered to work effectively on secondary or metastatic triple negative lung cancer. I was willing to try anything. The other bonus was that this chemo didn't result in hair loss. The side effects generally seemed a lot less brutal than my first chemo. I was fairly open minded. Despite having a significant tumour in my breast the main priority was dealing with the lung lesions. I started my second chemo in late October. As I had been told, it was indeed less debilitating. I had side effects but they were tolerable. The only problem was that my white blood cell count and my platelets were slow to recover and my 3 weekly cycles were regularly delayed. This of course caused stress. After 3 treatments I was due a scan to see how effective the treatments were. I went for my scan on Christmas eve. I then waited and worried until Jan 3rd for the results. I tried to take on board my specialist nurses advice, which was to live one day at a time. When she first said this back in October I remember thinking that I had no idea of how to do that. I am now better at it and believe it or not it is actually a very liberating feeling and definitely something that we could all benefit from. However, I would be lying to say that I don't worry prior to scan results. On the day of the results I was tired from lack of sleep and my mind took me to all sorts of dark places. I was being seen at 2 pm and it made for a very long day. Waiting to be called was painful and following the doctor into the consultation room felt like a very long walk. As always I was trying to discern the news from her body language. She didn't beat about the bush and basically told me that the news was not the best. I felt sick. In the space of 5 seconds I had myself dead and buried. I'm sure I will go through such emotions again. The news was not as bad as I had mentally prepared for. Unusually, the scan had shown that my lung lesions had not changed (this is considered good, shrinkage even better) however, the tumour in my breast had grown. While this was not a common finding, it was not unheard of. Strange as it may sound I was pretty happy with this news. The doctor advised that we put the chemo on hold and go for surgery to remove my breast. She booked me in to see my original surgeon the following week. I was very keen to have my breast removed. I saw the surgeon and she agreed that this was the best course of action. She was also keen to remove all of my axillary lymph nodes. To explain this, basically breast cancer cells can break off and spread to the lymph nodes in the armpit. This of course increases the chances of the cancer finding its way to other parts of the body. When undergoing breast surgery  a sample of lymph nodes will be taken (there are approx. 20 - 30) and examined for disease. As far as I know should there be disease detected then the entire axilla is removed. My sample had come back clear during my initial lumpectomy and therefore this hadn't been necessary. When the doctor recommended removing the lot this time around as I said, I was less accepting of everything in the medical world and challenged this. I asked her to give me information on what complications this could bring. She told me that there was a one in five chance of developing lymphedema. Here is a medical definition of lymphedema;
Lymphedema  involves blockage of the lymph vessels, with a resulting accumulation of lymphatic fluid in the interstitial tissues of the body. The lymphatic system consists of lymph vessels and lymph nodes throughout the body. The lymph vessels collect lymphatic fluid, which consists of protein, water, fats, and wastes from cells. The lymph vessels transport the fluid to the lymph nodes, where waste materials and foreign materials are filtered out from the fluid. The fluid is then returned to the blood. When the vessels are damaged or missing, the lymph fluid cannot move freely throughout the system but accumulates. This accumulation of fluid results in abnormal swelling of the arm(s) or leg(s), and occasionally swelling in other parts of the body.

Lymphedema is a very serious condition. There is no cure for lymphedema and once it develops, it can be a long-term, uncomfortable, and sometimes painful condition requiring daily treatment. When lymphedema is not treated, the protein-rich fluid continues to accumulate, leading to even more swelling and hardening (referred to as fibrosis) of the tissues. This fluid is a good culture medium for bacteria, thus resulting in reoccurring infections when there are injuries to the skin, decrease or loss of functioning of the affected limbs, and skin breakdown. Infections, referred to lymphangitis, can affect the connective tissue under the skin. Repeated infections may result in scarring, which in turn makes the tissue susceptible to more swelling and infection. Over time, these infections result in tissue hardening (i.e., fibrosis), which is a characteristic of advanced chronic lymphedema. In very severe cases, untreated lymphedema may even result in a rare form of lymphatic cancer called lymphangiosarcoma.

 

Hmm I wasn't too keen on this!

Given the stage in my journey I sought a second and third opinion. I had not been particularly lucky with the news so far and was determined to be more in control this time around. What if there was no disease in my lymph nodes and I ended up with lymphedema. Two other doctors agreed with me that during surgery only sample nodes should be taken. Should these show disease then further surgery could be done and so I was decided. I underwent a mastectomy in January and again the surgery was straightforward. I was discharged the following morning and recovered well. 10 days later I returned to hospital to have a check up and get the results of the lymph node biopsy. I was again worried. For the first time in19 months I was actually given good news. There was no disease in the lymph nodes which had been removed. Well how about that. Taking a bit of control over my illness had paid off, it was one less potential health problem to deal with. Ask questions, make decisions, it's YOUR body.

Rolling with the punches

The test of a first-rate intelligence is the ability to hold two opposed ideas in mind at the same time and still retain the ability to function. One should, for example, be able to see that things are hopeless and yet be determined to make them otherwise.
F. Scott Fitzgerald



No one had to speak, the news was delivered through silence. In fact it was me who spoke first. For some reason I was stunned. While I had been worried and fearful of the worst I was still utterly taken aback by the fact that I was about to face all of this shit again. How could this be? The nurse tried to comfort this inconsolable hysterical woman and  I remember saying through my tears that I couldn't go through another chemo. I was only just psychologically coming out of the last one. I remember swearing a lot and incoherently shouting about being let down and shit care etc etc etc. It's a bit of a blur. My lasting memory is of ruining a really nice scarf with tears and snotters. It lay in my car for months and every time I saw it I thought of that day. I've only recently felt able to clean it up and wear it again The doctor told me in a sombre manner that it would be necessary to remove my breast and I remember not quite understanding why she thought that this news may upset me. This was NOT my primary concern. My big fear was that a grade 3 tumour had been left unattended for up to 6 months. Why was I seemingly the only one in the room who saw this as a concern, a huge fucking concern. When I voiced my fears the nurse said that this was not necessarily the case I was healthy, felt fine etc. Now I realise that she was only doing her job and trying to allay fears but come on. Despite the potential threat of spread not being fully addressed, I was told that standard procedure was for a full body, bone and brain scan to be carried out. In the meantime I would be seen by a plastic surgeon and a mastectomy would be done followed by reconstruction. If this was all that I had to face then I would be happy. It's funny how your perspective changes.

Russell and I absorbed the news over the next few days and probably adapted to it with relative ease, all things considered. At this point we decided to get married. A wee bit of a theme was emerging here. Cancer diagnosis; house move, cancer diagnosis two; a wedding. Yes we appeared to like layering stressful situation upon stressful situation. Its how we roll apparently. As it turned out organising the wedding was pretty easy. Going through scans and awaiting the results was less so. I busied myself in getting a wedding together in 3 weeks. It turned out that having cancer was quite useful in persuading the lovely man at the registry office to slot me in for the 29th of September in Hamilton registry office. Job done. Just a few outfits to organise and a hotel to book for a very quiet reception. Meanwhile I had a lot of appointments to attend. On the day of my brain scan, Tracey spent the day with me and we went for lunch in between procedures. We talked honestly for the first time about the prospect of me being given unwanted news and how we would cope if this news was delivered prior to the day of the wedding. We both agreed that we would cope and enjoy the day regardless, but it was a sad wee moment. We quickly changed topics and moved on to what we do best, looking at dresses on Tracey's iphone.
I attended the Royal to see a plastic surgeon and he outlined potential options for reconstruction. Now, call me shallow but my mood improved dramatically when I realised that the outcome was going to mean that I would have a new breast built from my tummy fat. I feel compelled to mention that there wasn't enough fat in my tummy to build a breast the same size as my other (vanity is a defect that I am working on) and so it was agreed that I would have the other one reduced. This was sounding good, new boobs and a flat stomach. This I could cope with. With the bad can come the good. I used this to get me through the next couple of weeks. I was due to have surgery on the 10th of October and was finishing work on the 28th September, the day before we were getting married. And so life went on.
On the 20th of September I was in my classroom working when my mobile phone rang. I recognised the number, it was the hospital. I answered filled with dread and fear. It was indeed my doctor. She introduced herself on first name terms, I was good at spotting the calm before the storm and instantly recognised bad news ahead. After the initial pleasantries she asked me if I could speak privately. She told me that the chest scan had shown a "nodule" on my left lung. Again I was surprised by my reaction. It felt like my very first diagnosis when I was able to take the news without falling apart. I calmly asked her what this meant. She told me that it could be nothing but that given my situation they would have to investigate further. I concurred!(that one's for you Louise/Alan Mairs) I was booked in for a PET scan the following week. This scan is the latest technology which is able to detect metabolic activity at the suspicious site. Cancer cells are fast moving (of course they are, little bastards) and this can alert doctors to potential tumours as opposed to the more innocuous "nodules". This scan is not too pleasant but really it's the results which are the killer(pardon the pun).

I had the scan and of course feared the worst but I was getting married and so tried to keep bad thoughts at bay. I (and many others) was also mindful of many years of chest infections and one bout of pneumonia and was quietly praying that this was nothing more than scar tissue from this. I have realised on this journey that as human beings we are very resourceful when it comes to finding hope in seemingly hopeless situations. It has been a nice realisation. The wedding was great and I managed to forget all about the results which were due the following week, alcohol does that. Sadly that would become another issue but that's a whole other blog which some day I may write. Post wedding fear soon set in and suddenly it was time to go back to the hospital. When we arrived I remember looking at the over crowded waiting room and thinking that if I was called quickly then it wasn't good. Sure enough after a few minutes my name was called. Another wait which seemed to go on forever ensued in the room of doom. When the door opened, yet again the doctor had brought along the nurse and yes there was more silence and general awkwardness. I suppose I must have prepared myself more than I realised because again I spoke first and said it for them, it was cancer in my lung wasn't it. Yip, they didn't put me right. More apologies and platitudes which I didn't really hear. I was told that without a biopsy they could only make an informed decision on calling it cancer, there were actually 2 nodules and the medical team had agreed that they would be treated as cancerous tumours. It was decided not to biopsy as this would be too invasive. I agreed. I was scheduled to see an oncologist that morning and told that surgery would be cancelled and immediate chemo put in place instead. No flat tummy after all. The oncologist talked us through the options and I was told that I could be put forward to take part in a clinical trial which was aiming to determine whether or not a particular chemotherapy was effective on my type of cancer, non hormone sensitive or triple negative as its known. This whole mysterious, unusual form of breast cancer was now going to become more readily talked about and I was about to learn a whole lot more about it. I saw my original oncologist the following day and she put me forward for this trial. Russell asked her if this was curable and when she asked me if I wanted the answer to this question, I think we all know what it was. I wasn't quite as composed at this point and there would be many tears before the day was out. The dreaded chemo was now well and truly going to be part of my life. My cancer from here on in would be "managed" through the use of the thing that I hated most. This time around I would not be so accepting of it.

know your body

'Tis a lesson you should heed.  If at first you don't succeed, Try, try again.

1840 T. H. Palmer Teacher's Manual 223
Once I was admitted to hospital I was put on intravenous antibiotics and started to feel a bit better. We were due to move house that week and I was a bit stressed by that. Poor Russell had  a lot of running around to do and it wasn't helped by the fact that my signatures weren't matching up to computerised ones. Thank god for the lovely man at the RBS for trusting. When I was visited by a doctor she asked me to talk her through the last couple of months. She wasn't impressed by my tale and said that my chemo regime should have been changed long ago and my side effects were intolerable and unacceptable. Hmm my thoughts exactly. She asked my permission to write to the oncology staff stating this. I didn't argue.

I recovered and was dismissed in time to move into the new house. The bonus was that many friends had come round and spent their Saturday painting the whole house from vile magnolia to white. Thank you all of you. When I went back to the clinic I was asked if I wanted to stop chemo at this stage as it was doing so much damage. Anyone who has been through this type of situation will know how hard that was. The thought of another dose was hellish but at the same time I wanted to protect myself in the future. I decided to have another round at a reduced dosage (at last some tailoring of the drugs) and see how it went. I remember thinking that I couldn't live with myself if it came back and I had chosen to cut it short. This time around it was less awful, that's about the best I can say about it. I did get through it though without major health issues but it was still hard. At my next appointment it was decided that we would call it quits. I was delighted as it was nearly Christmas. Within a very short time I was feeling good and my hair was coming back. We had a nice festive season.

I was due to start my radiotherapy early January and I was dreading what that would bring. This regime means that you go daily for a session for a month. To be fair it was straightforward. During this time I started to have other problems. What I didn't know about chemo was that the effects linger on. Its not a really a big surprise I suppose. I had developed painful joints and other ailments. I was told that these were just the chemo hangover. I had also gone into early menopause and the hot flushes at night were causing massive problems with sleep. Again, just another nice wee reminder of the chemo. I ended up agreeing to take part in a piece of research into post chemo menopausal symptoms and the effects this had on sleep. I kept a sleep diary as part of this and only then realised that I was averaging about 3 hours sleep a night.

On February 10th 2012 I had my last radiotherapy session. It was over. I asked one of the radiographers what happened next and she told me that I would be sent a letter for an appointment with a consultant in about 6 weeks. That letter never came. Here is yet another example NOT to follow. I got energy back and tried to get back into a normal life. I was actually pretty down and I think its probably not uncommon to feel this way after such an experience, but at the time I couldn't understand why I didn't feel happier. By March I was noticing changes in my breast. It felt strange and the area around the scar from the lumpectomy felt hard. I wasn't overly worried as I rationalised that after all of the shit I had been through there couldn't possibly be any cancer. The changes continued though and when I went to the clinic as part of the research I was taking part in I asked to see my breast care specialist nurse. She wasn't available and I asked for a message to be passed on about my concerns. I never did get the chance to see her. I was confident that my follow up letter would arrive and that I could discuss the issue with a doctor soon.

Time slipped away and before I knew it, it was Easter holiday and then it was May. I still had no appointment through. By the May I was having pain in my breast and there was what I could only describe as a lump where the scar was. Russell told me to see my GP but my argument was that I was now in the care of the Beatson and my GP wouldn't really be able to do anything. Like most people I had always believed that breast cancer was not painful and that if you had a painful lump then it was more likely to be a cyst or some other benign problem. I didn't bury my head in the sand but I also didn't do as much as I would recommend anyone else to do about this. I did make many phone calls to my breast care nurse to find out about my follow up appointment and get general advice but these were unsuccessful. Getting through to the right people isn't easy and if I could go back in time I would turn up at the hospital and demand to be seen, please don't make my mistake if you are ever in such a position. Listen to your body and MAKE the care staff listen to you. More time passed and before I knew it I was back at work. The pain etc was still ongoing but I was less free to pursue the issue. By June I was no further forward and very frustrated. I decided that I would just wait and see my original consultant after my annual routine mammogram which was due in late June. I went for this and was going back for the results in the July. We went on holiday and my breast was becoming more painful and looked pretty mental by this point. I was back to the clinic to where it all began a year earlier, at the end of July. My original consultant came in to the room and announced the good news that the mammogram was clear. Great. I was less confident. I told her about the problems I had been having and she asked what they had said at my follow up. What follow up? This wasn't discussed any further. Deja vu? When she examined me she agreed that my breast looked pretty awful and suggested plastic surgery. She also said that we should have an ultrasound just to be on the safe side. This was scheduled for the following week. I was beginning to worry. The ultrasound again showed nothing suspicious and I was told that there was a lot of bad scar tissue but no sign of cancer. As a final precaution I was given a biopsy and would get the results the following week. I was told not to worry too much as I left.

The following week I went back for the biopsy results, I had taken the advice and not worried too much. So much so that I went alone as didn't see the point in Russell coming home from Ardroy. As I waited I was thinking about my Higher class and a couple of things I wanted to say to them later that morning. It was only when I was called in to the consultation room and left on my own for a few minutes that I asked myself "I wonder if I should be worried"? In no time my question was answered. The doctor appeared and yes the angel of doom just over her shoulder. The journey was about to take another twist.

Chemo days continued...

The 3 weeks between my first and second chemo were long and a bit crap. I felt pretty rubbish but I would say that the biggest issue was the non stop headache. The pain was kind of on a par with a migraine and I found it difficult to do much. The other side effects weren't too great either. I did have a respite period for a few days before it was time to do it all again. The system works in such a way that your breast cancer specialist nurse sees you every 3 weeks prior to the next chemo to assess how you're coping with it. I was hopeful that when I saw her and told her about the problems and in particular the headaches that this would be looked at and maybe something done about it. Wrong.

I said in my first post that I wanted to share with others my experiences so that they could learn from them should they ever need to use such an education. Hopefully this will be the case. Despite my awful headaches and numerous other symptoms I was back at the clinic on the Thursday for round 2.
The drill was much the same, and after treatment was given I went home. This time my headaches were even worse. My nurse had explained that she felt that these were being caused by the anti sickness drug which was given intravenously and then in tablet form to be taken for several days after chemo. She said that without these drugs I would throw up constantly and therefore they were necessary. I didn't think to question this. This time the headache was constant for about 18 days and no pain killer helped. It was difficult to function. I found myself in bed most of the time. My hair had completely fallen out. This had started about 2 weeks into the first treatment. My head had started to tingle and then hair began to shed. It was a wise move to take the clippers to it as the house was filled with hair. It actually wasn't as bad as I thought. Russell did the deed and I quite quickly came to terms with my new look. To be honest I felt so awful that I didn't really have time for vanity. Another major side effect for me was constipation. My bowel didn't work and the advice was to take lactulose. I don't know how many people have tried this liquid but I find it pretty hard to drink at the best of times, so trying to take it whilst nauseated was not easy. The constipation was to become an increasingly big problem.

I became increasingly withdrawn and depressed I suppose looking back. I was in bed most of the time and had no energy. When I went back for my check up I again relayed the issues but the regimen remained the same. Before chemo is given blood tests are carried out and your white blood cell count has to have recovered enough for the next dose. At the end of cycle 2 mine were too low and chemo was delayed a week. I suppose this wasn't a surprise given how hellish I felt. I got a "holiday" and it was nice to feel slightly normal. However the next round came around all too soon. It was taking longer at the clinic as my veins were less able to take the chemo, as they were being destroyed by it. It also becomes really hard for the nurses to find a vein to take blood from or put the canula into, this for many of us is a problem that we continue to live with. Sometimes its necessary to use veins in the feet. Again I had the constant headache along with all of the other shit. It was another 18 days in bed and a wee sense of relief for 3 days before going into the next session. I was definitely depressed by this time. In a moment of true wisdom we had bought a new house and were due to move in in a couple of weeks, funnily enough I didn't really feel that I had the energy!

By treatment 4 I had had enough and though I was trying to focus on the house move I felt crap. This one was particularly bad. After a couple of days I developed a really sore throat on top of everything else. Now when having chemo a sore throat can be dangerous as it is a sign of an infection which can then rapidly spread through your body leading to septicaemia, so not good! Its recommended no actually recommended is like a dish in a restaurant so forget that, its bloody imperative that you are seen by a doctor. Russell phoned my practice and requested a house visit. One of the doctors called back and said that instead of a visit he would leave a prescription for antibiotics to be picked up. Hmm wouldn't an examination be more appropriate. When we phoned the Beatson they said that this was unacceptable and that a visit was necessary. Another call was made to the surgery and much to the Doctors annoyance he agreed to come out. 5 hours later he arrived and was clearly not happy. he told Russell that this was a waste of his time and that antibiotics were more than enough. He came through to what felt like my death bed and after a cursory glance at my throat, said triumphantly, yes as I said just an inflamed throat. Jesus Christ this man was something else. After a few more words with Russell in the hall, whereby he told him that he had been through chemo and sore throats were just par for the course, he left. What brilliant care. 2 days later I developed more throat problems. To be fair this time a different doctor came quickly and diagnosed oral thrush on top of the infection. Life was good, ha! Another 2 days later I felt as bad as I ever had. I had a temperature which again is a vital sign of danger and couldn't get out of bed. A doctor was sent from NHS 24 and he asked me if I wanted to go to hospital. Hmm I didn't think it was about WANT, again the care was pretty shit. By the next morning things were bad enough that Russell called an ambulance and I was taken to hospital. For the first time I met a doctor who actually listened to me. I was neutropenic sepsis and she didn't hesitate in admitting me. Finally I was about to get some actual care. The things you have to do to get some attention! I hope that this message alerts others to being less accepting

Chemo days

He who has a “why” to live can bear with almost any “how.”

 Nietzsche


2 days before I was due to begin chemo I met with my breast cancer specialist care nurse. I was interested to see that the girl in front of me was the other under 60 from the previous weeks clinic. It looked like we had both drawn the short straw. In true conveyor belt fashion I would see her regularly, one step in front of me for the various checks and tests prior to the dreaded day of chemo. I was half expecting to see her at the hairdressers with my friend cutting her hair off before it was my turn.

I was told all of the things to expect on this 6, 3 weekly cycle drug regimen. Interestingly and only slightly amusingly named FEC, it was very aptly named it transpired. This particular regimen is a combination of three different chemos Fluorouracil, Epirubicin and Cyclophosphamide. It is used on breast cancer patients and is known to be a hash treatment, unfortunately I learned this to be the case the hard way. The common side effects I was told were, fatigue, skin irritation, definite hair loss, mouth sores/ulcers, nausea, constipation and a strange taste in the mouth. These didn't necessarily effect everyone and could be short lived I was told. There were other side effects too lengthy to mention but all listed on various cancer websites. It was daunting to reconcile that in a few days I would willingly allow this poison to be put into my veins, but so it was to be. My GP once said to me that our children would look at chemotherapy one day in amazement that it was inflicted in the name of medicine. I certainly hope that's the case. In the meantime I'll keep taking it. Anyway my breast cancer specialist nurse talked me through the various precautions to take, such as using a child's toothbrush as my mouth would be delicate, using baby shampoo (to wash the bald scalp I may add), avoiding the sun, eating bland foods, and other tips. It was all a bit overwhelming and in a sense unreal. What couldn't be advised was how to deal with it psychologically. That was down to me. I didn't have a clue!

I didn't really sleep in the couple of days prior to the first session and was slightly dazed on the morning of it. It was odd to leave the house feeling perfectly healthy and not having any idea of how I would feel on return. I'm sure I felt like the vast majority of people feel going into round one...ding ding.
The nurse at the clinic was very helpful and offered some advise on what to do once the chemo had been administered. It was important to drink copious quantities of water in order to flush out my system as it can cause UTI's. A strong memory I have of those days is standing in my kitchen drinking glass after glass of water until my urine went from bright pink back to normal and only then would I go to bed. The whole process between pre meds, which include anti sickness drugs and steroids, and the chemo drugs themselves took a couple of hours. The sensation of the chemo going through my veins was strange and pretty unpleasant. This would get worse as treatments went on. For me one of the worst things about this regimen was the damage that it did to my veins, damage that is lasting, unfortunately. Once it was over I was sent home. We stood in the kitchen and I drank and drank and drank (water, not wine, although I would try the latter later). I went to bed afterwards and waited for the side effects to take over. Who knows whether or not my mind was working overtime or if I had just been so tense, but my legs were in bloody agony. This was not a side effect I had been told about. The Beatson weren't too much help when we called, to be honest I think stress was the most obvious culprit. I drifted in and out of sleep and did feel nauseous I also had bizarre kind of trippy dreams. In short I felt WEIRD. Sleep that night proved difficult as I had strange cramps in my legs and more trippy dreams. I woke up the next day feeling just as shit and had a thumping headache, horrible taste in my mouth, nausea and general tiredness. The good news is that this only lasted, em most of the 3 weeks before I was due back for round 2! This was one fucker of a chemo.

and on it goes

 "None loves the messenger who brings bad news"

Sophocles







Having thought about the previous post I have realised that I would advise anyone to check out waiting times for examinations, surgery etc through their hospital guidelines depending upon which Health Board you come under.

I talked before about my waiting time and the problems that it brought. I would like to say a bit more about this. In the days between diagnosis and surgery I was in touch with breast care nurses at the hospital. I was told that in all likliehood after my surgery I would be referred to the Beatson for radiotherapy. It all sounded really quite straightforward (I had a friend who had ben through this without complication) and I have to say I didn't worry too much. The general feeling was that this situation would be dealt with in a straightforward way. It was with this feeling that I went in to both my surgery and my follow up appointment. The surgery itself was straightforward and I was home that evening. Recovery went pretty well. I returned to see the surgeon a week and a half later. It was interesting to see all of the women who had had surgery on the same day as me all gathered again to find out their fate. As you would expect I was definitely one of the younger women and out of 6 of us only 2 were under 60. One by one we were called in and judging from most of the faces on coming out the news was positive. One woman was happy to tell me that her tumour was grade 1 and she only required radiotherapy. Good for her! When it was my turn I was still not too concerned. Imagine my disappointment when the doctor broke the news that firstly; there was no disease in my lymph nodes, the drill seems to be that they start with a positive, although these would become increasingly hard to find, and then give the bad news. So, no lymph node disease, brilliant. Hmm, the BUT was coming, the tumour was grade 3, very aggressive and non hormone sensitive. The last bit of information was glossed over and I would only learn the real ramifications of this later. So what did this mean? Essentially it meant that rather than the straightforward scenario I had been expecting, instead I would be going through chemotherapy. This, I was told, was a belt and braces exercise. In other words they were confident that they had successfully removed the tumour, however the chemo was to clear up any potential stray cells. I was devastated for the first time. I had gone from looking at a month of therapy which would make me tired to 5 months of therapy which would do god knew what to me. This time I didn't cry for the doctors benefit. I was referred to an oncologist and the appointment was the following week. At this appointment I was given more information about my condition and why chemo was being strongly recommended. Again the whole non hormone sensitive issue was raised but not really explored or explained. Basically what I heard was that my type of cancer wouldn't respond too well (if at all) to the newer breast cancer drugs which are thought to be the wonder drugs, like Herceptin and Tamoxifen. Tamoxifen is a tablet which is prescribed to women who have an oestrogen based cancer and is taken for up to 5 years post surgery. For many women it is indeed a lifesaver. This wasn't the case for me. And so I signed up for the dreaded chemo. I stipulated that I would only begin treatment after the 20th August as I was having my 40th birthday party. They agreed. Chemo was scheduled to begin on August 25th. This was definitely the real test of my endurance.