Pack up your troubles in your old kit bag

As you know things have been stressful during the last few weeks... but today the sun is shining and after a difficult decision we're going on our little holiday up to Aberdovey today and over the Easter break. Four long, luxurious days. The dog is coming too.  I have no regrets and can't wait to get there now.  We are planning to r e l a x and watch the world go by.  The weather forecast is similar to today's; bright, cold and dry. Perfect.


Today is a beautiful, promising day.

We've already lined up an evening meal, no expense spared. I think an Indian is the most popular choice, especially with G11 and J.  I shan't mind - I am rather partial too, I might even order champagne.  We shall potter, walk along endless beautiful beaches, eat, drink and be merry.  Bliss.

This is totally unrelated but just had to just show you a picture of our ripening lemons (we have a few on this tree). It must be very happy here in the conservatory. Handy for all those G&Ts.

Happy lemon tree

SLNB

I'm back down in the dumps and been a bit hysterical. Tiredness doesn't help. And I've been Googling, not a good thing.  Jill called to say I will need a Sentinel Lymph Node Biopsy (SNLB) before my mastectomy.  This has been booked on the 4th April.

It's where blue dye is used with radioactive isotope (both in my case - I'm not crystal clear on the exact procedure).  The sentinel node is the 'on guard' node and is the first node in a group of nodes in the body where cancer cells may move to after they have left the original cancer. 

The radioactive isotope is injected near the area of DCIS and then a device is used to track it, identified further by blue staining. The benefit of a SLNB is that the surgeon only needs to remove the first one or two nodes that the cancer is most likely to drain into.  Once removed they are examined by a pathologist.  I won't know the results on the day.

If cancer cells aren't found in the sentinel nodes, that's good news. If they are that's not so good.

It's strange. I feel so well. In fact I'm never really ill and this procedure might make my perfect (physiologically speaking) body less perfect.  There can be side effects and tenderness that can last a lifetime. This worries me.

I'm trying to stay positive, and most of the time I'm not doing too badly. But this is an honest blog and honestly, at this moment I wish I could keep the status quo.

Talking helps. Just been doing that with someone who's already been through a mastectomy and node removal. Thank goodness for wonderful friends. I must stop roaming round the Internet willy nilly.

Hospital Visit

Popped to Morriston (Swansea... a good hour's drive away) today, Friday. I was overwhelmed on arrival. It's such a big hospital, more a village; new, modern and in the throws of expansion.

Morriston Hospital

It wasn't a long wait until I saw my female surgeon. I immediately liked her... sadly (after squeezing my belly) she said I didn't have enough fat to make more than an A cup (I'm a C cup and it suits my frame.) It's the first time I wished I had a larger belly (I thought I was doing quite well in that department.)  So the DIEP is out, in fact any procedure that uses a flap of my own tissue is really not viable... I just don't have enough.  She also mentioned that I had very youthful breasts (just have to drop that in!)  Kinda sad now I've got to lose one.

So we're down the implant route. I have to get my head round this now, after being so set on the DIEP... all change. I was told I will look fine in a bra but when undressed there will be an obvious difference between the two breasts. The implant will not 'age' with me like my own transferred body tissue might have.  I've never been keen on the concept of silicone implants; they don't have longevity (so will need to be replaced in 10 years or so) and they can split.  Although I've been repeatedly reassured they are safe.  Later G11 made me chuckle when I mentioned I was worried about foreign bodies too, "...couldn't I get one from the UK?"

On to the positives.  I'm undergoing a relatively new technique using a surgical mesh (Strattice®).  The material is derived from porcine skin that has been treated and preserved so it can be used safely inside the body.  The mesh works like an internal bra, cradling the implant and allowing some of the natural droop of a normal breast. Apparently very few surgeons in the UK are able to perform this operation, two are at Morriston and one of those is my surgeon.  So I'm fortunate to be able to take advantage of this procedure.  She's going to save my skin too, though regrettably can't save the nipple. Another plus point is that it will be a much shorter operation than a DIEP would have been (down to 3 to 4 hours) and a much shorter recovery time (only 2 - 6 weeks).  As I'm always running around doing things and not very patient, bouncing back quickly is quite important to me.

My surgeon wants me in on the 28th, that's March. That's less than two weeks away.  Typically it's the Easter bank holiday weekend and the only time we manage to get away on a break as a family unit is on bank holidays. So I'm torn.  She's given me another date of the 11th of April.  I'm to chat to J and G11 to see what we all think.  My surgeon has to cancel other operations to fit me in so we have until Monday morning to decide.

The hospital suggested I have my pre-meds to save me coming back, it meant a bit of waiting around but as it's a long round trip it was well worth doing.  I got a bit upset when they said they were going to take photographs, (I could refuse of course.)  In the end though I ticked all the 'release' boxes; publications, research, training. My right breast WILL live on in all its youthfulness!

It's now Monday and after having the weekend to think about it and talking it over with J, G11 and with Jill I have decided to go in on the 11th April.  I'm going to have the best holiday at Easter and make it one we'll never forget.  Then from the 11th I can begin to start moving forward again.

DCIS

I'm writing this before I see the breast cancer nurse.  I might not publish it... but I probably will when I feel the time is right.  Some friends and family may not understand this but for me it's cathartic - this writing lark.  And if I can help just one person on a similar journey it'll be worth it. 

I went to my first breast screening really to get Her Next Door along.  After 70 a certain age you don't get invited automatically and I'd missed my original appointment because of tooth problems.

There was a Breast Test Wales mobile unit travelling round Pembrokeshire so we caught up with it in Pembroke Dock.  It was a more uncomfortable experience than I realised and I remember wishing that I didn't have to go through it again in another three years. Be careful for what you wish for.

I received a call back letter to attend an assessment clinic in Swansea - I postponed my appointment as it clashed with something else I had arranged (delaying tactics?) Eventually though my re-arranged date arrived. I had a second mammogram and they showed me some white dots on the x-ray known as calcifications, although some were 'suspicious' and were not the right shape\density (or something) in two areas of the right breast. I remember looking but not really seeing. The doctor could find no lumps and the long and short of it was I had a core biopsy taken.  A computer and mammogram were used to accurately find the calcifications that needed closer examination. It was a long process and the computer crashed, which meant I had to remain squished and in place whilst it was rebooted. They told me not to jump as the staple gun (that's what it sounded like as I didn't dare look) went off.  Hard to do.  The results would come back a week later.

Off to Swansea again - the drive is long.  I had a bad feeling. That feeling was confirmed when my breast care nurse opened the door. And with a sledgehammer that was backed up when I saw the doctor in the room.  I remember very little.  Except the word mastectomy, 8cm and I didn't have secondaries.  They've picked up Ductal Carcinoma in Situ (DCIS - I wish I didn't have to learn this lingo).  The positive is that it's contained.  So breast off, problem gone. 

I've gone through the remit of emotions; denial, shock, bereavement, anger, relief, sadness, feeling fraudulent (some people don't think DCIS should be termed a cancer - it's rather a pre-cancer) and of course why me! 

I've certainly wept in the middle of the long nights for the upcoming loss of a part of me that defines my femininity. It's always been a favourite play thing for J and I in the bedroom (sincere apologies to any relatives reading this, I'm sure that's way too much information) and I fed my daughter G11 with it for many months - I was so proud to do this. Both useful and fun!  Now it is to be cut off and discarded. I find it difficult to get my head round that.

I'm waiting for the nurse this morning who is coming to my home to discuss my reconstructive options, there is a lot of choice which is rather overwhelming.  They would have talked to me in Swansea for as long as I wished but at that time I just wanted to get out of there, run away.

The nurse has now been and gone. Think I need some time to digest what she has said... my cells are in grade 2 and 3 which means some are pretty active little buggers (the grades range from 1 to 3).  There is no desperate rush for surgery - I have weeks, but can't wait until next year.  So Jill (can't keep calling her the breast care nurse, I have a feeling I will get to know her quite well) suggests I talk to the surgeon. The operation I'm currently favouring is DIEP (stands for deep inferior epigastric perforators, which are blood vessels) and so it looks like I'll be getting a tummy tuck thrown in. The recovery time is longer but my own fat (which I have some of) and skin is used and this particular procedure also preserves the abdominal muscles.  After this meeting I will tell you more, there are a lot of reconstruction options and this is just one of many procedures.  I may change my mind yet... which I am given full licence to do. They are keen that I feel happy with my choice. 

At the time of the mastectomy they will also examine my lymph nodes and of course all the tissue will be inspected for any signs of invasive cancer.  What they have sampled from the biopsy is 'non-invasive' (i.e. in situ and contained within the milk ducts) but of course there is a large area yet to be looked at. That's a new niggle at the back of my mind.

I haven't hit the menopause yet and am not sure whether oestrogen is a factor. I also have a coil, but think I will wait now for the results after the mastectomy to decide whether to have it removed or not (at least the thought of that pales in comparison).

That's it for now, I'm feeling quite upbeat... course that changes from moment to moment. xx

Cards, messages and 'The Tree of Life' made for me.
Friends and family I love you! xxx