Breast Cancer. Making a Will, recovering from surgery and getting on the Cancer Treadmill .

8th August 2013. I am off sick, long term sick, for the first time in my NHS career.

My recovery from the surgery was good. I felt better than I had for a long time and slept well as the pain in my breast; that had been keeping me awake, was gone.
My first view of the scar was a bit of a shock, the surgeon had cut me from my arm pit to below my breast, when I removed the dressing I could see that the incision was just under 6 inches long. I know why he did this as from the front you can not see that I have had any thing done so from a cosmetic point of view it is a very good job.
I was given a leaflet about exercises to do after surgery, http://www.breastcancercare.org.uk/upload/pdf/bcc_exercises06_web_0.pdf
and started to do these on day One after the operation. As soon as I felt able, I started to walk the dogs daily, at least a 3 Km walk.
I also sorted something out that should have been done ages ago, I made an appointment with a solicitor to get advice about Wills. It sounds very morbid, but it is something that needed sorting out. 19 August 2013. Visit to the local Solicitor. I chose this solicitor as he was connected to one on my colleagues. However this was a mistake as much to my shock the man was a total Chauvinist who was  not interest in my wishes, his only interest was in advising me to make sure I documented the type of funeral arrangements I wanted in my Will as 'this is what concerns most people'....NO!!! What concerned me was that my children get the bits of my estate that they are entitled to. All I was asking was that any assets my husband and I had, including my NHS pension, be protected upon my death. so that if my husband remarried his new spouse or any new children would have no claim on my 1/2 of 'the estate'.
I made another appointment with a more professional ( and coincidently Female Solicitor) who has produced the Will I wanted, it has all sorts of clauses in it, but the thing is, it expresses my wishes, all be it that some of them may sound odd. And that's what I think a Will should do, express the wishes of the dead person.
For my recovery, I bathed using Tea Tree and Lavender Essential oil each day. I rubbed Bio Oil into my wound each day. I drank Jason Vale Juices every day, especially the Green one with the Avocado in it. Despite its odd appearance it is very nice! I took my Holland & Barret 'Super One Formula and I walked the dogs.

23 August 2013. I am back at the breast care unit to see the surgeon. The waiting room has quite a few people with out hair in it, they have stylish scarves on. There is also a Man in the waiting area, I have to quietly inform my Husband that Men get Breast Cancer as well as Women.
the Surgeon is pleased with my wound. He tells me that the breast Cancer was a fast growing one. That in the time from my first appointment on 8th June 2013 to the 7th August 2013 it had gone through the duct so it was now a ' Grade 3, Invasive Ductal Carcinoma, with a high nuclear grade ', but the really good news was that the 3 Lymph nodes that had been removed did not have any cancer in them, and showed 'no evidence of metastasis'. He informs me that the Cancer has no Oestrogen receptors, no Herceptin receptors and is very, very weakly receptive to Progesterone. So almost a triple negative breast cancer. He advises me that my case has been discussed at the multidisciplinary meeting and I will be seeing the Oncologist and the radiologist in due course......I am on the Cancer Treadmill.

Breast Cancer. The day of the Sentinal Node Scan, Sentinal Node Biopsy and Wide Local Exicision or Lumpectomy.

7th August 2013. Nil by mouth from 00.00.
At 10.00 I am in the Department of Nuclear Medicine for my Sentinel Node Scan.  I am called in and advised that dye will be injected into my right nipple, I will then be asked to wait 20 mins or so, to allow the dye to move, then come back in for the scan.
The radiographer wears lead gloves and a lead apron and the dye is in its own small lead case. OK, so this stuff is going into my body!
I hardly feel a thing as the dye goes in and I am told I can get dressed and wait in the waiting room, or go to Costa if I want, I opt for the latter. As my operation is not until the afternoon I can drink and I really need a cup of tea. I am just about to leave when an agitated radiographer calls me back. It seems the reason I did not feel anything is due to the face that nothing went in! The syringe was faulty. I strip off again, lay on the scanning machine again, see the lead gloves again, and I feel the dye going in this time. Its not painful, just a sharp sting. This time they want to check the dye is in so start to scan straight away.
'This wont take long', the young radiographer says, 'Your Lymph moves really fast, it will only take about 15 mins'. As I lay there, I wonder if having fast moving Lymph is good or bad when you have cancer??????
The scan was over by 11.00am. I walked from the x-ray department to the Day Surgery Unit and checked in at the reception. It was a long wait.
At 12.30 I was called in and saw a nurse, she did my basic observations and showed me where to get changed and wait. I then saw the consultant Anaesthetist, he was a colleague of mine from the Maternity Unit, we have worked together a lot up to now! It seemed today was a good day to have an operation as all the new doctors started work today, and they were on their Trust Induction day. So the list today was staffed by Consultants! That was lucky!
I then waited in the small room again, until I was called to see the Consultant Surgeon. This was the first time I had actually met 'my' surgeon. He was lovely and explained what he would do, checked my consent form and said 'lets get on with it then!'.
With that a nurse led me to the theatre.
I must have been fast asleep, because as I was woken up from the general anaesthetic  I really thought I was at home in my bed, it was a shock to open my eyes and see the theatre recovery area. Once I had opened my eyes and responded to the ODAs questions I was wheeled down to the Day Unit.
At this point I reached for my right breast, just to check it was there, it was, I went back to sleep. As I lay in the day unit in my drugged state, many Theatre Nurses and ODPs who were passing saw me and came over to chat, I don't think I made much sense.
The day unit has rules, you have to have a drink and eat at least a biscuit before they will let you go home. I was struggling to wake up, it took me over 90 mins to eat the biscuit as I slowly emerged from the general aesthetic. I was in a Morphine induced haze as I struggled to drink tea.
As the last patient in the day unit I got up to go to the bathroom, I managed to do it, but vomited the tea and biscuit up at the same time! I did not tell any one as I wanted to go home. Who wants to stay overnight in hospital, its hot, noisy, and who can sleep with a plastic covered bed and  plastic pillows? I was going home!  I stripped my bed, with its vomited on sheets, I found the sluice and deposited the sheets into the linen skip. The Nurse was very impressed with my housekeeping efforts and ran through a long list of dos and don'ts and finally at 20.00 I got into my car and my husband drove me home to my own bed.
Now just the wait for the results and the treatment plan.

Breast Cancer, Seeing the Surgeon, its a mix up in many ways.

12 July 2013, 14.15. I arrive at the Breast Care Centre as instructed to see the Surgeon. But there is some mix up as a Nurse abruptly informs me that I have missed my appointment as I am late. He exact words were;
'You have DNAed your appointment!'
I inform her, very firmly,  that I have never DNAed an appointment in my life and tell her not to scribe the words 'DNA' (Did Not Attend) in my notes as I am not late. I get out my letter, there has been some kind of mix up as it clearly states Friday 12 July at 14.15, it is now 14.00. She is flustered now but still says I shouldn't be there. It turns out that I should have been at the clinic in the morning, but I have not been told this information! However  the surgeon has now finished his clinic and gone to do a theatre list.

The Nurses 'busy about' and say I can see a surgeon, but not 'mine'. I say OK and get called into a room. Here we meet my Nurse Specialist, the Surgeon and a House Officer. They sit us down, give me a box of tissues and tell us they have bad news.
As I work in the NHS, I realise there is (another) a break down in communication and that this team of people do not know that I know my diagnosis. They think that this appointment is to tell me the news that I have breast cancer, whilst I think this appointment it to give me a date to have the cancer cut out. My husband however puts 1 and 1 together and comes up with 3. He thinks  that I have not told him the truth and that I am terminally ill. He looks like he is about to collapse! I quickly tell the team I know I have Breast Cancer and regain control, my husband looks like he needs the nearest resuscitation trolley, I have to calm him down.
I am told I will be booked in for the surgery, and will have a Sentinel Node Scan prior to the surgery. I am also given lots of 'breast cancer care' books to read. I don't read them, all the books go straight into the recycle bin as I prefer to Google.uk.

16 July 2013. I get confirmation of my Sentinel Node Scan and Surgery, it will be on 29th July 2013.

22 July 2013, I receive a letter from the department of nuclear medicine informing me that 'due to unforeseen circumstances, we regret that your examination cannot be performed on 29 July 2013 but will be done on 7th August 2013 at 09.30 am'. I am confused, I thought I was having the dye put in then the operation, this way round doesn't work ?

23 July 2013, I am at work, teaching customised fundal height measurement. during a break I ring my nurse specialist.
She tells me that the surgeon 'they' want to do my operation is on holiday on the 29th July so I will be having the operation on the 7th of August.
In passing, she also comments that she has got the results of a Hormone Receptor Test they did on the punch biopsy specimens.
'They are not reacting to hormones' she says.
I ask what this means,
she says 'its not hormonal cancer, it may mean chemotherapy, but we will know more when the lump is out and we really know what we are dealing with'.
I get the feeling I am being drip fed information.

At home, I Google, 'Estrogen negative, Progesterone negative breast cancer'.
It comes back to me with 'Triple Negative Breast Cancer' (TNBC). I read about TNBC, I read the research papers, I read the blogs, I read the scary newspaper stuff, I research TNBC as if I am doing a dissertation. I am after all a Health Care Professional with a degree, I know where to go to find the research.
Until this point I did not know about all the different types of breast cancer that have been found, I do now.
I also realised that until the lump was removed I could not possibly know the rest of my treatment plan, as the treatment plans were individualised for each woman  using this vital information. So I would just have to wait and see.
The next day I researched alternatives to Chemotherapy, I find many blogs and find the Gerson therapy. I read all the information about vitamins, Kale, Broccoli sprouts. I dusted off the juicer, went to Aldi and emptied the shelves of fruit and veg and started to 'Juice'. I went to Holland and Barrett and brought super vitamins. I stopped drinking alcohol!
I spoke to my brother and told him I was going to kill the cancer with juice. My brother is a bit of a petrol head,  a motor bike enthusiast when he wants to be and he has always followed Barry Sheene.
He listens to me rambling about Juice, then tells me 'that's what Barry Sheene did, used juice to fight his cancer of the oesophagus and stomach, but died in 2003'. My brother doesn't say much at times, but he said a lot in that sentence.
I decide to do the Juice, have my vitamins, drink my wine  and have the chemotherapy if I needed to. I really do want to live! after all I have holidays planned..............but that's another blog.

Breast Cancer. I get the results of the scan and breast tissue biopsy.

Florida 2013..what am I eating?

Back from holiday;

7th July 2013, I pick up the pile of mail that greets us on our return from Florida, there is an appointment to see the breast surgeon on the 12th July 2013. So I know some thing is not correct! I warn my husband.
8th July 2013, 07.30. I am at work. Having been away for two weeks my mail box is full, it will take two weeks to clear it all! So I make a start.
08.45, As I work in the hospital where I am being treated I know that The Breast Care Team should be in the office by now, I bleep the Consultant Breast Care Nurse using the hospital bleep system.
09.45, no response from my bleep. I decide to walk over to the Breast Unit. It is a long walk of over 10 minutes as my office and the Breast Care Unit are at opposite ends of the hospital. Its a beautiful day so I enjoy the walk in the sun.
When I get to the reception desk, the consultant nurse is there, she smiles and says 'I got your bleep and was just ringing you, come into my office'. I do so, I sit on the chair as instructed. Following the introductions and small talk, how was your holiday etc, she gets down to the nitty gritty;
'Well!' she says, and smiles ....'its not'

..........I relax thank goodness its not Cancer, my Husband was correct..........

'it's not Good news'..............'It is breast cancer'.

My mind cant keep up. My brain says No! that cant be correct you just said 'its not'. I must look puzzled, as she says again, 'the biopsy shows it is Cancer'.

OK, my first words are 'I am not having Chemotherapy, as it makes well people ill'. She smiles, 'We are not any where near that point, I am sure that the Cancer is HRT related. They will do a lumpectomy, then radiotherapy then you will go on Tamoxifen'. I relax, that sounds OK, I can do that. Things have obviously moved on since I did my nurse training, well it was a long time ago! I am not a nurse now, I am a Midwife, what do I know about modern breast cancer treatment? Nothing, I understand the jargon, but that's it.
She then gives me some more results from the Scan/ Biopsy findings; It is Ductal Carcinoma in situ (DCIS) so not invasive, it is small, Stage One as its less than 2cm. it is Grade 2, so medium growing. Due to this I will need surgery. This will be 'breast conserving surgery', a wide local excision or lumpectomy and some Lymph Glands will have to come out. Then it will be radiotherapy and Tamoxifen. OK! so to me that all sounds doable, I can cope with it, in fact if your going to have Breast Cancer at all this sound like the stage to catch it at and I am not worried.
I thank her, she tells me I will get an appointment through the post to see the Surgeon and I go back to my office and back to work.
After work I sit in the garden, enjoying the sun, reading a book, planning our next holiday to South Africa in October, after all I will be better by then?
My husband comes home, I give him the news, saying is not so bad at least I don't have to have Chemotherapy, he doesn't say much.
The worst bit comes over the next week as I inform my family, friends and work colleagues about the news. I get sick of saying it 'I have breast cancer' and people react in many different ways. Luckily as I am in the health care profession most of my colleagues are experts in dealing with bad news and are very caring people.
The appointment to see the surgeon arrives the in the next days post, its for Friday 12th July, but I know that already thanks to the letter at home. 

Breast Cancer. The Consultant Breast Care Nurse and my first appointment.

18th June 2013, The Breast Care Unit.
The breast care unit at my local hospital is now a purpose built building, no longer part of the main out patients department as it was in 2008. It is a very nice department, I go in and meet the friendly  Consultant Breast Care Nurse. She takes my history;
I am 55 years old, do not smoke ( never have), have two daughters and breast fed then both for a long time. There is no family history of breast cancer. My BMI is 22. I have taken the pill in the past and am taking HRT now. I am fit and healthy for my age and she tells me in the 'low risk' group.....but she pulls a face at the word HRT.
She then gets a sheet of paper with a 'breast map' on it. Examines my breasts, she can feel the lump in the right breast at 9 O'clock, but whilst I say its a pea size lump, she thinks its more tubular in shape. Its is painful and I jump when it is palpated. She draws the findings on the breast map.
I move along the corridor to a room where I have a Mammogram. This is a very thorough examination as the Radiographer locates the lump with a special probe. But it is not unpleasant or painful. I don't understand why all the Mammograms are all so different?
The Consultant Breast Care Nurse calls me in to her office, the Mammogram does not show anything on it. But she is concerned as the lump is palpable and would like me to have a Scan. I go to another room for the scan.
The Doctor performing the scan can see the lump, but the out lines of it are 'poorly defined', so she asks if she can to do a Punch Biopsy. I consent. Lignocaine is injected into the area to numb the pain, then using a thick trocar needle she takes a few samples of the breast tissue. They look like worms in a pot. This procedure sounds worse than the Fine Needle Biopsy I had in 2008, but thanks to the lignocaine it was less painful than that was.
The Consultant Breast Nurse calls me back into her office to tell me that:
The Mammogram does not show anything, but the lump can be seen on scan and the Doctor performing the scan 'is undecided as to what it looks like'. The results of the biopsy will be back on Friday PM and how do I want to get the results. I explain that there is a problem with the date as I will be on a Virgin plane, with my family on the Friday. Bound for Orlando. She tells me that I can have the results sent to me by text? I decline, I don't want to know the results by Text as  its not going to make any difference to my plans, in that I won't be cancelling my holiday if it is Cancer........to late I will be on my way! and anyway it will not make a difference to any treatment plan or surgery schedule even if it is Cancer. I decide I will pop over on Monday 8th of July, when I am back at work and get the results then.
I tell her I have not told any one in my family, asking what she thinks I should do? She kindly advises me that I should let my husband know I have had the tests as it may be a shock for him if the result is Cancer, this is the right decision and I do it when I get home that evening. He seems to take the news well, but is totally convinced that it will be OK and cant possibly be Cancer..........I know it is denial.

I ask him not to tell the rest of the family as I don't want it to be the subject of discussion for the holiday.

Breast Cancer. The first step in my breast cancer journey, pain in my right breast.

Hello! this is my story of having Breast Cancer. I am a white English woman. I have a husband & 2 daughters and quite a few dogs. I am a Nurse and midwife and I work in the NHS. This is my experience.

 I qualified as a British Nurse in 1978. Whilst I was undertaking my training as a pupil nurse, an image that has remained with me through the years was of caring for a woman who had undergone a Classical Radical Mastectomy for Breast Cancer. The whole breast, including Nipple, Areola and her Lymph Nodes had been removed. Through my 18 year old eyes it looked like she had been butchered. I remember dressing the puckered skin, the Surgeon had done a sort of blanket stich straight across the woman's chest, she had drains in and was nursed with the arm up, above her head, in a hanging sling for at least 10 days. I think she stayed in the hospital for a period of about 15 days. That was my last experience of nursing a patient with Breast Cancer, as I went on to become a Midwife where women's breasts are used for other purposes.

Me at the time of my 50th Birthday.

In England when you are 50 your appointment for your first Mammogram comes through the post with your 50th Birthday Cards. In 2007, I had dutifully made my way to the screening van in the car park of a local superstore. Here my 32DD bust was squashed to a one inch flat pancake, then just as I thought it was painful, but bearable, the Radiographer ratchet it down even further in a vice like grip. I found it a horrible test, very painful and humiliating. I did not hear from them so assumed it was all clear. I later found out this was the case.
In 2008 I noted a 'thickening' around my Nipple area in my right breast at about 3 O'clock ( you quickly learn this is how the Surgeons and breast care nurses refer to the areas of your breasts). I went to the GP who sent me to the Breast Clinic at my local hospital. I had a 'Fine Needle Biopsy' (FNB) in the Out Patients Department. My breast was palpated, the area identified, then the surgeon inserting a green needle attached to a 20 ml syringe into the area, this was done with out anaesthetic and once he had draw a small amount of breast tissue into the green needle, this 'Biopsy' was send to the lab. I then had to go to another department for a Mammogram, but this was a very different experience that the 'Van in the Car Park' carry on, even though I was sore and bruised from the examination and FNB the Mammogram was not as painful as my first experience. When the results came back, they were all clear it was just a fibrous area of breast tissue. So my next routine Mammogram would now be in 2013 and I would be called as routine via letter.
March 2013, I had been experiencing a deep burning sensation in my right breast, this time at 9 O'clock for about 18 month. But I was busy with a full time demanding and stressfull job, by now a senior Midwife in the NHS in a practice development / delivery suite shift leader role. As well as a wife and mother to two adult daughters, two dogs, parents who were getting older.....LIFE!
April 2013, I went on holiday to Sri Lanka with my daughter. We went to a Yoga and Surfing Retreat at Talalla Lodge, this is a link to my travel blog http://www.blogger.com/blogger.g?blogID=435807495647998918#editor/target=post;postID=3645945395386130871;onPublishedMenu=posts;onClosedMenu=posts;postNum=5;src=postname
I went for a massage and realised that something couldn't be right as I was having difficulty laying on my front due to the pain in the breast.
May 2013, Very busy back at work, than at the end of May the pain in the right breast is keeping me awake at night and I feel a pea size lump. The next day I telephone the GP, after a long wait on the phone listening to mind numbing music I get an appointment for the first week in June.
6th June 2013, I go to see my GP, she can feel the lump as well. She refers me by email to the Breast Unit at the local Hospital. At this point I have not spoken to any one about this. Not my husband or my daughters, after all what the point of worrying them if its nothing? I get an appointment to go to the Breast Care Unit on 18th June 2013.


18th June 2013, at work the day of my appointment, displaying hats knitted for the New babies!