Am I the Weakest Link?

The next stage in The Battle of the Git was to meet my Onc (I love that word, makes me giggle every time I say it) and I had been assigned to Dr Anne Robinson's team (hence the title of today's post).  Now various terms had been used to describe her to me, "determined", "passionate about her patients", "dedicated" to mention just a few, but there was one that put the fear of God into me.... "Committed Arsenal Fan"!!  Was this someones idea of a sick joke?  Alan is a die hard West Ham fan, all our family support The Hammers to some extent.  Once she knew this (and I am sure she would be able to sense it  - after all desperation has a scent all of its own doesn't it?), would she even be prepared to take me on?  For those of you who don't know, West Ham and Arsenal are both big London football teams and are huge rivals.   Over the weekend I tried desperately to get Alan to switch allegiance - but he was having none of it.   I even considered taking his best mate Jason to the appointment with me instead because he lives, eats & breathes Arsenal.  Was I doomed?   I began to worry that I would be given my chemo via a blow dart rather than the traditional intravenous method!

The date of the meeting arrived and after sending Alan back indoors to remove his Hammers top, scarf and hat, we finally set off for the hospital.  We were taken into Dr R's office, where I had been warned the walls were covered with Arsenal memorabilia (I'd packed Alan a pair of sunglasses and some Kalms, just in case he found it bit too much) and we met her team, one of whom is called Debbie Reynolds (I kid you not!)   In all my imaginings about what might or might not be said at this meeting, the one thing that had remained constant was on which side of the desk the power lay and I'll give you a clue - it wasn't mine.  The following scene is what I expected:

Dr R: "OK Debbie, we are the experts and we have decided we are going to give you A B C"
Me: "OK Dr, when do we start?"

However, it soon transpired that patient choice is a BIG thing these days (well in that case I choose NOT to have cancer!)  And this is what actually happened:

The treatment routes were explained - twice, both with and without doodles.  Minutes passed and we found ourselves sitting there - all staring at each other rather awkwardly until a tumbleweed rolled past.....  Finally Dr R, probably thinking that everything she had ever heard about Hammers fans was right,  said "This is a very important decision Debbie, so err would you and Alan like to discuss it in private?"  Alan and I looked at each other blankly - discuss what in private?  Then the penny dropped..... they were waiting for me to decide which route I wanted them to take.  Wow!  I felt overwhelmed, I'm not the expert, I was relying on them to point me in the right direction - what if I made the wrong choice?  Just look at the time I told Alan that painting the hall, landing and stairs blue & white would be a big mistake - I couldn't have been more wrong!   There followed a rather convoluted conversation where I tried to trick the Dr into telling me which route I should take and she, being too clever for me, dodged it and instead tried to get me to commit to a choice and stick to it.   In the end we finally ascertained that it would make no difference whatsoever to the outcome so we made our decision (much to their relief) and decided on Option A - chemo followed by a mastectomy then radiation.

Once a decision had been reached we were given the names of the drugs I would be taking and in what order.  Herceptin, which latches onto the cancer cells and prevents them from regenerating.  It also helps prevent new cancers forming.  This would be given intravenously every 3 weeks for 9 weeks.  Docetaxol, the chemotherapy, which would be given every 3 weeks for 9 weeks (again intravenously).  EC, a different blend of chemo, which would start after the Docetaxol, again every 3 weeks for 9 weeks.  Then, finally, after the EC finished the Herceptin would start again and continue for a year.  I was told that, due to Christmas and all the Bank Holidays, the chemo unit was chocka-block so my treatment would start in the New Year - "great" I thought, at least I get to enjoy my Christmas dinner!!! (ha ha ha how someone up there must have been laughing that day....)

There was one other very important question that I needed answered that day.  I had uhmed and ahhed about it but finally I could hold it in no longer and.... "Dr, will you hold it against me that Alan is a Hammers fan?" I cried.   There was a deep intake of breath, the room went icy, the nurses couldn't look me in the eye and then she replied "No, Debbie, it's not your fault" Phew!  I also felt that I had to ask one other question, did she think my cancer was survivable?  Her response both immediate and definite was a resounding "Yes, Debbie, we are looking to cure you, not put you into remission".  To this day, I am not sure which answer calmed me down the most.

Before I could start the chemo, the Drs needed to know whether or not the Git had spread to my lymph nodes so I needed a Sentinel Node Biopsy (SNB).  This information would not affect my treatment plan but it would make a difference to the mastectomy operation later on in the year.  If the nodes were found to contain cancer, not only would the breast be removed but all the lymph glands too - quite a big operation which would leave me with an arm more prone to infections from cuts etc for the rest of my life.  If I am lucky and there is no node involvement, only the breast needs to be removed.  I am due to get the results on January 9th 2012.

On Friday 16th December I was booked in for a Breast MRI at 1.10pm and an SNB in the afternoon - I was going to have quite a busy day!

As Alan had to go back to work, it was arranged that Mum would come with me for the Op & MRI and that Dad would drive us to and from the hospital.  They arrived at mine about 10.30am and found me in a state of shock.  The Postie had just delivered an early Christmas "present" - two letters from the Chemotherapy Unit telling me they had managed to fit me in earlier than expected and my first Herceptin dose would be on 21st December followed 2 days later by my first Docetaxol on 23rd December - thanks Santa but I asked for a Kindle!  As you would expect, everyone's reaction to this latest news was "Good", "Great", "Excellent - lets get this show on the road" - funny enough though, when I asked if anyone fancied a swap  - there were no takers!

Mum and I got to the hospital and checked in on the General Surgery ward at 11.00am.  I reminded the nurse about my MRI appointment at 1.10pm and she assured me it was all "in hand".  At about 12.15pm the same nurse excitedly told me I was first on the list of that afternoons operations - and would be going down at 1.30pm - hmmm, now I knew the NHS were good, but time travel?  I mentioned the time clash and she ran off to rearrange the list.  Caspar had told me if that if I didn't have the MRI first then he couldn't perform the SNB - it was as simple and as straightforward as that.  So, at 12.30pm I told the nurse that I was going to my MRI appointment and would be back about 2.00pm - please note that it was "noted".

Mum and I navigated the hospital until we found the MRI unit, only to be told we'd gone to the wrong one.  On retracing our steps, I asked the helpful ladies at the WRVS desk (another plug, this time for my favourite volunteer organisation - I am a Meals on Wheels lady, so I'm biased) and they pointed us in the right direction.

An MRI of your breasts is probably as undignified as it gets ladies.  First I had to put on two of those awful hospital gowns - the first one on back to front (leaving your boobs exposed) and the second on the right way round (covering your modesty).  Then I had to have another of those flipping cannula's put in my hand, the nurse had trouble getting a vein (this was becoming a common complaint about me), he asked me to clench and unclench my fist a number of times - after a while he asked me to unclench my fist as I was making him nervous - considering he was the one with the bloody great needle I think he had a nerve!  I was then taken into the MRI suite and the top gown was removed.  Usually with an MRI you lie on your back and slide in head first but, in this case you climb up on to the bed perching on your knees with your back to the machine (at the same time holding the gown closed so you don't flash everyone in the room and trying not to fall off the bed).  Then comes the tricky bit.  At the top end, the bed has two holes cut out - guess what has to hang through there? (I wonder if there is a men's equivalent?).  So there you are lying on your front with your boobs dangling down through the two holes, in a room full of people you've never met in your life!  The cannula is connected up to a drip which, when the operator presses the button, will release a fluid which shows up in your body, making the scan easier to read.  The side effects of this drip can be much like the CT scan - a hot flush in the nether regions - luckily I was spared on this occasion.  The MRI took about 25 mins and would have been painless if I hadn't been subjected to Oasis Greatest Hits on the headphones at full volume!

I got back to the ward just after 2.00pm (as I said I would).  The lady on the admissions desk looked at me blankly when I smiled and said "Hi, I'm back".  The nurse who had assured me "everything is in hand" then came rushing over - it transpired they thought I had done a runner!  Caspar had arrived on the ward, they had taken him into my room and presented him with......... an empty bed!

Luckily, Caspar had realised what the confusion was and returned a couple of hours later.  He spent a few minutes going through the paperwork, drew a picture on my boob and said he would see me later - honestly, he didn't even buy me a coffee!

The porters came for me about 4.30pm and I was wheeled off the ward, into the lift, through the main corridor via Costa Coffee (honest!) and into Day Surgery.   Now, remember I said this would be warts and all - well, this is the "and all " bit.  So jump to the next paragraph if you are squeamish..............
The SNB is a relatively minor op but it is quite invasive.  At the start of the operation a blue dye is injected into the breast near to the nipple.   This dye travels along the many veins in the breast highlighting the lymph nodes, making it easier for the surgeon to locate and remove them.  To get to them he makes an incision (mine is about 2.5 inches long) into the top of the breast and then digs around until he can remove about 4-5 for testing (he probably has a technical term for it but "digs" sums it up just as well).  This "digging" disturbs the nest of nerves in that area and usually causes an amount of unavoidable nerve damage.  The pain is difficult to describe but imagine burning pins and needles both in your armpit and along your "bingo wings" and you have a rough idea. You also have a lack of strength there for a while too. Over the next 6-8 weeks not only do your nerves have to repair but your muscle as well.  You are given a list of do's and dont's to follow plus an exercise sheet.  All of which will help - if you stick to it!  I must say, I have had two C-sections and found those easier to recover from than this.  So, be warned, do not expect to be up and running within a few days of this op, take your time, take your painkillers and do your exercises.  Before I sign off, I must just share the list of do's and dont's.  In Week One, you cannot drive, dust, iron, do washing, hoover, garden or lift anything heavy.  However, sex is ok!  Anyone else think the list was written by a fella?

Ok, I think this post has gone on long enough so I will sign off now plus I have been preaching about doing exercises so I had better do mine.  My next post will be about my first dose of Herceptin & Docetaxol - let's just say, we weren't a Match.com success story!

As always, Onwards & Upwards!

Debs x