34. Oncology

The very word “Oncology” carries a range of emotions.  For those in the know it means treatment and hope and for those who aren’t in the know it can mean fear.  I don’t think I was frightened as Mr X had given me what  was good news but I was a tad anxious about the appointment on 29th December.  A new team of people to meet, a new area to visit…

The traffic was light as we made our way to Derriford and we parked near the back of the hospital in a car park close to the Oncology and as we were early went to the Mustard Tree for a cup of tea.  This was a good and calming move and it was just a short flight of stairs down to the Oncology Dept afterwards.

It wasn’t a school day so I didn’t have my “armour” of suit, name badge, school bag on but had dressed brightly with the POWER red lipstick applied.  Nick and I checked in and waited to be called.  It was very efficient and very busy.  When I was called it was to be weighed and have my height measured…. what…. get on those scales, here in the corridor, with those  people just over there…, but I’ve just eaten for Britain over Christmas…..  so I took my boots, cardi, scarf and anything else off which didn’t scare the other patients and made me weigh less.  It was ok – my BMI was under 25 despite that ton of turkey (cake, chocolate, sprouts, etc, etc).

Next we were invited into an office and Mr Y came in to meet us.  I don’t know how communication works in a big hospital but I think Mr X had written to Mr Y as he read through my file.  I didn’t get to see the letter but it may have started like this…

“Dear Mr Y,

I’m passing Mrs O on to you as we’ve had quite enough of her shenanigans here on floor 7.  On no account let her ask questions, get her folder out or share her treatment plan – she teaches Geography and has no medical expertise at all, apart from an expired first aid certificate.  When she says she is part of a multi-disciplinary team it is one made up of historians, geographers and sociologists not radiologists, oncologists and surgeons. If she insists on showing you her bionic boob do not be surprised if it has been dressed as some sort of animal… and she is quite impatient…”

I’ll never know as Mr Y, who had a very gentle and intent manner didn’t share the folder, he told us about the cancer which had been found and that the follow up treatment was to take a tablet once a day for the next 5 years.  No chemotherapy, no radiation treatment, instead hormone or endocrine therapy to ensure that my body did not produce oestrogen which would feed the cancer.  No high fives, no cartwheels – just HUGE smiles.  Then I had to be examined… that was a bit of a shock… no Paso Doble capes in oncology though – just a pillow slip and so it was the old routine, top off, bra off, lie back, arm up whilst Mr Y felt from my neck down to my tummy and around the bionic boob.  All appeared satisfactory and with my prescription for Letrozole we left Oncology.  There were some very poorly looking people there and I was extremely grateful that I’d got off so lightly.

I stepped off the NHS conveyor belt at least for now.

In a couple of days our friends from Italy would be arriving and we’d all be spending time with our gang of friends from Stoke for New Year.  After New Year I was allowed to start going back to the Life Centre for some exercise classes on the understanding that I’d take it easy.  In two weeks time I’d be going back to school for a phased return – lots to look forward to.

 

Prep for the oncology meeting and the Old Rectory branch of Holland and Barrett a la Rainbow Diet book – between oncology, growth mindset, Chris Woollams and Holland and Barrett the wretched cancer would not be coming back (touch wood).

 

33. Christmas

In the past I have found Christmas a bit stressful, I think there is a weight of expectation (real or imagined) that as the mum you have to ensure that everyone is having a fabulous time, that the Christmas Cake would make Delia Smith drool, the lunch is a feast and the presents perfect.

This year was not the same.  After the past 4-5 months I was really relaxed.  If the cake was a disaster so what, Nick had made it not me, if the sprouts were over boiled… no one would die and if the presents weren’t perfect it wasn’t going to be a big deal as this Christmas my folks and two of the three children were going to be here and that is all that mattered.  We saw friends and shared the good news from the Primrose Clinic, we went for walks and we watched old movies.  When I said “oh I’m sorry I haven’t done…..” there was a chorus of “No, Christmas is ruined….” followed by gales of laughter.

The tradition is that we spend Christmas Eve preparing for the feast – Radio 4 is on and I particularly like listening to the Festival of Carols from King’s College, Cambridge.  I’m not particularly religious or spiritual, I don’t think I’d be described as a person of “faith”.  I just like listening to the stories and singing along whilst chopping up vegetables and getting things ready.

In the past I’d have asked for all sorts of different things for Christmas – this year I wanted to be well, to have my nearest and dearest and a huge diamond with a Ferrari (no… just made that up!) and.. the Rainbow Diet book by Chris Woolams.  This book was going to be my Bible from now on.

Jewel red cabbage, par boiled potatoes dipped in semolina, sprouts with pancetta and chestnuts… it was beginning to look a lot like Christmas.

Tip:  You don’t need to be wonder woman and have nothing to prove.  When people offer help, accept it with both hands and if they don’t offer – ask and if they still don’t then tell them to.  These days I wonder where I have left my specs, wonder where my keys are and wonder what I went upstairs for.  

32. Rudolf – Growth Mindset

Teachers talk much about resilience – how our students can be resilient when times are hard, when learning and exams don’t go well for them – how to be academically resilient.  Where I teach we have some of the most socially resilient children in Plymouth who live in some of the most economically and socially deprived areas in the City.  We try and give the students a sense of worth and develop growth mindset.  Some of this comes from Matthew Syed and his books where he writes about marginal gains to enhance performance and that innovation dares to happen when we think differently.  If the students I worked with could be resilient so could I and I would challenge the status quo by not being the anxious patient during the histopathology feedback – I would be the patient who turned weaknesses into strengths.  Whatever the outcome I was determined it would be an upbeat meeting – I had nothing to lose. What would be, would be.

As I dressed for the trip up to Derriford I carefully applied a red bobble around the nipple scar, googley eyes and home made antlers to the bionic boob.  Nick thought it was crackers but I was already laughing as I did it.  Sports bra in place to hold it all together, bright red jumper and POWER red lipstick on I was ready to go.

It was the usual routine, leave plenty of time to travel the three miles, find a space in the impossible car park, walk past the M&S concession, the smokers in their PJs, through the concourse, up the stairs and follow the signs to the Primrose clinic – sign in and sit down.  I chuckled all the way!

In time we were called in by one of the Breast Care Nurses (this one had sat with me just before the surgery) and I told her what I was going to do.  She just raised an eyebrow and smiled in a benign way.  We went to the office and met Mr X, exchanged pleasantries and then into the adjoining treatment room where I had to put on the purple Paso Doble cape once more.  This time I sat on the edge of the bed and checked Rudolf was secure.  Mr X came in – professional as ever and asked how the breast was feeling.  I replied that it was fine apart from a bit of redness and it felt a bit woody at the top….. so he asked to see it and ………….Ta Dah…. I was crying with laughter, Nick was giggling, Mr X looked a bit surprised at first then joined in.  The bionic boob was examined – first with Rudolf attached and then without and it was healing up well.  Whatever the subsequent bit of the consultation was going to bring we had at least had a little bit of fun.  It had brightened my day.

Once dressed it was down to business and Nick and I sat together in the office whilst Mr X went through the histopathology results.  Two tumours were identified as being 10mm and 12mm in size (not three as in the original ultrasound), they were Grade 2, the clearance was GOOD, three lymph glands had been removed and one was positive with a micro bit of cancer 0.5mm.  This meant that the only adjuvant or follow up treatment was likely to be hormone therapy and this would be discussed with me at a follow up appointment in Oncology. I was welcome to come back to the Primrose unit to the see the surgeon in a year and have annual mammograms for the next 5 years.

Nick and I handed over some daft Christmas presents to Mr X and one for each of the Breast Care Nurses, gave Mr X and the nurse a hug and then we were out of there – who cared if the car park was impossible the impatient patient was effectively the cancer free patient (touch wood!).  To celebrate we had lunch at Il Pezzitino in Stoke – my first alcoholic drink in weeks (if you get the chance visit – it is run by a very dear friend, who is married to a surgeon who had gone out of their way to look after us).  CHEERS!  That  POWER red lipstick had done the trick – although I do look a bit dazed here.  After lunch we phoned my folks and the kids – tears and laughter all around.  Later I went to school and told the girls on the top corridor – more tears and laughter.   It was going to be a brilliant Christmas.

15th DecRudolf

 

 

 

 

30. The Primrose Foundation

At the same time as I was using Facebook to keep in touch with the family and our chums the important business of healing was taking place.  Part of the process is helped along by the Breast Care Nurses and other staff who work with The Primrose Foundation.  This is from their web site

“The Primrose Foundation is a breast care charity, based in Plymouth.  We are raising much needed funds to maintain and improve the existing equipment which is used to image breasts, which is essential in diagnosis. This is undertaken at the Primrose Breast Care Centre in Derriford Hospital.  We are determined to build on our achievements and remain at the forefront of treatment, care and support.  Working in partnership with NHS staff, we can make a significant difference to the future of breast care.”

To be frank I hadn’t heard of The Primrose Foundation before my diagnosis as breast cancer hadn’t really been part of my vocabulary.  Yes, I’d known about women who had the disease yet it was all a bit abstract.  It was only once I was going through it that I started to understand what this Charity does and offers – help, hope, holistic care and humour.

Upon diagnosis of breast cancer one is seen here –  earlier blog posts relate to  mammograms, ultrasounds and meeting surgeons.  After surgery the wounds are treated here.  I returned to the clinic on a weekly basis – week one – stitches were looked at and it was decided they were a bit too gloopy to come out.  It gave me a good opportunity to look at the new bionic boob which was 50 shades of brown and purple, marvel at the stitching and wonder how on earth Mr X had managed to get all my manky breast tissue out and fit a silicon implant in through what looked like a very small hole – I must have super stretchy skin or he must have some amazing surgical bungee cords (not something to dwell on… too Wallace and Gromit).

Week 2 – the bionic boob had swollen and felt like a hard football on my chest and I didn’t feel well which I was disappointed about as I thought I’d been doing brilliantly and had felt pretty good.  The super plastics Breast Care Nurse had a look and called in Mr X – he thought that a seroma (pocket of fluid) could have formed and so I had an ultrasound.  This is one of the huge advantages of the Primrose Clinic – it is a one stop shop.  A consultant radiographer fitted me in to her clinic and sure enough there was an area of additional fluid which had to be drained off (aspirated) with a large needle into a tupperware box.  No pain as I didn’t have sensation in the bionic boob, no fuss, all routine, all sorted quickly and efficiently.  Nick was with me the entire time and he and the consultant talked about Northern Ireland whilst I lay there – he recounted a story about a swan landing on a main road and how it had caused havoc… I just lay on my back, top off, sports bra off, arm up… as far as the lymph biopsy would allow.

Week 3:  A quick visit to check the seroma and remove the stitches – I’d applied lots of arnica cream to the bionic boob and it was turning a delicate shade of yellow.  There was plenty of good advice about how to massage the implant – no need for me to be singing   “My Sharona” whilst doing.  Seroma – so last week!  SEROMA not SHARONA

Week 4:  This is worthy of a separate blog as it is the official follow up to surgery.

The image below is taken from The Primrose Foundation web site and shows the Breast Care Nurses who work there.  There are specialists in Oncology and Plastics and a commonality in that they are ALL kind, caring and decent human beings.  Whatever you may be going through they have an answer, they’ve seen it all before and will treat you with respect because whilst it is unique for you as the patient it is routine to them. Thank you ladies – particularly the three who helped me during diagnosis, the run up to and time after surgery.

 

2. Always attend a mammogram appointment

“It is a cancer and will require a mastectomy” were words I never anticipated hearing and, despite being in the Primrose Breast Care clinic at Derriford Hospital was not the outcome I had imagined.  These words started my expedition into the world of becoming a breast cancer patient.

I am a wife, mum,  geography teacher and part of the leadership team at an inner city comprehensive in the “Ocean City” of Plymouth in Devon.  At the end of the summer holidays, after a glorious ten days in Sardinia, on a beautiful, hot morning my husband, Nick, and I went to Mount Batten water sports centre  to have a paddle boarding lesson.  Once we mastered how to get the wet suits on we joined a mixed bunch of other novices, carried the paddleboards down to River Plym and had two hours of learning a new skill, falling in the water and having fun with a bunch of strangers.  Little did we know that on our return home there would be a letter which would have a life changing impact.

Earlier in August 2017 I had been for a routine mammogram.  My GP surgery had signed up to an early screening programme so I had had a mammogram at the ages of 47, 50 and almost aged 53.  The morning of the mammogram, which was carried out in the Guildhall in Plymouth City Centre, was sunny, it was the school summer holidays and I had plenty of time.  The radiographers were busy and the young woman who pushed and squeezed my breasts into the machine told me there were 57 women who would have a similar experience that day. It was routine, matter of fact, brusque even… top off, breasts in, deep breath, arm up, arm around, other side.   I met a friend for coffee afterwards, I wasn’t worried, there were no lumps, bumps, lemon skin or puckering  on my breasts in fact I fancied they were in pretty good nick.

Tip:  Always attend your mammogram appointment – never put it off always go.