3) But I make my own Granola!!

And so results day finally came around. Over the past few days I had collected my ammunition for the ensuing war - ammunition in the form of knowledge; knowledge is power and all that! I read research papers, blogs, forums, the Cancer Research website, the Macmillan website, NICE guidelines, and looked at a million surgical images (perhaps NOT highly recommended at this point!). Now, I have a bit of an issue with stationary, as in I love it!! and this situation definitely called for a new notebook and pen!  I loaded my new book  with a ton of questions ready to ask the doctor (this strategy I would HIGHLY recommend). As a medical professional I've done the training on 'breaking bad news', I know the typical responses, I know that the recipients mind might completely empty of all information and questions, and that only key words might be heard: 'Cancer', 'surgery', 'chemotherapy' and the important filler information my be blocked out (so take a sensible person with you as a listener) - I also know its a very bad day in the office for the Doctor, and he can only tell me so much information in one sitting. And, I know how it feels to have the sadness and pain of your patient follow you home.

Now, if you are tempted to delve into the world of research and treatment etc. Please remember these few points: 

* Google or any other search engine, does NOT actually have a medical degree.

* Information from other countries is often irrelevant in the UK.

* You are unique, your cancer is unique, your treatment is unique, your side effects will be unique.

* There is a lot of very dubious information dressed up as 'evidence' out there.

However, there is also some very good stuff, hints, tips and advice. Personally I found that by researching I felt like I was doing something productive rather than just sitting around. I did find a claim in several sources that Camomile Essential oil can destroy 93% of breast cancer cells - I'm not endorsing this or saying that it is correct, but I did start rubbing the oil in three times a day, drinking Camomile tea, infusing it around the house and bathing in it - I slept really well......

Anyway, back to the point. Results day in Dr Mumbles room, and this time he was accompanied by a Breast Care Specialist Nurse who introduced herself as my Key Worker (if I didn't 'know' before, this would have been a huge clue as to what I was about to be told!) As everyone had been, she was completely lovely. After Nic and I sat down Dr Mumbles spoke (actually quite clearly) "I'm sorry to have to tell you that we have found cancer cells in 2 of the areas that we tested. The breast and the lymph node. Your chest wall is benign. It is Grade 3 cancer. You will need surgery and further treatment. Do you have any questions?" (Grade is different to stage, that comes later. Grade 3 is the most aggressive form of BC).

Now, this is probably not what he said at all - its what I heard (remember what I mentioned about breaking bad news!).  My brain switched into professional mode - don't you worry guys, I've got this!! no tears, no shock, I had known for the past 4 days anyway. Out came the lovely new notebook, and I bombarded Dr Mumbles with questions about size and location of tumors, guidelines, policies etc etc - turns out my tumors were quite small 16 and 19 mm, but the whole of my breast tissue was calcified which apparently indicates pre-cancerous changes. 

My left breast is completely normal and well behaved, now known as the party boob (as it hangs free and easy, doing its own merry thing),  the right breast is now known as 'the Evil Twin'!

As I finished my last question, the relief on Dr Mumbles face was plain to see, I feel sure he's more comfortable with patients who nod and agree to everything that's said. Nurse Lovely then escorted us into another room so that the doctor could do referrals for bone scans, CT scans and the MDT (multidisciplinary team, this is everyone involved in your care. They sit around a table on a Wednesday afternoon and talk about you! A bit like King Arthur and the knights, or Dr Evil from Austin Powers, depending on your preference).

Now on reflection - 7 weeks on, I realise my brain was not in 'professional mode' as previously mentioned, I think I was more  in 'manic mode' as my next conversation proved. As we entered the room Nurse Lovely asked how I was feeling, my reply was "well I just don't get it, I'm healthy, I don't tick any 'at risk' box - I even make my own flaming granola!!"so apparently making your own granola does not protect you from breast cancer! Who knew? !

Nurse Lovely talked to Nic and I about what the possible treatment plan might be (this would be discussed among the knights around the round table the following day), and we still had to wait another week to find out if my cancer was oestrogen receptive, progesterone receptive, HER positive, or triple negative. I also needed a bone scan and CT scan to see if the cancer had spread outside of the breast tissue - so my diagnosis was still not complete.

What I remember being told is that I would likely have chemotherapy first and then surgery. My hair WILL fall out. I WILL be pushed into the menopause. And I WILL be back to full fitness eventually! And this WILL all take around 9 months, surgery WILL be in May!

OK, firstly 9 months I can do - it takes 9 months go grow a human, so that's a good time frame for me to focus on. Secondly, (let's remind ourselves that I have identified I'm in manic mode) - I'M GETTING MARRIED IN MAY! I CANT HAVE SURGERY IN MAY!!!! however, thirdly, I was given a beautiful new pink folder filled with information booklets from Breast Cancer Care UK and Macmillan - stationary and bed time reading in one gift, winner!!

*** A little side note, Breast Cancer Care has really user friendly information and advice, aswell as forums etc - well worth a look!***

 www.breastcancercare.org.uk

 www.macmillan.org.uk

 www.cancerresearchuk.org

2) When I wanted to be an idiot!

One day, in late September, I had returned from my morning run and was having a shower. My right breast started to itch and when I scratched it I decided to do a quick breast check - something, I admit, I was not very good at doing frequently. It was then that I found a 'lump' in the side of my boob. "OK" I thought "I'm probably being an idiot, because I'm due on my period, I'll check again later". I checked the other boob and all was normal. When I left the shower I checked again - the 'lump' was not a 'pea' like I would have expected, it felt like thick tissue, irregular in shape, moved a bit and non-painful. I decided to make a GP appointment just in case, which would be a week away because its not really an emergency. Because my breast looked completely normal on the outside (no dimpling, shape change, oozing or redness), it wasn't a 'pea' like lump that didn't move, I'm vegetarian and love healthy eating, I'm a runner so I'm fit, I have a healthy BMI, I don't smoke, I don't drink, I have no family history and I'm pre-menopause - I KNEW I was being an idiot, and I'd see the GP and she would tell me exactly that :)
 

When Nic (my fiancé) got home that afternoon, I had re-checked the breast several times and asked him to feel it because, of course, he will tell me there is nothing there and call me an idiot. He didn't! he felt the boob and just said "Oh, yeah, there is something." - damn it!!

For the next week I checked the boob on a daily basis, usually 3-4 times, and the lump stayed, then I found its little friend!! Just inside my armpit I found the 'pea' I had initially expected, was this a gland? a cyst? a lymph node? paranoia kicked in and I wanted nothing more than to be called an idiot and stop messing with my boob! I was messing around with my boob so much, the armpit lump was becoming painful. 

The day of the GP appointment came round - I don't do GP visits very often, I don't do 'being ill',  I always feel like I'm wasting their time. She was lovely, I told her what I'd found and added "I'm sure it's nothing, just cysts or something, or hormones!" certain that she would examine me and then say the magic words "You are an idiot! go home and leave your boob alone!". She did not say these words. Instead it was "mmm, I see what you mean, its like thickening tissue isn't it? a couple of centimeters?" and "yes, I suppose that one (in the armpit) could be a cyst or a gland..... maybe". She made a 'fast track' referral to the Breast Clinic.

I had a two week wait for the next appointment, during this time I read everything I could get my hands on regarding breast lumps (and continued to check my boobs three times a day expecting the lumps to suddenly disappear now that they'd demanded the attention they didn't deserve). I knew the worst case scenario, treatment options etc etc. I read everything up to a point that I thought I would be able to cope with - but I also KNEW that this WAS going to diagnosed as either fatty tissue, or Fibroadenoma which is common in women under 30 (I'm 44, but that didn't really matter in my head!) and be told I was an idiot and was wasting NHS resources. On this occasion I was past caring about wasting resources.

At last, the day came. I was seen by a Dr of few words (and a few of the few I could actually make out from his mumbles!), he almost took my history and within seconds had his hands on my poor little boobies! (He hadn't even bought me a drink!) "Where is the lump?" he asked aggressively - there, where your hand is!, "where? there? this? where?" could it be that the lump had gone? was he going to be the one to call me an idiot? he then felt my armpit for 0.3 seconds and I saw his mouth twitch, this was it, this was going to be the moment - I held my breath waiting for it - and then he abruptly turned to the nurse and the words "mammogram and ultrasound" tumbled out of his mouth before he rushed off to see the next pair of unfortunate breasts. 

The nurse, a completely lovely woman, showed us where to go for the next leg of the journey. I had had Nic with me up until now, but he wasn't allowed to be with me for the tests so he waited like a lost puppy in the waiting room. I was greeted and welcomed by the most lovely South African woman (the mammographer), who showed me where to get changed into a theatre gown, then took me into the x-ray room. This woman was so kind, reassuring and chatty, but ...... Jesus!! she was determined to make my little boobies reach the unreachable on that machine!! I was pulled, twisted and manipulated like you wouldn't believe, and then squashed!!! not a gentle squeeze - oh no! squashed like an orange, it felt like my breasts had been made paper thin! I almost had to shout that her machine had clearly broken!! then a series of x-rays were taken. As lovely as this lady was (despite what she did to my poor little boobs), she didn't call me an idiot.

I was asked to wait for an ultrasound, during this time several women went in for mammogram and came out and went for ultrasound, through a door on the left. I sat watching, wondering if I'd been forgotten.  Eventually my name was called and I was invited into a room - on the right!! and I was introduced to the loveliest Consultant Sonographer, (I knew! as a Midwife I know when things don't 'feel' right, Consultants don't tend to see the routine and I know 'the look'). Also present was the Sonographers assistant who was just as lovely - a perfect team. I lay on the couch in a left lateral tilt, unable to see the monitor, but as the probe slid across my skin I felt the probe stop, then I heard the familiar sound of clicking, (familiar from observing maternity scans), she was taking measurements!! she had found something in my little boob that was worthy of measuring!! she moved and did the same, and up into my armpit and did the same again! then she stopped, wiped me down, sat me up and said "there are three areas of concern that we need to take biopsies from, we can do it now or you can come back another time" - I wanted to be an idiot, but I'm not that much of an idiot -  get on with it! 

Nic was asked to join us at this point. My rock! my unflappable man, just held me and reassured me that no matter what, everything was going to be OK. The Consultant talked us through the procedure and took consent, then Nic had to leave again - back to the puppy waiting room. Core biopsies from the original lump, the lymph node (the 'pea'), and from a lump I hadn't  known  about that was sitting on my chest wall. I didn't feel a thing, local anaesthetic had been used and it worked for about an hour after the procedure - then my nipple felt like it was on fire!!! When the Sonographer had finished she hugged me, and told me to go home and have a large wine, "I don't drink" I said, "now might be the time to start" she replied with a smile. I Knew!

The experience as a whole wasn't too bad, because the staff were so incredibly kind. I was sent back to the first mumbling doctor, my hopes of being called an idiot had all but gone. As we were shown back into the consulting room, I noted 'the look' on all of the nurses faces (a little sad smile with head tilted slightly to the left). In the room with the doctor, Nic and I were told "There are three areas that are very suspicious, and we are concerned". As a medical professional I know that they cannot give a diagnosis without the results of the biopsies, but as I'm not actually an Idiot, I also know what they are not telling me. I was given a piece of paper and told to make an appointment to go back on Tuesday - 4 days later.

When I returned it was confirmed - I am not an Idiot! I did not waste resources! I had breast cancer. 2 of the areas tested contained cancer cells. My chest wall was benign. 

 www.breastcancercare.org.uk

 www.macmillan.org.uk

 www.cancerresearchuk.org