Icicles & more ...

Icicles & more …

June 2012

Off we go then.  Blog-the-third attempts to say something about the reality of chemotherapy.

Hope this doesn’t depress anyone too much.  Various folk have expressed an interest in the actuality, so I thought I’d try to capture some of it at least.  I think it’s a delicate balance between stating the case as it is (or is for me), and being either falsely positive, or unnecessarily negative.  The line between having a positive attitude (without question the way to go in my mind) and denying the actual nature of the situation seems a thin one to me.  Therefore, I’ll just do my best …

So I’ll mention here that, as you’ll no doubt know, many people successfully work full-time all the way through chemo and manage to minimize the short-term side effects successfully enough to make this possible.  I think you have to be a pretty determined type to achieve it, but it is definitely possible.  Lovely Jacq, running her own company, has achieved exactly this, in spades.  In my case, I’m thankful not to be an employee at this stage, and to have the time available to take a slower approach.

                                                                                                                                                      

I’ll emphasise here that the nurses general position seems to be just get on with living your life, and deal with any issues if and when they arise.  Good advice.  Slightly easier said than done, but still good advice.

If you’re feeling delicate yourself and don’t want to know the reality, that’s ok with me, just skip reading this blog altogether and catch up next time round.

But, Lord above, where do the icicles fit in? (it’s coming …)

Chemotherapy City …

What is it like there? …

April to August 2012

Chemotherapy – ok, admittedly there are pleasanter ways to spend a day, but on the other hand not as terrible as you (or I) might fear.  Almost everyone I talk to seems already to understand a great deal about chemo, but for those still lucky enough not to I’m going to have a go at explaining a short(’ish) version of how things are day-to-day.  Can I just say, the obvious really does have to be emphasized – that every person undergoing chemo truly is experiencing a different journey.

Theoretically the same in broad principle, but drastically different in the detail.

Just like the rest of life then.  Here goes:

• There are over 50 chemotherapy drugs given in various ways – some are given on their own, some as two or more drugs together – called ‘combination chemotherapy’.  Doses depend on things like each persons own height and weight, and of course their condition.

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• My little cocktail is a two-part combo called EC90.  The drugs are Epirubicin and Cyclophosphamide.  As we all know, the internet is flooded with info on all the drugs, but for those that want it I really like the clarity of www.chemocare.com by Scott Hamilton.

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• Chemotherapy for most people (including me) means ‘cytotoxic chemotherapy’ i.e. toxic to cells.  As far as I understand what’s happening is the drugs attack every (rapidly dividing) cell in your body - that’s why you feel sick and exhausted, because you are under quite severe internal attack. The attack, and its side-effects are temporary – that’s why you, hopefully, get to recover.

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•  The idea goes along the lines of normal cells are well-developed, orderly, solidly structured, and can therefore recover from attack.  Cancer cells are apparently quite scruffy little individuals, chaotic and lacking structure, tending to give up the ghost fairly easily when pressurised.  So, that’s the aim, the good cells reassert themselves and live, and any bad ones croak-it.  Good.

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• Coming along at present are the newer anti-cancer drugs, which rather than taking the generalized approach above, are targeted treatments i.e. capable of targeting specific parts of individual cancer cells, and leaving healthy cells alone.  Therefore considerably more relevant (and less generally harmful) in the case of each individual.  Sounds fine to me - bring them on!

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The Chemo Cycle …

It’s all in the planning …

• So, each chemo cycle is 3 weeks – that’s 21 days to get attacked, recover, and prepare for the next attack.  The timing of the side effects is all quite precise, so actually that’s very helpful.  It means you know which days you’ll feel poor, and which days you’ll feel normal.  That’s great because it means you can actually plan the odd nice thing in – but you do need to get your timing right.

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• Of the 21 days, the first is the actual chemo day.  This is not as bad as ones mental image might portray.  For me (and most I imagine) the setting matters.  In York, luckily, this is a perfectly light and airy room full of perhaps ten very comfortable big armchairs for patients, whizzy chairs on castors for the nurses, and more chairs for companion, and lots of high-tech medical equipment!

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• The actual process of delivering the chemo drugs is very straight-forward.  The nurse inserts a cannula (thin, flexible tube) into a vein (hand or arm), attaches you to a drip and starts hooking on several bags of fluid containing the drugs in rotation, which drip in slowly. Takes about an hour.   If it wasn’t for the damn icicles, that would be it!

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• What icicles I hear you ask? (it’s coming …)

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• The nurses in York are really quite great.  Like swans – nice and calm on the surface, and apparently paddling like mad to get it all done underneath.  I’d honestly say I like the atmosphere they’ve created here in York.  It feels calm and controlled.  Well done them.  Tea is delivered frequently (by volunteers) and companions are made welcome.

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• Sadly, the old post-code lottery applies here.  My beautiful friend Chris did not have such a comforting experience in Essex.  She encountered patient over-crowding, horrible surroundings, and exhausted staff barely able to cope with their work-load, so spreading very negative vibes liberally around them.  Not great – probably no ones fault in particular, but not great.

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• Back to the chemo cycle.  Days 1 to 5 are fairly heavy-duty drugs – for me Emend (for nausea & vomiting) plus Dexamethasone (steroid) plus Ondemet (inhibits serotonin to the brain to reduce nausea & vomiting) plus other at-will anti-nausea drugs.  These days don’t feel great – nausea (in spite of the drugs) and tiredness.  I can do things, but may run out of energy half-way through.

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• Upsides are always available however.  Nurse advice is breakfast in bed whilst taking the drugs, so breakfast in bed it is (cheers again Andy).  And just generally lots of lounging about (writing blogs and similar ….).  Frankly, I feel I’ve always had panache when it comes to lounging about, so I’m in my element really.

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• There’s a thing unscientifically referred to as ‘chemo brain’ – meaning you can be temporarily quite confused.  I believe it’s as a result, literally, of the chemo drugs attacking your brain cells (along with all your other cells).  For me it seems to result in my saying things that are almost, but not quite, right, thus demonstrating the horrible power of what’s happening internally.

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• Days 7 to 10 (or possibly days 5 to 14 if it’s going less well) are when your white cells crash.  This unavoidable side-effect is neutropenia i.e. lowered resistance to infection.  EC90 reduces your white blood cell count making you susceptible to infection.  So not the best time to visit your sick aunt, the theatre, or similar.  After 14 days the cells start to recover again.

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• The good days are days 11 to 21.  Get out there.  Get motoring.  The world’s your oyster girl, and don’t you forget it!

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• Day 21 – a quick (30 minute max) visit to hospital for a super-fast blood check to make sure you’ve recovered enough for the next chemo-bashing tomorrow.  That’s it – one cycle.  Really, superficially not bad at all.  So, more than the daily reality, it’s the long-term repercussions I fear the most, but we’ll get to that in due course.

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Icicles, brrrrrrrrrrrr … What icicles?

Cold, I dread it …

April to August 2012

• Ok, so I can honestly say I haven’t felt fear (so far) as a result of my cancer diagnosis.  But cold now, as everyone who knows me knows full well, that reduces me to an incoherent blob.  Cold, winter, dark nights, it’s all wrapped up together for me, in fear and dread.  That life is periodically full of hazards I accept, and lack of control, and other not-perfect stuff – all necessary in order for us to learn along the way I’m sure.  So normally I’m quite philosophical about most things, and have no wish to change any of it, good or bad.  But bone-deep-cold, you see, that’s my uncontrollable fear.  It takes the desire to be alive right out of me.

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• So chemo causes hair loss.  That’s well-known.  It’s the epirubicin, delivered as a red liquid, which causes it.  It’s temporary, which doesn’t sound too bad (but actually, psychologically, it is).  However, if you’re on certain drugs you have a chance at avoiding hair-loss.  It’s called scalp-cooling.  ‘Cooling’ – it doesn’t sound sooooooooo bad as a word.

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• Scalp cooling works by literally cooling your scalp and thus reduces the blood supply to the hair cells.  This slows the activity in these cells, meaning less hair will fall out.  You are fitted with a close-fitting skull-cap (you end up looking like a very squashed jockey), and attached to a cooling machine that constantly circulates freezing water through the inside of the cap.

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• The process is achieved by cooling your whole head to minus 5 degrees celcius (which is pretty damn cold I can tell you) for about 5 hours.  It starts 30 minutes before the first drugs are administered, and lasts for about 3.5 hours after the last drugs have been dripped in.

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• The initial 10 minutes are horribly painful, then numbness sets in and the pain thankfully eases a bit.  So, the main challenge is just to get through the first 10 minutes!  I will say amazingly and unexpectedly I have got through the first 3 – purely thanks to Andy being there.  We play fast-and-furious card games to distract my thoughts.  If he wasn’t there, I would have failed every time.

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• Five hours later, the cap is removed, and – lord above – your head is covered in icicles!  And then it’s time to go home.  Now I ask you, is the icicle head look the best way to present yourself to the world?  I think not.  Yet the nurses say at this point, that’s it, we’re done for the day, off you go.  Honestly, we were flabbergasted the first time.  Like leaving the hairdressers half-done.  But actually, of course, they have no choice.  You can’t dry your hair with a hair-dryer or anything as it’s far too delicate and would just give up the ghost altogether and fall straight out.  So, it’s pat off the main icicles, on with a hat, and then off we go.

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• As with all things you’re warned there’s no guarantee of actual success.  It works for about a third of people, fails totally for another third, and leaves the last third with random tufts of hair that seem to be of no use to man nor beast. But importantly, one third of folk get to keep their hair!

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• In my case, it seems to be working.  That’s a relative statement of course.  I lost about a third of my hair after the first chemo (it just falls out uncontrollably in clumps), and a second third after the second chemo.  At this point we were convinced I’d got just a few days left of having my own hair, and were panic-buying wigs, scarves and hats like they were going out of fashion.

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• Then, the whole falling out thing unexpectedly slowed right down!  Yes!!!  Hooray!!!!!!  So now, I have hair – pretty thin and scruffy I admit, but currently still attached to my head in its own way, and we have wigs/scarves/hats at the ready!

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• Bizarrely, although the process of buying a wig has been truly horrible for me (my most traumatizing experience to date in fact), in the end I really like one that I have.  I feel like myself in it, which is the main thing for me.  I haven’t had to use it yet, but don’t mind the idea that I may end up doing so too much at all.  Time will tell.

• Interestingly, just so folk know, I’ve had no scans – not a one – where most cancer people seem to be ‘scanning’ for Britain.  I think it’s because it hadn’t spread.  Just thought I’d mention it, as that seems quite different to the experience of others.

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As far as I’m concerned life is still good and most importantly, its summer!!!

                                                                                                         

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See you in the next blog if not before.

Decisions, Decisions ...

Decisions, Decisions …

So it seems the bits of this whole breast cancer thing Andy and I are finding interesting may be different to the ones others find interesting.  Ok … so that gives me a few choices in writing this second blog.  So, I’m just going to split it into two bits, and perhaps each person can just read the bit they find interesting, and leave out the rest, and thus anyone who wants to keep up with the journey can do so without too much hassle.  Actually, once again I’m writing after the event because it’s complicated to keep up with experiencing all this, and writing it down simultaneously.

I guess that brings up the point that some of the detailed stuff just doesn’t make interesting reading – it’s pretty vital when you’re going through it, but a bit tedious otherwise I feel.  So, I’ll try to provide outlines, but all of us actually having the experience know there’s plenty more – some plain gruesome, some just plain funny.  As said before, I’m genuinely finding a lot of what we’re learning fascinating from all sorts of points of view.  To that end, I’m going to add in relevant information links where it seems a good idea, so anyone who really wants more detail can find it easily.  Just ignore them if that’s not you.

… and a boring note.  Everyone seems a bit freaked-out at the whole ‘blog’ thing, finding it difficult at first.  I know because I’m the same.  It seems you all do ‘Facebook’ and have got to grips with that.  I haven’t at all, because all the linking everyone to everyone just leaves me baffled.  I’ve found the ‘blog’ ok to write because to me it just feels like writing an ‘open’ letter and I don’t find that too scary!   So, most of you following this blog are doing so privately, not publicly.  No problem – I’m amazed anyone has read it at all!  So I’ve taken the ‘Followers’ thing off the blog, and will just send you all an e-mail when I update it to let you know.  Hope that’s ok with each of you!

Ok, off we go on this month’s journey.

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Decisions, Decisions …

How and why we ended up with chemotherapy …

March 2012

“…  Firstly, there’s a whole thing about how we (I’ve) ended up having chemotherapy when that was initially ruled out of the equation … “

So, already we’ve had several big learning points along the way.  One is that each time the professionals provide a timeline or path forward it’s liable to change further on - perhaps inevitable since this is a journey.  All the professionals emphasize that everything they do is just balancing and re-balancing risks at each point.  Also, that there are no paths / treatments, without risks.  Ok, that seems worth knowing.

Prior to my successful surgery results back on 1^st March, the professionals said no chemotherapy required.  Fantastic!  However, prior to our first meeting with my oncologist on 15^th March this changed, and we found ourselves sat with him unexpectedly discussing chemo.  This meeting in fact focused on risk of future recurrence of the cancer (called ‘distant recurrence’) which chemo exists to try to prevent.

Andy and I had already figured out according to our researches, this is the biggest issue that people apparently often don’t discuss with their professionals at all, but do in fact worry about for the rest of their lives – with good reason it turns out (more in the next blog on this whole thing).

So, there are loads of aspects to this.  The oncologists starting position was (with approx numbers):

• 48,000 people a year receive a breast cancer diagnosis in the UK.  Of these 37,000 are ER+ breast cancers (oestrogen receptor positive - that’s mine).  25,000 will automatically need chemotherapy (the cancer has already spread, and without the chemo would spread further - so, a simple decision for most – bring on the chemo and live!)  The other 12,000 people a year in the UK receive my exact same diagnosis (early onset – it hasn’t spread yet – and are borderline).

• Of these 12,000 my oncologist says 9/10 people will not benefit at all from receiving chemo, and could even be considerably harmed by it.  We query then why give it?  His reply is because it will save the life of the 1/10 patient.  Sounds logical - he also says that is his view precisely because he is not able to tell which of his patients are in the 9/10 camp, and who is the 1/10.

• Of course, that made Andy and I wonder if there is a way of finding out who is in which camp.  Well, wouldn’t you wonder just the same in this position?

• So, out comes Andy-the-ace-researcher again, and lo-and-behold he finds a Telegraph article by Stephen Adams on exactly this.  You can find out which camp you’re in!  If you’re interested, his article is at http://www.telegraph.co.uk/health/healthnews/8837132/New-breast-cancer-test-could-spare-thousands-chemo.html.

• The article splits my 12,000 differently and says 8,000 could benefit from a diagnostic test used routinely in the USA called ‘Oncotype DX’ that uses your levels of four proteins of importance to ER+ breast cancer to tell you exactly this (i.e. your risk of recurrence expressed as a number).   For those interested the Oncotype DX website is www.oncotypedx.com

• BUPA has been routinely using this test since 2010 (the English version is ‘IHC4’).  The NHS hasn’t committed to it yet, and is carrying out further research in the UK right now.  In fact NICE (National Institute for Clinical Excellence) are currently discussing a UK roll-out (maybe in the next year), saving patients unnecessary chemo, and the NHS a fortune in wasted treatment.

• Back we go to the oncologist on 22^nd March to say what does he know about this ‘Oncotype DX’ test?  Is it any use to me, and if so may we have it please?  His response is cautious, it exists exactly for patients with my precise diagnosis, and he knows everything about it, but he’s waiting for UK research and NICE to come to a conclusion to guide all the oncologists across the UK.

• Also, people don’t usually ask for it (only 1 patient in the last 2 years), and more to the point the NHS doesn’t pay for it yet.  So we counter with we’ll pay and can we have it?  He says yes ok, if that will help us make the decision whether to go for chemo or not.  Great – he sends my sample tissue to the USA, and we wait the 7 to 10 days it takes to get the results.

• Can I say a thank you here?  On learning we had to pay several of our friends and family offered to pay for it for us.  Not necessary, but wow – really WOW, so, without naming names, we would like to say THANK YOU and THANK YOU and THANK YOU and THANK YOU.                 We are Sooooooooo lucky to have you – you are all irreplaceable, and we know it!!

• Interestingly, my oncologist probably did find sending off for the ‘Oncotype DX’ test for us a bit of a nuisance to start with, but ended up saying it’s been an interesting learning experience for him too.  We’re only too glad to assist the NHS with their training costs I’m sure!  The good old NHS is sure doing plenty for me at present!

• Back to the ‘Oncotype DX’ results.  Obviously, we’re hoping it will come back and say you’re in the 9/10 who won’t benefit from chemo, so don’t do it (not benefiting here is defined as you are at very low risk of the cancer recurring in the future).

• NO chance sunshine.  It comes back on 10^th April – you are in the high-risk category of future recurrence.  Ah well – at least we now know there is a point to going through what’s to come.  Chemo starts two days later on 12^th April.

Treatment Arc …

The Point of the whole exercise …

January to October 2012

“ … Secondly, I think it’s quite interesting to understand the whole treatment ‘arc’.  Of course, I can only describe here my own treatment, as everyone’s varies considerably according to their own situation and cancer type, but I am going to try to capture mine because I think it’s interesting, even if it is just one example of very, very  many …”

My NHS treatment a while back was planned as two main stages, across three months:

Surgery in February 2012, followed by 3 weeks radiotherapy, and no chemotherapy required.  All completed by the end of March 2012.  Plus, eventually, 5 years of tamoxifen of course, but we’ll deal with that when we get there.

Now it’s a bit more extended, to three stages, across approximately nine months:

• Surgery February 2012 – localized treatment, been there, done that, all clear.  Marvellous.
• March 2012 was for rest, recuperation, and onward decision-making.

• Next up is 6 cycles of chemo April to August 2012, each three weeks apart, so spread over eighteen weeks in total.  For those who want dates:
• Cycles 1 to 3 : the first three were on 12^th April, 3^rd May and 24^th May – all three completed now, which means I’m half-way through already!  Yes!
• Cycles 4 to 6 : the next three chemo’s are due 14^th June, 5^th July and 26^th July (this last cycle ends 15^th August).

• Then approx. 3 to 4 weeks for more rest and recuperation (mid-August to mid-Sept).
• Onto 3 weeks of radiotherapy (mid-Sept to early Oct).
• And finally approx. 3 to 4 weeks recovery following that (that’s October taken care of).
• Which, surely, means I’m all done by the end of October 2012 with luck.
• Good, marvellous, thank God there’s something to look forward to!!!
• All looking good for my November birthday and Christmas.  Yippeeeeeeeeee.

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Just to say to round off, our whole life is not consumed with cancer at all at the moment.  True, it’s ever-present, and impossible to ignore on any level at all, but then again all of the rest of life continues as normal.  Perhaps just with a bit better planning required.

Loads of good stuff happening.  Birthdays surround us, therefore so do celebrations.  The biggest upcoming at present is Joy’s 80^th (Andy’s Mum) so that can only bring good stuff and plans with it.  Summer is here at last – I’m even getting compliments on looking well due to the first outings of newly-browned legs and shorts combinations! (can’t be too bad).  Light nights at last to make us (that’s just me really I know) forget the horror of winter cold and dark.  We’ve got the first couple of b-b-q’s under our belt now – always heaven as far as I’m concerned.  A couple of weekends ago we did a sudden-escape-to-Liverpool because I was really, really well and we had the most fun ever!  We hadn’t been before – who knows why, because it’s absolutely ace (I am receiving commission from the tourist board for this, never fear).  Anyone who hasn’t gone, and feels in need of some silly fun, try the “Yellow Duckmarine” for size – I haven’t laughed so much for ages.  Andy’s getting in an odd bike ride at last, or walk, or trip to the pub with friends to keep his sanity levels up.  My Mum’s successfully through yet another week in hospital.  So, loads of good stuff along with the rest!  And actually loads of lovely time with lots of you lovely folk, lazy lunches, games and good visits and outings in general

… Thank you all.

See you in the next blog, if not before.

Keeping It In Proportion

Keeping It In Proportion

April 2012

So, where to start – perhaps with others, rather than myself.  Andy and I are very conscious that we have really dear friends and family currently facing much more serious health issues than mine, cancer and otherwise.  That assists wonderfully in providing a lesson of keeping it in proportion.  As most will know two of my very best friends in the universe were both given cancer diagnosis last August / September.

My lovely Cornwall friend Jacq received her breast cancer diagnosis in August, and has written a blog throughout (she’s where I nicked this blog idea from – she knows I’m copying – imitation – the sincerest form of flattery!).  Wonderfully, she’s just about through her treatment now – only two more weeks to go and she’s flying free again!!  We thank her for her positive example, and inspirational determination not to be defined by her cancer, but only by her own super-positive outlook on life in general.

My wonderful lifelong friend Chris received her terminal lung cancer diagnosis in September 2011 – initially with a time frame of 12 to 18 months left on this planet.  Well, in the event she died on Easter Sunday this year.  Andy & I were lucky enough to be there all over Easter weekend – it was a privilege.  It was amazingly peaceful and loving and I swear she was happy because she was surrounded by people who loved her deeply.  So, 34 years of friendship brought to a conclusion, as is now her very unusual life and way of approaching her time on earth.  All I can say is what a gift it has been to share so deeply so many of her 52 years.

And now, Dave, Andy’s brother-in-law diagnosed with lymphoma, and in a much more serious situation than I myself – we send him every blessing, and good luck.  Previously, other members of Andy’s family with other cancers, and now through their treatment.  My Mum and 20+ years of heart problems, numerous operations … and still with us … thanks NHS.

It seems cancer (all the 200+ types) currently affects 1 in 3 of the UK population, so we will all know several people on this journey, or who have already completed the journey.  It seems to me it’s the disease of our times.  In the sense that whenever we happen to live in history, and in whatever society, there’s always a major disease (or several), and this is ours.  In that sense I’m not at all surprised to be included in the 1 in 3.  I’m sure there were some teenage years when I thought statistics somehow didn’t apply to me personally, but those years are far behind now, so I don’t feel surprised at all.

All of life, obviously, is learning, so Andy, Fran and I are now learning about the world of cancer first-hand.  Its ok, it’s not as scary as it could be by any means, and actually we’re finding it all quite interesting.  Andy has turned into super-researcher extraordinaire in addition to all the talents we already knew he has.  His particular talent for spreading calm is definitely coming in handy.  We’re not claiming total lack of shock and similar – that’s all in the mix as well.  Since Chris’s death we’ve been a house of tears, but after all they can be cleansing, so good.  And, again, as we all already know the price of love can always be loss, so only natural.

It seems this is a very interesting time to have cancer.  Just as the whole UK treatment emphasis is moving from generalized treatment, and aggressive over-treatment for all, to more specific and targeted treatments for each individual.  We’ll all be hearing the daily tv and radio discussions on imminent changes to treatments – very interesting stuff.  However, I’ve fallen into the current NHS systems – had I been diagnosed next year I feel it’s likely my entire treatment regime would be radically different.  Just to be clear – that’s not a complaint, just a point of interest.  Had I not been lucky enough to find this cancer this year, in its early stages, next year, who knows, the diagnosis may have been terminal.  So I’m definitely counting myself lucky, as it isn’t.

Ok, off we go on the journey.  I’ll attempt to get the medical stuff right, but the accuracy might not be 100%, so bear with me!

Diagnosis to Operation

January/February/March 2012

Lump found January this year.  GP referred me to hospital for mammograms, ultrasounds, and core biopsy.  Formal hospital diagnosis given to Andy and I at 5pm on Thursday 9^th February together with an offer of surgery at 10am on Friday 10^th February.  Lord above – we really can’t complain about NHS waiting times!  However, Andy and I had a similar reaction.  Apparently most people would have taken that offer.  We needed thinking time, so opted for surgery a week later on Friday 17^th February.  We spent the intervening week researching like mad.  Apparently lots of people ask no questions at all.  We had lots – really lots of questions.

• The formal diagnosis is breast cancer : invasive ductal carcinoma / hormone receptor positive & HER-2 negative.  The good news is it is small (30mm), and it hasn’t spread to my lymph nodes, therefore in theory hasn’t traveled to elsewhere in my body.  The bad news is it is aggressive (grade 3) and being fed by my own oestrogen.

• The plan is surgery on 17^th February, followed by 3 weeks radiotherapy, and 5 years tamoxifen - and no chemotherapy required.  The surgery is a wide local excision (a lumpectomy), so I’m lucky and am able to avoid a mastectomy – it was offered as a possibility, but not recommended.  All done by the end of March 2012!  Sounds fab, sounds manageable (hint - that changes later).

• Consequently, we decided not to tell friends and family at this point.  Plenty of them have bigger issues to deal with than this.

• So, a whirlwind week 10^th to 17^th February.  We had a couple of gorgeous Chinese students staying (Danqi Shen and Xixi Jin), who left on Saturday 11^th.  We hadn’t mentioned it to them 9^th and 10^th because they made us very happy and we didn’t want to spoil our last couple of days together.

• The day before the op involved a trip to the Nuclear Medicine department for a sentinel node imaging scan.  Blue radioactive dye injected to assist the surgeon to see what’s she’s doing.  I’m all in favour of the surgeon being able to see what she’s doing!  A super-quick, super-simple process, with the interesting side-effect of blue wee for the next couple of days!  On to the op.

• Op day 17^th February – all went ok.  As far as the surgeon is concerned, this is not complicated surgery (all surgery seems fairly mind-blowing to me – for a start cancer cells are invisible – how do they even start?).  Andy and I got in a couple of games of verbosity whilst waiting (I beat him hands down).  I was even allowed to come home the same day, which felt really, really good

• Nurses advice – no housework or similar for …. ooh… ages.  Suits me just fine (cheers Andy).

• After a few drugged and bruised lounging about days I got a bit lax, forgot I was still post-op, and overstretched … resulting in a haematoma (a localised collection of blood) pressing on my ribcage.  I’ve never had broken ribs, but imagine this may be how it feels… amazing pain … for 2 weeks.  It was eventually drained … what a relief!

• Results clinic on 1^st March.  Operation totally successful – the surgeon is very pleased with herself – me too.  What a woman.  Thanks.  After which Andy, Fran and I went out for the best celebration dinner ever at Plunkets - my favourite restaurant.  With real champagne no less, courtesy of my lovely Fran! (cheers Fran).

• On to the next stage – next blog in a while.