A touch of Spring and The Follow-Up

I wanted to bring you a montage of Spring (flowers, pond videos etc) to entertain you all before I went back to my stage 1 breast cancer journey tale. If you’ve just arrived the first instalment is HERE and the second HERE. 

So here is Spring – Cornish style (well in my garden anyway)

You can engage in some peaceful Newt Watching  [click here if reading on email  ] and just listen to the birds in the background! Or a wriggle of Tadpoles [click here if reading on email]
and just look at the flowers – all late – but here they come – and a nice bumble-bee too –  new life – JOY !

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And so now, in a relaxed and positive frame of mind, on to the second part of today’s blog, my stage 1 breast cancer journey continues …

The Follow-Up

Maybe I had over-done it at Belly Dance the Thursday before – but my breast was a bit tender and the bruising was still changing from blue through those wonderful yellow shades, so didn’t look a pretty sight (see below) Not that it would bother the surgeon, I’m sure. He was mostly interested in the healing of the incisions … which was good 🙂

He then went through the results: No cancers cells detected in the margin of ‘healthy’ cells they took out with the tumour. (GOOD NEWS) No cancer in any of the 4 lymph nodes that they took from under my arm. (Extra GOOD News!)

Of the tumour – a total of 22mm – the central 9mm was Grade 2 stage Invasive Ductal Carcinoma – the outer layer ‘intermediate* grade’ Ductal Carcinoma In-Situ (DCIS) (*as in between 1 and 2) Not such good news – as the grade 2 is invasive –  and had already broken out of the milk duct it began in.

To mop-up any stray individual cancer cells – or other cells in the breast that were planning on turning cancerous – 3 weeks radiotherapy was recommended. This is not without risks, varying from minor to major, from as common as one in four to very rare, and can be very uncomfortable and tiring at the time and for a while afterwards.

Then he told me that the cancer was Oestrogen Positive. {often written ER+ because the Americans spell it Estrogen} This means that the cancer uses oestrogen to stimulate it’s growth. Now, being past menopause – you would think there wasn’t too much oestrogen kicking around anyway – however, there’s enough to be a problem! So the recommendation is a five year course of oestrogen blockers ‘hormone therapy’ – that stop the uptake of oestrogen by the cancer cells.

Which – hang on ladies – can throw you back into all those menopause symptoms you thought you had at last got over! Yep! Hot flushes, night-sweats, brain fog – whatever was in your bag. And after doing five years to get through it ‘cold-turkey’ (i.e. no HRT – one thing that is shown to increase chances of breast cancer) is a teensy bit annoying.

However – there are more than one ‘family’ groups of oestrogen blockers – and if you don’t get on with one – say after 6 months (because it takes at  least that long to settle into it) you may be changed to another to find one that does suit you. They say it is rare that someone doesn’t get on with any but with my reactions to so many medicines (and anaesthetics!) I’m a little trepidatious but I intend to take it up…

WHY? well, because taking the oestrogen blocker stops the cancer cells getting hold of their growth boosting ingredient – and this is shown to give a better chance of surviving after having breast cancer treatment.

The doctors will use a tool called Predict – to tell you what your long-term chances are if you ask (that is – five years and ten years after surgery and whichever treatments you have).  Once you have all your details you can find it for yourself here :  PREDICT

The difference that oestrogen blockers make in an oestrogen-positive cancer patient with my details (age, how detected, size of tumour, HER2-,  grade, treatment plan) is 2.9% after ten years (from 79.2% still alive after 10 years, to 82.1%)

So … watch this space – as they say … quite a while to go yet though – radiotherapy first … and I’m not really looking forward to that either having watched Dad go through it all not so long ago!

Oh, I promised you a picture of how it is healing up? … hang on … there – healing well – complete with ‘interesting colours’  🙂wp_20180428_07_30_40_pro

Let me add – this is just my experience. I couldn’t find any early stage breast cancer stories on blogs – so decided that I would do it – for others who want to see what this stage is like ( as opposed to the drastic cases usually written about) Being positive, being informed, and getting on with it, is my way through. Hope you found something useful – and if you want to share your experiences please do use the comments. If you want to praise the bounties of Spring – you can do that too!  🙂

Best Ann

ps If you are reading this on email and would like to comment just click onto the title and it will take you to the actual blog – so you can comment there 🙂

pps If it is the first time you have written a comment don’t worry if it doesn’t appear immediately, your first comment has to be verified (to keep the spam-bots out) and I do this personally – so I am sure to see your comment – thanks for reading – Ann

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Plan of Action and Operation

primroses-with-redIn the last instalment of my stage 1 breast cancer journey – I had just received The Letter – and had an appointment to go and talk with the surgeon about my treatment.

So it was back to the Primrose Breast Care Centre and there I was met by a Primrose nurse and, having dis-robed my top half, was decked in a pink mini-cape. The surgeon then joined us to examine the problem.

To start with, I think the amount of bruising was exceptional, the Primrose nurse said ‘Oh my’ and she must see it all. I was asked twice if I was on any blood thinners – like aspirin. I am not.** see below **

I have to say that there were now two hard lumps, one about the size of half a marble, the other slightly smaller, that had come up with the bruising. I had put this down to the two sites of sampling, but when the surgeon said that the cancer sites (lumps) were quite palpable I had to say that they were not until the biopsy!

From the scan they had looked quite deep, but I was told they were here, where these two  ‘now palpable’ lumps were, therefore not far beneath the skin.

What can I say… if these, not-deep cancers, were not able to be felt – what chance to feel any deep-set ones! Yet the mammogram found them! So, as I said last week, if you get the call to the mammogram – GO!

Once dressed we met again to discuss the treatment, which had already been discussed with the medical team and a recommendation made. This was to remove the two lumps (a lumpectomy) along with a margin of cancer-free breast and also to remove one or more sentinel lymph nodes from just into my armpit.

Both the lumps and the nodes would be examined to check that there were no cancer cells, a, on the clear margin around the lumps and b, in the lymph nodes. If this is the case then, after time for healing, we can go forward to the next stage of treatment –  three weeks of radiotherapy.

** I thought I would look up the non-prescribed supplements that I take – in case any of these are blood-thinners… Cod liver oil, Vitamin D (used from October to May – while the sun isn’t strong enough to make vitamin D in the skin) Glucosamine and Chondroitin, Magnesium glycinate (half daily recommended dose) 3mg Boron, Vitamin B complex. The internet offered so much that was confusing and contradictory that I had another idea! No. 3 son is the one with the PhD in microbiology and works in a business that works with pharmaceutical companies – so I asked him. He came back with ‘there a whole lot of stuff that’s contradictory out there’, but, Chondroitin and Magnesium have scientific evidence of acting as blood thinners. Nothing wrong with this usually, but not good if you would like to avoid bruising. So I cut out both for a week before the operation **

The Operation Day

Another early morning – I really don’t do early very well but I was up early enough to shower and eat my usual breakfast one-egg omelette (breakfast was allowed as long as it was eaten before 7 – as my operation wasn’t until later in the afternoon).

The Husband dropped me off at the hospital at about 7.45am (about the time I start to wake up usually) and I made my way to my first stop – the Primrose Centre. I was armed for my waits with my kindle and a downloaded copy of Terry Pratchett’s ‘The Fifth Elephant’ – something easy to read, funny and distracting. I didn’t have much time to get stuck in as, within a couple of minutes of my appointment time, a nurse took me through to go through paperwork with me – mainly about the exercises to do after the operation and when and how to remove, or have the dressings removed, when the time came. A few minutes more and it was an ultrasound scan – from the same radiologist – who then drew on my breast to indicate the precise areas of the lumps as guided by the scan.

From there I had to head down to Nuclear Medicine – where a blue radioactive dye was injected into my breast so that it would flow through to the sentinel lymph nodes – whereby they could be made visible to the surgeon.

As it happens, I then had a two hour wait until I was due at my next appointment venue – the ward where I would go through all the preparations, checks and paperwork prior to the operation itself. It was a beautiful sunny day, if with a cool wind, so I set off to walk down behind the hospital to where I had seen a pond marked on trips with my Dad to the lowest areas of the hospital where the radiotherapy department is tucked away. The pond had both tadpoles and fish, which were diverting to watch for a few minutes, and a seat in a sunny spot that was ideal for reading, and chuckling, over Pratchett’s story.

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my ‘bit of brightness’ dressing-gown

Later, after waiting between being ‘seen’ (that saw me reading and chuckling to myself – over the book I was reading – other waiting patients probably thought me mad) and after blood-pressure taking nurse, chat with surgeon, who further annotated my chest with arrows pointing to armpit and breast, and finally the anaesthetist, it was – get changed! Oh yes, and pop on these pressure stockings! SO tight to get on – even when I read the tiny instructions and did it the right way – yes, I have well-developed calves!  Then the usual, oh so elegant, hospital gown and then, my flash red ‘silk’ with-Peacocks-and-Chinese-blossoms-all-over-it dressing-gown, to cover it all. Well you have to look bright sometimes … and off we went for a little walk to the prep-room, to be administered the anaesthetic  >>> . . . . .  .   .    .     .       .

.    .     .    .   .  .  .  . . . . . … and woozily I was called back to the world. And the fun began. I had said to the anaesthetist that I didn’t do well with general anaesthetics – well the last time I had them – over 24 years ago. I was, confidently, told that anaesthetics had moved on since then.

Hmm, not for me it hadn’t. So they gave me an antiemetic (anti-sickness drug) to dissolve under my tongue – then tried with the sips of water again …. OOops  no go!! I guess, finding me coherent, if still sick, they decided I was fine to go into the next stage of recovery, where, nibbled ginger biscuits and sips of water were tried … OOoops! no go! So it was that they gave me an intravenous antiemetic … then a cup of tea! Down in sips – and …. OOOOps out again!

Seems my body still doesn’t like anaesthetics! By now the woman who came in well after me was happily feasting on tea and sandwiches! So – this aspect is just how it affects me! They decided they’d call the Husband anyway as it was getting late  … which they did … and sent me off with him, a couple of packets of pain-killers and a sick bowl!

Next morning I was fine – managed to eat quite happily! I also polished off the rest of the Pratchett as I didn’t feel up to doing much else! I took a couple of pictures – so that anyone interested in what the operation looked like at this stage can compare, should they need to.breast-after-op-crop Not much additional bruising to be seen, just in two places. The dark bruising towards the nipple is still what remains from the biopsy – and nothing to do with the operation. (note: my phone doesn’t have a ‘selfie’ camera, just an away facing one, so it makes taking these pics tricky!)

This is also the morning to begin the exercises – and though the dressings pulled the skin they were attached to – these were fine, not actually hurting. Certainly worth doing to make sure flexibility and strength are maintained!

The First Six Days

All week it has been sore! I’ve been taking one paracetamol and one ibuprofen every four or five hours – and that includes half-way through the night when the ache/pain woke me. A few days I found I just had to go and lie down, and easily slipped into a doze. An hour later I woke feeling much refreshed. Maybe this is the effect of the painkillers (medicines I rarely take and then usually only one at a time or they knock me out) or the healing process I do not know – but it’s good to listen to your own body and follow it’s instructions!

Wearing a bra overnight is weird – but recommended and I would say it does help support, and therefore not pull, on the operation sites. A bra-extender was recommended to counteract the tightness of your usual bra brought on by the swelling from the operation. As I’d not thought about it until a bit late, I constructed my own from an old bra, cutting the two fastenings off and sewing them back together – it has worked really well, making the bra far more comfortable! For anyone who thinks about it earlier they are easily available on eBay or Amazon.

DAY 7

I was told to remove the waterproof dressings on day seven . Options were given a, do it yourself, b go into a practice nurse to have it done, or c, if you were worried or had extensive surgery (like a mastectomy) to go back into the Primrose to have it removed. I opted for a.

Then, in the shower, the steri-strips all peeled off. Leaving the naked lines of the cuts visible. Not too bad looking, though the one under the arm feels lumpy, and the waterproof dressings had started to irritate my skin and cause a rash. breast-dressings-off-cropBoth cuts are about 5 cms long. The bruising from the operation has also faded a bit now – though there’s still some from the biopsy. Whether this was because I’d cut out the magnesium and Chondratin or because there is less force in an operation, I do not know.

So this is where I am, recovering …

… and I hope that this has been of some use to anyone facing the same level of diagnosis. As I said – I’m blogging this experience to help anyone else going through it, now or in the future, to have some kind of comparison – as most blogs seem to be about the worst cases – rather than the early ones.

Thank you if you emailed me with kind words, they are appreciated.

Thoughts, Comments, Questions – All are welcome, you know I love to hear from you.

Best – Ann

ps If you are reading this on email and would like to comment just click onto the title and it will take you to the actual blog – so you can comment there 🙂

pps If it is the first time you have written a comment don’t worry if it doesn’t appear immediately, your first comment has to be verified (to keep the spam-bots out) and I do this personally – so I am sure to see your comment – thanks for reading – Ann

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And Now This …

And now this … those of you living near me probably know already … as I have roles in so many local groups that I found I had to tell a lot of people (so that I didn’t let anyone down at the last minute).

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primroses

Oh! Why?  

Glad you asked, well, my three-yearly mammogram came round about six weeks after Dad’s funeral. I went along – as I always do – quite happily, being sure that I felt no lumps or anything unusual – and I do check.    . . . First a bit of history …

Back in 2003 a mammogram had found something suspicious … that call-back, followed by a biopsy a couple of weeks later, resulted in a diagnosis of Micro-calcification. (poem from the time below)

Evidence of micro calcification

I find myself aware of life, all life
taking care not to harm
even the ant. Just as when expecting,
an un-thought, instinctive  
seeking wholeness and health.

I ask, ‘worse case scenario’
tuck away pieces of terminology
seek little more, seem un-worried
but later, research thoroughly
– the odds work both ways.

Biopsy; as always, do as I’m told
be as still as I know how
the conscientious student
the un-worried patient
put it all at the back of my mind.

From the bath I rescue
both silverfish and spider, for once
pray for myself instead of just others.
Then the letter, and my relief reveals
to me the degree of my anxiety.

Ann Foweraker

Nothing to worry about after-all !

Then a few years ago I had a sort-of sore feeling in my left breast when I lay on that side, nothing to feel lump-wise, just sore – a bit like an old bruise that still hurts when pressed. The ‘soreness’ didn’t go away, so after a few weeks I saw the GP, who referred me for a mammogram just to be sure – it showed nothing to worry about at all ! (and the soreness went away too after a little while)

Then this latest mammogramand the call-back. Immediately I checked again – I still couldn’t feel anything untoward! So set off in a hopeful mood – that this would also be a false alarm

In Plymouth’s Derriford Hospital we have the Primrose Breast Care Centre – here everything for breast care is drawn together so you don’t have to wander around the hospital, going from department to department. It is a charitable foundation working with the NHS to provide the best breast care experience and, completely coincidentally, something that one of the groups I’m involved with had recently voted as this year’s charity to support.

First it was in to take another set of mammograms – to check the area they were concerned with – though they took scans of both breasts – perhaps for comparison.

These must have been sent almost straight into the Radiographer, for that was my next port of call, within a few minutes. The doctor then did a ultrasound and told me, in a kind way, that there were two patches, right beside each other, that, in his opinion, looked very like cancer, and that he was usually right 19 out of 20 times. So he would need to do a biopsy.

There’s me thinking I would have to wait of a couple of weeks for this, as before – but no, within a minute or two he and the nurse were ready to perform the biopsy, the skin numbed and the needle guided by the ultra-sound scan. It wasn’t too painful – an odd tugging feeling in the breast as the needle ‘clunked’, twice, and it was done – the nurse pressing down to stop the bleeding and then putting paper-stitches and a waterproof dressing over the wound. After a meeting with another Primrose nurse to fill out forms, I was ready to go home.

Apparently the pressing is supposed to stop bruising – all I can say – is it didn’t work very well for me! I know I bruise easily – I’m always finding bruises on my hips and shoulders where I’ve caught something, so lightly I can’t remember doing it – but the bruise is there anyway.

breast-cropThis photo is after three days. You can see the site of the biopsy, where the tape was – it left un-bruised lines, and even the water-proof dressing curbed the depth of bruise – but the rest of the bruising spread far and wide! (Don’t be alarmed – it looks a lot worse than it felt – actually the main soreness was around the site of the needle insertion – the red dot)

 Then – about a week later – The Letter. ..

I’d definitely been diagnosed with breast cancer … and a trip into the Primrose Unit again beckoned, this time to discuss treatment with the surgeon.

My reaction? Well, to be honest – pretty miffed! I was just ready to get going again on so many fronts. Yet, somehow, not altogether surprised as I have seen, over the last ten years or so, so many people who have cared for others (often with cancer or another life-threatening, or debilitating, condition) who have then gone on to develop cancer themselves. . . it almost seems as if it is catching – but of course – it isn’t.

My next reaction – research! No point in panic or upset – I’ve just got to get on with it – but find out all I can! That’s me 🙂

Why? Oh Why? Am I blogging this?

Well, because my cancer is (provisional) stage 1 (Early – invasive ductal carcinoma) and, luckily HER2 negative (so, not aggressive) and when I was researching I found that there are many, many blogs out there about aggressive, or late-discovered tumours – but few about the early ones, therefore few to compare with.

AND because I couldn’t feel ANYTHING that would have warned me – even when I had the re-call letter and gave it a really thorough checking out! ONLY the MAMMOGRAM picked it up. So I want to say, when you get the call for your mammogram – GO! I’m only glad my call came this year – not in another couple!

One thing I know – there are hundreds and thousands of people out there who have had breast cancer – survived – and living life to the full – so if you’d like to share here – please do – as always, I love to hear from you – on this or anything else…

And that’s me for today … Best ~ Ann

ps If you are reading this on email and would like to comment just click onto the title and it will take you to the actual blog – so you can comment there 🙂

pps If it is the first time you have written a comment don’t worry if it doesn’t appear immediately, your first comment has to be verified (to keep the spam-bots out) and I do this personally – so I am sure to see your comment – thanks for reading – Ann

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