Category: Breast reconstruction surgery

Breast cancer lesson number nine: Some tears are worth crying

On By Jackie ScullyIn Breast reconstruction surgery, Kindness5 Comments

I’m one of life’s criers. I shed tears at a screening of Cool Runnings. I well up on hearing the heartfelt stories on Surprise Surprise and X Factor (yes, I do realise I have admitted this publically!). Even reading sentimental verses on birthday cards in shops is enough to set me off. In short, leaving the house without a packet of tissues is a daring act.

For a sensitive soul who wears her heart very much on her sleeve, I thought a cancer diagnosis would be my undoing (and shares in Kleenex, my pension pot). But, I must confess, beyond the odd epic wailing sessions (the boardroom at work being a particular highlight on day 4), I have shed very few tears about the unfair situation I now find myself in.  

In fact, most of my tears are due to the fact I have been truly touched and inspired by random acts of kindness, thoughtful gestures and supportive messages. These are tears worth crying in my book.

Read the news headlines, and you could be forgiven for thinking that the world is a pretty dark place, scarred by death, disaster and destruction. Scratch the surface, however, and you will discover that behind every sad story lies real beauty and tales of love that will move even the strongest person to tears. The truth is, the world is full of wonderful people – you just need to know where to look.

These wonderful people may not stop the presses, but there are so many reasons (too many for an entire blog, let alone one post) why they should. In my life right now, they are my front page and my headlines. They are the soundtrack to each day, filling up my heart and my Blackberry with the most humbling words and gestures.

Kindness takes many forms. It’s a cup of tea from a busy nurse. It’s a knowing smile from a stranger across a waiting room. It’s a thoughtful note left on my desk. It’s a touching email from someone I once helped. It’s reconnecting with an old friend. It’s a tip about wigs from a client. It’s a colleague who prints out a diagram demonstrating how a plane stays in the air (see lesson number four to see what I mean). It’s a plant with kind wishes from New Zealand. It’s a sleep CD. It’s a complete cancer care kit from teams at work – everything from an inflatable bath pillow to an overnight bag. It’s an offer of help. It’s a chemo care box from my kind soul, complete with words of encouragement. It’s cake and tea in plastic cups at Sketch (plus a pretty exciting excursion to the toilets). It’s a four and a half hour bus ride for a hospital appointment. It’s ice cream sundaes and smiles. It’s a coaster, roses, books and cookie cutters. It’s a ‘like’ and a ‘follow’ on social media. It’s an impromptu blood test (sorry Duncan). It’s a knitted teddy. It’s a knock on the door on a Saturday morning. It’s curry, cuticle cream and good chat. It’s research completed by a friend. It’s handmade bags for carrying my drains. It’s wine at lunch time. It’s chocolate and homemade treats to fatten me up. It’s a charity run – or two. It’s a never-ending list of kind acts that makes me feel happy to be alive – and ready to fight.

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Sorry cancer, in the face of such kindness and generosity, you don’t stand a chance. There are many memories from this phase that I hope will fade. There are others I will want to cling to forever – and take forward with me.

I am not sure I will ever be able to thank you all for the kindness you have shown me so far – and I haven’t even been anaesthetised yet! But, I am determined to focus on getting better, so I can spend the rest of my life trying.

So, this is my shout out to all the nice people in the world. If you’re reading this, that includes you. Thank you for being part of this chapter and for making me smile (when I am not crying about how amazing you are). You know who you are…

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Breast cancer lesson number seven: Cake is good for the soul and great for the boob!

On By Jackie ScullyIn Baking, Breast reconstruction surgery, Diagnosis and treatment planning5 Comments

Ok, so this isn’t an official medical recommendation. But, for someone who has a rather unhealthy obsession with hundreds and thousands and Green and Black’s vanilla white chocolate, it’s nice to know that the sweet stuff does have its uses!

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As you’ve probably guessed, I did pass the ‘fat’ test. But, in the words of my plastic surgeon, it is ‘tight’. That means, a week on Friday, I will be having a mastectomy (right boob off), axillary clearance (lymph nodes out) and immediate reconstruction (boob job) with, you guessed it, my tummy fat (a DIEP flap). I have always wanted to know what a flat stomach would look like. Now, for six weeks at least (post-op), I’ll know.

Today was an odd day to say the least. I did, however, learn two interesting things. Firstly, wear good knickers at all times because you never know when you are going to be asked to flash them. Secondly, don’t let anyone book your appointments the wrong way round – even if they say it won’t matter.

I started the day with the cancer surgeon, who revealed that the second biopsy confirmed the presence of even more cancer. At first he said: ‘I think it’s benign.’ Then he checked the notes and said: ‘ah, actually it’s more cancer.’ Interesting fact though, it doesn’t matter how many tumours you have in your boob, the treatment is based on attacking the largest one! So, no change then – just more cancer (nice).

The trouble is, because I hadn’t yet had the results of the ‘fat’ test, it was very hard to discuss the planned surgery. So, a completely hypothetical ‘what-happens-if-I-am-not-fat-enough-this-afternoon?’ discussion followed. One implant-measuring session and one consent form later and talk turned to surgery dates. ‘If we can’t use your fat, we can squeeze you in this week,’ the surgeon added. I am ashamed to admit, my immediate panic was more due to the fact I have conference calls, meetings, presentations and dinners planned for next week – not the fact I’d be starting to kick those cancer cells even earlier!

Thankfully, after spending lunch counting all the people that would be affected by this date change, I was relieved to discover that my commitment to cake eating had paid off. The most amusing part of all of this is that apparently tummy fat never forgets its origins. So, if I don’t cut back on the white chocolate and Cadbury’s Heroes after surgery, my right boob will make a rather ‘large’ statement. Almost worth trying just to see if it’s true.

Nothing if not obedient, I now have exactly 10 days to bake like Mary Berry before I am sentenced to six weeks of no exercise. I can’t even lift a supermarket shopping bag (he was quite specific, so that must mean other shopping is just fine). Every cloud… If only there was a way of bypassing the thighs and just channelling those calories into the abdomen.

One small aside before I finish. I have a first contender for Cancer Room 101 – people who moan in waiting rooms. There should be a big sign that says: ‘rejoice when there are long queues. It means the people caring for you are taking time to look after you and other people.’ Loud huffing and audible sighing is not cool. Next time, when you’re waiting and that clock is ticking, smile and say thank you for the dedication of the care team working tirelessly to fix you.

So let’s all raise a glass to flour, water, sugar and butter (preferably mixed and baked). It’s only taken a decade in the kitchen to realise just how important a mixing bowl and a wooden spoon are when your life is on the line! 

Breast cancer lesson number six: If Dr Google really had the answers, we’d all be camping out at A&E on a regular basis

On By Jackie ScullyIn Breast reconstruction surgery, Chemotherapy, Diagnosis and treatment planning, Reflections on cancerLeave a comment

Dr Google should be struck off! Far from reassuring us with his wit and his wisdom, one session on the computer is enough to make us run a mile – preferably in the direction of a general anaesthetic! (Please note, I have nothing against Google the colourful brand and the usefulness of its search functionality, just the medical company it keeps.)

In the fight against cancer, however, it doesn’t take long to learn that knowledge is power. And I’m a big fan of power. I walked into the hospital on diagnosis day thinking about my latest publishing deadlines and whether or not I had enough chorizo left to make a risotto for dinner. I came out armed with a small forest worth of paperwork and the determination to read and understand every word.

As far as I am concerned, cancer is just another client – albeit a rather impatient and demanding one that doesn’t seem to like my scheduling! It has its very own notebook, to-do list and meetings calendar. It also has its own agenda – which currently doesn’t quite match mine!

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So, having discharged myself from Dr Google’s rather unsteady hands, I took it upon myself to plough through more than 400 pages on the subject in just one day (it was a particularly fun day!) I am at last learning the language of breast cancer – and fertility for that matter. From lobules to lymph nodes and stages to systemic treatments, my brain is now a giant glossary of specialist terms that sound like they belong in a science fiction movie. I am also comfortable talking openly about boobs (hence the name of this blog), which has been a little alarming for the men in my life. 

Knowing that you feel well, but also knowing that there is something inside you trying to take your life away, is a hard thing to process. For the first few days after my diagnosis, I found it so hard to sleep. As irrational as it may sound, I thought that if I shut my eyes and let my body take charge, the cancer would take me. That’s why I quickly realised, it is so important to stick to what you know and what makes you feel like you are in control. For me, that’s hard work – and lots of it.

If you’re as interested as me about the little battle going on inside my angry right breast, here are the facts (as I currently know them). I must add here that two weeks does not a cancer surgeon make. I have a degree in English, not medicine, and this is my take on the information provided to me.

The Scully guide to Stage 2, invasive lobular carcinoma

1)   It wants to make friends: invasive (rather than ‘in situ’ or non-invasive cancer) means it has the ability to spread. It has already teamed up with the lymph nodes under my arm, so they’ve all got to come out on surgery day. I can assure you this is one invasion that won’t make the history books.

2)   It all started in the dairy: the lobular bit in the name means that cells started to divide and grow abnormally in my milk-producing glands or lobules (rather than my ducts – tubes that carry milk to the nipple). 

3)   It knows the score: whether you like it or not, your cancer gets a grade (and trust me, this is not the time to be top of the class!). The scoring system used grades the cancer (from 1 to 4) by looking at the size of the tumour, whether the lymph nodes are affected and whether there is any spread to other body parts. I have a tumour that is around 40mm (there are two other suspicious areas and I get the biopsy results tomorrow) and there is evidence of cancer in my lymph nodes. That puts me at stage 2. I’ll take that thanks.

4)   Oestrogen is keeping the cancer well fed: this is actually one of the hardest parts of the diagnosis to take in many ways. It feels like my own femininity is leading the charge. The only good thing is that there are more hormone drugs available to join my side of the battle.

There will always be more to learn but, for now, I think I know my enemy. Cancer, it’s time for you to be afraid, not me! 

Breast cancer lesson number three: Good things do not always come in small packages!

On By Jackie ScullyIn Breast reconstruction surgery, Chemotherapy, Diagnosis and treatment planning, Reflections on cancer8 Comments

As a pint-sized person, I have always been an advocate of the little things in life – Cadbury’s Heroes being a particularly good example (why would you eat a full-sized chocolate bar again?!). My breasts were no exception – until now!

It pains me to say it, but small is not always beautiful. In fact, in breast cancer land, small is pretty annoying.

My world view was crushed on what I truly believe to be the weirdest and most surreal day of my entire life. Thankfully, I wasn’t alone this time – although I think my amazing mum (hello mum!) could have been forgiven for wanting to go and lie down in darkened room about half way through. Massive credit to her for laughing along with me throughout – even without lunch.

It was supposed to be one 10am meeting with a surgeon and a breast nurse to discuss the MRI results and plan what I thought would be a wide local excision or lumpectomy (in other words, chop it out, move on to chemo). I thought I’d be back at work within the hour.

Here’s what happened:

1)   Surgeon (who is hilariously funny and witty for a surgeon) explains that the tumour is more like 40mm than 28mm and there are two other suspicious areas that need investigating (just to qualify, this part was not funny or witty). Still smiling though!

2)   Surgeon examines me – and brings mum in too for a quick feel – and confirms that my breast is just too small to save (thanks nature). Bit scared and annoyed with nature!

3)   Surgeon explains the two ‘reconstruction’ routes, one of which involves taking out my tummy tissue to give me a new mound. Has a feel of my tummy and thinks they might just be able to use it. Laughing now at fact tummy is being squeezed!

4)   Surgeon refers for second biopsy to investigate findings and my kind breast care nurse loads me up with breast reconstruction literature. Still smiling… just!

5)   Care staff at biopsy number two turn out to be very entertaining and lovely. Smiling lots to block out fact my boob is yet again being explored – trying not to laugh otherwise might disturb procedure.

6)   Lovely breast care nurse points us in direction of secret staff bus to whizz us to another hospital. Mum and I laugh while trying to look like serious hospital staff.

7)   Meet nurse quickly and get weighed! Best weight in three years (yay for dry January and losing my Christmas podge). Feeling pretty smug!

8)   Meet next nurse who makes us tea and explains that the Dutch only put milk in their children’s tea. Smiling at having discovered something new!

9)   Meet plastic surgeon, three nurses and a doctor who explain tummy procedure and give me a quick squeeze. Check leg and bum and confirm just too tight (oh yes!). Feeling pretty smug again at weight loss.

10)  Plastic surgeon thinks tummy might have enough fat to go ahead with procedure, but needs to do a CT scan to check. Feeling less smug and starting to regret losing Christmas weight. Maybe need to make a batch of mince pies!

11)  Surgeon refers me to pre op assessment (why not, while I’m here)!

12)  Behind door number one, nurse one takes blood pressure. It’s high (I would say this wasn’t surprising)! Second time round, I pass and move on to MRSA testing. Smiling due to the fact I like passing tests!

13)  Behind door number two, nurse two (who told us a lovely story about buying herself a dressing gown for Christmas and wrapping it up under the tree because she’d always wanted one and never got one) talks me through op day. Smiling lots at having met a friendly lady who would have otherwise remained a stranger!

14)  Behind door number three, nurse three takes blood. Uneventful. Smiling at fact needle went in vein and was uneventful!

15)  Op date confirmed: 21 February. Phew! Bit tired of smiling now.

So three waiting rooms, two surgeons, 15 care staff, six appointment rooms and six and a half HOURS later, and my mum and I are hugging and laughing at the tube station as we say goodbye.

While neither the day nor the results were what I was expecting when I woke up that morning, I was a) humbled and inspired by the amazing hospital staff and the way they fast-tracked me and b) happy to have spent the day experiencing and laughing through it all with my mum. Every cloud…

Tune in on Monday to find out if I passed the ‘fat’ test…

Breast cancer lesson number two: No matter how tough it gets, there is no excuse for criminal behaviour

On By Jackie ScullyIn Breast reconstruction surgery, Diagnosis and treatment planning, Reflections on cancer5 Comments

Ok, so ‘criminal behaviour’ might be a bit strong, but absentmindedly walking out of a Camden café without paying for a cup of tea before the MRI scan is not my usual style! (Having said that, being presented with tea in a cafetiere is enough to send anyone into shock!)

The MRI scan is not something I thought would ever make a blog post. While clever in determining the size and scope of the cancer (the ultrasound suggested it was an ill-defined highly suspicious mass measuring 28mm), strong magnetic fields and radio waves are not exactly the stuff of headline news. For anyone who has had one, lying still as you head into a long tube with earphones on is a pretty simple procedure – if you’re not me that is!

My history with the ‘simple’ procedure is chequered to say the least. This has nothing to do with my ability to lie still, but the injection part, where they put contrast dye into the body. I was kind enough to let a student practice on my hip back in 2006. This was a decision I immediately regretted when they injected the wrong part of my leg with the dye and I had to wait another three months for them to try again.

Convinced that lightning wouldn’t strike twice, I turned up after a client meeting (alone again, but will say nothing about my inability to learn from ‘lesson number one’) and was expecting to be in and out in no time. I was initially amused by the fact no one (not me, a GP, a consultant nor the radiographer) could work out the true ‘day one’ of my ‘cycle’ (and still can’t for that matter). I was also amused by the fact the man before me had the deepest combat trouser pockets I had ever seen and spent at least five minutes emptying them of coins and other bits of metal.

The amusement started to subside, however, when I was faced with my old friend Mr cannula! I have great veins, a high pain threshold and haven’t a clue what fainting feels like, so was still smiling when the first one went in – until it wouldn’t flush.

I was laughing and describing my engagement ring to the surrounding party of nurses when the second one went in. All looked good and I lay face down on the rather odd breast scanner bed (one nurse joked that you could tell it had been invented by a man as it looks more like a torture device than a bed).

I now know why they give you one of those buzzers to press in case of problems. As soon as the contrast dye went in, my left arm really started to hurt. I was soon pressing the ‘I want to get out of here’ button like it was going out of fashion. I was initially comforted for being brave until they realised they were filling my arm (rather than my veins) with the stuff.

I have always wanted to know what I’d look like with bodybuilder arms. Now I know – and it wasn’t pretty. Determined to see it through, however, we tried to get two more cannulas into me. On the fourth attempt in a vein on my wrist, it worked! Thanks have to go to the amazingly talented and patient nurses and radiographers who worked so hard to complete the procedure, even when my body didn’t want to play ball. 

There’s one form you certainly don’t want to see after an MRI: Patient advice in the event of extravasation. Sounds rather exciting, but it just means your arm is full of dye (and a bit larger than normal). I wish now I had taken a picture (photos will start soon when I am up to date). Let’s just say, it’s amazing how much work can be achieved with your arm in the air! Thankfully, my oversized bingo wing started to go down after a few hours of massage so no trip to A&E was required.

For those of you who are now worried that my moral compass is broken, do not despair. Having identified my crime in the hospital waiting room, I immediately texted my wonderful colleague Laura, who contacted the café. While I don’t think she will ever thank me for the conversation that followed (and the ridicule), she did confirm that the true cost of the tea was about 5p and the café could cope. Starting to think it would have been a bigger crime if I had paid, given the mark up!