Breast cancer lesson number 72: Set your boobs free!

Nine weeks ago today I was on the slab being separated from my cancer. Nine weeks on and I have been celebrating in a small, but meaningful way. Firstly (and not really related but worth a mention) by not vomiting for 24 hours straight thanks to the anti-nausea medication. And, secondly, by sleeping without my post-surgery bra for the first time.

Going ‘au naturel’ or braless in bed is another of those cancer milestones that doesn’t often get a look in, surrounded as it is chemo sickness stories and hairless updates. But, as a step towards the new ‘post-active-treatment’ normal to which I am heading, it feels like another great big tick on the cancer checklist.

My post-surgery bra and I have had some good times together. It may have aged me in the bra department by a good 30 years, but with its healing fibres and its soft fabric, it has been a loyal friend. So much so, that I could have stopped wearing it in bed a few weeks back, but chose to extend our relationship just that little bit longer. I have purposely chosen not to post it here so as not to scare off the male followers among you.

Before you question my hygiene levels, I did have two identical post-surgery bras (best to go up a back size when choosing just to give you added comfort around the swelling). I am delighted to report that they are now both in a drawer, replaced with a new non-wired bra for the daytime (another mini milestone). A good three months without wire is the recommendation and then I get to take a call on whether to return back to the underwired bras of my pre-cancer life, or opt for a lifetime of comfort. As someone who only wears heels on special occasions (and is known to walk like I’m drunk before I’ve had a drop when I do due to my rather special hips) it might be comfort all the way from now on. Last thing I want is a bit of wire digging into my new fat-filled boobie.

It will be a while before I get a nipple and any final nips and tucks. I will have a fleshy mound for a good six months post radiotherapy, so the tissue and skin have time to settle down. I should be seeing my surgeon again in a few months, however, to discuss these little reconstruction extras and, most importantly, get me added to the waiting list for day surgery next year. When your life is no longer dependent on surgery, the NHS waiting list system comes back into play. I wonder just how many nipple-less woman are currently waiting their turn for a manipulated bit of skin and a pinky tattoo?

So, to all reconstruction ladies out there I say, love your post-surgery bra (and pick wisely – I highly recommend my Royce one), but also love the day it comes off. It means you’re one step further away from the ‘patient’ label and one step closer to those post-cancer comforts.

As a side point, if anyone knows of any beautiful and comfortable non-wired bras, please do get in touch. They seem a little hard to find. 

Breast cancer lesson number sixteen: If you know what you’re in for, the road ahead seems a lot less daunting

As one of life’s planners, I know how important it is to be prepared (by which I don’t just mean making sure you have enough big knickers to see you through your hospital stay). While no one knows how you are going to respond to the treatment, or how well your body will recover after surgery, I think it’s helpful to have an idea of what might happen in hospital and what gismos you might just find strapped to you when you wake up!

So, here’s a quick peek inside my hospital diary. One small caveat before you are immersed in a world of cannulas and heart monitors. Every cancer, surgeon, care team and ward is different. This is my personal experience and you may find you get a few extra goodies (or a few less) depending on what you have, what you need and where you are. This diary is also based on having a full mastectomy, a DIEP (tummy) flap and an axillary clearance.

Day zero (probably so-called because you miss most of it due to the anaesthetic)
Highlight of day: making the recovery team laugh (even though they were probably just humouring me)

1)    Breast reconstruction surgery is big surgery. As such, you get your own theatre list (of one) and a team of about 10 people dedicated to you for the whole day. This means you will be due at the hospital around 7.30am to get prepped. It made me laugh when we arrived at the surgical admissions unit at about 6.50am only to find a queue of about 15 people already ahead of us. It’s certainly not a case of first come first served in the surgery game!

2)    Once you’re marked off the list, you’re given a little room to wait in. I was also given a urine pot (lucky me) for a quick sample. Quick change into a gown, some disposable panties, some white anti embolism stockings, dressing gown and slippers, I was ready to be visited by two nurses, one phlebotomist, a surgeon, a doctor, a researcher and an anaesthetist. One blood pressure check and a quick art lesson on my boobs and stomach later and me and my post-surgery bra were escorted to the anaesthetic room (via a hot blanket machine). It is worth noting that I didn’t see the cancer surgeon (or removal man). Hopefully I will meet him one day to thank him for saving my life.

3)    The anaesthetic room consisted of me, my lovely anaesthetist (who came to visit me in the ward afterwards and promised me some good drugs), a surgical nurse, a bed and cupboard full of drugs. The surgeon popped in to wish me luck (at which point I wished him more luck!) before I was fitted with heart monitors, an arm-holding contraption and the first cannula. The room was really cold, but after two hot blankets and some sleep-inducing drugs, I was off in my happy place and gone!

4)    I believe there was then lots of cutting, cancer removing, fat moving and sewing up. Apparently, they put you in the so-called ‘Jesus’ position for the op, so they have full access to the arms. Thank god for anaesthetic!

5)    Recovery was a row of beds and lots of monitoring. I had three cannulas, one arterial line measuring my blood pressure, a blood pressure cuff on my ankle, four drains, heart monitors, an oxygen mask, a catheter, a moving bed and, the weirdest bit, an inflated hot blanket to keep my temperature up. Interesting to note that all the needle/cannula action was on my left arm. My right arm is now off limits due to the axillary clearance, so was having a nice rest after being attacked earlier.

6)    After four hours, enough morphine to soothe a small nation (they kept turning off my PCA to give me extra shots), two small sips of water (we pretended the first one was a good red wine and the second one beer) and lots of laughter (particularly enjoyed watching one of the recovery nurses trying out a moving mattress to check it was working), I was being prepared for transfer.

7)    Five minutes with mum and dad and I was set up for a night of monitoring. Everything from my heart, blood pressure and temperature to oxygen levels, fluids and pain levels were checked at regular intervals. Sadly for the nurse looking after me, my PCA was playing up. Every time I pressed the button it started beeping. One other machine also kept beeping to tell him I wasn’t breathing. This was a little disconcerting at first, but we were laughing about it within an hour. Then came boobie testing. This consists of someone pressing the boob to check for blood flow and then holding an ultrasound monitor to the flap to wait for a pulse.

For a short day, it was a pretty long journey. Key aim: get through the night.

Day one
Highlight: Morphine, morphine and, oh yes, more morphine

1)    Day one was a dark day. While it was wonderful to lose the heart monitor, the hot blanket, the drips and the constant checks, it was a day defined by pain.

2)    I was visited by a surgeon and I was, at last, allowed some food. But, there was only one thing I wanted: drugs. I couldn’t even get out of bed.

3)    Rest of day was a bit of a blur. I felt like my tummy was ripping apart so got into a routine of: pain, tears, drugs, pain, tears, drugs (and tea), pain, tears, drugs! You get the picture!

4)    One piece of advice: don’t worry if your limbs swell up. My right arm trebled in size and a nurse suggested it could be permanent. I looked alarmed, but was later reassured it’s just post-surgery swelling. It eventually goes down – and it did!

Day two
Highlight: A shower

1)    What a difference a day makes! Following a ward round that it sound like I’d be going home tomorrow, I got up, got showered, had more morphine, got out of a gown and into a nightshirt, had mashed potato, had more morphine, saw family and friends, watched as 15 people crammed into the bay opposite and started praying, had more mash and more morphine (now morphine mash would be a novel idea).

2)    There was a lot of peeing. With the catheter out, I got up six times (with a nurse). By the sixth, I was pleading with my body to stop. The nurses laughed along, but did have morphine on tap!

3)    I went into hospital with a grannie leg (full of metal, hates the cold) and I now have a grannie stoop (bent double due to tummy tuck). Nurses said I had aged about 30 years.

4)    One thing that hasn’t featured yet? Sleep. Yep, there wasn’t a lot of that, but when you’re looking at the London Eye all lit up at night, it could be worse.

Day three
Highlight:
Less peeing, more mash

1)    Hospitals come alive on a Monday. I had seen my surgeon, my breast care nurse, a physio and a pharmacist before I’d even had a cup of tea! The surgeon was very kind, even though he insisted on shaking the hand on my bad arm twice (this was a very swollen arm with limited movement)

2)    When drains produce less than 30ml of liquid in a day, they’re out! As a result, two came out today. I obviously look friendly (or a bit gullible) as they requested a student take them out. She was brilliant though and will make a fantastic nurse.

3)    Glad to report, had lost a few years with less stooping.

Day four
Highlight: Taking the stairs

1)    When you’re helped to the toilet through the night, it is quite disconcerting to be told that on day four, you’re flying solo. Today was my equivalent of independence day, and I am delighted to say, I passed with flying colours. A wash, a walk, a flight of stairs and many toilet trips later and I started to doze off in my chair at 2pm. Yep, I am still 32 not 102!

2)    Slight blip came from the mirror moment I wasn’t expecting. Have suggested to the hospital that this is planned for others next time. The body has been savaged and, if you’re not ready to look, it can be quite scary. I am, however, delighted to think I might have had a slight augmentation factored in (although that could be the swelling).

3)    Drain number three came out. They don’t really hurt, but this one felt like it stretched the length of my abdomen, so was a like a worm inside my abdomen.

4)    I slept for four hours (did a little stooped dance round the bed).

Day five (to seven depending on speed at which you recover)
Highlight: A poo and home time!

1)    After many doses of Laxido (don’t be fooled by the orange smell, it tastes of gritty nothing), I have conquered the constipation. Was threatened with suppositories, so that may have done the trick!

2)    I passed the final drain test, so no need to carry it home. The doctor on the ward round said: “you’ve done really well”. Yay, big tick on my medical notes!

3)    Having cleaned out the chemist (bye bye morphine, but hello truck load of painkillers), said nice things on feedback forms, and signed my discharge papers, I am given permission to leave the building!

4)    One word of advice: use a wheelchair to get to the car park. I foolishly thought I would demonstrate my straighter posture to my mum and Duncan’s dad. The walk was fine. The lift was hell (felt like every jolt would rip my stomach apart).

5)    Back home and trying to get into a routine – but that’s another blog story!

Phew! That was a long six days. Am tired just thinking about it – and I’ll bet you’ll have sore eyes if you manage to get to the end of this post. 

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

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!