FEC

Breast cancer lesson number 93: How to face cancer with confidence

I think it would be fair to say that my make-up routine is less of a routine and more of a lifelong period of experimentation. I have the creams, the mascara, the eyebrow pencils and the obligatory make-up bag, but it seems that no matter how much stuff I apply to my face, I never look like I have any on. Some may call this skillful. Sadly, there is nothing skillful about it.

Whether or not you know your primer from your restorative lash treatment, when you’re undergoing treatment that dries your skin and steals away your eyelashes in the night, make-up does have its uses. For me, it’s not so much about hiding what’s happening to me, but more about giving me back the bits that make me smile. A hat can hide the lack of hairdo, but I do quite like to see some eyebrow when I look in the mirror.

In an attempt to help me reclaim my face, friends, family and medical professionals have been quick to send me top tips, hints and product recommendations. In the creams department, for example, I am sorted – so much so I’m surprised I don’t just slip right out of my clothes! Having diligently filled the bathroom with everything from Gimme Brow to Brow Zings on the make-up front, however, I do feel like in danger of looking more like a pantomime act than a publishing professional. Painting on eyebrows? I’d rather have a PICC line flush thanks.

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Enter Look Good, Feel Better (LGFB). This amazing international charity offers free skincare and make-up workshops for those coming to terms with the visible side effects of cancer treatment. With volunteers from the beauty industry (who better to teach you about wig care than a film make-up artist?), each session is a masterclass packed with trade secrets and handy tips. In two hours, you get a 12-step make-up routine and all the branded goodies to match (designed around your skin tone). And, even though you do have to sit in front of a mirror for an extended period, you do get an awful lot of laughing to go with your lipstick and eyeliner.

There are many things in life I never thought I’d have to worry about. Matching my foundation so that it blends in with my bald head is one of them. Now, however, I don’t just have the concealer, I know where (and most importantly when) to apply it. I can use green primer without looking like Kermit the frog and can advise you on which eye cream will make your bags glow in certain lights (not a great look for a wedding). I will also never use my eyeliner in the same way again. While ‘looking good’ may be pushing it, I left the session looking a whole lot better and, it felt great. To ease you in, I am only posting a photo of the goodie bag today. I need a bit more practice before I share my new eyebrow-shaping skills with the world and I’d rather not scare you off.

For the first time in my life, I have three amazing beauty secrets to share! First, book on a Look Good, Feel Better event today (they are extremely popular so click here to find your nearest location). Second, Macmillan Cancer Support does a really useful guide called Feel More Like You, which provides expert advice on skin, nail and hair care during treatment. And, lastly, only put green primer on the red bits, otherwise you might end up looking a lot worse than you feel! 

Of course, the one thing that a wonderful workshop such as this can’t do is account for nature. And, by nature, I mean the fact that I currently have a rather fetching mosquito bite plonk in the centre of my forehead. Perfectly timed for the filming of an exercise video tomorrow (oh yes, more on that soon)! That’s something no amount of make-up is going to sort.

Breast cancer lesson number 92: Embrace the change of pace

Yesterday, I was defeated by the vacuum cleaner. Strange as it may sound, a piece of plastic (albeit a well-crafted one) with multiple arm extensions brought a dust cloud to my otherwise bright and sunny day.

It could have waited a little while longer (even though the moths are getting a little friendly). I really didn’t need to clean the whole house. But, never one to leave a job unfinished, I dug out the vacuum after a lovely day with friends and had a good go at the carpet. And, you know what? I really wish I hadn’t.

Now before you think I’ve lost the plot, this is not a blog post about vacuuming (fun as I know that would be). This is the post about just how hard it is to go from the active, always-on-the-go Jackie with her ultimate to-do list to the chemo Jackie who often needs a bit of a sit down. Satisfaction comes from a to-do list that goes down not up. And, currently it feels like the list is getting longer by the day.

The trouble is, I wasn’t exactly overdoing it. A drive to see good friends, a short walk and a few household chores does not a packed day make. Admittedly, I probably should have saved the hob cleaning for another day, and didn’t need to do that second load of laundry. But, when chemo gifts you a window of energy, it’s really hard not to grab it.

Chemo fatigue is something about which I haven’t written so far. That’s not because I didn’t know about it or hadn’t experienced it. It’s because I thought that by not mentioning it, it might just go away. No one wants to feel like they’ve run the marathon when they’ve only just climbed the stairs – especially not at the age of 32. I spent my 20s watching friends have fun on the dance floor while I battled hip pain. I thought I’d be the one to set the pace in my 30s. Maybe next year…

The truth is, I have no choice but to slow it down. And, if I’m honest, that’s probably no bad thing. Nobody needs to watch TV while simultaneously tidying the coffee table, sorting papers and writing a shopping list. The dust can wait for another day (along with the wonky doorstop and the half-painted wall). Fighting cancer drugs is enough for most agendas and, for now, it has to be enough for me too.

Of course, the physios and occupational therapists do have a few tricks up their sleeves to help us make the most of every day. The secret? Pacing! The aim is to avoid getting into an overactivity-rest cycle. That means doing little and often every day to build up strength rather than trying to cram in a whole week’s worth of activity into one day just because you feel well (and then needing a few days to recover). That does mean planning in tasks (and sticking to the plan), but the plan has to be realistic! The motto is ‘do what you planned – not what you feel like’. It sounds simple. But, when running before you can walk is your default position, it takes a bit of getting used to.

So, for now, I shall try my best to sit back and enjoy this change of pace. And, if you are currently in the middle of a chemo cycle (or about to start), I hope you can too.

Just don’t expect a fluff-free floor on your next visit!

Breast cancer lesson number 90: Life is short. There is no time to leave important words unsaid

I am grateful that last night was just a night of sweats, broken sleep and nasty nausea rather than a night wedded to the washing-up bowl (I must stress the bowl has been retired from active washing-up duty in case you were worried). And, looking at the faces of mum and Duncan in the morning, I think I wasn’t the only one who was grateful!

I made it through. But I had to dig deep. The nausea and night sweats were among the worst I have ever endured. The Aprepitant drug worked wonders on the sickness and the quick hat and sock changes helped with the hot flushes. But there is one other trick I’d like to share, which – in between the waves of nausea – made the whole experience memorable in a more positive way.

I have never been one for counting sheep or filling my mind with the colour blue in an attempt to drift off. So, last night I introduced a new technique. From the beginning, I listed out all the wonderful and kind messages and gestures people have sent through over the last four months. By this, I don’t just mean the obvious. By this, I mean the well-timed tips, the lucky pre-surgery safety pin, the comment from an old schoolfriend about what she thought of me back then and how I hadn’t changed, the thank you from a girl I once helped in a small way and never thought much of it. Just yesterday, a lady I had met a month ago and showered in cancer-related tips stopped me in reception to thank me for my kindness. Those words meant everything to me. Each one of these moments has made an indelible mark on my heart. And, yesterday, I used them to build a patchwork quilt of happiness to comfort me at my lowest ebb. The great thing is, when I got out of bed this morning I smiled knowing that I have just scratched the surface, with many more patches to add.

Being at the receiving end of a lifetime of kindness has got me thinking about just how much we really say to those that inspire us and make us smile. When was the last time you turned to a friend and thanked them for just being there? When was the last time you contacted an old acquaintance and told them just how big an impression they have made on your life? When was the last time you thanked someone and meant it from the bottom of your heart? People can’t guess you’re your thinking unless you tell them. When the business of life gets in the way, it is hard to step back, reflect and not take all those you love and admire for granted. But, I can tell you now, there is so much I want to say to people while they are still around to hear it! People come and go in life, tucked away in chapters. But, their kindness will live on through you. I’d love to think that if someone were to cut me open (in a nice, non-cancer-surgery kind of way), I would be made up all of the brilliant people who have touched my life.

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So, I have chosen today, laced as it might be with a cocktail of drugs and a vat load of liquid, as the day to hand out my first pink hearts. The first is for my astonishing and truly wonderful mum who is one of the most beautiful people you’ll ever meet. She may weigh less than me currently (although we are having words), and she may not be able to take the pain of a cancer diagnosis away, but she has made living with it as comfortable and relaxing as possible. She has put her life on hold, so that I have the chance to get mine back. As a daughter, I have not always thanked my mother quite as often as I should. But she means everything to me and I plan to spend the rest of my days reminding her of that. While I won’t share the contents of my letter with you, I will share one line: ‘Life is no easy street, but you have made walking down it, so much more enjoyable.’

And, the second heart? You’ll just have to wait and see! I will also be posting more details of my pink heart plan (first mentioned in lesson number 30 – click here) in the weeks to some to inspire others to send ripples of kindness all across the world.

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All I ask is that you take a moment of your day to thank someone who matters to you. What is it about them that makes you smile? What it is you should have told them years ago, but never thought to mention? How have they helped make you the person you are today? I guarantee you’ll feel good saying it – but not as good as the person hearing it (especially if it’s for the first time).

Make today the day you start following your heart. Trust me, there’s no time to lose.

NB: it will take years to deliver all these hearts, so do bear with me. The accompanying letters are all handwritten and contain a piece of my heart. Plus, I have to make sure I don’t get arm ache! 

Breast cancer lesson number 89: A chemo day can be a good day

Believe it or not, today was a good day. I should qualify this by saying that most good days do not come with a helping of toxic drugs on the side. But as days on active treatment go, it was a complete success.

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I passed my blood test (yay!). My levels are good for someone on chemo (could be seen as a compliment). I had a lovely lunch with my lovely mum (that I could taste) and a walk along the river (in the sunshine). I met a friendly nurse who furnished me with a whole rucksack full of pills, mouthwashes and eye drops (including the mighty Emend/Aprepitant for vomiting). I got the chemo drugs (yay-ish because it wasn’t delayed) and actually waved goodbye to Epirubicin as the last red syringe was drained into my PICC line. I now know the name of the lovely lady who does my PICC line flushing every week (she doesn’t wear a name badge and after a few sessions, I felt it would be wrong to ask). I have sorted out my appointments for the next round (chemo is moving to a Friday). And, most importantly, the chemo unit LOVED the ginger cookies (although you could question whether or not a unit of patients with questionable taste buds is a robust test).

I also discovered a few new things (and we all know how much I love learning things)! One, there is such a thing as a menopause clinic, because I’ve been referred to it in an attempt to help me get a convincing night of sleep! (watch this space). Two, baked goods (with ingredients listed) are welcome on the unit (I did wonder whether health and safety would get in the way). Three (not the best revelation), the next set of chemo cycles requires me to have around 24 injections to help keep my white blood cell count at a good level (nothing like a few sub-cut injections to remind me of those fertility days). And last but not least, according to my stats, somebody discovered my blog by searching ‘extraordinary boobs’. Whoever found my blog by searching for this, all I can say is: great search terms (I wimped out after Googling it and sizing up the main subject matter) and I am sorry that I really don’t have extraordinary boobs. They are certainly not ordinary, but I am not sure that is what you were after!

Here’s a piccie of me in the unit ‘copping a feel’ (albeit not exactly going for a full grab) to show my support for the wonderful charity Coppafeel (click here), which was set up by a wonderful women called Kris, who was diagnosed with Stage four (advanced breast cancer) at the age of 23. Her mission is to make sure young women are more aware of their boobs, completing those regular checks that could just save their lives. It’s a simple and powerful message, and one I am going to help her spread over the coming months and years.

I may be nibbling my ginger cookies at a rapid rate to tackle the nausea inside me, but I think, as days go, it was a goodie. Let’s just hope I don’t have to make friends with my old washing-up bowl again tonight!

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I hope you’ve all had a good day!

 

Breast cancer lesson 88: Happiness is knowing the halfway point is in sight

Ok, so I may be pushing it slightly by suggesting tomorrow marks the halfway point in my chemo treatment. But, even though I have another 12 weeks (out of 18) to go (making it just a third in terms of timings) tomorrow is the third poisoning out of six. That makes it pretty special.

Being the third chemo, it also means an end to FEC and, in particular Epirubicin. No longer will I have to watch the blood red liquid being syringed slowly into my veins. No longer with I have pink pee to remind me of the poison every time I go to the loo. After tomorrow’s session, I will say goodbye to the three-drug cocktail and hello to a new challenge (Docetaxel) for round 4. While it does require me getting used to a whole new set of side effects, I like the idea of a change.

How am I feeling about going back on the steroids, the anti-sickness medication and the chemo drugs? If I’m honest, a few days ago, I was a little worried.

Cycle one had a go at my hair and showed me just how nasty mouth ulcers can be. Apart from that, however, it left me alone and reassured me that I have the strength and the positivity to get through this. I went into cycle two with a smile on my face, confident the drugs were on my side. Little did I know as I sat in the chemo chair, just how much it would test me.

Don’t get me wrong. I am one of the lucky ones. But, with its tongue and mouth ulcers, vomit, nausea, headaches, tiredness, coughing, runny nose, hot flushes and sleepless nights, chemo is no walk in the park. I am going into tomorrow with an ulcerated tongue, the end of a cough and on the back of few too many nights of broken sleep. Physically, I have been challenged and, while my body is fighting back, it is not quite as fit as I’d like it to be.

Ask me how I am feeling now, however, and I would say, I am ready (if we ignore the false start I had this morning where I misplaced my travelcard and threw my iPod in the recycling bin by mistake on the way to today’s appointments). I know, whatever goodies it has up its sleeve (or in its syringe), I can and will get through them all. I am stronger than the drugs – and I know that while they have destruction on their minds currently, they will end up making me even more so.

Plus, I have a few new tricks. The evening poisoning for cycle two caught me off guard. I met my mum at the hospital. I hurried my lunch following a rather soggy encounter with a washing machine that decided not to spin my clothes, but instead wash my floor. I wasn’t on my game and I wasn’t focused on the right opposition (my floor needed a wash anyway). Now I am.

My mum is here the night before to help me avoid any unnecessary hurrying. I have grapes in the freezer (apparently sucking on them while having chemo can help the mouth). I am ready to drink my body weight in water. I will be making my first batch of chemo cookies tonight to ward off sickness and nausea. And, I will be requesting more anti-sickness medication at tomorrow’s session with the nurse. For every side effect I know of, I have a solution. And, for every one I don’t, I have my supportive and kind mum. Quite frankly, if I were the chemo drugs, I’d be scared!

Let’s just hope I pass the blood test first thing. Wish me luck!

Breast cancer lesson number 71: You may be sore today, but you can be strong again tomorrow

I have only been sick three times in my life. That is, until about 12 hours ago. FEC chemo two brought with it more pink pee, another ice-cream headache and, yes, you guessed it, a bit more vomit than I’d bargained for (three lots so far!). Thank goodness a) I can read my body well enough to avoid the bedding and the new mattress and b) I had an old washing up bowl by the bed (just in case).

Having experienced nausea in cycle one, I went into yesterday’s session prepared. With an extra dose of anti-sickness medication, I wasn’t even expecting to feel sick, let alone be sick. Just goes to show that, when it comes to chemo, even the best laid plans can prove fruitless.

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As with chemo cycle one, the session itself was really rather nice. I passed by blood test and had a good laugh with the nurses. I got my medication ahead of schedule and everyone seemed to like not just my pretty PICC line cover, but my chemo-friendly Shakespearean T-shirt too (it says: ‘Though she be but little she is fierce’ and it was bought for me by a kind and lovely friend).

Everything was going so well. I enjoyed my dinner and even managed a few Miniature Heroes for dessert. Then the side effects kicked in. They were two hours earlier than round one and they were more intense from the start. Once in bed, I had to lie flat. If I rolled to either side and I felt like a spirit level knocked off balance. I tried to deep breathe my way out of the nausea, but it wasn’t long before I was saying hello again to my chicken and rice supper.

My poor tummy (thank goodness I’m back at pilates so it didn’t hurt to retch) and I made it through the night (along with a very concerned Duncan and mum), only to be greeted by another pile of bile-coloured vomit. The worst bit is when you’re tummy is empty, you’ve got nothing left to give, but your body is still trying to expel something.

Eight pills, two glasses of flat lemonade, a cup of tea and two pieces of toast later and I am still (touching all wood available) keeping food down. Let’s hope that I may make it out of my pyjamas/sleep cap/dressing gown/slanket combo at some point and face the world today. And if I don’t, there’s always tomorrow.

This is the first day in a long time that I actually feel like a sick person. You can read it in my face and the bags under my eyes. You can see it lurking under my sleep cap. And, I can certainly taste it in my mouth. Chemo hasn’t defeated me, but it’s giving me a bit of a beating.

Today, I have one objective: avoid vomiting. Chemo drugs, I plan to put up a good fight.

Breast cancer lesson number 43: Cure, Help, Empower, Me to Overcome = CHEMO

With the embryos now packed away in the freezer, one pixie haircut and one PICC line insertion are all that stand between me and chemotherapy. Cycle number one is planned in for next Wednesday and, I must confess, I’m already trying to imagine the side effects. Up to now, apart from a bit of pain, a lot of needles and enough drugs to stock a pharmacy, I have felt well. A week today, whether I like it or not, that’s all about to change.

They say the fear of chemo is often worse than the act of going through it. All I can say is, let’s hope they’re right (and that it’s not the cancer equivalent of ‘childbirth is fine’ so we all go into it with blind optimism). I have a rather vivid imagination and it’s currently in overdrive. This is in no small way to do with the consent form – or should I say dossier of potentially debilitating side effects. Beware drugs that come with consent forms! After seven pages listing out all the life-changing conditions I might end up with, it began to hit me that this is no normal prescription drug. This might actually be a bit grim.

For those wanting to know a bit more, chemotherapy is a systemic treatment using anti-cancer drugs. Its aim is to go after cancer cells in the whole body (not just the breast) and interfere with their ability to divide and grow. I will be going through what’s called adjuvant chemotherapy. This means it’s an additional treatment to reduce the risk of breast cancer returning after it has been removed (in some cases people have chemo before surgery – known as neo-adjuvant chemo – to slow the growth or shrink a tumour).

So, what awaits me in the chemotherapy chair? I will be undertaking something called the FEC-T regimen. First, I will enjoy three three-week cycles of FEC (lucky me). This is a combination of the following drugs:

1)    Fluorouracil (or 5FU)
2)    Epirubicin (a nice red liquid)
3)    Cyclophosphamide

Then, once I have got used to the way my body reacts to the above drugs, I will  move on to T or Docetaxel (one brand name is Taxotere, hence the letter T). This takes longer to administer and stays in the body longer (it gets better and better). And, I mustn’t forget the supply of anti-sickness drugs and steroids you get thrown in to keep said chemo drugs company.

In truth, the drugs are just words. It’s the list of side effects that leaves an impression. Everyone is different and no one knows how they are going to react. I know I’m strong, I know I’m positive, I know I will work when I can – and my consultant seems to think I’ll be just fine.

Bearing in mind, you probably wouldn’t take a paracetamol if you gave the pill packet too much attention, factsheets and side effects booklets are to be regarded with some caution. I will probably get some side effects, but if I get a lot, I will be more than a little unlucky and will be trading in my body for a better model at the next available opportunity.

The potential effects are many and varied. Rather than plough back through the consent form, here is my edit of the highlights (or lowlights depending on how you look at it):

1)    I will lose my hair: it seems the cold cap that is available will merely delay the inevitable, so I am going to lose my hair in style! Pre-chemo pixie is planned for Saturday and then, by the end of April, it will probably have disappeared. I am not particularly worried about this, am enjoying shopping for hats and am waiting for an opportunity to stand on a cliff with my bald head. Quite fancy not having to shave the rest of my body for months on end and it will, as a friend said, be interesting to see the shape of my head. My only fear? It growing back grey. At 32!

2)    I will get constipation: I doubt I’ll be able to beat eight days after hip surgery (not sure I want to try) so it will be back on the Laxido I’m sure. Whoop! You can also go the other way (now that would be a change!).

3)    I may get an infection: if my white blood cell levels drop, I will be more susceptible to infection. I plan to avoid the Underground where possible and have been acquainted with my new best friend, Mr thermometer. Apparently, if my temperature goes above 38 degrees, I will need to get to the hospital… and fast!

4)    I may vomit: having only vomited a few times in my life, I hope my strong constitution stands me in good stead. I certainly won’t be eating my favourite foods around the sessions, just in case I see them again ­– and then never want to eat them again. I hear the anti-sickness drugs can be effective but they can cause constipation (see 2).

5)    I may get fatigue: it’s fairly common, and the cumulative effect of all the treatment may take its toll.I plan to walk as often as I can and, of course, not operate any machinery if I feel tired (maybe just a kettle, a TV, a computer and a mobile phone).

6)    My sense of taste could change: I must say, I am intrigued by this side effect. Some say things taste like metal (yum) and others say they become addicted to sweet things. I better make sure I don’t overdo the baking, just in case. Let’s hope I don’t get too many ulcers and sores (another joyous side effect), so I can actually eat something.

7)    Docetaxel can cause bone pain: If it’s anything like my original hip pain or nerve pain, I will be willing these cycles to end!

8)    My hands or feet might start to tingle: This would be another treat from the wonderful T and is known as peripheral neuropathy. I am quite fond of my hands.

9)    Chemo brain: Chemo, if you’re listening, please don’t take my memory. I love remembering birthdays and running through my to-dos in my head. Take my memory and you take a big chunk of me. That’s not part of the deal.

All that, and I haven’t got started on heart problems, fluid retention, sun sensitivity, allergic reactions, blood clots, infertility or nail changes (or the side effects of Zoladex, the drug already in my system).

The truth is, by putting it out here in post form I wish to now close the A-Z of scary chemo effects. I will smile as the red liquid approaches. I will smile at my chemo nurses. I will smile as I write my first post-chemo blog. I will keep smiling until one of these things makes me smile no more.

As of this moment, I plan to take control of chemo. In an attempt to go down smiling (or better, not go down at all), I am in the market for chemo tips (I will write a post compiling them all later this week). Thanks to some beautiful friends, I have sleep caps, an inflatable bath pillow, nail varnish and queasy drops ticked off the list. I have senna. I have a toweling robe with which to dry myself and am on a mission to find the tastiest ginger nut. If you have a tip you think may help me stay strong and positive, please get in touch. I am willing to try, experiment and do anything (within reason), if I end up with a big smile on my face.

I was going to call this blog post ‘Know your enemy’, but when I finished writing it, I realised it’s wrong to call chemo the enemy. Cancer is the enemy and chemo is one of good guys (even if it likes to knock you down a few times along the way).

Here’s my deal. I’ll give you my hair, but you’ll have to fight me for everything else.