Breast cancer lesson number 94: How to get more from active treatment

Cancer treatment is like being signed up to run a marathon race with no training. In short, it hurts. But, just sometimes, days like today are sent along to remind us that there are plenty of pit stops along the way that are actually rather enjoyable. As long as you know how to find them that is – and make the most of them when you do!

On annual leave, you’ll usually find me tucked up in front of a log fire with a glass of wine or strolling along the Dorset Coast path. The UK is our oyster and we do our best to enjoy it. Today, however, I spent the day with my arms in the air for a really good cause.

While most of you were commuting to your desks, I was on my way to the wonderful Haven charity in Fulham to take part in an exercise video. By exercise video, I don’t mean raising a sweat (although I did have a few too many hot flushes). By exercise video, I mean a series of exercises designed to help those who have had lymph node surgery manage the risk of developing lymphoedema (or arm swelling). Ok, so it might be the world’s most sedentary exercise class and I am not about to give Nell McAndrew a run for her money. But that didn’t make it any less important.

exercisevideoday

Although I don’t think I am destined for life in front of the camera (I dread to think what my exercise face looks like and I waffled a bit on my vox pop at the end), it was a really wonderful day. I met a fantastic team dedicated to getting the medical side just right and also informing people about the latest thinking surrounding lymphoedema. No longer are we supposed to rest our affected arms and wear preventative compression sleeves. Exercise (within your limits) is the answer to ensuring we all have a really good base from which to get on with daily life. Managing the risk of lymphoedema isn’t about focusing on what you shouldn’t do, it’s about making a few adjustments to life so that you can keep doing everything you love. Saunas may not be top of the list, but everything else is pretty much up for grabs.

I also met some pretty special ladies, all at different stages of their treatment. With their positive spirits and colourful characters they were great film buddies. It will certainly be interesting to see the final cut, that’s for sure. Don’t expect a screening!

Never did I think that three rounds into chemo, I would be described as the fit one. It’s also strange to think that my hairless self (albeit in a hat) will now be immortalised, a DVD reminder of the fact that even when chemo piles on the side effects, you can still come out smiling.

Amusingly, I got a few odd looks on the tube. It seems a cancer patient with a hair loss cap, jeans and a t-shirt presents no challenge to onlookers. Dress her in leggings, trainers and yoga tops and suddenly she becomes an enigma. An active sick person. Does she deserve a seat or a round of applause? After what feels like about a thousand arm raises, I think I’ll take the seat thanks.

The great thing about today is it doesn’t end there. I am just doing a quick dress change before making my way to ZSL London Zoo for a safari gala dinner.

Take that cancer!

Breast cancer lesson number 38: If at first you don’t succeed, try, try again

Today was supposed to be a simple day. First, head to assisted conception to try and schedule my egg collection at a time that meant I could keep my oncology appointment on Monday too. Then, head to the breast clinic for the second of my arm measurements in the Lymphoedema clinical trial. In short, have a chat and stretch your arm out straight. Now, how hard could that be?

As it turns out, pretty hard. Nothing is ever quite as simple as it seems. Take assisted conception. It seems the Monday egg collection list that ‘isn’t planned until tomorrow when they know how many people are on it,’ is already pretty much full for the morning. I can only assume that has something to do with the volume of private patients on the collection list. Currently, I don’t appear on any list, but am just hoping my request to schedule it around my noon oncology and blood test appointment is taken on board, otherwise oncology might not be too pleased. Two blood tests, one suppository, one IV sedation, one egg collection and more discussions about toxic drugs await me on Monday. I’m already excited!

Determined to achieve something today, I set off to the breast clinic, practising my arm exercises on the way. As anyone who has read lesson 11 will know, I have dedicated my arm to science in order to help those trying to detect Lymphoedema as early as possible. The challenge for today? Can I get my right arm out as straight as I did a month ago? The answer? No chance. I tried (twice) and failed (twice). We even made a little graph out of the data to show me just how far off I was. My homework? More exercises until my arm is poker straight. They have two weeks to get the reading. I have two weeks to walk my arm up a wall and get it just that little bit straighter – and higher – than it is at the moment. At least I got my height measured so it wasn’t such a wasted trip for measurement man (not something I could fail at so easily)!

For those of you thinking: ‘but I thought she had breast and tummy surgery, so why is her arm hurting?,’ don’t worry, you haven’t missed a chapter. My restricted arm movement is as a result of having my lymph nodes removed (thankfully I did, given the cancer in one of the infected nodes had already spread out into the surrounding tissue). The surgery has given me a partially-numb, quite swollen and very sore right arm. It feels like someone has tightened everything inside my arm and it needs a while to loosen up. Think alien limb (whose only friend is numb new boob), and you’re not far off. With alien arm, I can write (for short periods), I can knit (for shorter periods), I can cook (as long as I don’t lift heavy pans), I can play quoits (albeit very badly) and I can lift tea (at any time), I just can’t carry supermarket shopping or, it seems, pass clinical trial tests.

Apart from a sore arm, the one thing no ANC (which means anxillary node clearance for anyone counting abbreviations after Saturday’s lesson) patient wants is Lymphoedema – or swelling. Without the lymph nodes to drain fluid from the arm, lymphatic fluid can build up in the surrounding tissues. It can be controlled, but, once it has developed (and it can develop any time in the future), it is unlikely to ever go away.

A compression sleeve is not something I’d like to wear with a wedding dress, so I am currently surrounding myself with as many tips and hints as possible to avoid getting injured or infected on that side. No one really knows what causes Lymphoedema (hence why I am on a trial), but this never-again-on-right-arm list should help reduce the risks:

The banned list

1)   Soap that dries out the skin (unperfumed moisturiser is a must for the kit bag). I think I can handle that.
2)   Very hot (or very cold water). They mention steam rooms and saunas, but am hoping occasional use is ok.
3)   Acupuncture on ‘at-risk’ arm (plenty more places to prick thankfully)
4)   Injections (woohoo!)
5)   Blood pressure cuffs (another woohoo! Quite liked it on my leg in hospital)
6)   Blood tests (don’t I know it!)
7)   Lots of weight gain (I will try, but who knows what chemo will do to me)
8)   Walking around with robot arm (being my right arm, am desperate to use it normally, so am not auditioning for a role in Star Wars)
9)   Deep tissue massage unless practitioner is specifically trained (they really know how to take away all my fun)
10) Sunburn (I have never actively tried to get burnt, but my skin just likes turning red when it looks at the sun. This could be challenging)
11)  Biting of nails (tried once, couldn’t work out how to bite them. Won’t be starting now)
12)  Washing up and gardening without gloves (I confess, I have bright pink marigolds, but am yet to put them on)
13)  Waxing or shaving the armpit with a manual razor (am hoping chemo will take care of any unwanted hair for a while)
14)  Tight jewellery or clothing (should be ok)
15)  Heavy shoulder bags (given I love to carry at least two bags at any one time, this is going to be particularly challenging)
16)  Arm strain through digging, pulling or lifting heavy bags (sounds like permission to sit drinking Pimms while Duncan does the gardening if you ask me)

NB: Please comment and add if I’ve missed any tips

Looks like I am going to become very closely acquainted with a large tub of aqueous cream (currently being applied to my tummy and boob) and antiseptic lotion (my new best friend should I get a cut, bite or baking burn).

I may have failed to achieve today’s tasks, but I still left the hospital with a spring in my step. While measurement man was measuring my height in the corridor, my breast surgeon did a double take and, realising it was me, came along to say hello. Impressed by how straight and well I looked, he gave me the biggest of smiles and said how lovely it was to see me. It may not have been a statement based on any medical examination (and I didn’t have the heart to tell him I had failed the arm test), but his smile certainly made me feel I must be doing something right. I’ll take that.

Let’s hope I can successfully be in two places at once on Monday – and that somebody will be able to find a vein!