Making the Effort: Taking the Time

I love getting letters. I was appalled when the cost of stamps went up by such a large percentage earlier this year because I am sure it will result in fewer and fewer letters and cards being sent. Who can blame anybody for using e-mail or social networking sites to keep in touch rather than more traditional methods when the costs are so great?

It is certainly lovely to have been receiving so many pretty cards from friends and relatives, despite the cost of postage!  Not only that but the flowers and visits continued to arrive. Friends further afield would skype, phone and write.  Suddenly time was more important than anything else and the fact people were willing to spend their time with me was very humbling.

Around this time it also became clear to me that I should make the effort to spend my time wisely.  

There are some things I do not have the energy to do. Although I am registered with the local library to assist people who need help to use a computer, I do not feel able to undertake this duty just now. I am just too tired. Exhaustion is one of the most debilitating side effects of my treatment for me. However, I did feel able to attend the meeting of the poetry group the meets on the library.  I was thrilled t be able to do that. It allowed me to thank the poetry group for the lovely bouquet of flowers they sent me.

It was a special pleasure to join the group that day as renowned local poet, Gerry McGrath was reading some of his verse.  His website is gerrymcgrath.co.uk. One of his books A to B is reviewed at: https://bookreviewstoday.wordpress.com/2013/04/05/from-a-to-b-by-gerry-mcgrath/

Although I got tired easily and felt a bit tender after the surgery, it was important to me to meet with the group and join in usual social intercourse that did not revolve around me being sick.  I do not like being ill. I am sure most people would prefer to avoid ill health, if they could.

While I was at the library, I was able to pick up the book the library book group was reading that month.   It was Gardens of Water by Alan Drew.

I was equally thrilled when I felt well enough to go to the singing class that runs in the Community Centre. It was another way for me to meet and mingle with the people that I share this interest with too.  members of the group had taken the time to visit me and bring me flowers, so I was able to thank them for the lovely bouquet of flowers.  There is no doubt that making the effort to spend time with people and taking the time to share my interests with them made me feel better.

Valerie Penny

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Friends and Flowers

I have never believed anybody who claims to have hundreds of friends. Friends are a treasure to be valued high above rubies and true, loyal friends are a very rare commodity. It is when times get tough that you really realise who your friends are. After the operation, word of my breast cancer spread amongst those I know quickly. I was truly overcome by the kindness, love, affection and support shown to me. The cards, flowers and chocolates given to me were lovely. Even more overwhelming were the phone calls, texts and visits.

When all of a sudden frailty struck and I had to accept the possibility of my own mortality, it was rather nice to know that there are those who care.

I received many lovely cards too. The living room of the house was so finely decorated by all these lovely things that the flowers given to me by friends at my book group and the local poetry group were displayed in the bedroom window.

There was only one problem. My disease had been found early in a scan. I had not had any symptoms. I had never felt ill, indeed, I was not aware I was ill. So I felt completely unworthy of all the good wishes I was receiving. I felt like a complete fraud. .

My sister and brother-in-law even came drove across the country to have lunch with my husband and me. Both their cars were out of action so they had to hire a car to spend time with us. What dedication to duty! How generous and kind!  We met for lunch at The Rowan Tree Restaurant, Ardrossan, Scotland. Have a look st a review of that restaurant: https://hotelandrestaurantreviews.wordpress.com/2013/04/13/the-rowan-tree…ossan-scotland/It was a lovely lunch.

The Rowan Tree offers an excellent choice of food at very reasonable prices. My sister and brother-in-law joined my husband and me for Sunday Lunch. We had a choice of the Roast of Pork as well as the regular menu. Service was unobtrusive, the meal was freshly cooked and tasty and the coffee very smooth. I always enjoy a visit to The Rowan Tree Restaurant. This visit was no exception. 

So much kindness: it all seemed too much. I was amazed how even just going to lunch made me so bone achingly tired. Exhaustion makes me miserable, but the love of friends and family is wonderful.

Valerie Penny

After My Breast Cancer Operation

Mr Osman does not use stitches in this kind of operation: he used glue. So I had to avoid soaking in a hot bath or taking showers that were long or hot. The cut under my arm was really a bit more uncomfortable that the cut on my breast.

I was terribly tired and slept for a large part of the day but I did have plans for the evening of the day after my operation. I could not cancel them without inconveniencing several people. I do not do that lightly. I run a writing group wkwriters you will find their work on their website http://wkwriters.wordpress.com and that evening was the only time the Scottish National Theatre Company was coming to the village. I had tickets for the members oft he group, wkwriters, to attend their performance. I needed to distribute the tickets to the members and I wanted to be there, if at all possible. It is very unusual for such a prestigious theatre company to visit a community as small as ours. I feel it is important to support such ventures to encourage them to be repeated. The play, The Strange Undoing of Prudencia Hart, was a sell out and part of the summer term course for my class. We put together reviews.  

I realise it probably took more energy than was sensible to attend the performance by the Scottish National Theatre Company. The following days were more exhausting than I could ever have imagined. Recovery was uppermost on my mind: but the road to recovery would take far more time than I could ever have imagined.

Valerie Penny

Breast Cancer Operation Day!

The nights always seem so long when I do not sleep. Luckily, that does not happen often.  I did not sleep well on the night before my operation. I was scheduled to be at the hospital by 7.30am on April 30. It was a grey morning and I suspect my mood was grey too, but the staff could not have been kinder. I filled in my pre-registration form and my husband waited with me until I left reception. I do not know who was more scared, him or me.

When I went through to the waiting area nurses gave me a bag to put my clothes into and put on a hospital gown and sat with the other women waiting for surgery.  I flicked through papers as the television in the waiting area played Jeremy Kyle. It felt like it was going to be a long day, but somehow it flew past.  Of course, Mr Kyle had his own battle against testicular cancer in 2012.  He credits his wife, Carla for helping him through the treatment.  I have no doubt that the unfailing care and support of my husband, David, were vital to my recovery too.

During the morning I was taken for additional X-rays, ultra sound checks and went into the nuclear medicine department to have a wire inserted into my tumour so that Mr Osman would be able to find it easily during the operation. The various visits to different departments helped to make the time pass more quickly.

Mr Osman took the time to come and speak to me before the operation. He explained to me that the purpose of the operation was to remove the tumour from my right breast and also to remove 2 lymph nodes from under my right arm. The purpose of removing the lymph nodes was to confirm whether or not the cancer had spread.

Lymph is a clear fluid that travels through your body’s arteries, circulates through your tissues to cleanse them and keep them firm, and then drains away through the lymphatic system.

Lymph nodes are the filters along the lymphatic system. Their job is to filter out and trap bacteria, viruses, cancer cells, and other unwanted substances, and to make sure they are safely eliminated from the body.  

Also traveling through the arteries is fresh blood, which brings oxygen and other nutrients to all parts of the body—including your breasts. Used blood leaves the breasts through the veins and is pumped back to the heart and lungs to be refreshed. Lymph must also be refreshed and recycled. Lymph drains away from your breasts through the lymphatic system, which is made up of lymphatic channels and lymph nodes.

When Mr Osman asked if I had any questions for him, he apparently meant questions that related to the surgery and not this week’s lottery numbers. That being the case, I do not know enough about medical procedures to know what to ask. I had no questions for him. I was even given a menu to allow me to choose my evening meal. This was a nice touch.

Most of the rest of the day was a bit of a blur. I remember being shown to a hospital bed and sitting reading and doing puzzles. I remember the anesthetist coming to speak to me and explaining what she would be doing. I remember she seemed very young! Then I have no clear recollections until the porters came to take me to theatre.

I do remember being in the theatre before the anesthetic took effect. Happily, I remember nothing thereafter until I smelt the evening meal, but I was still too tired to open my eyes, never mind eat the meal. When Mr Osman came to see me after the operation and to re-assure me that all had gone well.

The highlight of the evening, of course, was visiting time when my husband came to visit. I remember being given a cup of tea and a couple of biscuits. I was quite insistent that my husband should have a biscuit.  I also remember holding his hand, so that when I fell in and out of consciousness he could not leave without me knowing. To be fair to the man, he showed no signs of planning to leave early! When visiting time did, eventually come to an end and by then I was a little more awake and hungry. I am vegetarian and the nurses were so kind and got me some cheese and crackers to eat. The nurses could not have been more considerate or helpful.

I did not sleep well, probably partly because of the anaesthetic and because of the strange surroundings. I was also disturbed when the nurses came around and shone a torch at the beds to make sure the patients were settled. It was meant to be non-invasive, but struck me as a little strange.

The following morning I had the choice of having breakfast in the ward or in the waiting room. I chose to have it in the ward and then when the doctor gave me the all clear, I got dressed and phoned my husband. I waited for him to come to pick me up and take me home. It was lovely to be back.

Valerie Penny

Freaky Breast Cancer Friday

I was amazed when the hospital arranged an appointment for me to meet with my surgeon, Mr Osman on Friday, just two days after I got my diagnosis of the tumour. All of a sudden every thing seemed to be moving. In a few days I had gone from feeling fine, to having a battery of tests and then being told that I had a potentially fatal disease. It was too much to take in. I could not believe how fast everything was happening. Looking back, I am ashamed to say tat I simply had not recognised the discharge from my nipple nor my extreme tiredness as signs of breast cancer.

I called my friend across the road and told her. She asked me the name of my surgeon.  I had slightly misheard his name and told her it was Mr Osmond. I joked that I hoped it was Donny Osmond!donny osmond My friend disillusioned me by telling me that her surgeon was the same person, it was Mr Osman and certainly not a American entertainer! She also told me Mr.Osman is delightful and very helpful.

My appointment was for 11.30 on the Friday morning. but I was not seen until after 1pm. By this time, as I had arrived stressed, I was almost climbing the walls and had read almost all the magazines in the waiting room. It did not help that there was a man in the waiting room who chatted loudly and personally to many of the others there. Maybe it was his way of dealing with his own stress, but I found him intimidating and was glad to have my husband with me.  My Husband is a big guy, needless to say the man with the verbal diarrhea came nowhere near us. However, by the time I went into the consulting room I was up to high doe.

So to the embarrassment of my long suffering man, I asked the nurse who took me into the consulting room why my appointment had been made for 11.30 if I was not being seen until nearly 2 hours later. She explained that the clinics were very busy, but that did not answer the question as to why appointment were, apparently, made too close together if patients regularly overran their allotted time. She said I would need to take it up with Mr Osman. I agreed to do this. However, this became unnecessary, as my cancer care nurse came in to see me and calm me down. cancer care nurse I think my husband was even more glad about this than anyone, but I did get him to agree that I had not been rude and that the long wait had made a stressful situation worse.

Shortly afterwards, Mr Osman can in. He explained to me that the biopsy had shown the tumour to be malignant and that it needed to be removed. He also informed me that the tumour was found to be related to the fact that I had been taking HRT for many years. He told me I should stop taking that drug immediately.  I asked him about this because I had understood from my GP that the evidence of this was ambivalent. Maybe I had misunderstood him. Mr Osman smiled and said that the studies were not clear for those who had been taking HRT for 5 years or less. However, he said that for those who had been taking the drug for ten years or more. He noted that I fell squarely into this latter group as I had been taking HRT tablets for at least 12 years.  Mr Osman was, therefore very clear in his advice, I must stop the HRT now.

Then he asked me about when I thought my operation would take place. My friend had told me the time-lag was usually 2-3 weeks so I mentioned this to Mr Osman, but also said I appreciated this would largely depend on his schedules and work load. his kindly face broke into a wide smile. 2-3 weeks would be no problem. I returned his smile and smiled at my husband as Mr Osman went on to tell us that he had only that day negotiated an extra theatre day and he wondered if I was free on Monday.

Monday! This Monday, two days time. I gasped and grinned at my husband. I could not think of anything more pressing I had to do on Monday, or any other day. The thought of getting rid of the cancerous tumour so quickly was wonderful. I felt a bit ashamed that I had complained about the wait in the waiting room and was thrilled that the surgery would take place so quickly.

I was told to be at the hospital for 7.00am and that I would go for the various tests and scans before surgery in the afternoon.   Although the surgery s classed as day surgery, I would be required to stay in hospital overnight. I would be having a general anesthetic and the hospital wanted to keep an eye on me overnight.

We left the hospital in shock. Happy shock, but shock never the less.

Valerie Penny

Breast Cancer on Black Wednesday

Some days are better than others. Wednesday 25 April was a busy day. I spent the first half of it shuffling from one doctor to another. My first appointment was at my GP just for a regular check-up. It was then I was able to tell my GP that I had been recalled after my mammogram. He was quite cross that the hospital had not informed him. The GP also wanted to speak to me about the length of time I had been taking hormone replacement therapy (HRT). It was a long time, over 12 years. However, in light of the other appointment I had to attend later in the morning he decided not to make any changes at this point.

doctor's room

When I came back out of the surgery, I phoned my husband and he drove me on to my next medical appointment of the day. This, again was a regular appointment. It was my fortnightly visit to my psychologist. It is, perhaps, also ironic that I did not believe in depression until I was diagnosed with it over 10 years ago. Like many people, I thought it was not truly an illness, but a state of mind that could be surmounted simply by “pulling yourself together”. I cannot help but think a higher being was having a laugh when they got their own back and I have battled depression, without surmounting it, for so many years now.

However, when the psychologist asked how I felt about the possibility of a diagnosis of cancer, I still could not truly admit that it might, even now happen to me. So I put on my mask, as I so often do when faced with a problem too difficult to face, and told her that I did not know how to feel, until I knew what I had to face. It sounds sensible, but really, I simply could not release my emotions or inhibitions: not then, not yet.

When my husband and I walked from the psychology department of the hospital to the breast cancer care department we went quite slowly. Almost as if by not knowing the results of the biopsy and screening it would prevent the news from being bad.

We were not kept waiting long before I was called through to meet with the doctor and my husband came with me. None of the staff that I had seen the previous week were at the clinic that day. It was a little daunting to know I was to get the results from someone I had never met before.  However, the doctor introduced herself and the cancer nurse assigned to me was there and introduced herself too. She is Angela Watson.

It was explained to us that the biopsy had shown the tumour to be cancerous. It was explained to me that the disease had been found early and the tumour was about half the size of a baked bean. (I have always seen myself more as a “petit pois” kind of girl!) The doctor told me I would need to have surgery, a lumpectomy, (such an ugly word) to remove the tumour.  I was given an appointment to meet with the surgeon on Friday and that I would probably go for surgery in 2-3 weeks. What a lot of information.

Basic RGB

I was told the tumour was found to be HER-2 positive and that I should stop my HRT with immediate effect. HER2 is a protein found on the surface of certain cancer cells. Some breast cancers have a lot more HER2 receptors than others. In this case, the tumour is described as being HER2-positive. Tumours that are HER2-positive tend to grow more quickly than other types of breast cancer. Knowing if a cancer is HER2-positive can sometimes affect the choice of treatment. Women with HER2-positive breast cancer can benefit from a drug called trastuzumab (Herceptin). Herceptin only works in people who have high levels of the HER2 protein.

To understand HER2, it first helps to know a little about receptors and growth factors:

  • Receptors are particular proteins that are present within cells or on their surface. Other proteins or chemicals in the body can attach to these receptors to bring about change within a cell (for example, to make it reproduce or repair itself).
  • Growth factors are chemicals that attach to these receptors and stimulate cells to grow.

HER2 is a receptor found on the surface of certain cancer cells. It is made by a specific gene called the HER2/neu gene. HER2 is a receptor for a particular growth factor called human epidermal growth factor, which occurs naturally in the body. When human epidermal growth factor attaches itself to HER2 receptors on breast cancer cells, it can stimulate the cells to divide and grow.

Some breast cancer cells have a lot more HER2 receptors than others. In this case, the tumour is described as being HER2-positive. It is thought that about 1 in 5 women with breast cancer will have HER2 positive tumours. So roll on Friday and then I get to hear what the surgeon has to advise, but I am not ashamed to say, I have had better days.

Valerie Penny

The Longest Week: Waiting for Breast Cancer Screening Results

When it finally trickled down into my consciousness that, in fact, breast cancer maybe could happen to me, and perhaps the highly qualified radiographers might not have made a mistake, my life, all of a sudden,became quite tense.  Imagine how surprised I was when my husband and I pulled up at home after that morning in the hospital to meet one of our close friends and neighbour. I had not seen her for a few days. When I asked after her health and she told us she had recently been diagnosed with breast cancer, my blood ran cold. It was as if a hand cold from the ice-box had gripped my heart. This was all too real.

house

My husband and I decided not to tell anybody else about the investigations that were being carried out for me as we did not yet know whether the tumour was benign or cancerous. There seemed to be no reason to worry anybody when there might be nothing to worry about.

So I hugged my friend and tried to say all the right things. True to form she brushed my concerns aside telling me that it had been a bit of a shock but she would just have to get on with it. Her main concern seemed to be that she would not be able to join her cousin and his wife on a cruise in the Mediterranean they had planned. Her husband joined us. He looked sick. When my husband and I crossed the road to go home he said to me that he felt that way too.

I think waiting for the news was one of the longest weeks of my life. I spent the time hoping for the best and preparing for the worst. It was advice my Uncle had given me many years previously at another stressful time. The advice stood me in good stead then and did again now. My husband and I fretted individually, but we rarely spoke about the elephant in the room. My temper grew short. He withdrew into himself.

Eventually we had to talk. We hugged and cried and spoke about the fact that we may be worrying about nothing. Whatever happened we knew the tumour had been found early during a screening. I had no symptoms that I was aware of. I got tired easily and had a little discharge from my right nipple, but I felt fine. If I had even a basic knowledge of the signs of breast cancer, I would have realized these were classic signs of the disease. We would find out soon enough, the following Wednesday, whether or not there was anything to worry about. In the meantime we tried to be calm but that week seemed to last forever.  tumor_sizes[2]_tcm8-79578
Valerie Penny

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