Time for Reading and Writing and Sharing and Being treated for Breast Cancer

One of the things I have found while I am undergoing my treatment for breast cancer is that as I have less energy to do physical exercise or physical work, I am finding myself able to indulge in other interests. I find I am able to do more reading and writing. I enjoy this.

One of the books I read recently was “In The Dark” by Mark Billingham.  The book is reviewed here: https://bookreviewstoday.wordpress.com/2013/04/05/in-the-dark-by-mark-billingham/

On a rainy city night, a handgun is fired at random. A struck car swerves and plows into a bus stop, killing an unsuspecting bystander. In an explosive instant, a cold-blooded gang initiation ends one life and forever changes three others: the desperate teenager who pulled the trigger. A policewoman is on maternity leave and an aging is gangster plotting a terrifying revenge. The truth about the shocking incident will tie them all together in a lethal blood knot. And nothing is what it seems.

In the Dark” is the most powerful and unflinching crime novel yet from the remarkable Mark Billingham–a gripping journey into the modern urban darkness where violence is both indiscriminate and meticulously planned, and youth gangs take on established criminals for rule of the streets.

In a completely different vein is the novel by Jane Green ” Second Chance“. That book is reviewed here: https://bookreviewstoday.wordpress.com/2013/04/05/second-chance-by-jane-green/. Jane Green has become a nationally bestselling author with legions of fans through her novels about the true-life dilemmas of real women, their relationships, their careers, their loves, their triumphs and disappointments. In her latest book, Green tells the story of a group of people who haven’t seen each other since they were best friends at school. When one of them dies in a terrible tragedy, the reunited friends work through their grief together and find that each of their lives is impacted in ways they could have never foreseen. Warm, witty, and as wise as ever, this is a story of friendship, of family, and of life coming full circle.

I also managed to contribute work to the blog wkwriters.wordpress.com. Here is an example.

Jubilee  

So many years you’ve worked in a job

You never sought to do it did you, Ma’am?

But your Uncle married Wallis Simpson

It was then so unavoidable: so set

You would be Queen: you were: you are now

Those 60 years have passed, how fast they flew

With you upon the throne you saw the change

You see the change and yet you rise above

Consistent in a land you love, a land you serve

Duty, dignity, experience still

Few would trade you places if they could, you know

None could hope to do your job so well.

I also read the book promoted by my book group.  

The first novel by Peter Ho Davies is “The Welsh Girl“. It is reviewed here: https://bookreviewstoday.wordpress.com/2013/04/05/the-welsh-girl…eter-ho-davies/. The Welsh Girl is set in 1944, as World War II grinds through its final year. But of course his characters don’t know that they are within sight of the finishing-post. Instead, they inhabit the confusions of the present tense. Rotheram, a German Jewish refugee, came to Britain in 1936 and now works as a translator for Political Intelligence. Seventeen-year-old Esther, daughter of a Welsh shepherd, lives in a remote village where war impinges in the form of evacuees and English sappers building a prisoner-of-war camp. Karsten, a captured German naval infantryman, will become one of the first prisoners in the new camp.

The Welsh Girl is preoccupied with ideas of identity, belonging and alienation. Ho Davies explores the ways in which war ruptures the relationship between a human being and the place (or country) that is called home. Some forms of belonging are obvious as the novel begins to weave its strands. The sheep on the Welsh hills know their territory and don’t stray from it. This sense of belonging – cynefin – is passed on down the female line, from the ewes to the ewe-lambs, because the ram lambs are sent for slaughter. If the herd loses contact with its territory, it cannot thrive. This hard fact becomes a metaphor throughout the novel. It may be over-used, but it remains potent. Esther, who has lost her mother and is a little lost within her own life, will eventually give birth to an identity which allows her to reconnect, in her own way, with home and origins.

Language is a key marker of belonging in this fictional village. Certain thoughts and ideas belong within Welsh, resisting translation because they embody what is specific to that culture. Ho Davies describes his fictional setting as “a nationalist village, passionately so. It’s what holds the place together, like a cracked and glued china teapot.” However his treatment of the very complex and controversial subject of Welsh nationalist attitudes to the war is somewhat bland. Characters take an overview of their situation, and describe their feelings and thoughts to themselves in a way which robs these of life. Esther, for example, hears Churchill’s speech revealing the invasion of France, and reflects that “most of the locals are as filled with excitement as she is, even if they’re reluctant to admit it.” It seems very unlikely that a girl of 17 would think of the friends and family with whom she’s grown up as “the locals”.

Ho Davies is much more assured in his handling of characters who are uprooted. Rotheram, for example, has gone through a long battle over both his Germanness and his Jewishness. It is only towards the end of the novel that his Jewishness becomes real to him, because he has made his own bridge between what other people say he is, and where he feels he can belong. Karsten, like all the other prisoners, is stripped of the identity – or sustaining fantasy – supplied by Nazism. Already, however, a different fantasy is supplanting it: the prisoners begin to consider themselves both innocent and victimised, subtly entitled to resentment and furious when they are confronted with film of the liberation of Belsen. Esther, coerced into sex by her English sapper boyfriend, has to lie about what really happened for the rest of her life. Within this lie, the novel seems to argue that Esther finds a deeper truth which links her to her dead mother, and enables her to claim back her own territory.

The Welsh Girl handles its complex thematic structure with secure craft, intelligence and sense of direction. The introduction of a major historical figure into this fictional world may shake the scenery, but the novel recovers.

Rotheram is the most subtly-drawn and interesting character in the book. This may be because Ho Davies has not decided the outcome of his story as firmly as he appears to have done with Esther and Karsten, but has treated Rotheram with some of the uncertainty and passion which brings a character to life. In his characterisation of Esther, there is distance.

Ho Davies has already earned a reputation as a short-story writer, but that skill may not make it easier to risk the excess, embarrassment and commitment of a book which takes its author way beyond where he expected to find himself. Nevertheless, The Welsh Girl is good enough to suggest that he may become an impressive novelist once he is into his stride.

Everything has advantages and disadvantages. One of the few advantages of having breast cancer is that I have time to catch up with my reading, writing reviews of the books and even some poetry and sharing it all with you.

Valerie Penny

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Symptoms of the Cure for Breast Cancer

My cancer is breast cancer but was found early and surgery (hopefully) removed the tumour.  As a result of that I had had no symptoms that I noticed from my disease. Looking back, there were several signs that I ignored. The discharge from my right nipple and the least exertion made me very tired. Still, It never occurred to me that I had cancer. That would not happen to me. It could happen to other people, but not to me. It is therefore, I am told, unsurprising that, when I started having symptoms from the cure, I became quite resentful of that.  The flowers friends and family continued to send made the long days at home more easily endured.    Visits phone calls, texts and emails helped too. I like to feel part of the world and community, even if I don’t get out much.  I am so very lucky to have that network of support and love and prayer: I do not take any of that for granted.  

I have, however, taken my good digestive system and ability to sleep well, whatever the circumstances, for granted for many years.  When the side effects to my chemotherapy included constipation that was so bad it made me scream followed, a few days later, by constipation that made me weep, I felt miserable.  I also have had difficulty getting to sleep and staying asleep during periods of my chemotherapy cycle. I am not sure if that is caused by stress or by the treatment. Whatever caused it, I found it unusual and depressing.

I also find that food tastes a bit tinny this is quite unnerving. I find myself drawn to sweet and salty foods.  I also find that my eating habits have changed. I am finding myself eating little and often (or sometimes just little) rather than 3 square meals a day.

Another distressing side effect has been sudden, sometimes lengthy, nosebleeds. That has been quite upsetting for me and for my husband.  

I have found myself to be tired and lethargic. This has been compounded by pains in my joints, severe cramps in all the large muscle masses of my body and also tender muscles. These have required painkillers, easing with hot water bottles and comfort from cushions. I like to keep busy, with work, hobbies, interests and pursuits with family and friends. When I find myself so tired and my energy at a premium, I have just to get used to doing what I can when I can and not set my targets too high. That results in frustration and low mood. It is difficult to cope with this and having to take naps in the afternoon or sleeping longer into the morning. Still, I will just have to get used to my current limitations while my treatment is ongoing.

Late into my three week cycle two other side effects came to light.

The first of these was the dreaded hair thinning and subsequently hair loss. I had really not thought this would upset me too much as I have had thin hair due to an under-active thyroid. However, I did find it distressing and took up the offer of a wig financed through the NHS and am grateful for it.  It looks very realistic and is comfortable to wear.  I went to a local hairdresser and wig provider, Amanda who operates from Francis Hair and Beauty Salon at 29-31 Bridge Street, Galston, Ayrshire, Scotland.    I was very nervous and found the visits quite stressful. However, I need not have done. The staff were all so very kind and helpful and Amanda is knowledgeable. There were wigs to choose from in stock. She did, however, advise that she order up another couple of wigs so that I had an even larger choice to select from. as my hair loss was not so serious at this point, I took her advice to wait and make a full choice.

The second of the later side-effects was the development of a nasty chemical burn on my left hand. This, combined with the bad bruising caused by the use of a cannula to administer the chemotherapy, has resulted in a very sore and multi-coloured left hand.  The installation of a hickman line for future chemotherapies has been advised. Doubtless this will come.   I am not looking forward to yet another operation, but must be advised by the oncologist.

There is no doubt that many of the troublesome side effects do not become obvious for two or three days after the chemo has been administered and they do lessen towards the end of the three week cycle. Just about the time for the whole thing to start all over again!

Valerie Penny

The Longest Day of Chemotherapy

It was Tuesday, 5th June, Jubilee Day. Most of the UK was celebrating the 60 years of the reign of Queen Elizabeth II with an extra public holiday.   I marked the day with my first day of chemotherapy.   It was certainly memorable!

I met with the oncologist at 9.30 am.   She told me my blood results and scans from the previous week were satisfactory as a result of this,  I could go ahead with chemotherapy today as planned. This was both a relief and a challenge.  A relief because, due to my depression, I am not good at dealing with changes in plan.  A challenge, of course, because this meant, again,  it was made real to me that I had breast cancer a condition that required lengthy and invasive treatment.  Reality struck again.

Fortunately my husband was with me.  His very presence keeps me calm.  It was during this appointment that my breast cancer nurse, Angela Wallace, began to explain some of the side effects of the chemotherapy that I might expect. These were difficult to hear. The cancer had been caught so early that I had not recognised any symptoms of the disease in myself.  I felt quite resentful to hear of the side effects I might suffer from the cure.

She explained to me that I would be entitled to a wig, in case I suffered from hair loss.  She also told me that the hair loss would be likely to be from all over my body and that I could expect, among other things, to suffer from a dripping nose. It all sounded distressing and disgusting.

I told Angela that I did not think I would bother with a wig.  I thought it would be too hot during the summer. However, she explained to me that it can sometimes be easier for other people if I wear a wig, especially my mother and my children.   She also drew to my attention that my treatment would last well into October and therefore it would be the end of the year, a much colder time of year, before my hair would begin to grow back.  This was another reality check.

Chemotherapy is a treatment which uses anti-cancer drugs to destroy cancer cells. The drugs work by attacking the cancer cells and disrupting their growth. Unfortunately, they can also affect the normal cells in the body, including the cells of the hair follicles. This causes hair loss, also known as alopecia. Unlike cancer cells, however, the normal cells quickly recover, so if you lose your hair due to chemotherapy it will almost always grow back when your treatment is over.  Before you start chemotherapy, your doctor or chemotherapy nurse will discuss the possibility of hair loss and other side effects with you.

Not all chemotherapy drugs make your hair fall out, and sometimes the loss is so small it is hardly noticeable. However, some people will have temporary, partial or complete baldness.  Some chemotherapy drugs make other body hair fall out, such as eyebrows, eyelashes, nasal hair, beard, moustache, chest, underarm, leg and pubic hair. The amount of hair that falls out depends on the drug or combination of drugs used, the doses given and the way that your body reacts to the drug.

If your hair is going to fall out, it usually starts within two to three weeks of starting chemotherapy, although very occasionally it can start within a few days. The first thing you may notice is that your hair starts to come out more when you brush, comb or wash it. You may also find hair on your pillow in the morning.

Hair may just thin and become dry, fragile and break easily. For other people their hair may carry on falling out over a few weeks so that they become completely bald. Sometimes the hair comes out very quickly over 1-2 days, which can be very upsetting. Some people find that their scalp feels tender.

It was all so much to take in.

Angela explained to me about a method of trying to prevent or reduce hair loss. By cooling the scalp.  It is sometimes possible to reduce the amount of chemotherapy drugs that reach the hair follicles on your scalp. This reduces, and in some cases prevents, the hair from falling out. It is done by using a ‘cold cap’ or a machine that cools the scalp.  I decided to try that.  I was to go to the ward for my chemotherapy by 11am, so my husband and I had time for coffee in the hospital canteen before we went up, but life is never that simple! It is Jubilee Day. The canteen was closed for the public holiday – so we settled for coffee from a machine. Yugh!

  When we went to the ward, I was reminded of all my friend, Margaret Boe, had told me. She had been given the all clear after her breast cancer last October. She said that the ward was a surprisingly happy place. She told me every body, staff and patients alike were very friendly. She said everybody was happy there, but her husband, Billy, said he had not been happy and he found the whole experience of being present at Margaret’s treatment terribly difficult no matter how pleasant the surroundings were. In any event, I was glad to have my husband’s company and support. While this was a long day for me, at least I was the centre of attention. It was an even longer day for him. I was nervous and anxious. It was so important to me to have him there.

I was shown into the treatment room. There were 12 treatment chairs and I was shown to one that accommodated the use of a cool cap too. In the corner of the room a TV high up on the wall ran the Jubilee Day celebrations all day. In our neck of the woods the weather was beautiful but we watched the Royal Family enduring the downpour in London, England for  hours as they stood waving to the crowd. While I sat on the chair waiting for my treatment to start I was anxious. I was pleased to be starting my treatment, anxious about what it held for me and even more pleased that I was not in London getting drenched watching the Flotilla on the River Thames.   

The first struggle for the nursing staff was to get a cannula fitted into a vein in my left hand. That proved to be more of a struggle than expected so the staff began talking about getting a Hickman Line inserted into my chest.  This was to make taking blood and inserting chemotherapy easier in the future.  I was put more at ease when a woman came round and offered us all a cup of tea or coffee and a biscuit. Even the visitors got offered one. My husband was pleased!

In the meantime my treatment today began with a saline solution being inserted into my vein before two different antihistamines were added to the cocktail.  Antihistamines are a type of medicine often used to treat a number of allergic health conditions. Antihistamines work by blocking the effects of a protein called histamine.

Histamine is a protein that the immune system uses to help protect the body’s cells against infection. The immune system is the body’s natural defence against illness and infection.  If the immune system detects a harmful foreign object, such as bacteria or a virus, it will release histamine into nearby cells. The histamine causes small blood vessels to expand and the surrounding skin to swell. This is known as inflammation.  

The expansion of the blood vessels allows an increased number of infection-fighting white blood cells to be sent to the site of the infection. The swelling of the surrounding skin also makes it harder for an infection to spread to other parts of the body.

Histamine is usually a useful protein, but if you’re having an allergic reaction it’s sometimes necessary to block its effects. Allergic reactions occur when your immune system mistakes a harmless substance, such as pollen, as a threat.  The release of histamine causes the process of inflammation to begin and leads to nearby tissue becoming red and swollen. It can also affect the nerves in the skin, making the skin feel itchy.

I had been in the cancer treatment ward for over 2 hours and the chemotherapy itself had not started.  The next excitement was that the woman who had come round with the tea earlier came back. This time with bowls of soup and a choice of sandwiches for all the patients and the visitors. By this point she was my favourite member of staff!

Another nurse set me up for more saline drip: another half hour passed. It was only then the chemotherapy began and I got hooked up for my course of herceptin. The time lapse was this was to be another hour and a half. My husband took an opportunity to go for a walk and buy a magazine and a paper at the hospital shop. This opened in the afternoon notwithstanding the public holiday. He needed to stretch his legs and move around a bit. I really didn’t blame him for that.  By now it was almost 2pm and we had left the house more than 5 hours previously, it was clear it was going to be a long day: a very long day.

While the herceptin dripped into my vein I sat and flicked through another magazine left by someone in the ward. Herceptin is a cancer medication.   It interferes with the growth of cancer cells and slows their growth and spread in your body.  Herceptin is used to treat breast cancer that has progressed after treatment with other chemotherapy.

I was glad when my husband got back. I know the day was boring for him, but I was happy to have his company and support. I am not sure I ever told him that. I just expected him to know. When he did come back I did the puzzles in the magazine. It was something new to look at and think about apart from the unceasing coverage of the Queen and the Duke of Edinburgh endlessly waving to the crowds in the rain.  

The afternoon rumbled on and my favourite staff member came round again, this time with another cup of tea or coffee for the patients and family members with them. This woman secured her place in my heart!

After the dose of herceptin had completed, I was given another dose of saline and then the cool cap was switched on so that it would be ready for me to wear by the time I was ready for my dose of docetaxyl. Time continued to pass.  My favourite nurse was the person who put the cool cap on for me. It had to go on a full half hour before I started taking the docetaxyl at 4.50pm.

My husband was getting bored again. Who can blame him for that? He left the ward to go down to the car park. It was emptying fast as staff came to the end of their day and clinics ended, yet evening visiting had not yet started in the wards. He took the chance to move our car closer to the hospital so that I would not have so far to walk when we, eventually were able to make our way home. That time still seemed so far away to me.

Almost all the chairs in the ward had been used during the day. Now there was only one other patient, no great surprise really, most of the staff in the ward finished their shift at 5pm. This really was a marathon session.

The other patient in the room was a woman who was further into her treatment than me. Her daughter and two grandchildren were with her. The grand daughter was asking about the cool cap I was wearing. It did look a bit like a cycle cap and felt a bit like it does when you are standing in New York City, New York, USA in January waiting for a taxi. The only difference is there is no wind in the cool cap!

It was quite re-assuring to notice how accepting the family were of the woman’s hair loss and treatment. I am not looking forward to the prospect of losing my hair. My hair has been thin for some years due to an under-active thyroid, but the thought of losing it all together makes me very self-conscious.

So another hour passed while I sat with the docetaxyl dripping into me. By 6pm even the woman with the grandchildren had left and my husband and I were alone in the ward waiting for a nurse to come and unhook my drip. Even then the day was not over. When, eventually, the last nurse on duty in the ward came back in she told us the cool cap needed to stay on for another 20 minutes.  The nurse’s shift ended and she left. My husband and I were alone in the ward. He had been given instructions by the nurse as to how to turn off the cool cap and remove it from my head. It felt strange to be leaving from a completely empty ward.

My goodness I was tired by the end of all that. Not just because it had been such a long day, but also because everything was new and strange and stressful. The shops were shut when we were driving home by the time we got there we had been away from the house for over 11 hours. It was as long a day and as stressful day as I could remember. We were both too tired to cook, so we decided to pick up a meal from our local Chinese takeaway restaurant. This was a welcome end to the longest day.

Valerie Penny

Surviving Breast Cancer: More Reading, Listening and Sharing

Breast cancer re-aligns your priorities. The importance of family, friends and time to be with them and do things you enjoy become paramount.

I was glad of the opportunity to re-read Bill Bryson’s “Made in America” The book is reviewed here: https://bookreviewstoday.wordpress.com/2013/04/05/made-in-america-by-bill-bryson/. The text is an entertaining compendium of possible and less possible word origins. Does “okay” come from Martin Van Buren’s nickname, Old Kinderhook? Or from the fact that Andrew Jackson was reported to write “oll korrect”? Or is it from the Greek ollakalla(all good)? Bryson offers a cogent discussion of sexism in the language, and there’s a lot of orthography, etymology, and toponymy. But this isn’t just a book about language. It’s also a bestiary of American pop culture, many of whose stereotypes Bryson debunks (a back-formation from Buncombe County, N.C., of course): Ellis Island, in its original splendor, wasn’t half bad; the Puritans enjoyed a good time just like the rest of us; and Ray Kroc hadn’t the inventiveness of the Brothers MacDonald, after all. Bryson tells us a lot we surely never thought about. There’s the cost of sending a letter by Postal Express and the reason for the bump on the fuselage of the Boeing 747. “Debugging” of computers began, we are told, on the day 50 years ago when a moth entered a Navy computer. There are, however, some facts that aren’t facts. Bryson places the Polish-born British writer Joseph Conrad among the group of Americans whose names were changed from awkward foreignness. And, surprisingly for a lexicographer, he indulges in the popular confusion of the 18th-century “long s” and the modern “f.” This offering won’t replace the popular works by Flexner, much less the majestic Mencken, but the style is engaging and the narrative diverting. An index is appended, but there is no useful list of words and phrases.

If, as Winston Churchill has it, England and America are two countries divided by a common language, here’s some disarming help sent by a Yank from the other side of the pond.

Gerry McGrath’s first collection of poetry is published in his book “A to B”. It is reviewed here: https://bookreviewstoday.wordpress.com/2013/04/05/from-a-to-b-by-gerry-mcgrath/. He read from this when he came to visit a meeting of wkwriters. 

As well as being a highly visually stimulating poet, Gerry McGrath is also a poet concerned with humanity, with nature, with love and loss and how the prosaic and the poetic interact in day to day life.  The use of unconventional metaphors and similes gave many pleasant surprises as I saw things expressed in a way in which made perfect and beautiful sense however strange. Gerry McGrath describes ‘Untamed Lightning, Knees like Emaciated skulls, the sky…clean-shaven, Drowsy sail-cloth of your skin, Gossamer rain, Zany Butterflies, Pastry Roofs and Nicotine Grass.’ These are just a few examples of the arresting imagery which runs through this poetry collection. Some of the poems are as delicate as the ‘gossamer rain’ described by McGrath in the poem Sycamores. His poem Elegy appears in full here: https://survivingbreastcancernow.wordpress.com/2012/07/01/time-to-recover-watching-reading-listening-sharing/

I liked the later poems in this collection more than the earlier ones, although I do not know whether this was because they carried more depth of feeling or because by the time I reached them (I was more accustomed to and in tune with the poet’s tone of voice. The poems Secrets and Gift, which explore the art of writing poetry, struck me as particularly interesting as the creative process is highly individual to all writers and it is always interesting to be given a glimpse at how a poet writes. In Secrets he refers to a poet beginning with nothing and holding it ‘until it bleeds a secret’ a metaphor I found at once eerie and beautiful. In the poem Gift he refers to the way in which poets have the gift to observe ‘tiny immensities’, a gift which Gerry McGrath certainly has.

I think that ‘Tiny Immensities’ is such a beautiful and truthful phrase that it would make a good name for this collection of poetry, better than the current title A to B, which I found slightly off-putting. I understand that the collection was called A to B as it represents a journey, yet I feel that this title does not do the work as a whole any justice. The poem A to B from which I guess the title was taken, is my least favourite poem in the entire collection. In the poem McGrath tells us about butterflies, red-backed beetles and a dead marten but ends with ‘But let me tell you about the butterflies.’ While I realise that this premature ending was intentional I didn’t like it and felt let down that the poem did not go on to tell us about the butterflies as it seemingly promised to do. It only occurred to me later that this might refer to the other poems in the collection, some of which are as vulnerable and glorious as butterflies.

Some of the poems, particularly in the latter third of the book, were not so much poems, but snapshots of incidents, told in prose as precise as poetry. This was most apparent in the poems Busy, Currency, A Milky Sunlight, Two Friends, Mint Tea, Blue Light and Basics. I liked these almost poems best of all for the simplicity and honesty with which they were laid out and the way in which they all told an entire story in a snap shot. The scarcity of the language meant that by using fewer words McGrath was actually able to say more by imbuing his words with a deeper sense of meaning. The poem busy portrays someone cutting the poets hair while hearing about her Grandmother’s worsening condition. The combination of the prosaic ‘hair-clippings went flying out’ with the tragic ‘age, infirmity, depression, were all getting the better of her, pulling her down’ creates a beautiful sense of pathos, which runs on through the poems in this collection.

Every day is precious. Sometimes, in this blog, I may sound ungrateful. I am not. I know how lucky I am that my disease was found and treated early. I just do not like some of the results of my treatment. Still, it has made me slow down and given me time to spend time with those I love. Reading new books and some old favourites, sharing these with my family and friends and listening to all their views.

Valerie Penny

A Pleasant Interlude Before Chemotherapy for Breast Cancer

There is a time of year, it is usually around the second half of May when school children and students are studying for exams. They spend hours and days inside and in the libraries, so what happens? The sun comes out!  

This year was no different. During that sunny weather at the end of May, before the chemotherapy for my breast cancer began. My husband and I arranged for my mother to visit with us for a few days holiday, before I suffered hairloss and other side effects of the treatment. A mother should not have to witness that, if it can be avoided. During that week I did have to meet with my psychologist for my usual two-weekly therapy session.

I was able to air my feeling of resentment that I have never smoked, do not drink excessively and do take exercise. Nevertheless, cancer was the card I had drawn.  One day was interrupted when I had to go back to the hospital, this time for an initial set of blood readings to be taken before my chemotherapy sessions start. The hospital even did a pregnancy test! As if my long suffering husband did not have enough to worry about! I also had to go to the hospital for a cancer clinic visit with the oncologist and collect medications that I would need to take before chemotherapy began at the beginning of June.

We went to lunch with Mum and she had time to visit her friend who lives in the South of the county. Sometimes it was warm enough, just to sit in the sunshine in the garden and relax.

I was glad my mother was able to visit before the chemotherapy started and to see me still looking and acting like me. I had felt able to do plenty of home cooking and baking so we were able to ensure that many of her favourite recipes were served during her stay.  My mother had been treated for bowel cancer about four years ago and is presently cancer free.

She dealt with her ailments with dignity and an uncomplaining grace, even when the hospital infected her wound with MRSA. MRSA stands for methicillin-resistant Staphylococcus aureus.  Staphylococcus aureus is a species of bacterium commonly found on the skin and/or in the noses of healthy people. Although it is usually harmless at these sites, it may occasionally get into the body (eg through breaks in the skin such as abrasions, cuts, wounds, surgical incisions or indwelling catheters) and cause infections.

Patients may be colonised with MRSA when they leave hospital, and there has long been concern that MRSA might spread from hospitals into the community.  It was certainly true with my mother. Her condition was complicated by the fact she is allergic to penicillin.

I try to emulate her dignity and calm, but fall far short of the mark, I fear.  During my Mother’s visit the wkwriters had a visit from Gerry McGrath who read some of his poetry to us and focused on Blank Verse. One of Gerry’s anthologies of poetry is reviewed at https://bookreviewstoday.wordpress.com/2013/04/05/from-a-to-b-by-gerry-mcgrath/ My mother was able to join us for that meeting. I also re-read Made in America by Bill Bryson which I have reviewed at https://bookreviewstoday.wordpress.com/2013/04/05/made-in-america-by-bill-bryson/. The visit was a pleasant interlude and allowed me to divert my thoughts from cancer.

Valerie Penny

Countdown to Chemotherapy

I have said it before, I am a lucky woman. Nevertheless, during that time when I knew chemotherapy would need to be endured, I resented it. I resented the fact that I had had no symptoms from the breast cancer, but that I knew I would have symptoms, or side effects from the cure. It seemed unfair and ironic. Cancer is not fair.

I took great joy from the continuing good wishes of family and friends  and the huge number of cards and continuing bouquets of flowers that I received.  They were so pretty and they filled the house with colour and  light. It was so lovely to have so many vases in use!

Still, occasionally my husband and I would have a moment or so of tension or worry as we looked into the unknown and the void that is chemotherapy.  My husband works full time, he works 12 hour shifts at a time. Luckily, he had a day off on the day my first chemotherapy was scheduled. I was thrilled that I would have his support and company.

Funnily enough, during this period I got the most amazing help, supprt and advice from a man I have never met!

My friend Jane and I go line dancing to classes run by the amazing Danny and Sadie Kerr. Jane has taken me to hospital appointments that I would otherwise have to attend alone. It is wonderful to have company. Jane is particularly knowledgeable about hospitals and cancer treatments in particular as her brother, Michael, has been treated for many  cancerous tumours. I doubt there is a treatment that he has not endured.  Sadly, Michael has now been told that there are no more treatments that can help him. Michael’s condition is terminal.  

When I think of this I get embarrassed by my own moaning and frailty. Michael, through Jane, explained to me some of the side effects of chemotherapy. He explained to me the trauma of hair loss when it falls out in clumps.  His advice: to get it shaved off before that happens.

Jane explained to me how Michael had suffered severe pains in his joints. That the taste of his food changed and was so tinny.  Then Jane told me the most poignant thing that Michael had said.  The last time he finished chemotherapy he had said he never wanted to suffer like that any more.  Now he has been told that chemotherapy cannot help him any more he feels he is not ready to go yet. He would take chemotherapy or anything that would prolong his life.

I view this as a year of inconvenience. A scary and strange journey. I have learned a lot from Michael. I salute him and thank him for sharing his experiences with me. It was generous.

The flowers help to raise my mood and decorate the house.   The chemotherapy is scary but is a means to defeating this potentially deadly disease.  So roll on chemo: surely my imagination cannot be worse than reality.

Valerie Penny

Hard Truths about Cancer

Over the next few days I had an appointment about my breast cancer with my consultant, Mr Osman. He explained to me that the  tumour he had removed was slightly bigger than anticipated. It was about 8mm long. He had expected it to be about 5mm. It still did not sound big to me, but I knew bigger, in this case, did not equate to better.

Mr Osman also explained to me in some detail that the tumour was HER2 positive and that I would benefit from treatment with the drug Herceptin. 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.

He told me that some breast cancer cells have a lot more HER2 receptors than others. In my case, the tumour is described as being HER2-positive and that it is thought that about 1 in 5 women with breast cancer will have HER2-positive tumours.  HER2 is a gene that sends control signals to the cells, telling them to grow, divide, and make repairs. A healthy breast cell has 2 copies of the HER2 gene. Some kinds of breast cancer get started when a breast cell has more than 2 copies of that gene, and those copies start over-producing the HER2 protein. As a result, the affected cells grow and divide much too quickly.

This genetic problem is not inherited from your parents. The most likely cause of this problem is aging, and wear and tear on the body. It is not yet known if environmental factors (pollution, smoke, fumes) are part of the cause of this problem.  If your breast cancer is tested for HER2 status, the results will be graded as positive or negative. As my results were graded as HER2 positive that meant that my HER2 genes were over-producing the HER2 protein, and that those cells are growing rapidly and creating the cancer. Mr Osman thought that he had removed all the cancer from my body with the surgery but in order to be sure of this and to minimise the risk of return, he recommended that the oncologist discuss with me the benefit chemotherapy would offer me.  

The oncologist, Dr Lumsden, recommended that I should have three lots of three weekly cycles of chemotherapy. The first 3 would be Herceptin and then docetaxel in a liquid that I would get through a drip (infusion) into a vein (intravenously). Each infusion of herceptin takes about 90 minutes, the docetaxyl takes about an hour and I would have one treatent every 3 weeks for 9 weeks. He recommended that I would then have chemotherapy as a course of 3 cycles of FEC (fluorouracil, epirubicin and cyclophosphamide) for a further 9 weeks.

Docetaxel can cause an allergic reaction. To try to prevent this, Mr Lumsden explained I would be given steroid tablets to take, usually for 3 days, starting the day before each treatment. He went on to tell me that FEC treatment would be given to me as a day patient. Before I started treatment, I would need to have a blood test a day beforehand. He also told me that I would be seen by a doctor or specialist nurse. If the results of my blood test were normal, the pharmacy would prepare my chemotherapy drugs. All of this might take 2-3 hours.

A nurse would insert a thin, flexible tube (cannula) into a vein in my hand. Dr Lumsden told me also that some people need to have their chemotherapy given through a thin, plastic tube that is inserted under the skin and into a vein near the collarbone (hickman line). He did not know if this would be necessary for me. I was also to be given some anti-sickness drugs as tablets, or more usually by injection through the cannula, which is often connected to a drip.

The chemotherapy drugs are then given separately after this.

It was so much to take in. The disease had been found so early that I had had no symptoms that I was aware of. Looking back, the extreme tiredness and exhaustion caused by any degree of physical effort, so typical of cancer, had already started to show. I just did not know to consider it. Still, it sounded like the cure was going to be worse than the disease. All of a sudden it was emphasised to me that my condition was serious and needed to be fully eradicated.  I was forced to face some hard truths that, until then, I had preferred to try to ignore.

Valerie Penny

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