Good Morning Football Lovers Everywhere,
It would be incredibly remiss of me if I didn't make at least a passing mention of the trials and tribulations facing our great game. To distill it to its purest form- particularly for those readers of this blog who aren't such footy fans, I will put it like this...............
I honestly believe that I would rather be facing my cancer challenge than be in the tanarexic skin of one James Hird at the moment!!!!
Moreover, I think that the until now, seemingly impenetrable bulky frame of one Andreaus Demetrio will absorb some potentially fatal body blows in the coming weeks.
I would go as far as to suggest that this is a good thing because quite frankly, between these two blokes, and all the meat head ex-footballer media commentators, tripping over themselves to say something constructive using words of more than two syllables proves that footballers should just retreat quietly into the background post playing career.
Give me Caroline Wilson & Greg Baume of The Age and Patrick Cook of The Oz anyday.
And if that isnt enough, I have also to endure the unpleasant frequent assault of having the extremely unappealing heads of the Mister Rabbit and Mr Sheen dominating our media air waves, during this totally unedifying federal election campaign.
"What Evs"
I am heartily sick of all these blokes and their inflated bloody egos!!
My country's vision for the future and my personal code of religion is totally dominated by spin and counter spin.
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| The existence of sex appeal is really an individual thing I guess |
I demand a refund!!
Is it possible that a dead heat loss could be orchestrated for both scenarios?? Someone, anyone?? Antony Green, Mike Fitzpatrick, help me out here.
Before I enthrall you with my tales of woe of the effects of Docetaxel, during the past three weeks, I need to expunge a mental battle that I have been having with myself over the past six weeks. Its been keeping me up at night
When this chemo is over, I will need further surgery as some cancer cells remain in the margins of my left breast. As a result I have a decision to make as to the type of surgery I opt for, a) go into the same site and try and clear the margins, b) have a bi-lateral mastectomy (single left breast) or b) a double mastectomy. If I choose options b) or c) then there are further decision around the type of mastectomy and reconstruction but I will leave those fun details for later complete with some photos to illustrate the enormity of those decisions. My conundrum revolves around my role in the decision making process of the choices that I get to make.
Originally, post my second surgery, some members of my "team" were more supportive, for want of a better word, of the benefits of a double mastectomy for me given all the facts. For me it was a no brainer. I am 51 and despite popular culture indicating otherwise, this is relatively young. Notwithstanding this cancer, I am in good health. My beautiful beautiful mother died an awful horrible death from breast cancer at the age of 61, the memory of which stays with me each and every day despite it being 17 years ago. I have always maintained that I want to leave Peter Mac with just two things- and no, I don't mean two breasts!!!
The first deliverable for me is that I want to leave this experience having secured for myself the best and lowest odds possible for a chance of reoccurrence, not only in this left breast of mine but in both.
The second is that I leave this place with a peace of mind that provides me with some semblance of being able to reasonably place this episode into the memory of my life's experience towards the back stalls of my mind alongside the messier experiences of my epilepsy, my briefly traumatic adolescence and the many bad hair decisions of my past. Not to be relegated to the point of denial but not so present that it continues to unduly influence who I am and how I react to stuff. I thoroughly expect that I will undergo a consuming period of reflection for a time later this year or early next as I come to terms with the last twelve months but once that is done then I want to move on.
The second is that I leave this place with a peace of mind that provides me with some semblance of being able to reasonably place this episode into the memory of my life's experience towards the back stalls of my mind alongside the messier experiences of my epilepsy, my briefly traumatic adolescence and the many bad hair decisions of my past. Not to be relegated to the point of denial but not so present that it continues to unduly influence who I am and how I react to stuff. I thoroughly expect that I will undergo a consuming period of reflection for a time later this year or early next as I come to terms with the last twelve months but once that is done then I want to move on.
What I know about myself and my treating team do not, is that an essential ingredient for me being able to do that, is to have the peace of mind with the body image that I can accept, to do this. It is really that straight forward.
In recent meetings though I have sensed a strong reluctance from my medical oncologist and my breast nurse for a double mastectomy option because as it has been put to me this is arguably not essential or germane to effectively "dealing "with this cancer. I can understand that perpective but I cannot agree. Whilst they are there to deal with this particular bout of cancer, I am here to ensure that to the greatest extent possible, I dont return to deal with another return bout or new bout of cancer.
This got me to thinking about my role vis a vis the role of the clinicians in such an equation.
Once when I visited Mum at home, well into her illness, she was in a bad way. I went to visit her with a friend from work Lisa,who offered to change her pressure sore bandages. Mum was lying face down diagonally across the bed and as Fitzy changed her bandages Mum reached out her arm to me and as tears rolled down her face she said "I just don't know if I can do this anymore" I gave such an inadequate reply to her that day that it still makes me cry all these years later. I said to her that she would be alright. And neither she nor myself really knew any different. We knew so little. We asked so few questions. We put forward no challenges to the prevailing behaviour that the doctors knew and did what was in her "best interests".
In recent meetings though I have sensed a strong reluctance from my medical oncologist and my breast nurse for a double mastectomy option because as it has been put to me this is arguably not essential or germane to effectively "dealing "with this cancer. I can understand that perpective but I cannot agree. Whilst they are there to deal with this particular bout of cancer, I am here to ensure that to the greatest extent possible, I dont return to deal with another return bout or new bout of cancer.
This got me to thinking about my role vis a vis the role of the clinicians in such an equation.
In the management of my grief after her death, I promised my Mum and myself that I would never be as ignorant about my health as she and I were about hers. So with all the diplomatic tact of a Bolshevic, I have approached this tour of duty wanting to know and demanding to understand my options and not accepting at face value those that others would have for me.
Let me be very clear. My experience at Peter Mac has exceeded all maxims of excellence. They embody a patient centred experience that hitherto I thought only as empty quality-speak jargon. However, whilst the patient is at the centre of their deliberations, their clinical speciality remains the driver for their preferences - not the patient.
In my view, a radiology oncologist will want to use their knowledge and skill in conjunction with the medical oncologist and the surgeon to minimise if not eradicate the cancer that is present in the here and now. Likewise the medical oncologist having provided the comprehensive insurance policy of the course of chemo wants to see that complimented. Each has their preference or professional bias. And as previously indicated in my earlier entry, the team will order their argument to steer you In a certain direction.
I cannot believe that they are genuinely interested in my mental health in the coming months or years ahead. This isn't a criticism just a statement of fact. We share a brief leg of a journey looking out the same window. But then they disembark and I continue down the track facing new and challenging outlooks but still related to the same core issue - the existence of cancer and its potential to become a hostile squatter in my body again in the future, whilst coming to terms with what my breasts end up looking like.
As my last chemo cycle draws near, for the team with the exception of the surgeon, and plastic surgeon I suppose, I am nearing the tail end of the process. If I opt for the more radical surgery, then, as I understand it, the Rad Oncologist possibly doesnt have a role until after my surgery, if at all. Equally, if I elect for the more radical surgery, presuming a psychologist deems me suitable, then preserving my own nipples places me at risk of future cancer cells developing (DCIS, I presume). And for them who see this as a bigger and arguably unnecessary operation with greater risk associated, why bother about the possibility of fear when they can deliver a perfectly reasonable 11% chance only of re-occurrence. To them these are good odds. And I agree, if I was 75 or 80 years of age and didnt have decades ahead of me.
I understand their perspective and they may be thinking my position is one of pursuing unrealistically low odds and/or vanity but I disagree. According to my medical oncologist a double mastectomy reduces my odds from 11% (accompanied by oral meds for 5 years) to between 1 and 2%. So to me from the odds perspective, a riskier operation and a temporary longer recovery time is a no brainer as it affords me greater peace of mind for years. An opportunity cost that to mine is well worth it.
With the type of surgery options, I have yet to fully canvas all options so wont go into them as yet, suffice it to say, what little I have seen, I know that I could not have a single breast different from the other. What I have done to one I want done to the other. I dont want one breast without a nipple and one with, I dont want different coloured nipples (one fake & one real) or one perky breast with scars and one droopier breast without. This is not about vanity. While over time I have come to accept my short stumpy legs, fat knees and menopausally minted torso. I have long ago accepted that I am not a thing of beauty, I am drawn from the gene pool of my anscestors. To that end, though I have a great personality and I am a good and kind person ( and very humble clearly!!) but I have always had great boobs. They have been perfectly symetrical - unusual but true.
In the months ahead as I deal retrospectively with this without the distraction or diversion of appointments, tests and treatments, I dont want to look down in the shower or in the mirror and be negatively reminded each day of the ugly trauma my body has been through. I want them to be badges of honour and winning and not badges of depression and loss. If both my breasts approximate the same size, colour and shape with matching accessory nipples and scars then I can cope with that.
So, I need to understand and articulate my role and responsibility in making that happen. I need to convey this to my treating team in the weeks ahead. If I dont want to make waves, I can accept the Australian political model as a guide and simply follow the advice of my Ministers as our GG is required to do and comply with their advice based on their skill, knowledge and experience.
Or I can follow the American model of politics and upon hearing the advice based upon the experience skill amd knowledge of my Department Secretaries, I can make my own decision based upon what is best for me.
As I am the only member of my wonderfully skilled team, who knows me well enough to know what I can deal with that will secure the optimum outcome for me over the coming years, I will take opt for the Josiah Bartlett model and determine the outcome accordingly once I have all the facts and options before me.
I think Mum would be happy with that.
lotsa
Kellyxx
As my last chemo cycle draws near, for the team with the exception of the surgeon, and plastic surgeon I suppose, I am nearing the tail end of the process. If I opt for the more radical surgery, then, as I understand it, the Rad Oncologist possibly doesnt have a role until after my surgery, if at all. Equally, if I elect for the more radical surgery, presuming a psychologist deems me suitable, then preserving my own nipples places me at risk of future cancer cells developing (DCIS, I presume). And for them who see this as a bigger and arguably unnecessary operation with greater risk associated, why bother about the possibility of fear when they can deliver a perfectly reasonable 11% chance only of re-occurrence. To them these are good odds. And I agree, if I was 75 or 80 years of age and didnt have decades ahead of me.
I understand their perspective and they may be thinking my position is one of pursuing unrealistically low odds and/or vanity but I disagree. According to my medical oncologist a double mastectomy reduces my odds from 11% (accompanied by oral meds for 5 years) to between 1 and 2%. So to me from the odds perspective, a riskier operation and a temporary longer recovery time is a no brainer as it affords me greater peace of mind for years. An opportunity cost that to mine is well worth it.
With the type of surgery options, I have yet to fully canvas all options so wont go into them as yet, suffice it to say, what little I have seen, I know that I could not have a single breast different from the other. What I have done to one I want done to the other. I dont want one breast without a nipple and one with, I dont want different coloured nipples (one fake & one real) or one perky breast with scars and one droopier breast without. This is not about vanity. While over time I have come to accept my short stumpy legs, fat knees and menopausally minted torso. I have long ago accepted that I am not a thing of beauty, I am drawn from the gene pool of my anscestors. To that end, though I have a great personality and I am a good and kind person ( and very humble clearly!!) but I have always had great boobs. They have been perfectly symetrical - unusual but true.
In the months ahead as I deal retrospectively with this without the distraction or diversion of appointments, tests and treatments, I dont want to look down in the shower or in the mirror and be negatively reminded each day of the ugly trauma my body has been through. I want them to be badges of honour and winning and not badges of depression and loss. If both my breasts approximate the same size, colour and shape with matching accessory nipples and scars then I can cope with that.
So, I need to understand and articulate my role and responsibility in making that happen. I need to convey this to my treating team in the weeks ahead. If I dont want to make waves, I can accept the Australian political model as a guide and simply follow the advice of my Ministers as our GG is required to do and comply with their advice based on their skill, knowledge and experience.
Or I can follow the American model of politics and upon hearing the advice based upon the experience skill amd knowledge of my Department Secretaries, I can make my own decision based upon what is best for me.
As I am the only member of my wonderfully skilled team, who knows me well enough to know what I can deal with that will secure the optimum outcome for me over the coming years, I will take opt for the Josiah Bartlett model and determine the outcome accordingly once I have all the facts and options before me.
I think Mum would be happy with that.
lotsa
Kellyxx
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