Some bad news, and a cry but the washing still needs to be folded

Good afternoon Children of Mothers,

A happy mothers day to you if you are one (of both human or loved furry critter type) and happy mother's day to your mothers if you ain't.

We went to the surgeon (Anita) on Friday just past, to find out where to from here, now that all the pathology, testing and histopathology report was complete. I am saddened to report that it was less than optimal and obviously not what we were expecting nor what we would have liked to hear.

It seems that despite going back into the left breast tumour site a second time to surgically  "clear the margins", the team found more of the little buggers skulking around the parameters of the new margins. Although these are baby cancer cells, if left unattended they would develop. So I will need surgery again.

They have also found isolated tumour cells albeit in only two of twelve nodes under my arm, but it demonstrates that the type of cancer tumour that I had was reasonably aggressive so this fact, to a large degree has pretty much determined that I am headed for chemotherapy toot sweet! Although the tumour was small (1.6cm), it was classed as a Grade 3 because it had already made its way under my arm - in short , what the Surgeon referred to as a reasonably high turnover rate of cells - I presume she meant that it has quite a quick conversion capability.  So its chemo instead of chrysanthemums for me this year.

According to the surgeon, the debate apparently between the clincial team was, which need be first - surgery or chemo. If I was to opt for the surgery, then the type of surgery that I could have (and more of that a bit latter), would postpone the commencement of chemo as time would be required for sufficient healing. From her "surgeon's hat point of view" she said she can see the relative merits of getting the breast and underarm sorted, and thereby closing off that specific chapter. However, the infancy stage of these lurking cells means that we have time and to that end she agrees with her colleagues in this instance that chemo should commence as soon as possible. I will come back to my surgeon in a minute.

The oncologists and pathologists were barracking for chemo first and surgery latter. The reason is that the relative aggressiveness of the tumour was making them inclined to get the chemo through my system to flush out and kill any other cells that may have already broken away and headed into my blood stream and possibly lodged elsewhere. They wanted to be able to do this ASAP.

Now folks, all of that makes perfect logical and rational sense but when you are absorbing it in one go it makes for one industrial sized head spin. I was conscious of the effect of the news on Siobhan and on me and I was fighting really hard to stay in the moment and not lose the thread of what was being told to me. I was conscious of the almost physical effort I was making to remain focused.

Many things were going through my head at that moment - The  team obviously think that the cancer is relatively aggressive, that I could already have cancer cells cruising around my body looking for a nuturing place to lock and load, that I am going to have to wear a bloody wig, that I have a bloody big head and what if I can't find one to fit, that I will need to learn to draw on eyebrows, (but I need to be wearing my glasses to be able to do it properly and not look like a tragic drag queen) and finally  \what if I go through all of this and it comes back or a new one starts in the other boob.

Oh and "fuck" I kept thinking "Fuck"................

So I asked Anita. I said that someone had told me early on that having had breast cancer in one breast there was a high probability of it either a) spreading to the other breast or b) a new cancer occurring in the right breast. She confirmed that this was the case particularly in relation to the latter. So I said leaving the chemo question to one side for the moment, what were my surgery options.  It was at this juncture that she floated the relative merits of going again and revisiting the margins and scraping more out, versus a bi-lateral mastectomy, versus a double mastectomy. But that should I elect for chemo first, then this would allow me to explore reasearch and determine which surgical solution was the best option for me. A bi-lateral or double mastectomy would require longer healing times that if I went for that procedure now, would delay my starting chemo.

Radical stuff folks to take in in one go.

But it did show me how they gently steer you towards the optimum clinical solution in their collective opinions that they prefer. Although they were at constant pains to ensure that I was aware it was my choice as to how I proceed, the manner of how they queued the information led you to the path of obvious inevitability that chemo first was the only real option here.

I do think that perhaps they were expecting me to be a bit bolshie and likely to be seeking hard facts as they also advised that we were to meet with the medical oncologist immediately post this meeting which we hadn't been advised of prior. I had asked about survival rates, my own survival rate given these new developments, the percentages of re-occurence, more radical intervention to mitigate future risks etc, so I guess they figured I wasnt the crying and staring-into-the-distance-in-shock kind of gal..........

Before we left the meeting with my surgeon and breast nurse one good thing happened. The drainage bag was removed (a big yay for me!!) but Anita also advised something that totally spun me out. If all things being equal, the chemo works and mops up any cancer squatters taking up residence in my body and I have either a genetic predisposition or a strong family history that would warrant a double mastectomy (and bless her and her wonderful honesty, she said that if she was in my shoes, she would be opting for a double mastectomy with reconstructive surgery), she said that if I elect to go down that path - guess where they rebuild your boobs from folks??? From the fat in your tummy - so you end up with new boobs AND a tummy tuck ! Stay tuned because if we get to that stage folks the stories and the pics will be totally wild!

I will now not see Anita for about  three months but she has arranged a referral to Plastics, the familial centre for genetic testing and an ultra sound as they have identified a "mass" from my CT Scan .......but recorded it as an ovary !! D'oh.....so she is seeking clarification.

So then we meet the medical oncologist. A total cocky Irish wise-arse smart-mouth who I take to immediately. He can do the genetic logirthythm in his head based on family history of breast and other cancers, ages and pre and post menopausal factors and in his view I probably am not likely to be a gene carrier but will get it confirmed through testing. He also provides me with an interesting sheet of data as to what the odds are for a woman of my age, type of cancer and story thus far, of survival if electing to use available of therapies (chemo, radiotherapy and hormonal ) versus those who dont.

He then proceeds with an almost wickedand  delighted expression on his face to say he intends to thoroughly and totally poison me as soon as I agree commencing with FEC which is fluorouracil, epirubicin and cyclophosphamide. I will be given three cycles of this (one every three weeks for nine weeks in total). Followed by three cycles of docetaxel. (one every three weeks for nine weeks in total). A combined six cycles occurring over 18 weeks folks. Oh, and I will lose my hair in the second cycle of FEC .....just in time for the start of winter!!!

He tells me to seriously reduce alcohol intake (what sort of Irishman is this bloke) as the connection between breast cancer and alcohol is well established. In the interests of full disclosure peoples, I intend to do so, save for one notional glass at any important occassion but that this change to lifestyle will only commence when chemo does. So now we wait about three weeks and I will start chemo.

Siobhan and I left and walked across the road to the Fitzroy Gardens. The leaves have turned and have started to fall away. As we both digest the news, we look at the trees on this beautiful Melbourne autumnal day  and I say to Siobhan that I want to come back to this specific tree with her in spring, when new green shiny leaves have totally covered all its branches. I tell myself that this tree wil provide a metaphor for my own renewal.

To Joy and John D and to Pauline and Rob a very special thank you from us.

Kxxxx

PVC Jewellery & Calico - all hail the Thornbury Bag Lady

Good Evening Fashionistas,

Its been a few days since surgery and although still feeling a tad wasted, (and looking like some homeless woman)  I am incrementingly on the improve each day from the surgical chapter in this Cancer Chronicles novel in which I am the relunctant lead character. I was scheduled to meet with the Medical Oncologist late this afternoon to determine whether I am to to have some adventures in the Chemo and Radiotherapy chapters of this drama but it has been postponed til after I meet my Surgeon this coming Friday, who will on behalf of the whole Team Minogue, now that they have all my results and pathology results, advise me what luxury suite of procedures I get to enjoy over the coming months.  But that is for later, so let me fill you in on what has been happening over the last few days.

In pursuit of the maximum return for the health dollar spend, patients spend minimal time taking up bed space in a hospital these days so I was tipped out and sent home the day after surgery and I could not be happier. Not only does one not have to insult one's taste buds with less than tempting fare, but one can rely on the familiarity of one's own chosen mattress, 1000 threadcount (and absolutely not one thread less darlink!) and duck down accessories to ensure a truly comfortable night sleep. One that is uninterrupted by fellow inpatient snores or the slightly disturbing lurkings of the night duty nurse!!

To facilitate this transition however, Peter Mac sends a troupe of amazing people to tend and assist your recovery. This service is called Peter Mac @ Home. It is a service that has been going on for 40 years. Most other health services have only recently introduced it in the last 5 - 10 years. I have had five visits thus far by four nurses (and a second year nursing student) and they should all be bottled!! They are just tremendous. These very experienced people come into your home for about 40 minutes a day. They take your "obs" - blood pressure, pulse and tempertaure, check your wounds and then have a chat about how you are managing. All very low key - but these people are cunning.

In seemingly informal chit chat they can glean how you are managing and how you are coping,- they can offer you some good recommendations to follow up on an issue here, or a reference there, that you may be chatting about. They are a wealth of information and exceptionally professional. Now these attributes in a hospital setting would be both expected and indeed easier to convey. But within the context of a patient's own home, where this hitherto unknown person is able to convey both clinical professionalism as well as genuine warmth and approachability is the true skill and measure of these health professionals. I am in absolute awe.

Now, I am  mindful that I am clearly more receptive to healing because I am in familiar surroundings, with the room temperature, the house layout, the water pressure, the type of shampoo, snacks, use of my favourite teacup and tea type and preferred toilet paper of choice all of my own choosing for me to use and this aids the process. Aided and abetted of course by the care, the love and proximity of Siobhan and the four hairy nurses, as well as regular calls and visits from wonderful friends. But the psychological benefits that come from being at home, and maybe do a bit of sweeping here or dusting there, picking some flowers from my garden and placing them in our home, or getting the mail and taking a short walk, will better promote my well being far more effectively than swanning (and trust me, I can brilliantly execute serious swanning when I put my mind to it) around a hospital bed all day and night. Its been an facet to the whole process that I hadn't expected but am quite intrigued by. And to think that it has its genisis in bloody health spend economics!!!

What these nurses also do is change my drainage bag. 

Peoples,  you dont get to say that sentence too often in your life time!!!!!

In some poor facsimile of a Dominatrix with a rubber fetish, I get to 'sport' a rubbery plastic tubing 'stole' that is anchored under my arm about 30 centimeters inside my body down my left side  (can I just repeat that .....INSIDE my body) and protrudes about a metre and a half outside my body , at the end of which is a very fetching clear and white plastic bag of considerable thickness with intricate navy blue markings that measure the fluid outputs!!!

My research shows that this autumnal ensemble is the latest thing at all the reputable Paris atteliers or fashion houses this season. Tres chic or what!! It would appear that I am surgically attached to this eye catching Clinical Art Installation for at least a couple of weeks!

Now its one thing to be sprouting a tube and bag out of one's body. Its another thing entirely that over the course of a twenty four hour period my body expels liquids (yes plural) comprised of blood, water and sinew. I am wedded to this "NOT A PRADA DARLING", until my tubal leakage maxs out at 30mls or less for two consecutive days!! Folks to give you some idea of how I am travelling, first day's output was 240 mls,  most recent two days on the trot have been just over a 100mls each day - so I have aways to go!!!



On the first day, the volume of output looked like a cheap sangiovese in colour. The bouquet and taste clearly not for exploring or rating. But in recent days it has faded plenty and apparently we - dont you love the use of the collective pronoun......we are ultimately aiming for a pale straw colour - kind of like a Marlborough Slut Juice (a popular term I use for a NZ Savignon Blanc!!)

And even if you are ok with the concept of a continuous leak and I must confess it does make me feel abit queasy the worst part is not that - its walking around trying to be normal that is the hard part. On soooooooo many occassions thus far, I have hooked the bloody tubing on every kitchen drawer handle, door knob or shower tap, or dog leg and commenced to walk away blissfully unaware that in a matter of a few seconds I will look like a caricature from a cheap cartoon as I am hoiked backwards by the unforgiving tug of rubber and stitching on my delicate and sensitive underarm skin. If I was into slapstick - it would be funny. Its funny for everyone else though.

But even when you may think - gee she's doing it tough - it gets a whole lot worse.

Not only do you have to be umbillically attached to this little number but the very kind and well intentioned volunteers of Peter Mac take you to a whole new fashion plane and provide you with little fashion items to accessorise your new look.

No need to walk down the street screamining - "Look at Me. I am a Cancer Patient" No folks, these good good people have fashioned a whole line of accessories for you to look your best. And no-one will possibly suspect that inside that hand sewn calico bag strung awkwardly over your shoulder with a cross stitched hand cut flower motif on the front, is a drainage bag. Because after all, I am such a calicao bag, complete with floral motif, kinda gal!!!!!

But wait - there's more.

In addition to the Camouflage drainage bag Over the Shoulder Clutch, is a more robust handbag to keep all your drugs (plenty in number but of no serious street value), extra bags, dressings and appointment diary. This defies description and I will leave you to imagine the endless possibilities for how I can mix and match this very special number with my wardrobe. The interesting and most valuable of my presents though is the half moon shape cushion - not as you may assume a neck cushion - but a rather ingeneous cushion when placed over my left shoulder perfectly cushions my arm from pressing on my tube and wounds and enables a truly magnificent sleep. The little mouse thing in the bottom right hand corner is a lavender (natch!) smelly to make everything smell like little old ladies.

Now whilst I may jest about the fabric design and choices made by these good ladies for someone like me, make no mistake, I am exceptionally grateful for their kindness, their time and their efforts and I will treasure their sense of giving as I will treasure these articles for my care. I am grateful that I can benefit from someone who gives their time altruistically.

Merci Good Ladies - see you on the catwalk of recovery.


Kellyxx

Ding! Ding! Round 2. Peter Mac v Minogue Surgical Unit Ward 3

Well here I am again Thursday  2 May, this time for a total excavation of the auxilla and a re opening of the wide excision of left breast. In lay speak that means that they are taking out all the lymph nodes in the left arm pit and re-opening the left breast to scrape more tissue from the margins, which is the area surrounding where the tumour was. 

I have to confess that my super hero special strength, that of lightening recovery rate from general anaesthesia, deserted me this time. Normally referred to as GARL Girl (general anaesthetic lightening recovery girl) I felt more Gargoyle than Garlgirl!! Nicknames totally self appointed by the way. 

It's around 4am post surgery of late yesterday afternoon and I have had a shite time of it for the last 12 hours.  My day started beautifully. I headed to Peter Mac via public transport - and yes Lee, there are times when PT can be a joyous occasion! It was a superb Melbourne autumnal day. We drove to Clifton Hill, caught a train in 5 minutes to Jolimont, arrived in 8 minutes, and then Siobhan and I walked through the gardens from Wellington Road to Landsdowne street to Peter Mac. It's terribly un-Melbournian of me that I do not know these exquisite gardens correct name!

So there I am all checked in and frocked up waiting to go into theatre at 11.30. Siobhan has returned to work and will bring my food rescue package abit later. (clearly have got the priorities sorted people!) Mike has purple penned and initialed my left breast and then folks I wait for four and a half hours! It does not bode well for me that I wait as all these other late comers jump the queue and get 'done' before me. 

A lovely young girl is to be operated on and I learn that even in this ready state for a procedure involving anaesthetic,  a head covering is still required for her as a Muslim and one is fashioned to wear during the operation. What is terrific about one's place in this public system process is the people, the cultural issues and the education you receive from it. 

So there I am many hours later and last on the list for my surgeon for the day and I am wheeled in to a nice warm theatre. The waiting room has been freezing. My surgeon and I had had a per-op chat about my concerns that my scars appeared to be keloid already (check word reference) - that is hard and raised. She said she would make sure that they were done again to avoid this and thanked me for raising the issue with her. You gotta love a surgeon who is responsive to your concerns!! Quite the miracle generally speaking, but she is simply lovely (and skilled of course) but her demeanour makes it all the more positive an experience. I think that it is in no small part because she is a female. Now all you blokes, don't pooh pooh this. I think that high achieving women tend to be less hierarchical and less inclined to adopt the stereotypical mannerisms that often go along with specialist roles - The recently departed Baroness Thatcher notwithstanding! 

Next I know, I am waking up in recovery some few hours later. On first blush I feel good, start chatting to the recovery staff and feel a tad peckish. Ticks for me. Then they bring me a cup of tea and a salad sandwich and whilst I am grateful for the tea, the food makes me want to puke. Can't do it. This is the beginning of a stint of nauseousness that goes on for about 12 hours with significant peaks and troughs. Hate feeling queasy. It's exhausting. All your energy goes into distracting yourself from chucking up. 

My Ward 3 Nurse arrives to kidnap me and hold me prisoner in a room with three other patients. It's a full house across the Mac today so no special privileges for anyone. We are about to hear and become strangely accustomed to each other's bodily noises - both audibly and nasally detectable!!! Fortunately, we are all too trashed to care. 

Poor Siobhan gets to arrive finally,  having had to kill extra hours waiting in the city until I was back from theatre. I am off my head. Emotionally very vulnerable , very teary and feel all round crappy. No pain though- not one iota. Just an emotional mess in a dress (a very ugly dress - at that). Siobhan has brought me a tempting dinner of chicken satay and rice from a city restaurant but I cannot even look at it so in the fridge it goes. This is my relationship with food for the remainder of my stay. 

Siobhan heads home to feed the West Highland Nursing Agency team so that they are fighting fit to man the bed upon my discharge tomorrow. Can't have them doing a Dandenong and threatening strike action if their demands are not met. Conceding on all points of negotiation is my strategy to ensure a happy nursing team!!

The evening ploughs on through bad telly, some phone calls and emails to dear friends and I am totally exhausted but am in the extremely unusual mindset of fighting sleep. Anyone who knows me, knows that I am the queen of the Nanna nap and will gladly retire to sleep at the earliest opportunity - even when entertaining people at home. So this is weird. 

When finally I do decide to sleep at sound 11pm, I quickly arrive at the realisation that it was a total waste of time. Each time I fall asleep I am woken up by a violent wave of nausea. I have the drainage drip in place on my left side and a line in with fluids into my right hand to which they periodically add anti nausea stuff for some short term relief. I am also hooked up to oxygen through with one of those plasticky hose things. Given my somewhat amply designed honker, I am somewhat surprised that it keeps slipping out all the time. 

The next few hours are shitty. It's dark, my throat is sore from the tube down it during surgery (and no, not from snoring!!) I am having hot flashes very 15 minutes so am sweaty and grumpy and I feel like chucking regularly and I am too tired to read, play word games, browse the net or anything. The only thing not giving me grief is the actual surgery that I had. The bag is draining well, the surgical sites are not giving me any pain at all and from that perspective it's fantastic.  My fellow patients are periodically in some discomfort so there is pockets of activity and noise when I do start to drift off. Did I say how it sucks being a woman???  I am awake for a period of time each and every hour through the night. 

My night duty nurse is a delight and ever vigilant, ever patient and she kindly brings me tea and crackers. I am not normally this sooky so that in itself is hard to take but the combination of things is knocking me around and the effects even more amplified in the loud quietness of night.

It's now nearly 6am so things should start happening here so. Siobhan will be in around mid morning to collect as I am hopeful of a discharge then. Home to my lovely house and Siobhan's unstinting care and attention. 

I leave you now, knowing that in the coming days I will be facing an enormous battle.A battle that will call on all my strength, my mental toughness and sheer rat cunning. But I know I will prevail folks. I will secure, maintain and defend my space in my bed against those nursing terriers!!!!

Game on Folks

Kellyxx

It's official....... I have gone "Herbal"

Good Morning Fellow Fysical Followers,

Yesterday I was required to attend Peter Mac's Physiotherapy Department to undertake a bio- impedance assessment. This was to establish a baseline (pre-operatively) as to what the fluid level is in my left arm before they take out all my lovely hard working lymph glands from under my left arm pit. Apparently one can develop the "lymphoedema" - lymph meaning lymph gland and oedema meaning swelling. So albeit a low risk, I could end up with an arm like Guillermo Vilas. For those not familiar, Guillermo was a rather gorgeous tennis player circa late 70's early 80's, whose hitting arm was three times the size of his other arm!

So they run this electrical current through your body using these little stick-on pads that then connect to the machine to do the reading. They may have also thrown a piece of bacon on my tummy as well for their lunch but I can't be too sure - but here I am connected and feeling very Miss Frankenstein-esque. Felt very tempted to do a zombie like walk when leaving the department, arms outstretched and stiffly rocking side to side and groaning but they probably get that all the time. Reading is all good and within the acceptable range. I will head back in one month's time and they will check the levels again to see that the fluid is at an appropriate level and being redirected or re-routed to other lymph glands in my body (neck, groin etc) as expected.

But my real news for today is that I have finally succumbed and am about to confess - to come out, as it were to all you good people  and tell you dear friends that I have finally embraced what living in
Thornbury is really all about.

Yep, I am officiallya  card carrying Herbal.

I have thrown caution and conservatism to the wind and have gone to see a traditional Chinese Medicine practitioner who goes by the somewhat unusual Chinese name of Raffaele Vavala!!

See folks to live in Thornbury as a true native, is to embrace organic produce totally with the focus of a serial killer, to shop with an almost palpable religious fervour in search of the best super food that has travelled the least amount of food miles, adopt a superior sense of piousness about the goodness coursing through one's body that only comes from a diet of organic mung beans served with a brown rice pilaf and washed down with a chilled glass of 2013's finest wheat grass - brought not from the filthy capitalist supermarkets- good lord no- purchased only from either the Health Food Shop where the shop assistants all need a good shave (boys and girls alike) or from the local farmers market held at the local primary school of which Thornbury has plenty. It would appear that herbals are rather prolific breeders and have lots of chill'un with names like Zinia, Ennui, and Harness. Who knew?

So in the interests of truly assimilating, I have developed an acquired liking for independent music,
where such performances could be held in a telephone box, such is their appeal, a love of well-intended yet poorly executed community art such as an interpretative dance, the theme of which I think may have revolved around live animal exports followed by the possiblity of a commemorative fund raising purchase of such works portrayed through the craft of scrap booking!!

My diagnosis has afforded me the opportunity to slam dunk this sense of pure self and community by embracing those health provider options oft used by my more organic Thornbury brethren. So at the recommendation of the lovely Pauline, ( a free radical and non-conformist of long standing) I get my unshaven legs to take me to Raff's rooms where after a detailed consult, he sticks little needles in me like some voodoo doll to alleviate the return of meopausal symptons that have returned with a
vengeance, since ceasing HRT.

 I was considering the purchase of some hand spun, hand dyed, home made garments to complete the transformation but seriously, herbals just don't do a good outfit that goes with heels!! So I leave you good people with the new Minogue Mantra.........

"All this biodynamic food and decaf  beverages had better have some bloody benefit because they taste like shit"

Here Endeth the Lesson.

Kelly xx

ANZACS, Friends, Flowers and now more tests...........This is SCANdalous.........

ANZAC DAy 2013 will be memorable for many reasons. The day dawned with nationwide services watched somewhat pedestrianly by me from the comfort of bed and lounge. Always moving, always beautiful to see such lived-in lovely old faces. But dogs wait for no man and it was off for an invigorating walk with the dogs.

Upon our return Tony and John called by, later followed by Sally & Craig and we enjoyed a cuppa (read glass of wine) and the latest installment of the Essendon Drug Scandal. Anzac Day poses a serious connundrum for Carlton Supporters. In the clash between Essendon and Collingwood, it is always extremely difficult to ascertain who one loathes more. So after much discussion, consensus was reached. It seems a tad unchristian-like to wish injury on any young athlete (it is not their fault after all, that they have had the misfortune to end up at either of these cesspits of humanity). 

So we decide that Essendon inches ahead of Collingwood in loathesomeness and we hope that the  Bombers lose (adding insult to injury, as well as tannorexia, increased libido, and  reduced body fat arising from their "alleged" use of AO9437 or whatever the peptide is called). But in the interests of balance  we wish both sides a battery of player reports for serious offences.

We have been spoilt with chocolates, homemade bread, jam, soup, cakes, (Naomi, Pauline, Viv and Sally & Andy ) an amazing edible bloom from the lovely Lexine and Heather and a delightful Coonawarra red from Craig as well as flowers from Tony and Denise. To everyone, thank you for these thoughtful gifts as they lift the spirit incredibly. But if this keeps up, I will need to contact James Hird and get a reference to obtain a prescription for the anti-obesity drug he is "allegedly" familiar with. Below are some pictures of the lovely bounty.

So as the day moved into late afternoon, Siobhan transferred all these wonderful programs that Craig and Ty had undoubtedly lawfully downloaded so that in the coming times ahead I would not have to add insult to injury and watch Ellen, the B&B or any other daytime television crap.

 The downside of the day was an Essendon victory (and no serious reports!) but a lovely day catching up with friends. Its an early night because the next day its back to Mac for a couple of scans.

With no breakfast in the tummy, I am waiting bright eyed and bushy tailed at the Diagnostic Imaging waiting room. A palatial setting as you can tell from the images below. I arrived early to make sure I got a good seat. 

The Taj Mahal it aint

In the waiting area I am provided with a litre of water like substance to drink but am unsure whether its for the CT scan or the Bone Scan.

I am ushered into Nuclear Medicine and am advised that I will need more radioactive tracer. As regular readers will know, my last experience with this was horrendous and I am still sore from where it last went into my body. But apparently this time its painless because its going into a vein rather than just injected under my skin. What a relief!!!! So they put a line into my right arm with two junctions, take some blood, flush some water through, then inject the tracer from a little lead case. No pain. This apparently will now take about 4 hours to go through my body for my bones scanning performance premiering at 12.30pm. Its just after 8.30am now. She was too efficient for me to request a photo to show you but can I tell you that had I had a spare tissue or two I would have gladly provided them to her. I was clearly channelling my mother with my level of annoyance at the constant sniffing.

So back to the waiting room and about 15 minutes later I am ushered through another walkway in this labyrith of a department. I am requested to dress for the camera and I get to sport this incredibly elegant creation from the House of Princes Laundry Services" Tres Chic non ???? Non!

After that I was seated in a recliner, provided with a vaguely sweet cup of water to drink, the line in my arm was flushed with water again and then I was moved to an adjoing room for the CT Scan. This process was entirely painless but weird. I was placed on my back and arms over my head, the line in my arm was connected to another substance that went into my vein. During the time the machine was operating and moving above me from head to pelvic area, it talked to me in an American accent, like an annoying GPS, instructing me to hold and release my breath. The mystery substance then began to take effect as I could feel a warm melting sensation move down my face, throat and chest and finally, as I had been advised, to my groin, where it would feel like I was wetting myself!! And it did. Alot.

Once the process was completed I quickly sat up and - how does one express this delicately?? I surrepticiously felt about to see whether the feeling inside had impacted on the outside. Fortunately as these good people promised it was a sensation only.

Happy and dry!

During the intervening period I headed for tea and toast with Andrea and her two lovely daughters Rebecca and Emma and toothy-smiley granddaughter Marley. We had a laugh about boobs, family and ageing and then it was back to the Mac for Part 2. - the bone scan.

Piece of cake people, what with all the prep work having been done in the morning. Just needed to remove the shoes and top and lie back for 20 minutes and it was done.

So as my day at Peter Mac drew to an uneventful close, my experiences to date  yet again positively reaffirmed by such friendly helpful and hard working clinicians (sniffy chick's nasal problems  notwithstanding),  I was left with a final observation by the doctor taking a last glance at the bone scan preliminary reports. He advised that he can confirm people that I have arthritus in both knees and in my right ankle !!! This place just keeps on giving!!! If I were a horse, they would be putting the screens up.

Soldier On Good Friends. Lest we forget.

Kellyxx

Invasive Carcinoma - No Special Type (NST) My Arse!!!!

Good Evening Lumpsters,

Siobhan and I popped into Peter Mac today for the post surgery follow up. It was a happening day in outpatients. It was a bit like the old days footy finals series where you needed to take your fold up stripey patterned nylon chair and  stake your claim in the queue between the rabid knitting nannas and the old blokes reliving lost youth and coodabeen legendary status, and sleep out for the night before the tickets went on sale! Seats and patience in Outpatients were as rare as an undercover seat for a GF between Geelong and filthy Collingwood.

Waiting waiting

Now front of the queue!!


So to put this into context about what we were about to find out - its been just under a week since I had the surgery and I am here to be informed about what the plan is for treatment, if any is required. I have cut a paragraph (see below) from a previous post to revisit the elements under consideration. All this gobbledy gook is second nature to me now but I know for you, dear readers, that it may as well be latin. Its amazing how quickly all this  non-conversational medical crap can sink in but I cant seem to remember where I put my car keys!! And just to gross you out I have taken two happy snaps (breast and underarm) to let you know that I am healing well. The Surgeon removed my bandages and was tres happy with my healing capabilities! Just in case its not perfectly clear - the healing breast is the first photo below. A boob at this angle does look a tad odd.........

Just to take you through the next bit, here is the selection criteria, so to speak, when one finds oneself with a confirmed breast lump then the following provides a nifty plain speak summary of what you need to look and hope for..........if the lump is small, say >2cm, with no cancer cells in the lymph nodes and the  cancer cells have hormone receptors and the cells are HER2 negative and the cancer grade is low and the surgical margin is clear then the cancer is LESS likely to come back or spread. If they are the opposite of that, then it is likely to come back or spread. 

So we head into my appointment with my Surgeon and my Breast Nurse (that is the worst nomenclature for a clinical title I have heard since someone floated the idea for a Nurse Unit Manager - a NUM to be called a Business Unit Manager!!!) Its like my left breast has its very own Nurse..... sorry I digress.

In the Histopathology report I was given, my cancer is beigely described as Invasive Carcinoma of no special type (NST). Can it get any more bland? From the wide local excision of the left breast they took a tumour 16 mm x 10mm or 1.6cm x 1.0 in size - so far so good - its a small lump. The cancer cells in that tumour were highly hormone receptive  scoring an 8/8 for oestrogen and 5/8 for progesterone. So that also is a good thing. I have always been a high achiever!! The test as to whether it is HER-2 negative requires a further genetic test because the 'first glance" microscopic test isnt entirely conclusive, but it is suggesting that its negative at this stage - also a good thing - so far folks its three for three and yay for me.

Then we get to the not so good bits. The surgical margin isnt totally clear as there appears to be DCIS (ductal carcinoma in situ) in one of the margins. The tumour has been removed but these other little dudes if left to misbehave in the margins by themselves would get bored and turn into fully fledged cancer cells. So they need to come out. Secondly they discovered cancer cells in both the sentinel node and another lymph gland that they took out in the first surgey so I need to have all the lymph nodes taken out from under my left arm. Finally, the histopathology report grades the tumour - albeit only small, as a Grade 3 tumour. And I have to quote the report because perhaps one day someone, years into the future, will be able to translate this complex language of medicos and it will be because of my blog that us mere mortals will know what the fuck these people are talking about!!

"There are nests, trabeculae and cords of tumour cells with rare tubule formation and central sclerotic stroma (still with me??). The tumour cells have markedly pleomorphic nuclei and there are 15 mitotic figures per 10 high power fields placing it into Grade 3."

So what does this all mean ? Well first step is another date with the surgical team at Peter Mac next Thursday. What will follow is definitely a course of radiotherapy and in all probability prior to that because the tumour is Grade 3,  a course of Chemotherapy, and also a whole pile of pills. If the HER-2 genetic test comes back early next week positive or the lymph nodes that are removed next week have more cancer cells then I am definitely in for chemo. If, when they revisit the margin where the tumour was in the breast and they find more DCIS, then we will be discussing more radical surgery as an option. 

So not the trouble free news we were hoping for but it did lead me to formulate some future hair plans. Siobhan and I had a great laugh about what coiffure opportunities this could present. So  dear Carlton Football Crew, in the event that I have to have chemo and I lose my hair, I want you to buy me a tasteful wig as my birthday present for this year. Note the use of the word tasteful,  hence Craig, you will be in charge (with some consultation from Pauline and Viv) and I had better not end up looking like a drag queen (given that many people believe I already sound like one!!!) 

In the mean time I am off to Peter Mac the day after Anzac Day for a Bone Scan and a Cat Scan - it seems that they get to a stage where they like to do a total once over just in case any of these mischevious little cells have done a runner and migrated into the different landscapes and territories of my body and become what vile Tony Abbott calls "Illegal Refugees". 

Trust me, it would be the one and only time I would ever agree with that bastard !!!

I'd much rather "Cell"ulite!!

Kellyxxx 

Radioactive Needles + Chemically Enhanced Nanna Nap = Boobie Smurf!!!

The day has dawned and we head to Peter Mac. Tea and toast before 7am, and admitted by 9am. I say good bye to Siobhan with her wonkily best brave face in place, and head upstairs to Day Procedure. Ubiquitous vinyl chairs and crap TV awaits you. Surprisingly after mastering the free wifi, and just about to settle into some browsing, I get called in to a cubicle for the following to be taken- blood pressure, temperature and name/D.o.B.confirmed yet again. 

Do I know about what is going to happen to me today? I respond, an injection of radio-active stuff and then off to theatre. I say I have been told the needle hurts a little. 

Not so simple says young Nurse Ratchett. She kindly points out to me that this "injection" isn't so much an injection but a procedure that takes about 45 minutes - after I metaphorically pick myself up off the floor and digest this soupçon of information, she is at pains (no pun intended), that it doesn't hurt so much, as burn - a lot!!! I bet you all can just feel the love in that room that I was emitting at this stage peoples. And then she tells me the injection isn't under the arm - it's in the nipple area!!!! "Don't shoot the messenger" is my first thought - actually I lie. My first thought was a four letter word. 

Apparently this stuff ( called radioactive tracer) needs time to course it's way up your breast so that the sentinel node and/or lymph glands under your arm can light up like a cheap set of christmas lights made in China that blink on and off in a code that signals " here I am, here I am and I have those naughty little cancer cells right here with me!! " This in turn then serves as something akin to a Google Map to locate said nodes. Is it just me or do others find it not particularly reassuring that an experienced surgeon still needs a map to find stuff under a patient's arm????

But before we get to that fun stage, she provides me with a rather fetching outfit of a blue wrap around gown (which if I was a size 22, would have fitted perfectly). And to complete the ensemble, is a pair of baby blue paper booties (no heels peoples!) with a very becoming matching hat. Sort of a Gowns-on-the Gurney  equivalent to Fashions on the Field.

They way I am dressed I could do a shift on the canning line at SPC.  

So I am then walked around to nuclear medicine for quite a wait. Seems that Thursday is very popular with the radioactive crowd. Some time later am called through and meet a Nuclear Medicine Radiographer. Lovely girl. Explains what is about to happen and eloquently prepares me for the process on a recliner rocker in a small room. She kindly ( stupidly) offers her hand for me to hold.  The Nuclear Medicine Radiologist comes in with the stuff. Surprisingly he isn't wearing a Homer Simpson outfit of a space suit with a Darth Vader-esque helmet nor carrying a "glow-in-the-dark" stick of radioactive poison. Rather its a rather underwhelming lead container and in it is, a relatively speaking, inoffensive needle with bright greeny-yellowy liquid. 

He feels the lump and then directly above the lump, places a finger on my nipple. He begins to slowly (and I do mean painfully slowly) inject this stuff. At first I feel nothing. I must be super strong I think to myself.......and then it hits. If only I had been bitten by a spider before this radioactive injection, it could have then rationally explained my immediate vertical leap onto the ceiling from where I needed to be scraped. I repeated the same swear word in ascending volume over and over in order to have a goal instead of screaming out in pain. It was horrendous. It lasted for about 4 minutes which is the equivalent of a lifetime. I was drenched in sweat. 

In order to promote the tax payer funded journey this poison was making in my breast to Sentinal Node Station, I was expected to massage said burning breast for about 8 minutes. Now for most of us, this is not an unpleasant undertaking (gay boy readers, this clearly doesn't apply to you) but god, what an ask. It was burning, it was hot and it was painful. After about 12 minutes the burning sensation stopped and it was tolerable. It's amazing how the feeling of pain can so quickly recede. The brain and our body is an amazing thing. 

So next it was off to have more happy snaps of the trip this tracer was taking in my left boob. I was expecting a little scanner maybe on a trolley, but I walked into this "Arcticley"  chilled

room and what met me there was a machine the size of the Starship Enterprise. It does a number of things. I had to lie on the skinny bed and be mechanically moved part way into the tunnel and the two screens positioned either side of my breast were used to take films, front and side on. You stay in place and the machine barrel turns - I felt like one of those blue dudes being transported in Avatar- little did I realise how true that would turn out to be!!!!

From there I was taken to theatre and laid on a gurney. I met my lovely Anaesthetic Nurse who prepped me for theatre. He generously placed on my legs (embarrasingly non-waxed and a tad furry) some fetching compression stockings which they provide for all their "breast ladies" and introduced me to my Anaesthetist and his offsides- both of whom looked about 18!!!! My anaesthetist ran me through everything and was so engaging it was a stand-out. My Visiting Fellow then arrived and after what may have been a bit longer than genuinely required grope of my breast- he autographed, yes autographed my left breast with his name and an arrow in green texta. Protocol apparently, the autographing, not the extended groping. 

I am deemed ready to go so into theatre I roll. The surgeon is running a few minutes late so they give me a little something to make me drowsy. I talk to the nurses, the Fellow and the anaesthetist asks me whether I am getting drowsy. I say no. Now perhaps he wants to shut me up but I like to think that the surgeon was making her way into the theatre and he needed me under. Anyway don't recall a thing from here on in for the next 75 mins. I have two incisions the first is under the left boob and the second is under the arm - hope the hairy pitts arent detectable.

Next I know I am waking up in recovery. And I feel bloody tremendous. My recovery nurse asks me how I am. I say I have had the best sleep ever and that I am starving. She seems a tad surprised but says she will get me something to eat. I sit up and check out what's happening around me. Clearly not everyone has the good fortune responding to general anaesthetic that I do. Whilst munching on a ham and salad sanga and a much needed cup of tea, I observe my fellow theatre goers. Lots of moaning, vomiting and even some crying and swearing. Can't wait to get out of here. I don't think my sunny disposition is helpful in this instance! 

I get wheeled back to Day Surgery after a bit. Get the run down for not showering for 24 hours otherwise the wounds will bleed, rest up - no house cleaning or vacuuming for 10 years (might be a slight exaggeration there) and come back next week to discuss treatment plan options with the BCCC meeting - see earlier blog in the archive listing at the left hand side of the page. 

As we leave I feel quite perky, Siobhan is very happy and relieved to see me looking so well if a touch pale. 

I feel abit disappointed though. I didn't take a "selfie" when I had had the radioactive tracer - a bit distracted by monumental pain perhaps but I missed the opportunity to show you what a True Blue Trooper I am (or at least was for a brief time). All I have now is this pic of the last vestiges of when I was a Smurf wannabe. Apols to all the gayboy readers out there for whom the sight of a female nipple may be less than palatable!!

 

So I head home to the care of Siobhan and the team from the West Highland Nurses Agency !!! I am a very lucky patient indeed!

Thank you for all your words of support and kindness. It has been greatly appreciated. Next Wednesday I will have choices about what will happen from here.

Lotsa

Kelly x