The end, and yet just the beginning

So today is a pretty big milestone: I had my final radiotherapy this morning, which marks the end of 'active treatment' for me. After a challenging year, I'm so pleased I've reached this day just in time for Christmas. So this is the end of the treatment the NHS give me to nuke the cancer we found in February. As far as they're concerned, there's no evidence of it remaining in my body. From now on, all the treatment I receive (and there is still a considerable amount!) is to try to stop it from coming back, rather than treating what's there.

Tomorrow I take my first Tamoxifen: the little white tablet I have to take every day for 10 years, which aims to prevent the oestrogen my body produces from latching onto and feeding any future cancer cells. I will still have Herceptin every 3 weeks until the summer, and in February I will start my monthly Zoladex injections, which shut my ovaries down (again, trying to combat that damned oestrogen!). These medications will have their own side effects, but with my hair growing back post-chemo, and my strength returning little by little, I feel confident I'll find a way to cope.

Tanai and I are planning a quiet, relaxing Christmas at home in our little flat, where we'll cook yummy food and make plans for 2018. After the year we've had, we deserve to have our fortunes change next year.

I'm sure I will be a little contemplative over the next couple of weeks, and I plan to post something here about how I'm feeling in this transitional time. While I'm coming to the end of my active treatment, I know that this is just the beginning of the rest of my life as someone with a cancer diagnosis. I will have to navigate life in a new way, live with the knowledge that my body has changed, and will continue to be affected by my medication, and to learn how to deal with the fear of recurrence. In the meantime I plan to rest lots (I'm so exhausted after the last 10 months!), practice self-care, and slowly increase my exercise and social life again. Tomorrow is the first day of the rest of my life, and it's time to carpe the crap out of the diem!

Radiotherapy begins

I've now had 4 sessions of radiotherapy, and I have 15 more to go until I'm finished. It's going well so far. Each weekday morning I head into St Bart's and go to the basement, where the radiotherapy suites are located. Radiotherapy is often administered in hospital basements as the rooms have to be lined with lead to prevent the radiation from escaping. I have all 19 of my appointments (bar one) scheduled for either 8.45 or 9.00 in the morning, so that I can head off to work afterwards. There are five radiotherapy machines, and each is named after a planet. So far I have been treated on Saturn and Venus, and I also have treatments scheduled on Mars. The radiotherapy team are all extremely friendly, and the atmosphere in the department is one of jovial calm.

Treatment takes only a brief time, around 3-5 minutes, but the pre-amble makes it take a little longer. Basically I have to remove my clothes from the waist upwards, and lie on a plinth with my arms resting in armrests above my head. They use the tattoo dots on my body to line me up with some green lasers, according to the precise measurements they took at my planning appointment. They usually move me around a bit (I've been instructed to not help them, they need to move me sometimes by very small amounts) and they talk over the top of me, using numbers and codes and things that I don't understand, and they draw all over me with pen. It's very lovely though, at my first appointment they explained that they would need to talk over me while they were getting me in position, and that I shouldn't worry. They then leave the room and the robot-like machine blasts my boob with radiation, moves a bit, blasts it again from a different angle, and then I'm done. While it's doing its thing, I gaze at the ceiling, where there is a lovely artwork in the ceiling tiles, to distract me. On Saturn it's a Japanese cherry blossom tree and on Venus it's a fern-lined pool of water.

I can't feel the radiation, or see it, so it basically feels as though nothing is happening. Afterwards I have to apply thick cream to my whole breast, which I have to apply again at night. This is because one of the side effects can be something similar to sunburn on the skin where the radiation is targeting. I have aloe vera, which I'm keeping in the fridge so it's extra soothing, cetraben, and a cream called 'moo goo udder cream' which started out as a cream to treat sore udders on cows! Well, let's face it, this is basically the same thing! So far, it's felt a little sore but nothing too dramatic. The other main side effect is fatigue, but I'm feeling that already, so nothing new there. I'm resting in the evenings, making very few arrangements, and preserving as much energy as possible. Apparently the fatigue will be cumulative, so I'm expecting it to kick in properly in the next week or so. And it will last for a couple of months post-radiotherapy, so I'm keeping a low profile until the spring.

Generally though, I'm feeling much better than when I last posted. I've regained lots of my movement in my arm, I think the infection in my wound has pretty much cleared up, and I'm regaining strength each day. I'm enjoying being busy at work and getting back into things, and having more strength to do things around the home. This past weekend we had two of Tanai's friends over for dinner, visiting from Zurich and Milan. I was very pleased that my right arm was strong enough for me to bake a cake (folding in the egg whites took quite a bit of work, and I have not had the strength to do this since surgery). It was a flourless chocolate cake from the new Ottolenghi 'Sweet' book, layered with rosewater cream and caramelised walnuts. Delicious! We also went out with them for brunch near King's Cross the following morning, before they set off to the airport, which was really lovely. The autumn days here in London are blue-skied and sunny, but there's a chill in the air, and the temperature has not ventured above 10 degrees for some time.

Delicious cake!

A stroll near St Paul's Cathedral in the autumn sun

Brunch with the Italians

This coming weekend, we are planning to put up the Christmas decorations and make the flat all festive. I'm really looking forward to a very quiet, relaxed Christmas in our little flat, as I recover from my year of treatment.

New tattoos

This week I got three new tattoos! Sadly nothing as exciting as my first tattoo. These are three small black dots, given to me by the radiographer at St Bart's so they can align the laser beams while they're giving me radiotherapy. One is right in the middle of my chest and the others are on either side of my body, about where your elbow is when your arms are by your side. Radiotherapy has to be incredibly precise and it takes place every weekday for a month, so they can't afford to give me dots that might rub off over the course of that time. I was measured up on Wednesday morning, had my CT scan, and now they are fully planning what dosage and angles and everything, and I'm scheduled to start on 23 November (this coming Thursday) so if all goes to plan I'll be finished with radiotherapy just in time for Christmas.

The last couple of weeks have been pretty tough. I developed an infection in my armpit wound and while they drained some liquid out and sent it off to the lab to be tested, they prescribed me with a general course of antibiotics to get rid of it. Unfortunately a week later I found out that the infection was resistant to penicillin, so they had to switch me onto a different kind of antibiotics. So I still have an infection and I feel as though I lost a whole week trying to get rid of it. There is a lot of pain around my wound, it's red and inflamed, and I've lost a lot of the range of motion I was gaining by doing my daily physio exercises. I'm still doing them but recovery is much slower now. I'm also feeling generally really unwell. I'm tired, off my food, and a little impatient to be back on the road to recovery. I've been back at work but I've struggled with the long days and I'm not feeling very resilient at the moment. Plus the antibiotics are giving me diarrhoea which isn't great! I have struggled a bit with my commute, and the other day I had to say aloud on the tube, 'please could someone give me their seat', as I really couldn't remain standing. These kinds of situations can be pretty challenging for someone who is usually so independent and capable like me.

Commuting

And, to be honest, I'm feeling pretty emotionally vulnerable. It's difficult because I had such positive pathology results and so people are jubilant, but they're saying things like 'So you're almost done!', or 'You did it!', or they think I'm finished with treatment now. But there's still so much treatment to come, and I'm running on the fumes of an empty tank every day in terms of energy, I just don't feel like celebrating. Radiotherapy is apparently also very draining, so I'm genuinely wondering how I'm going to have the strength to get through the next couple of months. And after that, I still have a whole heap of other treatment still to come. I'll still be a regular at St Bart's for the forseeable future, and I'll still be dealing with side effects every day, managing the changes in my body and trying to get on with my life. People talk about a 'new normal' after cancer treatment and now I understand what they mean. I need to spend the next few months working out what my 'new normal' is because Past Carmel is never coming back.

So this weekend Tanai and I did some talking, thinking and planning, to come up with some practical measures to help me get through the next few months, and also some emotional parameters, to make sure that I don't bottle up my emotions but allow myself to feel the way I feel, to acknowledge the emotions, and then allow them to pass, without consuming me. I'm feeling a little more emotionally robust, much more prepared for the next few stages of treatment, and more able to get on with things. I've reduced my hours at work slightly, to 10am-4pm, so that I can avoid travelling at rush hour, and preserve some strength and energy during radiotherapy, while also ensuring that I'm there for my team. This should take me to the end of the year, and then I can start 2018 afresh, and put 2017 behind me. So next stop: radiotherapy.

Surgery results, Carmel 1: Cancer 0.

My surgery was 10 days ago, and today I had to go back into hospital to get my pathology results. These are the results from the lab where they have analysed the two lymph nodes they removed from my armpit, and the remainder of the lump they removed. And happily, it's all good news. There was no cancer in my lymph nodes, which means I don't need to have any further surgery, and the remaining lump was also clear, which means that the chemo had properly killed all the cancer in my breast. I'm so relieved and happy, this is a huge milestone on my treatment journey.

 

Sticking two fingers up at cancer!

My surgeon, Miss L___, removed my dressings, which I've had on since surgery, so it was the first time I've actually seen both of the wounds. They look incredible, she's done a fabulous job. My armpit wound is a small nick about 2cm long, under the armpit, barely noticeable. She very cleverly made the incision for the lump by cutting a crescent shape around my nipple, and then tunnelling in to get the lump. This means I'll have no visible scar in my cleavage, and once it heals, it will be practically invisible. There is a lot of bruising and swelling at the moment, but I already love my post-surgery body, and when I look at myself in the mirror, I see a strong, beautiful woman who has been through so much over the past few months, and I'm so proud of her for getting this far.

Today we also discussed the next steps, as my treatment isn't over yet! In a couple of weeks I will get measured up for radiotherapy: they'll do a CT scan and I will get two little tattoos on my chest so that they can properly line up the lasers, and then, as long as my wounds heal well, I should start radiotherapy about a week after that. I will have 19 sessions in total, every weekday for almost a month, and then I will be finished with what they call 'active treatment'. The radiotherapy is really belts and braces, to mop up any stray cancer cells and reduce the risk of the cancer coming back. The side effects are not as severe as chemotherapy, but most people say that the significant one is fatigue, which can last up to a couple of months after radiotherapy is finished. I'm preparing myself for another few weeks of having a minimal social life. Luckily the nights are drawing in and the temperature is getting wintry, so I'll just curl up at home with some good books, podcasts, movies and hearty food.

I have been given some exercises, which I'm diligently doing three times a day, to regain as much movement as possible in my right arm. At the moment it's quite difficult to lift my arm up over my head, and I'm still avoiding lifting anything heavy, but I'm doing well. Tanai took a week off work after my surgery and we mooched about at home, chilling out and resting. It's actually been quite lovely to rest and recuperate properly after surgery; I realised that I didn't properly rest through chemo and probably pushed myself a little too hard. I go back to work next Thursday so I'm making the most of my final rest days. 

My daily exercises

So, all being well, I should be done with active treatment by the end of the year. I'm looking forward to bidding 2017 farewell, to be honest, and we already have some fun things planned for 2018. I will continue having Herceptin injections every 3 weeks until July next year, and I have just received my first prescription of Tamoxifen, the tablet I'll be on for the next 10 years. I've decided I'm not going to start taking it until after radiotherapy, as I am not keen on having both side effects at once. Today the clinical oncologist also talked about giving me Zoladex injections every month for at least the next two years. This is because I'm pre-menopausal, and my cancer is fed by oestrogen. What do your ovaries do? Produce oestrogen! So Zoladex suppresses your ovaries to reduce the risk of the cancer returning. And along with that there is another injection they want to give me every 6 months to prevent the cancer returning in my bones. I've decided to take some time to research these other options before signing up, as I've heard they can also have some pretty nasty side effects. I want to be certain that their efficacy and the benefits I will receive from them is worth the potential impact on my quality of life. So more on here when I know what I've decided! Until then, I shall continue to be pretty happy with today's news and celebrate this weekend with friends at the Lewes bonfire.

Surgery (and some cool research projects)

Yesterday was my surgery day, and it seems to have all gone well. Here's a little summary of the day. One of the things I was most dreading was having to fast all day before surgery, so we cooked up a delicious meal the night before. I've been getting creative with the contents of our weekly veg box, and this week we got some celeriac, so made a celeriac hash, with ham hock, mustard, gruyere and duck eggs. Absolutely delicious! I then permitted myself two pints of water at 5.50am on the morning of surgery, and that was it. We had to be at the Percival Potts ward at 7am, situated in the attic of one of the old St Bart's buildings. With pointed windows and a sloping roof, it felt more like a school dorm than a hospital wing! I had to give an extra urine sample so they could do a pregnancy test (hilarious!) and then was ushered into my own room, which was ridiculously overheated and the windows were painted shut. 

Then followed a stream of various people wanting various things. Firstly, a nurse to issue sexy compression socks for me to wear during surgery (to avoid blood clots), take my blood pressure, check allergies etc. Next up was a woman from the clinical trials unit at Queen Mary University, with detail of two programmes they were asking me to participate in. Regular readers will know of my desire to get involved in clinical trials and 'give back' to medical science and potentially help cancer patients in the future, so I was very interested. The first research programme is a tissue bank, and they are requesting that I agree to a piece of the tissue from my cancer being stored in this bank in order that they can conduct research on it, compare it with other cancer tissue, study its molecules and potentially see how it could respond to different drugs. Of course I complied and signed all the forms, totally happy to help out! The second programme is a huge NHS initiative run by Genomics England (a company owned by the UK Department of Health) and is called The 100,000 Genomes Project and is really pretty cool. This is a huge country-wide project and will definitely change the future of cancer treatment, so I was very keen to be involved. It will involve my whole genome being sequenced (Tanai was a bit jealous!) and it differs from usual research projects in that the data is not anonymised. They wanted to collect a blood sample and a sample of my cancer, and will use this to shape the personalised medicine of the future. In the not too distant future, people will not be routinely given the same old treatment as everyone else. No, their DNA will be sequenced and they will be given the appropriate treatment for their very specific needs. In order to be able to gather as much data as possible for this, they need to be able to access my entire medical history, and will continue to access it for the rest of my life, and beyond. It will be analysed by several global teams and compared with the 99,000 other genomes they choose to sequence. They will also contact me if any of the research on my sample unearths anything of interest or relevance to me. Of course I signed up straight away, and it feels great to be able to contribute to such a groundbreaking project.

My next visitor was the anaesthetist, a tall, skinny guy with an infectiously calm manner. He asked me various questions and explained what he would be doing later to get me ready for surgery. Not only would he administer my anaesthetic, but would also have to place a breathing tube down my throat in order for me to breathe during surgery. And after he left, my surgeon, Miss L___, and a registrar came to visit me. They asked me to explain in my own words what I thought was going to happen. They seemed content with my response and she then rather unceremoniously scribbled all over my chest just below my collarbone to remind her what to do later on, I suppose, so she didn't mix me up with any of the three other women she was operating on that day. We also discussed my allergy to the various dressings they use at the hospital, and sticking plasters. She said she would use a milder dressing, but we shall see if it works.

R = Right breast, WGWLE = Wire Guided Wide Local Excision, SNB = Sentinel Node Biopsy

Sexy compression socks

My first task for the day was to pop over to the West Wing and have a wire inserted into my breast so that the surgeon could later locate the cancer (I explained a bit about this here). When the ultrasound technician tried to find the remaining cancer she had trouble: apparently it has shrunk to less than half a centimetre! So instead of using the ultrasound to guide in the wire, I had to have it guided in while being compressed in a mammogram machine. Those of you who have had a mammogram will know how uncomfortable that was. This was because they decided to aim for the titanium clip which remains in my breast from the biopsy, rather than aiming for a tiny tumour remnant. They know that this clip was placed in the original tumour, so if they aim for that, they should catch what's left of the cancer. I suppose it's quite difficult for the surgeon to operate, when she can't see the cancer (it doesn't look any different from my normal body from the inside, I suppose). So she operates with all my ultrasound and x-ray photos all around her, guiding her as to where it is likely to be located in my breast. The wire helps with that, as she can just remove it and a bunch of tissue around the base of it, and hope she got it all. I wonder if in future someone will invent glasses that surgeons can wear that will give them the ability to see cancer.

As an aside, while I was having my ultrasound, the nurse in the room just happened to be the same nurse who was there in February when I had my first biopsies, F___. Back then, before I had even received my diagnosis, she held my hand through 9 painful biopsies, and was so kind and thoughtful, I have not forgotten it. I was so glad to have the chance to tell her how much that had meant to me, and thank her for her kindness.

So with a wire hanging out of my boob (no, really!) I went back to my room to wait. And I waited, hungrily, for hours. I was 3rd out of the 4 women having surgery that day, but I think they scheduled the most complicated op first. Finally, at 3.30pm, I made my way to the theatre. My lovely anaesthetist was there, and we had a delightful chat about hiking on the Isle of Skye while I slowly drifted off to sleep. And 3 hours later, I woke up! It really is quite remarkable, medical science. 

The other part of the op, which I mentioned before, was the removal of some lymph nodes. Having been injected with radioactive dye the day before, they apparently used a geiger counter to find where the radioactivity was collecting, and that, combined with the blue dye, helped them locate the sentinel nodes to remove. I just find that so astonishing, what an incredible technique.

Coming round from the anaesthetic wasn't too much fun, but after a bit of anti-nausea medication and some sips of water (finally!) I felt vaguely human again, so they wheeled me back to my room, and to the welcoming arms of a rather worried-looking Tanai. I then proceeded to gingerly eat some of the leftovers from the day before (I'm sure I'm the only person to have broken their surgery fast with celeriac hash and duck eggs) and soon felt much more stable. Miss L____ came to check in on me, informed me that she'd removed two lymph nodes (as far as she could tell) and that it all seemed to have gone well. I'm to keep my dressings on until I go and see her on 3 November, when I'll also receive my pathology reports. So that's when I'll find out if the surgery was successful in removing all of the cancer, and if my lymph nodes are cancer-free. Fingers crossed I won't have to have any further surgery.

I then got dressed and we made our way downstairs. All along when preparing for surgery, everyone we've spoken to has insisted that we get a cab home, but it was such a charming, cool evening and I was feeling strong, so we defied advice and walked home through Smithfields market. It's only an 8-minute walk and we made it home fine. After some pumpkin soup which I'd made the day before I collapsed, exhausted into bed and slept very soundly.

So that's it! Surgery is ticked off the list (hopefully for good). I feel fine today, a little sore but I haven't had to have pain relief yet, and I still have some movement in my right arm. I keep having to remember not to pick things up with my right hand (which is tough as I'm right handed), and Tanai has taken the week off work to help me out. We managed a little afternoon walk today in the autumn sunshine and now I'm resting on the sofa. I'm wearing very comfortable clothes, a soft post-surgery bra (which I also have to sleep in) and I have a fabulous pillow which my friend Dee sent me, which hooks over my right shoulder and prevents my arm from chafing my armpit wound. I can shower as normal as the dressings are all waterproof. I'm sure it will get sore over the coming days, especially when I start to do my exercises (which I've been given in order to maintain movement in my right arm) but hopefully all will be well. If I have any problems I can just head straight over to St Bart's and they'll sort things out. So now I just have to rest and recuperate, and spend some time relaxing, reading books, listening to podcasts and catching up on some movies.

My fabulous arm pillow

This afternoon's walk through the St Bart's courtyard

Final pre-op prep

I'm heading in for my surgery tomorrow so just thought I'd update you on the final things that have happened this week. Since my pre-op check-up I have seen the cardio oncologist again, for the results of my various heart tests. She was very reassuring and said all the test results seem fine. She suspects I have what is called Ventricular Ectopy, where my heart decides to give an extra beat every now and again, for a short burst, which explains my chest pain and the fact that I'm feeling my heart beating quite aggressively. She said it's nothing to worry about in the short term, that I'm fine to proceed with surgery, but that if it's still happening in a couple of months I should head back in to see her. She did, however, point out that my blood results show I'm anaemic, so she has advised that I receive a blood transfusion after my surgery rather than simply being left to build my bloods back up on my own.

I also received a call this week from the clinic to say my bloods needed doing again, so it appears that they are not as good as they could be. The nurse told me my magnesium and potassium are low, or something like that (I didn't take notes) and she took three more vials from me to do further tests. Due to 6 months of sustained chemotherapy, my veins are not as good as they used to be, and have a tendency to collapse when someone tries to put a needle in them. She tried her hardest but had to use a vein that was quite deep, and now I have a huge bruise on my left arm! I asked the google what I could do about collapsed veins, thinking there might be some things I could do to help them regain their strength (such as drinking lots of water doing exercises etc) but all I unearthed were helpful websites urging me to stop doing drugs! It seems as though that's the main cause of collapsed veins, and the advice is all very admonishing, so I retreated. Anyway, hopefully they got what they needed at the hospital and my bloods are getting better.

Finally, this morning I had to go into the nuclear medicine department again so that they could inject me with some radioactivity. The nurse was fabulous and explained how it all works, before injecting it into my boob near the nipple. It only stung a little and now I'm back home. After the injection, she took a marker pen, circled the area she had injected and put a little arrow towards it with 'INJ' next to it! I suspect that is not the last time I will be written on with marker pen. Oh well, if it helps the surgeons I really don't mind. So tomorrow they will apparently use a Geiger counter to see where the radioactivity has gathered, and this will help them see where my primary lymph nodes are, to aid them in taking them out. It's all so fascinating.

At the nuclear medicine dept this morning. Far too early for Tanai!

On the way home, we stopped at St John's bakery and bought two donuts. They make delicious fresh donuts every day and fill them with different creams and custards. Tanai got one with honey and brandy cream, and I got one with a delicious spiced custard. This has become a bit of a tradition now, buying St John's donuts at each stage of my treatment. It's so lovely to have it to look forward to.

Today's yummy donuts

This weekend I also went to my first gig at the Roundhouse since the day before I received my prognosis back in March (we went to see Sampha and the very next day got all the test results). There was an all-day festival featuring some really funky music, including the Hot 8 Brass Band, who were great. I managed a whole glass of wine and we stayed out until 9pm! Crazy. After 6 months of being very boring and primarily staying home, it felt like a real treat.

I finally have a social life again

We also spent Sunday ferociously batch cooking, so that we have a freezer full of food in readiness. Although Tanai does love cooking, it's likely I will have mobility issues for a while in my right arm, so might not be able to cook for a while. Rather than have him cook every single night, I thought it would be nice to stock up on some yummy meals in our freezer. The flat still smells delicious!

Chef Cardona

We also did some DIY and installed a new ceiling light in the kitchen to brighten up a dark corner. We received a lesson from my dad over video whatsapp and then turned off the electric at the mains and wired in the light. A bit nervewracking but it worked!

Lovely new ceiling lamp

I have finally ditched the headscarves as I now have enough hair to look plausibly like another short-haired person, and I feel great. It's a little windy round my ears though, I wasn't prepared for the cold! But I'm enjoying how low-maintenance it is. Someone at work said 'big earrings and lippy' so I've taken that on board.

Rocking the short hair

I'll update you all after the op! Fingers crossed it all goes well.

Preparing for surgery

My surgery has been confirmed for Tuesday 24 October, so for the last couple of weeks I've been attending various appointments to prepare for the op. I saw my oncologist again on 2 October: my standard post-chemo check-up. She was really happy with my progress and I don't have to see her again until 4 December! It feels so strange, after seeing the oncology team every 3 weeks for the last 6 months, to have such a huge gap before seeing them next. As my treatment progresses my schedule of appointments will change, and once I'm done with radiotherapy I will drop down to seeing my oncologist and surgeon every 3 months, then every 6 months, and eventually I will only have to have annual check-ups. But I'm getting ahead of myself...

On 4 October I had my first Herceptin injection. Regular readers will know that this is a monoclonal antibody (I explained how they work here) which I have had intravenously during my last 4 rounds of chemo, along with Docetaxel and Pertuzumab. Its actual name is Trastuzumab but Herceptin is the brand name and widely used. Herceptin blocks the growth factor HER2 from helping the cancer cells to grow, and so the cancer cells eventually die. It has been shown to be hugely effective at preventing cancer from returning, so I have to continue receiving a dose of it every 3 weeks for a year in total. It took about an hour to receive it through an IV but now it's administered via a large needle in the thigh for a couple of minutes. Although this is much more convenient it bloody stings! My friend Jana came with me and distracted me and held my hand while the needle went in.

Next up was my pre-op assessment on 10 October, at my regular Breast Clinic in the West Wing of St Bart's. First they weighed and measured me again, so that they can calculate how much anaesthetic I need, then they took my blood pressure, took some blood for testing, and swabbed my nose, mouth and groin to check for staphyloccocus. I explained that I had actually had an outbreak of staphyloccocus aureous on my skin recently, but was on a course of antibiotics to get rid of it. It's highly infectious apparently, and can have major developments if not treated properly, so they have to control its spread in hospitals. Apparently if the tests come back positive, I will have to be last on the operating table that day, so they can scrub thoroughly after me.

Then I had to answer a whole heap of questions from a nurse, including whether I'd had general anaesthetic before, when I last had bronchitis, whether my ankles had swollen recently, and loads of other seemingly non-related questions. I had a general anaesthetic when I was a child for a multiple tooth extraction, I haven't had bronchitis since 2014 and yes, my ankles are swelling every day at the moment, in case you're interested. They are particularly concerned about some of the questions we're investigating to do with my heart, so they sent me off for another ECG and a doctor came to listen to my heart. Once again, the ECG seemed fine, but as I have an appointment with the cardio-oncologist next week, they're going to hold final judgement until then. Fingers crossed I'll be good to go for surgery on 24 October.

The patterns my heart makes

The nurse explained a little about what would happen which I will outline here for those of you interested. Firstly, the day before surgery, on Monday 23 October, I have to visit the nuclear medicine department for a Sentinel Node Scan. They'll inject some tracer near my breast and they track its progress in the lymph system by taking pictures over the course of 3 hours using a gamma camera. So basically I have to lie extremely still in a huge nuclear camera machine for the best part of half a day. Fun times. This will then guide the surgeon who will be removing my sentinel lymph node as well as the rest of my cancerous lump.

Then on the morning of 24 October I am not allowed to eat anything. Those of you who know how hangry I can get can appreciate that this is one of the things I'm most worried about. No food from midnight onwards and no water from 6am onwards. I'm going to get cranky! I also have to remove all nail varnish, and I'm not allowed to moisturise that morning or use an oil-based shower gel. I have to arrive at the hospital at 7am when I'll be greeted by the team and meet my anaesthetist. At this stage I don't know what time my surgery will be, as they decide on the day what order they will do everyone in.

So essentially the procedure is this. I am having two surgeries in one. Firstly, a Wire-Guided Wide Local Excision. This is the name of the procedure for removing the remainder of my cancerous lump. In the morning, they will use an ultrasound machine to guide a wire into my breast and they will leave the end of it right at the base of the remaining cancer. I will then have to go about with a wire hanging out of my boob until I head into surgery! This is to guide the surgeon, Miss L___, as she removes the cancer including a margin of healthy tissue so that we can be happy it's all gone. She will go down to the end of the wire and remove that along with the cancer. She will also take out the titanium clip which they put in there right back in February when they were doing my original biopsies.

And secondly, I'm having a Sentinel Lymph Node Biopsy. This is to check that the cancer has not spread into other parts of my body. The Lymph nodes are small, bean-shaped glands throughout the body. They are part of the lymph system, which carries fluid, nutrients and waste material between the body tissues and the bloodstream, and is an important part of the immune system. Cancer co-opts the lymph system in order to travel around the body and settle elsewhere, which is why it's possible to have Breast Cancer in your lungs, brain, and other organs. If my cancer has spread, it would do so via the lymph nodes in my armpit, so the surgeon is going to remove the first couple of glands and send them off to the lab, to see if they can find traces of cancer in there. The way they do this is quite funny. While I'm under anaesthetic, they inject my boob with blue dye, and then see where it goes. The first couple of nodes it appears in are the ones they will remove. They will take out 1-5 nodes (the average is 2.2). Apparently my breast can remain blue for up to 18 months after surgery! I think that Smurf Boob will be my new pirate name. Maybe I should audition for the next Avatar movie!

Once they're done, as long as there have been no complications, I can leave hospital the same day, and don't have to stay overnight. The lump and nodes will go off to a lab, and I will get the results 2 weeks later. If they have managed to take enough margin round the lump and my nodes are clear of cancer, I will not have to have any further surgery, and can go on to have radiotherapy a few weeks later. If the margins are not clear, or if there's cancer in the nodes, they will have to operate further.

I have been given an information sheet from Breast Cancer Care containing exercises I must do each day to ensure I get my full motion back in my right arm. There is a risk of Lymphodema, which is a permanent swelling of the arm due to there not being enough lymph nodes to fully drain from the arm and upper body. Also, I will not be able to have any blood pressure tests or blood taken from my right arm for the rest of my life! Let's hope my left arm can do all of that for me in future.

So now I'm feeling quite prepared for the surgery. I will take 2 weeks off work afterwards to recover, and hopefully will be fine to return after that.

And to further examine my heart, yesterday I had what's called a 'stress test' on my heart. This was quite a tricky test, I had to sit on a kind of exercise bike, but one where I was laying back at 45 degrees so they could put heart monitors around my chest and back. They set the 'bike' on a course which got increasingly difficult, and I had to keep pedalling in order to push my heart rate up. The tricky part was that they had to tilt the machine to the left in order to get the ultrasound wand and take photos of my heart. Riding a bike until your heart rate reaches 150, while tilted to the left so you feel as though you're going to fall off is quite challenging! But we made it in the end and they got all the pictures and videos they needed. I will see the cardio-oncologist on Tuesday for the results.

And my other hospital visit this week was on Wednesday, when I went back to the Royal London for the results of the biopsy on the skin tag I had removed a while ago. All good, I don't have skin cancer, hurrah! It was just a bundle of blood vessels so nothing to worry about.

One more week until surgery! It's a busy week at work but I'll be resting lots in the evenings and continuing to build strength and energy to help me see it through.

Lessons and revelations from chemotherapy

Today marks the official end of my chemotherapy treatment. It's been three weeks since my last dose, but unlike before, there is no top-up today of the poison which is also saving my life. My body can continue to recover and rebuild, and I'm busy regaining strength and energy in time for my surgery on 24 October.

So long, farewell, chemo. It's been... well, shit, to be honest, and I'm bloody glad to see the back of it! Now, I know I've been putting on a brave face (literally, in the case of drawing on eyebrows), but I feel as though I should at least write one candid post about the effects and lessons of my six months of chemotherapy. You'll laugh (I'm kidding myself if I think 'with' me, you'll laugh 'at' me), you'll cry, you'll wince, and you'll hope you never have to go through it yourself. And I hope you don't, I really do, although if you do, I'll hold your hand every step of the way. It's shit, yes, but I survived it, and thousands do, but we develop a sick sense of humour and lose all dignity in the process.

One of the words most commonly used to describe chemo by people who have been through it themselves is 'doable'. As in: 'it's awful, but it's doable'. This has always intrigued me, what does 'doable' even mean? It's such an insipid, unassuming word. It has no sense of the horror of chemo, but it's factually correct. I suppose chemo is indeed 'doable', but hiding behind that word is a whole storage locker of pain and indignity. Strangely enough, I will probably find myself using that word to describe it in future. I did it, it's doable, I'm still here to tell the tale.

I've learned a few lessons over the last six months, valuable lessons about myself and my relationships, and I've experienced things I never want to experience again. So here are the fruits of my chemo education.

A little caveat: everyone's response to chemo is completely different, regardless of their regimen. I've learnt this through many online conversations in my support groups and with women I've been put in touch with, so there's no rulebook (and there appears to be no logic either) but here is my honest and frank experience.

As I've mentioned before, having chemo is like spraying your entire garden with bog-standard weed killer because some pesky weeds killed your rosebush. You don't know how far the weed seeds or roots may have spread, but you don't want the weeds to kill anything else in your wonderful garden, so you take no chances, and you blast the whole thing with strong weed killer. It's not very targeted, but it's certainly effective.

Side effects of chemotherapy:

So let's start with the obvious: hair loss. I've been rocking the headscarves for a few months, so it's clear I've lost the hair on my head. But hey, I also learned that hair is not just an aesthetic thing, it's also actually kind of useful. Eyelashes and eyebrows have functions. Not only does my face look weird without them, but I keep getting things in my eyes these days, and they are constantly watering. The loss of my nose hair is super annoying, as I now have a permanent drip from the end of my nose. It drips on my notebook, or into my dinner, totally unannounced. And, TMI, hair 'down there' is also useful. Why on earth people pay to have it removed in its entirety is beyond me. I want it back please! Sadly, the leg hair is persistent, no silver lining there.

Then there's the fatigue. It's very hard to describe but I've never experienced anything like it before. And it has different stages. Usually for the first few days after I've had chemo, I have immense fatigue, I feel tired all the time and usually don't leave the house for at least a few days. When I do try to go for little walks I can barely make it round the block before I have to sit down on a bench. And I have a fog behind the eyes, and need to nap lots (gotta love naps!). I don't have the strength to open the coffee pot in the morning, I'm dizzy and often can't walk without holding onto the walls. I take baths instead of showers because I can't trust myself to have enough balance to stand in the shower. I slowly regain energy and strength as the days go by, but never to anything remotely like even 50% of my 'usual' energy. I practice energy conservation (lifts not stairs) and have to make tough decisions about what I spend my energy on (ie if I go into work, that uses up all that day's energy. Usually a walk around a gallery exhibition floors me, etc). Even having a conversation is exhausting. For someone who is used to running around doing a million things a day, the fatigue has probably been the side effect that has impacted my life more than any other. And I don't have the language to describe what it feels like ('fatigue' just doesn't cut it). I find myself saying 'I'm exhausted' to people and they just nod and say 'mmmm' and I know that they have absolutely NO IDEA what I'm talking about. 

The dehydration is intense. When I first started chemo, there were women in my support groups sharing tips on how to make water taste interesting. I laughed them off, thinking, 'I love water! I drink loads of it already, I'll be fine'. Not so. When you have to drink litres and litres of it each day it starts to get incredibly boring. No, more than that, I'm bloody sick of it! It makes me gag. So I had to try everything to make it taste interesting: diluted fresh orange juice, elderflower cordial, a plethora of interesting teas. And my skin is completely dry all the time, I've never moisturised so much in all my life. I've invested in a stash of 'Moo Goo' products, which are lovely and completely natural, free of nasties such as parabens etc. I'm obsessively moisturising my hands a million times a day, and my lip balm addiction has intensified. I put a spoonful of coconut oil in my bath. I'm applying nail oil to my nails and cuticles a few times a week, because, oh yes, my nails are getting dry and brittle, and are slowly peeling off.

On that note, I lost my first toenail last week. Yes! They're just coming right off. Fun times.

Everything takes a million years to heal. I have some mosquito bites on my leg which have been there for almost three months. If I accidentally cut myself, my blood just doesn't clot properly, and the wound takes weeks and weeks to heal. I put this down partly to my low neutrophils and white blood cells, as my body doesn't really have the mechanism to heal itself well. Interestingly, I was warned that this would make me more susceptible to catching infections, but ironically my own worst enemy has been my own body. The main things that have knocked me down are things which regularly exist happily and silently on my own body but have been able to make me ill because my immunity is compromised (such as the staphylococcus aureus I got all over my skin). If I so much as walk down the street I get blisters on the soles of my feet, and woe betide my hands if I don't wear rubber gloves while washing up.

My digestive system has been shot to pieces, every aspect of it. My tastebuds have changed, my eating habits affected, my tolerance to spices severely reduced and my cravings for beige food dramatically increased. And don't get me started on the other end of the digestive system. Let's just say I have 7 different types of laxatives in my medical cupboard now. Yes, seven.

Changed eating habits and lack of energy have led me to put on 6 kilos over chemo. I feel sluggish and most of my clothes no longer fit me. I'm looking forward to getting fit and healthy again. I am, however, grateful that I've been able to keep eating and feeding my body to give it the best possible chance to maintain energy and nutrition. Many people get such sore mouths and heaps of mouth ulcers during chemo so they lose weight due to lack of ability to eat. I'm very happy that it's been the other way round for me.

I get random nosebleeds all the time and there's nothing I can do about them. They won't clot, my nose remains dry and sore and I can't predict when they will happen. A couple of times they've happened in pretty embarrassing situations but I've always got tissues on me so I've escaped any major dramas.

Chemo brain is real. Yes, the cognitive impairment has been strange for me, especially as someone who prides herself on being articulate and decisive. At its worst it has been crippling: forgetting the words for things, forgetting how to use the oven, struggling to string a sentence together. I've developed coping mechanisms and workarounds, but this is one they say can linger, and I'm not looking forward to that.

Menopausal symptoms, the main one being hot flushes, have given me a new-found empathy for women going through the menopause. Hot flushes just come upon you suddenly, your entire body temperature soars and you're sweating all over, then a few minutes later you're shivering with cold. As this is happening regularly through the night as well as the daytime you can imagine how this is affecting my sleep. And when your body is trying to heal itself, sleep is something it really needs.

Then there are the side effects from the drugs they give you to prevent the chemo side effects. I kid you not! Each round I had to take steroids to make sure my organs kept working and to combat nausea. These prevented me from sleeping and gave me severe 'roid rage', turning me into a monster on day 4 or 5 of every cycle! The GCSF injections which Tanai administered daily after chemo were meant to encourage my bone marrow to produce white blood cells, thus preventing me from becoming neutropenic. Well these had the delightful knock-on effect of making all my bones ache like hell. A good dose of Epsom salts in the bath eased the pain.

There are more, but these are the 'highlights'. And I suspect that each one alone would be manageable. Many of them are not in themselves debilitating. But combined all together, when you're attempting to still function in society, they have been extremely challenging. I hope I've managed to demystify some of this experience without grossing you out too much.

On the plus side, the chemo has been busy NUKING THE CANCER, yeah. Let's face it that's the primary plus factor. Also most (but sadly not all) of the side effects are temporary. My hair will grow back (perhaps curly, who knows?), the fatigue will ease, I'll lose the chemo weight. But now I will continue to take Herceptin for a year (in injections every three weeks) and Tamoxifen for 10 years (a little tablet each morning), which bring their own side effects. There is also the likelihood that my treatment will bring on early menopause, eliciting a whole heap of other wonderful side effects. What treats I have in store!

There are other positives to this experience, though. There are so many organisations out there geared up to help. For example, Macmillan sent me a small plastic card for my wallet which requests that the person I show it to allows me to use their toilet in an emergency because of my cancer treatment. Useful when out and about! And Transport For London sent me a badge which passive-aggressively asks people to give up their seat for me.


And here are some of the things I've learned while going through chemo:

1) I can walk to my local city-centre Waitrose in tracksuit pants, no undies, flip flops, a baggy t-shirt and a headscarf and shop amongst the 'suits' at 5pm and not lose a shred of dignity.

2) It's actually possible to have both constipation and diarrhoea at the same time. It's like some kind of hideous pooping miracle!

3) Tanai loves me even when I am bald, have tonnes of coldsores, chronic constipation and I'm cranky from the steroids. The only way is up!

4) If I get to the end of the day and the only thing I've achieved is to stay alive, that's not a day wasted. Yes, I've definitely learned the art of slowing down and putting less pressure on myself. Long may it last.

I have to give a huge shout-out to those wonderful people in my life who have helped me get through this tough first phase of treatment. To the amazing friends who have sent or given me thoughtful cards and gifts after researching chemo side effects: nail oil, hand cream, headscarves, ginger sweets and tea, the biggest bucket of Epsom salts I've ever seen, a chilly towel all the way from Australia, homemade cheesy bikkies, gorgeous earrings to help me rock the hairless look, and so much more. To everyone who has popped over to our little flat to visit, some driving almost 6 hours for the privilege, others coming all the way from Australia, many bringing food and lolz. To everyone who has texted me jokes, messaged me support, reminded me they're thinking of me. These things have meant a great deal when you feel as isolated as I have felt at times. To my patient, supportive, caring colleagues, who put up with my regular TMI, have sanitised the heck out of the office, and who go and work in another part of the building when they've got a slightly sore throat. Our daily interactions at work have most definitely kept me sane through this. To the four incredible people who accompanied me to rounds of chemo and gave Tanai a break: Martin, Dom, Caroline and Siobhan. That really was above and beyond and I will be forever grateful. To mum for batch cooking and filling my freezer with delicious food, and dad for sending Tanai presents and reminding him he's awesome. To my uncles Paul and Paddy and their families, for providing Tanai and I with weekend respite before and during chemo. Getting away from the eye of the chemo storm was hugely important for our mental wellbeing, so thank you. I won't go on, partly because there is much more treatment to come, and I'm sure I'll be reaching out for further help and support, or grateful when it's offered unasked.

I've already had a couple of 'helpful' naysayers question my decision to proceed with this treatment, especially as I'm known for my holistic approach to health and my love of natural supplements and therapies. Aside from the fact that it's 100% my own decision how I proceed with tackling cancer, there's also the not so small matter of science. Eating kale does not get rid of cancer. Chemo does. End of.

If you've made it to the end of this post, well done! It was epic, I know, but the last six months have also been epic, and, like childbirth, I suspect that if I don't write about the experience, I'll forget the horror of it all. Onwards and upwards to the next stage of kicking cancer's arse!

Venturing out: art class

Now that I have finished chemotherapy, each day I can feel my body grow stronger and it's so wonderful to know that I won't have to take on any more poison just when I'm starting to feel human again. I feel as though I'm finally able to start healing, even though there is still more treatment to come. My surgery will be on 24 October, so I'm concentrating on trying to get as strong and well as I can before then, to give myself the best possible chance to recover from surgery quickly. But today's post is less about what's going on with my body, which is very well documented here, but more about what's been going on with my mind. While my body is healing well now, I've been emotionally quite vulnerable this last week, and it manifested itself in many ways when I went to my first art class last Wednesday. I'd like to share it with you here, as my mental health is also an important part of this journey, and as so much of this is new to me, I want to document my experience with honesty and openness.

I decided to enrol on the art class partly because I wanted something gentle and creative to do while recovering from treatment. I've spent 6 months doing very little other than work and having treatment, but I know that my energy levels won't suddenly bounce back to how they were before. I loved painting when I was at school, and I've always wanted to try it again. Plus my friend Jana has been attending this class for a couple of years, and she has been producing some wonderful work, so in a way it was a 'tried and tested' class. So I went along last Wednesday, excited to be doing something new and wondering what I would learn. The class is made up of about 8 people (although I think more will join us in week 2), many of whom have been attending this particular class for many years. Some of them have even sold paintings! The teacher is an artist herself and for week 1 she led us in a collage exercise so that we could create compositions that we will eventually paint. I had never done anything like this before, and I found it quite interesting, as ideas generation has always been the area where I fall down. I think this is why I have so often copied paintings in the past, but of course original work is what we should be striving for. 

I think I had failed to appreciate the significance of this class in so many ways relating to my cancer. This was the first time I had done something new, and met new people, since my diagnosis back in February. Before diagnosis I would not have thought twice about putting myself in a situation where I was meeting new people. I am generally quite confident in social situations and love meeting new people, but on Wednesday I felt vulnerable and unsure of myself, and I leaned on my friend Jana who was also in the class, almost clinging closely to her. I'm sure they are a lovely bunch of people, but I felt awkward and self-conscious about how I came across. The cognitive impairment brought about by diagnosis (sometimes called 'chemo brain') is very real, and I still struggle to be as fast and articulate as I used to be. So when the teacher asked me conversationally what artists I liked, my mind went blank and I could not think of any! I madly searched the recesses of my mind but struggled to know how to answer. I then felt so self-conscious about sounding stupid and disinterested (I'm in an art class for goodness' sake! And I can't name any artists I like!) which made the whole thing even worse. 

The other challenge I faced was whether or not to actually tell them I have cancer. While I've been open and candid with the people in my life over the last few months, these were people I was meeting for the first time, with whom I was going to develop a relationship over the next 11 weeks. I was reluctant to be 'the cancer girl' -- I'm very conscious of not wanting to be defined by this. Therefore I decided not to tell them, and simply present myself on face value. But then of course my challenge was that 'face value' is a very depleted, fatigued girl. By 9.30pm I was exhausted, and running out of steam. I almost started to shut down! But I'm much younger than most of the people in the class, so how do I explain that it's way past my usual bedtime and I have very limited energy these days due to treatment? To compound this, that day was the first day I ventured out of the house without a headscarf on. In retrospect I feel that it was way too early (I've worn the scarves ever since). Although I'm excited about finally growing some new hair, it really is still very short, and I garnered many more stares than I ever have with the scarves. So I suppose they also had no explanation for my appearance either.

Perhaps I'm making too much of it, but all I know is that the evening had a significant impact on me emotionally. I got home and cried and cried. So many thoughts were swimming around in my head. I will have to re-learn how to socialise. I have to learn how to navigate meeting new people and whether (or how) I reveal my diagnosis. I physically can't do what I used to be able to do. I have to learn how to 'be me' when I have changed significantly. I'm sure that over time it will get easier but it was quite an unexpected shock to be feeling these feelings from something as unassuming as an art class. I also then grappled with whether or not to return to the class, as I am worried that if I don't, I may never re-learn how to navigate the world, and that, a bit like falling off a horse, I really ought to see it through. 

I suppose the main lesson is that which I've been conscious of all along. My mental health is just as important as my physical health, and I need to practice just as much self-care in nurturing my emotional resilience as I do resting and looking after my body. I will grow stronger both physically and mentally over the coming weeks and months, and I will need to also make adjustments in my life, both physically and mentally. Once again, I need to ensure I'm not too hard on myself, and I give myself time to find my 'new normal'. So I shall go back to class this week, and try to be as strong as possible, and it will get easier each week. And who knows, I may even paint something awesome!

My new baby fluffy hair

A biomorphic collage

Final chemo

A week ago I had my final session of chemotherapy. Hurrah! Almost 6 months after my first session I am finally done with what is largely accepted to be the worst part of this experience. Although I still have lots of treatment to come, this feels like a hugely significant milestone, and I am understandably very happy to see the back of it!

Hooked up for the final time!

Of course I'm not really fully finished with chemo until it's out of my system and I'm through the side effects, but I'm feeling a little better each day already, and psychologically it feels brilliant to know that I won't be knocked down again in a couple of weeks, just as I'm starting to feel well again. I'm starting to look forward to having some more energy, to getting fit again after 6 months of relative inactivity, and to venture out into the social world once more.

The side effects haven't been too bad this time, perhaps it's a case of positive mind over matter, and I've been working from home over the last week. Each day I've tried to venture out at least once, for a little walk, to keep as active as possible, and I'm trying to sleep as well as I can. I've been eating nutritious, healthy food and taking Epsom salt baths most days to ease the bone pain.

My favourite bakery, Konditor and Cook, ran a competition this week on their instagram account, where they asked 'who do you think deserves a cake and why?'. I commented that my amazing husband Tanai deserved a cake for looking after me during chemo, and that it would be a great way to celebrate having the final round this week. Well, to my surprise, they agreed! So this weekend we picked up a delicious hazelnut and chocolate cake from their Waterloo bakery.

A lovely way to celebrate the end of 6 challenging months.

I'm preparing a long, candid and hopefully funny post about my chemo experiences, which I'll publish later this week. Next up for me is an appointment this Friday with my surgeon, when hopefully I'll get a date for my surgery and a plan for what will happen. They are going to remove what's left of the tumour and also take out a 'sentinel' lymph node from my armpit to check that the cancer hasn't made it into my lymph nodes (this is how the cancer spreads to other parts of the body). Hopefully it shouldn't be too invasive an operation, and I will recover in a couple of weeks. After that I will have a course of radiotherapy, and then some more tests to check that all the cancer has gone. I'm also going back to the chemo ward every three weeks to have a Herceptin injection in my leg, for the next year. In the meantime I'm taking tentative steps into the world of 'having a life' again, by starting a painting class this evening. I used to love painting when I was at school, but haven't really done any since then, so I'm going to see where my inspiration leads me and learn a new skill. Looking forward to it!

It never rains but it pours

Those of you who have known me for a while will know that I have a small reddish-purply skin tag on my left forearm, which has been there for about 6-8 years. It first appeared when I'd been living in Australia for a few years and has been sitting there on my forearm ever since. Early on I got it checked out by my local GP in Sydney and they advised that it was nothing to worry about, but that I might want to get it removed one day if it got irritating, as sometimes they can catch on clothing and they bleed profusely. Of course I never got round to getting it sorted out as there were always things higher up my list when I visited my GP (including a pesky lump in my right breast!).

Fast forward a few years and things are now critical. Over the last few weeks it has been growing steadily, from the size of a lentil to about the size of a kidney bean, and it has become more red and engorged. After my last chemo it started to bleed a lot and it's been impossible to deal with ever since. I have been covering it up with large plasters, to which of course I'm allergic, so now I also have a huge ugly-looking rash all over my forearm. Last week I went to see my GP about it, as the thought of keeping it under plasters until chemo is finished was making me feel upset, and I also wanted to check that there's nothing I should worry about. She took a photo of it on her phone and sent it to a dermatologist friend of hers who advised that I should get it looked at.

So this morning we found ourselves in the Dermatology unit at the Royal London Hospital in Whitechapel, a sister hospital of St Bart's, to finally get it seen to. (Yes, Nick, finally! You can stop nagging me about it.) We saw a lovely doctor who asked me a whole bunch of questions (How long did you live in Australia? Is there a history of skin cancer in your family? etc) and then took a look at everything. As soon as she saw it she immediately declared that she thought it was benign but that I should get it removed immediately and sent to the lab for testing. So that's what happened! After all these years it took a couple of minutes for a nurse to scrape and burn it off (after a healthy dose of local anaesthetic) and pop it in a tube to send to the lab. She was a lovely nurse and kept making jokes about how I was losing my best friend, that I'd been attached to for so many years. (Friend? Nemesis, more like!) So now I will have a small crater in my arm, kind of like a cigarette burn. Much preferable to what was there before. And I shall go back in 5 weeks for the results and to get a check up.

The Royal London Hospital

While the doctor was examining me she asked me about the obvious issues she could see on my mouth and my body. Basically I have sores all round my mouth and red spots all over my body. These have only appeared in the last couple of weeks, since my 7th round of chemo, and I just assumed they were because I was immunocompromised and that they would go away once I recovered from chemo. She agreed, but still said we could do something about them. She has taken swabs and sent those to the lab too, and given me some cream and tablets for them. She suspects mouth herpes (ah chemo, the gift that keeps on giving!) and some kind of bacteria forming the welts on my skin. It's all pretty gross, I know, but these are the realities of being immunocompromised: my body is susceptible to everything and I can't fight off any infection. So now I'm at home, very happy that the growth on my arm has been removed, once again delighted at how thorough the NHS are being about my health. I'm also hoping that I'm not in the business of collecting different types of cancer! We shall see on 11 October when I get the results.

I wanted to also add something to my last post. When I was having my heart echo test, the nurse left the sound on, so I could actually hear my own heart beating. It sounded different depending on where she placed the wand from the machine. I don't think I've ever heard my own heart beating before, so that was pretty cool!

More tests and trials

So last week I went to see the cardio-oncologist to get the results of my various heart tests. I was scheduled to have an echo test in the morning and then see the cardio-oncologist in the afternoon. I received a call from a research nurse asking me if I'd be interested in participating in a trial, to which I agreed (I'm always keen to contribute to medical science, as I am benefiting from it so much right now!). They were conducting a trial to see what type of heart test is the best type to use with cancer patients, so they wanted me to undergo a different type of test immediately before my echo test, and then they would compare the results. The trial test was an MRI heart test, where I had to lie in an MRI machine and hold my breath several times while the machine did its thing. Then I had my echo as expected, and then saw the cardio-oncologist. All the tests so far (including the heart monitor) show nothing out of the ordinary, so they are puzzled about my symptoms. They are going to investigate further, fitting me with a heart monitor for a whole week once I've had my next chemo, and they want me to come back and ride an exercise bike while hooked up to a heart monitor. Once again, I love the NHS for being so thorough, and it's good to hear that it doesn't seem to be cause for alarm.

Then today I had my pre-surgery tests: a mammogram, an ultrasound and an MRI. I'll discuss the results with my surgeon on 22 September when we'll plan my surgery. I've described these tests before so won't go into too much detail, except to remark on something. For the MRI I had to have a cannula inserted into the inside of my elbow so that they could inject the contrast dye during the testing, and they always flush a cannula with saline once it's in, just to test it. And the weird thing is, as soon as they inject the saline into my vein, I can taste it in my mouth! Isn't that strange? Fun fact.

So although I won't get the results from these tests for a while, the doctor who did my ultrasound told me the dimensions of my remaining cancerous lump, and it's 15% of its original size! And I still have one final chemo to go. So while the main purpose of chemo is to catch any stray cancer cells that have spread to other parts of the body, it's also shrunk my tumour to the point where surgery will be much less invasive than it would have been back in February.

Tanai drew the tumour sizes from my three ultrasounds, the original one, the half-way one and today's:

So tiny, I can no longer feel it. Here's to getting rid of it completely.

Heart scans and more tests

This week I had my 7th and penultimate chemo, and I'm now at home over a lovely sunny bank holiday weekend, recovering and trying to rest. My aunt Siobhan came down from Tunbridge Wells to join me in the hospital and she treated me to a relaxing hand and foot massage when we got back to the flat afterwards. I felt thoroughly pampered! It was so lovely to have a natter with her and catch up. An unexpected positive side effect of chemo. The other, not-so-positive side effects are kicking in now and I'm being gentle with myself, giving myself time to get well again. It's hard sometimes to look out of the window at the blue skies, hear the carefree laughter of passers by enjoying their summer long weekend, and not feel a little cheated by it all. But I know that this too shall pass, and I will have the opportunity to enjoy sunny long weekends again in the future. In the meantime I should rest, relax, heal and not be too hard on myself.

Since moving onto the new drug regime (which I've had for the last 3 rounds) I've been experiencing some heart palpitations which intensify about a week after treatment. I mentioned this to my oncologist on Monday so he has referred me to a cardio-oncologist to get my heart looked at. Although I have a Heart Echo test every 3 months to check that the Herceptin isn't having too strong an effect on my heart; as the nurse said at my last test, 'that's the plumbing, not the electrics'! So on Thursday morning I went back to St Bart's to have a 24-hour heart monitor attached. This consisted of three large circular patches, stuck to my chest and either side of my ribcage, which were each attached to some wires which then fed into a little box which clipped to my waistband. I had to wear it for 24 hours underneath my clothes and carry on as usual. I then popped back on Friday morning to take the kit back. Unfortunately (or fortunately, depending on how you look at it!) I didn't experience any major palpitations while I was wearing the kit. So we'll see what the results are. I have to head back into hospital on Tuesday afternoon for two different kinds of heart tests and to see the cardio-oncologist to assess the results. Once again, it's wonderful that the NHS are being so thorough at making sure I am okay: I feel as though I'm in safe hands.

Wearing my heart monitor

Today is quite a significant date, as it's exactly 6 months since Tanai and I were in a doctor's room and first heard the words 'you have a breast cancer'. I feel as though it's a milestone. Psychologically, perhaps in an attempt to contain what I'm going through, I have been thinking of this whole thing as 'pressing the pause button on life for a year'. I know it's much more complicated than that, but I want to ensure I don't feel bad about 'opting out' of things for a year while I go through treatment. It may take longer than a year, but at the moment that's how I'm looking at it. And I'm on track. So today is the half-way mark. From now on, I'm nearer to recovery than I am to diagnosis, and that feels good.

Only one more chemo to go! I know that a couple of months ago I never thought I'd get to this stage, so I feel very happy about this.

Siobhan enjoying the frittata and salad I made for our hospital picnic

Outside King George V building heading into chemo

Home to a relaxing foot massage

Collecting hair inspiration for when my hair starts to grow back