Finally, somewhat of a plan

This morning was results day, so Tanai and I arrived at St Bart's somewhat bleary-eyed after a late night (at a great Sampha gig) and broken sleep. I felt very calm and eager to find out what's what. So, here we go.

There's a lot of good news and I'm generally feeling very positive. I have a tough few months ahead but my inner project manager is kicking in, and soon I'll have a proper plan (complete with spreadsheets and gant charts, ha ha).

Thankfully, my left breast is fine, and the small lump in my right breast is benign, so the only cancer is the large lump in my right breast. It's a ductal carcinoma grade 3 (which means that it's a cancer in my milk ducts, looks different to normal breast cells and is fast-growing, or 'aggressive'). It's oestrogen receptive 7 and they're still waiting for the HER2 receptor results. This is relevant to deciding which drugs will be most effective to nuke the cancer.

I was expecting to have surgery first and then additional treatment, but my surgeon is advising me to have a course of chemotherapy first and then surgery. This is primarily because this cancer is likely to be receptive to chemo and hormone treatment, so it could be significantly reduced in size and may even be nuked completely by the drugs (although unlikely) so this is the best way round. They are making me an appointment with an oncologist for next week where I will discuss my chemo schedule, but it's likely that this will begin in a couple of weeks. They are also going to give me Pertuzumab which is a new drug only recently licenced, which is pretty cool. (I'm not used to being an 'early adopter' but why not start now!)

The general schedule for chemo is once every 3 weeks, for 6 rounds, which will pretty much take me through the summer (fun times!) and then some more tests and likely surgery in the autumn (September-ish). Hopefully the chemo will have shrunk the tumour to a teeny size so the surgery won't be too bad. When they remove the lump they will do more tests on it, and check my lymph nodes at the same time. Depending on the results of those tests (which will determine if it has spread) I may have to have a) more surgery, b) radiotherapy or c) nothing at all.

So, first things first. On the way home from the hospital Tanai and I stopped by St John's Bakery and got a couple of lemon cream-filled donuts to have with coffee as we digested the news. When life gives you lemons, eat delicious lemon cream-filled donuts!

My initial thoughts are very positive. It feels containable and treatable. It's also highly likely that I can continue to go to work while having chemo treatment, and with a combination of strategic allocation of my one day off a week, and timing of treatment, I could end up having minimum time off. It's likely that I would need to take a chunk of time off after surgery (eg 6 weeks) in the autumn but the doctors don't know for sure yet. And of course I don't know how my body will respond to the chemo so a degree of flexibility will have to be involved.

My surgeon, Miss L___, followed up her news about my results today with, "So of course, we will have to talk about fertility treatment..." I'd barely let her get the words out before I said "No we're not, we don't want kids!". She was a little taken aback. I suppose most childless women my age who are diagnosed have an initial response of "Will I still be able to have kids?", and they have various strategies to increase the possibility of future conception, such as egg harvesting. It's probably rare that someone is as blunt as I am, and blurts out that my only worry is that the hormone treatment interferes with my birth control and I accidentally end up pregnant! Poor Miss L___, my style is far too direct for her. I wonder if she will mellow a little over time.

Anyway, the news is still fresh, so I'm going to digest it today and have a low-key weekend working out what the practical next steps are. Buying wigs, etc. My style is to keep going, be honest about things but be positive and encourage people around me to be positive too, but I also need to develop a good way of assessing whether or not some days I'm better off staying at home and just letting myself have a Shit Day.

I'm not underestimating how huge this is, I know that chemo is a bastard and I've got a tough few months ahead, but I'd like to try to keep going as much as possible and I know that I have an amazingly supportive network of friends, family and colleagues around me. And of course Tanai is being awesome as ever. Now that we've eaten our yummy donuts he's gone off to work and I am going to enjoy the rest of my day off doing some Life Admin and trying to catch up on emails. I've had some lovely messages from people far and wide with really supportive and encouraging words. I will try to respond to everyone, but know that your positive thoughts are reaching me and giving me strength.

Cx

On becoming aware of my own mortality

Ralph Waldo Emerson once said, 'When I read a good book I wish that my life were three thousand years long'. As many of you know, I'm an avid reader (I'm on Goodreads here) so one of my random thoughts over the last couple of weeks has been: 'Gosh, I need to become more selective about what I choose to read, as time may be short, and there are so many books still unread'. I think that was my slightly circuitous way of expressing a new awareness of my own mortality.

Until now, my mortality has been a fairly abstract thought. Of course, it's not a new idea: we all know that we will die someday, but it's not until this moment that I believe I've truly understood the concept. Perhaps this sounds a little cliched, but once you stare death in the face, the world appears completely different. Even if I had ever tried to intellectualise it before, I could not grasp its true meaning.

And it manifests itself in different ways. This weekend, we are heading to Heidelberg for a short break, to visit some of my family who live there. Over breakfast I was explaining to Tanai that my uncle Paul retired last year, and I'm looking forward to finding out more about how he is enjoying his retirement. Last time I visited Heidelberg he was just about to finish his job and was planning to pursue all sorts of interests with his new-found free time. Tanai ruminated on the subject of retirement, and concluded that he, too, is looking forward to retiring, and the freedom it will bring. Suddenly I paused, and thought: 'I hope I'm still around when you retire so that we can enjoy it together'. This feels quite shocking for me: I've never been maudlin, or thought extensively about my own death, and to experience these reactions is new to me. When I shared my thoughts with Tanai he confessed he'd also felt similar things recently. Often, we will talk over breakfast or dinner about our plans or dreams for the future. And yet, recently, we have both (consciously or subconsciously) avoided discussing too many dreams far into the future. We cannot say for certainty what our dreams or plans are for when we are old, as we no longer know we will be old together. 

This is not to say I've suddenly become morose or convinced I will die soon. I remain pragmatic and optimistic and keen to overcome this new setback, but it's still an interesting revelation. I suppose I'm now aware of a potentially changed timetable; a sense of urgency where before I felt I had plenty of time left to do the things I want to do, and for Tanai and I to have all the adventures we wish to have together. I suspect it will lead to a reassessment of my priorities. I understand now why many people who have beaten cancer have a renewed sense of vigour, and often completely change their direction in life. Therefore, it has brought about a time of contemplation in me. I have been reflecting on where I am in my life, and how I feel about my life choices.

Happily, I think there is very little I would change. I'm feeling fulfilled in my job, my studies, my relationship and (for the little time left over for it) my social life. I have a huge capacity for friendship and cherish my friendships with people all over the world. Of course I'd love to have more time and money to see more of my friends more often, but I do as well as I can. I'm glad I took a gap year a couple of years ago and fed my soul with some solo travel. And I'm finding my masters degree incredibly rewarding. I don't have regrets and can't point to something significant that I wish to change. I suspect the impact of this growing awareness will be more subtle, and perhaps more fundamental.

Essentially, life feels to me more precious, more fragile than it did before. Moments are imbued with more value, and I do not wish to waste any of them. Therefore, I don’t want to spend my waking moments scrolling through a litany of Trump’s latest imbecilic actions, or frittering away evenings on things I’m only half-hearted about: instead I wish to use the days of my life wisely. Yes, I wish to read good books; to be absorbed in great art and culture; to travel to new places; to spend time researching things that interest me, seeking new knowledge, wrapping my brain around concepts and discovering great writers and thinkers. I wish to spend delightful weekends experimenting in the kitchen with my favourite sous-chef. To enjoy long, languorous evenings drinking wine and talking shit with my wonderful friends. 

Life is a series of choices, and suddenly I’ve become a lot more selective about what I shall choose.

New considerations

Last night we had a huge fundraising event at work, our biannual gala which raises a significant amount of the budget we need to do our charitable work. It's one of those events where everyone spends months working their arses off in the lead-up, and then in one night it's all over! It's a glittery, starry affair, featuring entertainment and a fancy dinner, and the fundraising elements include a live auction, a silent auction and a raffle.

It was only when I was trying to decide on my outfit that I realised that I ran the risk of having nothing to wear. The dressings from my most recent biopsies extended out into my cleavage and quite high on my chest, and almost all of my 'dressy' dresses are V-neck or at least a little bit cleavage-revealing. I suppose I've always opted for flaunting my assets (ie dresses that accentuate my lovely boobs and small waist) and hiding my bum/thighs (I often have a very 50s style). In fact, I found only 2 frocks which had a high enough neckline to cover the dressings and not cling to, and therefore reveal, the pressure bandages! Hmmmm, I hope a complete wardrobe change is not required in the future. So I popped one on, slapped on a bit of make-up and pepped myself up for the evening.

Pre-event toilet selfie!

I had actually toyed with the notion of bowing out and not working the event, but I'm really glad I persuaded myself to go. It was a fascinating evening and so intriguing to see a live auction in action! Part of the reason I wavered was because my manager took me off the official list of helpers, so I didn't have a specific task for the evening. I'm sure she was doing this to protect me, to make me feel like I wasn't pressured into coming if I didn't want to, and to prepare me for the inevitability of the future, where I will probably have to duck out of work events and projects, but it actually ended up making me quite upset. I felt as though I was being pushed out before I even have my prognosis, as though she is being practical and taking me off projects already, knowing that I will probably be out of action work-wise in just a few weeks, or because she now sees me as unreliable. I take so much pride in my work, and I'm so dedicated to my job and my team, I took this quite badly, feeling useless and unappreciated. I know this is my own issue, and I'm extremely grateful to my workplace for being so flexible and understanding about my diagnosis, but I couldn't help my emotional response.

The other new feelings I felt during the evening were about the fact that a small handful of people at work now know about my diagnosis, even though I've not made it completely public. So a couple of them came up to me during the event and discreetly said lovely things like 'I heard your news, I'm so sorry'. I wasn't prepared for how much this would hit me: I felt a prickling behind my eyes, the shock of hearing the news anew. I know they mean well, and again, I'm so grateful for their support and positive wishes, but it's a new feeling for me to be on the receiving end of this sympathy; this pity. I was then very conscious for the rest of the evening of the differentiation between those colleagues who know and those who don't. I felt self-conscious when smiling or laughing with colleagues or guests, and being observed by people who knew my news. And the worst of it was, feeling terrible for the potential negative impact my presence had on those who knew. I started to think that perhaps I had been taken off the list not for my own sake, but for the sake of others. Those who don't wish to be reminded of my situation. Those who don't want a dampener put on a celebratory, fun evening.

I'm sure this isn't the case, but I'm intrigued by these new feelings, these new considerations, and I'm committed to documenting this journey with honesty, so there it is. Let's see how these feelings progress as my news becomes more widely known, and if I develop better coping mechanisms as I repeatedly experience the response of others. I know I somehow have to try to find a way of prioritising self-care over protecting the feelings of others. I think this is going to be quite a challenge.

In the end, I snuck off shortly after midnight, when the evening was winding down and the staff were starting to feel relieved of their duties. I know that the night kicked on until quite late, but I just wasn't feeling it. In a way I wish I'd summoned up the energy to celebrate and dance with my colleagues, but these complex new thoughts are somewhat getting in the way of unbridled enjoyment.

Vacuums

Today I was back at St Bart's for some new biopsies, as my tests thus far have proved inconclusive (see previous post). My radiologist today was Dr D___, the first male doctor to treat me and definitely the most formal. So far, every single NHS employee who has met me has looked me in the eye and said 'Hello, my name is...' and used their first name. (Which, as an aside, has an incredible effect on me. I feel like a real person and not just someone on a conveyor belt. It creates a connection, however fleeting, and does wonders for your wellbeing.) This chap said 'Hello, my name is Dr D___', surname, not first name, so I knew there was no messing with him. Business rules apply.

I still had my usual cheery disposition though. For some reason, I have no idea why this happens, I put on this kind of goofy cheery persona when I'm seeing medical professionals. I almost apologise for being ill and taking up their time, and laugh at how silly this all is. I marvel at the science behind all of their medicine, asking loads of questions and being inquisitive about the details, while looking away during any procedure. Perhaps this is my nervous way of coping with it, but I'm sure it comes across as a little strange.

Today's biopsies were different from the previous ones, as these were 'vacuum biopsies'. They used a bigger needle than last time (we're talking industrial size, the length of your forearm and thicker than a fork prong) that was hooked up to a computer, which vacuumed out slices of tissue (ew, gross). I had the usual series of local anaesthetic beforehand so it was pain-free but the noises were weird. No clicking this time though. Afterwards the doctor put 2 little titanium clips inside my boob to mark where they'd taken the biopsies, just in case they need to go back in, or operate. Bionic woman!

No results today, so I'm back at home and catching up on some work. 

Here's a photo of a knackered looking me on the sofa with a bag of frozen peas pressed against my boob. Classy.

Today as we left the hospital Tanai declared that he's decided my pirate name is 'Black Boob Carmel', in honour of my incredibly bruised boob. He has a fantastic ability to make me laugh, even when things are shit. When I asked him what I should call this blog he thought about it for quite some time and then replied, in all sincerity: 'The Inevitability of Biology'. He's such a dork, but I love him, and I feel strong through this with him by my side.

Cx

Delays

Today was supposed to be results day, but it didn't quite work out that way. Tanai and I arrived at St Bart's promptly for my 9am appointment with my surgeon, Miss L___, but it didn't go to plan. She didn't yet have the report from Wednesday's MRI scan and apparently some of the biopsy results were inconclusive, so it's going to take a little while longer to know what is going on. She is fairly certain that the large lump is a cancer, but the results from the small lump are inconclusive, so I have to have another biopsy on Monday 20 March. This one will be a different kind (a vacuum one, hmmmm), and then I get my results on 31 March. THREE MORE WEEKS OF WAITING! Argh!

But apparently the results from the cells taken from my lymph node in my armpit were clear, which indicates that it's unlikely that the cancer has spread too far, which bodes well. I'm trying not to get too optimistic, but I'm certainly feeling more positive today. She is going to book me in for a provisional surgery date in April so at least I have a vague timeframe now.

On the way out of the hospital after a frustrating morning, we popped into the hospital museum. Yes, due to its fascinating history, St Bart's has a little museum, filled with medieval medical instruments and incredible facts. For example, I had no idea that, upon returning from Afghanistan, a Dr Watson met a certain Sherlock Holmes in a lab at St Bartholomew's:

Or that in the 1700s, the hospital had its own brewhouse, and patients drank beer as part of their diet (which was considerably better for them than the water of the time). Here is a malt shovel from the hospital's brewhouse:

There are also two magnificent Hogarth paintings on the stairs, one of the Good Samaritan and one of Christ healing the sick:

I wasn't as impressed by the amputation instruments from the 1500s, they looked pretty gruesome. On the way out of the hospital, we also realised that William Wallace, who fought for Scotland's independence in the 1200s, was hanged, drawn and quartered on a site very close to here:

Such a fascinating, history-filled area. Plenty to distract myself with while I play the waiting game for another three weeks.

Testing, testing...

This afternoon I went back to St Bart's for an MRI scan. This is a very interesting scan where you are placed in a kind of huge tube and they take detailed images of the inside of your body using strong magnetic fields and radio waves. It's all very sci-fi.

First I had to take all my clothes off and get gowned up. You have to take anything metal off, as it could react badly with the strong magnetic fields, but I could keep in my titanium belly button ring because titanium is not magnetic. It's so ridiculous, I got my belly button pierced at a music festival when I was about 16, and I've never taken it out since then! And it's not as though I go around wearing crop-tops and hip-height jeans any more. But I have just never bothered to take it out. Oh well, it can stay in for at least a while longer, an ode to Teenage Indie-kid Carmel.

A very friendly nurse put in a cannula, which I was not expecting, as they planned to feed some dye into my veins so that certain tissues and blood vessels show up more clearly. Apparently, because I am young, my breast tissue is quite dense, so MRIs show things more clearly than ultrasounds. I was pretty rubbish when the cannula went in. I mean, I'm pretty rubbish in general, I'm so squeamish! I can't even watch medical dramas on TV, they make me feel nauseous, and I'm terrible at visiting people in hospitals. I almost fainted today when the nurse put a vial of saline through the cannula to test it. He had to fan me with his clipboard! Ha ha. What will I be like if I have to have months of full-on treatment? Rubbish, that's what I will be like. Anyway, one step at a time.

So then I went to the MRI room. I had to lie on my front and put my boobs through two holes in the bed so they hung down. If you haven't had an MRI they are kind of weird. They don't hurt, and if you're not claustrophobic (which I'm not) they are totally fine, but they are incredibly loud, and make hard, repetitive noises kind of like really shit house music. So you have to lie there, in an enclosed space, enduring these weird loud noises, and after each cycle the nurses call over the tannoy (they are in the next room, operating the machine (and even the dye in my veins!) remotely. They were so lovely, checking in with me to see if I was okay, and telling me when we only had one round to go. I just closed my eyes, tried to breathe without moving too much, and attempted to make songs from the beats I was hearing.

So only two more sleeps and then we find out what the hell this is and what the plan is to beat it. I'm feeling resigned, calm and prepared. Whatever it is, bring it on, and I'll fight this thing!

In limbo

I don't think any days in my life have ever felt as though they are passing as s.l.o.w.l.y. as the last few days... Today is Tuesday and I still have 3 more days until I go back to St Bart's for my test results. I've been keeping myself busy at work and at home, and the wounds from the biopsies are slowly starting to heal. I've been cancelling most of my social arrangements and just keeping things low-key. Tanai and I have been coming home, cooking yummy, healthy dinners and having a quiet few days. We didn't even leave the flat once on Sunday! Lazy. But it feels good, I am looking after myself, trying to prepare myself for what's coming, and taking some time to talk things over with Tanai.

Although I've decided not to tell people until I have my proper diagnosis, I have reached out to a couple of friends who I know have experienced similar things. One friend's mum has just been diagnosed with cancer for the third time, and she was really supportive and made me feel less shit about burdening my friends with my news. Another friend had a tumour herself, and she told me she threw a 'reasons to be cheerful' party before her surgery (an idea which I'm sure I will steal!). And another friend in Australia whose mum had breast cancer and kicked its arse, has recommended me a book about the choices you have to make, and being informed when you make those choices. I'm about a quarter of the way through that book, and it's definitely helping me feel more informed. Tanai has been doing some research too, and I'm hoping he will ask most of the questions on Friday. He is a scientist after all, and approaches these things in a different way to me! Between us we have our bases covered.

Things we have been talking about this week:

Q) How do I feel about having one or both breasts removed?
A) To  be honest I am okay with that. I would rather be alive with no boobs than the alternative! And actually, although I have great boobs (they're really great, F cup, inorite!) they don't define me, and I certainly wouldn't feel any less of a woman without one or both of them. I had to read some of Audre Lorde's cancer journals for my masters studies recently, and she is pretty dismissive of boob reconstruction and the prosthetic industry. I would probably put something in my bra just to avoid being too lopsided (mainly to prevent others from feeling awkward!) but I'm not interested in having a fake boob, or preserving nipples or anything. Tanai agrees, luckily. Of course he likes my boobs, but he likes me even more.

Q) What about losing my hair?
A) Again, I'd just roll with whatever came. I have great hair, too, really thick and lush, but if I lost it, so what. I'd just get my friends to come over and teach me how to wear fabulous head scarves, or get some cute wigs. I've rocked short hair before, I can do it again.

We've also talked a lot about how to tell people. Tanai told his parents, which was tough. They both live in Colombia and don't speak English, so it's kind of hard for me to speak with them about this. But they are giving us both all their good thoughts and healing vibes. The thing I'm most worried about when I tell people is that they will start to treat me differently, or pity me. Urgh. I wonder how I can tell people while also guiding them to feel as strong and positive as I am trying to be. To still treat me like they normally do, and to not be afraid of saying anything that makes me upset (indeed, to not be afraid of me getting upset!). I think this is something I need to work on over the next few days.

After my biopsy I had dressings on my right breast which I was not allowed to get wet for a few days. I had to kneel on the bathroom floor while Tanai washed my hair over the bath. And I've been getting him to photograph my boobs each day as the bruise spreads, so that I have a document of everything. The bruising is pretty spectacular, all the colours of the rainbow! He is being incredibly supportive. Our relationship is relatively young, by most people's standards (we only met just over a year ago, and got married after 4 months, eloping to Vegas! Ha ha) but we are so close and I think this experience will probably bring us closer. We are having to have quite confronting conversations, and we have cried more in this last week than during the entire rest of our relationship, but we are being very open and honest with each other, gentle with each other, and hopefully this experience won't be too much of a strain on our relationship. It's not what we were expecting! Hell, we have 3 holidays booked this year that we may not be able to go on, but we'll just deal with it, and postpone some of our dreams.

I also told our head of HR at work, as I have to come up with a plan about how I am going to tell my team. She is amazing in general anyway, but in this instance was so helpful, supportive and wise. I didn't know but she has had personal experience with this, so not only is she supporting me in a professional way, but giving me very practical, specific advice too. I feel so grateful that I have so many wise, supportive people around me, and I know that once I spread my news wider, a strong support network will form around me to help me with this.

One of the other knock-on effects is that I'm being a little more conscious of my impact on others. I would say I'm quite a direct, sometimes brusque, person, and I don't suffer fools gladly. But over the last few days I have been more thoughtful of the time I give to others. The words of praise, encouragement. I feel as though I'm shedding some self-consciousness about being honest, and understanding with more acute awareness the emotional impact my actions have on others. It's a subtle change, because I think I kind of do this anyway, but it's an interesting discovery to note.

Okay, back to the waiting game...

I'm sorry, what?

So it all started in a fairly nonchalant way, as so many of life's most momentous events do. I had travelled to Colombia with my relatively new husband, Tanai, to meet his family for the first time, to roll out my terrible Spanish, celebrate Christmas there and to see the town where he was born. We were laying on a bed in his aunt's house in Monteria, Tanai's hometown, mid-December 2016, relaxing under the ceiling fan in the 35-degree heat, trying to move as little as possible so as to preserve energy (I'm not very good in hot climates!). Suddenly I felt a lump in my right breast that I'd not felt before, and it felt a little ominous.

"Tanai, check this out, do you think it's a lump? Should we get it looked at?" I asked.

We decided to get it checked out as soon as we were back home in the UK. Occasionally during the rest of our holiday my hand wandered to my boob, checking to see if the lump was still there, and it was, persistently.

We arrived back in London in early January but had to suddenly move house. What with essay deadlines for uni (I'm doing a Masters at the moment), finding somewhere new to live, actually moving house and registering with a new GP in our area, I didn't actually get the lump checked out by my GP until Friday 10 February 2017. Still, pretty swift moving, I reckon.

My GP decided to refer me to the hospital for more tests, "just to be on the safe side", which was why I found myself in the Breast Clinic at St Bartholomew's Hospital, near Spitalfields Market, this Monday, 27 February.

Let's take a moment to rewind about 8 years, when I was living in Australia, and I found a lump in my left breast. I visited a rather swanky clinic in Sydney and paid a few hundred dollars for a very painful biopsy, only to be told it was just a cyst, and I was fine. I naively imagined that this new lump would result in pretty much the same outcome, and when Tanai asked if I wanted him to come with me, I didn't think it was necessary. He insisted, and, in retrospect, how grateful I am that he was with me.

St Bartholomew's (affectionately known as St Bart's) is the oldest hospital in Britain still providing medical care, and was founded in 1123. Its funding was removed at the dissolution of the monasteries but King Henry VIII refounded it in 1546, and it was known as 'The House of the Poore in West Smithfield in the Suburbs of the City of London'. The Breast Clinic is in the West Wing, built in 1752 and situated through a rather grand old courtyard, but inside it's all modern, clean and efficient, with some lovely artwork in the waiting rooms. The place was packed with women of all ages, here for various tests, and we were warned it would take a while.

First up for me was the ultrasound. I was surprised as I'd been told in the leaflet I got in the mail that I would have to have a mammogram first but apparently they are not routine if you are under 40, so they started with the ultrasound. This is where they put some squidgy gel onto your boob and then use a hand-held scanning probe to scan your breast. You can immediately see the inside of your boob on the screen in front of you in black and white, which is pretty cool. My radiologist's name was Dr S___*, and she was really lovely. We casually chatted about art and culture while she scanned my boob, including her recent trip to Melbourne where she saw the Hockney exhibition at the NGV (with which so many of my Facebook friends back in Australia had recently flooded my feed!). She had also taken her family to see a recent show at the place where I work, called The Mad Hatter's Tea Party, a hip hop musical based on Alice in Wonderland, and they'd loved it. She was so lovely I almost forgot why I was there. She then said that they would like me to have a mammogram after all, so I was to pop back into the waiting room and someone would get me for that.

Mammograms are not much fun, if any of you have had one. They basically get a big machine and squish your boob between two plastic sheets so that they can take a 'flat' X-Ray of it. You have 4 X-Rays in total, two of each boob, at different angles. It's pretty uncomfortable, and you have to stay really still, but it doesn't last very long.

Then back to the waiting room for more waiting. Luckily, Tanai had brought his book and I had brought 2 essays with me that I had to read for uni, so the time passed. Then back to Dr S___'s room where she was going to take a biopsy.

Here's the bit where you look away if you don't like needles! There are several different types of biopsy, and I had 'stereotactic core biopsies'. A biopsy is where they take a large needle to take some samples of the lump inside your boob that is causing concern. These samples are then sent to a lab for testing. With a 'stereotactic' biopsy they use the ultrasound scanner on your boob at the same time, so that they can guide the needle into the right place. It helps them get the exact position so that you don't have to get the procedure repeated again (and believe me, you don't want it repeating!). First, they put two small needles of local anaesthetic in to numb the area, so that the biopsy needles don't hurt. Once it was numb, I didn't feel a thing. They make a loud 'click' noise when they're taking the samples, and Dr S___ and her assistant, F___, made sure they warned me each time I was going to hear a click.

They did 9 biopsies in total, which was a lot more than I was expecting, (5 from the big lump I had felt in Colombia and 4 from another little one which Dr S___ had spotted on the screen), and they then put a fine needle into my armpit to get some cells from a lymph node. That one hurt a lot, as there was no anaesthetic, but by then I was feeling very brave and just closed my eyes and breathed.

Then it was back down to the waiting room to wait for a consultant to give me the results. By this stage I was getting kind of suspicious. Everyone was being so incredibly nice to me, and kept asking if I wanted any water or a cup of tea. I mean, everyone knows the NHS is amazing, but really, this felt a little excessive. When the nurse (F___) came to get me, she suggested that Tanai come too. Then I was introduced to my surgeon, Miss L___, who checked my breasts and asked me some further questions about my health, before saying that she'd like me to come back on Friday 10 March to get the results of the biopsies, but that the lump was indeed very suspicious looking from what they could see on the ultrasound and mammograms, and that it's very likely that I have breast cancer.

Gosh, that's the first time I've written it out. In black and white. I have breast cancer. It's pretty shocking, I wasn't expecting to hear these words, or indeed to get such a diagnosis straight away, so it didn't immediately sink in.

Tanai asked some questions, and the staff were very lovely, but there's a limit to what they can tell us until we have the biopsy results next week. Now we just have to wait (what feels like forever!) to know the details, such as what stage it's at, and what my treatment plan is.

We walked home a little in shock, and got on with making lunch. I didn't go back into work as planned as I was feeling very sore from the biopsies (my boob is black and blue, I felt like I'd been beaten up!) and exhausted from the emotional rollercoaster. We simply held each other, talked a bit about it, cried a little, and tried to give each other as much support as possible. I had a movie to watch for one of my uni modules so we started watching that. And then we watched some videos on the Breast Cancer Care website about 'How to Tell Family and Friends about your Diagnosis' and I called my mum and my dad. Those calls were a bit strange as I didn't really have any facts to tell them, so I kept it brief and said I'd call them again when I got my results. And now I don't feel like telling anyone else. The only other person who knows is my manager at work, who has been incredibly supportive, and I've decided I don't want to tell anyone until I know what I'm actually telling them. It feels so speculative at the moment and I don't want people to worry if they don't have to. I know I will need to be strong for the people around me so I need to wait until I have a bit more information in order to do that.

F___ called back the same afternoon and said they've booked me in for an MRI scan on Wednesday 8 March. Because I'm relatively young (in comparison to most women who are diagnosed with breast cancer), my breast tissue is very dense, so the imaging on MRI scans is much clearer than on a mammogram or an ultrasound. So I guess this is for them to be very certain about it. I also had to pop back that afternoon for blood tests. All of the needles!

It's very strange, I've never imagined this would happen to me. And I've just reached a stage of my life where I'm so incredibly happy. In my work, my relationship, my home life, my studying, my friendships -- what a terrible blow. At my lowest moments I am heartbroken -- how can this happen to me? It's not fair! I'm so young! And then I know I can't think like that and I have to just be strong, and get through this. Cancer is a total lottery, I got (un)lucky. I took the tube to work the next day and was sitting on the train, looking around at the faces of Londoners heading to work, thinking 'I have a sad sad secret. What secrets do you have?'.

I was actually really thankful to be able to go into work. It's giving me something to concentrate on, to distract myself from negative thoughts, and believe me, I am concentrating hard. Occasionally a stupid thought will come into my head, like 'I need to write down all my passwords so that Tanai can log into things if he has to' and then I just feel silly, and dismiss the thought. We need to stay positive. We need to keep finding things to smile about, and laugh at. We need to still feel happiness in our day and not let this get us down. When I was crying over the Breast Cancer Care videos the other day, the stormy skies outside the flat cast a beautiful glowing light through the blind, and the daffodils on the windowsill made a lovely silhouette against the blind. I paused the video to point out the lovely image. I can't let this stop me finding the beauty in the everyday.

It's now Wednesday, two days after my diagnosis. I've been very busy at work. This morning I had to do a large presentation to 85 students from King's College, studying for their MA in Cultural Management. And then I had class myself at LSE this afternoon. Now I'm home and I've just put dinner in the oven. I have decided to start this blog as a record of my journey through whatever happens in the coming days, weeks and months. I don't really care if no-one reads it, but I think it will help me process what I'm going through, record my thoughts and feelings, and provide me with a bit of an outlet. And who knows, one day it may help someone else going through the same thing. So here it is, a blog I never thought I'd write: Carmel's Cancer Journey.

Cx

* Everyone in the NHS has been lovely, and most of them introduce themselves by name when you first meet them, and wear name badges. However, due to patient-doctor confidentiality, I'm not going to write any of their names in full on this blog.