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!