Discharged! In the Bart's quad
However, it's not quite that simple. For one thing, I still have plenty of medical appointments in the diary. There's my monthly Zoladex injection to suppress my ovaries. There's the Zometa every 6 months to help my bones. I'm still visiting the menopause clinic every 4 months to check up on how I'm going with that. And I'm still seeing the lymphodema clinic about my swollen right arm and hand.
But the biggest hurdles I have in front of me will be two lots of surgery next year, and preparation for these has progressed quite a bit over the last few weeks. As I carry the BRCA1 gene mutation (I explained more about this here) I am going to have an oophorectomy on Thursday 28 February, at the Royal London Hospital, where a team of surgeons will remove my ovaries and fallopian tubes. I have had some pre-op scans (apparently my ovaries are looking very fine and healthy, woop woop!) and some other tests. I have also been seeing a biokineticist to prepare me for the operation and ensure I am as strong as possible going into it, to enable me to have the best possible chance of a good and speedy recovery. I am doing a series of exercises every day to help strengthen my core and my back.
And on Thursday 19 September I will have a double mastectomy, removing both my breasts completely, as a preventative measure, because my chances of getting another breast cancer with this genetic mutation are 80%. This will be at St Bart's. I met my surgeon, Miss L____, on Tuesday this week (the same surgeon who originally told me I had breast cancer, and who carried out my lumpectomy in October last year), and we discussed a few things and set the date. She is as humourless as ever, and despite me indicating that I did not want reconstruction, proceeded to talk me through my reconstruction options. There is an assumption in the medical world that women, especially young women like me, will want their breasts reconstructed, and it's really hard to convince them that this is not necessarily the case. She even used the expression 'to make you look like normal'. As you can imagine, I had to bite my tongue! So I let her talk me through the options, and all the potential problems that can occur with each one. Firstly there is the silicone implant option, and she let Tanai and I hold a teardrop silicone implant to feel how 'realistic' it felt. As soon as I touched it I knew that I didn't want something like that inside my body. And then when she outlined the potential complications (it can rotate and look weird, it can cause cancer, it can rupture, it can infect the tissue around it, it requires regular maintenance including follow-up surgery etc) I knew even more firmly.
Next she made me take my clothes off and squidged my belly, before declaring that I didn't have enough belly fat for her to fashion two breasts 'at my current bra size'. I took that as a compliment, I have been losing my chemo weight quite efficiently! So then she looked at my back muscles, and explained how they could preserve the skin from my breasts, and then refashion breasts from belly fat or back muscle, and give me new breasts with the old skin and nipples. Again, I shuddered at the thought of this hugely invasive surgery, with its prolonged recovery time, and the potential complications including severely restricted mobility in my arms and shoulders (no more yoga, cycling, swimming!). After hearing all my options, I said again that I'd like to remain flat, and that I've even joined a facebook group called 'Flat Friends' where there are all sorts of amazing women who have had single or double mastectomies and have chosen to remain flat, and I am receiving lots of advice and support from them.
So in order to proceed I have to jump through a few more hoops. I have to discuss my options once again with the Breast Care Nurse team. They have to refer me to a psychologist and only after they have cleared me will they agree to carry out the surgery without reconstruction. What a rigmarole! But I will proceed and when I see the surgeon again in May I will be more emphatic about my decision. We have chosen September as my surgery date because my dissertation is due in August so I thought I'd get that out of the way before having my op.
I will have to take a few weeks off work after each operation, to recover, and I'm going to make sure that I properly recover this time, instead of going back to work too early and making myself ill, like I did after my first breast surgery. All offers of home cooked food and visitors while I'm convalescing are very welcome.
Just before I left the appointment I shook Miss L___'s hand and apologised to her that I was going to ruin her handiwork. She did such a fantastic job of my first surgery and the scar is so neat, but now we're going to be getting rid of it all! I think I did finally raise a glimmer of a smile; she may have even laughed a little. I call that a win!
But with all this ahead of me, you can see why I wasn't so jubilant today at receiving my discharge notice. This year has been a wonderful year of recuperation, rest, holidays, recovery and building up my physical and mental strength. 2019 is going to be another challenging year of treatment, plus the intensity of finishing my masters, but I'm feeling very positive about my surgery decisions, and I'm looking forward to being done with it all, and able to just get on with my life. And to develop a new style once I'm a flattie!
