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Wednesday 1 March 2017

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.

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