Ready for surgery

Tomorrow is my surgery date for my double mastectomy, so I thought I'd give you a summary of the build up and what I can expect. I saw my surgeon again a few weeks ago and we went through the final prep. It was quite funny actually because she had a student doctor with her and so was using me as a teaching tool. I've been naked in front of a gazillion people over the last three years and I don't have a shred of pride left, so I'm more than happy for someone to learn from my body and my experience. So I stripped off from the waist up and my surgeon asked the trainee 'so what can you tell about this lady before you've even examined her, just by looking?'. The poor girl didn't know where to look, and only glanced in my direction before offering a tentative, 'She has one breast bigger than the other?' My surgeon was not impressed. She pointed at my small radiotherapy tattoo, the one in the centre of my chest. 'What is this?' she asked the student doctor, who muttered that she didn't know. 'That's a radiotherapy tattoo. And if you look at the sides of her rib cage you will find two more. This tells you she's had radiotherapy. Can you tell where she has had radiotherapy? Can you see that her right breast is still red from the radiotherapy?' She then pointed at my scar from my first surgery, which the trainee had failed to notice (to be fair, it's pretty impressively neat and inconspicuous). 'And you can see from this that she's had breast surgery before. And if you look under her armpit you'll see the scar from where she's had lymph nodes removed. All of this you can see before you've even given her a physical examination.' The poor girl was by now red with embarrassment. Looks as though she has a lot to learn!

About a month ago, I had my follow-up appointment with the psychologist, to ensure I was cleared for surgery. We had a lovely chat and she sent a very detailed summary to my surgeon, saying 'I see no psychological reason why she would not be a good candidate for surgery'... and 'she explained that her breasts have not been a big part of her identity through life and mastectomy surgery would therefore not result in a significant change for her in terms of body image and identity'... and 'following my meeting with Carmel my impression is that she has made a considered and informed decision with regards to surgery and has the internal and external resources to help her adjust to this and associated body changes'. So there we are! I'm green lit to have my breasts removed and not have reconstruction.

I also had to have my bloods taken, and swabs of my mouth, nose and groin to check for MRSA.

At my pre-op prep appointment, the nurses gave me a bottle of Octenisan body wash, which is a hypoallergenic antiseptic wash, and instructed me to use it for a few days before and after surgery. This evening I washed my hair with it, as well as my body, and I have to wear clean pyjamas every day, and wash the bed sheets every day on a hot wash. I also have to brush and floss my teeth and use a new toothbrush every day for a few days. This is to reduce the chance of infection. I also had to remove my toenail polish and I am not allowed to use moisturiser or deoderant tomorrow. And I'm nil by mouth from midnight.

Last week we went on holiday to the Isle of Skye for a week, to visit my dear friend Jill who is over from Australia visiting her parents. Jill has been so supportive during my treatment and kept me amused during chemo with tales of her funny son, Billy. Well this week we got to spend a good amount of time hanging out with them both, and experiencing Billy's comedy first hand. It has been a magnificent, restful and restorative week and I'm feeling ready for tomorrow.

In the magic light on Skye

Today I had a few deliveries of things I'd ordered online, including a large U-shaped pregnancy pillow to help me sleep when my wounds are new, and a huge online food shop so that our cupboards are stocked up. I've also got two heart-shaped pillows from the volunteers at 'Jen's Friends' who sew these pillows which you hook over your shoulders and they prevent your arms from irritating your wounds. A few weeks ago we went to 'Cook' in Maida Vale, as my magnificent former colleagues in Australia had sent me some vouchers to spend. They make posh frozen meals basically, so our freezer is full of yummy 'homemade' food which should make the next few weeks easier. I have a rota of my friends here in London coming to make lunch for me for the next 2 weeks as Tanai needs to get back to work as soon as possible this week and I'm not allowed to lift anything for a few weeks. As this is my third surgery this year, he's pretty much used up his compassionate leave, (and some!). I'm so lucky to have such a fabulous, global network of friends helping support me through all of this.

So tomorrow I have to be at the hospital at 7am, and apparently I'm first on the list. Of course, I could always get bumped if there's an emergency, as mine is elective surgery, but hopefully it will all go smoothly as planned. I'll be in overnight and then home and glued to my sofa for a few weeks. I'm just packing my bags now and then I'll try to get an early night. We were hoping to get our Christmas tree up today but they didn't have any stands in the shop, so we'll have to do it at the weekend. This means Tanai will bear the brunt of the decorating responsibilities (and I'll have to direct them from the sofa).

I shall keep you posted on instagram as to my progress!

At home recovering

Reading over my last post, I sounded a little down, which I think is understandable given that I was in so much pain, feeling incredibly sleep-deprived, and completely immobile. Now that I am home and slowly regaining my strength, my spirits are also rising. It's so great to be back in my own bed, although I'm having broken sleep, and I'm still not able to really do much more than occasionally move from the couch to the bathroom and back. I'm slowly regaining my appetite, and the doctor has recommended I eat a protein-rich diet to help my wound heal, so I'm trying to make sure I eat lots of protein. I have a craft project on the go, as I'm still not really ready to focus on reading a book just yet, and I'm listening to the fifth Tales of the City book on audible. Tanai is working from home this week and basically doing everything around the house, as I'm not allowed to lift anything and can't even bend over to pick something up off the floor. He's being a total legend.

Eating lunch at home

I want to take a moment to acknowledge how incredible our NHS is. For those of you not UK-based, this is the National Health Service, a 70-year-old institution funded by our taxes, which provides universal healthcare free at the point of delivery for all people residing in the UK. I received all my treatment for breast cancer through the NHS and now I'm having my ovarian cancer treatment with them too. I haven't paid a penny and won't need to pay anything, which I know differs markedly from the healthcare provisions in other countries. Having cancer is stressful enough without having to worry about getting into massive debt to pay for healthcare! Yes, their systems and processes need updating (it's very paper-based) and they are being run into the ground due to chronic underfunding by the Tory government and a major shortage of nurses due to Brexit, but it's still (just about) creaking on, and I am so incredibly grateful. They are saving my life for a second time.

I stayed in hospital for 6 days after my surgery. Each day the NHS worked like clockwork around me and the other patients on my ward. I had my temperature and blood pressure checked hourly in the first few days, and every 3 hours once I had stabilised. The doctors did their rounds in the morning, assessed me, and revised their judgements about when I should go home. My bed linen was changed every morning and I had a little wash and donned a fresh gown. All my meals were provided, as well as regular coffees, teas, hot chocolates. The food is a bit like school dinners, and consisted mainly of overcooked, bland vegetables with questionable meat, but it was nutritious, and also free. The nurses work in 12-hour shifts, a day team and a night team, so there is round the clock care. I had a buzzer on my bed which I could press at any time, and a nurse would come and attend me, so when I was feeling incredible pain at 3am, someone came and brought me liquid morphine to ease the pain. My wound dressings were removed by two student nurses under the supervision of the ward nurse, which they did very well, and they thanked me for allowing them to get experience doing this as it all counts towards their nursing qualifications. And when I was discharged, I was given a massive bag of meds: 3 different types of pain relief to last me 7 days, the rest of the course of antibiotics they have put me on, some tablets to prevent stomach ulcers due to the pain relief, anti-sickness tablets, and 28 little injections that I have to inject myself in my belly for a month to prevent blood clots (due to being immobile). Once again, no payment exchanged hands for these. 

They do so many thankless tasks, changing my bag of pee when I had a catheter, turning and lifting people who are immobile, dealing with people who are cranky and distressed, and in one instance, racist (the lady next to me was on the phone complaining to her husband about how 'all the nurses were blacks'!), and they are paid in some instances less than the London Living Wage. It makes me so angry that we live in a culture which values care work and other vital professions, such as teaching, on such a low level, and yet values other types of work (eg banking, politics) so highly. Our society relies on people in the caring professions to have some kind of 'vocation', and to do the job because they love it, not for the money. This is fine, I've never been particularly motivated by money, but you need to pay people a decent living wage. One of my chemo nurses quipped that she would be better off getting a job in retail as it pays more and is less stressful than nursing! And this is being borne out by the numbers of people leaving the profession, and the reduction in people applying to train. Last year there was a shortage of 70,000 nurses applying for job in the NHS. Brexit has a lot to do with this, as Europeans are uncertain of their rights to work here, but also other non-Brits are feeling less and less welcome in the UK. I would say, over the two years of being treated for cancer, around 10% of the people caring for me have been British. The NHS would fall apart without migrant workers, and that is exactly what it is doing. I am witnessing it crumbling from the inside. The nurses and doctors are all so overworked, you can feel the strain on them of being short staffed. They are all having to cover each other's duties and it's taking its toll. It's incredibly tragic to see, but with the continuing conservative governments and their ongoing privatisation of NHS services, I don't see how this trend can be reversed. I feel lucky to be getting my treatment in the twilight years of the NHS, and hope that I can once again be cancer-free before it totally falls apart.

I'm going to post a photo of my scar at the bottom of this post, so don't scroll down if you're squeamish, as it's quite a Frankenstein-esque scar! I have 42 industrial-sized staples in there, which I need to get removed at my GP on Friday. Then next Wednesday I go back to clinic to see my surgeon and find out the pathology of all the elements they have removed, and get the next steps. Until then, it's a glacial recovery, slowly getting stronger and more mobile each day.

 What a scar!