So, how did it go? Well, yet again I feel much better than I thought I would! I’m not really sure what I was expecting, but I certainly don’t feel like I’ve just had an operation!

Is it just me? Or is the way I feel reflective of why I’m writing this blog in the first place? People’s perceptions of cancer, what it’s like to have cancer, and what it’s like to have treatment for cancer – are they all over-rated, or am I just super lucky in how my body is responding to all this?

Who knows, but here’s how phase two is playing out for me so far…

 The boob job

To start with, things were delayed, so instead of going in on Tuesday for my pre-op, I had everything done on Wednesday. When they told me this, I was initially disappointed; if I had to do the pre-op on Wednesday morning, my surgery would be pushed later, reducing my chances of being able to come home the same day. But in fact, it made things better, as I didn’t have time to stop and think about what was happening.

I went in on Wednesday at 9am, and the first thing to happen was a scan. The downside of doing things in another language, is that sometimes things get a little ‘lost in translation’. So there I am explaining to Kari what happens in an MRI, when a nurse comes and shuffles me into the Ultrasound room… erm ok, I don’t mind that – it’s far less invasive and there’s no cannulas – yay! As the image comes up on screen, Nursey is happy that she can see the tumour, and is ready to inject it with dye (so the surgeon can clearly see it when she opens me up). Now I’m not sure how I thought they’d inject the dye other than by using a needle. But when she pulled out this three-inch long needle, I suddenly realized where that thing was going! I may have survived five months of chemotherapy, but my pain threshold is useless – I squeal when plucking my eyebrows! So when I ask if I’ll have any anaesthetic for that thing, and she replies “no”, things start to get real! But nursey explains that the needle is super thin, and I’ll only feel a little prick as it touches my skin. Luckily she was right. There was a funny kind of numbness inside my boob when the dye went in, but all I really felt was a tiny prick, that’s all – happy days!

So while the dye is doing it’s thing, it’s time for more scans… Next, I go into a huge room with an MRI-like machine, where I lie on a conveyor belt and slide into a big round machine. Two scans, one on my back and one on my side. Five minutes for each, no cannulas. The nurse tells me that they need to do this twice, just in case the first scans don’t show the dye properly. So after the first round, I’m taken up to the ward and introduced to my bed.

I change into my delightful blue gown and ‘normal stretch’ pants – hot! – and the ward nurse appears with a pipe. Right. What? I know I’m having treatment in the Netherlands, but a pipe? And it’s smoking? Yes, they actually want me to smoke this thing! We have a few giggles about how to say “puff” in English and there I am, sitting in a hospital ward, wearing a blue gown, puffing away on a bong?! (Apparently, the pipe is a nebulizer to clean my lungs, but I preferred to think of it as a bong.)

Before long, it’s time to go back downstairs for my second round of scans. This time I’m going down on a bed, so I can go straight into surgery afterwards. OK now this is starting to get serious.

I’m wheeled back down to radiology for the second round of scans, this time with nurse Kari in tow, and we’re trying to figure out how to attach a number 44 to my bed (a la Lewis Hamilton). Every time I’m wheeled anywhere, we describe it as “Practice 1 / 2 / 3” until finally I’m wheeled down to the recovery room – that was “Qually” – to get me ready for surgery, at which point Nurse Kari leaves me.

I’m wheeled into theatre, where I meet David, my friendly anaesthetist. “He’s one of you” I’m told by the surgical staff, “he’s English”. Enter David – a six-foot delicious looking Bristolian, who sounds like Prince Harry. From that point, all I remember is him telling me to think of something nice “like Lewis winning the Grand Prix on Sunday?” I reply. “It does help” he replies “you look like you’ve been on holiday recently, judging by the tan lines?” I blush and acknowledge that the tan lines on my boobs are indeed wonky, thanks to having one boob bigger than the other at the moment. But I’m hoping this is going to put that straight, right? “Of course” he replies “where did you go, anywhere nice?” “Barbados” I reply, and with that I’m out for the count…

Apparently, I was super cold during surgery and they couldn’t get me warm again, so I wake up in the recovery room with a heater over me… Dr Donkervoort, my surgeon, appears and speaks to me… I’m not really awake yet but I think she said she was happy with how it went? Not really sure, I’m still… zzzzzzzzzzzzz I spend the next hour or so dozing and gradually coming round. 

Meanwhile, upstairs in the ward, Nurse Kari has been pacing the floor wandering what’s happening – the op was only meant to take an hour, I went down to theatre at 1:30, it’s now 5:30, what’s going on? Eventually, she gets a call to say I’m awake and have been out of surgery for ages (they did try calling earlier, but for some reason didn’t get through to her – she was probably off chatting up some hot anaesthetist somewhere… hang on…?)

I open my eyes at about 6:30 to see Nurse Kari waving through the window like a nutcase 🙂 She comes into the recovery room and they wheel us back up to the ward (the parade lap, obviously). Still a bit blurry and not entirely sure what’s going on, all I can feel is an itchy annoying tube going up my nose spraying cold air into my airway. I have a drip connected to a cannula on my arm, which has to remain in place until I can prove I can pee.

First things first – cup of tea? Yes please!

Next – I need to FaceTime mum (apparently, everyone was getting worried when I didn’t come back from theatre, so this call meant more to them than anything).

And finally, food – I’m given the biggest plate of dinner, which I know I can’t eat, but as long as I eat something, they’re happy. So I polish off a beetroot salad and a few mouthfuls of fish. About an hour later I need the loo… “Oh by the way, your pee will be magic for a few days” What? Apparently, the dye they injected is considered a toxin (obviously) which the body needs to get rid of. So I need to drink lots of water to flush out the blue dye – once my pee goes back to normal, the dye is all out and I’m ‘clean’ again. So I go to the loo and, just as predicted, my pee looks the colour of antifreeze!

At this point, the team are happy that I can eat and pee, so I’m allowed to go home.

I’m now home and, over the next few days, I’m sure things will change, so I’ll post again as the wounds evolve!

#BoxyOut

As I haven’t posted an update for the past six weeks, I’m a bit stuck on how to start this… In some ways, there’s nothing to tell (my last post was celebrating the end of chemo, and since then I’ve had no treatment). But in other ways, heaps has happened (my immune system recovered, meaning I could finally get on a plane – woo hoo! – and my itinerary in the past six weeks has been pretty packed!) So I’ll try and do a quick recap, then explain what happens next… (this could be good, everyone knows I can’t do a ‘quick recap’!)

The end of chemo

Although I finished chemo on 27^th March, the drugs still had to do their work inside me, so for the first couple of weeks it was the usual cycle – a few days feeling fine, then a few days feeling crap, before my body started to recover and I picked up again. By mid-April, my blood levels were on the up and my immune system was well enough for me to travel.

This was a big deal for me… Before finding out I had cancer, I used to travel all the time – I’d fly off to see friends at the weekends, went to at least five F1 races each year, and often just got on a plane at a moment’s notice! I was like a fly in a jam jar – going to events, exploring new places, seeing my friends and family, and making the most of every day! So not being able to do this for five months was really tough, but I knew that after chemo, once my bloods recovered, I’d be able to do this again, I just need to be patient (unfortunately, I’m a very impatient patient!)

The Stockholm wobble

But about three weeks into my recovery, I had a bit of a wobble… I felt the lump again. I was convinced that I hadn’t been able to feel it at some point during chemo, so my immediate reaction was “oh my god, it’s growing back”. In reality, the MRI at the end of chemo showed that the lump hadn’t gone completely; it was still there, but was significantly smaller than it had been. But because I’d thought it was gone, being able to feel it again made me panic.

Looking back, I think I was just over-complicating things. The idea of having chemo in cycles is that you hit it hard, then give yourself time to recover, but not enough time for the cancer to recover too. For the past five months, I’ve had medics regularly checking my blood levels, feeling my boobs, and pumping me full of chemicals. So suddenly not having all that going on, I was worried that the cancer was getting up to no good inside me, and I found myself almost wanting chemo… a bit like Stockholm syndrome, if that makes sense?

Either way, I preferred to let the doctors know, so they could decide if we needed to move surgery forward. So I called the hospital and asked to see the surgeon again, mentally preparing myself for canceling my holiday and heading for surgery the next day! Luckily, my friend Em was in Amsterdam that week, and came with me to see the surgeon, and afterwards, she told me she’s never seen such a look of relief in anyone’s face, as she saw on mine when Dr Donkervoort said “in my opinion, it hasn’t grown”! Clearly, surgeons don’t expect to be asked to clarify! So when Little Miss Paranoid here asked “so you’re happy for us to stick with 10^th May for surgery?” her response was simply “Rebecca, go and enjoy your holiday!”

So that’s what I did! I went to London, caught up with my friends and family, met my seven-week old cousin for the first time, then flew out to Barbados for ten days in the sun!

Time for the boob job!

So now back In Amsterdam, I’m preparing for the next stage of treatment: surgery.

The operation itself is a lumpectomy (removing a lump) rather than a mastectomy (removing a boob). My surgeon proudly told me this is a straightforward procedure for her, and on average takes her 62 minutes (I like her precision!) However, if the the tumour is larger than we see on the scans, she’ll need to take more than planned. Her view is that she’ll take as much tissue as she feels necessary, to maximize her chances of getting it all. I guess this is obvious, but still felt reassuring to hear! She also suggested she could keep the scar pretty discreet, as it’s around the edge of the areola (the larger circular area around the nipple) – nice to know, but not something I’m frightened of – scars make us who we are and every one has a story to tell, right?!

There’s also a second part to the surgery, which is to remove any naughty lymph nodes. In the axilla (armpit), most people have around 20 nodes, and on my scans, four of them looked up to no good. However, the biopsy found no cancerous cells. So based on experience and what they saw on the scans, they think four of my nodes are naughty, but until they get one under a microscope, they can’t be sure. Rather than just wip them all out, they’d rather leave them alone if they can (as these things do have a job!) So the plan is to take one, send it off for analysis, then if it proves nasty, I’ll have a second operation to go back and take out the other three.

About a week after surgery, we’ll have the results show, when I’ll find out if I’ll need a second operation to take out the other naughty lymph nodes. I’ll also find out what treatment I’ll need after that – just radio, or a combination of radio and more chemo. The best scenario is that I don’t need a second operation or extra chemo. I’m mentally prepared for both, but for now I’m just thinking about getting through the next week or two – the surgery tomorrow and recovery afterwards.

To help me, I have Nurse Kari Immelda Gertrude Allen – she arrived today and has so far bought one new blouse, cooked enough pasta to feed an army, had my parents in hysterics on FaceTime, and played a vital role in helping me hang five pictures “up a bit” “left a bit” “more coffee?” “can’t you just whack in a nail?” “y’know, coffee makes a great skin scrub”… She’s expecting a casting in the next series of Grey’s Anatomy, and while I’m recovering from the anaesthetic, I am completely expecting her to take silly photos of me, dressed in delightful hospital gown, with precariously positioned post-it notes, and shameless selfies to keep you posted via Instagram! Watch this space!

#breastsurgery
#boxysboobjob
#timetotacklethetumour
#lookoutcancerwerecomingtogetya
#hopethegownhasaswooshonit

Five months to the day since my first treatment, this afternoon I had the results of my post-chemo MRI…

 

Before…

After…

Last Monday morning, I went to hospital at 08:30 as usual, let them take my blood and came home again, with fingers crossed and a nervous sense of uncertainty. The doctors have lowered my chemo to 75% of the original dose, so my blood will recover quicker (and they can blast me again). But with one week instead of two between chemo cycles, there’s still no guarantee my blood will be ok, and going into my last cycle, I wanted more than ever to get the green light, just one more time…

Well, needless to say I didn’t get a “we’re sorry but…” phone call later that morning, so I scooted excitedly back to hospital later that afternoon and rolled up my sleeve, grinning like a Cheshire cat!

At this point it occurs to me that I’ve never actually written about what happens during chemo…? I’ve shared photos, but apart from comments about my growing sneaker collection (which I doubt would’ve grown so fast had I not started Instagramming a different pair each time?! Foolish girl, Rebecca, foolish…) I’ve not actually shared the detail. So here we go…

I don’t have chemo on a hospital ward. It’s a separate room off the ward, so despite having medical equipment and wheelie intravenous thingies everywhere, it doesn’t really feel like a hospital. There are about 10 chairs, each of which has a wheelie intravenous thingy, a chair for if I have someone with me, and a table to accommodate my iPad, munchies, cups of tea etc. The place is very laid back; although I have an appointment time, there’s no waiting around, so if I’m early it’s fine, and if I’m late, that’s cool too. I just wander in and pick my spot, and then pretty much own my own space. It doesn’t feel formal or governed at all. And the nurses totally support this atmosphere, being very laid back, friendly, chatty and fun.

Once I’m settled, the first thing they do is ask which side I want to go in… it’s my choice but best to mix and match, so I don’t end up giving one vein a beating (the damage done by the injections repairs over time, but mixing it up gives each side time to repair before we hit it again).

Then comes the nice bit – to help the veins come to the surface of the skin (and make it easier to insert the cannula), they put a heat pack on my hand/wrist/arm. It’s just a standard gel pack about a foot long, which they heat in the microwave then rest on my arm for 10 minutes or so. (This may not sound special, but one side effect of chemo is that you feel the cold… so anything warm and cosy is nice!)

After about 10 minutes, they take off the pack and look for a good vein. As I have a number of injections during the course of treatment, they start on the back of the hand, then gradually work their way up the arm, to avoid injecting in the same spot every time. When they find a good vein, the next thing is to put in the cannula (this is like a straight tube which is inserted into a vein and strapped to my skin, the drugs are then injected through the cannula so they go straight into my blood). Putting the cannula in isn’t nice, but once it’s in, I don’t feel the rest.

The veins in the arm are generally straighter/longer than on the back of the hand, where they’re shorter and more wiggly. So navigating the wiggly veins in my hand, into which to push an inch-long straight cannula can be tricky, especially when they’re trying to avoid where they’ve gone in before. And if they get it wrong and pick a bendy vein, they end up going straight through and out the other side… OUCH! Needless to say, I hate the cannula bit.

Right – here I’ll pause for a second, as there’s something worth sharing which I wish I’d known in October… cannulas into your arm hurt less than into your hand!

I discovered this on Monday – my 11^th treatment, out of 12. Yes, I’ve spent the past five months having cannulas in the back of my hand and dreading it, because it hurts, and I have a low pain threshold (seriously, I squeal when plucking my own eyebrows – god knows what I’m going to be like in surgery…?!) They did tell me at the beginning that they’d work their way up my arms, but for some reason they’ve always gone into my hands. So people, if you ever have to have a cannula, go for the arm – the plethora of lovely, long, straight veins make this a far nicer experience than hitting a bendy bit in the hand!

Once the cannula’s in, we’re good to go. The nurse brings over the chemo drugs, asks me my name and date of birth (to check they’re giving the right batch to the right person), then they hang them on my wheelie thing and, one by one, in they go. In the meantime, I just sit there and read a mag, take photos of sneakers, or do whatever my lovely friends have brought to entertain me… Kari prepared the quiz of the century and grilled me on general knowledge… Mum hijacked the blue glove box and tried to ‘administer H2O’… Alex just hopped into a chair and asked them to manicure the pom-poms on her shoes…

How long the whole process lasts depends on what chemo drugs you have – some are given in larger volumes, so take longer to go in. My first treatment (AC) took about 90 minutes, whereas the one I’m on now (TC) takes around 2.5 hours. Different drugs also have different side effects – the ones I had before gave me a killer headache, whereas the ones I’m on now just make me tired. So once the drugs are in, the cannula comes out and they put a small bandage over my hand/arm and that’s it. Then I just hang around and chill for a bit until I’m ready to head home.

After that, the chemo starts to do its thing… kill my cells. So while the treatment itself is on a Monday, and lasts just a few hours, it’s the following few days when I start to feel weaker, more tired, and more ‘sick’. During this time, I take the meds the doctors have prescribed to combat the side effects while the chemo is in my system (in this case, around four days).

Once the chemo is out of my system, my bloods then have chance to fight back. This means my lowest point (in terms of blood strength) is about four days after chemo (day five).

Luckily for me, on day five this week, my best friends arrived for the weekend to help me celebrate my birthday and finishing chemo! We’ve been out for dinner, brunch, coffee and apple pie, and they are now causing chaos in my kitchen, baking me a ‘secret’ birthday cake (read as: I’m not allowed to know what they’re doing, but they’ve asked me where I keep my baking tins, how to use my oven, and whether the local Albert Heijn sells baking powder and icing sugar…) 🙂

 

And tomorrow is a BIG day – my final chemo treatment, my 40^th birthday, and my dad’s 65^th birthday. Dad’s in his favourite place, with my mum and a hotel full of surprise guests; I’m in one of Europe’s most amazing cities, with my three best friends and what’s looking like the most amazing chocolate cake; and this time tomorrow night, I’ll have finished chemotherapy, and reached the first major milestone in showing this nasty little f****r the door! So much to be excited about!

SO BRING IT ON CHEMO: ONE. MORE. TIME. We’ve got this, we’re better than you, we’re stronger than you, we’ve got this far, we’re still standing, and we are NOT giving you an inch!

Let’s do this – COME ON!!

#FeelingFierce #StandingStrong #BadassBoxy