16 March - Facing up to the next steps

Monday 16 March. The local NHS hospital. I had been here once before to drop my son off for some minor surgery but hadn’t been inside. It wasn’t an inspiring first impression. Old buildings, too many sick looking people, old people, overweight people, scruffy environment, overcrowded waiting rooms and long lines just to check in at outpatients. Check in was indescribable. The receptionists talked to each other rather than the patients. When they did deign to call you forward it was with a ‘Next’ and a grim dose of minimal eye contact. And they took forever to find the appointment. Once they had, the instruction was find a seat somewhere in this general area and someone will call you. Right - we had an appointment for 11.45. In my world that means 11.45 not 12.45 which was when we eventually got in to see Mr P. Fortunately we were both forearmed with books and Sudoku puzzles – something I was going to become increasingly reliant on during the next weeks and months.

Mr P was charming and was accompanied by a very nice key worker breast nurse – M D. Refreshingly he didn’t ask me to take my top and bra off as he had enough information from the doctor at the breast clinic. Basically he outlined the next steps. He would carry out a lumpectomy and sentinel node biopsy to see if the cancer had progressed to the lymph nodes. His assessment was that as the cancer was so small this was unlikely to have happened. We agreed a date - 30 March when I would come in to have a Breast Wire Localisation – more on this later, and then have the operation on 31 March. My questions to him were mainly around logistics and how long recovery would take etc. I was worried that we had to bring my mother out of the nursing home on 6 April, which was only a few days after the operation and we also had holiday booked to our place in Spain for some golf in the sun in early May. Mr P suggested I discuss all this with M D and before we knew it we were out of his consulting room and following MD to another office. She spent some time explaining the operation – especially how the sentinel node biopsy is done using a blue dye which completely permeates your system and causes you to pee blue, poo blue and gives you a blue boob for a few weeks…..lovely. One downside to all this is that she tells me I will have to wear a support/sports bra for a while after the operation instead of my rather fetching black under wired ones. Oh well – off to M&S. She also provided a comprehensive handbook and loads of information and contact points. I am not a joiner of groups and had no intention of getting involved in support groups – not my scene but good for those who need it. Overall I was impressed by the care and support available despite the ghastly hospital. We parted with appointments being made for a pre-op visit and tests, and for the admittance on the day. The only downside was that it seemed that I had to have the breast wire localisation at 0930 on the 30 March and then hang around all day and overnight until the operation sometime on 31 March. But at least I knew what was happening and when – I was back in control. Back home I had some more information to research – Breast Wire Localisation and Sentinel Node Biopsy. The Breast Wire Localisation is needed because of the surgeon’s difficulty in locating the area that needs to be removed when it is not very obvious as a lump. Because my cancer was so small they needed to insert a very thin flexible wire with a hook in the end of into the cancer site. This is done in radiography using ultrasound and local anaesthetic. The hook means the wire can’t move and the end of it is coiled around and taped to your skin until the surgeon removes it along with the cancer. The sentinel node biopsy is a relatively new procedure and can only be done by surgeons who have been properly trained in the technique– fortunately Mr P was one. This procedure avoids removing a lot of lymph nodes in the first instance and therefore means less risk of unnecessary side effects and complication such as lymphodema (swelling of the arm due to lymph fluid building up and not being able to drain out of the arm because of scar tissue in the excised area of the lymph system). The recovery time seemed OK and as long as may partner drove I reckoned we could get my mother back into her home without letting on that I had just had surgery. I still didn’t want to tell her if there was no need to.



So on we went. I decided that I would still not tell my mother anything but my partner and I did decide we would tell friends and family without making a big thing of it. I didn’t want this to be seen as a tragedy. OK it wasn’t good but I could deal with it and wanted things to be as normal as possible. Needless to say friends and family were and are still fantastically supportive.

The pre admission visit was as expected apart from having to be swabbed for potential MRSA susceptibility…. didn’t show anything up so we seemed OK there.