Invisible me

I'm You’ll be pleased to know that I was discharged from hospital on Tuesday 25th July and not before time! A&E were super efficient in responding to the infection. 

Unfortunately I didn’t experience the NHS at it’s finest on  the ward. I didn’t mind in the least that I had to wait 12 hours in a treatment room for a bed, though this sure bothered my loved ones. I am also pleased that the infection was successfully treated and grateful for that, however it was the lack of attention to my holistic care needs that had me climbing the walls and leaving the ward on discharge in a complete huff! 

Several times my pain relief had been forgotten and was as good as ‘told off’ by the cleaner for not having my breakfast earlier, when this 'said' breakfast had also been  forgotten, because this caused a delay in her cleaning routine. 

 I was in a side room on a demanding  ward, staffed predominantly by agency personnel and I picked up staffing and resource  difficulties and challenges in the overall care that  I received. There were of course some excellent nurses and HCA’s that saw me as a human entity, however this seemed an exception to the rule. As I was becoming  more alert , and my feistiness levels as well as my neutrofils levels were increasing,  the  lack of the human  component in my care was becoming more obvious . 

The Saturday night  sticks well and truly in mind when I was abruptly woken with kurt words at 2am and bright lights being turned on without warning for my IV antibiotics treatment.  The Nurse very efficiently administered the treatment and left the room with a clatter bang as she threw her apron and gloves in the steel bin without a single word.  

By the time I was discharged, I was feeling more and more like ’Mr cellophane’  (Chicago musical)  and my tolerance levels were waining, so  when my discharge note omitted significant information I finally launched into a dignified protest, that saw staff  bounce me  from colleague to colleague all keen on avoiding any additional work! 

People don't go into nursing to do a bad job and saw this all as a reflection on a systemic failure within the ward not on any particular individual. 

 I was almost SORRY that I was causing a 'nuisance', ANGRY that I was experiencing this at my most vulnerable time, CONCERNED for patients by age or infirmity that are less robust than I am and I truly HOPE that the feedback that I have left is helpful in terms of  improving their care of patients. 

That all being said,I remain the NHS's biggest fan,though 'if' there is a next time I shall,  with out a doubt, be going to Northampton General Hospital  where there is a specialist ward best equipped to deal with cancer patients. 

The day after my discharge I attended a treatment review at NGH and I was told that I will be given the g-csf injections after every chemo from now on, to reduce the likelihood of further  infections.  With huge relief I also learnt that round #2 of my chemo was not being delayed and as long as my blood tests came back ok chemo would proceed as planned on the 31st July 2017. 

This relief however was  short lived after hearing of problems with my liver function test within hours of having my bloods taken on 28th July ! This means my liver will need a little longer to recover from the damage caused by the chemo and/or infection, so treatment has been delayed  for a week after all!  

This pesky cell is clearly not going down without a fight, but neither am I, and whilst feeling weary, I shall bear recent events as misfortunes of the war that I have unleashed on it. 

Neutropenic Sepsis

Well, I thought I was completely done with telling you about the side effects of my 1st chemo so I could move onto some more of the pleasantly exciting areas of my life, but it seems this cancer lark had other ideas ! 

I was admitted to Kettering General Hospital  late on Thursday 20th July and I'm writing this update from my hospital bed! 

There was really nothing dramatic about it all , and I wasn't really experiencing anything other than fatigue and general 'Blahhhhness' that I recognised as the usual symptoms of chemo ! 

Melanie my niece had come up on Thursday ready for a day out the next day to the Xfactor boot camp auditions , and at bed time I noticed a small lump behind my ear and noted a temperature between 37.8 and 38.1. I was advised by my oncology team to go to A&E as I was in the stage of my chemo cycle where I'm most susceptible to infection due to low blood count.

Kettering A&E were prepared for me when I arrived with Melanie and they took me straight to a side room and took my bloods .

I had been through this with my primary diagnosis and treatment a few times and was always sent home following blood tests, so I expected nothing else this time and I was determined that cancer was not going to interrupt my plans with Melanie!

It was 11pm and I didn't even call Danny and told Russ, and only because he happened to call me, that he didn't need to come and that I would call him when I got home. 

Thankfully, Russ didn't do as he was told and appeared about an hour later just as the Dr arrived to confirm that I was 'neutropenic', had high infection markers and would need to stay in Hospital for IV antibiotics. It was not clear at that time how long I would need to be admitted for. 

I was then determined that Melanie should take advantage of the Xfactor tickets and I sent her home so she could enjoy them with 

Tom, her boyfriend.

There were strict instructions for Melanie to send me pictures, so imagine my excitement when her first text came through the next day, but then the disappointment as I  read that they wouldn't let her have  tickets without my ID!  Sounds as if I have some making up to do with cookie dough ice cream for starters! Lol! 

So.... there were no beds or side rooms available and I spent the night on an A&E examination bed before being moved 12 hours later to an assessment ward. 

I sent Russ home about 2am to care for Reuben and get some sleep. 

I was desperately tired and got 'some' sleep though the sores in my mouth and lips that had been developing since presenting at A&E were preventing me from eating the food offered and reaching the sleep I craved. 

It took over 7 hours and 3 reminders to get the 'Difflam' I had asked for to relive the symptoms, though by that time Russ had brought my bottle of the stuff from home.

The information I had  been given was rather patchy. I was not my usual enquiring feisty self , but was happy with the efficiency of A&E and their  focus on treating the infection with IV antibiotics. 

It was the consultant on the assessment ward that confirmed I had Neutropenic Sepsis and by this time I was clearly more alert to the seriousness of the condition. Basically my immune system had flat lined with neutrophils at 0.1 and I had an infection somewhere that I had no chance of fighting off without hospital treatment. 

To look at me you would wonder what the fuss was all about, though it is 'classed as a medical emergency' and there is great emphasis and advice given on avoiding infections. I had been tempted to seek advice the following morning, and the Dr told me that if I had, this could have been a very different emergency ... and not in a very good way! 

An 'oncology' nurse, Kathy was sent to assess me and advise the Dr's on the assessment ward  on my treatment pathway plan. 

Kathy immediately noted the blistered rash on my hand and was surprised that this had developed and alluded to some careless treatment and advised that I speak to my oncologist about it.

It got me wondering if I should have pushed for a blood test on the Wednesday when I was in the NGH assessment bay about the blisters and whether I was 'neutropenic' then ? 

Anyway , Russ had somehow managed to pull off; Reuben duties, work and family commitments AND ensure that I had all the essentials for my hospital stay! What a legend! 

It was after Russ left at about 2.30pm on the Friday that I probably started to feel all tired,  emotional and a huge burden on all those around me . 

There has been absolutely nothing that anyone  did to have made me feel this way and it's probably a 'default setting' of mine. I just 

feel guilty for bringing cancer into the lives of my loved ones.  Another typical effect of cancer  I'm told! 

Don't worry, I have been told how ridiculous this is and know I need to work on it. Never the less, it's been tough to navigate the 'being needy and feeling out of control' part of this whole affair and have  found it difficult to ask or respond to the many offers of support and realise that this is frustrating for my cheerleaders!

So, having been in the assessment ward for about 6 hours , I was transferred to Deene ward... a big thanks to Taymar who settled me into my new 'cell' during a  'surprise' appearance on the Friday evening. I loved that she just turned up and gave me a much needed boost! 

I would admit to having a few wobblies on the Saturday and probably feeling a tad sorry for myself, but nothing that my VIP  visitors that day didn't sort out ! Thank you Danny, Russ and Mary; you helped helped more than I will ever admit lol !!

I've  been otherwise happily distracted with social media and motivated by the weekend adventures of my friends and family. 

There's been lots of  texts, calls and face time from my cheerleading gang to occupy my time and of course there has been the  excitement of the hospital food that each meal time has brought ! 

             'Food a la NHS'

  Face time with Reuben ! 

Cheerleading pics !

I am writing this blog on Sunday evening, the time  has gone rather quickly, feeling too 'tired' and 'icky' to be bored or bothered about the cell like room that I am in! 

I was supposed to be at the family pic nic that I had arranged today with over 25 of my family members and not writing this blog from my hospital bed ... but I'm deterred  not, the plans are merely postponed and  I look forward to sharing some special moments with those I love very soon .

I got to see Danny today and entertained by his awesomeness...  he left me with 'boofle' to keep me company and a 'cheerleading' pack that he lovingly prepared with 

DIL! 

I'm expecting to learn tomorrow whether my neutrophils have increased and whether the 6 hourly IV antibiotics have done the trick ! 

I've been having daily G-CSF injections to stimulate my bone marrow to produce blood cells , so I'm hoping this has worked so I may go home tomorrow to my home comforts and  my lil' love bug Reuben x 

'Pharpsy pants'

I started to write this post on 10th July 2017 direct from the newly refurbished Chemo suite and the rather comfortable electric reclining chair that all our fundraising adventures contributed towards the last time around … a job well done…. Thanks guys!

        Link for opening article

It's taken until now to pull this post together and this is purely down to CBA reasons! Writing down my experiences remains such a helpful process for me,  but translating my thoughts and experiences into 'interesting'  bite sized chunks is a lot easier said than done when experiencing general feelings of malaise ... and when it isn't 'flowing it 'aint' happening'.... my mind is exploding with things to write and this is where I have got to;

The treatment 

So, following an echo cardiogram and PCA (pre chemo assessment), the first lot of 'targeted'  treatment went a head on 10th July 2017. I was given Herceptin and Pertuzumab intravenously and was at the hospital for most of the day for monitoring.  It was a looooooong day, though it seemed to go really quickly with DangeRuss for company and time filled with card games and a take away from Dreams Coffee Shop. Yum ! 

The chemo nurse recognised me and remembered my hair dares from the  last time around and the familiarity I felt certainly took the edge from affairs. I felt glad that I had decided to return to Northampton General Hospital  for treatment despite my move to the Kettering area.

I was back at the hospital the next day with my newly wed friend, Ruth, and this time for the Docetaxol chemotherapy treatment. We were in and out within 2 hours and quite literally it felt like an 'ordinary' catch up between friends although I could feel the significance of the event in Ruth's exemplary care and concern for me.

post chemo breakfast treat and Cath up with Caroline

The side effects 

The fatigue, tiredness and taste changes were the first of the side effects to take a hold, almost immediately, although it is quite possible that some restless, anxious nights and  busy day's contributed to the overall feeling of lethargy.  I slept a lot for the first few day's and as symptoms developed around  day 4 and 5, I have relied on pain relief  to manage the  'sledge hammer' force pain in my ribs and skull.  I remember this from the last time and thankfully it is all manageable with the concoction of medications provided by the hospital. 

There is already some 'chemo fog';  with some slow processing of information and I'm frustratingly struggling to grasp the words I want to say….. general ditziness really. I don't think I fully recovered from the first time around, though never before now, have I poured fairy washing up liquid in the laundry detergent 'thingy' for my washing machine! I really didn't need to admit that …there were no witnesses! 

I'm sure Danny will be keen to tell me 'no change there' then and remind me of similar faux pas, so I shall give him a preemptive  'kick up the but' for his cheek when I see him !

Then there is the blurry vision, I certainly didn't experience this the last time…. even with my prescription glasses, I have struggled to focus my eyes at times, but this is nothing compared to the more embarrassing 'abdominal' symptoms that have found their way into my life …………… I will leave the detail to the imagination but 'DangeRuss' captured the general theme of things in a recent remark…

'How can someone so beautiful, smell so bad!' 

Seriously though this IS 'a thing' when you're on chemo, so I shall allow myself some guilt free 'chemo pharpsing' and hope my dignity survives this round of chemo ....Those nearest and dearest will  be relieved to know, that this only lasts a few days ! I am literally crying with laughter writing about this and thankfully I'm over this 'pharpsing phase' so it really is safe to be around me !

Moving along nicely  now...

I saw myself calling the emergency assessment bay on 16th July for advice after a rash and swelling was emerging from where the cannula from treatment had been on my right hand. 

By the 29th July small blisters had developed requiring a trip to the hospital for assessment and treatment with steroid cream. It seems the chemo is ' an irritant' ( no s#@t Sherlock) and probably leaked a little. I recall making comment after the Docetaxol treatment about the rather heavy handed chemo nurse,  who seemed to 'tear the cannula and dressing' from my hand. Whether this contributed or not to the rash, I do not know, though I can't wait to offer some helpful  'feedback' !

I've lost concentration and done talking about the side effects now! These  are just features of my world at the moment, life does go on and at the moment, this means attending to the  'normal' day to day things and finding as much 'mischief' and sharing as many moments as I can with family and friends, to avoid feeling 'lost and left behind'. 

Pre chemo family mischief

'Hot Spots' and treatment plan

I have somewhat dusted my self off since my last post and I am pleased to say, some emotional balance is restored. I have had some fabulous messages of care and concern that have been cheer leading me along …. though, I really didn't mean to worry anyone and have felt a little embarrassed to be honest.

You see, what I omitted in my last post, and I am able to best assure everyone, now that the dust has settled, is that I remain stedfast in positivity. Yes…..the cancer diagnosis has blown my mind and for the time being, an undercurrent of sadness has established itself  my world, but this does not mean that I have lost sight of the wonders in my world and the joy and the happiness around me.

This I guess is what being human  and life is all about….. where sadness and happiness as seemingly incompatible emotional states can co exists …. where one emotional state can dominate over the other at times, and as it has done for me recently; set me off balance.

It's quite logical that I experience 'sadness' as I begin to re focus the direction of my long term hopes and dreams. But rest assured this year IS already being defined by immense joy; I will just have to 'know', that my emotions will fluctuate and this may happen in a 'nano second' when I become frighted or overwhelmed.  I'm assured by the ladies in the 'living with secondary cancer' group within  the Young Breast Cancer Network site (YBCN), that this is all part of the process and that this will get easier as time goes on…. This seems all the more doable with the presence of many cheerleaders that have spared a word and a thought for me, to whom I owe a debt of gratitude.

Having unintentionally gone out of my comfort zone and exposed the vulnerable me, I funnily enough, found it to have been a relief , and so I'm glad I 'kept it real'.

'Anyhow' (said in a 'Gill Shipman' like Scottish accent), apologies for the emotional waffle, the point of this post was actually to update you on the medical stuff, so without further ado…..

The results

I met with the Registrar (I cant remember his name) on 20th June and saw him alone initially whilst I learnt  the results of my CT PET Scan. Danny, Sue; my XMIL and Russ  came to the appointment with me,  however I had decided  before hand that I wanted to hear  news of the results first. I was glad I did…… the news was the best that it could be, but that time alone with the Registrar allowed me to 'tune in' to the news and 'tune out' of others.

So, I learnt that I have several 'hot spots' (malignant lymph nodes) in my 1) right and left Supraclavicular area ( left and right collar bone), 2) left axilla (arm pit) and 3) left groin. It seems the one in the groin is unusual, and the Registrar seemed happy that I had already had my ovaries removed! 

The Registrar went through my results with me using a written report and he happily logged into the images when I expressed  curiosity about them. 

There was certainly some 'Scanxiety' leading up to the appointment, so much so that I booked myself and my XMIL last minute tickets to see Celine Dion at the O2 for the evening of the appointment, hoping that it would 'void out' what ever news I had. I know I do this a lot ..... always have done; to find  something that stops oneself from being paralysed by the challenges of life and why not....it's my way and it's worked for me so far ! 

With HUGE relief I was told that there was no sign that the cancer had spread to any other areas of my body and for that, I felt I had won the lottery and making Celine Dion a special memory making moment with my XMIL!

And while we are at it… although side tracking somewhat ; there were some more 'joie de vivre' and 'sugar coating the crap' moments ' at Royal Ascot this year at Ladies day!

Ok, so back to business…

The prognosis

I broached the 'prognosis' question, and to be honest I was initially a little frustrated that there wasn't a number given in terms of years of life…..I think I just wanted to be able to 'plan', you know; life, finances, work and well…..'stuff', but alas, it seems that this all relies on how my body responds to the treatment.

The Registrar explained that ladies can live several years and told me of a lady in the clinic that day that has been stable on Herceptin treatment after 10 years. I found this reassuring and have decided that this will be me….right!?…

I am also acutely aware that other ladies are not so lucky as the Registrar confirmed, so the focus shall have to be on the quality of my life…not the years.

How I feel about this: To articulate my feelings exactly, I'm stealing the words of Lesley Graham, who lost her life to breast cancer but not before campaigning for NHS availability of cancer drug Kadcyla 

 "living with cancer is like someone pulling the pin out of a hand grenade and forcing you to swallow it. The grenade might go off, it might never go off, or it might go off in the next 10 minutes"

mmmm……

The treatment plan

Well, with Danny, XMIL and Russ in the room….oh and Kath the BCN , the Registrar told us all that the treatment plan will start with 6 cycles of docetaxel chemotherapy which will be administered intravenously every 3 weeks.  This is aimed at getting rid of the known 'hot spots' and preventing the spread of the cancer.

I will also be given Herceptin and Pertuzumab which are targeted therapies and I will be on this combination every 3 weeks for as long as it continues to keep the cancer cells from spreading.  The Registrar has to make an application to the drugs fund for Pertuzumab as this is not standardly available on NHS.

Contrary to what I was originally told, I was advised that radiotherapy was not part of the plan, and this is because of the amount of 'hot spots' there are. Radiotherapy may be an option in the future.

I am booked for an echocardiogram on 4th July and a Pre Chemo Assessment(PCA) on 5th July 2017. The chemo will then all begin on 10th and 11th July, it will be the start of a life time of treatment for me and I will be scanned regularly to check how treatments working.

I had docetaxel x3 the last time around and am familiar with it's side effects. I hope to tolerate this as well as I did last time…… I will lose my hair again, a necessary evil, never the less it is not something I am looking forward to.  

I have been pondering over using the cold cap to try and prevent hair loss. I may not be eligible for this, but anyway on balance I'm not sure it's the right way to go for me anyway.

I also had Herceptin the last time around and these side effects were more doable, although  these will now be long term and I will be motored via echocardiograms for known heart related side effects. 

Suffice to say I have a busy few months ahead of me but finally glad that 'the show is on the road'

In the mean time I will leave you with this article posted by my SIL on FB. Thanks Susan, it speaks volumes and worthy read  if you know someone close affected by cancer.  

click link : What your friends with cancer want you to know but are afraid to say

'The Wonderful World of Haribo'

Well, I've been back from Barbados for over a week now and 'WOWZER', I had such an amazing time. I have totally fallen in love with the Island, just like Ruth and Trevor said I would, and most importantly I got to watch two of my favourite people get married.

Seeing Ruth so happy was priceless and I feel so blessed that I was part of her special day. I really have come away enriched with wonderful memories and new friendships. lucky me I say!

Holiday jovialities and mischief never quite gave the 'elephant in my head' a break from thoughts of cancer, pending tests,results, treatments and more significantly my prognosis, all the same,  never enough to disrupt the memory making and merriments of the holiday.

However, within days of my return, I came back down to earth with an almighty emotional crash, having become overwhelmed with feelings of powerlessness.  I'm deliberately being cryptic about this, but suffice to say I am experiencing some sadness at the moment about cancer and what it has, is, may take away from me.

I 'don't do' sad and I certainly don't plan  to linger  in my sadness for long if I can help it, but there again I've never before been given an incurable, life limiting diagnosis, so  recognise that I need to explore this with someone, a professional that can help me work through it and I have arranged for this to happen via Macmillan.

There is, otherwise only a couple of medical updates to report; I received the results about my HER2
status and this is positive. This means I may benefit from recent advances in cancer treatment. I have
an appointment with the oncologist on 20th June, where I will learn; the outcome of the CT PET scan I had on 9th June and my treatment plan.

The Letrizole medication that I changed to recently has given me some side effects that I am learning to manage and live with. This includes some hair loss, I have plenty of hair for the time being, so this is not noticeable, but the shower drain and the Dyson are taking a  'bashing'. The bloating is uncomfortable   and head aches are niggly. I'm also experiencing restless nights, increased  tiredness, fatigue and some weakness, though one wonders if there is an emotional element here.

I have taken a further  two weeks of annual leave from work , whilst I find out where the land lies in
terms of treatment. I will be able to make some decisions about work after my appointment,
something that is also actively circling my thoughts.

I am naturally anxious about the CT PET scan results. I am all out of educated guesses about the results  and what to expect. But hey, It is what it is and I will deal with it;  It just  seems so long since I found out that my cancer had spread, and am keen for it all to gather  some momentum now.

I have been dealing with medical hiatus by escaping into 'The Wonderful World of Haribo' with my secret stash of 'Tangfastic stixx' and eating my emotions.

Not that this is the most nutritious, but never the less it has  also been helpful in weaning me off the rum punch, happy hour cocktails in the'Wonderful world of Barbados'. lol!

'Brace Brace Brace'

So, I made it to Barbados and knew the decision to come was  the  best , when I was met at the airport by the Ruth & Trevor and was surrounded by their comforting friendship ! 

I had a crazy run up to the holiday with the winding up of work matters  and appointments. I quite literally threw my holiday packing together at the last minute and on DIL's orders I have done well 'so far' in leaving the 'metaphorical' baggage behind! 

I'm still waiting for an oncology appointment and to be honest I feel rather frustrated with the poor communication between departments at the hospital,  that has meant I have come away with lose ends that are playing on my mind a little ! I'm glad to say that I have left the chasing to my XMIL and hope to have a date soon to settle my mind. 

The CT PET scan has now been booked for 9th June and I am lucky enough to have people fighting over who is going with me , so I know I'll be well supported ! 

I have settled into the Barbadian life quite nicely and have been thankful of the opportunity to catch my breath and reflect over the last few weeks and try and make sense  of this crazy world of mine! 

So, as promised, the events that lead the re diagnosis is as follows; 

It was rather an incidental find during a normal weekday morning on 11th April 2017 , I certainly  wasn't looking for anything. I had somewhat moved away from any thought of a reoccurrence and whilst I still experience fatigue , I had been feeling quite invincible actually!

So ,  I was in bed at the time and the position of my arm and neck seemed to expose a lump in the very moment that my fingers were near, so I could quite clearly feel it. I couldn't see it and for sure it could not be felt when I was in  the sitting or standing position unless I dug around! 

The original cancer had  affected the left boob so having a lump on the right side confused me , however my intuition placed all of my senses on high alert 

I felt sucked into a slip steam  of thoughts, with every eventuality playing out in fine detail in my mind.  Always hoping for the best but bracing my self for the worst. 

There have been some occasions over the last couple of years where I have checked out some symptoms with my GP and consultant and undergone some tests . I approached these with rational insight and had correctly satisfied myself that these were symptoms of treatment and not a recurrence.

Don't get me wrong, each time each symptom and each test played heavy on my mind , however the emergence of this lump somehow felt very different. 

I waited the Easter bank holiday weekend and after booking  myself in with the GP on 18th April 2017, I was immediately referred to the two week wait clinic at Northampton General Hospital. 

The GP told me he wasn't overly concerned, but referred me because of my history. 

When I called the appointment line for NGH , I was told to contact Integrated Surgery Dpt. directly as there were no appointments available. Starved of sleep, with the worst playing over and over in my mind, I was far from impressed when told by the hospital that they were short of staff and unable to give me an appointment. To cut a very long story short, with persistence I was given an appointment for the 26th April 2017. 

I was given the option of waiting for an appointment with Mr Dawson , my original surgeon , however  I chose to be seen by Dr Milanowski, as I could see him within a week of my GP appointment. Being seen within the week is pretty good going, but only achieved through some persistence. Goodness only knows when I would have been seen if I had sat back and waited.

So, I met the rather 'interesting' Dr Milanowski for my initial screening.  By this time I had noticed another smaller lump in my neck and pointed these out to Dr M. He didn't seem overly concerned and said it was 'not usual' to have lymphnode spread  on my right side if the original cancer site was on my left ! 

I had googled away before my appointment and this was not a surprise to me, but I knew that if something sinister 'was' lurking in that node, that this would mean the cancer was not a 'local' (curable) spread but had 'advanced' (treatable but not curable)

I also showed Dr M some changes to my reconstructed boob. There was some swelling and pitting  and he seemed sure this was necrotic tissue from the surgery, however the  ultrasound showed no such concerns. 

The mammogram of the 'perfect boob' also showed no concern and the ultrasound of my neck/collar bone picked up several slightly swollen nodes and the one in the crease of my collar bone measured 8mm. 

The radiographer explained the images on the screen throughout the procedure and whilst the 'nodes were within 'normal' parameters she noted that they looked solid. (not good) . She took a fine needle aspiration of the 'node guided by the ultrasound. The radiographer wasn't the chattiest, however when asked she told me the fluid drawn, was 'cloudy', but she could not be coaxed into what this meant. I already knew that if it was from a harmless infection the fluid would be clear! Eeeek! 

The radiographer wasn't  trained for the 'supraclavicular' / neck area and she  suggested that I would need to be seen by one of her colleagues. 

So, Dr M , in summarising the events of the day, told me not to worry and 'seemed' sure it was  an infection. Did he 'seem it' because that was what I wanted to see with all my heart, or because he had cause for genuine reassurance?? 

Mmmm.... I certainly took from him the impression that it was from an infection somewhere in my body. I had been quite well and I was curious to enquire where the infection could be from ... and rather peculiarly,  he asked me whether I was married and carried on to say ; that it could be because I use my arm to 'hit my husband'!! 

Ok, so with a shared look of 'did he really just say that' with Kath, the breast cancer nurse, I accepted his comments as a major collision of language and cultural worlds! 

His intention was clearly to allay my concerns using  comedy, and I came away thinking he was a 'muppet', but thankfully  a 'muppet' that seemed to know what he was doing ! 

My inner child was desperate to embrace and cling to every inch of  the reassurance offered , however with a profound sense of intuition and the jigsaw pieces falling into place, I adopted the 'Brace Brace Brace' position, feeling never more happy at the prospect of an opportunity to  'eat my own words'  and have my intuition proved wrong ! 

Well, I didn't get to 'eat my words' and neither do I feel smug that my intuition played out .... I don't even feel imperious that Dr M 'kinda' had to 'eat his own words'  on 5th May 2017 when he told me, with Russ be my side,  that I had advanced breast cancer. 

Dr M's heavily accented and sometimes broken English language meant that the significance of what he was sharing was mostly lost in translation , but I got the gist ; 'advanced'... 'treatable' ..CT Scan.... chemo... radiotherapy ... neck specialist ... guided biopsy'.

How I felt : devastated, heart broken and desperate to hold my son. 

Mr M's announcement was totally lost on Russ (more about Russ soon!) and he only realised the seriousness of what was being said by the swell of tears in my eyes and Kath's look of concern. That guy was clearly struggling with the news, but prioritised me in those moments. 

When asked whether  I had any questions, my immediate voice was for my son and daughter in law and how I could possibly put them through this again ! I was told that praying was a good option by Mr M! That goes without saying, though not quite what I expected a Dr to say in that moment, but probably another thing lost in translation . 

I left the the appointment feeling totally bewildered and knowing  the next step was seeing a neck specialist who was to take a guided biopsy of the node. 

So there you have it .. all up to date now and a rather cathartic process for me.