'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. 

Metastatic breast cancer

I was seen on 18th May 2017 by the most marvellous Mr Khan and he wasn't phased at all by my 4 piece cheerleading entourage ! 

Home made, quilting 'Cheerleading' gift from Julia xx thank you 

Danny, XDIL, XFIL and DangeRuss were eagerly by my side , however there  was no surprising news from Mr Khan; he confirmed my CT scans showed no concerns and told me that I am to have a CT PET scan that aims to  picks up more detail about what's going on in my body. So I'm awaiting an appointment for this.

Mr Khans honesty and turn of words was refreshing,  he confirmed that because of the location of the infected lymphnode , that  I have 'distant' metastasis and that the cancer is no longer curable but very assuringly treatable.  Mr Khan was keen to explain that with new treatments coming though , that ladies can live for many years with advanced breast cancer , and this is of course my plan ! 

How I'm feeling about this? :  Disoriented 

Because of the  location of the 'cancer party' in my lymphnode it would suggest that the cancer has spread elsewhere and it will be the CT PET scan that could trace where if any, 'micro met' cancer cells might be lurking . I'm told that they do not routinely do this as it is an expensive procedure , however  it seems necessary in my case and I'm  feeling thankful that the NHS is looking out for me!

The biopsy confirmed that there is breast cancer cells in the supracavicular lymphnode and that they are oestrogen receptor positive.  The HER2 results from the biopsy  are still outstanding, and this will influence the treatment  regime that  I will have. Mr Khan and I are hoping that I am positive for the  HER2 protein, as there are some new and excellent 'targeted treatments' available to help blast the pesky cell into remission!

My treatment has also

included a change of hormone therapy ; from Tamoxifen to Letrozole. The Tamoxifen I have been taking since 2014 clearly hasn't worked and gave me some side effects that required treatment for polyps earlier this year . It seems Letrozole is more in keeping with ladies that are post menopausal in any event, and I have high hopes that this will help... I'm summoning the power of positive thinking, so let's have a high five for Letrozole!! 

Systemic therapy' i.e. chemotherapy is also part of the plan as is  radiotherapy. I am now waiting for an appointment with Dr Knighton in oncology to give me more details. Whilst I have completed this kind of treatment before, this is in a whole different league and the start of a life time of treatment for me!

I'm not saying that I'll be in chemo for life but my new reality is that my treatment will never be over, and that I will be relying on treatments to manage this very unsolicited cancer party in my body! 

How I feel about this; it's been a bit of an emotional overload to be honest , but it is what it is and  ' I got this'

Funnily enough, I have just received an invitation from Northampton General Hospital to the opening of their new chemo suite on 6th June 2017, because of the fundraising 'we' did for them through the 'hair dares' adventures of 2014. So, with some sweet irony, It seems I will get to directly experience the new and improved chemo suite ! 

Surgery to remove the lymphnode was put forward by locum consultant Mr Milanowski , however Mr Khan explained that the research available would suggest this would have  no particular benefit and not at all in keeping with practice.  To have 2 conflicting thoughts about this, has probably not been the most helpful to me, however I feel in safe hands with Mr Khan's assessment and some pre appointment googling has made me feel satisfied with surgery not being part of the plan.  

A vital component of my 'treatment' plan is of course my support network. There's research that suggests that social isolation may lead to poor survival rates in breast cancer patients. I know I'm already blessed with an army of cheerleaders, and know I have to be open to the support that sometimes I struggle to accept . 

So, Kath, the breast care nurse has been tasked to coordinate and chase appointments for me and it seems that I will be referred to the metastatic breast care nurse , a new service offered by NGH!

And now for the good news !!

I get to go to my friends wedding in Barbados next week !! Yay! 

When I asked Mr Khan about this, he told me that the cancer in itself would not be an issue , but with a cancer diagnosis I am a high risk of blood clots during flight. It really did sound as if he was advising against it, though said there were steps I could take to reduce this. I finally  got what I needed to make a decision about the holiday, when I acknowledged his duty to inform me of the risks, and asked what his advice would be if his wife was in the same situation . So it seems the benefits out weigh the risks and I'm off to Barbados . Happy days !

Cheerleaders!

So, you now know what I know on a medical front. On an emotional level, I can't quite find the right words to translate what's going on in my head at the moment, but know this ; Every fibre in my body is braced  to kick some cancer  'ass' .

The 'elephant in my head'

I'm pleased to report that my  F.U Cancer Cheerleading Squad is growing nicely and I have been overwhelmed by the encouraging  'Pom Pom shakes' so far !! Thank you !

A cheerleading message from Spain, thank you Elizabeth!

I went for the CT scan on Tuesday 9th May with chief cheerleader, Becky, my DIL. This seemed all pretty routine and the scan itself was over and done with no time. There was only three attempts at inserting a cannula in my arm/hand for the procedure and luckily I quite liked the taste of the aniseed flavoured  concoction I had to drink over an hour period before hand.

I wasn't supposed to get the results of the CT scan until 18th May ,however when I went for the guided biopsy procedure on 12th May with Dr Moss, I took the opportunity to enquire about the results when he told me he had reviewed them . Dr Moss was absolutely 'amazing' with me and told me that the CT scan indicated no concerns relating to my internal organs .

What a relief !!!!! My friend Mary who was on cheerleading duties with me that day couldn't contain her 'relief' and was 'whooping' all the way back home!

I do reserve some caution though, because my original cancer had been occult and was undetected via CT, MRI or mammogram, and so I have questions prepared about this for my appointment with consultant, Mr Khan on 18th May , where I expect to receive the results officially.

Dr Moss' charm and professionalism meant that the guided biopsy procedure went  without any drama. He used ultrasound to locate the lump I had found  in the crease of my right collar bone, aka supraclavicular lymphnode. The area was numbed with a couple on injections and two samples were taken. It was only the 'trigger sound' each time that caused my toes to curl!

Dr Moss told me that he saw a few lymphnodes during the ultrasound and that the biggest one, the one that I had noticed was 8mm in size.  Apparently this is within normal parameters and would not necessarily have raised concern had it not been for my history. In 2013, I had been told the same and we all know what that led to!

The black blob on the screen is the pesky lymphnode! 

So that's all the tests for now and I am now keen to see Mr Khan with my list of questions.

I also aim to find out whether I can go to the wedding of my dear friends , Ruth and Trevor in Barbados. I'm  due to fly out on 24th May , however all the holiday preparations are on hold until 18th May. Fingers crossed  x 

Love you guys x 

How I feel today: Keen to get the 'show on the road'. Lots of wonderful and exciting things happening this year! 

I've been existing in a pretty surreal world since I was re diagnosed. I remain at work and had been aiming to maintain a business as usual approach  in my professional life , but last week I admitted defeat when the 'elephant in my head' was just not letting me concentrate enough to hold it all together whilst balancing work, the emotional fall out and attending hospital appointments.

I clearly underestimated the impact the news would have on me and I have since been focussing on winding up my work and have had to rely on my colleagues to cover some of my responsibilities this week. Luckily I have a planned period of holiday leave next week which will give me a chance to catch my breath and make further plans about work and life when I know what my  treatment plan is!

I'll be catching you up shortly on events that led to the re diagnosis and will be sure to update you following my appointment. 

Cheerleaders

There's certainly  no 'sugar coating' in me for today's update; the 'pesky cell' is back. 

How I feel today; Angry and very determined! 

I've spent the last couple of days letting my nearest and dearest know and having found myself repeating the story and then forgetting what details I've shared and with who, I have decided to use my blog again to keep updated, those minded to follow my story. 

I'll recap on events and provide more details in future posts, but for now I am due to have a  CT scan on 9th May and a guided biopsy procedure on 22th May and the results will pave the way for the next chapter of my rather eventful story. 

I sure have been feeling 'the love' from those that have been learning of my news. People have been super keen to know how they may help and so what I have asked for and need at the moment  my lovely friends are some 'cheerleaders' , ready to furnish me with  encouragement as I prepare to pick a determined fight with this rather persistent pesky cell. 

New Boobs, New beginnings

It's that time of the year for me that inspires a pause for reflection …. The 24th October 2013, 3 years ago,  I was diagnosed with breast cancer,  news that knocked the direction my life was taking out of the stratosphere and launched it, without ceremony, onto a course of self discovery and self fulfilment. 

I look back and see this whole period of my life as a metamorphosis. The diagnosis and the initial cancer treatment was only the beginning, and I whooped that phase well into touch….. The  last 2  years or so, I found the most difficult, where my energies were spent  rebuilding my body and mind & my home and work life.

I left my story somewhat 'hanging' since my last posts, the truth is that fatigue, mind fog and doubts have distracted me  from putting 'pen to paper' and writing the next instalment.  On the run up to the anniversary of my diagnosis, I've had some prompting from friends and family,  and even friends of friend's and friends of family' to provide an update!!! 

I have found the interest in my ongoing story curious. Susan my SIL, recently explained that my blog was an honest and vulnerable account that affected and inspired people in many ways and of course there would be an interest in how things have turned out for me !

I'm ever humbled by the interest in my story  even after 3 years and if it inspires  in some way and people are interested, then I'm happy to share my experiences!

So in terms of a health update;

After  the diep flap procedure, in December 2015,  my energies concentrated on healing physically. I was off work for 12 weeks until the end of March 2016, and I felt like I had been run over by a bus for most of that time!

Gosh, I  had missed my cleavage….and I was beyond excited with the results of my surgery…..…. To call it a 'boob job'  undermines the physical ravages of breast cancer and does not represent at all the reality of reconstruction, never the less I was  overjoyed at having some 'symmetry' back in my life!

Life without a boob, was wholly doable and besides some inconveniences and clothing practicalities there were few limitations for me.  I'd come to terms with my 'wonky boobs' very early on in my cancer story, and the personal growth spurt I was experiencing,  eased any downers I had about my physical appearance.  

I always knew there would be a phase 2 of my reconstruction and that happened on 3rd June 2016, but not before an impromptu operation to remove my ovaries, an 'oophorectomy', 6 weeks earlier on 21st April 2016!

My ovaries succumbed to the effects of the chemo … and having had some 'scary' blood loss, the decision was made to remove them and so I was catapulted into a surgical menopause. It was never really my intention to have any more children, however the cruel  effects of the chemo, took that control away from me and to be honest, for a moment I felt a little 'broken'….  I'm quite fulfilled with the Son and DIL that I have, so my ongoing thoughts about this are for the many women, denied the choice of family because of cancer treatments!

My experience of the menopause is not as nature intended. After the 'oophorectomy' procedure, my body  just stopped producing oestrogen and what seems like over night , I was presented with its  affects. The hot flashes, fatigue are an inconvenience  and the weight increase, frankly annoying!  Adapting is the key and managing the symptoms, particularly the propensity for the weight increase, has been high on my priority… I'm still finding my way.

So, Phase 2 of the reconstruction surgery  involved creating a new nipple on my left boob, tidying  the scars and lipo suction. The 'perfect boob'  boob had a lil' lift too, to even up matters!

This was supposed to have been a day surgical procedure, however  the anaesthetist mistakenly  placed the cannula in my left arm and because I have no lymph nodes in that arm, this caused considerable swelling and I woke from the operation with my arm lifted in a sling and so I had an unplanned overnight stay in hospital, and later a diagnosis of Lymphedema

Mike Tyler was keen to achieve the best results and the operation took 4.5 hours, longer than expected and the results of phase 2 are fabulous. I remain heavily scarred, however  Mr Tyler's awesomeness means that my scars are tidy and in keeping with the contours of my body. 

I have  quickly learnt to love the new me, and with Mr Tyler's skills , I feel confident that what I see in front of me  is the very best of me and I feel quite proud of my  pair of 'perfect boob's', despite the hairy recreated nipple  lol!

So in terms of my work life;

The oophorectomy and Phase 2 of the reconstruction  meant further time off  work. I had been getting really 'fed up'  with the surgical interruptions of 2015/16  and  I was keen to get back to work as soon as possible after these recent ops. On reflection, I did not manage this well and I am declaring myself my own worst enemy!

I worked from home straight after the oophorectomy . This was against the advice of the nurses, however I had somehow managed to convince the Dr at the hospital that I could manage this ……  This 'sort of' worked  after the first op, and feeling confident that I could do it again ,  I totally went against Dr's orders after Phase 2, and tried to work from home before I was ready. Two surgeries within six weeks clearly took it's toll, both emotionally and physically.  

I was clearly trying to recreate what once was, and bounce back at the pace I left behind pre diagnosis!  This didn't work out as planned….. I have changed,  the work 'climate'  has changed and so I made some important decisions to reflect this. 

It's crazy, given the perspective the cancer diagnosis gave me, that I  prioritised work over health …something I vowed  never to do and even advised against.  I shall put this down to experience and give friends and family permission to 'slap' me if I do it again! 

Anyway, the time was right for a change in direction and so I found myself  a job and on 24th October 2016, exactly 3 years on from my diagnosis, I started this new work adventure. 

Whilst he job is as equally demanding, the role is significantly less pressurised … and more importantly it is a role that stimulates me professionally and gives me more control over work life balance.  

There 'is' more to the work story, but what is more important is that I have shaped my own path and now that there are no other operations ahead of me, I am out of 'professional limbo'. 

It's taken 3 years to get to the point where it feels right in my work world.  

And for my personal life;

I have experienced a great sense of peace living alone, following the relationship breakdown that occurred during the initial  cancer treatment.  I  appreciated the time this gave me to 'hibernate' and heal emotionally and physically from the ordeals.  My life has been pretty full on and  there have been periods of isolation , sometimes self imposed,  since the main treatments ended in July 2014.  

I haven't always been as OK as I have indicated to others, despite looking quite well on the outside.  This is just my way. There is of course no right or wrong way, It was just a matter of relying on my faith that things would right themselves, and recognising when I needed  support through the toughest of times.  ]

When the medical interventions ended and the support receded, these were probably the 'wobbliest' of times where I doubted, and had fears for the future. It was a full 2 years post diagnosis that I sought support from my GP re my emotional health, when I struggled to manage a culmination of life demands, which was out of character for me. 

Thankfully this phase was short lived and by February 2016, when 'Reuben', the most adorable Lhasa Apso puppy exploded into my life, I felt largely back on track. Having Reuben has been  therapeutic, he is a true companion and clearly focuses my mind on what is right with my world. 

The fear of a re occurrence of breast cancer, is about the only fear that is lingering , however there is no sign of cancer now and I certainly feel more detached from this fear as time goes on. I have never really been overwhelmed with this particular fear, but I am not going to  let go of this fear totally. I am going to use this to keep me alert for signs and symptoms, and  remind me that life is for living!

Any fears I had about being 'left on the shelf' and finding romance again have been totally unfounded.  I was naturally cautious about how the physical changes of cancer would be received,as this had previously led to a painful rejection and a relationship breakdown.  I shall keep my own counsel for now on the issue of romance, a lady never tells and all that, but suffice to say that I have dated some lovely suitors, and have literally been in 'demand' despite the spoils of the cancer war!  Ha ha!  

Body confidence has been an issue and I see this as working progress.  It has been my growing sense of self awareness and self worth that has guided my choices in the dating world….   I'm probably more in tune with relationship compatibilities than I ever have been, and whether this is through age or cancer insight, this has attracted the right kind of people, and  in fact one person in particular!  I am involved in a fledgling romance and this is promising to be something quite special… I really do not want to jinx it by saying anything else …so watch this space!

So… that is all I really have to say for now….. I still have ongoing 6 monthly oncology reviews, lymphedema  clinic appointments, yearly mammograms and Tamoxifen to look forward to !, however  I feel very much over the main treatment hurdles and for the first time in 3 years, there are no pending cancer related interruptions in my life! 

Writing this has served as a reminder on how far I have come and probably reads more overwhelming than it really was. There has been lots of changes, that isn't cancer, that is just life and what ever your troubles, have faith and hang on in there, It's working out for me. Little by little….its amazing what you can achieve!