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2011 - Blog

On 11th August JH was, indeed, at her GP's Surgery where the Practice Nurse took off the see-through dressings.  As I was experiencing my usual aches and pains, the Practice Nurse kindly arranged for me to see Dr Jilly Coleman who had been at the Practice for 6 years.  I was told by Dr Coleman that I could take Ibuprofen in the short term - which I already knew but just needed reassurance!  I noted in my diary that I was entertained - both in conversation and visibly - by the flamboyant lady in the waiting room: I passed a remark to Dr Coleman who smiled broadly and said that the lady was, indeed, rather striking in her appearance! 

In the meanwhile - I received an appointment from Vision Express to attend for my 'routine' eye examination on 16th August 2011: I had been referred to Vision Express by Bateman's Opticians whom I had been attending for many years until they closed their Business.  The Optometrist informed me that she would write a letter to show to my 'Consultant' - in view of the fact that I was in the middle of being treated for Breast Cancer, and taking a few prescription medications.  Apparently, my pupils were not reacting to light adequately.  However, as I was not feeling robustly 'in charge of myself' I did not remind the Optometrist - that I was taking Amitriptyline to 'damp down' my chronic pain problems.  I was further distressed by the 'Charity Mugger' who stopped me by the Sundial in Plymouth, and - on receiving the response that I did not want to donate to his Charity because I already donated to Charities of my choice - he waved his hands about over my head, and then he informed me that he was 'adjusting my halo'!  I simply replied that 'I try to keep my halo rather inconspicuous' and walked away.  Subsequently, many fellow pedestrians wrote to the Plymouth Herald and complained about these Charity Muggers' behaviour: and so they should. 

18 August 2011: It is very easy to be wise after the event (as the saying goes) but I do regret not taking in the 'writing on the wall' - in this instance actually written on a sheet of paper handed to me by Jenny.  Together, Miss Prance and Jenny Richards explained that I had a tumour which was 27mm at its maximum dimension - which necessitated excision of breast tissue of 35 mm dimension; the Histopathology Report identified the tumour as 'Invasive Ductal Carcinoma in Situ (DCIS); during the surgery a margin of tissue was excised round the tumour but the tumour reached the medial margin of the excision; the tumour cells were sensitive to Oestrogen.  The cells in two lymph glands from under my arm which had been excised (through a separate incision) were not sensitive to Oestrogen.  I was told that further surgery was required but I was then told by Miss Prance that she would not be performing my next operation because she was leaving Derriford Hospital.

I showed the letter from Vision Express to Miss Prance who, of course, stated that she did not have an ophthalmoscope in her Consulting Room.  She handed the letter back to me. The Optometrist had actually addressed the letter to my General Practitioner.  Furthermore - my main aggravation was that she had, throughout the text, referred to me as 'Mrs' whereas it quite clearly stated at the top of the letter that my title is 'Miss'.  I subsequently showed the letter to Dr Dawson, at my GP Surgery, and he pronounced my eyes as being perfectly normal - the accommodation of my pupils being only fleetingly affected by the Amitriptyline [1].

Furthermore, I did burden Miss Prance's ears with the story of being asked to stay in overnight following surgery because there was no SHO available - which story rather irritated her as she assured me that the discharge summary should 'automatically' have been filled in immediately after surgery.  Also, I was aware that Jenny was a bit bothered by my bothering my busy Surgeon!

On 5th September 2011 I attended an Appointment at the Primrose Unit to meet the Surgeon, Mr Cant - who explained that a further attempt at excision of a wider margin round the tumour site would be performed: I signed a Consent Form.  Mr Cant was at pains to state that I might eventually need to have a mastectomy.  I had already thought of this possibility: in fact - having read the written information which I had been given at my postoperative appointment, I did wonder if - had I been more assertive and less frightened - I should have 'insisted' on having a mastectomy at the outset: it is very easy to be wise after the event.  In the afternoon, I attended Erme Ward where further swabs were taken to screen me for MRSA.

My niece Stefanie, together with her eldest daughter my great niece Hanna, aged 12, visited me from 7th September until 11th September.  Ann had told me that '. . . we have decided that Hanna should not be told that her great aunt has breast cancer'.  On enquiring of a number of my friends in Plymouth, they found this 'embargo' on communication rather strange - as I did.  The whole of my German Family were aware that Ann had had breast cancer herself.  In fact, young Johannes used to say to Ann 'Mummy, your boob is slipping again!' {ie, in the German equivalent} in the days after his mother had had a mastectomy at the age of 43.

On 12th September 2011 I received a very friendly reception on my re-arrival on Erme Ward: perhaps I was feeling in better spirits because I had actually got up at 7.00am in time to have breakfast!  According to my diary, 'I did a lot of people watching'.  One Nurse - who checked that my clinical history was unchanged and 'labelled' me - I had previously met; the Escort Nurse was from the Philippines; the Surgical Registrar was from Jordan:- he told me that the procedure might be a little more prolonged because of there being scar tissue from previous surgery; the Anaesthetist was from Bulgaria:- somehow . . . there was a suggestion that the order of the Operating List should be altered - as JH mentioned she had a 'burping problem' which was accentuated by having last eaten at the crack of dawn.  I obtained instructions - on how to use my recently-acquired Mobile Phone - from a gentleman who was waiting for his wife, and I rang Mary.  In any event, I was the last patient to go to Theatre at about 4.30pm.  I do not recollect having a long walk to the Theatre.

At 6.00pm I was back in Postbridge Recovery Ward; Mary had arrived at 5.30pm as arranged.  The patient was dozily aware that she farted, when she coughed as the Anaesthetist's endotracheal tube was removed, and subsequently the patient realised she had PUd into her pants (which one is allowed to keep on under one's operation gown).  Oh Dear!  But Mary had two pairs of knickers with her and so loaned a pair to JH, and Mary found a plastic bag in which to place the wet item/s (why are pants and knickers plural?)!  The patient ate some biscuits with a drink of water.  Thereafter I departed with Mary who took me home in a Taxi.  We both had a light tea/supper of soup, and 'Mary's custard' - in other words - custard which Mary made, or brought with her?  Here . . . JH reports that, during each operation, I received a saline infusion to keep me hydrated but also, of course, necessitates PUing rather frequently during the subsequent night!  The following morning I had the remains of a tin of cream and marmalade on toast for my breakfast, as I still had a food deficit.  I introduced Mary to Godfather's Fish and Chip Café in Saltash - as a thank you for Mary's further escort duties!

On the last day during which Tinside Lido was open 'for the season' - Sunday 18th September - I really enjoyed my last swim in the open air!  The temperature of the water was recorded as being 12°C but I did not feel particularly cold therein - perhaps this was because the ambient air temperature was not particularly high, and there was no breeze.  I took my see-through dressing off myself on the day after my swim - my 7th postoperative day.

At my second post-operative appointment on 28th September 2011, Mr Cant informed me that tumour cells had, again, been found in shavings off the cavity of the first excision.  In actual fact he waved two bits of paper at me - one in each hand - which indicated clearly to me that he considered the need for mastectomy being unavoidable now.  However, as he was prepared to try a third excision of the tissue surrounding the cavity, I accepted this offer.  Most patients are offered three tries at excision of all tumour cells but Jenny did tell me that one lady had a fourth local excision which was successful . . . but only one lady . . ..   I had written in my diary that I 'got a bit bogged down with discussions about Stefanie's gene, and percentage of ladies having mastectomy after three excisions' - Yes! Quite So! 

By-the way, JH had noticed - in the waiting room in the Primrose Unit - magazines about 'things mechanical'  which she assumed was for the men to read whilst they waited for their spouses to attend an appointment.  However, when JH mentioned her observation to a member of staff, she was reminded that a small but not insignificant number of men develop breast cancer.

http://www.cancerresearchuk.org/about-cancer/type/rare-cancers/rare-cancers-name/breast-cancer-in-men

As instructed I phoned Erme Ward - on the Tuesday following - to check if it was necessary for me to be seen prior to my third admission for surgery: I was told that this would not be necessary.  However . . . on the Thursday after that, 6 October 2011, I received several phone calls from the Hospital - apparently my MRSA screening was not as it should be - so I nipped up to Erme that afternoon to have more swabs taken from my nose.  I did have a pleasant surprise, however: Ray Trevitt, the Live Transplant Co-ordinator, phoned me up to enquire about my health, because Kathy had attended an appointment at the Royal London Hospital and had told Ray that I had breast cancer.


[1] JH stopped taking Amitriptyline in the Summer of 2014 because she felt she was dozy enough - as she got older - without taking a 'soporific' drug:- and the aches and pains were maneagable, and JH just about 'kept up' with her irritable bowel!

 
 
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