39. The response

“An appointment has been arranged….” yes, yes, surely those road works to improve access to the north of the city had finished?  There was some progress but like me there was still work to be done.  Whereas the City Council was dealing with tarmac I felt I was dealing with silicon with more than of a hint of concrete and iron.

With a skin sparing mastectomy the removed breast tissue is weighed and an implant of a similar weight is inserted but the density is greater which means that if feels very different.  I don’t know if the removed boob is taken to pathology like jelly on a plate or just slung into a tupperware tub – I was asleep for this bit.  I didn’t get to choose the implant either… just as well really as a Geographer we deal with contour lines and drumlins neither use silicon.

Back to the impossible car park, past a new gang vaping under the no smoking sign, through the concourse and up the stairs to sign into the Primrose Clinic.  Although I was in my school uniform (badge, lanyard, school bag) I no longer felt I needed the “armour” as I was a “NED” no evidence of disease impatient patient.  Nick and I were invited into the office to meet Mr X.  I had brought the BRAPAS guide to reconstructive surgery with me (BRAPAS GUIDE PDF) I’d read through it, highlighted bits and added post it notes.  Mr X and the lovely plastics Breast Care Nurse laughed as I got this out of my bag as they’d wondered what I’d bring to this consultation.  Before I could talk them through this though I said I had something very important to show them.

I kicked off my shoes, handed Nick my jacket and demonstrated two different types of plank – plank a) high plank – arms out straight, weight forward and core tucked in and plank b) left arm boxed out, right arm bent and resting on elbow and then I showed them a few dips.  I knew I could do this as I’d done it at Barre.  The response was – great, super, we can see you are very strong.. sit on the chair please.

I only had one question…. what would they recommend from the menu offered in the BRAPAS guide?

The DIEP flap, as observed on the BBC 2 programme, is considered the gold standard of breast reconstruction.  To see if I could go for gold it was the old routine.. top off, bra off, but this time could I stand up please as Mr X had to sit in front of me and assess my tummy.  I wasn’t allowed to put my arms and hands way up in the air, stand on tip toes of breathe in to make my tummy look smaller – nope, it was just stand there and have old jelly belly prodded to see if there was enough material for a new boob… or two, subject to blood vessels being suitable.

I had done some more research and read a few academic papers on the pros and cons of a risk reducing mastectomy on my one good boob.  The overwhelming evidence suggests that with the use of hormone/endocrine therapy the cancer was unlikely to manifest in the good boob…. if it were to return then my bones, liver or brain would most likely be the preferred option for these heinous cells.  I think, I’m almost sure that removing the no evidence of disease boob is the wrong thing to do… but there is just a tiny voice which scuppers the evidence and says “yes but… the tissue is the same, the milk lobes were the source of the original cancer..” which is usually heard about 3am.

Tip:  You don’t have to do a plank or any other form of exercise during a consultation, many patients and most consultants would prefer it if you just took a seat but they must have more patience than me.

Tip:  Difficult as it may be try to live in the “now” and don’t think what if ….. unless a secondary cancer diagnosis becomes a reality.

Author: fionaosmaston

I live in Plymouth, Devon with my husband Nick and near my parents Sandy and Sheena. Our three children, Marcus, Phoebe and Miles are grown up. I am a geographer and love teaching Geography. My current role is as an Assistant Vice Principal in an inner city comprehensive school where I lead on coaching and initial teacher training. In August 2017 I was diagnosed with invasive lobular carcinoma and following a skin sparing mastectomy and endrocrine/hormone treatment I am now awaiting a final reconstruction. These views are my own and writing this story has helped me come to terms with where I am in this interlude of life which has been dominated by breast cancer.

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