(Warning for detailed descriptions of medical procedures.)
So Dean and I trudged down to the U/S department, where I was stripped, draped, anaesthetized (local) and where it suddenly struck me how different it is to be a patient in a hospital, as opposed to a doctor. I suppose a certain amount of objectivity about what was happening to me is part of my defence mechanisms, but when I saw the long core biopsy needle they were about to stick into me, I suddenly realized; I am the patient now.
It is one thing to be the doctor, standing beside the bed and explaining why this test is actually for the patient's benefit and that it will be done in 'as comfortable a manner as possible'. It is something completely different to be lying on the table, about to be on the receiving end. I've done core biopsies on people. They damn well hurt.
Dean gave me two fingers to hold - a technique he learned for labour, but I recommend it to anyone who is going to offer to hold the hand of someone who is going through pain. It prevents your hand being crushed. No need for both of you to suffer.
It took them ages to get ready, going back and forth between the U/S screen and the lightbox with the printed images from my scans earlier in the day. Finally, someone positioned the needle over the square of exposed skin, just beneath where the U/S probe was resting. I looked away. Not my job to be in control any more. All I had to do was lie still and endure until it was finished.
Clunk.
It was both a sound and a feeling. The deep thud of the spring mechanism merged with the jolt all through my body, and yes, it hurt. But it wasn't over. The needle had snagged on the lump deep inside my breast, and they were having to wriggle and twist to get it back out. I felt like a fish on a hook. The automatic spring was trying to retract with the sample, but it was also caught on my tissue. The tension felt like it was trying to pull the lump out through my skin without the benefit of surgery.
I controlled my breathing. Concentrated on just breathing. I knew that if I started crying or breathing irregularly, that would make their job more difficult. Lie still. Let them do their work.
Other people are in control and it hurts! Scream! Run! Make them stop! Do whatever it takes to get away!
No. Breathe. Just breathe.
Eventually, they were able to withdraw the needle from my skin. The precious sample went into the bottle of preserving fluid, and I finally allowed myself to take a deep, shaky breath.
"You are doing so well, just three more," soothed the radiologist.
Three more? I can't! I can't!
I couldn't speak. I kept my mouth closed and my face turned away. They continued anyway.
Clunk. Clunk. Clunk. Clunk. Clunk. Clunk.
Oh God, that's more than three! What are they doing to me? I just want to go home.
Clunk. Clunk. Clunk. Clunk. Clunk.
After what I later found out was 12 biopsies, they finally had all the bits of me they needed. My jaw was sore from clenching my teeth and my throat was sore from all the screams I was swallowing.
Don't cry. Don't let go. If you start crying you might never be able to stop.
I finally managed to croak, "So, did you get milk out?"
No-one answered my question.
The ultrasonographer murmured something to the radiologist, at the same time as I noticed something warm and wet running down out of the anaesthetized area. Sloppy gel probably. At least they warmed it up this time.
The nurse abandoned the sticky dressings she had been applying to my skin, and started applying direct pressure lower down, beyond the drapes obscuring my view of what they were doing. Dean stood up to look over at what they were doing.
"Size 8 sterile gloves. Now!"
I hadn't heard his surgeon voice before. It worked. In literally a few seconds he had on sterile gloves and was leaning across me. The amount of pressure four people were applying was becoming distinctly uncomfortable.
Not milk then.
Thursday 28 August 2014
Tuesday 26 August 2014
In the beginning...
It was a Thursday. I had picked up an extra shift at the hospital because there was a gap that needed to be filled. I had an appointment with my GP in the afternoon about a blocked duct but I went in and did a ward round in the morning and sorted out all the patients and students before darting off to see my own doctor.
I wouldn't have bothered on my own account, but husbands can be such worriers! It seemed to be my fate to have at least one bout of either blocked ducts or mastitis with each baby, and Benji had suddenly stopped feeding on the right side. Besides, I like my GP. She is funny, sensible, good at what she does and we often have a laugh together about the anxieties of husbands.
I had last seen her during my pregnancy with Benji (also for husband-related anxiety) so we had quite a bit of catching up to do. I explained I was there for her to see this breast lump which was probably a blocked duct, and that I was doing my wifely duty, so could I please have a message from her to take to my husband telling him not to worry?
One of the things I like about my GP is that she is thorough. Even though we both knew this would not be anything, she went very seriously through all the steps of examining me, looking carefully at everything (even the lymph glands under my arms and in my neck) and generally doing a very good job. I always take notes about her style when I see her - she has been in practice a good twenty years longer than I have, and I hope one day to have her bedside manner.
However, I have to admit that I was not impressed when she said that my lump was "not obviously a blocked duct" and that I would have to have a mammogram and ultrasound. One of the annoying things about seeing a good doctor is that I would have to be an idiot not to take her advice. So I checked my watch, decided that I could fit in her requested investigations as long as the registrar did not call, and went over to the radiology suite.
She had called ahead and so when I arrived I went straight in to the MMG. It was rather uncomfortable, but not as bad as I had feared. The worst part was the reading material in the waiting room - 50 Shades of Grey. I decided I would rather stare at the walls.
Then the U/S, which unfortunately took a very long time. In the middle of it, my phone rang. It was the registrar at the hospital for which I was currently on-call. The ultrasonographer waved to indicate that I should take the call, so I did. It was a routine update on the patients of the afternoon and the results from the morning's blood tests. I talked to the reg for a while, and while I was annoyed to notice that the ultrasonographer had turned the screen away so that I could not see what he was doing, as I was on the phone I could not correct him.
The phone call and the ultrasound ended at about the same time, so I was given the films and released to take them back to my GP. Straight away please, and they would fax over the report within the next ten minutes, as soon as the radiologist was finished. Amazing service! I trotted back to my GP, hoping that we would be able to wrap this all up before the end of the day.
But no. She was doing the professional frown and "concerned" look that I have felt on my own face when I have to give someone news they are not going to like. Sure enough, the U/S was "inconclusive" and the report said "recommend biopsy".
"I can't. I'm on call."
My usually very understanding GP seemed to be rather dense today.
"It is one thing to have an U/S while I'm on call, but I can't have a sedative, local anaesthetic and be lying under a sterile sheet having a biopsy while I am supposed to be on call!"
Totally unsympathetically, she suggested I call in sick.
"But I've never chucked a sickie in my life before! I don't even know how to call in sick at this hospital!"
"There will be a way."
"And I'm meant to be on call this weekend as well!"
Finally, I managed to turn my mind to tackling the issue, found the relevant phone numbers, and called in sick. Then my increasingly dictatorial GP said that I should call my husband to come and hold my hand for the biopsy.
I scoffed at that. Did she think I was some kind of inexperienced person who has never been in a hospital before, that I needed my hand held? She was insistent. She even rang through to the theatre where Dean was operating. I was rather scandalised by her nerve. She did not bother to ask what he was doing - just told him to drop everything and come straight to the hospital to meet me. (I had never dared try that, not even the day I thought Zoe had a broken arm!)
So with a deep sigh I wandered off down to the surgeon's rooms for a fine needle biopsy. I still thought this was all rather overkill for what was most likely going to turn out to be a blocked duct. Lactating women are notoriously difficult to image, and I was well aware of the number of "false positives" which MMGs turn up in women under 40. Still, my GP was very compelling.
So the surgeon gave me an injection of local anaesthetic and stuck a small needle in me.
I asked him, "Did you get any milk out?"
"No." He gave me a rather strange look that seemed to say, "Are you sure you're a doctor?"
The needle did not hurt. I could not feel anything except for a small amount of wetness leaking down my side.
"Sorry about this, but I might be leaking milk on your examination couch."
He turned around quickly from preparing the slides and hurried back to apply direct pressure to the site. Lactating women bleed quite a lot when you stick a needle in the breast, apparently.
Dean arrived just in time for the conversation about "FNA inconclusive, suggest U/S guided core biopsy." After a quick conversation, we agreed that the girls were already with his mother and it might be best to get it out of the way immediately, so we headed downstairs for the core biopsy. Fortunately they were able to squeeze me in just before 5pm. I did not need it (of course) but I was glad all the same that Dean was there to hold my hand.
I wouldn't have bothered on my own account, but husbands can be such worriers! It seemed to be my fate to have at least one bout of either blocked ducts or mastitis with each baby, and Benji had suddenly stopped feeding on the right side. Besides, I like my GP. She is funny, sensible, good at what she does and we often have a laugh together about the anxieties of husbands.
I had last seen her during my pregnancy with Benji (also for husband-related anxiety) so we had quite a bit of catching up to do. I explained I was there for her to see this breast lump which was probably a blocked duct, and that I was doing my wifely duty, so could I please have a message from her to take to my husband telling him not to worry?
One of the things I like about my GP is that she is thorough. Even though we both knew this would not be anything, she went very seriously through all the steps of examining me, looking carefully at everything (even the lymph glands under my arms and in my neck) and generally doing a very good job. I always take notes about her style when I see her - she has been in practice a good twenty years longer than I have, and I hope one day to have her bedside manner.
However, I have to admit that I was not impressed when she said that my lump was "not obviously a blocked duct" and that I would have to have a mammogram and ultrasound. One of the annoying things about seeing a good doctor is that I would have to be an idiot not to take her advice. So I checked my watch, decided that I could fit in her requested investigations as long as the registrar did not call, and went over to the radiology suite.
She had called ahead and so when I arrived I went straight in to the MMG. It was rather uncomfortable, but not as bad as I had feared. The worst part was the reading material in the waiting room - 50 Shades of Grey. I decided I would rather stare at the walls.
Then the U/S, which unfortunately took a very long time. In the middle of it, my phone rang. It was the registrar at the hospital for which I was currently on-call. The ultrasonographer waved to indicate that I should take the call, so I did. It was a routine update on the patients of the afternoon and the results from the morning's blood tests. I talked to the reg for a while, and while I was annoyed to notice that the ultrasonographer had turned the screen away so that I could not see what he was doing, as I was on the phone I could not correct him.
The phone call and the ultrasound ended at about the same time, so I was given the films and released to take them back to my GP. Straight away please, and they would fax over the report within the next ten minutes, as soon as the radiologist was finished. Amazing service! I trotted back to my GP, hoping that we would be able to wrap this all up before the end of the day.
But no. She was doing the professional frown and "concerned" look that I have felt on my own face when I have to give someone news they are not going to like. Sure enough, the U/S was "inconclusive" and the report said "recommend biopsy".
"I can't. I'm on call."
My usually very understanding GP seemed to be rather dense today.
"It is one thing to have an U/S while I'm on call, but I can't have a sedative, local anaesthetic and be lying under a sterile sheet having a biopsy while I am supposed to be on call!"
Totally unsympathetically, she suggested I call in sick.
"But I've never chucked a sickie in my life before! I don't even know how to call in sick at this hospital!"
"There will be a way."
"And I'm meant to be on call this weekend as well!"
Finally, I managed to turn my mind to tackling the issue, found the relevant phone numbers, and called in sick. Then my increasingly dictatorial GP said that I should call my husband to come and hold my hand for the biopsy.
I scoffed at that. Did she think I was some kind of inexperienced person who has never been in a hospital before, that I needed my hand held? She was insistent. She even rang through to the theatre where Dean was operating. I was rather scandalised by her nerve. She did not bother to ask what he was doing - just told him to drop everything and come straight to the hospital to meet me. (I had never dared try that, not even the day I thought Zoe had a broken arm!)
So with a deep sigh I wandered off down to the surgeon's rooms for a fine needle biopsy. I still thought this was all rather overkill for what was most likely going to turn out to be a blocked duct. Lactating women are notoriously difficult to image, and I was well aware of the number of "false positives" which MMGs turn up in women under 40. Still, my GP was very compelling.
So the surgeon gave me an injection of local anaesthetic and stuck a small needle in me.
I asked him, "Did you get any milk out?"
"No." He gave me a rather strange look that seemed to say, "Are you sure you're a doctor?"
The needle did not hurt. I could not feel anything except for a small amount of wetness leaking down my side.
"Sorry about this, but I might be leaking milk on your examination couch."
He turned around quickly from preparing the slides and hurried back to apply direct pressure to the site. Lactating women bleed quite a lot when you stick a needle in the breast, apparently.
Dean arrived just in time for the conversation about "FNA inconclusive, suggest U/S guided core biopsy." After a quick conversation, we agreed that the girls were already with his mother and it might be best to get it out of the way immediately, so we headed downstairs for the core biopsy. Fortunately they were able to squeeze me in just before 5pm. I did not need it (of course) but I was glad all the same that Dean was there to hold my hand.
* * *
It was a long day, so I'm going to split it into two posts. Also, I've just been told that some people prefer to follow blogs on FB, so I've created a FB page for this blog and all updates will also be posted there. https://www.facebook.com/honeysandwichesandbreastcancer
Monday 25 August 2014
Welcome to my new blog!
You might be wondering why someone who already has four blogs, a Facebook account, two fan fiction pseudonyms and a reddit account needs another place to air her thoughts. Or you might be unaware that I already have all those. Anyway, I decided I need a different space to talk about my cancer journey and how it intersects with my parenting and with the rest of my life.
So here we are! Honey Sandwiches!
The title was chosen because I realized how important honey sandwiches are in my life, or more accurately, in Evie's life. It was because one day when everything was just too hard, and I was just too tired and there was just too much going on, I decided that Evie could have honey sandwiches in her lunchbox. I do not generally consider honey sandwiches to be the last word in nutrition for a child's school lunchbox. I do not encourage anyone else to give their child honey sandwiches for lunch, and certainly not on a regular basis.
But on this particular morning I was overwhelmed and stressed and I decided to chuck it all in the too-hard basket, embrace my inner "bad mother" and let Evie have honey sandwiches for lunch for once.
But the world did not end. No-one came to take my child away, or even visited to ask me probing questions. Evie ate her lunch and loved it! And I decided that on the whole, there is a place for cutting myself some slack and giving my kids honey sandwiches every now and then.
So, honey sandwiches are a symbol to me of letting myself prioritize my sanity over my perfectionism, of recognizing that I'm often too tired to do everything well and have to make some tough choices, of letting go and giving myself some grace.
Having cancer has taught me many life lessons which I am keen to record and reflect upon. You are invited to join me on this journey.
PS - If this is the first you have heard about my cancer diagnosis at all, don't feel you are the only one. I have deliberately kept it very quiet to date. I am only now beginning to be able to talk about it. The next few posts of this blog will detail how it all happened, and why I have not spoken about it much.
So here we are! Honey Sandwiches!
The title was chosen because I realized how important honey sandwiches are in my life, or more accurately, in Evie's life. It was because one day when everything was just too hard, and I was just too tired and there was just too much going on, I decided that Evie could have honey sandwiches in her lunchbox. I do not generally consider honey sandwiches to be the last word in nutrition for a child's school lunchbox. I do not encourage anyone else to give their child honey sandwiches for lunch, and certainly not on a regular basis.
But on this particular morning I was overwhelmed and stressed and I decided to chuck it all in the too-hard basket, embrace my inner "bad mother" and let Evie have honey sandwiches for lunch for once.
But the world did not end. No-one came to take my child away, or even visited to ask me probing questions. Evie ate her lunch and loved it! And I decided that on the whole, there is a place for cutting myself some slack and giving my kids honey sandwiches every now and then.
So, honey sandwiches are a symbol to me of letting myself prioritize my sanity over my perfectionism, of recognizing that I'm often too tired to do everything well and have to make some tough choices, of letting go and giving myself some grace.
Having cancer has taught me many life lessons which I am keen to record and reflect upon. You are invited to join me on this journey.
PS - If this is the first you have heard about my cancer diagnosis at all, don't feel you are the only one. I have deliberately kept it very quiet to date. I am only now beginning to be able to talk about it. The next few posts of this blog will detail how it all happened, and why I have not spoken about it much.
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