30th of October - Results

My Husband and I are sat in the waiting room waiting to see my consultant/surgeon. I'm looking over to the lady opposite and surmise that she is wearing a wig (What the **** is happening to me?).

I've become obsessed with hair and taking plenty of photographs of mine whilst I have it. The Royal Shrewsbury Hospital have run trials in the past on using the cold cap and no longer offer this as an option to their patients.

Through this link you can search for scalp cooling in the UK. Enter your postcode to find your nearest hospital http://www.paxman-coolers.co.uk/campaigns

http://www.nhs.uk/Conditions/Chemotherapy/Pages/Side-effects.aspx

http://www.macmillan.org.uk/Cancerinformation/Livingwithandaftercancer/Symptomssideeffects/Hairloss/Scalpcooling.aspx

Another woman across the waiting room said " I have followed you around appointment after appointment and I half expected you to be on the ward on my day of surgery".

We exchanged the fact that her surgery had been on the Tuesday and mine was on the Thursday. I had obviously been in such a daze not to have notice her, although she was so friendly and familiar. She said I had stood out to her whilst we waited outside x-ray  for the mammogram as she said I was much younger than anyone else there. I explained that I had a lumpectomy and the next course of action was chemotherapy and that I was gutted to be losing my hair, followed by radiotherapy. She said that she had come for her first mammogram (as I think that cancer screening is offered at the age of 50 in the UK) and it was only then that they had detected an anomaly, whisked into surgery and would now need radiotherapy (no chemo involved).

http://www.macmillan.org.uk/Cancerinformation/Testsscreening/Breastscreening/Breastscreeningunder50.aspx

We initially went in to see my Breast Cancer Care Nurse Specialist and a nursing student in her second year at Staffordshire University and they checked the wound site and then called in my Consultant to have a gander at his handy work, which my husband and I are exceptionally pleased with.

The incision across my right boob is 3.5 inches in length
The incision made for the sentinel lymph node biopsy just below my right armpit is 3 inches in length

He explained that it was Grade 3 invasive breast cancer. He had removed the margins of the tumour site and they were clear and that the Sentinel Lymph Node Biopsy was also clear.

Staging and grading of Breast Cancer
http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Breast/Symptomsdiagnosis/Stagingandgrading.aspx

I tested Negative for ER status and Negative for HER2 Status. I am still awaiting the results to whether I am PR Negative status. This determines whether I take Tamoxifen for 5 years post chemotherapy and radiotherapy or whether I am Triple Negative, which is found in about 1 in 5 with breast cancer (15-20%).

Tamoxifen
http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Breast/Treatingbreastcancer/Hormonaltherapies/Tamoxifen.aspx

Triple Negative Breast Cancer
http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Breast/Aboutbreastcancer/Typesandrelatedconditions/Triplenegativebreastcancer.aspx

I am now waiting for an appointment at the Lingen Davies Centre at the Royal Shrewsbury Hospital to discuss the side effects of chemotherapy and the chemotherapy treatment I will be having. All appointments from here on in will be in Shrewsbury - Hurrah.

All I can think at the moment is FEC off ......

FEC Chemotherapy 
http://www.macmillan.org.uk/Cancerinformation/Cancertreatment/Treatmenttypes/Chemotherapy/Combinationregimen/FEC.aspx

17th of October - Lumpectomy

Wide local excision/Lumpectomy/ Breast conserving surgery + Sentinel Lymph Node Biopsy (SLNB)

http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Breast/Treatingbreastcancer/Surgery/Typesofsurgery.aspx

I arrived at The Princess Royal Hospital in Telford at 07:30. I checked in and found my bed and was told that I would be the first person up to surgery. My fabtabulous Husband helped me into my gown and my sexy surgery socks trying to keep my mind off the inevitable and then I had a cannula fitted. I had NOT been looking forward to this day and had a bee in my bonnet that I was going to wake up mid surgery. The Anaesthetist tried to comfort me and explain that I would be given something to help me feel calm.  I was quite tearful at this point anyway but when my husband left me by the anesthetists door, there was no stopping me. There's something very vulnerable about lying on a hospital bed being wheeled into the unknown.

Whilst in surgery I will have a Sentinel Lymph Node Biopsy, where blue dye is injected into the breast. This makes your faeces and urine blue after surgery (and even now as I am writing up these posts, my right breast is still blue, the date today is 29/11/2013). The blue dye can be visible from a few days to a couple of months later and I'm sure the Breast Cancer Care Nurse is sick and tired of all the Smurf jokes.

Sentinel lymph node biopsy is another way of finding out whether cancer cells have spread into any of the lymph nodes under the arm. During your breast cancer surgery, your surgeon injects a small amount of blue dye into the area of the breast around the tumour. Sometimes they also inject a mildly radioactive fluid known as a tracer. The dye drains away from the breast to the lymph glands close to the area. The surgeon can see when the dye reaches the first group of lymph nodes. They call these the sentinel nodes. The surgeon removes about 1 to 3 of these nodes and sends them off to the lab to see if they contain cancer cells. If the surgeon thinks any of the sentinel nodes look as though they contain cancer cells, they will remove the node and the nodes around it. Usually, the operation is then over, and you and your surgeon will get the results of tests on the sentinel node a week or so later. (Source: http://www.cancerresearchuk.org/cancer-help/type/breast-cancer/treatment/surgery/types-of-breast-cancer-surgery)

The last time I had been under General anaesthesia and into surgery was back in 1998 at the age of 26, when I had my tonsils extracted and had what I term as "an adverse reaction to Morphine".

I confirmed my name and d.o.b and spoke briefly with my surgeon. I was then asked what my favourite tipple was and as I was slurring "Shailor Jerree" I was under.

Wednesday 16th of October Fertility Clinic followed by Isotape Scan

9:30am
The Royal Shrewsbury Hospital
Fertility Services

Bloods taken x4 vials
Scans
Injection of Centrorelix

Gwen, the most fabulous Fertility Nurse, administered my first stabbing of Centrorelix.  I brought it in from home after having all my fertility drugs delivered and one particular box being housed securely in the fridge for later use. My husband will be administering this subcutaneously as I can't bring myself to do it.

Link to Administration of a subcutaneous injection:

http://www.gloshospitals.org.uk/SharePoint5/Patient%20Information%20Leaflets/GHPI0898.pdf

12:15
The Princess Royal Hospital, Telford
X-Ray Department

Nuclear Isotope Scan/Sentinel Node Imaging
CT Scan

My appointment letter read " The examination will involve you receiving a small injection of a radioisotope followed by some pictures"

Sentinel Node Imaging is carried out on the day or on the morning of your operation

A small amount of radioactive material is injected into the breast at the edge of the peri-areolar tissue, which is the darker skin around the nipple. The material is carried into the armpit by the lymph vessels and trapped in the sentinel node(s) which can then be seen on a scan after a short time delay. The scan shows where the sentinel node is located and not whether it contains tumour cells or not.

For me personally this injection stung like hell but was bearable, however I'm not sure the nurse holding my hand would agree. The nurse manipulated the material by rubbing the area of the injection site.