Ep.7: Vanity prevails
We saw my Surgeon on Thursday, in theory it was to get the test results back from the biopsies following the MRI but none of us were expecting anything other than that the cancer has spread beyond the initial lump I found. It has and I’ve had a week anticipating this point. He does his usual thing of summing up where we’ve got to and why. He confirms a mastectomy is no longer a choice, its my only option then asks how I feel about that. I shrug, I’ve known this was coming, I’ve done my homework, I’d figured it out. I nod to the A4 sheet of typed questions I’m clutching. The nurse smiles and says they’re usually written on scraps of paper. Not me. If there’s one thing I know how to do, a place I know where to take control, it’s when it comes to writing questions. And these questions have come easily over the past week. I was never the kid who was afraid of putting up their hand in case of asking something stupid. If I’m curious then I’m curious and I want answers. I’ve made a career out of wanting answers.
So we pick our way through my list. Will it come back in my right breast? The evidence suggests there’s no higher risk. Is there a genetic link, I need to know for B? Unlikely but they’ll investigate if we need to find out more. Do I need to have my coil removed? No, not unless I want to but don’t get it replaced. I question this one more thoroughly. ‘How come?’ I ask, ‘if I’m going to take Tamoxofen (because we now know my cancer is responsive to hormones) isn’t that counter intuitive?’, the Surgeon gives me his thoughts, I’m satisfied and move on. Down through my list we dance until I come to rest on ‘how scarred will I be?’. ‘Do you want to see photos?’ he asks, ‘yes’ I say.
So as he goes out of the room to find his photos I mull over the curious statistic he’s offered that in the Highlands only 15-20% of women he sees opt for a reconstruction. I’m surprised by this. He says you need to consider why you want a reconstruction. We’ve had to push and pull this one around a bit. I did consider how I would feel just having a mastectomy without reconstruction, tried to imagine the feel of nothingness. I looked up pictures and flinched at the odd, pinched-in torso of double mastectomy survivors. I’d asked David to be honest with me. Asked if he thought I was someone who needed to be more whole, he said a very definite ‘yes’. I wondered whether that made me vain but in the end thought that it would be the fastest route back to some kind of normality, even if recovery was more prolonged. So I’ve opted to be one of the 15% but I still find the prospect hard to swallow.
The Surgeon shows me his work. We flick through anonymous photos of women with latissimus dorsi reconstructions, looking for breasts that compare in size and shape to my own. This is surreal. 3.5 weeks ago this was not part of my landscape. Now here I am sitting in a beigely bland hospital consulting room flicking through a macabre catalogue of life saving surgery. He shows me what he describes as his ‘best’ work and I am impressed. He says he can’t show me the worst but it looked like a shark attack, it all fell apart. I’m deeply reassured by his honesty and his ability to deduce that I need that honesty. I don’t need subtle smooth words I need fact and flinty reality.
Suddenly it all moves forwards with a jolt. A date is booked for a sentinel node biopsy, a later date for the surgery itself, a commitment to come back in between the two to discuss whether there’s lymph node involvement. We have a plan. We’re introduced to Karen, the breast care nurse, who hands me quantities of leaflets and her card so I can call with any further questions. She takes us along to the pre-op assessment team who immediately say they’ll see me before their afternoon appointments. I’m being moved to the top of a queue it seems. After 3 weeks of wading through life in slow motion we’re being fast tracked past waiting lists and appointment letters. If I was suddenly to be whooshed into theatre here and now I wouldn’t be surprised. The nurses in pre-op assessment ask question after question in duplicate, tick box after tick box testifying how little I drink, how good a diet I have, that I’m not over weight, don’t smoke, how much exercise I do, the underlying scream in my head being WHY I SHOULDN’T BE HERE FOR FUCK’S SAKE! Then they say they’ll need to take some blood and I blanch. I say they’ll need to lie me down and once again I feel an idiot for being so good at fainting and so bad at coping with these kinds of medical interventions and invasions into my body.
I’m taken to a different room and a different nurse introduces herself but I’m not paying attention because my brain is still reeling from the sudden pace of the cancer conveyor belt. I lie down and she chats amiably as she tightens a tourniquet round my right arm and searches for a vein. At first I do ok. I chat back, smile and play the game. But after the first vein collapses and the second attempt to find some blood fails too, tears start to come. She calls for one of the anaesthetists to help. They move the bed so he can get to my left arm instead. Another tourniquet and I pump my hand obediently. It hurts and I’m now in floods of tears and the beautiful nurse holds my hand in hers and looks me in the face and whispers ‘you’re stronger than you realise, you can do this, you’re so strong’. And now it’s the compassion in her eyes that is bringing me to tears and I’m unspeakably moved at how moved she is by my misery.
And then I’m finished and out of there and walking with David to the car and I’m wishing I could remember her name. And I’m already starting to mourn the loss of my left breast while starting to panic at how and when we will finally tell B about all of this and none of it.