17. Cancer Diaries - Iterating

Hello reader, if you remember from last time I was about to head off to hospital for my operation. Let me pick up from there. 

The first stop was to the Outpatients where I had guide-wires fitted. The process was via Ultrasound to identify the original marker clips that were inserted at the Breast Clinic back in March. Then, once found an injection was used to push a wire into my breast, and a separate one into the main lymph node, which would act as a guide for the Surgeon to find the main spots to cut out; a guide-wire. I literally had wires sticking out of my body. I couldn’t see them due to the angle, or feel them, thanks to local anesthetic, and I was then padded up so I couldn’t knock them either. A quick Mammogram to take pictures of the Doctor's fine work and that was phase one completed. 

I shuffled around the corner to the main hospital and checked into my room for the night. (Do you check into a private hospital?) A few hours later I wandered down to the operating theatre for the main event. 

You maybe wondering what these images represent. The common aspect is a blue-ish colour. In addition to the guide-wires my surgeon also used a blue dye to identify the main lymph node that connected my breast to the main lymph node motorway. Once identified it was removed, along with 4 others. The blue dye was injected into my breast and the dye lingers about - for months. I now have an oval shape blue mark on my breast about 7cm in length. It's going to be with me for a few months while it takes time to fade out of my skin. I've tried to match the colour to a Dulux paint chart, and Teal Touch is the closest I can find. My surgeon mentioned that I am now a member of the Bluetit club, hence the bird picture. As for the pictures of Smurfette and Avatar, well these are famous blue ladies that have also been associated with me over the past couple of weeks. Bring it on!

Surgery completed, I was returned to my room to rest for the night. No morphine was supplied during this trip, I had to content myself with chocolate ice cream instead.

I was allowed home the next day with strict instructions to do my arm exercises so that I could regain full movement in my arm after being cut around the armpit area. I was diligent with my exercises as they are super important. Even now I still have some numbness in the area and also a strange feeling like I have grazed myself along my tricep. This is all nerve damage which I'm hoping will be temporary. 

The following Friday I went to see my Surgeon for a wound check and to see if there had been any initial results back from the biopsies taken. There were. 

Breast. 1mm of cancer tumour was remaining in the breast. This was removed along a healthy margin of tissue surrounding it. The biopsy results showed that the tissue was indeed healthy. Everyone is happy with the result and no more is needed to be done to the breast. Looking it at in the mirror, I also think that no reconstruction work is needed either. The surgery only removed a tiny amount of tissue, so all good. It's just a bit blue. 

Now, with every silver lining there is a cloud, so here is mine. Lymph nodes. The procedure was initially planned to take 4 lymph nodes out, but my Surgeon, with decades of experience, felt that a fifth one didn't feel right and so he removed that too. This 5th node presented with active cancer cells under the microscope. I still had cancer in my body. 

We initially thought that the chemotherapy had done an excellent job of killing the cancer. Certainly it had reduced the tumours down to a tiny size, but it hadn't totally removed the cancer. We downgraded the result to a good response. 

It is medical protocol to do further surgery. I now need to have a full clearance of the lymph nodes on my left arm. This will remove any other affected lymph nodes from the area and effectively break the circuit and stop any cancer from spreading to other parts of my body. In essence, this surgery will give me a long term prognosis, a future. 

You may be wondering what lymph nodes do in the body. Let me explain in some simple terms, as I understand it. Lymph nodes are all over our body and contain fluid. They are the body's first line of defence to trap any virus or germs and to help heal the body. The average person can have anywhere from 0-50 lymph nodes in the armpit area alone and lymph nodes come in different widths.

This next surgery will take an upside down pyramid shape of tissue from my armpit area to do a full clearance of lymph nodes. This issue of doing this will mean that my left arm will become fragile. I will have to be super careful of any bite, scratch or bruise to the arm as my body will no longer have its natural defence mechanism. I will have to keep antiseptic cream and antibiotics nearby to counteract the possibility of Lymphedema, which will really put my arm at risk. Oh joy. 

I have to confess that I didn't take this news well. It was a step back for me; not as bad as the original diagnosis but a bump to my journey so far. This second surgery will be more impactful than the first. I will be fitted with a drain for about 10 days to collect lymphatic fluid. Eugh! Is it a good time to tell you that I'm not good with bodily fluids? The prospect of the drain is making me feel squeamish to say the least. 

I have to remember the positives from having this surgery - I get to have a future and it is as blunt as that. So I will be a good patient and head back to the hospital this Friday for the next procedure. It also means that I am no longer on the happy path of treatment. I won't be able to raise a glass of fizz at Christmas knowing that the treatments of Chemo, Surgery and Radiotherapy are all completed. Don't get me wrong, it won't stop me from drinking the fizz, just to be clear. 

Instead, the Radiotherapy stage will start in January and it may also have a boosted element to it, based on what has already been found in the lymph nodes. For now I can only take it one stage at a time. Get the surgery completed and the cancer finally out of my body and then see what comes next.

It's not the news I wanted to share, but it's the news I have. We are now having to iterate on the original plan. Buckle up kids, we're in for a bumpy ride.