The next step - surgery!

So it’s the night before surgery.  Its been a long time coming to be honest…….in fact now I think about it the day of surgery is exactly 5 months after my date of diagnosis.  Whilst the 5 months have gone relatively quick it has given me a bit of time to think about the surgery, although I’ve only done that properly since chemo finished a few weeks ago as I wanted to focus my energy on getting through that first and I needed to know the plan put in place for me by the medics. 

I believe more often than not surgery is carried out first followed by chemo and then radiotherapy.  I guess this gives you very little time to think and worry about the surgery but also makes you wonder what the point of chemo is afterwards if the cancer has in theory been “removed”.  Hopefully you all remember my fabulous online “chemo friends” that I met thanks to an online cancer forum, I shall from now on refer to them as the “Stars”!  Well the majority of Stars went down this route of having surgery first.  For them the chemo was a “belts and braces” job, an insurance policy if you like to ensure that any stray cancer cells were zapped after surgery. 

A few of the Stars have however gone down the same route as me, having chemo first and surgery second.  I had to follow this route in order to be prescribed the new drug Perjeta but it’s been a little bit tough knowing that the cancer has been with me all this time.  However I’ve been able to see it shrink away to nothing which I guess you don’t get to do if you have surgery first. 

I honestly can’t say which is the best way to do things as both have good and bad points, anyway you don’t get a choice really as it’s something the doctors decide!  I’ve been lucky to have a wealth of knowledge and experience beside me regarding surgery from the Stars and of course the lovely Minnie (who followed the same route as I have) and have been able to ask many questions about my up-coming surgery.  I guess the Stars who had surgery first didn’t really get that opportunity as our group didn’t exist when they were going under the knife back in the summer.  I’m really grateful to the Stars and Minnie for all of their invaluable advice and patience in answering my questions. 

So that has been good and although I still don’t want to do it I am heading into it knowing what to expect.  I know I have to do exercises from day one, I know I’ll hopefully be out of hospital fairly quickly (hopefully one night will be plenty, well I know it will be more than plenty for me I’m just hoping the nurses agree), I know I’ll probably not be in a huge amount of pain, I know I’ll hopefully bounce back to normal life fairly quickly and I also know what my limitations will be. 

I think another plus to come from this is that the Stars who had surgery first have seen first-hand how chemo has worked on the tumours in those of us who have had to wait for surgery and I believe this has given them a lot of reassurance that chemo really does work. 

So last week I had my pre-assessment: the usual round of tests prior to having a general anaesthetic – bloods taken, blood pressure measured, weight taken, height measured, calf’s measured for the surgical socks, heart and chest listened too and a list taken of medication I take – this last one amused me slightly as although I don’t take any regular medication I did point out that I was only three weeks out of chemo and the nurse taking my details was highly impressed I knew the names of the three drugs Id had been having and had to get me to spell them!! 

Anyway everything checked out fine and I am at this point in time presuming my bloods are fine as they were good a couple of weeks ago when I went to have my iffy nail checked out.  This is important as after chemo your white blood cells need to be back to a good level to ensure the body can recover and heal after surgery and if need be fight any infection I guess.

I then had a physiotherapy appointment where I was shown the exercises I will need to do from day one.  When they perform the mastectomy they will also remove a number of my lymph nodes.  This means I am now at risk of a condition called lymphoedema which could cause my arm to swell up.  As a result of the surgeon removing the nodes from my right armpit I am now no longer allowed to have any kind of needle in this arm, I can’t have my blood pressure taken on that side and if I get a cut or sting on that arm I need to keep a close eye on it as these things can all lead to lymphoedema.  I’m supposed to heavily moisturise that arm too, I think this is to stop the skin cracking and getting infected but I’m generally rubbish at “beauty” things like that so I don’t rate my chances of following that one through.  Another thing to worry about though, just great!! 

But I will do my exercises as requested to try to ensure I don’t end up with lymphoedema!  Luckily they aren’t too strenuous, those of you that know me well know I don’t do exercise really, Simon thought it was hilarious that I was called to the physiotherapy department!  It is however another one of those things that just need doing so I shall show him!  I was pleased to pass the pre-operation tests set by the physiotherapist – moving my head from side to side and up and down, lifting my arms above my head, out to the side, in front of me and behind me…….needed a lie down after though but I did well! 

So tomorrow I report to ward 7 at 8am having had nothing to eat or drink since midnight.  I’m told I’ll meet the anaesthetist who will write up a list of drugs I’ll have.  I’m not good at taking pills, I don’t really like them so I’m hoping I can get by on paracetamol.  I’m a bit worried they give me something that sends me a bit funny.  I had pethidine when I had Kyle and I hated it, I was rather out of it which I didn’t like at all.  I gather pethidine is from the same family as morphine so I really don’t want that if I can help it.  I had Leo with the help of a bit of gas and air in 45 minutes and he was 10lb 1oz so I’m really hoping my pain threshold doesn’t let me down.  I’m not daft enough to suffer as that would be silly but I’d rather be in a bit of discomfort and with it than be numb and out of it.

So that’s the plan at this point anyway but I’ll see how things go.  Taking this into account I have instructed Simon to look after my phone and not give it to me until he is quite happy that I am fully awake and not taking gibberish!  I’d hate to make a fool of myself.

This part has taken me back to the start of this rather rubbish journey and the dreadful waiting bit!  Im terribly impatient anyway but Ill be honest and tell you that some nasty thoughts have popped back into my head in the days leading up to this next stage.  I suppose I have to get used to a lifetime of that now.  Following surgery the hospital will analyse what they remove for any remaining signs of cancer.  I hope I don’t have to wait too long for these results to come back and even if the chemo didn’t get rid of every single cell the radiotherapy and continuation of Herceptin and Perjeta for 12 more cycles will ensure they are zapped too. 

Anyway I’m sure I’ll be fine, like I say I’m going into this with a fair bit of knowledge about what to expect and hopefully I’ll bounce back pretty quickly!  Speak to you all soon and just in case Simon gives me my phone back too early I had better apologise for any gibberish I may post on Facebook or text people with xxx

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