8. 19th April 2021 - Farewell Tilly

Today is the day. I didn't sleep too well. I am happy that Tilly will be leaving the building, but still so scared about what the future will hold. I am also anxious about the actual surgery, Miss D has explained how she will perform the operation. She will cut around my areola and then perform a wide local excision, cutting away the lump including some healthy cells to ensure that it is completely removed. She will then inject some dye under my arm, which will feed into the lymph nodes so that she can easily see which lymph nodes to remove. She will take the first 2, which will be sent to pathology to prove beyond doubt that there has been no spread of the cancer.

I arrive at the Day Surgery Unit (DSU) at 0715hrs - I am called through to a bed space, advised to change into a hospital gown and some highly fashionable surgical stockings, then to take a seat. I have the choice of a very lovely reclining chair or a very uncomfortable hospital trolley. A nurse comes to check me in - everyone is very friendly but my tension is rising.

The nurse takes my temperature, oxygen sats and blood pressure. Surprisingly my blood pressure is normal! She says that Miss D and the Anaethetist will come to see me soon. There are 5 of us on the list and I already know that I will be last as I was added as an extra. The Nurse anticipates that I will go down around 2pm and says I can drink water only until 10am - I have already had to starve from the previous evening.

She pulls my curtain around my cubicle and I settle back to wait my turn. I have brought a book and a magazine, I have my phone to listen to Podcasts or music - but I can't concentrate on anything. I still feel in a bit of a haze and haven’t really accepted that this is actually happening to me - it is just going on around me. As I sit there alone, listening to the other patients - who all sound much older than me (not that I’m particularly young) it all starts to build up inside and I do have a little cry - this is the first time since I found Tilly that I have shown any real emotion - but even now it’s only a few tears - if I don’t acknowledge it then is it even real?

I can hear Miss D doing her rounds of the other patients - she sounds just as positive and friendly as always and obviously has a good relationship with all of her patients. She eventually gets to me and takes time to reassure me that the operation will go well and apologised that I was at the end of the list but she would try to get to me asap. I am just happy to be there today (well not exactly happy but you know what I mean!)

Shortly after her visit the Anaethetist arrives and runs through a few safety checks before he too leaves me to my own thoughts. I have my glass of water but now it is after 10am so I am allowed nothing else. Time ticks slowly by and I hear the other patients go down to the theatre and return a couple of hours later. At least 2 of them have complications which cause delays - it is now after 3pm and I’m still waiting and have such a bad headache - probably from dehydration. At 3.30pm they take my trolley and then thankfully come for me at 4pm.

I am taken into the anaesthetic room, I am lying on a trolley and feeling really anxious as you would expect. A theatre nurse is with me and is chatting away, I assume to try to put me at my ease. This was working until she asked me the following question. ‘ Oh, I see you work in radiology - do you think that’s why you have breast cancer?’ I mean, seriously? The anaesthetist looked at me and just raised his eyes and shook his head - I just totally ignored her - I mean why would you say something like that?

Anyway, moving on...the operation took about 2 hours and I then spent a further hour in post op - I remember waking up thrashing around and crying, saying that ‘I didn’t want this - make it go away!’ and also my headache was still banging!

I was taken back to the DSU and a lovely nurse got me some painkillers and an ice pack for the back of my neck - absolute heaven! They won’t let me leave until I have had something to eat and drink and been to the loo but at the moment I still feel really woozy from the anaesthetic so this will take a little while!

I am eventually picked up by Sophie at 9.30pm - it’s been a VERY long day!

The next few days are spent recovering at home in bed. I am dreadful with anaesthetic and it always stays in my body for days - I am struggling to stay awake and just doze off and on. My lovely mum comes and sits with me and it’s day 4 before I can manage to get up for a potter around. I have to say I am not wrapped in dressings - there is simply some micropore tape around the areola and a small plaster under my arm - it has been quite painful but I have been given plenty of pain relief. I am particularly surprised with how good it all looks. Miss D took the time to move my breast tissue to rebuild my breast so it really looks like I have had a little lift - my boobs look great! She had previously said that I have very young looking breasts - (yay, go me!) so perhaps this has played a part in how good they look today. The scar under my arm is short and neat - I do have a large blue area that looks like a nasty bruise but it is simply where the dye was injected - I have been warned that this can last for some months.

I should say at this point that not every breast surgeon performs the operation this way - some will cut from the axilla (underarm) to the nipple but Miss D believes that it should be as non-invasive as possible and goes to great lengths to minimise any scars.

It is very important to get your arm moving asap after surgery in order to avoid stiffness and pain - and I have been given a booklet detailing exercises to do. These need to be done daily and, although it is uncomfortable initially, I soon find that I have full movement in my arm and shoulder. Removal of lymph nodes can also increase the risk of developing Lymphedema which is the build-up of fluid in the soft tissues - which will cause your arm to swell. Apparently, once you get it you can’t get rid of it, so the idea is to prevent it happening in the first place. Any injury to the arm increases the risk so you just have to be really aware - this seems really daunting at first and I found I was constantly checking and being overly concerned - but you soon realise that you just need to put it all into perspective and just be aware. I have also been advised that I must never have my blood pressure or blood tests taken from my left arm again - this is also to avoid any risk of Lymphedema.

The most important thing I need to remember now is that I NO LONGER HAVE CANCER!!!!!! Tilly has gone and now I just need treatment FOR breast cancer. This takes a while to sink in and I am still reminded of t regularly by my family and friends. It is such a strange feeling - I haven't even fully got my head around having cancer - and now I don’t! It’s a crazy feeling. And life carries on.