After such an amazing week, with my birthday and completing the sprint triathlon, I shouldn’t have been surprised that I started to get very, very low. The reality of having cancer was slowly kicking in. Up until now, I had still been in denial - I didn’t really have cancer, I wasn’t really going to have surgery, and chemotherapy was just something I was going through.
Suddenly, I started to feel sorry for myself, and was crying in the shower. Could I not just go to sleep and wake up when everything was over? I did actually see this as a good thing. It had to happen at some point during my treatment, and I was glad it was now and not in six months’ time, when the pressure valve would have a lot more steam to release.
Your body was made
One of the main things that was getting me down was my appearance. I think it must be very hard for anyone to truly like themselves during chemo. There is so much to contend with - no hair, thinning or no eyelashes / eyebrows, weight gain or weight loss, swollen ankles, flushed cheeks, rashes, ruined finger / toe-nails, visible lumps and bumps, ports and scars - the list goes on and on.
In the house alone, without my makeup and bravado, I avoid my reflection. When I have made an effort, and I look in the mirror before I leave the house, I think I look OK, but the moment I see ‘normal’ women in their party frocks, with a full head of hair, and eyebrows, wearing heels that aren’t crippling them because their toe nails aren’t soggy and lifting off, I suddenly lose that smidgeon of self confidence I had.
BreastCancerCare and Macmillan have a lot of advice regarding dealing with your body image during and after chemotherapy, and there are always people you can talk to, through both websites, for support.
There is one song that can almost always bring me back around and put a smile on my face, and that’s ‘Your Body Was Made’ by Ezra Furman. We saw his band play at the John Peel Centre at Stowmarket, and he performed wearing a denim miniskirt and bright red lipstick. This song is about accepting who you are, and I should probably listen to it at least once a day. It’s my chemo anthem. These are the lyrics.
When good news is bad news
This week I had to see the oncologist again, after having more bloods taken, and get the results of my MRI scan and echo. I was nervous, but couldn’t explain why. I knew that the tumour had shrunk because it was no longer visible, but was still anxious. Firstly, the echo was fine. I have a couple of tiny heart murmurs, which you can hardly hear, but nothing that would stop me having the next round of chemo. I’m going to move on to FEC (5-Fluorouracil or FU, Epirubicin and Cyclophosphamide) which can weaken or damage the heart.
On to the MRI - and the report said that the tumour was shrinking, and was now ill-defined instead of having clear edges, and my oncologist and my husband were delighted. I, however, was upset. I wasn’t expecting such good news, and I didn’t know how to cope with it. A tiny part of me wanted the chemo not to have worked.
I had prepared myself for the worst when I went to get the scan results, and hearing that it was all OK was an anti-climax. I know how to handle bad news, but good news….?
I explain to some of my patients with small, good-prognosis cancers who don’t need chemotherapy that they might feel that they don’t get the sympathy they think they deserve from friends and family. Yes, they have cancer, but they had a small operation (in and out on the same day), could carry on working through radiotherapy, and unless they told anyone, no-one would know they had had cancer. Now for some women this is perfect - they can keep things private and continue with their lives. But for others, they need / want the visible symptoms of cancer, to wear the badge and get the comfort / concern / support that most women having chemo get.
A friend told me recently that they were glad when they got a recurrence, because it meant they could stop wondering if ‘today was the day’ and finally get on with the rest of their life. I completely understood what they meant. Cancer really does screw with your head.
Doctor, Patient or something in-between?
I had asked my oncologist to move my chemo date from Friday to the Monday, so I could attend a ‘Hot Topics in Breast Cancer’ conference organised by The Royal Marsden Hospital. I go every year, and it’s the most useful conference in the calendar. I didn’t think I could go this year, as a colleague had already booked to attend and only one of us is allowed leave at any one time. But now I was off sick, I was free.
There were going to be some interesting talks relating to lobular breast cancer, as well as a lecture on acupuncture to treat hot flushes, and I was definitely suffering with those. It would also be chance to catch up with people I hadn’t seen in ages. I put on my new glasses, wrapped up warm and set off to London. And from the moment I arrived, I knew it was completely the wrong thing to do.
I stuck out like a sore thumb. I normally stand out because I’m tall, and used to have a head of thick, curly hair. But now I’m bald and there was nowhere to hide. People were lovely but didn’t really know what to say to me. The one good thing was that I could go around the trade stands as both a doctor and a patient, and was given some free samples of mouth washes and lubricants and information on what anti-sickness drugs I should be having with the next lot of chemo.
Once I was sat in the lecture theatre, listening to new information about how inaccurate certain scans are, or how cancers spread, or new ways to treat brain metastases, it was all too much. It was all I could do to stop myself from crying. I made my excuses and left at lunchtime and went straight home to bed where I stayed until Dermot came home.
I felt like I didn’t fit in to the world I knew and loved, and didn’t know whether I would ever fit in again. I wasn’t just a breast surgeon, I was also a patient, and I knew at that moment that I didn’t belong. I had lost my sense of identity. All people wanted to talk to me about was my cancer, and my blog, and I had been reduced to an illness.
The internet is bad for you
I spent the weekend attached to my phone scouring the internet. I was reading forums about the side-effects of FEC, such as horrific nausea, constant vomiting - which was a bloody stupid thing to do. The majority of women said that FEC was much easier to handle that Docetaxel, and that their symptoms only lasted for a few days and that the anti-sickness tablets worked for most people. But I was hoping that I would get the worst of it, almost needed to be really ill. If the second half of my chemo was a breeze, I wasn’t sure I’d be able to mentally cope. My poor husband had to deal with a very down-in-the-dumps Liz, and instead of making the most of our ‘extra’ good weekend, I felt like I had ruined it for both of us.
All that was left was to wait out the weekend, and turn up on Monday for chemo. That feeling of being out of control, and not knowing what to expect, was almost too much to handle, and my inner superwoman had definitely left the building.