At that moment my consultant came in, and then there were 3 of us that knew. I then needed to have a biopsy. Now I do biopsies in clinic, and I was suddenly nervous. I tell my patients that the local anaesthetic feels like a nettle sting, that lasts for a few seconds. I then say that they might feel some pushing and pulling, but it shouldn’t hurt. I’ve never had local or a biopsy. What if I’d been lying to my patients all these years? The local was actually more of a burning sensation, but lasted for seconds, and I didn’t feel a thing. The biopsy gun makes a loud noise when it is fired, and although I was expecting it, it was still a shock. But no pain.
Then I went back to my consultant’s office, with my husband who had come down to see how I was getting on (no reception in the breast unit so I couldn’t text him). I was going to have an MRI, because the lump hadn’t shown on the mammogram, and they would try and rush the results through for that Friday (i.e in 3 days’ time).
Normally patients have to wait about a week for the results - firstly to give the path department time to process the biopsy and to look at it properly, and secondly, everyone has to be discussed at a multi-disciplinary meeting (MDT). This is where everyone involved in the treatment of breast cancer discusses every patient, so when the patient is seen in clinic, there is an agreed plan of treatment. I was going to be seen again in week’s time after the MDT, but getting confirmation of what we already knew would make all the difference. There aren’t many perks to working in the NHS or in being treated in a hospital where you’ve worked before, but I was glad of this one.
That evening, I rang my close friends and family to pre-warn them. I knew it was a cancer, and thought it best to soften the blow. There was a lot of reassurance and disbelief, but I felt better for doing it. That night neither my husband or I slept well. I was busy running through all the possible outcomes in my head, and even got up in the middle of the night to go to NHS PREDICT to put in random numbers. It’s something we use in MDT and clinic to predict 10 year survival, and scared the hell out of me. I spend my life telling patients not to google things until we have all the answers, so they can then target their searches, and here was me ignoring my own advice.
Coping at work (just)
Wednesday I had to go to work and appear to function normally. I had to tell my nurses and colleagues, because West Suffolk were going to ring me in clinic with an MRI date. They are all wonderful, and I only saw new patients and didn’t have to break bad news. I got through on autopilot. In the afternoon I had a big case planned - a bilateral reduction for cancer and symmetry. My colleagues were great, and came and did it for me / with me, so I could just assist, and not worry about the complexities of the surgery. We actually spend most of the afternoon laughing at some of the stories one of my colleagues was sharing. For example, he told us that you can tell how big a man’s brain is by the size of his bottom. Apparently smaller bums mean big brains…. You had to be there.
After another sleepless night, I had a list in the morning, and an MRI in the afternoon. The list was really tough - just me and a new locum registrar, and it was really hard to focus. I was also aware of the time, as I needed to drive back to West Suffolk and find a parking space. But I got there in the nick of time. I was a bit apprehensive about the MRI, as I had heard lots of horror stories - it’s like being trapped in a tunnel / claustrophobic / noisy etc etc. The girls looking after me were wonderful, and put me at ease. For a breast MRI, you lie on your front on an incline bench, and it takes about 40 minutes. Before I got into position, they taped cod liver oil capsules to my nipples!!! This is because nipples don’t often show up and the person reading the scan needs an anatomical reference point. It made us all laugh! I was then given headphones and a massive choice of playlists to listen to, and we were off. It was noisy, but not unbearably so, and I could almost hear the classical music. Every so often the girls would tell me what was happening, and I almost dozed off at one point.
The night before…
That night I got a text from my consultant (who is also a good friend) to say the results were back. Gulp. It’s about to get real. I wanted to create a happy memory before things changed, so my husband and I and our 2 dogs went to Southwold beach. It was a glorious evening, I was up to my waist in the sea, not caring about how wet or sandy we got, and we were both laughing and giggling at our drowned rat of a cocker spaniel chasing balls. We then went to get fish and chips at Leiston (recommendation from a patient, and they are definitely worth the drive), and saw 4 Red Deer as a bonus. The perfect evening….
The ‘big hair’ shots are ironic - I knew I wouldn’t have long left to feel the wind in my hair…
After yet another sleepless night, I met my husband in clinic. Breast clinics are a funny place to wait. I knew that this was a results clinic, and the tension in the room when everyone is anxiously waiting with their husbands / partners / friends was not pleasant. A patient of mine once told me, when I went in to see her to give her bad news, was that she knew it was bad when I walked in with the breast care nurse. And she was right. If it’s good news, I go in by myself. We were called through by the breast care nurse….
My consultant was straight to the point, which was just what I wanted. Her first words were “Right, it’s a cancer”. The receptors and the MRI results weren’t back yet, but they had discussed me with the oncologists. The plan was to give me chemotherapy first, with a staging CT scan right after the clinic. When I heard ‘chemotherapy’, which I had been expecting because of my age, I then ran through all the possible side effects in my head, including almost certainly not being able to have children - no longer my decision to make.
The plan was to see me next Wednesday after the MDT with all the results of the scans, and then I would see the oncologist that afternoon, with a view to starting chemo on the Friday. 11 days from diagnosis to treatment. The NHS truly is wonderful. We were all a bit weepy when we said goodbye. Treating me was going to be just as hard, in a different way, for my consultant, and I was sad that for the duration of treatment, I would lose a close friend.
My husband and I then sat with the breast care nurse, who gave us a pile of leaflets, and then it was off to the CT scanner for me, which didn’t take long, and to the nearby park for my husband for a stroll and some thinking time.
And then we were home, alone, and our lives would never be the same again.