Mind the Gap between Diagnostics and Surgery

The knock of the knot – A Breast Cancer Blog with Lacanian Angles Curves

 Cancer Tests…Patience! Warrior or Worrier?

Who knows the depths of this rabbit hole? When will the falling stop? We came away with the diagnosis of IDC Invasive Ductal Carcinoma. “Cancer Patient” what an earth does one do with that title? What a hot potato! The recent history of vitamin D deficiencies and femur pain alerted the specialists to arrange a full body CT scan and MRi, the results of which would be known before surgery. In the meantime celebrations were in order for remaining whole. It seemed appropriate to run the first of the month 10K. Who knew how the surgery and treatment would alter my running ability. My breasts, my lungs, my thorax and my general ability to be me.

run girl 3b run girl run britania yoga

The run was steady and just over the hour. My PB stands at 54 minutes but that was several years ago and before the Half Marathon Training. My times had become slower after learning to run over longer distances. My Barcelona Half Marathon Time (la Mitja Marató) was two hours and seven minutes. Considering all that had happened throughout August I was not going to beat myself up with some ‘self-flagellation’ for taking a few extra minutes on such an amazingly sunny day. Running in London in a crop top at 48, who wouldn’t scream “Carpe Diem” and take a few snaps. What’s wrong with being a self voyeuring narcissist! In fact why hadn’t pictures been taken more frequently! Notice the word “pictures” not “selfies”. Perhaps because a body is taken for granted on the day-to-day and no-one expects alterations to come out of the blue.Who ever expects a personal Frankenstein to step into their lives? In fact who wonders if they will become the next wretched monster. With the zing of post- biopsy nerve pain easing, to run was bliss.


My preferred sports’ bras are both Royce and Shock Absorber. I combine but tend always to wear two bras if I want to go under the radar. The visible jiggle, joggle, jug-gle is both discomforting for me and distracting for onlookers. Not to mention damaging for the jugs in the frame! Mine are still pretty pert – two sports bras, see! We don’t wish for casualties!

2 reasons for 2

The knock had come as a warning to wise up, chivvy and prepare for an impending change. Atishoo, atisshoo, pass me a tissue as self indulgent tears are welling, not of pain but of fear and impotence. Dates are marked on the calendar as time slows whilst smiling like a super-trouper to keep up the formal normalcy of each working week.http://www.drugs.com/mcp/breast-biopsy#Image_What_you_can_expect  September 7th and it’s time for the bone scan. Why oh why do my veins vanish when shiny needles appear. Of course it was impossible to put the cannula in the crook of my arm. Deep veins, narrow veins, delicate veins, I’ve heard it all. So the tube was plugged into one of the bulbous veins in the transparent skin upon the back of my bony hand. Ouchy. Stripped into the hospital robe I lay upon the machine as the nurses fled for cover in their little bunker. Once switched on, a burning hot sensation seeped into my hand as the radioactive liquid rushed into my body. It was burny. I called out in case that was unusual. My voice was swallowed by emptiness as no-one replied. Silently, eyes closed the machine whirred. It’s drone-like shadow inches from my face. It’s metallic greyness leaving a cybernetic taste upon my lips. In a different life those mineral atoms and molecules may have become a mountain bike or a child’s scooter and these living cells of mine may have had a reprise: no hawk-eyed nurse, with hours of CPD training would have noticed tell tale signs of cells showing suspicion of malignancy. Who is this person being scanned for cancer?

Some days after the whole body bone scan came the breast MRi. Wearing two medical gowns the specialist eyed my veins which once again hid away, having to be coaxed into action from the dark bruises on the back of my hand. A cannula was attached and a cold dye injected in order to achieve clear images once the machine was activated. Despite waiting some time before my turn came, no-one had explained the postures required. A slight confusion and sense of humiliation and impotence flooded over me as I was asked to mount the machine on all fours. I felt incompetent like a child and emotion chugged hot behind my eyes. Clambering upon my hands and knees I lurched my stomach forward lizard-like, before lowering these pendulous dugs into the hollow depressions within the scanner. How ungraceful. The clinician adjusted my chin on a padded rest and fiddled with the side openings where my body dangled. If only I had seen a photo of the machine and ungraceful posturing then maybe the sting of salt would have been prevented. It was tolerable and over in a flash but those moments of confusion had left a heave of sadness and desolation. On September 11th the results came through to confirm that things were as before, no worse, no better, although the lumpectomy and sentinel node biopsy would bring the final judgement by determining if the lymph nodes were clear. All that was left was to wait for the date of surgery. Breathing into these events my hope was to maintain a modicum of normality.






Tick Tock – Run Rabbit Run!

The knock of the knot –  A Breast Cancer Blog with Lacanian Angles Curves

There is no “if”

The recommended hospital check up on August 17th became a dizzy drama which had ended in the collection of three biopsy samples tagged with the verbal verdict “suspicious of malignancy”. We now fast forward a week to August 24th for the consultant’s truths and the clinical evaluations of the extracted tissue. Cancer is bad enough. But breast cancer is not just a question of removing the invasive tissue, the damage is more often than not on display for all to witness. Sweaters or shirts, yoga or work, small is beautiful, big is better, size doesn’t matter, asymmetry is the new me. Aesthetics are examined because the gaze is where it’s at and choices are weighed according to appearance. Seen, gazed upon, evaluated by well qualified clinicians and ones own inner critic. Yet only the survivor will know how or what they feel. Once the “C” word has been uttered the die is cast – the journey has begun.  And how different it is to be the follower of the path rather than the one who watches the follower trip-trap, trembling into the face of the unknown.

Run Rabbit Run!

The speed of events leading to that place called “diagnosis” leaves a cut that strikes to the quick. The cancer journey traverses the path of the Lacanian Borromean Knot at a surreal pace. The criss-crossing shifts between the raw horror of the Real Order to the incomprehensible medical spiel in the Symbolic Order. Here one hears a series of numbers and ciphers that announce the severity and spread of the tumours. All of it takes a while to sink in. How does a mere mortal with no medical knowledge interpret, contemplate, face or side step these truths? How if not with flights of fancy, fear and fortitude? The Imaginary Order assists to re-play all possibilities no matter how far fetched.

For one who enjoys contemplating all case scenarios in order not to get nasty surprises a mastectomy or even wide spread malignancy were in that worst category. How does one deal with the receipt of such news? In the past week my knowledge and reading about breast cancer had increased exponentially. I had over forty windows open on my cell phone. The most difficult to assimilate was recent publicity regarding over-diagnosis. Particularly I was concerned about an apparently benign type of cell disorder namely DCIS, ductal carcinoma in-situ. Yet this bugger of a stage zero cancer pointed to all sorts of possible future complications and is often treated with double mastectomy. Okay if a huge tumour were present then a mastectomy had to be the course of action but if they’d discovered one of these supposedly benign dubiousities what would be the decision then? Throughout the week my imaginings ran riot and my non-medical brain clung to “watchful waiting” an expression that seemed to do very nicely. My semi-subconscious had affirmed that if it were all neat and small then it would be permissible to “just wait and see”. Maybe the bad cells would slip away unobserved if they weren’t given the centre stage. Mastectomy however was on another astral plane. Of course anyone in this situation goes through the list of “what ifs” and it is necessary to do so. It is necessary to prepare oneself for the decision making to come; to arm oneself with the knowledge and try to find the strength to take the next step. It is natural to consult and scan the evidence from: medical trials, hospital case studies and those who’ve had first hand experiences in blogs and forums.

If a mastectomy were needed then so be it. There is no choice remaining if that is the considered treatment. So easy to say and so quickly contemplated in that safe imaginary space. But then what? Then comes chemotherapy, being irradiated and the immediate discussions about remaining flat or facing reconstruction. Now that is a biggie because often it is the patient’s choice. Never have been good with choice – how can anyone know what is for the best? As a big breasted gal having part of my body replaced with a prosthesis goes against the grain. I like my breasts. I’m slim, I maintain that lollipop shape and I like my breasts. But maybe that is the reaction of many. Would choosing flat be closer to remaining me? Remaining authentic?  Would a unilateral operation then soon imply the need for a double mastectomy just for gravitational balance? What would the physical complications be if the healthy side remained a 30GG? Becoming so lopsided is probably asking for future structural and musculoskeletal complications! A one breasted quasimodo!

alice 2In the consultant’s room I had the letter in hand, the classification was U4. Falling into the biopsy procedure seemed almost an accident yet a lump had been noticed. It wasn’t just routine. I myself had flagged up the possibility that maybe there was an irregularity, an irregularity that was part of my body topography and that had been noticeable as a visible palpable knot for months. I heard myself explaining this as the consultant sat squeezed in front of us in quite a tiny room. About to embark on my “leave well alone” strategy I began to speak, “If it is a cancer….” Before I could say more the consultant had doubled in size. He rose up in his seat and rapidly stiffened, bracing himself to reply. His response to my bargaining plea almost knocked me into the back wall. In retrospect I don’t think he spoke loudly but his tone and gust of breath gave no room for nonsense. “IF…if… there is NO place here for if. It is cancer!”

That piece of straight talking brought us all into the here and now. No menacing real, no vague cloud of symbolism and no room for imaginative reprise. Yet all the Borromean elements were present. The real like a spectre in the corner. The symbolic of voice, body language, gaze and scientific convention opened a chasm between us. The rabbit hole was widening as I was falling further and further away from what I new as tierra firme.

U = ultrasoundThey’d not discovered a benign lesion. It was a baddie. It was not DCIS or a cyst or fibrous tissue. It was IDC. Invasive Ductal Carcinoma that the biopsy had siphoned out. Leaving rogue cells (that had already broken out of their region) to possibly spread further around the body was out of the question. There were no ifs nor buts, it had to be excised: scalpel brandished and incisions made. The consultant wasn’t part of the team I had seen on the day my world was turned on its head. He gave little room for chat. He was very matter of fact and an operation was going to be planned. The lump was to be removed, clear margins sought and the sentinel lymph nodes biopsied. Only after the surgery would the specialists really know what they were dealing with. What imposter was I harbouring? BUPA was mentioned. Could BUPA be a saving grace? Everything was already moving way to fast and the surgeon most likely would be the same guy whether I were to choose private or not. Why fast track to BUPA?  I’ll stick with the NHS. The word “lucky” began to infiltrate into conversations. Lucky to be in a part of the planet with a pretty amazing healthy care system. Lucky that the malignancy had been found early.  Lucky to live not so far from the hospital. Lucky not to have to consider those worst case scenarios. Lucky to be relatively young, very fit and healthy. Healthy! Yes healthy – Bah humbug – Lucky Lucky Lucky.