Thursday, September 27, 2007

An eventful morning

Meet the counseller at Macmillan and get 'counselled'. There is such a long story to tell (and I don't tend to edit very well) that I talk for a full hour and she only occasionally interjects to ask me about a certain aspect of treatment, or work issues, or other stuff that's bogging me down at the moment. Clearly this is only the beginning. I'm apparently entitled to 9 sessions in total, so I can have as many of those, or as few, as I like.

It's not as scary as I feared, and not as hard. And it's good to talk to someone unadulterated by this whole experience (but vastly experienced in the similar experiences of others). So I aim to book another session with her and take it from there.

The only downside to this hour was that she ended things very abruptly, catching sight of the clock and realising she'd let us run over by 15 mins. I was rushed out of the room and ran down to radiotherapy, feeling slightly odd as I breezily greeted today's assistants when only moments before I'd been talking about my innermost innermosts.

Dance the dance of radiotherapy. 15 minutes late. I'm taking my top off as I walk through the door. Lights dim. Half an inf out. 90.7, moving 10.4 to the right. And that's great cover. Watch the green line bisecting me move from my belly button to my right hand side in the reflective plate. Lights up and the nurses exit. Beam on. Beam off. 'Shaft' is playing on the stereo. This was on last week as well in one of my sessions. How many CDs must they have in order for me to be hearing the same music track for the second time, on treatment 14? Machine whirs in it's trajectory from my left to the right. Beam on. Beam off. One of the nurses bounds back in. Arms down, relax. Step off the board and back into my clothes and out. I am now a consumate professional at this game.

Linger downstaris as the breast care nurse tries to find out for me if Dr Piggott wants to see me now, or later. She wants to see me for my weekly check up with her but also needs to do some plotting and planning for the booster schedule. This is the final week of radiotherapy where they plan to just zap the area immediately around where the original tumour was located. My concern is that I was meant to meet one of the therapists at Macmillan for my hour long therapy session (massage this time, not therapy of the counselling variety). It was due to start at 10.45 but everything has run late this morning since I got halfway to the station and had to turn back for something I forgot. Eventually the breast care nurse reappears. Go upstairs, have your therapy, she says.

The therapist and I make the most of what's left of my session. This is one of four I am entitled to and I have squandered it by trying to cram everything too close together as usual. Bugger. At least we get the paperwork done and next time I'll go straight into the massage.

I reappear downstairs in radiotherapy and get a nurse to let Dr Piggott know that I am back to see her when she becomes available. She turns up almost immediately and I'm ushered into a room with her and two nurses, and a simulated radiotherapy back board and arm supports. Again, i find myself starting to remove my top before I'm asked. I stop and check that they actually want me to remove my clothes - lets face it, it will be an awkward day when I walk into some medical professional's office and just start stripping for no good reason.

More felt tip is used to draw on me. A photo is taken of my boob and its lumpectomy scar. The neatness of my scars are admired and I am asked 'who did them'. This is not the first time. All nurses and specialists like to know 'who did your port?' or 'who did the lumpectomy?'. Then when you tell them the name of your star surgeon they nod appreciatively. It's what discussions about plastic surgery must be like. Or interior designers. Or chefs. Or wedding suppliers.

"Who did your nose/kitchen/catering/flowers?"

It's the sort of question which implies great snobbery in the trade to which it refers. But then again, I'm grateful for the neatness of my scars, so if we want to treat our star surgeons with such fawning respect then who am I to argue with them? It's rather like half the creative people I've ever worked with in advertising. If someone's a genius in their specialist field, you let them get away with murder and treat them like a god.

Back in the planning room, a woman is placing a transparent piece of film over my right boob and tracing things. I ask questions I've been storing up for my consultant. One is about whether or not I should be getting my port flushed if it's staying in for any length of time. Turns out I do need it flushed. Every five weeks at most. Oops. It's been over six weeks since I last had chemo, when it last would have been flushed. Someone could have told me...

The second question is one about a small mole type thing I have on my right breast. It's a mole that has developed in my adult life. It's skin coloured so is barely noticeable but you can feel it as a small raised bump with slightly scalloped edges. It's not got any bigger and doesn't hurt, but I'm just more aware of it now that I'm rubbing cream on my boob twice a day. And given events over the last six months, I am more likely to take action and see someone about it, rather than shrug it off and assume shit only happens to other people.

We go into another room and a bright light is shone at the culprit. Dr Piggott announces that she isn't a dermatologist but... to her it looks like what is called a rodent ulcer. Nice name. It's also known as basal cell carcinoma. When I hear the carcinoma word I wince. That's what they used to describe the tumour in my breast.

"Is it skin cancer?" I ask, steeling myself, as I instantly imagine a slow slide into metastasis and more invasive treatments ending up in the inevitable deathbed scenarios. All of this happens in a blink of an eye as Dr Piggott is very quick to put my fears at rest. Basal cell carcinomas do not metastasise, they only grow larger and may ulcerate (the surface breaks and bleeds). Treatment is simply whipping them off, or, ironically, radiation to the area. And she's going to refer me to a dermatologist to get it checked out properly.

Big phew.


After a trip upstairs to revist chemo day care and get my port flushed I head back to the office, reflecting on two things.

I remember reading somewhere shortly after being diagnosed that once you've had cancer, you can never look at a spot and just see a spot. They were right.

I also felt sick twice during the course of this morning. Once when I was in the chemo day care centre and felt that familiar anticiatory nausea wash over me with the smell of the equipment and antiseptic. The other time was when I was nowhere near the chemo day care unit, but downstairs in radiotherapy hanging around for appointments. I happened to be near the lift, where a porter was taking someone's lunch up to them on a tray. It was the sort of lunch that I was served in the chemo unit - the one where Rich would take the sandwiches because I would feel too sick. Seeing this plateful of food brought back memories of the day when I had to send him over to the other side of the room because the smell of the sandwiches was just making me ill. These sandwiches today were wrapped in clingfilm, so I couldn't smell them. But the sight brought back the memory of the smell, and the chemo, and left me retching in the corridor.

Seems like chemo-related nausea triggered by sense memories take a while to wear off. If ever.

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