Just champion

Day 70  

General status update

Fatigue/weakness: getting stronger every day. Tomorrow I will go to the hospital to have another blood test, and see if my neutrophils have recovered enough for me to have chemo this week.

Hair: It needs cutting, but that is not going to happen until after chemo, if there’s still enough left to cut.

Nausea demon: Has sent us a postcard from the Lake District, where he seems to be enjoying himself enormously yomping over the fells.

Chemo Muse: Sat me down this morning, and got me to work again – I feel all the better for it.

Despair Demon: kicked him out again, with the help of the Chemo Muse – hard work is the antidote to most spiritual ailments.

Chemo Brian: seems unusually riled by Camille Paglia’s assertion in the Sunday Times today that Rihanna is the new Diana; I tend to agree with R’s view that Camille Paglia is best left back in the nineties, where she belongs.

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Anxiety level (1-10): my only anxiety at the moment is anything standing between me and FEC 4 on Thursday.

State of mind: improving

News from the Tramuntana Mountains: MamaFo rings, having lunched well (a few butterflied prawns, followed by a little foie gras with apple; she invented the high protein diet about 50 years ago, and remains a size 10) to say how much the title of yesterday’s blog post had made her laugh. She also observes that after 69 days of reading my blog she is now determined never to have chemo herself, should the eventuality ever arise. She reminds me that she is nearly 82, has been smoking for 60 years, and has yet to get cancer. ‘Hilarious, isn’t it, darling?’ ‘Yes, Mother’ I reply ‘Yes, it really is’.

The Men’s Final of the US Open is pushed back to Monday in 2012, because of inclement weather. I have a strong feeling that this match is going to be the one when Andy Murray finally becomes a Grand Slam Champion, something I have been waiting for ever since I first saw him play as a lanky, stroppy teenager back in 2005. He needed time to finish growing, become stronger, and sort out his head, but right from the beginning it was evident he had not only the talent, but that inner core of steel needed to become a Grand Slam Champion, and the US Open has always been his favourite tournament, on his best surface, the one he is most likely to win.

So Monday September 10^th is a big day for me, one I’ve been waiting for a very long time; it is also the day on which we are going back to Charing Cross Hospital to meet the surgeon who is going to operate on my breast. Before today, this has all been very theoretical; now, the wheels are beginning to turn, and I have to face up to what is going to happen to me.

The appointment is for 9.10, which is good, as clinics tend to run late as the day goes on; at the beginning of the day, we should get in and out reasonably quickly, and then R can go to work. At 9.15 a doctor calls us into an office, sits us down, and tells us that he’s very sorry, but Mr H, the surgeon, won’t be there for another two hours. He doesn’t explain why. We don’t have to stay and wait; we are free to leave, but should return at 11.15 am. We thank him for letting us know, and walk outside into the sunshine, debating what to do.

We decide to make use of the time by going to the Haven, the Breast Cancer Support Centre which is quite close by, in Fulham, so that R can see it for the first time. R hunkers down on a sofa and reads his book, while I browse in the library, but we’re both too tense to concentrate. By 11am we are back in the Breast Clinic waiting room, and 20 minutes later a man comes in whom I recognise as Mr H – I’ve already googled him. Google has informed me that Mr H is a highly experienced breast surgeon of about 50 who has worked in the USA as well as the UK, has an MPhil as well as all his medical qualifications, and a number of research publications to his name. He also has a private practice in Harley Street, and is Head of Breast Surgery at this hospital; on paper, at least, he sounds excellent.

After my bruising experience with Mr G, however, I am approaching this meeting with extreme caution, and a great deal of anxiety. I know surgeons need to be good at cutting people up, and putting them back together again; interpersonal skills are not part of the job description. But I’m damned if I’m going to let anyone else treat me with such blatant discourtesy.

I needn’t have worried – Mr H turns out to be as impressive in person as he is on paper; he is courteous, kind, and doesn’t feel the need to talk down to us. On the internet I found a list of questions that you should ask your breast surgeon when you meet him for the first time; top of the list is how many times he has done this kind of operation, but I can see that might not do, here. Operating on breasts is what Mr H does, and has been doing for at least 20 years, so we can skip the preliminaries. We ask about the cancer, and how they decide on the course of treatment: he has endless patience with our questions, which are many, and is crystal clear in his explanations. This is a man completely on top of his game, who is also personable, and taking pains to put us at our ease; he cannot be faulted.

My tumour is, they think, relatively small - about 1.4 cm. It is Stage II, which means that although it has invaded the breast tissue outside the duct in which it originated, it is still at an early stage, and its growth is relatively slow; it is not an aggressive cancer. They don't think it has yet spread to my lymph nodes, which are the first port of call after the breast when a cancer begins to spread. The operation Mr H will perform is a Wide Local Excision (WLE), commonly known as a lumpectomy. In the bad old days, a diagnosis of breast cancer automatically meant a mastectomy, however small the tumour, or early the stage; nowadays, though, they try to conserve the breast if at all possible. Mr H assures us that the cosmetic result in my case is likely to be very good, that the breast will not be notably different in size or shape, and that there will be little, if any, scarring.

He asks to examine my breast, as he needs to think about how to approach the surgery. I disrobe, and point to the location of the lump, just under the surface on the upper slope of my right breast. Mr H feels the lump with great care, and gazes at my breast, deep in thought. At this point it strikes me, very forcefully, that my life will literally be in this man’s hands: he is going to take a scalpel and slice me open to remove the lump of deadly mutant cells inside. My future is completely dependent on his skill. I’ve never had any kind of surgery before, and this sudden realisation of what he is going to do is shocking; my eyes fill with tears and I close them, so no one will see.

Mr H starts to talk about what he will do, his fingers moving over my breast to show me. He is a sculptor, I realise, a sculptor of breasts, and he talks like the craftsman he is.

‘What we’ll do’ he says ‘is make the incision around the areola, the edge of the nipple here, in order to minimise any scarring. Then, when we’ve taken out the tumour, we’ll move some tissue from down here’ – he touches the lower curve of my breast below the nipple – ‘up to fill the space, and then we’ll re-position the nipple higher up.’

Oh, Jesus Christ, he’s going to MOVE my NIPPLE. Please God, no, please don’t let this be happening to me.

Mr H continues, smiling ‘So, really, we’ll just be giving you a breast lift’.

What the F***? Did he just say a BREAST LIFT???

I gaze at him stupidly. ‘A breast lift? You mean like in cosmetic surgery?’

‘It’s not cosmetic surgery’ says Mr H,  slightly terse, ‘It’s oncoplastic surgery.’

‘Yes, yes, of course’ I say, terrified of having offended him. ‘I do realise that. Sorry – I was just a bit surprised.’

He continues: ‘But yes, the overall effect will be the same as a cosmetic breast lift. Afterwards, your nipple will be higher up on the breast.’

I am still finding this difficult to compute.

‘So afterwards it will look different from my other breast?’

‘Oh, don’t worry about that’ says Mr H ‘I can do the other one to match, later on.’

That afternoon, after R has gone to work, I google breast lifts, and discover that women apparently in their right minds, healthy women with healthy breasts, pay upwards of £5,000 to have this kind of surgery. It floors me. I read about the risks of the surgery, and the pain it involves, and how long it takes to recover, and I think ‘Healthy women PAY to have this done to themselves? REALLY?’

My immediate public reaction is to start writing cheery emails about wonderful my surgeon is, and joking about how I’m going to end up with the tits of a 22 year old, and how lucky is THAT?

Inside my head, though, I’m not doing too well.

In the late evening, it’s the tennis, and my chance to exult as Andy Murray roars through a titanic five set struggle to become Britain’s first male Grand Slam Champion for nearly a century. My heart isn’t in it, though, and we go to bed, but I lie there in the dark unable to sleep, my head full of what is going to happen on the operating table.

Eventually I give up and get out of bed, creeping out of the room as quietly as possible so as not to wake R. In the sitting room I finally stop trying to hold myself together, and sit watching the last set of the tennis with tears streaming down my face, trying to cry quietly.

I end up on the floor, curled up in a foetal position on the old Caucasian rug which is one of the few things I brought with me when I moved in with R. Andy Murray wins, achieves his life-time dream and weeps with joy, as R comes in and finds me on the floor, sobbing one sentence over and over again: ‘I don’t want him to cut me up, I don’t want him to cut me up, I don’t want him to cut me up.’

We both know, of course, that what I want is no longer of any importance whatsoever.