Armageddon

This is FEC chemotherapy. Well actually it isn’t because this is just the E bit of it, F and C come in a few extra syringes. There are lots and lots of syringes and they arrive in sealed biohazard packaging.  The chemo-nurses wear special gloves and aprons when administering these drugs, they pair-up to check the information on every syringe is exactly what’s on the patient’s drug chart and they also double-check the victim patient they’re about to push these things into is the person named on all the paperwork.  With Armageddon safely underway inside said patient, spent syringes and associated paraphernalia goes off for secure disposal.  It’s a bit like USAMRIID (http://www.usamriid.army.mil/) without the military personnel.

FEC stands for 5-fluorouracil (5-FU), epirubicin and cyclophosphamide. 5-FU is one of the oldest chemotherapy agents and has been around for over 40 years. Epirubicin (affectionately known by staff and patients as the red devil) has been in use since the early 1980’s and cyclophosphamide is a nitrogen mustard.  If you’re wondering whether nitrogen mustard is something to do with mustard gas you aren’t far off.  It’s also been around for 40-odd years, fortunately as a chemotherapeutic agent and not for widespread production of WMD’s. Each drug works in a slightly different way to interrupt cell division or induce cell death.

Info about side-effects can be found here http://www.cancernet.co.uk/chem-fec.htm.  There are some additional side-effects that don’t get published in the patient guides and your oncologist will tell you about them if you want to know. You have to ask the right questions e.g. Are there any other risks I should be aware of? Are there any side-effects that cause serious or long-term issues (and more importantly is there anything we can do about them)?  Knowledge can be a blessing and a curse. I like to know but as the saying goes ‘if you might not like the answer, don’t ask the question.’

Chemotherapy strikes fear in most people and not without good cause. Poisoning our bodies is a drastic thing to do. But the reality is that it’s the best solution currently available to us for a variety of cancers and often the only solution when dealing with particularly aggressive forms.  Hold on to the thought that oncologists aren’t Thomas Wainewright. They don’t set out to hurt, harm or poison other people.  They’re doctors and they’re trying hard to cure or treat us with the best possible tools in their toolkit.

There’s no denying some of the side-effects are crap but I can assure you dying from cancer is altogether crappier.

Jehovah’s Witnesses

I live in the countryside in the middle of nowhere. It’s green, very peaceful and Mermaids show up more frequently than people of faith out here. So it struck me as odd that the weekend before Armageddon was about to be launched in my body (aka FEC chemo) two Jehovah’s Witnesses arrived at my door.

What made this visitation even more surreal was the realisation that the last time a Jehovah’s Witness called on me was 3rd December 1996. I remember it clearly because it was the day after my Mum died from cancer treatment complications aged 47.  I still can’t stand ‘You’re Gorgeous’ by Babybird simply because it was the first song on the radio when Dad and I got in the car to drive home that evening.  I’d been up all night crying and I looked and felt foul.  The unfortunate Jehovah’s Witness who visited me that day got a sharp-tongued rebuke about good, evil and my all too raw experience of a violent death.  She didn’t stay to convince me dying was a gift or being with God was safe and happy… which was a good thing because she was in danger of meeting Him much sooner than she anticipated so fragile was my state of mind at the time.

My two more recent visitors wanted to know if I thought women are treated fairly. Well let me think…. if you count the fact that women still make up a paltry percentage of senior executive roles, are continually expected to be ultra-glamorous, stick-thin, super-woman working-mothers and regularly face the joys of things like polycystic ovary disease, osteoporosis and breast cancer…. gosh it’s a tough one.   But my visitors tell me fear not. None of us need worry (including all you guys out there) because we’re in ‘the last days.’  And if we believe in God like my visitors believe in God then we’ll all go to a happy, harmonious, sun-shiny place where love is all around and life is eternally good.

I’ve nothing against religion and I certainly don’t condone illegal drugs, but crystal meth can take you to la-la land too. Or so I’m told.

When is a pig not a pig?

WARNING: may be offensive to vegetarians, pigs & pig-lovers.

Ever heard of acellular dermal matrix? No, me neither until July. ADM is a decellularised pig product, in my case pig intestine.   With my ‘no diet, no gym’ flat stomach dream lost in the ether the revelation that I had “insufficient droop” to undergo an immediate silicon reconstruction was another potential blow. I’d need a two-step expansion process – not my idea of fun… OR if I wasn’t adverse to pig-products I might be able to use ADM to support an immediate silicon implant.  Not fun either but better, in my view, than becoming a blow-up dolly!  Once again salvaging something positive from an uncertain situation I decided the insufficient droop comment was, in fact, a compliment. By 43 things do start heading south.

So what to do about ADM?  Two thoughts struck me:

1. I’m an animal lover and I don’t support animal exploitation. Somehow having our porcine friends live on in women who need reconstructive surgery seems more worthy than turning them into bacon sarnies. (OK, I confess, bacon sarnies taste nice too).

2. I’m not one for shortcuts but when it comes to medical procedures I’m happy to get them over and done with as quickly and simply as possible.

End of story? No, not quite. Right up to the time I went into theatre I had no idea what I’d wake up with – complete new breast, fried-egg expander or nothing on the right-side at all. Until M got to work she couldn’t assess how much room she’d have or how well the surgery would go.

So I went to sleep in my fetching faded mint-green hospital gown complete with super-sexy surgical stockings wondering if I’d wake up like San Francisco’s twin peaks or Japan’s Mount Fuji.

    

I’ve always liked San Francisco 🙂

Free NHS tummy-tucks

Back in July my consultant M talked about the option of a diep flap reconstruction. 18 years ago when my Mum developed breast cancer the choices were lumpectomy and a distorted boob or mastectomy and a prosthesis. Today we’re luckier. There are lots of very good reconstruction options including temporary expanders, immediate silicon, latimus dorsi or diep flaps. Diep flap is nothing short of a free NHS tummy-tuck relocating skin, fat and blood supplies from below the navel up the abdomen into the chest to create a nice, 100% natural replacement breast.

I thought exchanging my right breast for a flat stomach was a pretty good deal, even though diep is a long and complex surgery.  I was certain (having been attached to it for a long time) there was enough squidgy flab on my midriff to create an average sized breast. We weren’t talking Dolly Parton after all!   M asked me to stand up so she could take a look and I stood there feeling awkward all the while day-dreaming about my new ‘no diet, no gym’ super flat stomach. Then she dropped another bombshell. “No, I’m afraid you don’t have enough fat to create a new breast” said M.  What? I don’t understand!  I’ve seen that stomach day-in day-out and its cosy layer of fat would look much better shoved up onto my chest.

Scrambling around for a way to change M’s mind, I tried convincing her with the most plausible, medically sound argument I could come up with.  There must be enough fat because my BMI says so. How could she possibly explain my ‘keep off the pies’ rating if I didn’t have enough fat to build an average sized breast? Where the hell IS all this weight if I’m not covered head to toe (but mainly on my stomach) with a thick layer of gloopy fat?

“It’s not fat, its bone mass” she said.  My dreams of the ‘no diet, no gym’ flat stomach were lost forever.