Once I was left alone in my room, it was with a rising sense of trepidation that I peeked below my gown to look at my chest. I could see a large white dressing across the underside of my left breast, but to my relief the rest of my breast looked exactly the same as it had done that morning. I’m not sure what I expected, but I was pleased that the plaster seemed relatively small to me. I could feel another dressing under my arm where they had removed some lymph nodes, but neither area was in the slightest bit painful. I was also very relieved that I did not feel at all sick. After previous operations I had felt really woozy and totally out of it, but this time I felt alert and ravenously hungry.
When a nurse appeared I asked if I could get something to eat and she said she would bring me some tea and toast. While I was waiting I texted various people to tell them I was out of theatre and soon after my sister-in-law Sue, who works in the children’s hospital, came in to see me. She sat with me while I ate my toast and commented on how well I looked considering. I asked the nurse when I would be able to go home and she said that Mr Masannat would be round to see me soon and would discuss this with me. I was amazed at how good I felt. I was excited and buoyant that the operation was over and I was keen to get back home as soon as possible. So I had a quick wash and got dressed and when Mr Masannat arrived I was sitting up on the bed watching BBC IPlayer on my phone.
Getting discharged
He told me he was very pleased how the operation had gone. He said that he had managed to remove the lump cleanly and that he had removed five lymph nodes from under my arm. He did caveat this by saying that the lump and lymph nodes would be examined and tested to ensure that he had got a clear margin of good cells round the lump – ie that he had removed all of the cancerous cells and the lymph nodes would be checked to see if the cancer had spread to them, which might mean further surgery. I asked him when I would get these results and he told me it was usually about two weeks. I asked him about the stitches and when would they be taken out, to which he replied that they wouldn’t need to be – the internal stitches were dissolving ones and he used steri strips instead of stitches to close the wounds. I then turned to the matter of going home. I think he could see that I was itching to get back and he seemed happy that I was fit enough. So, I got the OK from him and he advised one of the nurses that they could arrange for me to be discharged. I was tickled and rather proud with myself when I heard him a short time later in the staff room that was opposite my room comment to a colleague “You would never guess she had just been in surgery this morning, quite remarkable!”
By the time Andrew arrived at 16:00 to pick me up, I had my bag packed and my discharge letter in my hand. We were soon on our way and I was pleased that we were able to pick the kids up from Mary’s and spend the evening together. I hoped they were reassured by seeing me home so soon that all had gone well and I told them how pleased Mr Masannat had been with the operation.
Check up after the operation
The next day after the full effects of the anaesthetic and the pain killers had worn off, my left armpit felt very sore and I had considerably restricted movement. I took more paracetamol and ibuprofen and over the next few days I made a conscious effort to keep moving my arm as much as I could and slowly I could see improvement in my range of movement. When I took the dressings off I could see the scars properly. The one on my breast was a line along the very bottom about three inches long, so that looking at my chest from above I could not see it. I was amazed at how neat it was and elated, as I knew that given time it would fade and because it was under my breast it would not be noticeable, and would probably be hidden when old age and saggy boobs kicked in!! The scar under my armpit was the painful one and four days after the op the steristrips came off and so I went to see the nurse at my local GP’s to get some more put on.
Over the next few days a fairly large soft lump developed on the scar, which I knew was a seroma from one of the numerous leaflets I had been given at the hospital. A very common occurrence, which was a collection of clear fluid that the body produces as a result of the incision (the same sort of thing as the clear liquid that you sometimes get on a bad graze). I had been told by the nurses to look out for this and that it may need to be drained. So ten days after my op I went back to the nurse at my GP’s. She asked a doctor to look at it and he said I would be best to go to see my breast nurse at ARI, so he phoned and arranged for me to go straight in.
When I arrived Kate reassured me that it was very common and nothing at all to worry about. She donned some gloves and cleaned the area and then found what looked like a fairly large needle, but that was more like a very thin straw, as it had an open end, so that when it was inserted into the wound, the fluid could drain out from it. She gave me a jug and asked me to hold it under my arm to catch the fluid while she inserted the needle. I watched, fascinated at the amount of liquid that came out into the jug. It was clear and slightly yellow in colour (similar to urine). Kate made a note of the amount of fluid that came out and forewarned me that it was common for the seroma to build back up and that I may need to come back if it returned and was uncomfortable and painful, however, the body would over time reabsorb the liquid and so it would naturally sort itself.
Over the next few days the seroma did develop again, but as it was not too uncomfortable I decided to give it some time and let it settle by itself, which it did over the next week or so.
Results from the operation
Two weeks after the operation I phoned the breast clinic to see if they had the results from my operation. Fiona my other nurse told me that they were not back yet. She explained that once the results were back they had a multi department meeting with the surgeon, oncology and radiotherapy staff to discuss and agree on my treatment plan. These were held once a week, so it would be another week before I might have any news.
Although it was frustrating to know I had to wait another week until I heard anything, it was good to know that there would definitely be no update any sooner, so I could try to put it out of my mind until the following week. After three weeks off work I felt ready to go back. My scar on the underside of my breast was healing nicely and the seroma under my arm was reducing in size. My left arm also had got reasonably good movement back, so I was happy to drive.
So I was at work the following week when my mobile rang. It was Fiona and she advised me my results were back and they had had the meeting to plan my treatment. She explained that normally I would have an appointment with Mr Masannat to discuss things, but he was on holiday for the next couple of weeks. She said that he was happy for her to discuss things with me over the phone, or I could wait until he came back if I wanted to see him. I was more than happy to get the results now and so Fiona explained that the results from analysing the lump were good, that they had got a clear margin of healthy tissue all around the lump so I would not need further surgery.
She went on to tell me that they had analysed the five lymph nodes that had been removed and one of them had a micromet. I asked her what this was and she explained a micrometastasis is a tumor deposit that is between 0.2mm and 2mm in diameter. It means some cells have broken away from the original tumor and made their way into the lymph node. I was alarmed by this and asked her if that meant that the cancer could have spread to other places in my body. She reassured me that a micromet is very small and it is the very early stages of the cancer spreading and that as the nodes had been removed it would not have had an opportunity to spread. She asked if I had been given an appointment for a scan and I confirmed that I had received notification to come to the hospital on 12th July. She assured me that this would be a double check, but that I shouldn’t worry as they had removed five nodes and only one showed a micromet. She said the next steps would be to start my chemotherapy and the oncologists would manage this. She told me that I would receive an appointment to see them in the next couple of weeks and they would explain what type of chemotherapy I would have and how many sessions I would need. After that I would need radiotherapy, but that was far easier than chemo and it was best to focus on the next step, rather than worry about what was further down the road.
I was elated that the news was good and that I didn’t have to have any further surgery, but I was alarmed to know that the cancer had started to spread so quickly. Thoughts filled my mind – what if I hadn’t seen that Facebook post? What if I had left it longer before I went to the GP? What if some cancer cells had already spread to other parts of my body? So it was with mixed emotions of relief and fear that I phoned Andrew to tell him the news. I had read enough and spoken to other people to know that chemotherapy would be pretty horrible and I would be in for a rough ride, but I felt that I was strong enough that I would be able to cope with whatever was thrown at me, as long as I knew that once I was through it the cancer would be gone.
