Tuesday 7 August 2012

Plan B

I worked out today that it's 28 weeks since I was first diagnosed. Sadly cancer still hasn't f*cked off but at least we do have the secondary option of mastectomy.

I'm certainly now feeling much more 'practical' about it all and that things are finally moving forward again. That wasn't the case a few weeks ago. In fact, I was very frustrated. Knowing that I had a big decision to make but not having any access to the information or people that could help me make that choice was very distressing.

In particular, I was very disappointed with my breast care nurses not picking up the phone or returning calls. This was not the support that I had been led to expect. I was left feeling very let down and cast adrift at what is a very uncertain and upsetting time.

Basically, I was told on 20th July that there were two main mastectomy options: a DIEP flap, that is, one using your own tissue (usually from your stomach, like a tummy tuck); or an implant (of which there are various sorts).

However trying to find out more detail about both, while not knowing if I was even eligible for the DIEP or when someone would tell me, was excruciating.

Anyway, I eventually got to see a plastic surgeon to discuss a DIEP on 1 August. I say eventually because I had to chase for the appointment and then the surgeon was an hour late despite our appointment being the first of the morning!

And then, not a sniff of an apology ...

Well, Mr P. wasn't having that! He'd already collared the breast care nurse about her poor response and wasn't going to let a tardy Harley Street specialist off scott free. The bloke looked visibly shocked to be asked so directly 'So, what was the hold up?' and, coupled with a firm handshake and a hard stare from an imposing Mr P., was left so unsettled and shaken that he had to leave the room to compose himself. Awkward!

But also quite right too. There hadn't been any appointments before ours but instead of being there at 9am at the start of the clinic, as we were, he turned up at 10am. We know, because we heard the receptionist say so. And I know these things happen but to not even apologise or acknowledge the fact that he was an hour late arriving at clinic was pretty outrageous.

Anyway, ticking off over - the meeting was quite productive. I've decided, on the plastic surgeon's recommendation, to have an implant - which may, or may not be permanent.

He thinks that I might just have enough tissue on my stomach to do a tissue reconstruction but - given that I may yet need radiotherapy and radiotherapy can shrink the new breast tissue - they think it best to save my tummy for now, given that I don't have 'surplus'!

However, I can still have the tissue reconstruction at a later date, should I want one. It could even be years from now (as implants do need to be replaced). Obviously both types of reconstruction have benefits and risks - and a failure rate of about 1%. But at least I have some flexibility should I need it.

So, I won't be seeing the plastic surgeon again - which I think he's probably quite relieved about! Instead my implant will be done by my original breast surgeon Mr Gui who is, apparently, an expert in this type of reconstruction.

And we shall see him tomorrow to discuss the next steps which should, hopefully, include an operation date. My appointment is a 10.45am but I think I might take the precaution of packing some sandwiches ... ;-)

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