I awoke in the middle of the night, in a sweat, trembling and my heart racing The details of the vivid dream refusing to recede as I struggled to reach for consciousness. The day of the annual hospital check I had slept well, emotionally and physically exhausted. But the following night sleep came reluctantly and when it did, it brought its own nasties, nightmares of a sky filled with planes all preparing to disgorge destruction. In my dream I knew it was my last day on earth and the thoughts going through my mind were vivid. In my dream sheltered inside, because I did not want to see what was coming and anticipate those last moments. I have not had nightmares which linked closely to my experience in a conflict setting for some time. It is over three years ago, and was rapidly overshadowed by the cancer nightmare.
Even my lay mind can see the connection between the trauma of the annual check and the extreme nightmare.
As always, I did not sleep very well the night before the checks. I made sure to keep well hydrated prior to the fast from midnight. As well as making it easier for bloodletting, I am convinced that dehydration contributed to raised tumour markers a year ago.
The day started early and before 7 am I was heading to the hospital, stomach churning, wondering if my landscape would be different at the end of the day.
The hospital has a pink ribbon theme and there were two large pink ribbon trees in the foyers. A series of posters about breast cancer were on display throughout the hospital and the staff were wearing little badges. And that is the most evidence I have seen of Breast Cancer Awareness Month. It is a bit strange having the Big Annual Check amongst all this but it is not overwhelming.
I arrived at Counter No 2 and was greeted by Dr W2’s PA and her warm friendly smile. A few clicks in the computer and I was waved off to the lab for blood letting. And that answered my first question. No CT scan today! Phew! For insertion of an IV line I am always directed to one of the little rooms and an oncology nurse from floor 5 with her extra gentle techniques is provided for me. The fact I was heading to the lab meant a simple blood take. Sure enough, 4 huge vials of blood later and a sticky plaster and the first needle stick of the day was over. And no IV line.
I was then sent to the Imaging department. Bleurgh. The memories of Diagnosis Day flood back as I walk through the automatic doors and I am escorted to the changing area. I put on the gown and return to the waiting area, my stomach churning. Within minutes, I am called. I am led into the X-Ray room, somewhat unexpected. But that is fine, I am happy for an X-Ray as I have visions of my ribs and bones disintegrating thanks to surgery and radiation. Oh, and cancer. Just as rapidly, I am returned to the waiting area. All too soon a technician calls my name and I follow obediently, like a biddable puppy, to the mammogram room.
Mammograms are not pleasant but nor are they too bleurgh. While the plates are compressed to get the best possible picture, it is painful but not unbearable. And it is soon over each time. A few more poses, Twang Arm persuaded to stretch towards the reaches of its limits and soon I am told that the mammo is done. Good to tick that one off.
I am then ushered into the small “ladies” waiting area to await my call to ultrasound. And again. I am not waiting long before I am summoned. For some reason this is the part which I find the most difficult. Perhaps because I can see the images on the screen above me, and I can see the technician pegging contours. And very likely because that is where I first encountered the “spaceship” shape and met Dr W. That is where I found out there were at least 3 masses in my left breast 2 years ago. Bleurgh, bleurgh, bleurgh.
The Ultrasound technician started her procedure, carefully working her way around my chest and upper abdomen areas. Every swimming image on the screen made my heart beat faster. I knew there had been a small cyst in my right side last year, so I was looking out for that to appear. Nothing seemed to materialise though. Then she moved to my abdomen area. Little masses started appearing and soon she was pegging them and keying in letters. I saw the word “cyst” appear. More than once. I asked her about the cyst in my breast and she told me that it was not easily visible this time, perhaps it had disappeared. Cancer doesn’t disappear – does it? I grabbed at that snippet of information and grasped it tightly. It seemed to be ages before she finally told me that she was finished.
Relieved to be finished with the scans I sat up. Then she burst my bubble. She told me there was an area on my right side which was not clearly visible, and she was sending me back for more mammo images. She wanted to see magnified images of an area on my right breast. She also wanted my left side to be mammogrammified. That would be a bit of a challenge.
I was led back to the mammo room and again was pulled into different directions and compressed. I could feel the plates pinching my port but she told me not to worry about it. It took some time to get enough flesh between the plates on my mastectomy side but eventually she seemed happy with the little she got.
Finally the scans and imagining were finished and I could return to the changing room and dress.
The physical side of this is easily tolerable. However, the mental and emotional aspect is torturous. All the time, my mind was going over and over the fact that there was something that they wanted to look at more closely. I am incredibly fortunate that I get the results the same day, but even the wait of a few hours is agonising. Bleurgh.
I am also incredibly fortunate in that I have again been able to schedule my checks at the same time as my friend. We turn into schoolgirl cancer rebels and descend rapidly into silliness as a way of getting through the day. Silliness verging on hysteria. However juvenile it is though, it helps!
My next trip was to see my endocrinologist, Dr A. Prior to my consultation I had my usual weight, blood pressure and vital signs checked. Unsurprisingly my BP was high. Dr A was happy that my thyroid levels are stable thanks to the thyroxine medication, happy with kidney and liver functions and delighted with my cholesterol!! He was also happy to note a slight decrease in my blood sugar readings. This is good news because I know I am set to follow my mother, grandmother and great grandmother towards late onset diabetes. The longer I can keep this at bay by careful diet and exercise the better. He was not so happy about my BP but could see that I was in a state of anxiety following the scans and preceding my appointments with onc and surgeon for the verdicts. He was very interested in my Croc shoes and asked if they were comfortable and good for rainy season. I told him that they were not only comfortable and waterproof but they were also quite smart and I could wear them to work. It must be a good sign when your endocrinologist likes your shoes!! He took my BP again and noted that although it was still high, it was falling. He saw no point in changing the dosage of meds and being happy all round with my endocrines or whatever they are, he sent me packing for 6 months. Phew!
I had already been at the hospital around 3 hours by now, and having fasted since midnight it was time for sustenance. My friend and I grabbed a coffee and snack and I updated her in minute detail about the scans and my worry about having been sent back for a magnified image. She expressed surprise and alluded to my abundance of right side, saying that it surely didn’t need to be magnified. This made us both snort with laughter and was just what I needed to hear.
Next in the timetable were our appointments with Dr W2, our shared and larger than life oncologist. My name was called a good before the scheduled appointment time, another example of how good the patient experience is in our hospital. They knew I would be hanging around all day so I was slotted in early. Greatly appreciated.
Dr W2 was in his usual ebullient mood and proceeded to ask me all about the changing political landscape in my work context. He had a good old physical examination and then he called me back to the seat. My heart beating fast, I asked him about the scans. He said that the imagining showed up the small cyst on my right side and the nodules on my liver which had been checked 6 months previously. They hadn’t changed. He was that the mammo had come up with a Birads 2 result (benign findings) and that he was not concerned about it. My CEA tumour marker was down again and I was looking strong. I asked him about the mark on my lower arm which I just wanted him to be aware of. Just in case. He pronounced it to be “age” and told me I am getting older. This made him roar with laughter. He loves his own jokes!
I asked him whether he has been flying commercial planes in his spare time and he loved that idea. Then he started writing on my notes, saying out loud as he wrote “no relapse”. No relapse – jut the words I wanted to hear. Finally I could exhale.
I returned to the waiting area, with a grin across my face. Even though I still had to see my surgeon, I knew the headlines and trusted there would be no nasty surprises. Bleurgh but okay bleurgh.
Next is a trip to floor 5 and the oncology ward for port flushing. Bleurgh The nurses there greet me like a long lost sister and show me into one of the side rooms. I have already applied my Emla but to be honest the abject fear which the port procedures instilled in me at one time have gone. I don’t like the port procedure of course, but I know it is quick and easy. There is no blood return but the nurses say that the infusion is fine and they are not concerned. Within minutes I am holding my breath again and the long needle coes out. That’s me flushed again. Another task done and checked off
I settled down to a little online time while waiting for my last appointment, my attention span incapable of even engaging with Facebook.
Finally the time came for my appointment with Dr W, my other hero. I was ushered in first which was very welcome and he greeted me warmly. He is always very thorough in his examinations which I find very reassuring. If there is anything at all palpable then he would be sure to find it. He scolded Twang Arm again. Twang Arm and I seem to have reached a kind of stalemate, a resentful co-existence. I do have a surprise up my sleeve (;)) for Twang Arm though for some point in the future.
After the exam, I dressed and Dr W was scrolling through the many images. He is always very serious and focused as he concentrates on image after image and while I am glad that he is, I always think he is seeing something that the reports have missed. The fact that it was him who said the cancer word to me, changing my life, makes this a nerve wracking time. While I welcome and value his thoroughness and attention to detail, it terrifies me at the same time.
Finally he looked up though, and said that he was happy with the reports and the imaging. Then he asked me when I wanted to come back – what about 3 months? My lip petted as I have been anticipating the move beyond my 2 years from diagnosis and towards 6 monthly checks as a huge milestone. I replied that I wondered if I would progress to 6 monthly checks now that I had crossed the 2 year point. He was happy with that, as long as I keep taking the Tamoxifen. I was planning on taking the Tamoxifen anyway, but if that was the reassurance he needed then I was more than happy to provide it.
He told me to keep on doing what I am doing and that he would see me again in six months!
So all is good. Friend and I have been sent away clutching our envelopes with results and appointment slips for next time.
We are rather sombre but that we have made a pact. Celebratory bubbles if all is good and commiseratory bubbles if it is not good. I find it amusing to pick up pink bubbles. We toast each other.
So why does it feel so weird? No leaping about, high fiving and squealing. I simply feel like weeping. I have been here before, and while I would far rather be here than where I was 2 years ago, it is a strange place. An emotional pit.
I think my nightmare reveals part of the answer. This is not the first time I have had a nightmare which takes me back to a terrifying experience I have lived through. I have had tsunami and earthquake dreams following the checks. This nightmare of being in an air raid is not purely from my imagination. It opens a chapter which is usually closed, but can never be forgotten.
And I think I can understand why. Being told you have cancer is terrifying. Being told that there is no evidence of cancer is of course an enormous relief. However, there is an undoubted feeling that you have had a “lucky escape”. So the mind seems to flick back to another time when you are confronted with mortality. Such as an earthquake. Or an air raid. Previous traumatic experiences which I have lived through. My subconscious accepts that the cancer fear has been allayed for now but it feels as if it rewinds to another point of abject fear and plays back a version in my dreams to correspond with the fear I have of recurrence.
I wonder if this is a classic sign of post traumatic stress disorder? Irrespective of whether it is or not, it just goes to show that a cancer diagnosis is just as traumatic and vivid as a seemingly more dramatic trauma.
I believe that this affirms the extent of a cancer diagnosis on each of us and its life changing nature. It is indeed a huge deal. We must recognise and acknowledge the impact this has on us.
And to be honest, it’s often just bleurgh.