No Seven Year Itch

This is my 7th cancerversary. And I am beyond happy to be here to type those words.

If there’s something I have learned these past years about cancerversaries, it is this. They are pretty much all the same but they are all different too. Each year, similar emotions are stirred. The memory of those words “highly suspicious of cancer” never fades, nor does the memory of feeling petrified. Petrified in its most pure sense, being frozen by fear, immobile, terrified and numb. The feeling of loss, that comes when faced with mortality. The knowledge that things can never return to they way they were before diagnosis. Yet, in seeming contradiction, I have found each cancerversary different. Some I have marked in quiet reflection and thankfulness. Some more analytical than others, and some more intense than others. None, not one has been celebratory. October is brimming with memories and landmark days as well as being compounded with the irony of Breast Cancer Awareness Month so I am surrounded by reminders both in my own head as well as all around me.

October also marks the time of the Big Check. Usually I roll up at Counter No 2 of my familiar Bangkok hospital, am greeted like a long lost friend and find myself on a conveyor belt of blood draws, scans, x-ray, mammo and vitals before seeing my dream team who unravel the mysteries held in the various tests. That’s usually when the tears start, while sitting waiting to wrap up the final paperwork and leave the hospital. An overwhelmingly emotional mix of relief, grief, release of tension as I find myself connected, sometimes a little less directly than others, with NED, No Evidence of Disease.

This year is very different. There is no seven year itch which leads to a rupture in the long relationship with my wonderful team in Bangkok. The reality is that I am no longer an hour’s flight from this team which has looked after me so well for so many years. I am now on Africa soil and would need to find a new dream team in the region. I had considered returning for one final Big Check in October but the unexpected health hiccup in August meant that was unrealistic and a long haul trip unwise. However, the extra time in the UK meant that was able to hurriedly arrange a check up. This was far less detailed than the Bangkok checks, protocols being very different and incorporated mammogram and bloodwork. And no tumour markers. We know these are controversial, and not considered reliable. I know that, yet the yearly or twice yearly marker check is one I cling to as I find reassurance in stable results. It has been strange starting my story at the beginning with new specialists and support teams. It was unsettling not to have a physical examination. I almost feel that I need to go through the intensity of so many tests to be able to breathe when I come out the other side, always knowing that breathing is a luxury and not guaranteed. This year, my bloodwork was fine. Kidney and liver functions and the other key bloodwork all normal. Slightly anaemic, unsurprisingly given the bleed just beforehand. And the mammo was also unremarkable. All reassuring and welcome news delivered over the phone just a few hours before I boarded my flight to return to Africa. I had half guessed this though. The mammo had been carried out a few days earlier, and the oncologist had my phone number and knew I was leaving the country. I knew that if there was something worrisome, then I would have received a call much earlier. Though my heart did stop when her PA called me with the opening words “unfortunately…” This was not related to the tests, thank goodness, but to difficulty in getting me a replenishment of Femara before I departed! So there was no moment when I was shooed out of Dr W’s door to be banished until the next round of checks. No release of  tension, nor tears. Perhaps the seven year point coincides with this new landscape and brings a new perspective even to the Big Checks.

So with the Big Check behind me, friendship maintained with NED, how do I mark this seven year cancerversary? I always have something to say, being a “remember-the-date” kind of girl and October 2 with its cancerversary status is one firmly etched in my mind. This morning Facebook welcome me with a swathe of reminders about the previous posts I have written on this day over the past years. Last year my Big Checks fell on the same day and date as the diagnosis six years previously and I focused on the similarities and differences of those appointments.  The previous year marked five years after diagnosis, a time scale which is widely held to be a magical milestone but which is far more complex. At four years, I was in a contemplative mood with few words but a great deal of thinking and remembering, noting that this was “a day of recognition, quiet reflection and gratitude for a a present which is precious and fragile“. On the third cancerversary I wrote about the line in the sand which you cross when you hear the cancer words. That line which marks the time before and the time after. At the two year point, I dwelt on what I had lost and what I had gained, much of it intangible and psychological. All of it real and intense.

But the very first cancerversary is one which retains its own particular character. That one year mark was an important one, especially given that I did not think I would see Christmas beyond diagnosis, let alone a whole year. Life had changed beyond recognition and I wanted to tell cancer a few things. So I wrote a letter to cancer. I re-read it this morning and realise that in fact, much of this sentiment holds true years later, so I have decided to share the letter again.

October 2 2010

Dear Cancer

It is a year since you came into my life and it’s about time I told you what I really think.

You were uninvited.  And unwanted.  And unexpected.  You have changed my life beyond belief and it really will never be the same again.

I had no choice about your unwelcome arrival, you didn’t give me any chance to opt in our out.  You were just there.

The first time I realised you might be there I remember a terrible fear. It was late September and I remember thinking that I would not see that Christmas.  The thought of you kept me awake at night, my mind veering between hope that there was another medical reason for your symptoms, and sheer terror that indeed you were the cause.  I admit I had never really thought that you would try and invade my life, after all you have not troubled our family before and I naively thought that you preferred certain genetic and family traits.  So when I was told that you were there I was shocked and surprised.  And terrified.

You are such a destructive force and that meant I had to endure destructive treatments.   For my survival I was trapped in an overwhelming battle between massively destructive powers. I had to lose parts of myself to cut you out of my body. My body hosted a long and violent battle between you and the toxic chemotherapy and the rays of radiotherapy as they sought out any trace you might have hidden as a seed for the future.  I know that I was left sick, exhausted and very weak but that was worth every ounce of suffering to know I tried everything in the hands of the powerful team I have to banish you.

While this has taken me through a horrible journey, when I have had numerous side effects, lost my hair, caught pneumonia, lost much of the use of my left arm and generally felt very ill, it has brought me some special things too.  The relationships with those near and dear have grown and strengthened and we have cherished time which we might otherwise have squandered.  While it was my body which you invaded, you touched the lives of many beside me with your heavy dark hand.  I have had to face up to some horrible and unpleasant procedures and been able to find a strength and resilience that I had no idea I possessed.  I have connected with many other women all around the world whose lives you have also invaded and we have shared the most private of details from the terrifying through to the hilarious.  We have laughed at your expense, even though we acknowledge that you have had possibly the bigger laugh.  Time will tell if you have the last one.  While I value and treasure these factors which I found through you, don’t get any ideas that this might endear me to you.  No, I CAN’T EVEN BEGIN TO LIKE YOU!  I get your point and I will continue to do everything possible to keep you as far from me as possible.

I am still frightened of you because you are such a destructive and determined force. You are also horribly sneaky and I know how powerful you are.  I know that I have always to be vigilant because I don’t know when or where or how you might try another attack on me.

I resent you because I am no longer able to think of the future without worrying about you coming back.  I resent you because I now live my life through what I call the “cancer lens”.  Even if I don’t need to take you into account in what I do, you have changed the way I see everything. You could say that instead of seeing life through rose tinted spectacles, I see through pink breast cancer spectacles.  I might not particularly like it, but I recognise, accept and live with it.

So I will be keeping a very keen eye open for any attempts you make to sneak back into my life.  And trust me, if you do try any comeback, you will be treated to exactly the same welcome.

Yours candidly

One Feisty Blue Gecko

This makes me think of the French expression “plus ça change, plus c’est la même chose” which translates along the lines of “the more things change, the more they stay the same”. Indeed they do. The landscape is new yet somewhat familiar in certain elements. The perspex plates which cause both physical and emotional discomfort in mammogram machines, the needles and skilled fingers which try to find blood in reticent veins and the anxious waiting all easily cross continents. Yet, the team now looking after me, and the systems and procedures are very new as is the African soil, the flowers and the birdsong.

Indeed in these times, there is always something to take us back to that which truly counts. The dry season which was underway when I arrived in Africa has given way to a short rainy season. It is less humid, and far less warm than Yangon but the thunderstorms which light up the skies are reassuringly constant in their dramatic nature. The lightning reveals the silhouettes of a thousand hills and causes electricity lines to blow. In the fresh post rain air this morning, I spotted on the rain-sodden grass an unexpected splash of colour. There in the middle of the grass was a brand new flower. As if placed there for this day of note.

A perfect, timely reminder to cherish the past and embrace the new.

africa

Friday 2 October

Friday 2 October 2015

I’m in Bangkok, having just gone through the Big Checks. I’m exhausted. Utterly drained, numb and emotional. I struggle not to cry.

Friday 2 October 2009

I was in Bangkok, having arrived from Yangon in the afternoon and going immediately to the hospital from the airport. I was exhausted. I had not slept properly since I had found that lump and been referred to Samitivej Hospital. I was terrified.

Friday 2 October 2015

Bloods first. four large vials, all with my name on the outside, colour coded for each type of test. A bit of a struggle and fiddle to persuade the vein to cooperate, but it yielded fairly quickly. These phlebotomists are highly skilled.  I hate needles and blood takes, but nowadays I hardly flinch. If I could count the number of needles which have pierced my skin to draw blood…. Next, through to Imaging and changing into a fetching blue gown.

I was handed a locker key, and found that I could not reach the locker. Rather than ask for another locker, I threw my clothes upwards, using the non Twang Arm. First was the X-Ray. Always quick and not uncomfortable. Next was mammo. “Right breast first” said the technician. “Right breast only” was my reply. Less comfortable, squeezed so tightly I felt that my breast might not be able to hold its contents under the pressure, but happily it did. A couple of different images in different angles, and in no time I was back in the waiting area.

Friday 2 October 2009

The flight was a little late and the traffic from the airport very busy, so I arrived late at Samitivej. I was met by our Liaison Manager and ushered immediately through to the Imaging Centre. At some point I must have filled in some paperwork, but I don’t recall that right now.

I had never had a mammogram. I had no idea what to expect. I knew it would be uncomfortable, even painful. I was in that room for heaven knows how long. I moved, for new images at different angles. I heard “calcifications” and thought that was a good sign. I have no idea when I was finally released from the mammogram room but eventually I was.

Friday 2 October 2015

Next was the Ultrasound. I hate this one. I freaks me out, quite simply. I hear the beeps as shapes are pegged and even though there is no visible screen, I am straining for hints. “You remember me?” states the Doctor. Yes I do. I think. I think she was the Ultrasound Doctor last year. The one who asked me if I was seeing my Doctor that day. I remember that freaking me out. “Yes,” I smiled. I remember.

Again she asked me if I was seeing my Doctor. I reassured that I would see no less than Three Doctors. Is this normal or something to worry about, I wondered. Silence and beeps. Gel everywhere. Too much attention under my right ribcage. There’s something wrong.

Suddenly and abruptly she stands up. “Finished” she announces. A good sign or a bad sign, I wonder?

“I will send my report to your Doctor”. she says as she is leaving the examination room and I am being cleaned of gloop. More worry. What is there to report???

Friday 2 October 2009

You know when there periods in your life that you play and replay, on a loop? The Ultrasound is one of those times. I will never forget that Ultrasound, the drawings, the straining for clues, the clinging on to hope and the devastation and denial combined when I saw the Doctor key in ” M _ A _ S _ S ……  N _ O 1…..

Here is how I captured it at the time

Next was ultrasound.  Again the investigation was very thorough.  This time though I could see the screen and all sorts of weird ghostly shapes as the doctor methodically worked her way through the process. Again, I tried to pick up clues and hints and soon got a big one  “left side – problem”, I was told.  Hmmm.  The chittering started again, perhaps helped by the Air Conditioning and the cold ultrasound gel. “You need biopsy”.  Oh dear – more chitter chitter!  The technician was lovely – calm, professional but clear.  I said I was worried and she told me not to worry (lurch of hope) – my Doctor is a great specialist and I am in the best of hands.  She then started pegging the dimensions of what she was seeing in the scan.  I had to watch, but kept looking away as she pegged a strange shape and clicked to save it.  Then my stomach turned as she keyed in – m-a-s-s-.  That is a clue, and not a good one.  She didn’t stop there – mass.. n-o- 1.  I closed my eyes and swallowed. There is more than one lump.

I think it was around then that the specialist himself appeared, his Bluetooth flashing in his ear, and he joined the party.  Or maybe it was a training workshop because he had a magic marker in his hand and methodically they started to draw on my chest.  I started chittering again – actually I am not convinced I had stopped.  They reassured me that they were not going to hurt me – just draw on me!  These were the markings for the biopsy.  Another worry lurch when I was asked if I had eaten – surely they are not going to operate tonight?

Eventually the drawing was complete, the ultrasound images all recorded and I knew that the time was coming for biopsy and diagnosis.

Friday 2 October 2015

Waiting, waiting, waiting……

The bloods are taken and have released their secrets to the Doctors. I have no idea what messages they tell.  I have to wait. And wait. My Blood Pressure, weight and temperature are taken. I have lost another few micrograms, half a kilo. That is good, all things considered.

My Blood Pressure though is sky high. I am stressed. By too much. There is no hiding this fact, my BP does not respect secrets or confidentiality.

Twang Arm is complaining. And hurting. And the wait is tortuous…..

Friday 2 October 2009

Dr W had joined the discussion in the Ultrasound room. I remember his bluetooth. I remember him arriving at the door and say “Khun Philippa?” I remember a lot of conversation in Thai and a great deal of marker pen.

I remember being afraid, but thinking that this cannot be cancer. There is no cancer in my family…. 80% of lumps are benign….

Friday 2 October 2015

Finally, the appointments are looming. Dr A first, my endocrinologist. I still don’t really what one of those is. But I do know that Dr A looks after me. He understands and offered suggestions when I dissolved in tears at the last consultation. Today, he goes through my results.

My blood sugar is ok, slightly down from last time. Down is good. Really good. I am breaking the trend, and I want to keep doing that. Cholesterol is good. Kidney and liver functions are also good. He moves briefly over my tumour marker results. They are consistent and show no increases. That is good. Very good.He is happy with my minimal weight reduction, and understands my frustration at not being able to swim. Before we know it, I am saying goodbye for the next few months.

I sit down in the waiting room again. Next is Dr W2 my oncologist. Within a few minutes though, I am waved through to go and see Dr W. Dr W2 is running late? I don’t know, but I head through to the other waiting area. Dr W no longer consults in Room No 59 but that is ok. His current room has been auspicious so far.

Dr W welcomes me. How are you? How is Yangon …. Many questions, and then “How many years now…”

“Six years” I tell him. “Six years. Can you believe it?”

I am not sure if he can or not.

I tell him that Twang Arm is causing me grief. Not too much swelling, he observes, but a bit.  Lymphoedema. After so so long. So unfair…. I tell him of my challenges in finding a new swimming space. He encourages me to find such a space. I will…. I promise to myself.

He reviews the results. He ordered the mammo and the ultrasound. He is happy with the results. Nothing sinister.

He then asks when should be the next appointment. I don’t want to say, I want to be told.

“A year?” he asks? My heart lifts and I look up expectantly. “”Too long?” he enquires. Perhaps he is taking my reticence for the need for more frequent review.  I SO SO badly want a review in one year. What a statement of recovery that would be. “It’s six years now” he adds. When will you come back? I reply that I do not yet know, that Dr W2 will make a suggestion or decision. “One year is fine”, he tells me. “but if you come back before then, please come and see me too”.

So I know. One year is fine, but if (and I know that it is highly likely that Dr W2 will request a return presence in either 3 or 6 months) it could be sooner. We settle for an appointment when I next return.  I am enormously heartened by the fact that he is happy to see me n one year. ONE YEAR. That is MILES away.

I return to the waiting area. Dr W2’s PA realises that I am there.  She ushers me in to his consulting room. I am fairly relaxed because by now I have learned the results of the Ultrasound, mammogram. I know that there are no surprises, My mammo result is good  (Birads 2 no less. Why, Birads 2 is classified as benign.) and bloods are fine. I know that my tumour markers are stable, my critical results are fine).

I complain mildly about Twang Arm. Twang Arm has already been well examined. Hmmm, is the  consensus. Lymphedema. Not welcome, but not sinister.

“How long is it now, since you were diagnosed” asks Dr W2. “Four years?”

Aha, no – no. “Six years tomorrow, I reply.

SIX YEARS. Six year whole years.

I have never, ever, asked how long I would have survived without treatment when I was diagnosed back in 2009. But something inside of me would like to know. One day perhaps…

Dr W2 has recalled me every three months for a while now, following the Pulmonary Embolism and some other glitches, so I await his directive anxiously at the end of the consultation. I silently plea that he will not call me back again in 3 months. So when he suggests that I come back in 6 months time, I am more than happy. Six months is a long way hence, and I am quietly delighted to have a longer breathing space,

Friday 2 October 2009

Dr W has explained the scans and Ultrasound to me. The calcifications are not innocent. They are worrying. He shows me the space ship. The shape on the screen with its irregular growing patterns.

“This is highly suspicious of cancer” he tells me gently yet irrecoverably.

Once you speak these words they can never be taken back. “THIS IS HIGHLY SUSPICIOUS OF CANCER… HIGHLY SUSPICIOUS……

This is cancer.

Yes, you are going to die.

That is all I can hear.

These are the words, once spoken, which can never be retracted.

“This is highly suspicious of cancer…. highly suspicious of cancer… highly suspicious…….highly suspicious………

Friday 2 October 2015

I realise it is my “Happy Cancerversary”

I realise that today marks six whole years since I heard those words. “highly suspicious… highly suspicious.”…

Six years ago, I slithered up to Shwe Dagon in the early morning, before my flight to Bangkok, to give blessings and, and to plea, nay beg that this wold not be cancer.

But it was cancer,. Despite all the odds.

And still, I am here., Six years ago, when 2 October was also a Friday and I learned that I was mortal and that I was not somehow protected from cancer.

October 2. Every year.

Yes, I often wonder how long my prognosis would have been back in October 2009.

I have never been able to ask that question. But I do know that I would not be here still, without treatment……..

Today, I AM still here. the path has been hard and gruelling but I am still here.

So, many returns then, eh?

tomorrow

October 2 – Happy Cancerversary!

Bleurgh

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.