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July 28, 2014

Sarah, VIC – Like smacking into a wall at high speed, I was completely floored.

On the evening of June 6th, 2014 I received the worst news I could possibly imagine when my breast surgeon called to tell me that I had breast cancer.

I don’t remember the exact conversation but it went something like this:

Dr: “Are you at home?”
Me: “Yes”
Dr: “Are you sitting down?”
Me: “Yes”
Dr: “Do you have someone with you?”
Me: “Yes”
Dr: “I have the result of your biopsy and I’m afraid it’s not good news….It’s cancer”
Me: “Oh f**k!”

I can’t tell you how many times I’ve let the “f-bomb” fly that night and have dropped it since; justifiably so, I think.

Like smacking into a wall at high speed, I was completely floored. Even though I kind of expected that result, I still felt that I was just preparing myself for the worst case scenario, but it wasn’t really going to turn out that way. But it sure as hell did.

It was all I could do to breathe at that point so that I could get through the rest of our conversation and digest what he’d just said to me.

The one thing I clearly remember about that call was when he asked me if I had any questions. I said to him at that stage, “Not really, I just don’t want to die,” and I dissolved into tears. He said to me, “You’ll be ok.” That was all I needed to hear.

I haven’t for a moment though about dying, and I believe that I’ll get through this totally awful time in my life and come out of it stronger and healthier and much wiser than my pre-cancer self. I firmly believe in fate and my chance meeting with breast surgeon Mr Michael Law a few weeks ago may well have saved my life. He is an angel.

The next week felt like the longest of my life so far. Towards the end of our conversation on the night of Friday 6th June, Michael told me that he would arrange for staging for the following week. This would involve a bunch of scans to determine whether there was any spread of the cancer throughout the body. “WTF,” I thought. My heart skipped a beat and I found it hard to breathe as the gravity of my situation really hit me.

He also asked me how I felt about preserving the breast, as a mastectomy was an option to consider. Without any hesitation I said that I could care less about preservation at all and I just wanted this thing out of me as soon as possible. This is one thing I was very clear on from the start, and I don’t regret it for a second.

I spent the weekend on this crazy emotional rollercoaster as my partner Frank and I processed the raw diagnosis and went over what little information we had so far. I went around to my parents’ house on Friday night and gave them the news, and cried…again! I went back there on Saturday, still shell-shocked, and mulled things over again. There’s been a whole lot of mulling going on!

One of the hardest things is knowing how to tell your kids. How do you tell them you have cancer when you really don’t know what that means? How do you keep it all together so that they don’t see how scared you really are?

Our daughter Casey is 17 and our son Jesse is almost 13. They’re very switched on kids and we agreed that the best approach was to be absolutely honest, and to tell them separately. I told Casey and she took it pretty well, with very little fuss. Frank told Jesse; he also coped well. His main concern was that I didn’t have lung cancer as I’d smoked for a long time, and those TV commercials really get those little brains thinking!

We remain totally open to any questions they may have and plan on keeping them as fully informed as they want to be.

Staging week involved a mammogram – my first ever – and a CT scan of the chest, abdomen and pelvis, followed lastly by a bone scan. None of these were any fun I can tell you and waiting for the results was excruciating.

On the Friday afternoon, one week post D-Day, I received a text from Michael to say that staging was all clear. I was so excited by some good news; I hadn’t smiled like that all week. I actually rang and spoke to one of his secretaries to confirm that this was good news, just to be sure!

So it was that I had this lump of cancer in my left breast that I just wanted out. I’d been working all week between scans to stay busy and distracted and here I was on Friday evening sitting in my car in the driveway as Michael rang to confirm the results – all good!

Now we needed a plan. I had two clear options. One was to undergo chemotherapy with the view to shrinking the tumour enough that I could then have a lumpectomy, followed by radiotherapy. The alternative was much more appealing in that I would have surgery first – a mastectomy plus or minus an axillary lymph node clearance, and be rid of the bugger!

I was adamant that I wanted to rid of it as soon as possible, and then follow up with chemo and radiotherapy. Michael suggested that I think it over and discuss options with Frank but there was no doubt in my mind that this was the best option for me.

I didn’t have prominent breasts to begin with so I wasn’t devastated about losing the breast. I even joked about the possibility of ending up with the rack I’ve always wanted after reconstruction. You have to see the bright side!

And so with decision made, I confirmed on Monday that I was 110% sure I wanted to go ahead. And the ball rolled. Within two to three weeks I would have surgery and follow up with whatever treatment, depending on the pathology of the tumour once removed.

We are extremely fortunate in this lucky country to have an amazing public healthcare system which is super-efficient and accessible to all. For this I am incredibly grateful.

Surgery set for Friday 27th June. From there to here, time to back track.

The first time I took any notice of this lump in my left breast was a couple of months ago when I felt a sharp pain right under the nipple. I couldn’t recall doing anything that would have caused pain so felt around and noticed it was actually really painful to palpate, and the lump was bigger than usual.When I say bigger than usual, I’ve had a lump in this spot for as long as I can remember since breastfeeding; probably 10-12 years. I had a GP palpate it years ago and she said that I had lumpy breasts and shouldn’t worry about it. So I didn’t.

I do breast self-exams regularly and noticed about a year ago that it was a bit bigger. But when you have something for a long time and it changes very gradually, it can be deceptive. I had my regular routine pap smear back then and got referrals for a mammogram and blood tests just because I’d never had either.

But as usual, my crazy busy life got in the way and I put it off. I’m also the CEO of our household and there’s always something more important to pay for or arrange so it just wasn’t a priority then.

I decided that at the end of this month’s cycle I would have the lump checked out, as I’d heard it’s better to wait to have a lump looked at when any swelling or tenderness has settled. And indeed, by the end of my cycle the breast was no longer painful. But, I noticed in the mirror that the lump was actually visible and it definitely felt bigger, quite hard and irregular.

During the week of that period I had a chance meeting with a breast surgeon; this is where I truly believe that fate stepped in. I was working in the PACU of a private hospital, looking after a patient who’d just had breast surgery and her surgeon Michael Law came out to speak to her and finish off some paperwork.

Many surgeons send their assistants out to do this sort of stuff and this is what struck me as unusual at first. He spoke with his patient and then we chatted briefly about his practice. There was something very unique about this unassuming doctor; his friendly demeanour and confident, caring attitude prompted me to get his business card and I vowed to make an appointment.

A couple of days later I made an appointment to see my GP. I was armed with my radiology referral form requesting a breast ultrasound, so all he had to do was sign it and refer me on to Michael if need be.

If I’ve learned one valuable lesson so far, it’s that it pays to be in charge of one’s own referrals and be persistent about being seen as soon as possible. My GP happily signed my referral and I went home to organise the scan.

Initially when I rang Uniradiology to make an appointment, they suggested a time a couple of days away. But for some reason my sense of urgency was growing by the hour and felt this couldn’t wait. 30 minutes later I was lying on the exam table having an ultrasound of the left breast.

I was trying really hard to read the expression of the radiographer as he hovered over the lump; he must have noticed me staring at him because he said to me, “If you are trying to read my face, you wouldn’t get anywhere. I have a poker face.”

My referral was only for the left breast, as I wasn’t at all concerned about the right. Mr Radiographer wasn’t happy with this and after consulting with the house radiologist and gaining my consent, proceeded to scan the right breast for a complete picture. The whole thing was not at all painful and the Uniradiology staff was fantastic, but as I left their practice I started to feel a little anxious.

That afternoon, I received an unexpected phone call from my GP to let me know that the result was back already. He felt it would be a good idea to have a review with a breast surgeon. SH*T! The next morning I rang Michael’s office to make an appointment, and the only one available was a month away. I said that I really didn’t want to wait that long. Persistence pays, or maybe it was something in my voice; I got an appointment two days later.

I drove myself to Michaels Law’s practice and waited a short time before being called in. He remembered our brief meeting and we chatted about my medical history – or lack of – before getting to the point. He looked at my scans and was immediately concerned by the appearance of the lump in my breast. It looked to be very vascular and benign lumps are usually not. He said that I should have a mammogram first so that he’d have a complete picture before biopsy.

I promised to get one as soon as possible after the biopsy. I really did not want to wait. He went ahead with local anaesthetic then a punch biopsy of the lump. I could tell he had difficulty penetrating the lump with the instrument; it’s bigger than a needle and sounds like a staple gun.

Samples were taken and it bled a lot; not a good sign when a lump is very vascular and dense. With biopsy done, I redressed and chatted again about what this might be. The likelihood of cancer was mentioned for the first time and I quietly lost it. I tried so hard not to cry but the magnitude of what he was suggesting was overwhelming and I just couldn’t stop it.

He was already planning a lumpectomy for the following week, depending on the result of histology due back in 24 hours. If it was benign, I would have surgery the following week to remove it. If it was malignant, that plan for surgery would be cancelled and a new plan made.

I kind of got it together enough to leave his office but by the time I reached reception, was in tears again and left the office in a fair state of distress as I tried to process the last 45 mins of hell. From there, I drove straight to my parents’ house, dissolved into tears again and told them what was going on. My parents are the most supportive, amazing pair and were, as expected, rock solid in their support.

I still hadn’t said anything at all to my partner of 26 years. I don’t like to worry anyone unnecessarily and felt that saying something too soon would have made it even worse. That night, I told Frank. He had lots of questions and I had very few answers and so neither of us slept much; both of us went to work on Friday as usual.

As arranged, I sent Michael a text on Friday night after work when I arrived home to let him know I was home and ready for his call. An hour later he called me to tell me the news was not good.

The countdown begins… the next two weeks passed quickly as I maintained a frantic pace every day just to stay busy and think less. The agency was fabulous when I told them I only had a couple of weeks of work left. They gave me as many shifts as I could physically fit in during the week.

Weekends were set aside for my business on Saturdays and a full day at the farm on Sundays. I love my job and was grateful to be able to focus on caring for others, to take my mind off my own predicament.

There were moments when I forgot completely. I even thought occasionally that I’d dreamt it, then something would snap me back to reality and the whole cycle of anxiety and dread would start over. I managed to hide the emotional turmoil pretty well I think; no one at work knew what was happening.

I have some gorgeous colleagues who I probably could have told but figured that everyone has their own stuff going on. I didn’t feel like I wanted to bring anyone else down, especially in a PACU where patients need us to be positive and supportive when they’re at their most vulnerable. The fact that nobody knew allowed me to just do my job and not talk about it. That meant another day over when I didn’t lose it! No one looks pretty when they cry.

I probably should have spent some time cooking and freezing meals and that sort of thing, but I don’t love cooking at the best of times so I really couldn’t be bothered! I’d also quit smoking on D-Day so the less time I spent at home being tempted, the better. Thank God for shisha pens; a poor substitute for the real thing perhaps, but they sure helped me to break a very bad habit.

The kids carried on as usual which was exactly what we wanted. School and hanging out with friends and part-time work for Casey; nothing out of the ordinary. There were some random questions from them at times which we answered honestly, with the little knowledge either of us had. No dramas.

One thing I’m glad I did was let the student welfare co-ordinator at school know what was going on. As we have no idea how it’s going to go, I thought it smart to have the kids’ teachers keep an eye out for anything out of character. Kids are so resilient, I know, but it can’t hurt to be on the lookout.

In the lead up to the 27th, I felt that lump many times a day and I swear it grew in size; I stressed non-stop about it spreading throughout the rest of my body. It had definitely changed since the biopsy and with every twinge somewhere else, I wondered if that could be a metastasis. The stress of it!

Thank God also for the sedative effect of red wine which I just happen to love. The sleep was short those nights but at least I got some. By DOS I was completely knackered, physically and emotionally. I just wanted it out.

It was a relief when the day finally arrived. I threw some things into a bag, most of which I didn’t need. I woke before the alarm as usual, showered and of all things, deliberated about what I should wear to the hospital. Who cares!

Clearly I wasn’t going on holiday so just needed something “loose and comfortable” and warm because it was freezing out. Before I had time to finish, Dad was at the door and it was time to go. It was on…

I’ve started a blog where you can read more about my story: alittlelessboob.wordpress.com.