Friday, 29 May 2009

Scanned from Bottom to Top

This week has been a whirlwind. On Wednesday I phoned Bupa to get authorisation codes for a battery of tests and procedures. Then I cancelled all my appointments for the rest of the week. Yesterday I had an MRI scan of my breasts. If you’ve never had an MRI it’s a bit like being in 2001 – a Space Odyssey. They slip your body into a claustrophobic white tube and then play all sorts of loud, discordant thrumming and whanging noises. It reminded me of a Laurie Anderson concert.

This morning I had a CT scan of my lungs. After that Nick and I went to meet Honoria, who is to be my breast care nurse at the Harley Street Clinic. She’s small and blonde and wears lashings of eye make-up. I could tell straight away that she’s quite wonderfully batty. We sat and chatted in a room that was full of boxes of underwear – mastectomy bras and the like. Nick’s eye fell upon a knitted silk camisole. “That’s nice darling,” he said, “you should get one of those.” “Those are for people having radiotherapy, “ said Honoria.

Next up was a radioactive injection in preparation for the big one - a bone scan this afternoon. The technician warned me about radioactive contamination. No kissing. No fraternising with small children. Wash your hands twice after peeing and don’t touch your clothes. And please use the special toilet reserved for radioactive people.

There’s quite a bit of hanging around, waiting for the injection to do its work before I have the bone scan. Eventually I feel the need to use the special toilet. I pee and then wash my hands twice. But then it occurs to me, what if some of the other radioactive inmates failed to wash their hands? How do I get out of here without touching the radioactive door handle?

The bone scan is quite a procedure. I have to lie perfectly still whilst a rather prehistoric looking giant box camera about a yard square photographs my body in sections. I guess they use huge pieces of film. Each exposure takes several minutes.

Now Nick and I are in Mr Hadjiminas’s consulting room. He looks at me, “Good news,” he says, there was no cancer on the CT scan of my lungs. Then, “Not such good news,” the MRI scan a showed second tumour in my left breast. “Oh” I say, “and what does that...” my voice trails away. “It means you’ll have a mastectomy,” says Mr Hadjiminas, helpfully. I gawp at him for a bit. I look at my fingernails and then sit on my hands. “But I don’t want a mastectomy,” I say. “It’s for the best,” replies Mr Hadjiminas, and he’s off: “We save the nipple and the skin. And we can do reconstruction at the same time.” Mr Hadjiminas warms to his subject, “and it means you won’t need to have radiotherapy. If there’s no breast, there’s no possibility of the cancer recurring.” I realise that I’m out of my depth. What I really want to do is stick my fingers in my ears and sing “la-la-la”. I don’t know what I’m talking about but something almost subconscious prompts me further. “Is there any alternative?” I ask. I sound desperate.

Mr Hadjiminas looks thoughtful. “Well yes, there is,” he says. “We can do a quadrantectomy.” “And what is that?” I ask. “Well, we take away about a quarter of your breast and the sentinel lymph node, then we have to look at all that in the lab. If we’ve got all the cancer out and the margins are clear then we can do reconstruction surgery three days later. We use a muscle that we take from your back. If we find anything in the sentinel lymph node then we remove all the other lymph nodes from under your arm at the same time." Suddenly, Mr Hadjiminas is just as fired up about this procedure. “And does that mean I will still have feeling in my breast?” I ask. “Yes it does,” he replies. “And will it look alright?” Mr Hadjiminas reaches for his photo album. It is full of pictures of women’s breasts.

He opens it to a spread that obviously displays some of his best work. Before showing me the photo on the right hand page he judiciously covers the left hand page with a piece of paper. I guess it’s the 'before' photo. In any case, whatever lies beneath that piece of paper cannot possibly be as horrifying as what I'm imagining. The right hand page shows a photograph of a woman's torso. She has the most beautiful pair of breasts. "Those are fantastic tits," blurts Nick. “Not as fantastic as mine,” I say, a touch frostily. “Oh, I don’t know...” “Anyway,” I say, slapping the desk decisively, “that’s what I’m having.” Then I suddenly feel that maybe I’m being too forceful. I don’t know what is the best treatment for me. Mr Hadjiminas does this every day. He’s trained for decades. How can I tell him what to do? “I mean, is it ok to do that?” I ask, sounding a bit sheepish. “I wouldn’t even offer it to you if it wasn’t ok,” replies Mr Hadjiminas, “but if the margins are not clear then we will have to do a mastectomy anyway. That’s the risk.” “It’s a risk I’m prepared to take” I reply.

We all look at one another. That, it seems, is a done deal. Honoria puts her coat on. Mr Hadjiminas looks at his watch. It’s after six and it’s Friday. “What about the bone scan?” I ask. “Oh it’s not ready. Probably fine. The full report hasn’t come through. We’ll let you know on Monday.” I look at them both. I cannot possibly endure the anxiety of waiting two days for to find out if there is cancer in my bones. I must insist. I tell them the story of Gaby.

Honoria takes her coat off. Mr Hadjiminas sits down and picks up the phone. “Please bring Miss Lily’s scans and report across as soon as they are ready.” We all settle down to wait.

After about twenty minutes a porter appears with an A4 envelope. If the giant camera was anything to go by I was expecting an envelope the size of the table. Mr Hadjiminas pulls out a piece of film. On it are a series of images of a teeny-tiny skeleton, about two inches long. “These are all clear” he says.


Anonymous said...

(I'm reading your blog from the beginning, in date order.)

You had to cope with a lot of detailed information when I was diagnosed with grade 2 cancer (3cm).

I didn't even know about margins and lymph nodes for several weeks.

I had a lumpectomy and a sentinel node biopsy (margins and nodes all clear, yay!). I'm not sure I'd have had the wherewithall as you to ask for alternatives.