Shock and Awe

Anxiety has been building for the last couple of weeks. Don’t think about it. Don’t think about it. On Friday I completely deconstructed my book and began at the beginning again – with two months to the deadline. Don’t think about it. Don’t think about it. This morning I woke up with an imaginary tiger clawing at my chest. Don’t think about it. Don’t think about it. I’ve meditated. I’ve been for walks. I’ve watched countless old episodes of CSI. But the more I try to distract myself the more I think about it: today I’m having my follow-up mammogram and ultrasound scans.

As I’m meditating away: breathe, one, breathe, two, breathe, three... the phone rings. I forgot to switch it off. Don’t answer it. Breathe, four... ring. Breathe five... ring! It’s May. May is coming to the hospital with me. One of the life skills that I’ve learned in the past fourteen months and twenty-two days is how to ask for help. The old Lily would have just toughed it out and gone to the hospital alone. That is what I did on the day I was diagnosed. I remember my feelings of bafflement as the ultrasound doctor said “There is a tumour here and in my opinion it could be malignant. I’m sorry...” and my confusion as I stumbled from the room. I sat alone on a plastic chair in the corridor and tears sprouted from my eyes. I tried not to look at the people passing by. I desperately wanted a hand to hold.

If I think about it I may have had some kind of unacknowledged notion that enduring the hard moments alone was somehow courageous. I now regard such bravado as foolish.

So I asked Iris and Flossie and Tessa and Wanda and May. I wasn’t discouraged when any of them said they couldn’t make it. I didn’t assume that nobody loves me. My friends have lives and commitments. I knew somebody would say “yes.” That somebody was May. And what woman wouldn’t want a talented artist and trainee Shaman like May by her side when visiting the breast clinic?

I leave May in charge of the car for a few minutes. “I’m just going to zip into Pret-a-Manger and get us some coffees. Here’s the key, in case a parking warden comes.”

“Is it difficult to drive?”

“No, it’s an automatic.”

As I’m standing in the queue at Pret my phone rings, “How do you get the car out of park?”

My tests today are being done at the Harley Street Breast Clinic. Confusingly, this is different to the Harley Street Clinic where I normally go. Meg and I are shown into a miniscule waiting room. There are two other women sitting on a sofa about eighteen inches away. We and they conduct our conversations in low tones, trying to pretend that we can’t overhear everything that the other pair are saying. A nurse comes in. “Please complete this form.” It’s the usual you agree to exonerate the clinic of any responsibility for everything and pay through the nose should your insurance company fail to cough up contract. I notice that the insurance pre-authorisation number is missing from the form. I fish out my iPhone and call Bupa.

“Hello, I’m just about to have my follow-up mammogram and ultrasound but the hospital don’t seem to have a note of the pre-authorisation number. Could you check it for me?”

“Have you been seen by our medical assessment team?”

“Eh? No. What are you talking about?”

“Please hold the line.”

I spend an uneventful five minutes listening to the annoying Bupa music. Radiographer Jane comes in. “We’re ready for you Miss Lily.”

“Won’t be a minute,” I mouth and point to the phone. Another five minutes passes. I feel my shoulders rising ever so slightly.

“Miss Lily, when were you diagnosed with breast cancer?”

“Fourteen months ago”

“You only joined Bupa in May so this is a pre-exisiting condition. I can’t authorise treatment at this time.”

In a strained voice I tell Valerie, that is her name, that I joined Bupa in 1989. I explain that I temporarily transferred my policy to Bupa Australia and then transferred it back on my return to the UK, in May. I note, through gritted teeth, that although Bupa guaranteed me that my cover would be continuous I have had several hiccups of this nature in the last few months and that on each occasion I have been assured that the problem would be fixed.

“Well you should have called us earlier for authorisation.”

“I did. I called you fourteen months ago and was given authorisation. I’m just calling you now to check the number.”

“I cannot authorise treatment at this time.”

Suddenly I am in melt-down: “Listen Valerie, do you appreciate that I am at this moment in the hospital? Whilst you have kept me on hold for ten minutes the radiographer called me in for my mammogram. So you’re not only keeping me waiting but also the radiographer and all the other patients. Now you’re telling me that the treatment that was authorised last year is no longer authorised, seemingly because Bupa, despite repeated requests, have failed to correct a mistake on my computer record. And what I and the radiographer and my friend May and the other patients are all waiting for is to find out whether or not I have breast cancer.  Do you have any idea HOW STRESSFUL THIS SITUATION IS FOR ME?”

The two women sitting on the sofa eighteen inches away look totally absorbed in their magazines.

“I’m sorry I don’t like your tone of voice. I may have to terminate this call.”

I terminate the call.

***

I stand before the mammogram machine, uncovered in more ways that one. No clothes. No medical insurance. Jane inspects my breast “Wow,” she says, “Where’s the scar? Who was your surgeon? You must be very pleased with it.”

Squash. “Ow!” “Don’t breathe.” Zap.

I rejoin May in the waiting room clutching my very own CD of my very own mammograms. The CD has a big fancy ‘H’ on the front of it, along with my name and hospital number. I wave it in front of May’s face: “Lily’s greatest tits.”

Next up is the ultrasound. By comparison it’s positively relaxing.

***

“Come along Lily.” May and I grab our coats, bags and empty coffee cups and follow in Mr Hadjiminas’ wake to his consulting room. Pictures of my breasts are already plastered all over his light box. Without any messing about he gets straight to the point. “Everything is fine.”

I’m not really taking it in.

Next he examines my back. “That’s settled down well.” Since the last steroid injection a month ago the swelling has not returned. All of my crossing of fingers and knocking on wood seems to have done the trick.

“So, come back and see Suzy Cleator in three months. We will do another ultrasound in six months and your next mammogram will be a year from now.”

Before I know what’s happened I’ve shaken hands with Mr H, kissed nurse Tara and May and I are out the door. I stare about me at the elegant town houses on Harley Street. My body begins to tremble. I start to laugh. Then to cry. “How do you feel?” asks May. “I kind of want to lie down here on the pavement,” I reply. “Lily, I think you’re in shock.”

***

Since there’s still half an hour left on the parking meter we leg it down to Being Content. “Hello,” says Imelda. “Imelda!” I say, “I’ve just come from the clinic I had my mammogram and ultrasound scans they’re ALL CLEAR I need some nail varnish remover and an eye pencil.”*

***

May and I are recovering with tea and tomatoes on toast at Lowry & Baker, my local cosy café. I text everyone I’ve ever known: All clear!

“You should mark this day Lily,” says May, wearing her Shaman hat, “Go out onto your balcony tonight and light a fire in a saucepan. Write down all the things you are now leaving behind and burn them. Then get three sticks to represent what you want for the future and put those on the fire too.”

“I will do that May.” As I speak I upend my plate, spraying olive oil and sliced tomatoes all over my famous breasts. “How big do the sticks need to be?” I ask, indicating sizes with my fingers. I lower my hands and they crash hard onto the table, upsetting the teacups. It seems that in the overwhelming shock and relief of learning that I’m not going to die I have lost the comprehension of where my body is in space.

“Actually Lily, I think maybe you should forget about the fire. You might burn your flat down.”

*Reviews to follow.

All Clear!

I’m still processing yesterday’s huge events. Iris came with me to the hospital. If you’re not sure who your friends are here is a clue: they are the people who are prepared to spend half a day sitting around in stuffy waiting rooms reading dreary magazines and just... waiting... whilst you try to look all breezy and unconcerned and they try to mentally devise what they are going to say or do if you happen to receive the worst news of your life in the next ten minutes. Iris, it has to be said, made the best of the situation. “I just love drinks machines,” she enthused, “I could stay here all day zipping these little plastic capsules into the slot and watching the coffee come out.”

The receptionist raises a wary eyebrow.

Vanessa, a pretty radiographer, calls my name. “Come with me Iris,” I whisper. We process down the hall, Iris clutching her coffee and magazine. Vanessa bars her at the door. “You can’t come in here. It’s an x-ray room.” Oh. I enter alone. I remember the drill from the first time I had a mammogram. Strip to the waist. Get prodded, poked and pulled into a position that would probably land one a leading role in some kind of gymnastic-porno movie. Have right breast squashed flat between a metal plate and a plastic paddle. So far so good. Then the left breast, the one that had the cancer, the surgery and the radiotherapy. I twist and turn. The paddle descends. The squashing commences. I scream uncontrollably. “Sorry. Sorry. Sorry,” gulps Vanessa and releases the vice. Gasping for air I leap across the floor and pull my jumper on. “Just two more images to do,” says Vanessa. Trembling, I disrobe again and step back up to the plate.

A few excruciating minutes later we exit the room. Iris is loitering outside the door. “Was that you yelling?” she asks and rolls her eyes.

Then it’s down to the labyrinth where the ultrasound lurks. I lie on the bench in a blue patterned hospital gown. Iris flicks the pages of Elle. Dr Teo bustles in. “Your mammogram looks fine,” he announces. Here is something I’ve learned about medical professionals. If everything is fine they tell you straight away. If it’s not fine they stay tight-lipped. “So, are you worried about anything?” the doctor asks. I tell him about all my worries: feeling lumps in my armpit; stabbing pains under and around my breast; anxiety; shortness of breath; the continued swelling in my back. I consider adding in my fear of losing my home and dying alone or the earth being swallowed up by a black hole. Dr Teo interrupts quickly, “Ok, let’s have a look.” He runs the magic wand over my breasts as I stare wildly about the room. Very soon he is reassuring me. “Nothing to worry about here.”

In the pit of my stomach I feel that feeling that one feels when they finally let you off the giant Ferris wheel, only better.

Next stop: Mr Hadjiminas. He is all smiles. I hand him the mammogram films and he clips them to the light box. “These look perfect.” The image of my left breast is peppered with tiny white shapes, like arrowheads. “What are those?” I exclaim. “Oh, titanium staples,” replies Mr H. Life is full of little surprises. Mr H is equally happy with the ultrasound scans. “Now, let’s have a look at your back.”

Behind the screen, Mr Hadjiminas inspects the wobbly cushion of fluid in my back. “Hmm. This seems to have got worse. I think it might need more surgery.” He looks at the scar that runs down my side. “It will be tricky.” I gulp. “For me, not for you” he adds hastily. Well I should hope so. I will be unconscious. “Let’s give it to the end of the summer.” Fine by me.

“So, next time,” I ask, “can I not have the mammogram, just the ultrasound scan?” Mr H almost snorts. “Do you think we are giving you these mammograms just for fun? Of course you have to have the mammogram.” Well it was worth a try.

Better than Winning the Lottery

I had two scans this afternoon, a mammogram and an ultrasound. They are both clear.

Get With the Programme

Storm clouds by cjohnson7 

Fear of having my first follow-up scans is haunting my mind. If I could run down to Harley Street and have them RIGHT NOW, I would (it’s 2 a.m.). I want them out of the way so I can get on with my life. And if the news is not good... well I would rather know than not. But my appointment is scheduled for Monday so I have a long weekend in prospect.

I have lost a lot of weight. I tell myself that could be caused by emotional distress and smoking. I wake up sweating in the night. Fear? A side effect of Tamoxien? I find myself fingering a lump under my arm. Mr Hargreaves said it is just scar tissue.

In all likelihood I am well and clear of cancer. My chances are excellent. But am I jinxing myself by saying that? ...and so the obsessive thoughts go around.

I try not to worry. How, exactly, does one do that?

In the rehab I met a hilarious woman called Vic. She has a great technique. We named it ‘The Vic Flick’. Whenever a self-defeating thought crosses her mind Vic says, “thanks for the information” and flicks a finger, like a windscreen wiper, across her forehead.

My forehead is becoming a touch chafed.

I guess that the best thing that I can do is renew my commitment to positive daily action.

So I have devised the official Canalily weight gain diet:

1. Stop smoking
2. Eat lots

Who On Earth is She Talking To?

I had an appointment at St Mary’s hospital this morning for an ultrasound scan. Nothing unusual about that. I’m always popping into St Mary’s or Charing Cross or Hammersmith hospital or the Cromwell for a scan or x-ray or something. Broken fingernail? Quick! MRI needed!

I recently went to see West London’s loveliest GP, Dr Camilla Ducker. I’d been feeling a bit tired and, where most people would probably have a little lie-down, I opted for the full blood count. Whilst I was there I mentioned that my left breast has been feeling a bit hard and quite tender lately. “Well you’d better get it checked out”, she said. That was two weeks ago. In the interim Nick and I have been travelling in Tuscany.

Early summer is the most glorious time of the year to be immersed in the most fairytale countryside on planet earth. Hillsides of bright red poppies waver up toward ridges lined with dark silhouettes of flame-shaped cypresses interspersed with the delightfully rounded outlines of umbrella pines. The yellow stone of a mediaeval hilltop town catches the sunlight, glowing against a deep azure lake of sky. For the last twenty years this is where I’ve come to visit my cousin Gaby. With every curve in the sweeping road I think of her, throwing back her blonde head in unsuppressed laughter. Beside each lavender bush I see her angelic face, bent close, intently examining every leaf and bud. Amongst the boxes of vegetables at the greengrocer’s I hear Gab’s throaty voice lovingly praising a tomato or a cabbage. But I won’t see Gaby on this trip. She died seven months ago, of cancer. I’ve come now to mourn and remember her.

Nick didn’t know Gaby. He and I met on the second of January, In Sydney. It’s been a fabulous whirlwind romance. He followed me back to London and we’ve slipped into a lovely, easy togetherness. I’ve introduced him to all my favourite bits of London. We’ve travelled to Istanbul and Cardiff (don’t ask). At first I hesitated to take him to Tuscany. Would it be appropriate to bring my new boyfriend to such an intimate and sad family event? Now I’m glad that I did. I would dearly love for Gaby to know Nick. I would want her to laugh at his capers, to flirt with him as she flirts with all the world. I’d love her to love him, as I do. Knowing Gaby’s world: her family; her husband; her village and her garden is as close as Nick will ever get to knowing her.

When we got back there was a letter on the mat inviting me to attend the breast care clinic at St Mary’s.

I’m not normally one to miss out on the chance of a morning hanging around in a waiting room reading half a copy of Hello from September 2007 and stickybeaking at all the other patients, trying to figure out what their particular ghastly disease or disability might be. This morning, however, cuddles with Nick held me to the bed like magnetic honey. Finally guilt and a sense of civic duty prised me from our nest. All those posters admonishing the general public about the cost to the taxpayer (me!) of missed appointments have done their job with me. With many sighs and lingering backward glances I left Nick propped on the pillows reading the International Herald Tribune online and drinking a nice cup of tea. “Seeya” he said, lovingly.

A nice looking Registrar sought me out in the waiting room. “Miss Lily” he asked, “would you be willing to take part in the trial of a new diagnostic machine?” He described a device that claims to detect tumours by infra red or sonar or some such method. How could I refuse? I’d get to have a scan and advance the cause of medical science at the same time. I signed some papers and he ushered me into the presence of a white-coated consultant, Mr Hadjiminas. Over the years I have learned that it is proper to call doctors ‘doctor’ but surgeons are called ‘Mister’, don'tyaknow. After a brief chit-chat I half-undressed behind the screen. Mr Hadjiminas applied the device. It made some thrumming sounds. Then he examined my breasts by hand. He filled out some forms. “Ok, we’ll just send you up for a Mammogram and an ultrasound.” “But I haven’t come here for a Mammogram” I protested. “Oh it’s routine, everybody has one”. That statement felt unconvincing.

I have always heard that Mammograms are very painful, especially for those with small-but-perfectly-formed breasts. Well in my experience, it’s not true. There’s a certain amount of awkwardness involved in angling one’s torso so that one’s tit may be sandwiched flat between two sheets of clear plastic whilst one’s jaw and cheekbone are crushed up against the back-plate of the machine and one’s shoulder blade is wrenched backward to facilitate one’s arm being twisted around behind one’s waist. But that’s all fairly routine stuff for a yoga bunny like me. And of course there is the sartorial pain of having to wander the public corridors robed in a hideously patterned hospital gown with half the tapes missing.

Next stop was the ultrasound. I lay still whilst some chilly goo was applied and then looked at the pulsating swirl on the screen wondering, as I often do, how anyone can make head or tail of it. The doctor doing the scan was French. And a woman. That’s all I can tell you. She looked at me and said “There is a tumour here and in my opinion it could be malignant. I’m sorry but I have to tell you this now because I need to do a biopsy of your lymph node right away.” Somewhere, far away, a mind that was not my own thought the following thought: “Who on earth is she talking to?” The next thing I knew she inserted a long needle into my armpit. I don’t think it hurt particularly but I started to cry.

I dressed and returned to the breast clinic to wait whilst they emailed the findings to Mr Hadjiminas. The waiting room was now full. I looked around for a chair but somehow I couldn’t really comprehend the information. My eyes relayed pictures of vacant seats to my brain but it couldn’t figure out what to do with them. I stood in the middle of the room staring helplessly this way and that. Finally I plumped down next to a striking black lady with an elaborate hairdo. I guess the autopilot said: “sit next to the most stylish looking person in the room.”

It seemed that half the waiting room was for people having blood tests whilst the other half was for the breast clinic. Suddenly I felt too exposed. I wished all the blood test people would go away and leave us breast clinic people to ourselves. We have serious things to worry about like possible malignant tumours. Who cares if they’re feeling a bit tired? Why don’t they just go for a little lie-down?

The elaborate hairdo lady put her hand on my arm. “There’s nothing that Jesus can’t heal,” she said, “it is God’s will that you are to be well, healthy and whole”. I gaped at her like a malignant carp. She handed me a Xeroxed sheet titled with the words Healing and Jesus Loves You. She reached into her capacious handbag and pulled out a full-sized hardback bible. She opened it at one of the many pages marked with post-it notes. She began to read: “He Shall Call Upon Me, and I Will Answer Thee, I Will be with Thee In Trouble, I Will Deliver Thee, and Honour Thee...” I wanted to throw myself into her arms and weep. Of all the people in the waiting room, I had had the good fortune to sit next to someone who wasn’t embarrassed to extend a hand of kindness, someone who had the courage to show empathy. Maybe it wasn’t her hairstyle that my autopilot was attracted to after all.

“Miss Lily” called a voice.

Back in the consulting room quite a crowd had gathered. Suddenly they were all being very nice to me. I took that as a bad sign. Mr Hadjiminas did another needle biopsy, this time from my breast. “We’d like you to come back this afternoon for your biopsy results.” “Surely you mean ‘come back in three weeks and hang around for two hours and then we might see you’?” I thought to myself. “What time?” I said. “Oh, whenever is convenient for you.” I took that as a very bad sign.

I don’t remember driving home. I don’t remember parking the car. I do remember walking in the door and seeing Nick, still propped up in bed with the laptop and another nice cup of tea. “Hey darling, how’d it go?” he asked, brightly.