Meeting my surgeon, MRI results, ‘incidental findings’ and decisions

Having cancer seems to involve an inordinate amount of waiting. Waiting for appointments, waiting in the waiting room to be seen at appointments, waiting for results, waiting for scans, waiting for results of those scans. It would appear patience with a capital P is what’s required.

After another period of waiting we returned to the hospital to get the results of my MRI scan. I had felt really anxious and was dreading this appointment. My doctor began by giving us an overview of where we were at this point with my diagnosis. He said that the MRI had not shown any further cancer anywhere else in the breast or any abnormalities in the other breast. Phew! Pats and I looked at each other and smiled. Well that’s a relief I thought to myself, nothing else sinister there.

He went on to say that it had confirmed there was something in the area that they were concerned about. He said that obviously when they scan an area of the body, that by chance it would also show up other things as well. Oh shit…I grabbed Pats’s hand tightly, what the hell was he going to say here. “There are some incidental findings there as well. I don’t think these are cancerous and don’t think that they’re serious, but I’m not an expert on what these things are.” He went on to say that the scan had shown a 3 x 1.5cm lesion at the back of my chest (behind my heart in what is called the mediastinum area) which he said is most likely to be a ‘meningocele’.  There was also another one 6mm in size – a definite meningocele where the spinal chord exits. My imagination went wild, I tried to hold back the tears but I started to cry at this point. Holy shit, could I not come to a hospital and receive some good news for a change?!  What the hell is a meningocele?!

He explained that this wasn’t his area of his expertise, but that the covering of the spinal cord and the brain is called the meninges (when people get meningitis it’s this covering that gets inflamed). He said that a meningocele is an outpouching of  the meninges. He said his gut feeling is that it is something that my well have been with me since birth but that it would need to be looked by a relevant specialist at some point and I may need to have a more focused MRI scan.  He didn’t think it is related to the breast cancer.

Right okay, so not really sure what to do with that right now, when I heard the word lesion my world initially started to cave in.. maybe I’m riddled with it I thought.

I asked him if it was a cancerous lump and he said that they didn’t think it was likely to be – it was probably a benign cystic lesion and there was nothing to suggest that it’s cancer. He said we would need to park it for now and continue with the cancer treatment but that my GP should be able to refer me to a specialist. He didn’t think it was relevant or a cause for concern but obviously didn’t want to just leave it without further investigation and said we would carry on treating the breast cancer and then have it investigated.

Okay, I can go with that – far too much else to think about at the moment, so I would try and ‘park it’.

I then had a whole ream of questions to fire at him – he must have felt like he was on Mastermind the poor chap! He said he assumed I was sticking with the plan of a wide local excision, removing just the lump and not a mastectomy, which I agreed and said that had been advised to me. We had previously been told that there was no need to have a mastectomy as there was no difference in terms of survival rates as opposed to having a lumpectomy so it seemed the obvious choice.

He went on to say that a cancer measuring 15mm on the scan, could actually turn out to be 5cm. Cancer cells can be invisible to see on a scan or may look normal when removing in surgery – it’s only by looking at it under a microscope that they can tell for sure. The goal of the surgery would be to take out all of the breast cancer along with a margin of normal tissue around it. This is to be sure that all of the cancer has been removed.  The margins are checked after the surgery and he said that one in five people have to come back for more surgery because the margins are not all clear.

He then indicated with levelling his hands in the air as to the level of survival of people having a lumpectomy and those having a mastectomy. He said that, long term, survival is lower for those who have a lumpectomy over those who have a mastectomy.  However, if radiotherapy is used on people who have had a lumpectomy then the survival rates climb up. He said that whilst lots of people say survival rates are the same, there is a small difference – but not enough to say they don’t offer breast conserving surgery.

Those that have a lumpectomy have to have radiotherapy to sterilise the rest of the breast area. In terms of it coming back in the future, if there is no radiotherapy treatment there is a difference, however if radiotherapy is used, the rate comes down (not to quite the same level).  He said there is a slight difference in the chance of a local recurrence because obviously there is a larger amount of breast tissue left. But again, still not enough for them not to offer a lumpectomy – if that was the case they would only be performing mastectomies on people.  He said they do more breast conserving surgery than they do mastectomies.

I then asked him if it were his wife or his sister in this situation what would he recommend for them? He said that was a very difficult question to answer as there are so many facets to it. There are physical and psychological things to consider, if having radiotherapy, what are the implications of that? With so many swings and roundabouts there is no one answer that is definitely right. Great, a politician’s response – not what I was after!

He said he provides options and that they would support me in whichever decision I made. I started to doubt the decision that I’d made – or more, the advice that had been offered to us based on statistics.  Should I go for a mastectomy? How awful it must be to lose a part of your womanhood – could I hack that? Surely it’s better to be boobless than lifeless I thought?! I started getting really distressed as I hadn’t even considered along the way that this was really an option for me.

I know these guys do an absolutely fantastic job, but I was looking to him as the expert to recommended what I should do for the best – take the choice away from me. I’m not good at making on the spot decisions quickly or easily.  I like to go away and analyse the pros and cons of a decision, evaluating which is the best option. But I could also see what he was saying – they give people options and it’s their right to choose.

I asked what the risk of it coming back in the other breast was and he said I’m at a slightly higher risk than someone who’s never had breast cancer, but I’m not at a risk level which would warrant them recommending treatment to the other breast.  The fact that I would be taking Tamoxifen which would reduce my risk of developing breast cancer on the other side too – by taking this it will half that risk.

I also asked how long I’d be on Tamoxifen for which he said that the evidence up until January last year was that five years was the norm, however new data now suggests that 10 years is better than five.  But he said that everyone is different and that could be tempered depending on the risk benefit. For some people the benefit of the drug is going to be high for others its going to be low depending on the risk of relapse. If someone had a very horrible nasty cancer, the drug would have more to do than a miniscule cancer.

After some time, and with some interjection from him, I finally decided to go along with the initial plan of the lumpectomy and completed the consent form. He went through the list of risks associated with the operation – severe scars, risk of infection, risk of clots in the legs, risk of bleeding which could go to the lungs – all of which are apparently standard for every operation.

He then went on to say that whenever operating on the armpit there are risks of stiffness in the shoulder, swelling of the arm (lymphedema) and a numb patch to the upper arm. They would also inject a blue dye and a radioactive substance into my breast so they can determine which glands to remove from the armpit. The blue dye apparently stains your body fluids for 48 hours so I could potentially cry blue tears, pee blue urine and I may look a bit blue-ish in colour – a bit like a Smurf! There also is a 1 in 200 chance that I would be allergic to the blue dye and could end up in intensive care. He said he’s done a number of these operations and has seen people end up in intensive care. Bloody hell this is scary shit!  I then signed on the dotted line.

I started to get really teary at this point, it had been a really long appointment with the doctor.. It was good to be able to ask all the questions I had, but it just all felt really mammoth.

Before we left we asked about the holiday we had booked to go to Cyprus on 27th May and he recommended that as my surgery was on the 22nd that we should cancel it as it would be safer to be in the UK just in case I had any issues.

MRI Scan

This was another first for me – other than having my teeth x-rayed at the dentist I’d never had any other scans before in my life. Upon arriving at the scanning unit I changed into a rather fetching hospital gown – luckily I was able to bring my own dressing gown to cover my modesty! I left Pats in the waiting area and the nurse showed me through to the scanning room.

As I entered I saw the large tunnel machine with a bed attached to it – just as you see in pictures and on TV. Unlike the poor lady who was before me, luckily I wasn’t claustrophobic so I wasn’t worried about actually being inside the tunnel. The appointment letter had said I could bring along a CD to listen to whilst I was being scanned so I handed over my Amy Winehouse Lioness: Hidden Treasures album.

The nurse fitted a cannula to my arm which she explained would be used to inject a dye into me whilst I was inside the scanner. I laid face down on the bed that had two plastic holes for the chest area that I had to position myself in.  She explained that there would be two scans, one of which I would hear a noise to indicate that the dye injection was being triggered. She placed a buzzer in my left hand and said if I had any problems at all whilst I was in there I just needed to press the button and they would bring me out straight away. She did say they wouldn’t be able to inject the dye into me again on the same day so if I did have to come out I’d need to go back for another appointment.

She said I would hear some noises whilst inside the scanner and gave me a pair of headphones explaining that I’d be able to hear my CD through them and that I would also be able to hear her too. After they put the earphones on me and left the room I shut my eyes tightly. My eyes started to well up slightly as I was left all alone.  Boy did this feel weird!

I began to feel the bed moving in what must have been a backward motion and the first track on the album started playing ‘Our day will come’. I immediately thought of Pats, thinking to myself that after all this is through our day would truly come. My mind wandered off into thoughts of our wedding day – the beautiful Italian setting, the gorgeous weather, our friends and family and that feeling of complete and utter peace and happiness. It’s always the place I go to when I have to take my mind off what’s going on- usually it’s whilst having my teeth drilled at the dentist and saying to myself ‘think happy thoughts, think happy thoughts!’

I continued to feel the movement of the bed swaying and various clicking noises were going on around me. Having the scan wasn’t painful in any way it was just the whole experience of being there, it made everything more real and to be completely honest I felt frightened.  It was soon over and I got dressed and joined Pats again outside. All done…now we just had to wait for the results.

The Nuffield Victoria Wing

At our first consultation appointment we met with a nurse who went through some questions regarding my breast surgery and planned cancer treatment.  She explained that the fertility treatment would commence at the start of my period and that I would be put on a “short protocol” to get me through as quickly as possible.

I had an AMH blood test taken – a hormone test that gives an indication of how many eggs I have left in my ovaries.  The result wouldn’t give a number of how many eggs are actually left, it would be a measure of how strong the hormone is (if the level was not very high it could indicate approaching the menopause). The result of this test would help them get the correct dosing for the medication used for the IVF.

She asked if we were self funding the treatment which we said we were because I wasn’t due to be having chemotherapy and because we were over the age of 34. She said how much of a post code lottery IVF funding is and that had we lived in Surrey we would have been able to have treatment up to the age of 39 and would have been funded for two cycles.  Damn it – we just moved from Surrey!!

We both completed a medical questionnaire each and a whole host of other paperwork and then she scheduled in our next appointment which she said would be approx. 2 hours long. This session would cover how to do injections, how they monitor the cycle with ultrasound scans, how they collect the eggs and then create embryos for us as well as storage of the embryos and the hormone supplements to be taken.

The nurse also explained the two types of fertility treatment . IVF (In vitro fertilisation) where the egg and sperm are put together in a dish and they find each other and fertilise naturally. ICSI (Intra-cytoplasmic sperm injection) where they manually inject a single sperm into an egg which increases fertilisation rates. She said they would rather prepare us for the fact that we may need the latter as it would cost an extra £1,300 rather than shock us on the day. Jesus, this is all so expensive!

She said that the average number of eggs collected is between 8-10, although not all of those would be high enough quality to freeze – they would only freeze the good quality ones as they’re the ones that will survive the freezing and thawing process. As this would be our only shot at having the treatment they would likely freeze as many as possible.  The storage of the embryos would be done in a batch and would cost approximately £400.

We were then introduced to the Doctor for our initial consultation.  He immediately brought up the topic of funding, and said he couldn’t understand why our case hadn’t been look into in terms of funding on the NHS. We explained what the consultant at QA had said to us about my planned radiotherapy treatment and the upper age limit making us not eligible. He said they would apply for funding for us and see what they would say, it was worth the chance and he said in my situation they may be slightly more flexible.

He agreed that the right decision had been made in terms of having the surgery first, and that in the window between having the op and starting treatment they would take me through a cycle. He said that the recommendation after you have been on Tamoxifen for two or three years is that it’s possible to place the embryos back. Current teaching is that Tamoxifen is taken for five years, however he said that conventionally it’s two to three years (this would depend on the staging and type of cancer from the analysis).

The doctor reassured us that they will do their very best to obtain the best quality embryos to maintain my fertility and whilst it may not be my priority in terms of getting through the cancer, once I am through with my treatment that my ability to carry a baby would in no way be compromised.

He said his goal would be to get around 10 eggs, to then have seven to eight embryos, with four to five blastocysts. We would have an approx 30% chance per transfer of each of those embryos.

He offered us their counselling services and also suggested we take Omega 3, Vitamins B, C and D and a supplement called Proxeed. We were already both rattling with about 12 different vitamin supplements we’d been taking so think we were safely covered there!

We walked away feeling positive about the potential results of the treatment and definitely felt like we were in very safe, caring hands.

Back at home later on that day I received an unexpected delivery of flowers from a colleague at work. They were beautiful and I was touched by her kindness and thoughtfulness.

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Someone like me

Before we went to meet the consultant on our first trip to the Nuffield, Caroline urged me that it would be crucial to harvest my eggs before my surgery to ensure the best possible chance of saving them. This put me into a huge quandary as the consultant we had seen previously said that my surgery was the most important thing and that the egg harvesting would happen post-op. Pats re-iterated to me what the consultant had said in that having the surgery was paramount – he was adamant that there would be no point in having any of my eggs to preserve if that meant adding risk for me.

Having not spoken to my breast surgeon at all as yet, I then went into a frenzy of trying to speak to someone at the hospital to find out what I should do. I’d left two voicemail messages with his secretary but hadn’t heard anything. The breast care nurses I had been in contact had all been fantastic, however they weren’t able to actually advise me what to do. I felt like I was having to liaise with people separately about what was best for me and wasn’t able to quickly get the answers I needed.  My period was due in the next day or two and I felt like I could be missing the only window of opportunity. This was all so stressful, it was such an important decision to make and to be made so urgently but I couldn’t decide by myself.. what on earth did I know about breast surgery and fertility treatment?!

I looked on forums, websites and did all sort of searches to try and find out more information. I had received literature from the Breast Cancer Care charity which included details of a helpline to call. I had a chat with a really lovely lady who had asked a specialist there for me and they had said there was no clinical reason to have my eggs collected before my op and that surgery and radiotherapy wouldn’t affect my eggs. I also talked over a few other concerns I had with her which was extremely helpful and put my mind at rest.  She recommended the ‘Someone Like Me‘ service where they try to connect you with someone who has had a similar diagnosis and treatment to you.

After my initial phone call to the Someone Like Me number, they put me in touch with a lady called Eileen who very kindly called me for a chat. She had been diagnosed with hormone receptive breast cancer when she was 36, some 10 years ago. She had a lumpectomy, followed by a course of radiotherapy and had also taken tamoxifen. I asked her questions about her surgery and what radiotherapy was like. After surgery she had felt numb and she still feels slightly numbness now and she was less mobile in the affected arm after surgery. Eileen said she felt tired having her radiotherapy and that her skin became itchy/flaky and irritated (a bit like sunburn) and that she regularly put E45/Aqueous cream on to moisturise the area. Whilst taking Tamoxifen she experienced more tiredness, night sweats, hot flushes and she felt bloated – the tablets mimic menopausal symptoms.

I explained my situation around trying to conceive and she said that no one had talked to her about being able to harvest or freeze her embryos back then but that she’d successfully gone on to have a little girl at the age of 41. I felt encouraged by speaking to someone who had been through a similar experience and who had successfully gone on to have a child after her treatment too.

I then finally managed to speak to my breast care nurse, who having spoken to the doctor, recommended not doing anything regarding egg harvesting this side of the surgery – getting the cancer out was the priority and then I could have the fertility treatment afterwards. They said they couldn’t be 100% sure, but that I may not need chemotherapy and that the Tamoxifen tablets would not make me infertile. I felt great relief from this and that someone who knew the history of my diagnosis and treatment was giving me an answer – one which I think deep down inside I knew anyway.

Claire had said that as it seemed I had so many outstanding questions that she’d book me an appointment to meet the doctor on the Monday so we could discuss them together. She also said they recommended I have an MRI scan as due to my age and breast density they couldn’t see clearly see from the mammogram I’d had and that in the unlikely event that the lump was bigger the MRI would be able to give better detail.

Call 0845 077 1893 or email someonelikeme@breastcancercare.org.uk to access the Someone Like Me service.

Finding a fertility clinic …tick tock tick tock

In the short space of leaving the hospital and driving home, we’d both come to the agreement that we would go ahead with the fertility treatment. Finding the money worried us, but we’d spent money on far less important things in the past – I’m sure we could find the money.

Something was troubling me about the letter that the consultant’s secretary had handed us. It looked like the Gynaecologist was affiliated with the Complete Fertility clinic in Southampton. Some close friends of ours had previously received IVF treatment at this clinic and, very sadly, were unsuccessful in their attempts. Amongst this tragedy my friend had told me at the time (and also very recently) what an awful after care experience they’d received there and said that she wouldn’t recommend the clinic at all – this kept playing on my mind. Whilst he seemed like a nice enough chap and very knowledgeable specialist, I felt I didn’t want to put myself in the hands of people who may not treat me in the manner in which I’d expect, especially with everything else going on and also having to pay thousands of the pounds for such care too. I voiced my concerns to Pats and we both agreed that given that we were paying for the treatment ourselves it would be best to find an alternative clinic.

When we got home we called my Mum and Dad to let them know what they’d said at the hospital and to asked if they’d be able to lend us the money for the treatment. They seemed as pleased as we were that there was some hope for a baby at some point in the future and very kindly agreed to lend us the money. That was a huge relief and now knowing that we were going to go ahead with the treatment and with the backing of my parents to help us fund it, all I now had to find a suitable fertility clinic.

Whilst we had experienced difficulties falling pregnant naturally, we hadn’t got to the point of looking into IVF options so I had no experience or knowledge of where to start the search.  I found the Human Fertilisation & Embryology Authority  (HFEA) website – the regulating body that licenses and regulates UK fertility clinics. I put in a search with our postcode and up came a list of clinics. The HFEA website was very good and detailed and had data for a whole host of options but I felt overwhelmed by all the information. I looked at the success rates and thought I’d start a spreadsheet to list them all to determine which would be the best option.

A friend of mine had not so long ago successfully given birth to a beautiful baby girl via IVF treatment and had called up that day to see how I was doing. She works in the pharmaceutical industry and offered to use her contacts to gain some advice for me. I said I didn’t have a clue of how to choose the most suitable clinic and she recommended  asking for success rates for frozen cycles and said that the clinic in Surrey that they had used was very good and she also very kindly offered to help do some research for me. It was good to speak to someone who had been through the same experience and I was grateful for the help.

Not wanting to rely on my friend’s ability to research an option for me, I then started to look at forums to try and find out people’s experiences of clinics –  after all that was the reason why we weren’t going with Complete. I started to feel so stressed with it all, not knowing what to do for the best and knowing we had to make a decision within the next day or two it just all got on top of me. It wasn’t like choosing an energy provider or a plumber, this was such an important choice to make.

Another friend of mine had already had a few rounds of IVF in the UK but unfortunately had been unsuccessful each time, she felt despondent at the treatment she’d received here and was about to embark on a trip to Athens to a clinic called Serum IVF. She’d told me how brilliant they had been with her and that their success rates were really high. The lady, called Penny, there seemed to be quite well known, as when I mentioned this to my dear friend, Kate, previously that week she seemed to know all about her from seeing her on TV. I felt compelled to get in contact with the clinic and after reading all the amazing testimonials on their facebook page I felt like it could be a good opportunity for us. I’d mentioned it to Pats that evening but he laughed and said ‘You are joking aren’t you? You’re not going to be travelling to Athens after you’ve just had surgery Allie!’ It did seem like a crazy idea but one that looked like had been so successful for many others.

The following morning I’d already completed the initial enquiry form for the Serum IVF clinic and they came back to me instantly. I told Pats that they’d replied and that’s when he flipped slightly. He said it was ridiculous for me to be thinking about travelling to Athens after I’d had surgery and to a country that is in such a dire state economically. I felt so upset I burst into tears in the bathroom – I knew deep down inside that he was right but it somehow felt like a better option. He came to kiss me goodbye as he set off for work and saw I was crying. I felt so mean as I know he was just looking out for what was best for me, and he could see I was clinging onto the best chance of us having a baby. He hugged me so tight and the tears eventually stopped – this was all starting to take its toll emotionally on us.

I’d called work that morning in quite a distressed state and said I wasn’t going to be at work – they’d been so supportive of me ever since my diagnosis – they said to take the time so that I could do my research and figure out our options.

Amongst the clinics I rang, I decided to call the Nuffield in Surrey as that’s where our friends had been as well as another friend. I spoke to someone there called Caroline and asked whether it would be possible to transport embryos from there to Athens. She questioned why I wanted to do that and I explained the whole situation to her. She said it would be very costly to transport and that I’d need to arrange the transfer myself via an international courier and the process would be quite complex. She told me that the best place for me was here in the UK, that their clinic had just been audited by the HFEA who were thoroughly impressed by all their working practices and had received an outstanding assessment. She went on to explain similar information that the consultant at QA had and said that acting quickly really was crucial in all of this. Caroline had such a way about her that she made me feel completely at ease and that I could totally entrust our treatment with them.

In the meantime my friend had come back to me and said her contact had recommended the Royal Marsden Hospital in London (I did not know this at the time but this is a leading cancer hospital). I wanted to consider this an option, however the time it would take to drive there and back made it an unsuitable choice for us. After speaking with Pats about the pros and cons of each, we agreed that we would use the Nuffield for our treatment. Caroline went on to book us an appointment with the consultant that Friday. Apparently there is normally is a 6-8 week waiting list, but because of my circumstances we were able to jump the queue – the one and only benefit of having cancer!

She sent me a list of all the tests we’d need to have in place before the appointment.  I then spent the next day or so running from our new doctor’s surgery to have tests and to my old surgery collecting copies of previous smear tests, and Pats and I both had our bloods taken at a separate local hospital .

At last, I could see a way ahead and felt confident we’d chosen a good clinic with people who would take good care of us.

A glimmer of hope

The very next day we were back at the hospital again, this time to meet with the fertility specialist that Claire had arranged. I felt really nervous going back to the hospital that day. What were they going to say to us? Would they burst the bubble on the dream of our little family? Pats and I sat in the waiting room together clutching each other’s hand.

We were greeted by a chap who was a Consultant Gynaecologist. He started off asking us lots of questions about our history, health and my cancer diagnosis and treatment plan. After this he went on to explain that there was a possibility of trying to preserve some embryos before I undergo treatment.

He said if I wasn’t undergoing chemotherapy then my ovaries wouldn’t be affected in a major way by the anti-oestrogen tablets but it would obviously delay matters if I wanted to get pregnant.  ‘And at the age of 39, time is much more of the essence than if you were 32/33 because whilst you’re on the anti-oestrogens you can’t get pregnant – so there will be a delay of a number of years. If you were to get the all clear in 2-3 years’ time you’ll be 41/42 and your chances of getting pregnant then are less than they are now.’ He went on to say that most ladies they see  are having chemotherapy which destroys some of the eggs meaning their chances of getting pregnant are much less than those having the treatment that was planned for me.

‘So it is possible that you’re able to conceive after the treatment, but there will be an effective delay.’ His words brought a sense of relief and I was now starting to feel much better and more confident that there was still a chance for us further down the line – albeit when we are a bit older!

He said if we wanted to go ahead and preserve and store the embryos that would mean the chances of getting pregnant would be from the age of a 39-year old as opposed to someone aged 41-42.  I would need to undergo an IVF cycle which he said was complicated and expensive, because in my circumstances it was unlikely that funding would be available. He said the costs were substantial and would be approximately £4,000 for an attempt at IVF and storing embryos. He stressed that if we wanted to go down that road it would need to be done as soon as possible and that they would try to fit it in between surgery and the medical treatment and that I would need to liaise with my oncologist as it will mean the tamoxifen treatment will be delayed by a number of weeks.

He said the first decision we would need to make is whether we wanted to go down that road and also whether we were prepared to pay for it. I asked him if the funding wasn’t available because of our age or where we lived and he said that IVF funding on the NHS is very limited and is available for some couples, but that we’d need to tick a number of boxes and that unfortunately one of the boxes is that I should not be older than 34. I had heard there was an age limit from friends who had tried for NHS funding but thought that 34 seemed a really low age to cap it and that the tick box criteria seemed a little unfair given our circumstances. He explained that they try to obtain individual funding for special cases but that those are for women having chemotherapy because they have less of a chance of conceiving afterwards.

If we wanted to go down that road, he said they would need to make quite a few arrangements to fit it all in. The treatment wouldn’t be available in Portsmouth, with the nearest clinic being at the unit in the Princess Anne hospital in Southampton. We would both need blood tests for screening, I would need an ultrasound scan plus there would be a lot of paperwork to be completed.  I asked whether that was an NHS unit in Southampton and he said it was but that they also see people who are paying for treatment themselves. He said it wasn’t essential that we go there, if we were paying for the treatment we could go anywhere we wanted.

They would start the treatment on the first day of the period I have following the surgery. I asked if there was any risk of taking the fertility medication. He said that the drugs used will stimulate the ovaries to produce a good amount of eggs meaning they’ll be working on overtime and therefore the oestrogen levels in my blood will be pretty high. With breast cancer there is always a concern that the high oestrogen levels may have a detrimental effect on the cancer itself. He said it wasn’t proven, but it certainly was there and to try and counteract this they would give me an additional drug that they don’t normally use to try to keep oestrogen to a lower level. He said the risk is more theoretical than real but the theoretical risk is certainly there

Pats asked how long we had to decide, what with not being eligible for funding, we’d need to organise how we pay for it if we were to go down this route. He said we’d need to decide before the surgery, and preferably sooner, because we would need the blood tests done and to have results and paperwork in place.

I asked if whether being pregnant in the future would have an effect on whether the cancer would come back. He said I would need to speak to my oncologist about that but in general the risk would be small. ‘They wouldn’t advise you to get pregnant unless they’re happy anyway – they’re not going to tell you to get pregnant 6 months after surgery – it’s going to be a number of years.’ Pats commented that I’d need to take the anti hormone tablets for five years, to which he said that it may not necessarily be as long as that ‘Medicine is not black and white, it depends on individual circumstances and they may be willing to reduce that time period.’  Well that was another positive, perhaps I wouldn’t be as old or have to wait as long as we initially thought.

He went on to say that as part of the treatment I’d need to go onto drugs that would take control of my ovaries allowing them to create more than one egg. During the treatment I would undergo regular scans – 2-3 times a week. The treatment would take 2-3 weeks and involve a small operation to take the eggs out of the ovaries and that on the day Pats’s ‘services would be required’. They would inseminate the eggs with his sample in the lab on the same day. The next day they would know how many have fertilised and they would let them grow into embryos for approx five days and then freeze them. Only embryos of good quality would be frozen – average quality embryos wouldn’t survive the freezing and thawing process. The embryos could then be stored for up to ten years.

Pats asked about what happens when the time comes to put the embryo back in. He said that this would be a much simpler process, where they would give me some drugs – but nowhere near the same amount – and it would then just be a matter of preparing the lining of the womb and then putting them back. He said the chances of it working putting one embryo back with a good quality egg is on average one in three (about 35%). In my case it would be less because of my age, and for a 39-year old it would be around 25% per embryo put back. But he said we may have more than one egg to put back and that each one put back will have the same chance each time (assuming the embryos survive freezing). The charge each time to put an embryo back would be approx £1,000.

He then gave us some more detailed information to take away and think about. He reiterated that there would be financial implications for us and that we’d be expected to pay the cost when we start the treatment itself. He said he only works at the hospital on Tuesday’s and Thursday’s so would try and fit us in the following week and recommended we went in on that Friday to get the blood tests underway.

As we both left the hospital I could tell Pats was still thinking about whether we should do it or not – and at £5,000 it’s certainly not a cheap option. But to me it was our only option and this was the only window in which we could ever do it as there would be no other options further down the line given how old I’d be.

Someone had offered us a chance and to me it was one we should grab with both hands.  The 25% success rate is not amazing but hey, it’s 25 times better than 0.

Mammogram

Pats and I went back to the hospital on the Monday for my mammogram scan. Although I felt less worried about the trip to there this time, I still felt anxious about the mammogram as I’d heard that it could be painful.  I tried to put this to the back of my mind, after all, I was pretty much at the back of the queue when big boobs were being handed out, so hopefully that would be of some benefit to me now.

My Mum had been having regular mammograms for some years and had said to me that whilst it wasn’t pleasant it’d be over very quickly. ‘Be brave’, she said.

The nurse there was really lovely and even commented on how nice my handbag was.  It was a Mulberry handbag that I’d found in a charity shop when we visited Bath last year (anybody who knows me will know I have a slight addition for charity shops!).  Lots of people have said how much they like it, and then I tell them where I’ve bought it and they’re astounded.  The nurse said she reckoned I shouldn’t tell people where I’d got it and should just take the compliment!

I then stood up against this machine and she helped me into position. She pressed a foot pedal and two large plates gradually came towards me and moved closer together squeezing my boob. ‘This isn’t too bad,’ I thought to myself.  Then she pressed the pedal once more and it squeezed that last bit making it feel really uncomfortable as she told me it would only be there for a few seconds. It wasn’t particularly nice but, like she said, it was over in a few seconds. She then did the other side. Phew, I thought to myself, feeling pleased it was done. ‘Right now we just need to do two more from a different angle.’ Bugger! Before I knew it I was back outside again with Pats.

When we  got back home that day we found a gift wrapped box of beautiful flowers on the door step from my sister-in-law, Laura, with a note to say they were thinking of me. It was such a lovely thought and after a few more tears at her kindness a smile came to my face.

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Hope

That night I hadn’t slept well at all. Once again I’d found myself wide awake in the middle of the night. I sat on the sofa downstairs with a cuppa and my iPhone. I was on Google, breast cancer forums and Amazon..I wanted to know all I could about this nasty thing inside my body. I downloaded a kindle version of a book called Hey Miss Have You Turned Mexican? a true story about having and surviving breast cancer by Denise Shaw. I found some comfort in reading about someone else’s story and could relate to what she was going through.

I returned to bed and lay there weeping quietly, trying not to wake Pats up. I eventually drifted off to sleep.

Come the morning I awoke tired and bleary eyed. I still desperately wanted to go and see Tara but didn’t feel I’d be able to do the four-hour drive on my own. In true Pats style, he offered to take me there and ‘drop me off’ and would then come and ‘pick me up’ on the Sunday. This was absolutely no trouble for him, a 440-mile round trip twice in one weekend. This is  one of the many reasons that I love my hubby – he would do anything for anyone if it meant helping them out.  He is the most unselfish person I know and I am certainly very privileged  to be married to him ♡

Pats’ car was in the garage being repaired that week so he had a mini on hire. ‘It’s a mini adventure’, he said chirpily as we set off! I wasn’t able to get put on the insurance so unfortunately couldn’t help him out with the driving. It took us just over four hours to get there and as we drove through the Peak District area it was just beautiful – I’d thoroughly recommend a visit if you’ve not been.

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We drove through charming little villages filled with quaint buildings and cottages, all made of a similar oldy worldy stone – you felt like you could have been transported there 200 years ago and apart from the cars it would have looked exactly the same. The stunning green landscape was filled with moors, valleys and farmland, all neatly partitioned by its character stone walls, sprinkled with sheep and baby lambs.  The scenery and charm of the whole area was breathtaking and if it wasn’t 200 miles away it would be an idyllic place to live.

We were staying in a rather aptly named and equally charming village called Hope. I’d managed to find us a really good deal on the internet and whilst it looked lovely in the pictures I was apprehensive about whether it would be as good a deal as it had appeared.

Considering Tara had driven a good four hours herself from the opposite end of the country, we rather spookily arrived within about five minutes of each other. Upon getting out of the car she gave me the biggest hug which bought a tear to my eye…god I miss this girl!  After saying our goodbyes to Pats, off he drove – the mere 200 miles home!

We were not disappointed by the hotel at all and after we dropped our bags in our room we ventured downstairs for afternoon tea. We were presented with a lovely array of sandwiches and cakes, washed down with a nice cuppa – and crisp glass of wine to boot!

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Tara has been my best friend since we met each other at school (a whopping 26 years ago!) and she is my oldest and closest pal. We made an instant friendship back in those school days – one that has stood the test the time. We grew up together, through our school antics and escapades, we endured the trials and tribulations of our boyfriends in our younger years and have shared lots of laughs and good times together.  Through our adult lives we have been there for each other through the happy times and also the tough times. Although we live many miles apart and I miss her being around, she has always been there for me in my darkest hours, cheering me up when I am down, I am so lucky to have a friend as special as her.

Anyone who has ever had the pleasure of meeting Tara will know what an adorable and charming character she is.  She is beautiful on the inside and out – very thoughtful, kind and caring.  She also  has an awesome infectious sense of humour – she’ll have you in giggles instantly!

We sat and chatted away like we’d only seen each other last week. Like Pats, Tara is another cheerful soul who likes to look on the bright side of life and definitely sees the glass half full. She has an amazing way with words, always knowing the right thing to say and with her cheeky sense of humour she made me feel better instantly.

We both had a tension busting hot stone massage booked which I can really only describe as being ‘utter bliss’.  Later we headed down to the restaurant for our dinner where we were presented with a delightful tray of canapés. The food was absolutely amazing and the three-course dinner was all included in our package. We joked and laughed over a bottle of wine, reminiscing over some of the antics in our younger days.

They also had a hot tub outside so after we’d finished dinner, we slipped into our swimmers and took a bottle of sparkly down with us. That was just heaven, chatting and giggling under the clear night sky soaking up the warm bubbles.

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The next day Tara drove us out to a little shop she’d spotted in one of the magazines – it looked like our type of shop. After buying a few bits we ventured into the children’s toy shop next door. As Tara gathered some gifts for her lovely three children to take home, I felt a sudden rise of tears to my eyes, there were all these gorgeous things in the shop and I realised I may never get to do this myself one day. I felt silly with tears in my eyes so instantly left the shop.

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After more shopping in some of the irresistible little shops we headed back to the hotel for lunch. The rest of the weekend was filled with relaxing treatments, tantalising food, lots of laughs and bubbles ..and more hot tub time. It was exactly what I needed and it recharged and relaxed us both.

Pats drove the epic journey again to come and ‘pick me up’ on the Sunday. His little cheery face appearing at the hotel like my knight in shining armour. We went for a little roam around Chatsworth House (well Tara and I actually spent most of the time in the shops rather than the house!) and then stopped for some lunch at a lovely pub near Barlow.

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Tara had bought me a little stone heart with the words ‘Hope’ etched on it, a keepsake of our trip and a positive thought to end the weekend. We all said our goodbyes to each other and went off our separate ways. I felt so sad to be saying goodbye to Tara so quickly and knew I wouldn’t see her for quite some time, but felt very blessed that we’d shared such a fab weekend together.