The icing on the cake

Saw one of my breast surgeons at the 'Marsden today and she was very pleased with my "excellent result". So pleased, in fact, that she dragged in another colleague to have a look.

Mr P: Boobs and cake. What's not to like?

To be fair, my boobs do look great. Far more balanced in shape than I had anticipated and quite natural in texture due to the earlier fat transfer.

The next and final stage is nipple reconstruction. A lot of people don't bother with this but I really don't need to decide until I go back again for my review in eight weeks.

Nipple-wise, they can either create one out of scar tissue or mould a prosthetic one that you stick on with skin glue, presumably for special occasions ...

The argument for creating one from scar tissue is (a) it's permanent and (b) it looks realistic "from a distance". Now, call me old fashioned, but I generally only display my nipples in close proximity, so I'm not sure that this is a massive selling point. However, it would be nice to complete the process and feel that I'm finally finished.

Mr P. and I still wanted to mark the occasion though. And so we did, with coffee and cake ... OK, quite a few cakes, care of the Hummingbird Bakery.

It was also an important day for another reason. Eight years ago today, I lost my lovely Dad to bowel cancer. It simultaneously feels like both a short time and a long time, but I think of him often.

So here's to you, Dad. Thumbs up! x

"I must, I must, I must improve my bust!"

And I finally have! Yesterday, I was back for surgery at the 'Marsden for the fourth time in less than 10 months to get my implants. Even one of the day ward nurses commented: "I recognise you. You've been here loads!"

It's true I have. Never mind the surgery but all the assessment, review, counselling and nursing consultations have been pretty numerous.

It was quite nice though to see my surgical team again, Gerald Gui and Ana Agusti, who have looked after my case for exactly a year. They also brought another member of the team in pre-op to assess my 'breast volume'.

I thought this was quite funny and asked him, "so doctor, your job is to look at naked breasts and guess what size they are?" He looked a bit embarrassed and then, when Mr P. asked for a business card, the poor bloke didn't know what to say!


It's been a right old 'Carry On'
but Mr P and I are pleased with the outcome

However, he obviously judged well because I'm very pleased with both the sizing match and the symmetry in my clothes. I really don't think anyone else would know the difference but it does mean that I don't have to pad out 'lefty' any more and can start wearing my nice bras again instead of mastectomy ones.

That said, I have received a few texts from people asking how it went, including a very direct one: "Let's see 'em then!" All in good time, ladies, all in good time ... ;-)

I'm still very taped up and sore. The left hand side is particularly painful as I hadn't had surgery there before, but both sides are very tender. I can lift my arms up above my head but can't reach up yet so will definitely need next week off work to recover before I brave the Tube for my post-op assessment next Friday (10th).

Anyway, Mr P is staying with me today to help me do things and the weekend will see my boobs' first outing (not literally) at a big family gathering in Oxford, with all of Mr P's extended clan.

It's going to be quite a celebration.

Positive moves

Three weeks into my new job and I feel like I've been there three months; it's certainly been a baptism of fire!

Given that I hadn't worked (at least, not properly) since January 2012, I was amazed how quickly and easily I jumped straight back into things; writing plans, managing staff and fielding calls from aggressive international media. And that was just my second day!

So while it has been tiring, and stressful, it has also been enormously confidence boosting. I took this new role because I felt I needed a fresh start, an opportunity to reinvigorate myself both personally and professionally. And that's exactly what I got.

For the first time, in many years, I feel like the old Kate. While I loved my old company and all my colleagues, this change was much needed. I had become lazy and complacent and had forgotten how much I could love my work, and be bloody GOOD at it!

Next week: A nice new pair

Of course, next week I will also have another big change: my new boobs. Finally! After eight months of discomfort and 'tissue expansion', I will have my fourth operation and get my permanent implant. 'Lefty' is going to get a makeover too, or augmentation, so that I get an (almost) matching pair.

And lastly, fertility. The NHS have confirmed funding and I'll be undergoing 'fertility preservation' in the next week or two. There are no guarantees of success, given the changes caused by my chemotherapy treatment but, just to have the opportunity to try, feels a very positive step.

My life is good. :-)

Spring forward

Apparently, it's now British Summer Time. Certainly the clocks have gone forward but the weather is taking its time to catch up.

For me though, life is definitely on the move. Today we went to IVF Hammersmith and got all the info and drugs I need to undergo the 'fertility preservation' treatment.

It won't start now until early May and will probably coincide with my surgical recovery (post-op at The 'Marsden) but that's possibly a good thing and could minimise any disruption with work etc.

Because tomorrow I start my new job. I'm obviously apprehensive but I'm looking forward to getting my teeth into something new.

I've definitely got a spring in my step!

Celebrations all round!

Today is Mr P’s birthday and we’ve both taken the day off to lie in bed, drink Bucks Fizz and be very, very lazy. And tonight we’re off to a ‘Sports Dinner’ with friends to enjoy some nice food and some great company before I leave my job (of over 12 years) tomorrow.

As I wrote in my last post, it’s been an interesting couple of weeks. Things have definitely started to fall into place, in a way that has truly surpassed all my expectations.

Specifically, I have been told this week that I can definitely start hormone treatment and freeze MY OWN eggs! I could start taking the drugs as early as Easter (although the end of April is more likely).

I’m still pinching myself about all of this. Eight weeks ago I felt completely crushed and let down by the system. I felt that I had been cruelly deprived of life options but didn’t feel that I had the energy to fight the NHS bureaucrats.

But, two months later, and the situation is very different. Hot on the heels of being told by the ‘Marsden’s Oncology team that I could stop Tamoxifen for a month and take hormone treatment, I got a random phone call from Queen Charlottes’ IVF Team which resulted in me going in for more tests and getting their agreement that I can start the drugs for egg stimulation ASAP.

I don't know if my 'letter of concern' to the Primary Care Trust's CEO has accelerated any of this but I'm not going to look a gift horse in the mouth. It all feels brilliantly surreal.

Of course, I know it’s not going to be an easy process, far from it. And the timing could be better: who wants to start a new job dosed up to the max on hormones(!) but, f*ck it, I'm just going to go with the flow. By the end of June, IVF and surgery should be finished and I can start my 'naughty forties' with perky new boobs and some frozen eggs in the bank. ;-)

So tomorrow, when I leave AAT, it will be with a real sense of optimism. I'm enormously grateful for all the support that I've received over the last 15 months (and indeed, 12 years) but I do believe that everything happens for a reason and that my life is now moving forward in an incredibly positive way.

I'm also looking forward to meeting up with some ex. AAT friends who will be celebrating with me. Onwards and upwards, as they say!

All change!

Crikey, a lot can happen in two weeks.

Firstly, I’ve got a new job and resigned from my current role. I’ve been with the company for 12 years, so it is a big deal (for me, at least!) but I think a change will do me good and give me a renewed sense of purpose. I need to feel that my life is moving forward again.

Ironically, I wasn’t really looking but I saw the post advertised in January and speculatively applied. Getting it though, did make me feel a bit guilty. My current company, AAT, have been amazing in their support of me over the last year and had been trying to revise my role. However, I do also think that the right things happen at the right time and I will wave farewell on Friday 22 March and, following a short break, start my new role after Easter.

Secondly, I have submitted a letter to the North West London Primary Care Trusts regarding my cancer treatment (and specifically the lack of fertility guidance/support) and have been advised that my GP will need to make an individual funding request in order to secure funding for any fertility-saving treatment for me past the age of 40. You have to be able to cite exceptional circumstances, which I think we can (and he has agreed to do), so we’ll see how that goes …

Thirdly, and related to the fertility issues, I met with the oncology team at the ‘Marsden. It was a very informative and positive meeting because (a) I am definitely not menopausal, and (b) they do not see any reason why (if Queen Charlotte’s Hospital thought it could be successful) I would not be able to take the necessary hormones for egg harvesting myself.

This is, of course, a big ‘if’ as my ovarian function has been significantly diminished by chemotherapy. However, the fact that they do not see an issue in the short-term application of hormones, and stopping my Tamoxifen for a month or so, was a very pleasant surprise. They would also prefer me to do this sooner rather than later as then I can have a much longer, uninterrupted period on the medication.

Lastly, I have seen my surgical team. They seem happy with the results of the ‘Coleman Fat Transfer’ so it’s full steam ahead for my implant operation on Thursday 2 May and a new pair of matching boobs, which were ordered today.

So, all in all, it’s been a very positive start to 2013.

So what happened next?

Sorry for being a bit quiet of late but there have been a few things to organise and sort out ...

Many of my friends will know how upset I’ve been about not being able to take any steps, pre-chemotherapy, to try and preserve my fertility. It has caused me untold sleepless nights – especially as I now realise that, contrary to what I was told, I did ‘have time’ and that there were drugs they could have offered me to protect my ovarian function.

So while we can’t undo what happened a year ago, Mr P. and I do want to take issue both with the Primary Care Trusts and with Ealing and Charing Cross hospitals themselves; just to get it on record that we feel that we were given erroneous information.

The cynical part of me, also can’t fail to note that the procrastinations of Ealing Hospital in dealing with my diagnosis and treatment plan also brought me very close to the 31-day deadline by which NHS guidelines say that I needed to start my treatment (after diagnosis). So maybe it wasn’t actually me, that didn’t ‘have time’ … ?

Fortunately my GP has been very supportive and recognises the anxiety that this has caused me. The Royal Marsden too, has been very good in getting me referred to Queen Charlotte’s Hospital for fertility tests and allowed us to explore our other options.

Peas in a pod:
Clare and Katie

This is where my very lovely (and conveniently, identical twin) sister comes in. Because of the nature of my cancer, and the drugs that I am now taking, it is not feasible for me to take any hormone-based treatments. However, my sister has said that - subject to her being suitable with successful test results etc. – she would be willing look at the possibility of acting as an egg donor and letting us freeze some ‘options’ for potential future use.

This would obviously be a very generous thing for her to do. Egg donation is clearly a much more, ahem, ‘involved’ process than sperm donation requiring a month of hormone injections and essentially feeling like crap.

She’s already been down to London and spoken to our consultant, where he explained some of what would be involved and the timescales/potential costs. She’s also had a blood test and scan, the results of which we will get just after Easter (when she will be in London again).

There’s still an awful lot to be discussed before we know how far along this road we can go but it is an enormous relief to me to know that there are still possibilities that can be explored. In particular, my medical team at the ‘Marsden have arranged for me to speak to their Oncologist this week (Friday 1 March) to get a much better idea of whether or not I could ever be allowed to have a hormone-heavy IVF treatment. Moreover, I want to be sure that - given our identical DNA and my previous breast cancer (and her fibroadenoma) – I will not be putting my sister at any increased medical risk from a hormone treatment.

However, there have been some lighter moments this month. Mr P. and I are both really enjoying being back on stage and rehearsing for our next amateur play, the first that we’ve done together since the summer of 2011.

I also hosted a charity wine-tasting event for a number of my friends. Sarah at Window on Wine (and Tesco wine community blog(ger) of the year 2012) donated her time and expertise free of charge and took us through a variety of sparkling wines, which we learnt to ‘swirl, sniff and swig’ with increasing enthusiasm with each additional glass.

It also turns out that Phoebe (my cat) is quite the ‘party animal’. You’d think that fourteen loud, lairy, wine-swigging women would phase a little puss but, no, she worked that room like one of the girls.

All in all, it was a great night and we raised over £100 for the Institute of Cancer Research. Cheers, ladies!