Okay, so I've debated with myself a lot about starting this blog. Part of me feels like its a good way for me to process everything that's going on at the moment, and to let people know some details so that I'm not asked the same questions over and over again. Another part of me feels it's a little bit self indulgent and that now is not really the time to share such personal things. I guess if you're reading this then the first part won through.
I started writing a blog back in 2013, when I moved to Tanzania, for the sole reason of keeping people updated with stories and pictures, but found that the blog became a bit of a therapeutic tool for me more than anything else. Since leaving Tanzania I haven't continued with blogging, I didn't even really finish that one properly. In the year and a half since I returned I have struggled a little bit to adjust back to life in the UK, I've spent the time as a bit of a nomad working as a locum and moving around various hospitals in the north of Scotland. I've really enjoyed it and have seen some beautiful places and made some amazing new friends. Locuming has kept me on my toes with lots of new challenges, but I've always had one eye on the future waiting for my next big challenge. In January, a few weeks after starting a new locum position in Inverness, that new challenge found me. I was diagnosed with Breast Cancer. Not exactly the challenge I was hoping for, but a challenge nevertheless.
So for those of you who I haven't actually managed to tell in person about this, I'm sorry, but as you can imagine it's not exactly the easiest conversation to have over and over again. For those I have told, thank you so much for your support, I've been overwhelmed by peoples' kindness and good wishes, I've had more flowers/chocolates/presents/cards than I've ever had in my life and I appreciate them all so very much. I'm not going to pretend that this has been easy, and I know it's about to get a whole lot harder, but I think generally I'm doing well, all things considered.
So here are some answers to the questions that many people have been asking:
Q. How did you find out?
A. I discovered a lump, did the usual internet searches for advice (sticking to NHS sites trying not to scare myself too much), monitored the lump for about a month to check for hormonal changes. When nothing changed I mentioned it to a nurse at a routine appointment who booked me in to see a GP the next day. The GP referred me to a breast clinic, the breast clinic did a mammogram and ultrasound and decided I needed a biopsy which was performed immediately. A week later I got the results.
(n.b. the whole time I was quite sure it was nothing to worry about and that I was just bothering people or time wasting and so was taken quite by surprise by the results).
Q. What's the diagnosis?
A. I was diagnosed with invasive ductal carcinoma, after further investigation the tumour was found to be Grade 3 (fastest growing), Oestrogen receptor positive and HER2 positive. The lymph node biopsy showed no spread to the lymph nodes.
Q. You're so young (?!), does it run in your family?
A. No, it doesn't seem so. I don't have a strong family history and the type that I have (ER+ and HER2+) means that it is unlikely to be genetic and so I haven't been tested for that.
Q. What treatment do you need?
A. I had surgery two weeks after my diagnosis, a lumpectomy and sentinel node biopsy (to check for spread), they were happy with the outcome (clear margins) and so I shouldn't need more surgery. Due to my age, the grade of the tumour and the HER2+ status I will require chemotherapy. This will be a regime called FEC-T and consists of 6 cycles with each cycle lasting 3 weeks, starting on Friday 3rd March. After this I will require injections of a drug called Herceptin which should all finish in about a year's time. Then I will need to take a drug called Tamoxifen.
*Update - I will also have radiotherapy after the chemotherapy which will consist of 4 weeks of daily sessions. This has always been the plan but I forgot to write about it!*
Q. Will you stay in Inverness? What about work? Where will you live?
A. Yes, I have decided to stay in Inverness as long as I can and will continue to work as long as I am able. As a locum the length of my contract is a bit uncertain but the managers have been incredibly supportive so far. I am currently living in hospital accommodation but hoping to move soon.
Q. Do you have a good support network there?
A. I'm very lucky that one of my oldest and closest friends lives just outside Inverness and she and her husband have been incredibly supportive. I also have friends scattered around Scotland including Aberdeen where I have needed to spend a bit of time. My family and friends 'down south' have been wonderful and made the long journey up to see me to help out with appointments and when I had surgery, and even just to give me a hug! I know there'll be more visits to come, and although I feel bad that people have to travel so far, I do believe I have made the right decision to stay in Inverness.
Q. Will you be able to have children?
A. Okay, so thankfully most people haven't actually asked me this question. It's one of those questions they want to ask but can't quite, and I'm grateful for that. To be honest it's not something I want to discuss, all I will say is that things are more complicated now but not totally impossible. Only time will tell.
Q. Will you lose your hair? What symptoms will you have and when?
A. With the chemotherapy that I am having it is almost certain I will lose my hair, although everyone reacts differently. As for the symptoms, again everyone reacts differently so I won't really know until I start.
Q. So, how are you?
A. Generally I'm doing okay, I'm not going to pretend I've not had my moments but generally they seem to be short lived and brought on by small random things. I've realised I just have to take one thing at a time, if I try to think about too many things I get overwhelmed. I know I've been so lucky that this was caught early and I'm just focusing on that.
Those are the most common questions that I can remember for the time being and I hope that they help to explain some things. Once my chemotherapy starts on Friday it's going to be difficult to hide all this so I guess it's better to get things out in the open. Although this has never been a secret I have been careful who I tell just because it can be a bit too much at times when people get in touch, so if I don't return a call or answer a message please don't be offended, I appreciate all the good thoughts.
Finally, if you find something you are worried about, don't be nervous about contacting your GP, I'm so thankful that I had that routine appointment and forced myself to mention the lump that was "probably nothing".
I started writing a blog back in 2013, when I moved to Tanzania, for the sole reason of keeping people updated with stories and pictures, but found that the blog became a bit of a therapeutic tool for me more than anything else. Since leaving Tanzania I haven't continued with blogging, I didn't even really finish that one properly. In the year and a half since I returned I have struggled a little bit to adjust back to life in the UK, I've spent the time as a bit of a nomad working as a locum and moving around various hospitals in the north of Scotland. I've really enjoyed it and have seen some beautiful places and made some amazing new friends. Locuming has kept me on my toes with lots of new challenges, but I've always had one eye on the future waiting for my next big challenge. In January, a few weeks after starting a new locum position in Inverness, that new challenge found me. I was diagnosed with Breast Cancer. Not exactly the challenge I was hoping for, but a challenge nevertheless.
So for those of you who I haven't actually managed to tell in person about this, I'm sorry, but as you can imagine it's not exactly the easiest conversation to have over and over again. For those I have told, thank you so much for your support, I've been overwhelmed by peoples' kindness and good wishes, I've had more flowers/chocolates/presents/cards than I've ever had in my life and I appreciate them all so very much. I'm not going to pretend that this has been easy, and I know it's about to get a whole lot harder, but I think generally I'm doing well, all things considered.
So here are some answers to the questions that many people have been asking:
Q. How did you find out?
A. I discovered a lump, did the usual internet searches for advice (sticking to NHS sites trying not to scare myself too much), monitored the lump for about a month to check for hormonal changes. When nothing changed I mentioned it to a nurse at a routine appointment who booked me in to see a GP the next day. The GP referred me to a breast clinic, the breast clinic did a mammogram and ultrasound and decided I needed a biopsy which was performed immediately. A week later I got the results.
(n.b. the whole time I was quite sure it was nothing to worry about and that I was just bothering people or time wasting and so was taken quite by surprise by the results).
Q. What's the diagnosis?
A. I was diagnosed with invasive ductal carcinoma, after further investigation the tumour was found to be Grade 3 (fastest growing), Oestrogen receptor positive and HER2 positive. The lymph node biopsy showed no spread to the lymph nodes.
Q. You're so young (?!), does it run in your family?
A. No, it doesn't seem so. I don't have a strong family history and the type that I have (ER+ and HER2+) means that it is unlikely to be genetic and so I haven't been tested for that.
Q. What treatment do you need?
A. I had surgery two weeks after my diagnosis, a lumpectomy and sentinel node biopsy (to check for spread), they were happy with the outcome (clear margins) and so I shouldn't need more surgery. Due to my age, the grade of the tumour and the HER2+ status I will require chemotherapy. This will be a regime called FEC-T and consists of 6 cycles with each cycle lasting 3 weeks, starting on Friday 3rd March. After this I will require injections of a drug called Herceptin which should all finish in about a year's time. Then I will need to take a drug called Tamoxifen.
*Update - I will also have radiotherapy after the chemotherapy which will consist of 4 weeks of daily sessions. This has always been the plan but I forgot to write about it!*
Q. Will you stay in Inverness? What about work? Where will you live?
A. Yes, I have decided to stay in Inverness as long as I can and will continue to work as long as I am able. As a locum the length of my contract is a bit uncertain but the managers have been incredibly supportive so far. I am currently living in hospital accommodation but hoping to move soon.
Q. Do you have a good support network there?
A. I'm very lucky that one of my oldest and closest friends lives just outside Inverness and she and her husband have been incredibly supportive. I also have friends scattered around Scotland including Aberdeen where I have needed to spend a bit of time. My family and friends 'down south' have been wonderful and made the long journey up to see me to help out with appointments and when I had surgery, and even just to give me a hug! I know there'll be more visits to come, and although I feel bad that people have to travel so far, I do believe I have made the right decision to stay in Inverness.
Q. Will you be able to have children?
A. Okay, so thankfully most people haven't actually asked me this question. It's one of those questions they want to ask but can't quite, and I'm grateful for that. To be honest it's not something I want to discuss, all I will say is that things are more complicated now but not totally impossible. Only time will tell.
Q. Will you lose your hair? What symptoms will you have and when?
A. With the chemotherapy that I am having it is almost certain I will lose my hair, although everyone reacts differently. As for the symptoms, again everyone reacts differently so I won't really know until I start.
Q. So, how are you?
A. Generally I'm doing okay, I'm not going to pretend I've not had my moments but generally they seem to be short lived and brought on by small random things. I've realised I just have to take one thing at a time, if I try to think about too many things I get overwhelmed. I know I've been so lucky that this was caught early and I'm just focusing on that.
Those are the most common questions that I can remember for the time being and I hope that they help to explain some things. Once my chemotherapy starts on Friday it's going to be difficult to hide all this so I guess it's better to get things out in the open. Although this has never been a secret I have been careful who I tell just because it can be a bit too much at times when people get in touch, so if I don't return a call or answer a message please don't be offended, I appreciate all the good thoughts.
Finally, if you find something you are worried about, don't be nervous about contacting your GP, I'm so thankful that I had that routine appointment and forced myself to mention the lump that was "probably nothing".
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