Wednesday, 29 December 2010

The Beginning Of My Journey

25th August 2009

I arrive at the hospital on my own just for a simple mammogram. The breast clinic is on the first floor only to be told I need to go to the x-ray department. Why they don’t say in the letter on arrival go straight to x-ray department I do not know! I navigate my way through the long corridors following the signs.

The smell of hospitals is not a new experience and you never adjust to that nervous feeling you get. It remains strong as ever each time you enter those automatic doors that greet you on arrival.

I wait in line to sign in so they know I have arrived only to take note of the word URGENT written in bold on my paperwork. It’s not on a list like everyone else, oh no it’s separate. My eyes say it all, Oh pooh! I’m in trouble yet again. Ok, so I have to remain calm so joke mode comes out.

(When I am nervous or in trouble I make fun of the situation.)

“So does that mean I’m first on the list?” I ask the nurse pointing to the urgent written on the paperwork and smiling. The receptionist frowned at me and requested I go sit on the long metal blue bench to the left near the corridor behind me. So I’m sat there all on my lonesome when another woman sits next to me. She pulls out a book from her bag and begins to read.

I’m thinking ok, she is not new to this. She had the sense to bring a book along. Then I change my mind because most Londoners carry books to eases the boredom of travelling on the tube or bus.

I am from up north originally, Scarborough to be precise. I always said I would never move to London, but the work I do opens more opportunities’ here.

I find London is a very intimidating place, but I put it down to the cultural clashes and manners or lack of. You barely hear the words thank you, and excuses me is none existent. No-one is leading by example it is just accepted amongst the various cultures that thrive here. I find people complain, but it is no good complaining if you don’t practice what you preach.

I was pre-warned before moving here that the NHS system and hospitals are over stretched and treatment is not as good as up north. It is a conveyer belt of paperwork and budgets that need to be met. Patient care is the least of their worries amongst the stressed out staff that run the various departments. So keep one step ahead and monitor closely so you get the right treatment.

Anyway the woman who was reading the book has her name called out and she vanish into a room across from me. Then two more women sit next to me. They were mum and daughter. I start a conversation with them and they look at me thinking this is one odd ball, but I’m a friendly northerner. It beats sitting there looking into an open space worrying about something that might not be there.

I tell them what brought me here and the daughter replies “Well it’s probably nothing.” The daughter turns to her mum with a confused look.
I smile and say “My life is not that easy, but we can live and hope.”
They look at me puzzled and I can understand why people find me odd, some replies you just don’t say out load. You are supposed to remain positive in times of stress or at least stay quiet. My hubbies’ mantra is exactly that. ‘No negativity only positivity can help you gain strength and move forward’.
Then the nurse calls my name and I enter a room opposite me. In the front of me are a mammogram machine and a grey chair for your clothes to be placed on. She requests my date of birth, full name and asks me some questions that are on a questionnaire.

One that I remember -:

Do you have a history of breast cancer in your family?
The answer is a positive No!
That question you do not forget easily at least not in a hurry. It sort of wakes you up to the reality why you are really there.

Then the nurse leaves me alone to remove my shirt and bra. Now I’m nervous as it is and my jaws had been going sixty to the dozen outside. But now my jaw was rattling sixty to the dozen because I was cold. I was not given a gown to keep my modesty intact or warm. I start to read the posters on the wall to distract me from how cold the room was, and the fact I was topless.

The nurse returned five minutes later apologizing for leaving me for so long and for leaving the air conditioning on. My reply to eases the nerves was, “I just thought the mammogram wanted my nipples to be erect not relaxed.”
The nurse smiled and said, “You must be nervous I do apologise again, but try to relax.”
I was going to explain to her that my humour is relaxing me, but I thought no she wants to see what she wants to see. A miserable nervous patient worried shitless about the outcome. Yes I am, but I know humour is one way of getting through a stressful situation.
Another nurse entered the room to help prepare the machine and set it up.
So I’m looking at my future a cold bold white machine. Thinking ok please be good to me or else I’ll disconnect your wires and make me a nice microwave out of your spare parts. The machine reminded me of Metal Mickey from the children’s program in 1980’s. You could actually see it doing a dance to the Metal Mickey theme tune. Don’t ask me why but I’m looking for a comparison and Metal Mickey could do X-rays.
The nurse that had entered the room last manoeuvres’ me closer to the machine so she can position it to my breast. The machine moves up and down so I can slap my poor breasts in or on. She gives the plates a quick wipe and dry and the fun begins.
I’m only a 34B so it’s a lean in, pull and squeeze. First the side clamp of my right breast leaning into the machine with my head turned to the left and my right arm holding a handle as this contraption slowly squeezes my breast into a pancake. With the nurse controlling it with foot pedals while manhandling my breast to stay put. My poor breast wants to slide out and do a Houdini.
My mum had explained to me how painful it can be. So I was preparing for the worst where pain was concerned. But I must admit the discomfort was not that bad it was bearable.
The nurse asks me to stay still while the x-ray is taken. She steps outside while the other nurse controls the machine from a small booth near the entrance of the door.
I had to hold my breath because every time I took a breath my breast was fighting the plates. The only way to explain this sensation is. Grasp your hands tightly so your palms act like plates onto your breast and pull. That’s what I had to contend with through the ordeal every time I took a breath.
Then they have to do the same again, but from the top of my chest down. The machine has a way of turning so the plates are up and below rather than on a side.
So to sum it up you have squeeze it in pancake, slap it on pancake. Odd way of describing the experience, but it is exact.
Again the nurse was good with the foot pedals and said, “Just say if it is too tight? But we need it to be tight as possible so the pictures are clear”. I look at the nurse thinking do you really like manhandling woman’s boobs?
Come off it we females ask that question every time we have an examination. The cervical smear is the best one. ‘They would recognise me by my bits rather than my face.” My friend would say, but she had given birth four times so what would she expect.

Part of me just wanted to ask a load of awkward questions to see what she would do, but I thought nah leave the poor women be. She probably wouldn’t be able to handle the broad sense of humour I have. She might have taken offence if I was too direct. After all I was in a serious situation and I was supposed to be concerned. Not only that but my breast was jammed in the plates and she and the other nurse were in control of the foot pedals. I would not want that foot pedal pressed for too long.
My husband would be less than impressed with the outcome.

The same procedure was repeated on my left breast, but I could see from the computer screen facing me the breast did not look right. The right breast picture was clear with a few lines here and there where veins were. The left looked like it had white bits showing and not so transparent.

The nurse turns to me and asks, “Are you sure you do not have a history of breast cancer in the family?”
I quickly reply, “No!”

Now when they ask once it is ok, it is routine. When they ask twice you begin to let your mind run away with you. My heart begins to race a little as I focus on the image. So I say to myself ok you daft cow you know too much so calm down!

I had visited too many hospitals to know when you’re in trouble. I could see by the urgency of the nurse who was examining the pictures this was going to be a long day. The nurse asks me to put my bra and shirt back on and to wait outside. The mum and daughter were still there and looked on with the same worry I had written on my face. They had seen the activity going back and forth from the room. So I took a rocky pose, “Hey it isn’t going to beat me!” I say shadow boxing. “Piece of cake” I say.

They give me a half hearted smile over my predicament while others looked on with curiosity at my behaviour. I calm down and rest my head against the wall looking to the ceiling analysing its shade. Then the nurse vanishes to the next room across the corridor from the mammogram room.

People are always drawn to someone worse off than they are. It helps to come to terms with their own predicaments in life. That’s why we have forums online we can compare stories and find comfort. My bruise is bigger than yours syndrome I call it. Poor comparison, but we all think our problems are more important than others. Until we actually meet a person or read about a person in more distress than ourselves. It makes people sort fiction from non-fiction. Maybe that is why I am writing this diary. So my two daughters can look back and say, “Ah so that is what happened.”
The mother and daughter were next ushered into the room. Returning within fifteen minutes with that just isn’t normal look as the mother rubs her chest. But I did say it was a piece of cake.
The daughter asked, “So what happened?”
I sit down next to her.
“I don’t know but the picture did not look clear on my left breast. They asked me to wait here until someone has examined the x-rays.”
“It will be ok”. She replied.
“Of course I’m in hospital best place really”. I smile not so convincingly to hide the nerves.
“You could see it like that”, said the daughter as she shrugged. She finally starts to relax in my company knowing I’m no head banger and my situation is serious.
“My mum is here because of a small lump found on a routine examination by her doctor. They say it probably is nothing to worry about, but she missed her mammogram and she’s sixty”.
Her mum looks away as we chat, but I can understand why she did not go for her mammograms. My mum had ducked an appointment because of the discomfort she experienced the first time round. Plus they hear horror stories from others who did not have a wonderful experience at their mammogram appointments. This convinces them they made the right decision. Why face discomfort for five minutes?

People will put their head in the sand rather than face the word CANCER.

We continue to chat about the whole experience. Holding out hope the results are clear and we can return to a normal uneventful life.
Then a woman in her 50’s comes along. I stood up so she could have my seat. I asked if she was ok and she explained what they had done to her. She was shivering with pain and no-one had put a cover on her back the ties that kept her gown together were loose. So I went over to the pile of gowns on a shelf and took one. The nurse followed me as I returned to the clearly distressed women. I thought please don’t say anything because being flippant is in my nature.
The nurse had watched poor women walk over to the seating and had not gone to her aid. Her excuse could have been she was busy, but the nurse was stood gossiping. I placed the gown on the metal back of the chair so the cold did not hit her back. She started to cry I reassured her as best I could, but hospitals are not always compassionate places to be in. You’re a list of names and numbers not even faces at times your easily forgotten. At least that’s my experience of hospitals both north and now south.

The only time they can remember you are when you spend a lot of time in one department. Then they know you by your first name and you get offered a drink sometimes. Even your partner if he holds doors open often enough and gives small chat to the nurses so they remember his face.
I decide to ring my husband and tell him what is happening so far. He said, “Don’t worry they are probably trying to be thorough.” Thorough my arse I say to myself, they have found something.

If Steve knocks his toes he questions do you think I have broken it? He gets a bit of cramp in his leg it is a major disaster. The fact that I could actually be really ill is out of the question. It would ruin his plans for the week or even future. I know he is trying to reassure me, but it seems empty in some way.

Ten minutes goes by and I’m called back into the room they say they want to magnify my right breast. So I’m thinking well maybe I read that mammogram wrong. But this time there are three nurses, not two checking the screen. So more squeezing and pulling and leaning.

“We have seen an area on your right breast and we want a clearer image.” said the nurse. Then she asked, “Are you sure there is no breast cancer in your family?”

So this is the third time I am asked and the humour is dissolving. Right now if my darling husband was in this room I would thump him.
She shows me on the screen a tiny speck. Part of me wants to shout, but what about the left one? That was no small lump, but most my breast effected. I take hold of myself and think, Ok I can do this.

I take my shirt and bra off so they can take more X-ray pictures. They alter the plates on the machine so it magnifies the area. The X-rays instantly flash up on the screen and they closely examine them chatting amongst themselves. At times like this you become invisible and you’re searching for the slightest bit of info.
Again they released me from the plates and I was asked to dress. After waiting outside for further five more minutes I was told to return to the breast clinic.

I say goodbye to the mother and daughter still waiting outside they wished me luck. Part of me feels I need more than luck to get out of this mess, but I nod and smile.
I walked into the clinic and the receptionists said, “Are you Mrs Mendoza?”
I nodded with confusion I had not met this women before, but she knew my name.

Had my X-rays been the gossip of the clinic?

Another ten minutes of nurses whispering and looking in my direction hearing my name mentioned quietly. I was called into the room of the oncologist consultant and now I am worried.
The consultant requests I take a seat while he starts taking notes and marks areas on a diagram. Then the consultant explains that he had seen something on both breasts there is a tiny lump on the right, but to him it was not an issue and could be investigated later. The other has what looks like calcification which needs further urgent examination done.
I look at the consultant but I am not listening, its switch off mode. Apparently this is a common thing to happen when you’re in shock. Your mind runs wild with thoughts of what ifs. The word calcification I could hear rattling around my skull whatever else he said did not mean a thing. I had never heard of calcification in breast tissue before.

Now they do advice you take a pad and pen to ask questions, but I expected nothing to come of this. It would turn out to be a serious case of mastitis and more anti-biotic. There was no lump surely if it was cancer there would be a lump. All the information I knew on breast cancer and what to look for was lumps and nipple distortion. After all he did not say cancer which is good, but calcification.

He asks me to go to the room next door so he can examine me more closely. Again I am asked, “Do you have breast cancer in the family?”

Again I shake my head and say, “No history”.

Now I want to ring my husband again because four times they have asked. So there must be something there to causes concern.

I remove my shirt and bra with the nurse placing them on a chair. I sit on the edge of the examination bed. The room goes quiet as he asks me to raise my arms placing my hands on the back of my head one at a time.

I apologised for my sweaty arm pits and the fact I had no deodorant on even though it was requested no deodorant in the appointment letter. He asks me to relax both my arms to the side of me and prods my chest further. Then he steps back making a mental note of the left nipple being scabbed over and sore. He squeezes it to see if any discharge is coming out. He asks me if it has been weeping I show him my make shift pad made of gauze. The pad was soiled where the nipple had wept onto it.

Then he asks me to lie on the bed and to raise my arms again. Then the consultant checks me with my arms relaxed to my side. The consultant digs his hand into my arm pits checking my lymph nodes.

“Do you have any pain in your breast?” pointing to my left breast.

“Yes my left breast had swelled up on the side and I was on a course of anti-biotic for it”. I explained to the consultant.

“I can confirm there is a lump on the right breast I can feel that, but small. I am more concerned with your left breast. I want you to go for an ultra sound core biopsy to be done today. I am marking this as urgently needed.” He asks me to dress again and come back into the other room.

I am handed a slip of white paper to go to the ultra sound receptionist with. I am totally numb by what the consultant has said. It feels like one big bad dream that I am surely going to wake up from.

I return back down stairs, but I’m stopped by a nurse who tells me you will have a long wait so get yourself a drink and a bite to eat first.
I’m thinking if I don’t go now I’ll be in this hospital forever besides my husband had to take my youngest to work with him and he was in a meeting.
Yet again I’m thinking about everyone else but me, but hey I’m a mum first.
I step outside the hospital to phone my husband to tell him it will take a little longer than expected. He told me to take my time and phone him once I was done. Then I work my way through the corridors to the ultra sound department. I give my bit of paper over to the receptionist to see a message written on a board in pen.

‘We apologise for any inconvenience.
There is a waiting time
Due to one of the ultra sound machines being maintained.’

All the seats were full of people waiting to be seen. At that moment the mother and daughter from the mammogram walk into the ultra sound department. I smile and offer my seat to her mum and go sit on a table. The daughter stands next to me she said “You have come here too?”
“Of course”, I reply. “They like me too much to let me leave”. I smile. “We have got a long wait”. I point to the board and the daughter looks at her mum shaking her head.

Then I look over to a Chinese couple sat in the far corner. She is in a wheel chair and is in pain the husband goes over to the receptionist and asks how much longer. You could see the frustration and concern written on his face. She looks at the list and apologises for the wait and says it should be not much longer now. He returns to his wives side touching her hand reassuringly.
Part of me wishes Steve was here to comfort me, but how was he supposed to know this would happen. I am certain he would have taken the day of work if he had known.

Then the receptionist calls out some names and says you can go home and we shall send you a letter to come back. The mums name was called out and I say, “Hey you got a lucky escape”.
The mum gives me a cuddle and says, “I hope everything goes well for you”.
“So do I, but who knows”. I reply.

 Five minutes goes by and the woman sat next to my right asks. “What are you here for?”
“Breast cancer scare you know how it is”. I look around nervously.
That was the first time I had dared mention the word cancer.
I can hear my husband saying, “I’m wishing it on myself. I am not being positive about the situation I have submitted to defeat”, but I did say the word scare too at the end.
“I don’t half love”, she replied. “My husband has testicular cancer we have been waiting a good half hour, but you know how men are they hate waiting”. I smile at her husband. He gets up and heads for the corridor where the ultra sound rooms are. “Look at him he is so nervous”, she says, “All he wants is to leave and forget what’s happening, but he can’t”.

I look at him thinking he is the same age as my dad. The fact he could walk by you and not think he had anything wrong. It is the same for me people keep saying nothing is wrong. I am an energetic healthy individual that does not let anything get in her way. This whole day has opened my eyes to things we have a way of ignoring.

I turn to the women not really knowing how to reply. Because what she has just said I honestly feel like doing myself.
“I know what you mean”, I reply “Looking at the clock it has been a long day for me”. I resort to placing my head into my hands.
“What time did you arrive here?” The woman looks on fishing for information to pass time.
“9.30am and it is now 11am. So much to a simple mammogram”, I say lifting my head up to the woman and smiling.
“You have had a mammogram too today?” she widens her eyes. “They are not very nice.” she shakes her head.
“It was not bad really.” I reply
“Well at least they are dealing with you quickly.” she looks at her husband tilting her head. That pity this poor girl tilt that friends give one another acknowledging someone’s distress.
Then I hear my name called out and a nurse waiting takes me into the ultra sound room. The woman wishes me luck and her husband looks on and manages a smile.

Again I’m asked to repeat my name and date of birth before being asked to remove my shirt and bra. I lay on the bed reminiscing about my ultra sound scans I had for my daughters.

When I conceived Kayleigh the doctor at hospital swore it was my kidneys. Then I saw this baby doing a hip wiggle on the screen. I was twelve weeks pregnant and I was amazed with the detail. I smile thinking about it, but then I feel a tear welling in my eye. I quickly gather my thoughts together and control my emotions quick smart. Time has flown by, and now I’m having the same procedure for possible cancer. She quickly gets the gel on me and glides it across my left breast looking at every detail. “Ok” says the radiologist, “I can do a core biopsy now using the ultra sound or you can wait three days and have it done by mammogram?”

I look at her and say, “Look, let’s get this out of the way besides I have a habit of fainting”. I say without any thought.
The radiologist looked on with alarm written on her face.
“Do you?”
I reassure her that it is nothing it’s just needles and I don’t agree with each other.
“Have you ever been tested for epilepsy?” She asks.
“Yes and nothing was found”. I reply.
“Do you have a phobia of needles?” She looks on analyzing my replies with a curious eye.
“No!” I continue “I just faint for no reason and shake. They did checks when it first happened and recently when having a vaccine for some reason it happened again. So I would sooner lie down and have the procedure done.”
“Do you have any warning signs before it happens?” asks the nurse.
“Just a sweet smell or a warm sensation, but sometimes I’m able to control it before it gets out of hand.” I turn to the radiologist. “It is nothing really I just have to tell you just in case it happens. I don’t want anyone panicking for no reason that’s all”
“Well if you had it done by the mammogram you would be sat in a chair and you will see it the procedure being done.” says the radiologist.
“Let’s just get it over with.” I reply trying to get off the subject.
“Well if you feel it coming on I want you to tell Me.” replies the radiologist with concern in her voice.

The nurse that had taken me into the ultra sound room vanishes to get a trolley with all the items needed for the operation. While the radiologist prepared the machine with a clear plastic bag put over the head of the device that sweeps across your skin.
I hear the nurse saying “Do we need litmus paper?”
The radiologist agrees so the nurse vanishes and brings back a piece of paper which she added chemicals to create litmus paper. Apparently they had run out of the paper so they made some in front of me. I found this alarming, but amazing at the same time. We had done this as kids in physics lab so I brushed it off. The nurse pushes the trolley into the room to the side so I cannot see what is happening. I’m asked to lean to my right slightly so she can sterilise the area with antiseptic. Then a square piece of surgical paper is draped over my left breast.
The radiologist said “This will sting a little, but I’m giving you an injection to numb the area of your left breast”.
The nurse encourages me to talk to her while this is done.
“Don’t go quiet on me?” the nurse said.
“You must be the first person all day who has asked me to talk. I think the rest wanted just peace and quiet.”
I feel a sharp pain as the local aesthetic is injected into my breast in several areas.
Then after a few minutes the area becomes numb
“Can you feel this?” the radiologist scratches my breast with something blunt.
“No.” I reply calmly.
“Ok then we can start, but just tell me if there is any pain you should just feel some pulling.”

She glides the head of the ultra sound across my breast searching for good areas to take samples from. I try to focus in on the ultra sound monitor to see what she is seeing, but I could not make it out. It is not as clear as the x-rays because everything is moving.
Then I see what looks like a rather large knitting needle out the corner of my eye.
“This is a core biopsy needle and she shows me. You will hear a loud snap noise when the sample is being taken, but don’t be scared. If you feel uncomfortable at anytime just say and we will stop.”

An incision is made into my breast just down from my arm pit. Then the nurse holds my hand as the radiologist inserts the core biopsy needle into the incision. I could feel pulling, but no pain so I relax into talking to the nurse again.
“So do you have children?” the nurse asks.
“I have two daughters nineteen, and four years old.” I reply trying not to watch what is happening.
“Large gap!” she says as I hear the first snap.
“Do you have children?” I ask.
“Yes two daughters and a son,” the nurse replies.
Then I hear a second snap this procedure went on for several minutes and don’t know how many samples she took I lost count after the second snap. I could see the ultra sound screen and the needle moving around the breast tissue searching for the best areas for samples. The nurses was observing it too and reassuring me every time I heard the snap.
“All done now, let’s get you cleaned up”. She put some sterile-strips over the wound and a mepore plaster to stop infection getting in.
“Now keep the area dry so infection can’t get in. Leave it three days before you shower. You can take paracetmol as instructed on the packet. You will find you will experience some pain. The bruising will take some time to settle. Do not take ibuprofen or aspirin. Are there any other questions you would like to ask?”
“No.” I reply.
Then she hands me some pieces of paper telling me about the procedure I had done.
“Do not do any heavy lifting it explains it all with the information we have given you”

Now we all know as mothers that is an impossibility to do. Personally I do all the shopping, cleaning and taking care of my four year old. My husband has the tendency to take short cuts to save time. So personally there will be no break for me in my home.

She goes on to tell me “Well hopefully we have caught this in time.”
Part of me wanted to say, caught what? But I knew what she was saying.
I put my bra and shirt back on full of questions, but feeling completely blank and I return to the breast clinic upstairs to see the oncologist consultant again.

The consultant is stood in reception and greets me with a firm hand shake.
“Right it is clearly a waiting game now and I know this is the worst possible time because we do not have any answers for you yet. Now I want you to return to my clinic on Wednesday next week.”
He ticked a box on the piece of paper in front of him saying urgent one week.
“The results need to go in front of a panel of consultants (MDT) and we shall decide what we shall do from there. Are you going to be ok? I know it has been a long stressful day with a lot to take on board. Has anyone come with you?”
“No.” I reply “I’ll be ok.”

I leave the breast care department trying to keep the tears under control. As I enter the foyer to leave the hospital. The gentleman with testicular cancer who was in the ultra sound department earlier is stood there. He beckons me to come over and gives me a cuddle.
“Everything will be alright love.” He says.

It is strange how two strangers with one disease in common can find comfort in each other’s words.

My mind starts to drift again ok there is something there but what and then I remember the word CALCIFICATION.

The minute I left hospital I started to inform the few friends and family I had told. They all had their fingers crossed it were nothing to worry about, but deep down I already knew it was not going to be as easy as that.

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