Save the date

I got the date for surgery. So the big cut is coming on the 20th July. This is a couple of weeks later than I was expecting. The surgeon did say it would be the week of the 6th July and my pre-op appointments are that week but then there’s a two week gap before the actual surgery. I’m not sure why the gap. It could be because the surgeon wants to give me more time to regroup before giving my body another big hit. Or there are just too many bad boobs in East Sussex to slice and dice. I’m undecided about how to feel about this. On the one hand it’ll be nice to have some extra time to feel good. But this period has taken on a limbo-like air and part of me wants to just get on with it.

It was a big cancer day today as well because I also had my first Herceptin injection at home. Herceptin is this amazing drug that targets the cancer cells directly rather than chemo drugs that carpet bomb anything that moves. It can do this because my particular cancer (remember there are 14 different types) has this receptor for a protein called HER2. I realise I may have lost most of you half-way through that sentence. So let’s break it down. Cells have these jigsaw piece-like holes (receptors) on the outside of them that can hook things they need to grow and replicate. The things they need (sugars for energy, proteins to grow etc) have the jigsaw-like shape to fit the holes on the cells. My cancer has lots of holes for a protein called HER2 which it needs to grow. So the Herceptin drug is shaped like the HER2 protein and fits snugly into the holes on the cancer cells. So when the real HER2 protein floats by it doesn’t have anywhere to slot into and therefore doesn’t feed the cell what it needs to grow. Clever wee drug.

I’ll have these visits from the home nurse for the next year, every three weeks. It takes about 2 minutes for them to inject me as it has to go in slowly. It stings a bit for the first 30 seconds or so but inane questions from hubby about train times and The Little Mermaid film kept me distracted from the discomfort. The slightly strange part of it is that it wasn’t the district nurse who administered the injection but a nurse from a private company called Healthcare at Home.

healthcare at home

I have a visceral negative reaction to private healthcare and I think it’s mostly because it feels like a slow creep that will eventually overwhelm the NHS. I realise though after asking a few questions that it is more complicated than my knee-jerk reaction and I’d have to do months of research before I could do justice to such a complex subject. I was treated in a private hospital for my chemo as well and of course it was lovely. It was amazing to have the same nurse every time and build a trusting and warm relationship with her. The chemo unit was designed by cancer patients and they made a stressful experience as nice as it could be. There were some fairly clear downsides to it as well without the hardcore research. The head nurse at the unit told me that they charge a day rate to the NHS and so often end up taking on patients that are on the cheaper chemo drugs in order to increase their profit margin. I’m not sure if this means anything. I would guess though that the more complex medical cancer cases might end up staying in the NHS system and the private sector cherry pick the straight forward patients. Again I would have to do a lot more research on whether this is actually happening.

A small incident just happened with the Healthcare at Home nurse where Adam asked him if he could take away our Sharpsguard box. It’s a locked plastic box where I can put my old needles. He wasn’t able to take it because they have to pay for every box they dispose of and because the box had writing on it identifying it as an NHS-given box, he couldn’t sneak it past his corporate overlords. A minor thing but interesting in terms of the competing needs of the patient and profit. In all encounters with private versus public healthcare, the staff have always been caring and competent. Except for the people who take my bloods. The NHS always rush me through and I get more bruises because they haven’t taken the extra 10 seconds to press the flesh.

The whole visit took two hours and now I await possible side effects. They were invisible in the whole chemo hellishness so let’s see what happens.

10 thoughts on “Save the date

  1. Joba

    Really fascinating read love. Thanks for being so open, transparent and clear about the complicated bits…I feel I’m following what’s going on with you and also learning so much more about important stuff about our healthcare system too. much love.x

  2. Emily

    You are nearly there Heidi! I told you cancer was no match for you! Stay strong, lots of love! Xxx

  3. Karen

    Really interesting insights into the health service – I am looking forward to your future career as a health journalist once all this crap is over! Looks like there is so much that needs deep analysis. Ideally while sitting in the Brian Eno room at Montefiore!

    It’s also great to hear about the miracle of herceptin – sounds bloomin’ amazing!! It will be interesting to see if any side effects pop up when you don’t have all the chemo hell to contend with – hope not!!


    1. Heidi

      I feel like I could spend a whole life researching the health sector. It’s so complex. I didn’t want to make any generalised statements about it without having done the work. Just put out my totally subjective feelings and experience with it.

      So far I have had a bit of nausea from the Herceptin which the nurse says is the dead cancer cells provoking an immune response to purge. So I guess that means it’s working! But it is making me nervous that the overwhelming nausea will return and nobody wants to see that. xx

    1. Heidi

      nausea is coming in waves so not quite the same as chemo. I’m hoping this is as bad as it gets and I won’t be subjected to nausea hell. it’s normally today when things get worse so we’ll see..

  4. Kamila

    Warm hugs Heidi, I got some courage to write to you again just to remind you that I read all your posts and am grateful what you write, for the simple and nice explanation of the protein receptor issues. I wonder if drugs like Herceptin are produced from any naturally occuring proteins, which we can eat from time to time to block any cancer cells.
    The question of public versus private health service is new to me, in Poland our basic insurance does not cover any private health services yet.
    I really so much wish you all the health you can get, whatever the public or private services will be its providers:)
    Myself I am a little bit lost these days, as usual, but started writing a blog, too, my dialogues with Higher Power, and I enjoy doing it, and they help me a lot.
    Loads of Love Heidi

    1. Heidi

      thanks dearest kamila for your lovely comment. I’m not sure about the naturally occurring thing. Herceptin also acts as a immune system drug too so it waves at my white blood cells and tells them to check out the cancer cells. I’m not positive anything outside the lab could do all that : ) I will have a look at your blog. blogging rocks!! xx

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