Monday is the day. By 11:30am I shall be hungry, dehydrated and dressed in a thin unattractive hospital gown waiting to go under the knife once more. My re-excision surgery is imminent. Another centimetre of my flesh is going to be removed around the original site of the tumour. Apparently this kind of surgery is quite common and about 30-50% of people with my kind of breast cancer go through this. If that number seems very imprecise then that’s because there isn’t much data around and the variants are pretty big. I did find one small study that 23.8% of people who specifically had the kind of surgery I had, ended up having a re-excision. It’s also a pretty big must for me. Not to blind you with stats but it doubles my risk of the cancer returning if I don’t have clear margins.
It has been a rougher time emotionally lately and I’ve been contemplating why. I think chemo was so hard and gruelling that I hadn’t spent much time preparing for the impact of surgery. I was all la-la-la, nothing will be as bad as chemo. I can do this in my sleep. But surgery has brought its own challenges and they’re very different from chemo so my coping strategies didn’t help me. Walking on the beach and hanging out at the allotment were a no-go. I was too devastatingly tired and I couldn’t lift a shovel, no mind dig with one. Pain also makes meditating and mindfulness impossible. Being in the moment when they are overwhelmingly filled with agony is not somewhere you want to dwell. Body scans remind you that everything hurts. Pain also disconnects you from everyone around you. I was too scared to go out in case I got bumped. When your body is constantly stimulated internally (by pain), the sun seems too bright, the world too noisy. I had this feeling at the height of nausea but it passed quicker. Plus there’s no bear hugs. So the isolation gets intensely physical and emotional.
The medical aftercare was also poor and there didn’t seem a clear structure or point of contact for problems. During chemo I had the hospital, the cancer ward, my oncologist. This time it felt like all the carers couldn’t wait to hand me off to some other schmuck. Where the chemo care was careful and cautious, the surgical was quick, sharp and fast. Perhaps much like the treatments themselves. I’m sure there’s a PhD in there somewhere. The single biggest outside form of support I’ve had was from kind and generous internet strangers on the Facebook page for the Younger Breast Cancer Network (YBCN). User-led, all my fears and questions found an audience who could reassure me with their own experiences and make me feel less alone. I take solace in that.
I did have another Buffy-style fleeting moment. This time I was going through my nighttime routine of gingerly scooting my front-fastening bra off my shoulder. It’s a tricky business as it can be unpredictable at which angle my scars will start to protest. For instance, I was in a changing room today trying on a top that I had managed to squeeze into feet first but I realised getting it off was another matter. I stood there staring in the mirror, perplexed, shifting one shoulder one way and wriggling one arm another. I even considered leaving it on and simply going to the till, bending over the desk and asking them to scan it from there. Luckily I had the awesome Kat to come to the rescue and pull my arms out. Anyway, back to bedtime. As the strap dropped down and I sat there with boobs flopping, I felt this wave of irritation and wish for these sacks of flesh to just disappear. Poof, be gone. I wasn’t sad, I wasn’t scared. I didn’t feel emotionally attached to them. What I think this means is that I’m transitioning to a state where I see my boobs as the enemy. I’ve heard other women talk this way and I never got it. Until now. At the beginning of all this, my boobs were mine. They were fun, bouncy, part of my identity. They did cool things, they played a role in sex, in feeding my baby. They gave me lovely, beautiful cleavage that caught my food (I actually found a chip in there the other day, a whole chip).
But ever so gradually, those things have been replaced. My boobs have been on show to the public. They’ve been handled many times by strangers, stared at in a non-appreciative way, cut into. The surgery clinched it and pushed this forward more. My boobs are starting to take on new meanings that are eclipsing what they were before. They are bits of flesh, parts of my body with no purpose other than cosmetic. And they are trying to kill me. Maybe this is psychological prep work for any future mastectomy. Or maybe it’s a dangerous trick of my mind, disconnecting me from a part of my body that I need to reintegrate into my sense of self. I’m on the fence. Maybe both those things are true and I will exist in this state until the cancer decides for me. As usual, I live with uncertainty.
So now I am learning my lessons. I am preparing for what’s coming on Monday. Kat has cooked everything in sight and the freezer is full of frozen delights. My Brighton Buddy is coming over tomorrow and I will hand her the hoover as she walks in the door. Now I just have to pack my bag in case something goes awry and I end up in hospital overnight. There are many things I cannot control about all this. But some things I can. Here I go then, preparing as best I can.