The next bit

After a bit of a break from all the appointments following the surgery, things started to pick up again. We met with an oncologist, a colleague of my surgeon (because she’s now on maternity leave) and the genetics nurse. We were given a lot of information, most of it pretty complicated.

The best news was that the surgeon and the oncologist were very happy with how the surgery had gone, and confident that everything had been removed. The cancer was a fairly aggressive one, and it was heading for the lymph nodes, but the lymph nodes that were removed were clear, so it hadn’t got there yet. The implication was clear; I was lucky to have found the lump when I did.

Because of my BRCA2 diagnosis, the surgeon discussed the possibility of further surgery with me, and talked me through some of my options. This surgery would be preventative rather than reactive, so there’s no huge hurry to make any decisions, but it seems pretty clear-cut to me. I have roughly a 50% chance of developing another breast cancer in my lifetime, and that’s not a risk I want to live with. My family don’t deserve to have that kind of threat lurking, and neither do I.

But it’s not just a case of opting for a double mastectomy. There’s the question of reconstruction; whether or not I want to have it, and, if I do, whether I want to have implants or use tissue from elsewhere on my body. I don’t like the idea of implants. Of having foreign objects in my body that could potentially burst or leak at any time, and which would have to be replaced roughly every ten years.

And although it would mean more scars and a far longer surgery and recovery time, I do like the idea of having fat taken from my tummy for reconstruction. I like to think of it as a tummy tuck that’s thrown in for free. When the surgeon was explaining this possibility, he looked at my swollen belly and said that it’s impossible to tell right now whether I have enough fat for this to work. I assured him that it wouldn’t be a problem. He told me to think through my options, have my baby and the rest of my treatment, and come back to see him when I was ready.

We saw the oncologist privately. Paul and I both have private healthcare through his work, and it seemed sensible to use it for the chemotherapy treatment. He was a softly spoken, calm man who explained everything very clearly and answered all our questions with great patience. It turned out that the need for chemotherapy wasn’t as clear-cut as we’d thought. A test had been carried out. If a patient’s result is 5% or higher, chemo is definitely recommended. 2% or lower, and it’s not recommended. My result was 3%.

He explained that a part of my tumour would be sent to the States, to the one place in the world where another kind of test is undertaken, and the results of this would determine whether or not we went ahead. I was astonished that there was a chance of escaping chemo, but I tried not to think about it too much, because it was still the less likely outcome. There would be a two-week wait for the results.

And when the result came, it was as I expected. I would be having chemo. The blow was softened by the fact that the oncologist called me personally from India, where he’d travelled because of a close family bereavement. I thanked him for taking the time, and he said that it was nothing. He said that he was sorry it wasn’t the result I was hoping for. And I just thanked him again, still shocked by his capacity to care about my situation at such a time.

In the midst of all this, my sister was taken into hospital with agonising back pain. She’s four weeks further into her pregnancy than I am, and at exactly this point in her last pregnancy, she was taken into hospital with the same symptoms. That time, she stayed in for a week and then my nephew, Louie, was delivered.

It was tough to hear that it all seemed to be happening again, and it came on a day when Joseph was being his most difficult two-year-old self. At one point, when I was desperately trying to put him to bed for a nap and he was refusing to cooperate, I burst into tears. He was visibly shocked, and then he started crying too, a horrible, inconsolable wail. After a couple of minutes, he stopped and said ‘Are you a bit sad? I’m sad too but now I’m ok. Do you want this monkey?’

Meanwhile, the days of my pregnancy continued to mount up and, amazingly, my blood pressure remained under control. When Joseph stands right in front of me, his head is level with my bump. ‘That’s the baby sister,’ he always says, pointing. As if I might have forgotten. ‘Yes,’ I say. ‘What’s she doing in there?’ ‘Growing,’ he tells me, seriously. And she is. We’ve been having growth scans every three weeks. In the middle of May, she was an estimated 4lb 1oz. In the first week of June, she’d stepped up to an estimated 5lb 7oz. The obstetrician said that she’d liaise with the oncologist, but that she was happy to induce me to fit with his plans for chemo.

Last weekend, Paul made the nursery furniture with a bit of help from Joseph. I’ve washed all the tiny clothes. We’ve bought a buggy, got the Moses basket out. A few days ago, I was sitting with Joseph on my lap, reading him a story, when the baby gave a strong kick. He turned around and looked at my bump, and then said ‘Baby sister, don’t take my scuttlebug and my cars, ok?’ I think we’re almost ready for her to join us.