Sister Stories: Kim Hamilton Mennillo

Greetings, fellow breast cancer warriors! My name is Kim, I live in North Carolina, married with two marvelous children and four fantastic grandkids! The biggest blessing of all that came from having cancer is that I completely changed careers and went into the healing profession of massage therapy. Cancer has been a gift is so many ways!

My life with cancer begins . . . well, it begins in 1959 when my grandma was sitting in the back seat with me on a car trip, patted my thigh and said to my mom, "Mother, there's something wrong with this child's leg." I was four. The tumor was benign, but its removal was not the end.

At age 17, a senior in high school, I discovered a lump in my right breast, as well as another one in my left thigh in the same spot. There were actually two lumps in my thigh all wrapped up in muscle. All benign again, but the doc advised me to eliminate caffeine from my diet as the diagnosis for the breast lump was fibrocystic disease. He was also way ahead of his time, sternly urging me to never wear underwire bras so lymph fluid around the breasts would flow the way it should to keep them healthier.

Time passed, I married in 1977, and had my first baby in 1979. On a trip home to Ohio to see family, I caught the flu bug from my grandfather. Sick as a dog when my son was only four months old, stressed from being a new mother and facing a major move, my immune system attacked again and when my son was six months old, I was diagnosed with hyperthyroidism and Graves disease. No amount of medication brought it back to normal, and after another major move in 1981, I was given the option of having my thyroid removed surgically or swallowing radioactive iodine. I opted for the later and became hypothyroidone month later. I was also told to wait a year before being allowed to conceive the second child we wanted.

Our daughter was born in 1983 shortly after we moved into our new home. One day, a year later, as I stepped down on my left foot while carrying a load of laundry upstairs, I felt a familiar "pop" in my thigh. "Oh, not again!" I sighed heavily. More surgery, larger tumor, this time not so good a diagnosis—malignant neural sarcoma. The tumor was sitting on a nerve and it was the size of a goose egg! Quite concerned about my tumor-prone history, the surgeon recommended removal of part of the vastus medialis (inner thigh) muscle so these tumors would not keep recurring. He noted how each time the tumors came back, they were in areas north of the previous surgeries. If that continued, he was afraid the cancer would eventually return farther up my thigh and into the lymph nodes of my groin, which then would be much more serious and difficult to fight.

Believe it or not, all of my past tumors had clean margins and the cancer in my thigh had not spread, either. Regardless, he felt preventive surgery was necessary, so two months after the removal of that very large lump, a divot-sized section of muscle and skin was removed from my thigh. A divot! Leave it to a doctor to describe one’s surgery in golf terminology!

I rehabbed quickly, needed no chemo or other adjuvant treatment and prayed my cancer journey was over. I did have one slight scare. A couple of years after the preventive surgery, an x-ray picked up a spot on my femur. The doctor was concerned and ordered another test after a period of time to see if it changed in any way. I came home, told the kids we were going to do some Shakespeare and they would be allowed to swear! I asked them to get very close to my leg and shout, "Out, out, damned spot!" They loved it. And yelled it. Over and over (after all, I never said how many times they could swear!) We all giggled, but I couldn't stop their fun. It empowered them to take part in Mama's healing process. Don't you know that spot was not there at all when the next x-ray was performed! My little miracle workers!

So, no more cancer, right? Bwah ha ha ha ha ha! But, hey, not in my leg, anyway. Five years passed and while doing my routine monthly exam, I thought I felt a lump in my right breast. Saw my OB-GYN who said, "No, but you do have one in your left breast." Ordered a mammogram which showed nothing, then sent me to his wife's surgeon. He didn't think it was anything, said I was too young for breast cancer (I was 32) and advised we "just watch it." (Ladies, NEVER let your doctor say that. Please insist on a biopsy.) I went home happy, thinking I was free and clear.

Six months later at the city pool, I turned over onto my stomach while tanning and jerked right back up again. THAT HURT! My hand went immediately to my chest, in pain from lying on hard concrete. At home, with my thumb and fingers around my areola, I could move the lump all around in any direction. That sucker was directly behind my nipple. I had my mom check to see if she could feel what I was feeling. She did, and she cried, hugged me hard and begged me to go back to the doctor. Her mom (my grandma who discovered the lump in my thigh) passed away in 1975 from metastatic inflammatory breast cancer because she, too, was told it was "nothing."

Naturally, I went back to the surgeon who, upon examination, said, "This needs to come out." I didn't say anything, but I was thinking, "No shit, Sherlock!” He ordered another mammogram which again showed no tumor, and scheduled the surgery. I had since turned 33 and my first devastating realization was, "I'm the age Jesus was when he died on the cross!" And yes, this time the tumor in my breast was malignant (ductal in situ). The surgeon was standing over me, crying, as I awakened in recovery. He apologized profusely and said, "I really didn’t think you had cancer, but you do." To which I looked up at him and groggily replied, "I know." Somehow I knew something wasn't right. For a long time I had just felt soooo extremely tired, which I came to find out later is one of the most common symptoms of cancer.

At that point, the doctor gave me two options: 1) go home and discuss your options/treatment/etc., or 2) have a mastectomy the next morning. When he told me the removal of the tumor pretty much destroyed what was left of my very small size A cup breast, I said, "Take it off. Nothing to think about." I knew my family would just want me to live. I was done with childbearing and nursing, and having a breast or not made no difference at all to my husband.

During the first appointment with my oncologist, I begged him not to give me chemo. I remembered the horrible experience my grandmother had with it and didn’t relish the same for myself. Fortunately, he agreed and said a five-year course of Tamoxifen should do the trick. (I was actually in the first study group of PREmenopausal women to take this drug. The results were so positive for postmenopausal patients, the medical community was eager to try it with younger women.) I was so excited about NOT taking chemo, I called my mom to give her the good news. She said, "Honey, Grandma didn't have chemo, she had Cobalt treatments." I replied, "Oh! Well, ignorance is bliss, huh? The doc said I don’t need chemo anyway."

My breast cancer tumor margins were clean, there was no lymph node involvement and I pretty much sailed through Tamoxifen. For four and a half years of the five, anyway. I started having every side effect, including the rare ones (the most bothersome being vaginal discharge every damned day—truly, it’s a wonder I didn’t have toxic shock syndrome!), and asked the doc on March 17, 1992, if I could please stop taking it. He replied, "Yes, you're doing very well. I believe I can safely say you're cancer free!” I smiled and said, "It's St. Patrick's Day...what a lucky day to stop taking a drug!"

Shortly after my first mastectomy in 1988, I started to attend breast cancer support groups. Alas, the only groups around were filled with women in their 60s, 70s and 80s. I had little in common with these women other than the fact of breast cancer. I was young, my children were still home, I was still in the workforce. Fortunately, I found three other younger women who felt the same way, and the four of us co-founded a support group for pre-menopausal breast cancer survivors. It was such a wonderful thing to have this kind of sisterhood, camaraderie among women the same age, with similar concerns and questions. We laughed and cried together, grieved when someone in the group died and worked with the medical community to reach out to as many young breast cancer patients as possible. The only problem after our first meeting is that we didn't know what to name the group. And this is where humor during recovery comes in. I told my husband we had an amazing group of women but we didn't know what to call ourselves. He looked at me and deadpanned, "How about 'The Young and the Breastless?'" I was mortified and declared, "We can't name ourselves that! How is that going to look on a brochure?" Well, much to my surprise, the group loved it! And I learned a valuable lesson. NEVER take yourself or your illness or your treatment too seriously. Lighten up. Have a good sense of humor and share that with others. Laughter and humor will get you through cancer better than almost anything else. By the way, our literature read The Y & B Group and we told everyone in the medical community that stood for The Young & the Beautiful, but those of us in the group knew what it really meant!

A year after my mastectomy, I had my right breast removed prophylactically. Every month when I did my self exams I drove myself crazy with worry. Am I feeling something there? Or is that just scar tissue? WHAT is this? I decided enough was enough, underwent a second mastectomy and had saline implants (Becker tissue expanders) put in on both sides. Five years, ten, fifteen, twenty...with each passing year breast cancer was less and less on my mind. Except for in my career as a massage therapist where it took on a whole new meaning.

During my 1988/89 recoveries, I was re-evaluating my life, trying to decide what I really wanted to do or be. In the fall of 1990, I enrolled in massage school after the relief I got during a very painful period of my reconstruction. The release of the tension between my shoulder blades felt so good, I knew early in my education I wanted to take this career in the direction of helping others who had breast surgery. I have been blessed to offer my specialty in breast surgery massage to many clients, as well as teach this modality to other therapists. This year is my 26th anniversary of being a licensed massage therapist and it has been very rewarding and humbling. I truly feel it has been my way of giving back to the cancer community.

Aaaaand then just when you think everything is going so well, a new wrinkle messes up your freshly pressed life. It was the morning of Pi Day, March 14, 2015. My hubby and I were all set to get up, get dressed, go out and get a pie to share. Not so fast there, Skippy! Stretching to get the kinks out before I got out of bed, my hands ran down over my shoulders to get the circulation going, when, UH OH! "Honey!” I called out to my hubby. “I've got a flat tire!" The right saline implant had completely deflated after a well-behaved, 26-year run. How dare it give up on me! My "girls" were nicely rounded, high and perky on my chest and I hadn't worn a bra in 26 years! Now I'm going to have to wear one to hide this defect until I can get it repaired? NOT FUN!

Quickly, I called a friend who used to do bra fittings for mastectomy patients to ask if she had any fiberfill inserts I could borrow. Also had to find bra in that long forgotten section of my lingerie drawer. I was surprised it hadn't deteriorated after so many years of non use! Asked her, too, for plastic surgeon recommendations here in Charlotte. I knew no one as all my surgeries had been done in Ohio. After doing a bit of research, I realized the deflated implant would have to be removed, preferably within two weeks to avoid any possible infection. God love my friend, she helped me with all my requests and kept checking with me to see if I needed anything else!

The Becker tissue expander is no longer being used, and my new plastic surgeon recommended the "gummy bear" implants. He had a difficult time on the right side with scar tissue and the surgery took longer than expected. For whatever reason, these new implants never felt right. The year after they were installed, I needed a capsulorraphy to keep them from falling to the sides when I lay down. The one on the right still sat lower, so I asked for an inframammary fold lift. The doc agreed, but said he might have to use mesh to hold it in place. Then the bombshell! The implant on the left had developed capsular contracture, so it would have to be removed and a new implant put in. I was NOT expecting that! My body was rejecting them. However, not knowing what else to do, I was all set to have that surgery in early January of 2017 until I was giving a massage to a client who had the DIEP flap procedure. I was so impressed by the way she looks, and after speaking with a couple more DIEP flap patients, I scheduled that surgery for early March. Since implants have to be replaced every 10-15 years, and I would be 70-75 years old had I decided to go that route, I am so glad I had an operation using my own body's tissue. One and done! And no more foreign objects. Hallelujah!

Phase 2 of the DIEP flap surgery was done in November of 2018. The only existing challenge at this point is a bit of lymphedema above the abdominal incision. I am currently seeing an occupational therapist for relief from this swelling. She is using manual lymphatic drainage techniques and kinesiotape to redirect the lymph flow, and cold infrared therapy to break up underlying scar tissue. At home I’m applying scar reducing tape along the abdominal incision and breast scars.

My story will continue, I'm sure. The BRCA 1&2 tests I finally had done show no hereditary connection, so my daughter and granddaughters can breathe a little easier. I realize I am extremely lucky that I have not had to endure the horrible side effects of chemo and radiation of most of my fellow cancer warriors. My experiences, nevertheless, have been challenging in their own ways. Truly, I fret more over my thyroid condition and its continuing impact on me than I ever have with breast cancer concerns. Eternally grateful for the path God has, in his infinite wisdom, deigned me to take, I fully expect to enjoy a long and healthy life, serving others through support, massage and any way I can be of service on their journey to health and wellness.

NOTE: I purposely did not cite any or all possible risk factors I might have had for getting breast cancer. Suffice it to say, there were many, including hereditary, environmental, and occupational ones. I was born and raised in a very polluted area of southeast Ohio, but I do not and cannot place blame there. Yes, there was cancer in my family, but genetic testing was not done when those relatives were alive. It is pointless to lay blame anywhere. All I can do and continue to do, is take charge of my health and do everything I can to stay healthy. I hold only myself accountable and my faith in God is firm and unshakeable. I’ll be 63 this July and count every birthday as a precious gift. Never will I be one of those women who doesn’t reveal her true age. I’m eternally grateful for every one that rolls around! And if you count my age in years as a breast cancer survivor, I’m really only 30 years old!

To everyone, I wish you good health, a sparkle in your eyes, a smile on your lips and joy in your hearts as we walk this journey together. And be sure to keep your sense of humor! May God bless us all!

Kim Hamilton Mennillo
Cornelius, NC

Mastectomy Results Day

I wake up apprehensive and still tired. Our appointment isn't until 3.10pm which just prolongs the agony. We arrange for Grandma and Grandpa to pick the children up from school and head off. It's a strange journey. My husband and I hardly speak, we just listen to The Greatest Showman CD for most of the journey. When 'This Is Me' come on the lyrics hit me.

I've learned to be ashamed of all my scars
Run away, they say
No one'll love you as you are...

These past few months have been so tough. I've piled on weight which hasn't helped but more importantly I've lost myself. I feel different, less confident and despite my positive and bubble personality, I hate what I see when I look in the mirror.

Soon enough we arrive in the car park, we hold hands as we walk in to the hospital. I give my name in at the desk and head to the usual waiting room. My heart begins it's usual pounding. I hate the waiting, its agonising. For me not knowing is worse than knowing. I hate the unknown.

Despite our usual hour in the waiting room, today we are called out of the packed waiting area after about 10 minutes - this never happens.

"Leanne Nash"

I real of my date of birth and head in to see Mr M. Today as well as my consultant and two nurses there is another man in there, he's introduced as the Lead Registrar. I'm asked firstly to head behind the curtain and take my top clothes off.

Mr M says everything is looking good. They had added 250cc into the expander during surgery. Today he would add 50cc more. The needle is huge, so much so that Mr M makes a joke about it being like the needle from Pulp Fiction.

Looking at that image though, Id say my syringe was definitely bigger. Don't panic though ladies - the needle itself is no bigger than the needles they use to take blood.

It's a strange sensation as the saline goes in. The expander moves around inside as it's filled, it's uncomfortable but it's nothing compared to what I've been through so far. My heart is still pounding, wondering the outcome of the results so the syringe moves up and down as my chest moves.

Once complete I get dressed and head back out beyond the curtain. It's time.

"Ok, we've got the histology results back. There was more DCIS in your breast - another 10cm - so in fact it was basically right through your entire breast...

...BUT... (I cling on to this 'but' for what feels like an age, awaiting my fate)

...we have managed to get it all. We've discussed your case in the MDT meeting this morning and because no invasive cancer was found and the lymphnodes we took were clear, you will not need and radiotherapy or chemotherapy."

THANK GOD. SCREAM IT FROM THE ROOFTOPS. DING DONG THE CANCERS GONE.

He continues to tell me I definitely made the right decision having the mastectomy. There was always a chance that there would be no further disease at all and that my breast could have been saved but in my case my whole left boob had been riddled.

The only remaining treatment -  should I decide to take it is a tablet called Tamoxifen. Mr M tells be approximately 13 times that one of the main side effects is vaginal dryness. No word of a lie - they are pretty much the only words I remember from that discussion. And, whilst vaginal dryness is certainly no laughing matter, I did struggle to contain my giggles.

Rather than deciding what to do straight away, I'm given a leaflet to take away and decide over the week what to do.

For now though, with my aching filled up boob, we head home with the best news we've had in 6 months.

Mastectomy Day Diary

Midnight
I stayed up late to have a bowl of my favorite Weetabix Minis Chocolate Crunch. Now matter how hard I try and so nervous about the operation that I can not sleep. I listen to my Calm app but it doesn't work. Chris lies next to me tossing and turning too. I just remember that I don't need to worry - I'll be put to sleep tomorrow anyway so tiredness isn't an issue!

2.00am
Still cant get to sleep. Tomorrow is so huge. What if it all goes wrong? What if I don't wake up?

6.00am
I wake up to my alarm. I feel like I've only just got to sleep. My eyes are heavy. I get dressed and re-check my hospital bag. I think I have everything. I can sense Chris is nervous too.

7.00am 
After de-icing the car we set off. We're even nervous talking to each other on the journey. We make small talk. It's so odd.

7.30am
We arrive at the hospital at and suddenly I feel strangely calm considering what I'm about to go through. There are 3 other ladies in the waiting area also having breast surgery and lymph node biopsies today. Chris and I sit in the waiting area, the Winter Olympics is on the TV.

8.45am
"Leanne Nash" I'm called in to the anesthetist first. She puts name bands on both of my wrists and  runs through the usual questions. I confirm the operation I'm having, we discuss past surgeries and my DVT history. All good, I return to the waiting room.

9.15am
"Leanne Nash" Mr M, my surgeon calls me through. He apologises that he may smell of garlic because he was celebrating Chinese New Year yesterday. I take my top off and he marks me up with his marker pen. The comical arrow pointed to the riddled boob. He asks if I have any questions and we talk about lymphnodes. He says he will try and take the sentinel nodes from the main incision so hopefully I'll just have the one scar.

9.30am
"Leanne Nash"
The nurse calls me in to go through everything again. Check the op im having etc. She measures my legs for the DVT stockings. I'm second in to theatre so it will be later on this morning that I'm called. She passes me my tights and down but says I don't need to change just yet so i keep hold of them.

10.30am
"Right ladies. Those you that are having the dye injections for sentinel node biopsy, would you like to follow me?"
I panic because I'm not changed in to my gown. The nurse tells me not to worry but to take everything with me in case I need to go straight to theatre from the radiology department. There are 4 ladies, each with their husbands in tow. We are told to follow two young boys aged about 16 or 17 down to the clinic. They speed off. It takes at least 5 minutes to walk, and we struggle to keep up with them which they clearly find hilarious. I hear them laugh and say they nearly lost all of us. As we walk past the Cafe I can smell bacon and my mouth waters, I'm so hungry!

We are taken to a small waiting room. One by one we are called in. I am the last. Since Chris cant come in I send him off to the cafe. No reason why he should starve himself too.

I go in and the nurse asks my name and date of birth but my brain doesn't work and I forget what shes asked. We have a good laugh.They explain that the needle needs to go in to the cancer tumour location. I explain that I have DCIS but I've already had two surgeries to remove it. We decide that injecting in to the area closest to my scar will work best.

What is a Sentinel Node Biopsy?

To explain, when you have cancer, the sentinel lymph node is the node that the cancer would get to first if it was trying to spread. Examining cells in these first nodes can give your doctor a lot of information about the state of your cancer. During the sentinel lymph node biopsy, they inject dye in to the cancer site. The dye then moves from to the injection site in to the lymphatic system. Blue nodes, or "hot" nodes (nodes with high radioactive counts), are where the dye hits first, these are called the sentinel nodes and all hot nodes are removed and sent to histology for testing.

The injection doesn't take long and then I'm sent back to the waiting area. One of the ladies already in her gown is told she will be going straight to theatre. We are wait for someone to come and take us backup to the ward when I hear the phone ring in the office. I hear my name repeated back and the word theatre. Oh god, I must be going straight to theatre too. I panic! I haven't even got my gown on, it takes about 20 minutes for me to get the DVT sock on usually and Chris is in the cafe!!

I sit there for a few minutes expecting someone to come and let me know but no one does so I knock on the office door. "Excuse me, did I just hear that I'm going to theatre. Do I need to get my gown on?" "Oh yes, sorry love."

The lady that did my injection overhears, she shows me to the changing room and volunteers to go and collect Chris from the Cafe.

I rush as I get ready but feel calm again when I hear Chris' voice outside. I stuff my clothes and boots in to my bag and don my dressing gown and slippers.

A man from theatre arrives with a wheel chair and we head off. The hospital is huge. We go through what feels like hundreds of corridors and up in a lift. Chris and I kiss and say goodbye and I'm wheeled in to the theatre recovery room. Apparently there is a lot of work going on in the hospital so the waiting and recovery rooms are combined fora few weeks.

11.30
I'm checked in at the desk. 2 theatre staff check my name, date of birth and NHS number against my wrist band. There are a number of people in the room, some of which are recovering from surgery and some (like me) waiting to go down. Each person has a member of the medical team assigned to them. Mine is the guy that wheeled me here. I recognise another as the anaesthetist from my last surgery.

12.00
I'm still waiting, making small talk with my new friend when a  new lady is brought back from theatre. The curtain next to me is drawn and i can here the team trying to bring her round. All of a sudden there is a huge commotion. The lady is attempting to get out of bed. They call for assistance, people are running to physically pin this lady down. She is becoming really aggressive shouting at the nurses to get off her and at one point almost pulls her drain out - she's had breast surgery too and I quickly realise that it was one of the other ladies I'd seen up on the ward earlier. After about 20 minutes of constant struggle it becomes apparent that this lady has become aggressive after previous anesthetic before - its on her notes.  I'm on my own, just listening to the poor lady who sounds so scared and the staff trying desperately to calm her down.

12.20
Mr M, my surgeon pops his head around the curtain and lets me know he won't be too long. He takes my notes from the back of the wheelchair that I am still in so he can refresh himself on my journey and diagnosis before he begins.

12.30
The poor lady next door is still fighting so one of the nursing team pops over to reassure me that the lady is ok. Its nothing they have done and it wont be too long now 'til I go down.

12.40
Finally I'm on my way to theatre. Only it appears that I have put my gown on back to front so I have to quickly get half naked in the theatre anesthetic room while everyone looks away. I'm mortified!

Next job is to get the cannula in, I pump my fist to try and assist. Usually I have great veins but since I haven't had a drink for over 12 hours it seems they have shriveled. They get one in but when they try to flush it, it becomes clear that it's not in the right place. They quickly take it out and ask me to pump my first again. As she tries a new place I can feel a lot blood dripping out of the the place shes just tried. The lady realises and asks someone too pass some gauze - there must be blood all over the floor! Soon it's in but it's in a really awkward place at the side of my wrist.

The oxygen mask goes on and the anaesthetic goes in.

SLEEP

15.00 As I start to come around I glance at the clock. I'm told everything went well. Everything feels very numb and I have one drain in place. I'm given a cup of water and I ask for more. I'm so thirsty. I drift back off to sleep.

16.10 I wake up again and ask for more water and more pain killers. I'm really sore. I tell them I'm hungry but they cant give me anything until I'm moved to a ward and at the minute there are no beds.

17.30 I'm still here. Still hungry. They keep me watered but I really need food! People that have come out of theatre after me have already left for the ward. I ask the nurse of they have contacted Chris to let him know I'm ok. She said they usually do that on the ward. I explain he'll be really worried so she goes to get the phone. It won't connect! Typical.

18.00 Still here!! I ask them to try Chris again. This time they leave me with the phone and I get through. Chris sounds so relieved to here my voice. He'd been calling different parts of the hospital and had been really starting to worry. He'd left me over 6 and a half hours ago for an op that should have taken only 2 and he had been thinking the worst.

19.15 At last I hear that I'm moving. I'm the only one left on the recovery ward and I still haven't eaten. Apparently there are no beds on the main ward so I'm going to my own room in the private part of the hospital. Result! Lets hope they have some decent food there because I honestly feel like I'm being tortured. I ask to call Chris again so he can make his way in.

19.30 I arrive. Finally!! They leave me on the theatre bed and wheel me in. I have an en suite room and a TV (although no remote!) I ask them to pass me my mobile so I can call my mum. I tell her I'm ok then buzz for food. They bring me some soup and a sandwich which I devour in minutes. I decided to get up to go to the loo so I pop my drain in my special Drain Dollies drain bag and head in. I'm so glad I have my own room.

20.00 Chris arrives. I'm so relieved to see him. He brings me more food - yay for hospital grapes! The children are at his mum's so I know he cant stay long.

21.30 Chris heads off and I ask for more painkillers. I'm given oramorph but it doesn't agree with me and soon I'm feeling very sickly. I keep drinking water to take the nasty feeling away. My obs are checked and all is well. Although I've slept so much in the recovery are that I'm wide awake.

02:00 After a few toilet trips,more obs and pain killers and a lot of TV I finally turn my light off and head off to sleep.

Central Excision Results Day

Today was the worst appointment of my journey so far. Not because of the news or the results, just because I was really unhappy with the way I was treated.

As usual I felt sick in the pit of my stomach as we traveled to the hospital. The waiting room is packed, we take the last two seats. Everyone looks so desperate in here. I scan the room and hope that everyone else is just there for scans and their journey can end today with a clear result.

We wait anxiously for over an hour in the waiting room. My heart palpitating at a whole new level. I cross my fingers as I wait. I pray that the margins have come back clear and no more surgery is required.

"Leanne Nash"

Oh god it's time. The nurse asks for my date of birth and I real it off as usual. My whole bosy is pulsing with nerves.

When I enter the room I'm surprised that my regular consultant, Mrs S is away and Tracy my regular breast nurse isn't there either. Mr H introduces himself by name, not title. There's something I dislike about him but I cant put my finger on it. He asks me if I've had any pain and I explain how I've been feeling. "Right, first things first, lets take a look - is that ok?" I head behind the curtain and do the standard top half strip. Gown on.

He looks at the scar, says it's healing well. Then asks if he can have a look at my right breast. I agree. He's happy that they are looking similar in size. "Ok, get dressed." I feel calmer, maybe it's good news if he's checking the size match - hopefully no more surgery.

I put my clothes back on and sit back down.

"So we have the results back from your central excision. There was DCIS found in the margins so you will need to have a mastectomy with immediate reconstruction." He refers to the DCIS as pre-cancer and I feel anger in the pit of my tummy.

Listen mate, I think to myself, I can tell you this is NOT pre-cancer. My lovely Macmillan nurse has said the same. It is very much breast cancer, I'm just 'lucky' it has been caught early enough for it not to have spread. I think back to the pre-cancerous cells that were found on a regular smear test - I wasn't told I needed a hysterectomy was I?? If it's not cancer then why the actual hell are you proposing to chop my boob off!?

He continues... "We will insert an expander first then later replace with silicone  I can do that for you on 8th February. Now, it wont look the same as before, it wont feel the same as before but we hope to give you a fair result. Any questions?"

Fair? What the hell is that supposed to mean? None of this is fair.

I nodded as he spoke but inside I was dying. I had hoped with all my heart that it would not come to this. I asked him about the margins and he explained that all edges bar one were positive and the one clear margin was only 1mm.

All along, deep down, I've known it would come to this... a mastectomy. And having had this in the back of my head, I had made a decision that when/if it did happen,  I would like to opt for a bilateral mastectomy. Take both away. I'd said that backin December as soon as I got the initial diagnosis. If only I'd pushed for it.

I tell him I want to have a double mastectomy rather than just the left. He dismisses me, tells me that it's not an option. They would never remove a healthy breast. I explain that I am still worried there is something wrong in the right side. He dismisses me again and tells me that all scans were clear. I remind him the scans were clear on the diseased breast too. "Yes, but you had the discharge and you don't on the right."

IT'S MY GODDAMN BODY!!!!! WHY CANT I JUST MAKE MY OWN DECISION?!

Soon enough we are exiting the room. My blood is boiling. My head is all over the place and we are lead by the nurse to what I now call 'the room of doom' - a small private room where anyone newly diagnosed is taken to so they can take everything in and sit with the Macmillan nurse to ask questions. We're left alone while the nurse goes to find more information to hand to us.

I begin to cry at the enormity of what we've just been told and Chris holds my hand. We hug.

But then I stop, the clouds in my head parting for a moment. I wonder why I've just been TOLD what was happening instead of discussing all of the reconstruction options that I've read about. Then I get angry again. I don't even know who this man is, what's his job? I don't want him to do my operation. Is he a doctor? A consultant? What?

I had wanted a mastectomy from the start but I was persuaded that that was completely unnecessary and that a 'breast conserving' central excision would be best for me but if later down the line I wanted a risk reducing mastectomy then that would be fine, I could do that, but that was obviously a lie.

When the nurse returns I tell her again, I'd really like to opt for a double mastectomy but she tells me if that's really what I want then I would have to have the risk reducing mastectomy later down the line. The left mastectomy is their priority and if I want the right gone too then I'll need to wait months and months and see a psychologist so he can confirm that I am aware of the consequences of my actions! Wow.

I ask her to explain the reasons why and this time she explains that if I was to catch an infection on the right side from the risk reducing surgery and then an invasive cancer was to be found on the left then I could potentially be putting myself at risk. An infection due to an unnecessary operation could potentially prevent me from having life saving treatment if invasive cancer is discovered. A lot of ifs!

Next I ask about the different flap reconstruction options. I really don't want silicone - especially if I'm only having it in one side. I picture myself in my 80s with one perky boob on the left and one saggy dog ear on the right - imagine the sight - I'd look like a bloody Darlek!!

The nurse hands me a Breast Cancer Care booklet with details of all of the reconstruction options available. I tell her my feelings on silicone and that I don't really want to have an implant. Ideally I'd prefer a DIEP flap reconstruction where they take fat from your tummy and use that to reconstruct a new breast. She tells me they don't do that at this hospital. I explain my feelings and she heads back in to see Mr H. She said "Mr H says that's a shame because he thinks your the perfect candidate for silicone, he says if you don't want implants then he could do a back flap here at this hospital." No thanks!! I'm fuming that these options weren't given to me 20 minutes ago when I was with him myself. She tells me to take the booklet home and have a read then call back if I still want to discuss my options.

Chris asks about Mrs S performing the surgery but apparently shes not back until the end of the month and they don't want to delay. Hmmm, if it's ONLY pre-cancer then why the urgency. I hate this day. I feel like the nurse just wants us to leave. Chris probes again "Who is Mr H? Is he any good?" The nurse says he's a lovely man. Chris replies "I don't care how nice he is!Is he any good with a knife and fork?" I smirk. The nurse tells us all of the surgeons are fantastic.

I have another question  - no one has told me the results of my hormone test. Again the nurse heads back in to Mr H. "Oh he didn't know you hadn't been told, sorry. You're Oestrogen positive 7/8. I have no idea what this means and it's not explained but my heart is pounding with all of my emotions.

Upset, sadness and anger fill me.

We leave with the mastectomy info sheet and sentinal node bipsy sheet and the reconstruction option booklet.

This is not over. I am so disappointed.

Central Excision Day

I feel calm. Don't get me wrong, I've cried. I'm desperately sad to loose my nipple. I'm literally grieving for it. But the show must go on.

Today is the day of my central excision. We head in to the hospital - early this time. We arrive at 7.30am. I haven't eaten since midnight. I'm thirsty.

After half an hour the Macmillan nurse visits. She talks to me about the procedure and some exercises to do afterwards. There's some confusion over whether I am having lymph nodes taken. I was told I wasn't but the nurses seem to think I am. I know from my research that this would mean having a dye injected in to me so my surgery wouldn't be until the afternoon if that was the case. I'm secretly happy - I've had this horrible nagging pain under my arm for months and I have convinced myself it's something sinister - at least this would confirm it either way.

The anaesthetist arrives and calls me in to a side room. He asks me to confirm my name, date of birth and the operation I'm having. He runs through his list of questions - all good - and I return to the waiting room.

After an hour and a half, I see my consultant arrive. She calls another patient in first. I'm next - second on the list. Mrs S tells me they definitely aren't taking any nodes. She reminds me she is going in blind on this op as the cancerous cells haven't shown up on any scans. She will do her best to take it all away and get the clear margins I desperately want.

A clear margin means that no cancer cells are seen at the outer edge of the tissue removed. The tissue removed is usually sliced in to many pieces so the histology gives a very clear report on exactly what is removed.

Before I know it I'm in my gown and socks. A nurse walks me to the theatre. I'm hooked up to all the monitors again, cannula in.

I look at the clock - 10.10am. By 10.14 I'm drifting off....

---

When I start to come round in recovery I am in so much pain. I'm still drowsy but the pain is so intense that I can hear myself groaning. The nurse asks me about my pain and administers me with morphine. I'm unaware that anyone else is in the recovery area.

Within 10 minutes the pain looses its edge. I'm so thirsty and drink 2 glasses of water. That's when I realise there's about 4 or 5 other patients that have been listening to me groan with the pain. I'm mortified.

I'm sore but I cant wait to head home. I fall sleep for a few hours and when I awake I'm offered the famous hospital toast. The greastest toast ever. That perks me right up and before I know it, it's 4pm and I'm heading home.

The car journey is excruciating.  We really need to get a car with better suspension.I'm signed off work for two weeks to recover. Hopefully we've managed to rid all of this horrible disease from my body.

The wait continues.

Microductectomy Results Day - I Have Cancer

I've remained positive but inside I've been dreading today. We drive to the hospital and my tummy flutters. I try and breath deeply to calm my nerves. By the time I sit down in the waiting room my heart is pounding so fast that I feel like it is about to burst out of my rib cage. The wait feels like an age. Until eventually....

"Leanne Nash"

I just about get my date of birth out and enter the consultation room. This time there is an extra person in the room - another nurse. My brain goes in to overdrive. I sit down and I am asked how I am, hows the pain? I don't feel like I'm really there, I just feel odd. I'm asked to go behind the curtain and put the gown on. The consultant removes the steri-strips and checks the wound. Everything looks good so I get dressed and sit down again.

Mrs S, my consultant, explains that they did find a papilloma which was likely what was causing the bleeding. However, while she was removing the duct she had been able to feel that the surrounding ducts weren't right. They didn't feel as they should. She explained that she had tried to remove the areas that felt odd but they went deeper and deeper she had to stop. All of the areas she had removed had been sent away for screening and the results showed that there was a cancer present. A very early form of cancer known as DCIS - ductal carcinoma in situ. She was very apologetic - I think most likely because they were convinced I was healthy and it was me that had  to push for the microductectomy in the first place. Immediately the additional nurse was introduced, she was a Macmillan nurse specialising in breast cancer.

Time stood still for a minute. I don't think I spoke. The nurse left to get me some water.

It was explained that the next step would be for me to have a mammogram and another ultrasound to see if the DCIS was visible then we would need to go back and see her again later today. She thought that the best way to proceed would be to perform a central excision. A large incision would be made across my left breast. They would aim to remove all of the DCIS but they would need to remove my nipple.

I left the consultants room and began to cry. I honestly think the thought of losing my nipple had hit me harder than hearing the word cancer. That may seem ridiculous but right then in that moment that was what mattered to me. My femininity. It doesn't matter whats going on in the inside as long as you look and feel the same on the outside.

I were ushered in to a side room and handed some tissues. The Macmillan nurse came in with lots of booklets for us to read. I told her, "I honestly just want them to take both boobs". I didn't want to risk my life. We talked for a while and she explained that having a bilateral mastectomy was a huge decision. I'd have to have a reconstruction with silicone implants. The silicone implants wouldn't feel like part of my body, Id have no feeling and they'd feel very cold.

I asked more questions about the results. The consultant had removed a 10cm x 1cm area and a 2cm x 1cm area. All of which came back as high grade DCIS. Luckily DCIS is completely contained within the ducts of the breast and has not yet got the ability to spread outside. As far as we know, my cancer is contained.

DCIS is graded in three ways based on how the cells look under a microscope. A system is used to classify the cancer cells according to how different they are to normal breast cells:

Macmillan Cancer Support: DCIS Grading

The nurse asks about whether we will tell the children. I explain that because of Dad and the association that his death has with the word cancer, we would not tell them. She agrees its probably best. We're eventually left alone to wait for my name to be called for the mammogram. We hug each other tightly.

The mammogram was horrible. I was still healing from the operation and having my boobs squished in a vice was the last thing I needed. As I stood there top off, boob flattened, I realised that I just had to get on with it. I would fight this - no matter what.

A couple of hours later we were back in with the specialist. She explained that nothing at all was visible on the scan, there was no visible calcification. Mrs S explained that because of this she would need to go in blind but the only option would be for me to have the central excision. Ideally she would have liked to have had an MRI scan done but because of my recent surgery the scan would only show inflamed areas where the previous operation had been performed. You have to wait 6 weeks post surgery to get a clear view and she explained we didn't have time to wait. I'm told it is likely that I will need radiotherapy once I'm recovered, just to ensure that all of the bad cells are eradicated.

I asked how long I was likely to have had this growing inside me and she explained because it had reached high grade it certainly would have been a number of years. I explained my concern about having pain under my arm but she thinks it's likely just down to the surgery I've had.

I was given a folder confirming my diagnosis "left breast cancer". My operation will be performed on 8th January 2018.

As we leave the hospital I see the messages and missed calls from my mum. How the hell am I supposed to tell her I have cancer so soon after losing Dad?