Breast Cancer in Retreat: Routine of Chemotherapy and Radiation is over; now it is Herceptin every three weeks. Chapter 7

It is so hard to believe but I have just had two weeks without any need to go to St Vincent’s Private Hospital.  Easter is now over and it is time to start thinking along the lines of being a breast cancer survivor.  It was time for a renewal of my three monthly supply of medications and to get a blood check for Lithium levels.  My GP Dr Peter Cahill has worked alongside Boots pharmacy in Upper Baggot Street, Dublin 4, as a diligent team to remove much of the stress associated with being diagnosed with cancer; while being medicated for bipolar and anxiety also.

I was given a book on loan because it was special to the person lending it to me.  Having read it I don’t think I would recommend it to others with a diagnosis of breast cancer because it is a bitter stark reality of a Mum, Ruth Picardie, Journalist, back in the 1990’s who was diagnosed with breast cancer and who died within one year.  As I have no doubt said many times before the fact that memory deficits erode all details on a daily basis; it is difficult for me to record any side effects or identify with what I really feel about having breast cancer so this alters my experience with that of other people with the same diagnosis. The book title is “Before I Say Goodbye” by Ruth Picardie (10 pence was donated to the Lavender Trust http://www.breastcancercare.org.uk › Donate › Other ways to give for every copy sold) and the title goes on to state ‘The bottom line is, I’m dying’.  At first I was shocked that anyone would give such a book to a person diagnosed with breast cancer but as I gently read each page I realised that it acted as a prompt to me to be diligent in noting side effects and being aware of the possibilities of secondary cancer as detailed in this link https://www.cancer.gov/publications/dictionaries/cancer-terms/def/secondary-tumor and also the importance of notifying the medical team about any abnormal changes, no matter how insignificant.  Also, it made me realise that no two cases are the same. Ruth Picardie, unlike me, was leaving behind twin children aged 2 years and her young husband.  Ruth was only 33 years old and since Ruth passed away in 1998, there have been massive improvements in cancer diagnosis and treatment over the last two decades.  http://medhum.med.nyu.edu/view/11933

The idea of including the exchange of emails with friends and readers of Ruth’s articles in the Observer magazine highlighted how necessary it is for me to keep a diary and details of symptoms which I must report to the medical team.  I have fatigue and I need to sleep for an hour in the evening but again I have no doubt said this before, the fatigue in no way resembles what I experienced for many years with Chronic Fatigue.  I notice my vision is blurred and occasionally I get a sharp pain in my left eye, but it is only momentary.  By evening time my lower back aches but it is not so severe that I need to take pain medication.   Then of course there is my right thumb.  It is swollen but I have been assured this is nothing to do with cancer.  I have to say that when I feel a little arthritic all I can say is not Arthritis too.  Sickness is a lonely journey; KT is so protective over me I don’t want to cause him any more worry than he has at present.  For now, I will leave the book and return to day to day life.

I look at the comb beside my bed and then I remember my hair which is non existent.  I just cannot wear the wig; I am happy with my night hat and my day hat.  After routine of treatment, having me time means I could have coffee at our local Insomnia and meet up with special friends.  April 5th with nobody to meet and a little time to explore I decided to go to the Irish Cancer Society (Charity/Third Sector) in Northumberland Road, Dublin 4, http://www.cancer.ie/ and see if I could gather up some more leaflets.  I browsed and a very engaged receptionist asked if I needed anything else.  I suspect she identified that I had cancer because of my blue hat and no hair falling beyond its tight parameters.  I stuttered a bit; but when she asked if I  would like to meet a nurse if available, I said yes and later was really pleased to have met with Nurse Susan.  It is so important to know that there are people who are there to give advice especially when people are ill.  My experience is negligible support is truly given by the charities related to Depression or for that matter Traumatic Brain Injury.  I exclude both Aware (St Patrick’s Foundation hospital http://www.aware.ie/, the monthly lectures and Headway http://headway.ie/ but their support is limited especially as the years roll on and you adapt to your state of mind and reduced abilities.

Nurse Susan met me in the reception area and brought me to a very comfortable room where we could chat.  Immediately she conveyed that I was in a secure environment and she was there to assist me.  I realised that I had been mulling around side effects but doing nothing about them.  I had forgotten that I was told by Oncology ‘no matter how insignificant a change to call Oncology’.  Susan appropriately did not give me the answers to my questions about my perceived symptoms but she asked when I was due to go to the hospital and said write out a list and give it to the team.  She then asked about my diet and stressed the importance of eating fruit vegetables and importance of a breakfast including some toast, cereal or scrambled eggs.  She said that I could buy frozen fish and vegetables because they retained their nutrients and said to avoid chips and cakes and that it was important to avoid processed foods.  This may seem so obvious but sometimes you just need an outsider to remind you.

Being interested in research for decades now, I asked Susan about Research and the Irish Cancer Society.  She told me there was a comprehensive area dedicated to research and affiliated to leading hospitals.  Then she explained that I might be interested in the “Psycho-Social” aspect of being a cancer patient.  There are two locations in Dublin and it is available to people with cancer and there are talks for cancer patients families and carers, one location is South Circular Road, which is nearest to me and the other is in Eccles Street on the Northside of Dublin.  The drop-in centres of ARC Cancer Support Centres http://arccancersupport.ie/drop-in-centres  Every month you can download their monthly calendar enabling you to plan your day around sessions that there are available.  These include Relaxation and Visualisation; Yoga; Pilates; Knitting Group, Open Men’s Cancer Peer Support Group; Women’s Peer Support Group; Secondary Cancer Peer Support Group.  Also subject to booking you have access to special Citizens Information; Boots Positive Appearance and Carers Stress Management (4 wk programme).  Services by appointment including counselling (short-term), acupuncture, reflexology, Roches wig fitting and breast care services are also provided.  Also by appointment at South Circular Road only you can have manual lymph damage and bio-therapy, metamorphosis, IHM.  There is so much more offered and so practical too.  There is even a workshop on Wills and Probate in April for people affected by cancer (presented by Caroline McCall from the High Court Probate Office) on 26th April.  So much available but thankfully my partner, my canine best friend Freddie, writing, social media especially Twitter means I have learned through past experiences to be alone but not lonely.  I left the Irish Cancer Society in confidence and aware that I am lucky in that the support system surrounds me.  I thanked Susan and I knew that I would write the list.  The blurred vision worries me.

Now it is time to return to Ruth Picardie “Before I say Goodbye”.  It is not Ruth’s narrative that has captured my attention, because every cancer patient travels their own journey but it is that of her husband, Matt Seaton, also a Journalist.  My experience through manic depression, traumatic brain injury, and now breast cancer, it is those closest to you who have to cope with a crisis in your health that impacts on their lives.

to quote sentences that cause reaction within me

“…but in retrospect the lump not only grew within her, but between us, spreading, as inexorably as the cancer itself did.

…You always imagine death as a sudden event, a clear break between being and non being, possession and loss, and for some, facing perhaps the dreadful trauma of losing a loved one killed suddenly in an accident, that is how it must be.

But with a progressive disease like cancer, dying is a relentless attritional process of estrangement.  You so much to do and say the right thing, but you are doomed to frustration, failure and regret.  The only really ‘right thing’ would be to make the person you love well again, and that is the one great godlike task you cannot perform”

The cancer had interpolated itself, sending out its rogue cells to multiply madly and lay waste like an army of termites.  Cancer changed everything; it put us on different tracks, stretching our grasp of one another to the limit and eventually forcing us apart.  In the end, I could not reach her, and it felt like a failure in me. And then she was gone.”

Michelle mulls on this and hopes from the bottom of her heart that if cancer spreads that KT will not suffer in this way because since the day of I met him, waitng for the 46A bus on Morehampton Road, Dublin 4, to go to Church in St Patrick’s Cathedral, while in much despair and ill-health, KT has stood by me through thick and thin and as you will see from the attached link, the journey was one of building self esteem, teaching me how to cope with traumatic brain injury, bipolar, anxiety, chronic fatigue https://canisgallicus.com/2015/03/12/nietzche-he-who-has-the-reason-why-can-deal-with-any-how/  It was November 2003 that KT appeared and he became my advocate to navigate inclusion in a new community without what destiny seemed to be telling me and that was plans made by others to curtail my life to one of routine and constraint.  KT encouraged me to meet people; to talk to them; to write; to engage; to have rows with him especially knowing he would still stand by me and as our dear friend Joe Murray, Barrister, once said to me ‘he makes you laugh’.  Life was a like conundrum, nothing really made sense but somehow in the trail of his confidence, I followed and felt a security that I never had before.  There was a high price, in old fashioned terms, my family “disowned me” ie except on their terms ie brief meetings in hotels or coffee shops and solo.

I know if even the worst happens and secondaries occur, unlike another life, a life of over 14 years marriage, which when challenged with the outcome of traumatic brain injury, that person imposed a life of further hardship to the trauma of the injuries sustained.  He had affairs and ultimately he married the woman who was pregnant with his child and he divorced me.  Therein lies the pain in my life that has created the wisdom and peace that I now have with KT and the security he has created for me.  My divorce cam through in 2000 and I was so relieved to be through the desolation that lasted over four years.  But revenge did not stop with the decision of the Judge in the Family Courts (Divorce).  No there had to be a justification for the woman bearing his child to have recognition as his wife but at the cost of declaring our marriage of over 14 years as non existent, most likely based on the crude analysis called ‘Insanity’.  The Catholic Church said our marriage was void.  I have detailed the experience, especially when you are most vulnerable and a woman, when your case is called before those ‘Men in Frocks’ as KT calls them in the Archbishop Palace https://canisgallicus.com/2015/09/09/pope-francis-bureaucracy-and-costly-system-currently-in-place-for-church-annulments-a-path-to-justice-for-one-condemned-by-men-in-black-in-hidden-canonical-courts/ KT met me in the middle of this hideous affront and he negotiated with the Archbishop and others but the Annulment proceeded; I had no case; most probably as later confirmed that the woman expecting my partner’s child, wanted a Church Wedding, as did her mother. 

I have left this behind; but it has given me strength of character to take each day as it comes and I know KT will have no regrets if anything should result in my passing.  He has fought for me every step of the way and as I say he has given me that sense of security, I never had.

20th April 2018:  Happy Birthday Bud; I am so sad you are no longer meeting me at the Westin.  I must admit avoidance prevents me from going into town because I always associate it with meeting you and knowing that you have passed away, to hopefully a better place and that you are again among the people who were important to you.  Me – I have so little true faith but somehow today suggests fate or faith, created a question.  KT went shopping and returned with a beautiful bunch of deep red roses; the memories flowed in of your rose garden and of course Johnnie who always wore a rose in his lapel.  This could have no significance but then it is too much of a coincidence.  Too add to this it is a beautiful day Rose, the cherry blossom trees are pink and white; and life goes on but the loss is still felt.

Back to the cancer journey, April 10th 2018, I met with Professor Crown and as advised by Susan (Irish Cancer Society) I had a note of the side effects.  The main concern for me was the blurred vision, the occasional dart of sharp pain in my left eye and my fear of aphasia.  Professor Crown carried out the pen test and decided it was time for an MRI.  As yet, I have not received the results so I presume all is okay; and that these are side effects of Herceptin intravenous every three weeks.  I am still struggling with my vision, the dart of pain still exists as does ache in my lower back.  Fatigue also applies but fear could be a large component.  My two main fears in life depression (that requires hospitalisation) or dementia.  A simple problem with spelling creates panic and sometimes when I am typing for KT recently I am finding it hard to work out whether it is the blurred vision, aphasia or recall of spellings.  As bipolar I am allowed to have a little neurosis; so enough of this topic and time to move on.  Today the nurses encountered problems locating suitable veins so when they were told about the MRI it was decided that the cannula drip once put in place for the Herceptin would be used again for the MRI.  I had several hours to wait for the MRI so luckily as always I had a selection of reading material so I had a coffee, read and then went to Radiology.  Thankfully the woman in the chair next to me, who had cancer for 18 years with 10 years remission, warned me about the noise element of the MRI http://www.webmd.com/a-to-z-guides/what-is-an-mri  What a relief she told me and it was exactly as she had said:-  Think of the noise on a  busy construction site and yes it was 30 minutes of this noise – assorted.  No doubt I have had MRI’s in the past but I had forgotten about what is involved.  You basically strip to your panties only your head emerges into a machine and a shield like the one hurling players wear is placed over your head.  You are told to keep your eyes closed and you are given a bell just in case claustrophobia takes hold.  Half an hour later I was free to return home.  Again I am so lucky in that I live near the hospital, just a taxi journey and the receptionist phones for a taxi while you sit in the lobby (like a hotel) and wait.  KT and our dog Freddie were waiting for me; yes I know KT was anxious but this will be the case for a couple of years going forward; that is what cancer is about.  There is no cure as yet but you are called for tests and if the news is good, you are told you are cancer clear for a year.

The oncology team under the direction of Professor Crown suggested that I attend the Oncology Clinical Psychologist, Dr. Isabella.   Tuesday 17th April I attended Dr Isabella at St Vincent’s Private hospital.  It was very helpful but we jointly decided that I have developed over the two decades of being ill a coping strategy and it was unlikely that counseling would be of any benefit to me.  Dr Isabella reassured me that if I felt at a later stage I needed to see her, this would be possible.  We discussed suicide; Dr Isabella explained that any sessions we would have would be confidential but that in the case of suicide ideation, she would be bound to notify the Oncology team.  My belief is that when you are going through cancer it is very important to have the support of a Psychologist as part of your team but in my case due to brain injury and amnesia, I just don’t recall the past or what has happened (hence the reason for journal) and have extremely limited means of creating a plan going forward because I live in ‘Groundhog Day’.  However, I still retain what they call emotional intelligence and I am aware enough to know what I fear and that (as I have said before) is depression and dementia but there are profound reasons for this as you can see from my health history.

We live in an apartment complex and I have to say my neighbours have been consistent in their good wishes.  I received so many plants and flowers but was surprised to receive another beautiful arrangement tonight (the day of my Mum’s birthday).  The family know about cancer from personal experience and they thought I looked a little tired and hence the kind gift.

Newspapers:

http://www.theguardian.com/society/2018/apr/22/cancer-mutations-and-the-facts-of-life-evolution-oncogene-robert-weinberg

 

 

 

 

 

 

 

 

 

 

About michelleclarke2015

Life event that changes all: Horse riding accident in Zimbabwe in 1993, a fractured skull et al including bipolar anxiety, chronic fatigue …. co-morbidities (Nietzche 'He who has the reason why can deal with any how' details my health history from 1993 to date). 17th 2017 August operation for breast cancer (no indications just an appointment came from BreastCheck through the Post). Trinity College Dublin Business Economics and Social Studies (but no degree) 1997-2003; UCD 1997/1998 night classes) essays, projects, writings. Trinity Horizon Programme 1997/98 (Centre for Women Studies Trinity College Dublin/St. Patrick's Foundation (Professor McKeon) EU Horizon funded: research study of 15 women (I was one of this group and it became the cornerstone of my journey to now 2017) over 9 mth period diagnosed with depression and their reintegration into society, with special emphasis on work, arts, further education; Notes from time at Trinity Horizon Project 1997/98; Articles written for Irishhealth.com 2003/2004; St Patricks Foundation monthly lecture notes for a specific period in time; Selection of Poetry including poems written by people I know; Quotations 1998-2017; other writings mainly with theme of social justice under the heading Citizen Journalism Ireland. Letters written to friends about life in Zimbabwe; Family history including Michael Comyn KC, my grandfather, my grandmother's family, the O'Donnellan ffrench Blake-Forsters; Moral wrong: An acrimonious divorce but the real injustice was the Catholic Church granting an annulment – you can read it and make your own judgment, I have mine. Topics I have written about include annual Brain Awareness week, Mashonaland Irish Associataion in Zimbabwe, Suicide (a life sentence to those left behind); Nostalgia: Tara Hill, Co. Meath.
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