Breast Cancer: Diary of a DIEP #1
THE SURGERY: The day of my mastectomy and immediate reconstruction with some tips and advice
November 17. Early morning.
My alarm goes off at 5.30am. We have to be at St Thomas’s hospital in central London for 7am. For some insane reason that I can only put down to mounting stress, my partner Jonny and I have decided we will take the bus there. We have eschewed the offer of a lift from a kind friend and ruled out getting a taxi. ‘The bus will be easy’, we say. ‘Quicker than an Uber at that time in the morning. Less crowded than the train’, we say, ‘We can sit and chat’. Mistake number one.
I go and say goodbye to my 14-year-old son who is slumbering upstairs and has been entrusted to make his own breakfast and way to school. His big sister left home six weeks ago for her first ever term away at university. He’ll be home alone for a couple of hours after rejecting the suggestion of a sleepover at one of his mate’s. He gives me a half-asleep, ‘Goodbye mum,’ his brown curly hair nestled into his pillow. I tell him I love him and I’ll see him soon. He mumbles a ‘love you’, his heavy lids barely open.
I leave his room praying he will hear his alarm later on and mobilise without the usual stream of prompts delivered to his lair via Alexa.
Five minutes later we are at the bus stop.
BAD DECISION. The 185 is rammed. I make my way quickly to a solitary empty seat I spy at the back clutching my hospital bag and a Lidl bag for life containing the pillow I am bringing as some kind of feeble home-comfort item.
After a few stops and some jenga-like shuffling with people getting on and off, Jonny finds the only other empty seat near the front.
As I sit looking out of the window squashed up, pillow on my lap and with no-one to talk to, I can’t help but feel this is a low point. I am on my way to be sliced open, my tumour removed, I will be unconscious for at least seven hours. I want to tell the people surrounding me what my day-ahead entails. They are wearing headphones, eyes locked on phones, scrolling through emails, Instagram, Snapchat. I assume most are off to work. ‘Just off for a mastectomy and major surgery’, I want to share. I stay silent and look out of the smeared and dirty bus window onto the faintly depressing London streets of South London.
Once at the hospital we navigate lifts and corridors to make our way to the allotted floor. We see the straggle of other early shifters queuing to be let into the waiting room. It’s an eerie group to be part of and the tension in the air is palpable. Everyone here is going to be having some kind of surgery today and understandably people are nervous not to mention dutifully and crucially empty-stomached ahead of their anaesthetic. Once checked-in we sit silently waiting for our names to be called as two smiley hosts with perfect white teeth and good hair deliver a morning breakfast show from the large flatscreen TV mounted on the wall.
I check my phone, there is a flurry of ‘good luck’, ‘thinking of you’ and ‘we hope it goes well’ messages coming through. I’m impressed that my friends and family are awake and on it at this early hour.
‘Tess Lamacraft?’ My stomach squeezes like an orange being clamped in tight, graspy fingers. A nurse appears and Jonny is instructed to stay behind as she leads me through a door and down a corridor, ushering me into a side room. She introduces herself and passes me the hospital gown and the support stockings I will have to wear during surgery. She points to the green plastic bags that I must put my clothes and belongings in as she prints out some labels with my name and patient number on and sticks them on the bags.
As we run through her list of questions, checking my name, age, address she explains what is going to be happening again to make sure I understand. I have various consent forms to sign. I must read the list of things that could happen, the side effects and risks, the complications that could ensue. I struggle to form my signature on the computer using the mouse that she slides my way. I will have to try again.
’It’s all online now. We’ve got a new system that’s been introduced to the hospital’ she explains. She waits patiently until, on my third attempt, I finally manage to conjure up a few illegible zig zags for ‘Lamacraft’
She leaves the room asking me to put on my gown and support stockings. She’ll be back in a few minutes. I am alone.
Suddenly this all feels too much. The enormity of what I’m about to go through sloshes over me. My fingers feel like useless chipolatas as I grapple to put on my gown and manage to put it on back to front. When I attempt to pull on the super-tight stockings, I just can’t do it. I’m fumbling and overwhelmed. The nurse comes back into the room and I break into tearful sobs. My support stockings lie limply on the floor like two sad donkey ears. It is the first time I have cried in quite a while. The floodgates have finally opened. I am taken by surprise. Weeks of anxiety and tension spill out into the small confines of the room.
She gives me a big hug and tells me everything is going to be fine. I am so grateful for that hug as I rest my head on her chest and she gives me a squeeze.
The next half hour is taken up with various medical staff coming in and out to introduce themselves and explain what is going to be happening.
Mr Ho-Asjoe, the plastic surgeon who will be doing the breast reconstruction and who I have met twice before during previous consultations, pops in. It is the first time I’ve seen him wearing a coat. It feels incongruous and reminds me that it is still very early in the morning.
I meet my anaesthetist, who is called Ben, and one of his colleagues. Both of them are lovely and make me feel very reassured. Ben seems very sprightly and for some reason I picture him on a bike cycling to work just minutes before meeting me, his first patient of the day. I have no idea if he owns a bike. Or cycles.
Then the registrar Henrietta who I have met before during a meeting with Mr Ho-Asjoe, comes in. I like her. She exudes calm and efficiency.
I remove my gown as requested and stand with my back to the door as Henrietta draws lines on me with a large marker pen down my stomach and across and beneath my left breast where the lobular tumour is. She notes my belly button is not central and is positioned slightly to the left.
‘Did you know that?’ she smiles.
‘No I didn’t’. I manage a reciprocal smile. I have been fully marked up and feel like one of those pictures you see at a butcher’s showing the various cuts of meat.
I will be getting a new tummy button as part of the micro surgery. A new hole made where fat is removed from my stomach to create a new left breast and my skin stretched down towards my groin. It’s the ‘tummy tuck’ bit of the DIEP (which stands for deep inferior epigastric perforators - blood vessels from the stomach area will be reattached to the chest area of the breast being operated on. A small part of one of my ribs will be removed.
The two surgeons and their teams will work on me at the same time. I imagine it will be quite a gathering in that operating theatre. There is a knock at the door and Mr Arif, the surgeon who will perform the mastectomy and remove the tumour comes in. It’s the first time I’ve met him. I am getting very used to showing my breasts to people I’ve only just said hello to.
I open my gown again and leave it dangling from my shoulders as I stand in front of him in just my pants, support stockings and non slip-hospital socks with little grips on them. They remind me of the ones my children had to wear, (parents had to fork out for), at trampoline parties in years gone by as they bounced and somersaulted skyward with joyful abandon. Mr Arif looks at the breast that he will be operating on and its partner that will remain untouched, his eyes assessing me pre-surgery. I am his job for the day.
When I first found out my surgery would be on a Friday I felt a flutter of fear. ‘Surely my surgeons will have nudging thoughts about weekend plans, possibly planning their next round of golf, their theatre outing, their restaurant meal (yes, I’m stereotyping heavily), but at the very least surely the team will have that slightly more relaxed ‘Friday vibe’ about them? Do more surgical procedures go wrong on Fridays? Are outcomes worse?’
I have become used to my brain darting and racing with panicky questions like this. Thankfully these days and with practice and learned techniques I have got better at quieting it down. (I will be sharing some of these techniques in later posts).
Mr Arif, like everyone else I’ve met this morning, makes me feel I will be in good hands.
Jonny comes back into the room and it’s time to say goodbye. I am jangling with nerves and adrenaline but he always puts a smile on my face and even now we find something to laugh about although I can’t remember what exactly.
I take my contact lenses out and put on my glasses. I am so vain. I hate my glasses because I am very long-sighted and they magnify my eyes making me look like a bulgy-eyed insect with thick spidery eyelashes.
I have written my name on the case as instructed. My glasses will be removed just before my surgery and transported to the recovery ward along with the rest of my things.
Jonny and I hug and say our goodbyes. He tells me he loves me. I reply that I love him too. The assistant anaesthetist and his colleague come back in and say they are ready to take me to the operating theatre.
I am expecting to be wheeled or pushed because I have watched too many hospital dramas on TV. It feels surreal to instead find myself walking along the corridors with the two of them flanking me as if we’re going for a friendly little stroll. We walk and talk and chat about the area of South East London where I live and the taller one with a kind smile and tattoos on his arms asks me what my children are up to today.
We arrive in some kind of holding room outside the operating theatre where Ben the sprightly anaesthetist is ready and tapping out some information on a computer. He curses the new tech system that has been introduced into the hospital for admin purposes as something on his computer isn’t doing what he wants it to. I try not to worry about this.
There is some more chat as some final checks are made. I am lying down on the bed now and it’s time to take off my glasses meaning my vision goes into a gentle blurry fuzz.
‘Are you going to get me to count to ten?’ I ask, memories of a childhood operation swirling back in which the anaesthetist asked me to count to ten as a syringe went into my vein. I recall getting to about four before sliding into slumbering oblivion.
Ben tells me he doesn’t mind what we do. I can count, chat, my choice. He asks me something about where I live and then that is it. The last thing I remember.
It is just after 8am.
I wake nearly eight hours later. I am aware of a medical staff member by my bed asking me how I’m feeling. I open my eyes in a haze and look at her. ‘You’ve done really well’, she says. ‘Your surgery went well and you’re here in the recovery room. Your husband, (we’re not married but she doesn’t know that), is on his way and will be here in a minute.’
I feel a huge surge of relief. It is done. The tumour is out of me. I am alive.
And then there he is. I’m aware that Jonny is standing by my side. We smile.
I note the various tubes coming out of me, a catheter, a drain from my left breast to collect blood and a cannula with another tube attached for pain relief. I feel groggy, disorientated but am flooded with relief. I am almost jubilant.
I stay in the recovery room for the next couple of hours while people come in and do various checks on me. I am told as soon as a room is ready on the ward upstairs they will take me up there.
A few hours later I am being wheeled along the corridors of St Thomas’s in my bed, Jonny is by my side.
The last time I was in this hospital being wheeled to a ward was after I’d given birth to our daughter in the sweltering summer of 2005 following a long labour and an epidural. She was tucked into the crook of my arm, a neat little newborn bundle with a pink face and matted hair as we were pushed along the corridors to the maternity ward. I was high on life and pain relief following her glorious entry into the world.
This time I’m wheeled into my room on Somerset Ward a few floors above. The name provides some kind of comfort as it’s the county where I grew up. I am grasping onto any positives I can right now with clutching fingertips.
The London Eye is outside, the nocturnal lights are glittering and reflecting onto the River Thames. The stunning skyline of London stretches before me. Jonny is allowed to stay until I’m settled and then he must leave.
The first night post-surgery lies ahead. I have been warned it will be challenging. I have spoken to women who have gone through it. I have read books about what to expect. I am mentally prepared.
The tumour is out.
The tumour is out.
I close my eyes.
Next time: The first night post-surgery and the mistake I made.
If you have found this post helpful or enjoyed reading it please do share, press the like button, restack it and look out for the next diary post which will be coming soon. Do think about subscribing if you haven’t already and you’ll get it delivered straight to your in-box without having to check back here. Magic. In the meantime a few tips below for anyone here going through this / anyone you know going through this.
TIPS. A FEW THINGS TO THINK ABOUT
As the day of surgery approaches here are a few things to consider…
*Have you got your hospital bag ready? What should you pack? (I’m going to do a separate post on tips of helpful things to take).
*Plan in advance how you will be getting to the hospital (perhaps avoid a crowded bus at 6am if possible).
*Do you have children and if so who is going to take them to school or nursery and be there at school pick-up?
*Do your children, or anyone else who is dependent on you, need to stay overnight somewhere / do you need a friend or relative at your home if you have an early start at the hospital?
*Check what time you need your partner/ friend/ supportive person back at the hospital once your surgery is over. Jonny went home. There was no point in him hanging around for the entire day at the hospital while I was unconscious.
*Make sure the medical team have your partner’s phone number or whoever they need to call to say that you have come out of surgery.
*If you haven’t got a partner, friend/ supportive person in mind, try and identify one in the weeks ahead of your surgery. People will surprise you by stepping up when required.
*Never be afraid to ask for help. This is a huge thing you are going through and however brave you are feeling in the run up to your surgery the enormity may creep up and floor you at the most unexpected times.
*Choose someone who will make you feel calm, not someone likely to add to your stress. Who have you turned to in testing times before who was helpful and supportive?
*Set up a WhatsApp group in the days before your surgery that can be manned by your helpful person in order to update everyone you want updated in one fell swoop. The last thing you want is your phone constantly pinging or being clogged up with unopened messages from concerned friends and family checking to see how the surgery went / how you are doing.
If you have found this post helpful or enjoyed reading it please do share, press the like button, restack it and forward to anyone you think may find it helpful.
Next time: The first night post-surgery and the mistake I made.