boobs

part two

By the age of forty I’d had breast cancer twice, and a generous helping of the side dishes that came with it. I felt I’d done enough to appease the gods of unlucky statistics, and would live the rest of my life in boring equilibrium. Ha! Once again, the hand of shite reached down and pointed at my breast. While washing in the shower, I found a lump on my right breast. Rather than waiting for a doctor’s referral I phoned the oncologist’s office directly, and was admitted to hospital where guiding wires were inserted in my breast under ultrasound, and the lump removed with local anaesthetic. The procedure was every bit as unpleasant as it sounds! A week later, when the oncologist gave us fab news that it was a benign cyst, I asked him the chances of cancer occurring in my remaining breast. He replied the chances were twenty-five percent.

“Well, you know you offered me breast reconstruction” I said, sitting up straight because I felt I had to sell the idea, “I’ve been thinking if have reconstruction done, they’ll have to operate on the other breast to level it up, or else one will be pert, and the other pendulous.” I paused, and Dr. Goode nodded. I took a deep breath before continuing, trying to make what I was saying sound like a request and not a question. “As there’s a high possibility of still getting breast cancer, could you take the other one off and reconstruct them both at the same time.” This was seventeen years before Angelina Jolie made preventative mastectomy fashionable, and genetic screening made the reasons more obvious, and my request was breaking new territory. Dr Goode wrote some notes in my file, and said he thought a woman in Bournemouth had recently had a prophylactic double mastectomy, and he would raise the issue at the next oncology meeting. I knew I could trust Dr Goode to do his best for me, and three weeks later, I got an appointment to see Mr Hobby the plastic surgeon.

The plastic surgeon cupped my remaining 34DD breast in his hand and asked me what size I would like to be.

“A perfect 34C please” I replied, and he nodded approvingly.

He explained the lengthy procedure, which took pads of latissimus dorsi muscle from the shoulders and swiveled them around to the front, to give support for the breast implants while maintaining the blood supply. They would remove triangles of skin from the centre of my back to shape the breasts, and graft nipples from skin on my inner thigh, for an authentically coloured areola. He said he would insert the implants slightly above the breast line, allowing them to drop into their correct position. I was worried about silicone leakage and toxicity, and we had a lengthy discussion about my decision to have saline filled implants; my biggest concern was falling off my horse and rupturing them. He said he didn’t have another patient who rode after reconstruction, but reluctantly agreed with my reasoning. He must have been both baffled and amused by my priorities.

On December 29^th Mark and I celebrated our first wedding anniversary with overflowing glasses of champagne and wry smiles; some year eh? If we were still laughing after that first year, we would conquer anything, and two days later, I was booking into hospital for six hours of breast surgery; Mr Rowe-Jones would do the mastectomy, then pass my body to Mr. Hobby the plastic surgeon for reconstruction. New Years Eve was the only free date in their schedules, and the nurse recounted later how they both arrived and left wearing their black dinner suits, ready to celebrate New Years Eve. Two suave surgeons, dressed in formal attire for my surgery!

A nurse with a kindly face held my hand tightly in the freezing cold pre-theatre room, as the anaesthetist pushed the plunger on his syringe. It felt cold inside my veins, and then the next moment, Mark was standing over me as I woke-up in the recovery room. There was a white pony wandering between the beds, which nobody had noticed, and I told Mark to catch him QUICKLY! Mark walked to the next bed, slipped an imaginary halter on an imaginary pony and turned to me with a look of real-life confusion.

“Tie him up to the end of the bed!” I said with exasperation. “What is it with everybody here”?

I remember feeling excruciating pain as they tried to move me from the hospital trolley to my bed. In a dreamy far-off land, I heard bloodcurdling screams and someone swearing vehemently. Nurses darted about holding tubes, moving wires and issuing commands, as they slid me in ungainly style onto the cold white sheets. Exhausted from pain, I couldn’t catch my breath with the oxygen mask covering my mouth, and was uncertain who or where I was (or even if I still was?) I saw Mark on my right side, jostling for space between the equipment and the nurses; he looked terrified. The nurse showed me how to press a button on the morphine drip for pain relief, then Mark showed me, then the nurses showed me again. “Press the button Elaine” was all I could hear, but I couldn’t understand it. What button? Then nurse Christine with the kind face took charge, and as I pressed the button she winked at me. I wished her Happy New Year before pressing the button again and slipping into cloudy oblivion.

I spent my birthday in hospital, and shared the ‘celebration’ with my new breasts, which were one week old. ^.I was napping on the bed when a nurse woke me. I’d barely opened my eyes when all the nurses came into the room, carrying a pink iced birthday cake with blazing pink candles, and sang happy birthday. Such a lovely gesture and I was deeply touched by their kindness, but I hated it; I was feeling grumpy and emotional and not in the least like being the centre of attention. I thanked everyone profusely and cut half the cake for them to take to the nurse’s station, but all I wanted was to curl-up, and stop trying to be strong. I knew I should celebrate every day but it was such hard work, and cancer clouded so much. I wanted to ride my horse, and breathe into his soft neck and feel alive again, but here I was, in hospital, on my birthday. It was one of the few times I’ve felt total, wretched despair, and I didn’t know how to climb out of it.

The despair got worse when the surgical dressings came off, exposing skin as pink as the birthday cake. The right breast reconstruction was neatly shaped, but the left implant sat extremely high, with a weird lopsided overhang at the top. The doctor explained again that the implant would gradually settle into the correct placing, but in later months it became clear this wasn’t going to happen. Eventually the consultant opined radiotherapy and surgery had compromised breast tissue quality, and the implant was unable to move. I knew things weren’t going to look perfect, but I wish I’d known about encapsulation so I could’ve been prepared. It was my first big lesson that you don’t get answers if you don’t know the right questions to ask; a lesson that set me in good stead for the future.

My daily excursion around the hospital corridors had progressed from a hunched, protective-mode shuffle to a brisk walk, made easier once the drains came out, and the bottles didn’t bounce around in my pockets. The incision and the skin graft on my back were numb, which meant sleep was more comfortable, and the elasticated bandage bound my breasts would stay on for another three weeks; I felt an uncanny empathy with Frankenstein’s monster. Pain meds made no impact on the hundred small knives stabbing my insides when I moved my arms, picked anything up or tried to push down. I imagined all the severed nerves irrevocably parted to front and back, frantically waving and calling in vain for their Other Ends. Eventually they ceased calling. With strict instructions to rest, I was discharged from hospital ten days after surgery. Pain was a compelling threshold to cross, and I did too much too soon. I still haven’t mastered the fact that recuperation takes time.

In the spring of 1998, a friend was staying with us, and we were happily sitting around the supper table, laughing eating and drinking, when for some reason I looked down at my bosom and saw only one breast. With an overwhelming sense of panic, I made an excuse, dashed to the bathroom, and tore off my clothes. My left breast was intact, still perched high above my bra but my right breast was just a fold of loose skin with no filling; the implant had ruptured. I phoned the hospital but it was ‘out of hours’ and there was nothing they could do except confirm I must have leaked, and tell me to call again in the morning. There was no pain, and the saline would just disperse into my body, but I felt so angry this had happened to me. For some reason I also felt embarrassed. I clamped my arm firmly across my chest, returned to the table and drank several large glasses of wine. Next day at the hospital, the plastic surgeon looked aghast. Yes, the saline implant had leaked and a pair of fresh implants would need fitting; he was adamant he’d use silicone, and I couldn’t really argue.

If only it had been that easy. Breast reconstruction following mastectomy is now a standard option with cancer treatment, but back then, it was a fairly new procedure, and the NHS were reticent to replace the implants. The implant supplier discovered a batch of implants had leaky valves, which meant the saline wasn’t completely sealed; if I wanted, I could sue them but litigation would take some time. I needed something done quickly, so I went on the warpath and phoned the hospital and plastic surgeon daily. I made allies of the medical secretaries who were tremendously sympathetic and helpful, and got the implant suppliers to reimburse the NHS. A month after Waterleakgate, I got an operation date, and spent four nights in hospital for what is now a day-case procedure. My stay was unmemorable except for the nurse who attempted to remove my drain without first removing the holding stitches; that pain was worse than all my surgery! I left the hospital with a new set of scars, but on the positive side, I had two evenly placed silicone boobs.

When I look back, wonky breasts were the least of my problems. Cancer came back in 2004, 2010 and 2011 despite extensive surgeries, and a steady supply of anti-cancer meds (all with their own side effects). Mark and I continued trying to live life alongside our foe, and not let it live life for us. Through a series of events that I’ll describe in another post, Bruce the horse came to me in 2010. He had anxiety issues that I didn’t handle tactfully, and together with my cancer recurrences and treatment, we both struggled. On New Years Day 2012, I had just completed a particularly harrowing course of chemotherapy, and I decided to take him for a walk in hand, across the fields. As the walk progressed, we both became extremely agitated; with eachother, with our circumstances, with the icy wind whistling though our ears. Eventually, in a field miles away from anywhere, we both boiled over. Bruce was bouncing sideways, setting his neck and using his shoulder to keep me as far away as possible, and I was terrified, gripping his bridle like a predator clinging to prey. As we turned to come back home, the Perfect Storm erupted; he reared up and I yanked him back down, screaming obscenities into the wind. He spun round and took off at a gallop, with me hanging on to the reins for what was only seconds but seemed an eternity. Of course, sixteen hands of Irish Draught strength won, and as I let go, he put his head down and bucked. I was directly behind him with a fence to my side, and had nowhere to go; in that strangely surrealistic way that one vision sums up a complete event, I remember how perfectly shaped the inside of his hooves were, as they came flying to meet me with unstoppable force.

I took the full impact in my chest. It shattered a breast implant, broke three ribs and punctured a lung, before hurling me to the ground. I landed forcefully on one shoulder and the back of my head, and as I lay looking up at the winter sky, I tried to figure out why I bothered to stay alive. At the hospital, the story has become legend; notoriety for all the wrong reasons. It took months for the damage to mend, and when I could eventually have yet another replacement implant op, the breast surgeon said she had never seen so much silicone splattered over such a wide surface. It seemed that being “fitted with airbags” had prevented worse damage to my lungs and ribs, and had possibly saved my life.

Strangely enough, the entire episode (for which I accept all responsibility) drew a line under my life before. In order to stay safe with Bruce, I had to find a new way of dealing with both our anxieties, because what I thought was ok wasn’t working for either of us. I had to find a better way of thinking, a better way with horses, and I had to help him find a quiet place in his mind. In doing so, Bruce led me towards finding my peace; he needed what I needed. They say you get the right horse at the right time, and a better phrase has never been said. To help him, I enrolled in a mindfulness course, practised Tai Chi and tried to meditate. I learnt to breathe, to pause, and to clear my mind; the simplest things but all so difficult to do. Bruce started to breathe out when I breathed slowly, we both became less reactionary, and Kirsty introduced me to a way of riding that focused on breath, energy and clear thought. Along the way, I found it easier to be around myself; I showed myself compassion, and accepted that the cancer wasn’t my fault.  It took a very special horse to deliver a new future. He literally re-booted my life.