Breast Cancer, Lymphodema, Lymphoedema

Breast Cancer And Lymphoedema – Managing The Risk.


I posted this as a comment on a fellow breast cancer sufferer’s blog today, but feel I should really do a full post about it.

This was my comment in response to her post about suddenly being confronted with the risk of developing lymphoedema / lymphodema if you’re in the US. It seems common for lymphoedema to be not mentioned at all. It’s usually something someone else tells us about – (this was originally laid out better than it has appeared here, but for some reason known only unto the WP gods, it is refusing to show the line spaces I’ve inserted in the edit – they’re in the edit, but refuse to show in the finished post! Aarrrrggghhhh!)

 
July 2, 2015 at 8:17 am

 
I’m so sorry to see you’re going through this.

For some of us, that’s how it goes. You might want to see a rheumatologist if you’re experiencing any unusual muscle pain, especially noticeable if you press your fingertips into muscles, or fatigue – you say your energy is good at the moment, so was mine until about 4-6 months post chemo and radio – because the treatments may MAY have pushed you into fibromyalgia. They do to a lot of us. Early treatment of fibro is way more successful than late treatment.

 

No-one told me about lymphoedema either. I knew because my Mum, who had breast cancer 18 months before me, told me about it. When I screamed at them “Why didn’t you TELL ME???” they spouted some shit about Gradual Disclosure, about not ever telling any of us the whole story for fear of scaring us. I was furious, just like you.
You should know though, that even though the risk of developing lymphoedema stays with us forever once we’ve had axillary clearance surgery, with every passing year that you DON’T develop it fully, the risk gets smaller.

 

We make sure that we have a stock of systemic and topical antibiotics at home so I can immediately self-treat if I get so much as a scratch, and that my GP knows I will need immediate anti b’s if I present at the surgery with any damage to my left arm. It’s also writ large on all my hospital and other medical notes that no-one can use my lymphoedema risk arm for so much as taking blood pressure, and certainly not for taking blood. You must make sure everyone you are ever likely to come in contact with is fully aware that your lymphoedema arm must NOT be used for anything. Nothing. Get one of those Medic Alert bracelets or pendants and make sure it’s listed in that. Protect yourself.

 

 

 
One thing I found helpful on the occasions that mine swelled up was to sit there with that arm as high up in the air as I could keep it. Range of movement, if yours is still restricted post surgery, does come back after a few months, but you do have to keep pushing it to be able to get it up past your ear like you could do pre-surgery.

 

 
I’m 7 years out of chemo and radio, and I already unknowingly had fibromyalgia before the treatments. That was made much much worse by the treatments. Like you, I am more ill post cancer than I was with the cancer, which is just so wrong, and so frustrating. I watched dozens of others hop up from their chemo chairs and pop back to work for the afternoon, whilst I struggled to even sit in the chair and couldn’t do any work at all. I think this happens to more of us than medicine cares to acknowledge, because it’s all about insisting how marvellous these “life-saving drugs” are. I don’t mean to sound ungrateful, because I’m grateful to still be here, but I’m now disabled and haven’t been able to return to any work (acting, training horses, nutritional consultancy) or finish the final year of my BA/BSc joint degree. It sucks. I’m not “grateful” for that. I’m furious, and massively upset and depressed about it. No-one warned me, either.

 

 
Good luck with staving off the lymphoedema – not everyone develops it, and if you’re careful with that arm for the next few years, there’s a very very good chance you won’t develop it at all 🙂 If you hate the compression sleeve (who doesn’t?) try the arm-in-the-air thing if you swell up. Make sure you have enough anti b’s at home so if you get a scratch, graze, split, bite, whatever to that arm, you can self-treat out of hours. As a bare minimum, keep a bottle of tea tree oil at home. Keep from putting undue strain on that hand and arm, lift everything with your other arm when you can. I know it’s hard with a child, but you must. The riskiest injuries, by the way, are cuts, splits and scratches, burns etc to your fingers or down the sides of your nails. Wear gloves when possible.

 

 
I know it’s no consolation to know that some people suffer even worse consequences of the treatments than you’re currently experiencing, so I won’t go there 🙂 Just know you have my sympathy, because I do know what a shock it is to find that the people you trusted to do their best for you turn out to have witheld vital information from you, if not actively lied to you about the possible consequences. They claim that those of us who don’t bounce back from chemo et al are “very unusual”. That’s another lie; there are millions of us.

 
I hope you get through the lymphoedema threat stage successfully. Despite my many consequences of chemo etc, it’s 8 years this August since my surgery, and I still haven’t yet developed it, so that’s encouraging 🙂 My arm has swelled up several times, I’ve determinedly thrust it in the air and eventually it’s reduced again. I fight off any medic who approaches that arm with blood pressure cuffs or needles, and refused two lots of surgery they wanted to perform on that shoulder. Some medics are ignorant of lymphoedema. Any damage to my arm or hand immediately gets anti biotics. I use a topical lotion called Zineryt, a mixture of zinc and erythromycin, direct on any wounds, and take a broad spectrum oral anti biotic, too. You still have some lymph nodes in the rest of your arm, even if they removed every last one from your arm pit, so you aren’t completely vulnerable.

 

As for the lymph massage, I’m sure that self-massage, with your arm up and working from wrist to arm pit using your other hand, will be at least helpful in getting fluid to drain back properly.

 
I’m here if you need to ask me anything.
Good luck,

 
L. X

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Breast Cancer, Chronic Illness, Depression, Drug Companues, Exhaustion, Fibro, Fibro Life, Fibro Management, Fibromyalgia, Natural Medicine, Practical Fibro, Western Medicine

Big Pharma, New Lower Blood Test Numbers To Qualify You For More Of Their Drugs Sooner & Type 2 Diabetes, Cholesterol, Vitamin D3.


I initially started to put this on Painkills2’s comments when I reblogged her post about cannabis being more helpful and less damaging to us than various thoroughly unpleasant drugs that Big Pharma want our doctors to sell to us.

I found that I’d gone into Rant Mode, so figured I ought to just post my original “comment”…….with apologies to Jo for apparently hi-jacking her post –  please see the post before this one for the link to Jo’s site and her post about it –

Reblogged this on effingfibro and commented:
“I only wish it was legal here in the UK……can’t even get MM for cancer pain, never mind all the issues that fibro throws up on top. Apparently, or so my old GP told me, it’s only available here on prescription if you have MS. Nothing else justifies it. Probably because Big Pharma can’t make any money out of it. Makes me livid, the hold Big Pharma has on our health care system. It decries all natural medicine because it can’t make money from naturally occurring substances, then makes fake chemical versions of natural substances which it CAN make money from via patenting (lasts 20 years before others can copy their “original” drug, hence Valium became available as generic diazepam since I don’t know when, the 90’s or possibly earlier, I really don’t know. But that’s where they make their money, the first 20 years of a patented product).

The data is always skewed to showcase whichever new drug they’ve invented – nicked from the natural world – with no regard for side-effects. Big Pharma LOVES side-effects – more drugs needed to subdue the side-effects of the first, still more for the side-effects of the second…….and on you go. Don’t misunderstand me, there are some drugs which I personally couldn’t be without – literally in a couple of cases, because without them I’d die, but the majority of the UK’s health system is dictated to by the drug companies recommendations, so currently all the qualifying numbers from blood tests for type 2 diabetes and cholesterol levels have, in the past year alone, been lowered so that they can insist on patients being shoved onto metformin and statins sooner!

The side-effects of BOTH those drugs are awful, extremely deleterious to human health……which then creates further need for extra drugs to manage the side-effects.

I did a lot of research into all of this earlier this year, when my previously normal numbers suddenly put me into metformin territory and I refused point blank to take it. My cholesterol numbers were suddenly deemed “High” too, and I wasn’t about to take statins, either. They were actually already lower than they’d been for two years, the only negative change was in the definition of the numbers, not the numbers themselves. I’ve been able to massively reduce my “Bad” cholesterol (cholesterol is a much-misunderstood subject anyway) through taking very specific supplements, none of which are claiming to be cholesterol reducing products, I just looked at studies that had been done, decided what I knew about cholesterol fitted in with what the studies were saying, and built my own programme to combat it. No way was I going on statins! And my figures last month were too low to qualify for even these ridiculous new qualifying numbers they’ve come up with, so Ha!

Likewise, I am still reversing my type 2 diabetes, all with natural medicine supplements – herbs, nutritional things, so things like Gymnema, B3, biotin, GTF chromium, and others. I will NOT be scaremongered into taking yet MORE drugs. I need a sodding flat-bed truck to collect my monthly repeats as it is, thanks.
I’m sure if Big Pharma could somehow reinvent dope, MM would suddenly be recommended for a trillion different conditions. Likewise, the recent revelations about Vitamin D led Big Pharma to start “inventing” their own nasty synthetic chemical analogues. Before Big Pharma got wind about D3, the figures were – 75-200 nmol/l = sufficient. 50-75nmol = insufficient. Below 50 was deficient. Once Big Pharma saw how many people were taking way more than the recommended “maximum safe” dose of 400IU a day (bear in mind you’d make around 30,000IU in a sunny afternoon at the beach), they lowered ALL of those figures so that now you have to be less than 20nmol/l to be deficient, and anything from 60nmol is now deemed sufficient. The upper reference range of 200nmol seems to have come down to half that.

All this is because a lot of the pharmaceuticals are still waiting for their horrid analogues to be approved. Once they are, I expect the reference ranges will go back up again.

Even the Vitamin D Council seems to me to have been got at by Big Pharma, because in Feb 2013, they recommended 10,000IU a day, but by the June that same year, they’d changed it to 5,000IU instead. I wrote to them, telling them I was taking 20,000IU/day, and was finding it helpful with a lot of previously intractable symptoms, and asking them why they’d lowered their earlier recommendation. I expected some support for what I was doing, but instead got the most unpleasant mouthful back on email, basically telling me what umpteen doctors had told me – I was going to kill myself doing that. Well, I didn’t, because I know what else to take it with to prevent high blood calcium, which is the risk attached to taking too much D3. I have my bloods checked monthly, and even when my D3 has been up in the 800’s, my calcium is still very normal. I reduced to 5,000IU/d recently, and my last bloods showed a huge drop in levels – I went from 542nmol/l to just 132nmol/l, which explains why I’ve been more ill than normal lately. So I’ve upped my dose again.
Without high dose D3, I would certainly be on metformin AND statins by now, and be having to deal with a whole new batch of shitty, painful, horrible side-effects from them.

I just wish I could get cannabis over here, because then I probably wouldn’t get as much nausea, anxiety, muscle and bone pain, poor quality sleep, rubbish appetite, IBS, or depression. I know it helps with all those things.
Think I might need to convert this “comment” into a post – I appear to have gone off in Rant Mode! Sorry Jo!
L. X”

To add a little bit to that, it would also help with my nerve pain, and possibly with the actual damage that chemo inflicted on my nerves, too. I have peripheral neuropathy in my feet, and nerve damage to my bladder and bowels. There are a huge amount of symptoms that I am positive would bd helped by cannabis/pot/weed/hash, but it’s illegal over here again at the moment. It’s never been fully legal, but for a year or so, owning for personal use only was legal. Supposedly, we have a thriving black market in the stuff, and a news programme recently pronounced that cannabis is currently “easier to buy than sausages”. Well, I’d like to know where they’re hiding it, because I haven’t even seen any for years!

I’ll do more posts about Vitamin D3 another time, just know for now that if you take high dose D3, you NEED to take Vitamin K2 to send any excess blood calcium to your bones instead of it being dumped into areas of soft tissue like tendons, kidneys, and other very undesireable locations.

Also, please understand that I am NOT a doctor, and any health advice I give on my blog is my opinion, or my experience, and is not intended to be used as a diagnostic or treatment tool by anyone. What works for me might not necessarily work for you, and I am not responsible for any effects you may experience from trying anything I recommend. ALWAYS seek your own doctor’s advice before embarking on any supplements or natural medicine therapies, and do your own research, too. Don’t just take MY word for it – find out to your own satisfaction! 

I do a lot of research in my efforts to be well again. The way I see it, if you’re ill, you can never know too much about your body, how it works, why it’s got sick, and how you may be able to help yourself get well again.

Who cares more about you getting well than you? Even the most passionately caring doctor does not have the time, nor the detailed knowledge of our illnesses that is needed to try and find appropriate treatments or possible cures, that we do.

Investigate, research, ask questions, and never take a study as gospel. Just because someone wrote a paper about it doesn’t automatically mean it’s true. Many are skewed in favour of an interested party – and that goes for natural medicine, too, because the supplements industry is a big money industry. Not as big as the pharmaceutical companies, but still big, like the anti-sun industry is. Don’t fall into the trap of thinking all things natural must be good. Just because something is natural doesn’t mean it can’t do harm – arsenic is natural! Many natural medicine products deserve just as much respect as pharmaceutical chemicals do, because some are very powerful. You CAN have too much of a good thing! Also, many nutritional substances in our bodies have to be kept in very fine balance with each other in order for us to be healthy. It’s quite easy to throw out the normal balance between sodium and potassium, for example. If you’re on a low or no salt diet, or take a potassium supplement when you don’t need it, or take more potassium than you have salt coming in from your diet, you seriously run the risk of hyperkalaemia – high potassium – which is THE leading cause of all cardiac-related events in the UK. To me, knowing this means that the still-tenacious fad for No Salt diets as recommended by doctors in the US and the UK is one that is positively dangerous. If you want salt, in my opinion you should listen to your body and have salt. If you have low adrenal function, that will make you throw out more sodium than is good for you, and if you have this condition, you WILL crave salt. Obviously, there are some situations where monitoring or reducing your salt intake would be adviseable, like if you habitually stuff yourself with prepackaged, processed or tinned foods, because they can have very high amounts of hidden salt in them (even the sweet ones – did you know chocolate has salt in?) and you might not even be aware that you’re eating that much salt because processed food stops us from tasting the majority of it in that type of food. (If you took the same amount of salt that’s in a processed meal and applied it as plain old table salt to ordinary, plain food, you probably wouldn’t enjoy the taste very much). If you have clinically high blood pressure, they recommend you cut down on salt to stop it getting any higher (salt increases blood volume, which in turn increases the pressure in all your blood vessels).

So, ALWAYS consult your doctor before taking any supplements or following any advice that I give out on my posts. ALWAYS!  

Apart from any other considerations, like allergies, intolerances etc, there may be a clash between some natural medicine products and your meds or another health condition, which is why I keep saying check with your own doctor first.

If anyone feels in desperate need of a full, proper consultation with me, that can be arranged. It’s how I used to make a living before I got wrecked by chemo and radiotherapy, so feel free to email me and we can talk about it. Otherwise, talk to your doctor, do some research of your own, read some studies, examine the evidence, and make your own mind up. We get most of our natural health stuff from iherb in the US, and if you want, I can give you a discount code that will get you money off your first order with them (email me from the Contact Me section). I don’t work for them, and I don’t earn any money out of referring customers to their site (I wish I did!) but I do get points for me to use against my own purchases there. The reason we use them is because they are mostly a lot cheaper than the same products are in the UK, even after VAT and delivery have been added on. They carry a huge range, seem to me to be very good on price, and deliver quickly. I can get an order from iherb faster than from some UK companies! I’ve been getting stuff from them for more than ten years, so they’re an established company with a reputation to protect, not some fly-by-night bunch of cowboys.

Breast Cancer, Chronic Illness, Fibromyalgia

Anything You Can Do, I Can Do Better.


At the start of “All This”, the breast cancer chemo, the exacerbation of my mystery illness et al, I had a partner (and I use the term in the loosest possible sense) who simply had to outdo me on every symptom I had. It was a compulsion. Worse, it was a competition. Worse still, it was a competition I had no interest in winning.  True, he really couldn’t compete on losing a body part to a life-threatening disease, but he did a damn fine job on presenting his suffering as so much “worse” (for which read, More Important) than anything I could possibly be experiencing.

“My back’s really hurting today,” I said once, staring pointedly at the one sofa which was long enough to lie down on, and which he was currently occupying to its full capacity. I was a few months post-surgery, and in the middle of chemo.

He stared straight back.

“Welcome to MY world,” said this delightful love of my life.

“Please, I really don’t think I can sit up.”

“You snooze, you lose,” he snipped back, referring to the amount of time I’d had the audacity to have been asleep for. I hadn’t made it downstairs til after lunchtime that day, and he was annoyed by that. HE’D struggled out of bed. HE’D fought through back pain. HE’D been quick enough to nab the long sofa for himself.

Anything You Can Do, I Can Do Better……

The thing that got me about that wasn’t so much the lack of sympathy or consideration, it was more the lack of recognition for the endless sympathy and consideration I’d heaped on him and all of his many and varied health problems prior to the cancer knocking me for six – I swear to this day that he had fibro as well. I even bought a massage couch and did an hour and a half full body (and head, and feet – I have many hidden talents!) aromatherapy massage on him once. Just the once, because he didn’t enjoy it and didn’t want another one. The oils he chose stunk, the couch was the wrong shape, the face hole hurt, I wasn’t doing it right…….you get the idea. The point is, I’d tried so hard to help him with his problems (pain, insomnia, light sensitivity, noise sensitivity, weight gain, depression, anger, anxiety, agoraphobia,  fatigue – you see why I think he had fibro?) for the whole 6 years we’d been together, and he’d rejected every single idea for helping him that I’d been asked to come up with.

I bought him a lightbox for his depression (his light sensitivity centred around not being able to stand LED displays on the TV equipment in the bedroom, he wasn’t averse to sunlight, just little lights in the dark. Guess astronomy was never on the cards for him,) but it gave him a headache.

I bought him a sunrise simulator alarm clock, to make waking up easier. He hated the LED display (my bad, I really should have seen that one coming).

I sent him to the doctor’s. Being a man, that went down like a lead brick. Doctor sent him to physio about his back and shoulders, and was no use about the depression. Just told him to stop wallowing and get up earlier. Physio gave him exercises to strengthen his core, and he refused to do them.

I bought different supplements, which he hysterically claimed “exploded into green froth coming out of my mouth!” He declined pain killers. He didn’t like our me-imposed Paleo diet, claiming it was the evil broccoli that was making him fat.

I frequently gave up the long sofa whenever I could see he was suffering – I dislike seeing anyone suffer.

In short, I had sympathised myself purple, trying to get him some relief from his myriad of symptoms. He was one of those people who only seem really happy when they can elevate their own suffering to a higher level than anyone else’s, and so he declined or derided any and every offer of help.

I think when my cancer hit, he was angry because felt out-done by it. He managed to be incredibly supportive for about……I was going to say “until chemo”, when he appeared to pass responsibility over to oncology, but it wasn’t even as long as that. A week or so of having to cook dinner while I was stuck in bed literally unable to move post-surgery and pre-chemo was enough for him. I asked tentatively one night at 8pm if we were going to be eating anything that night, and in response he threw an apple and a yoghurt onto my bed from the doorway before sullenly skulking off again. Anyway, it’s very sad and all that, but I think the prospect of losing the Pain and Problems competition was too much for him, and he lost  his short temper over it.

But he isn’t the topic of this post. That can wait for another time. The point of this post is to highlight how easy it is to find yourself in the middle of a competition that someone else has entered you in, with the “winner” being the one in greatest suffering.

Let’s get something straight. Chronic illness, immediately life-threatening or not, sucks, period. We each of us suffer in our own, sometimes unique, way. We adopt and adapt different coping strategies. We adapt our lives, our expectations, sometimes our homes, in order to handle our illness. We come to some sort of acceptance.  Sadly, it seems almost impossible to get our family, friends, acquaintances and others to adapt in a similar fashion.

What some people think is sympathy – Oh, I know! I had JUST the same thing happen to me on Friday! I was SO exhausted, I couldn’t go to work! (no, you had a self-induced hangover from doing shots at that leaving do that didn’t finish til 3am….) or, Oh, I know! My back’s been KILLING me! (and yet you seem to be moving freely) – comes off as one-upmanship. These and other  seemingly minor health issues are clearly very significant to them, and are fairly obvious cries for a little bit of sympathy. But they break the unwritten Sympathy Code. Yes, whether you’re aware of it or not, there’s a definite Sympathy Code. It goes along the lines of “Don’t ask me to sympathise with your terrible athlete’s foot when I’ve just had my leg amputated”,  sort of thing, but infringements of The Sympathy Code happen in every sphere of suffering.

Some of us are in more need of more sympathy than others. and any prior experience of Sympathy Code Infringements were put firmly into perspective at my first breast cancer support group meeting.

After basic introductions, we were invited to share more about where we were “on the cancer journey”. (Journey. Ha! Like it’s a day out to the seaside,  or a trip to the Maldives, or to some other place with a beautiful,  yearned-after destination. The cancer “journey” has an alarmingly limited number of destinations,  the only yearned-after one is survival, and it’s rarely that beautiful in practice.) It rapidly became apparent that unless my tumour exceeded certain dimensions, I wasn’t about to find myself very high up the breast cancer hierarchy. I had naively assumed we were all in the same boat, and were there to mutually afford support, insight, comfort, encouragement and sympathy to each other. I was wrong. It was a shock to find that I was once again in unwilling competition.

One woman said, tremblingly, that her tumour had been 2cm when they found it. Another indignantly cut across her with, “Well, MINE was  FIVE, so imagine how I felt!”  Mine was only 4.5cm, so I didn’t feel able to compete.

Anything You Can Do, I Can Do Better……..

Some had had lumpectomies, retaining the bulk of their breast, including the nipple. Others, like me, had had to have a radical mastectomy, where the whole lot is removed.

Anything You Can Do……….

Another woman raged about the unfairness of how chemo had destroyed her chances of a third, much longed for child; I had had my last possible chance of a first child removed in the same way, and at that point would have cheerfully killed to have had one, never mind two. I gazed in jealous disbelief.

Anything You Can Do……….

Another outdid all of us by pronouncing that she wasn’t frightened by having breast cancer. She truly seemed to believe that, although I am still at a loss to understand that. Cancer was terrifying to me. Still is.

Anything You Can Do……….

Then there were the ladies crocheting chemo hats for charity, or making jam, or running marathons to raise  breast cancer awareness, doing 10km Moonwalks in their altered bras,  sponsored swims…….the list of their achievements left me feeling inadequate, and like I was somehow letting the side down by being too ill to do any of them.

Anything You Can Do, I Can Do Better……..

And I’m finding the same attitudes in the fibro community. I kind of expect it from Normals, those who simply have no comprehension of what someone with a chronic illness goes through every day. Yet pain, illness, all of it, it’s all relative to the individual. It’s no walk in the park to have to navigate illness on a daily basis. It doesn’t matter if you have severe fibro or mild fibro, fibro is a bitch. CFS is a bitch. ME is a bitch. Arthritis is a bitch. Disability is a bitch. Migraines are a bitch. Pain is a bitch. Depression is a bitch.  Every chronic condition, physical, mental or emotional, is a bitch. None of it’s fair. All of it deserves sympathy and support because all of it matters intensely to the individual concerned; whether it matters to you as an outsider to that person’s life is immaterial, it matters to them.

So enough with the one-upmanship, enough of the competition, enough of the automatic ranking of someone else’s condition against yours. Isn’t it time we all of us developed a little more compassion?

What do you think? Do you think you deserve more sympathy than others with the same condition, if you perceive your experience of it to be worse than others’?  Do you find yourself upping the stakes to win the adversity competition? Do you look down on other chronically ill people who seem to have got off more lightly than you? Are you jealous of those who seem to be coping better than you, or does it make you feel deficient?

Breast Cancer, Chronic Illness, Fibro Life, Fibromyalgia

Getting It Off My Chest – Breast Cancer & Me.


I have a great deal to say about breast cancer. Excuse the pun, but I definitely have a need to get it off my chest, just like they did to one of my boobs.

I was considered too young for breast cancer when I was diagnosed. I was 45 and looked more like 35. My age was always being queried. Both parts of that sentence have now changed. Breast cancer is striking women at a younger and younger age, and 45 would not now be considered young because of the sheer number of 20 and 30 somethings who are being diagnosed. I feel for them. I feel for any woman of any age who is forced on this sinister journey.

As for always looking at least 10 years younger than my chronological existence on the planet…..well, chemo, steroids, surgery, radiotherapy, hormone treatments and being thrust chemically into an early menopause have seen the end of that. I used to be referred to as “that girl” when mothers with wayward toddlers told them to be careful not to run into my legs, but it rapidly changed to “that lady” when iatrongenically accelerated ageing kicked in.

Suddenly, I was being called into medical appointments as “Mrs Young”, instead of “Miss Young”, an assumption that can only have been made on my appearance of age. That pissed me off. I started to sound like that Dick Emery character, Mandy, I think her name was, because I found myself hissily correcting anyone who said it with,

Miss. I’m not married. I’m MISS Young.”

It never did sink in with my local hospital, and one day they left me alone in a room with my notes. I pulled out a big black marker pen and wrote “MISS” in front of my name.

I went so far as to underline it.

But they still call me in with “Mrs Young, please,” and I still sound like Mandy.

Actually, now I look so much older, so much more decrepit (my hated rollator – a hideous yet handy wheeled trolley with a seat – only adds to the age-perception), I’m not sure which is the most insulting or depressing: I infer being thought of as old and unmarried, as opposed to young and unmarried, as the very definition of shrivelled spinsterhood, and I imagine the Drs and nurses do, too. The implication is that, despite my apparently advanced years, no-one has ever, in all that time, wanted or loved me enough to put me in a flouncy white dress and say so publicly.

I preferred it when they all thought I was young and single, the latter by choice.

Before my surgery, which was within 3 short weeks of my diagnosis, I was a UK size 8-10. Occasionally, when my then mystery illness – the fibromyalgia – was very bad, I was a 12. My weight bounced between 9 and 9 1/2 stone (times that by 14 to get the equivalent number of pounds if you’re in the U.S, and don’t ask me what it is in kilograms, but it isn’t much). I was borderline skinny. I modelled. I acted. I rode and trained horses. I danced. I had an athletic, boyish figure, and hadn’t worn a bra since the unfortunate incident of My Mother, The Washing Machine, And The Underwired Bra.

Let me explain that. My mother was notorious in our house for ruining clothes in the top-loading washing machine that lived in our cloakroom from the 1970’s onwards. Inevitably, being 17 and flat-chested, I had bought myself a glamourous bra with impressive padding and underwiring designed to boost my tiny ‘A’ sized assets. Just as inevitably, it went into the washing machine the second I brought it home, because “You never know who else has tried it on!”

I still don’t know how my mother did what she did to clothes; she practically invented wide, baggy cropped sweatshirts and tee-shirts at a time when fashion dictated they be long enough and skinny enough to be tucked into our baggy jeans and secured with ratchet belts. Anyway, I was smooching with a good-looking but not very tall young man in a packed nightclub one Saturday night, proudly sticking out my padded and underwire-boosted chest, when he suddenly stiffened – and not in a good way. He stood very still. Expectantly, I did the same. Was he about to kiss me? He was looking down with an unidentifiable expression on his face. Down to where something was visibly poking him in the chin. I squinted in the gloom, wondering what it could be. It looked like some sort of radio antenna…..then I realised in horror that it was one of my underwires. It turned out that Mother And The Machine had somehow shredded the fabric stitched over the underwire at the (non-existent) cleavage end; moorings thus removed, it had wriggled its way up and out towards freedom with every sway of my body. Until it hit something solid.

I was mortified!  I hastily disengaged the wire from this poor lad’s dented chin, and ran to the Ladies loos, where I spent the rest of the evening whimpering with shame. I furiously ripped off my glamourous new bra and dispatched it immediately to the nearest bin. Not really what I’d had in mind for it.

And that was enough to put me off bras forever. Funny, that.

Luckily, because I never graduated beyond a ‘B’ cup, there was never very much for greedy gravity to grab a hold of, and I was active enough to maintain the natural bra muscle that we all have. I reasoned that, like any other muscle, if it wasn’t kept in full use, if it was let off work by virtue of a bra doing all of the support instead, then that would surely be the quickest way to get saggy boobies. I wore sports bras sometimes, but only if I was in the gym, or running, or dancing, or any other similarly strenuous activity that might give gravity more of a purchase and drag my perkies south. Of course, there were still the occasional recreational bras, worn to excite and invite, but I rarely wore ordinary bras, and certainly not every day. I thought them uncomfortable, inconvenient and unnecessary.

And it worked for me; at 45 I had almost zero ptosis, which is medical jargon for drooping breasts. Everything was still pointing proudly upwards, neither boob had tried to make friends with my armpits and I passed the pencil test with ease.

Now I can’t pass the pencil-case test. Not even the really big, jumbo-sized ones.

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This will have to serve as an introduction to my breast cancer story. More to follow, but right now, I’m booked for my nightly sofa-snuggle time with my beloved. He doesn’t care that I have one saggy boob that needs major bra support in public.

But then I’ve never poked him in the chin with a suddenly freed underwire!