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Friday, September 30, 2011

The Diagnosis: Part 1

On Monday, 19 September 2011, I celebrated my 48th birthday and by Friday, 23 September, I had been diagnosed with early stage breast cancer and it is with an attempt at a clinical, third-party objectivity that I've been keeping track of what's happened to me so far.

In the ensuing issues of this blog, I hope that my experience will help you or someone you know in dealing with the ramifications and repercussions of what is one of the more indiscriminating diseases in the world.

In 2011, it's estimated that around 14,300 women and men in Australia will be diagnosed with breast cancer with 75% of cases developing in women aged over 50. The KNOWN risk factors are:

- Being a woman
- Getting older
- Inheriting a faulty gene that increases the risk
- Having a strong family history of breast cancer.

Of these, I have all but one.

My journey begins around the second week of June 2011 when for the first time in my life, I get the flu. I put it down to the increasing virulence of the germ and batten down to fighting it. But the cold hangs around.

This concerns me, a tiny bit. Generally, I've had the constitution of an ox. In Year 12, to my great embarrassment, I was one of two kids to receive a special citation for perfect attendance: I did not have a single day sick in five years of senior schooling.

Through my early working years, I amassed a fortune in untaken sick days - I was never sick. I mean NEVER.

In part, you'd put this down to the fact that I'm a serial exerciser and a health nut. I've lived a moderate life and tried to take good care of myself as best I can.

You could also put it down to good genes - my great-grandmother is rumoured to have died at 110.

So yes, getting the Flu is a tiny sign.

But there are other clues. Normally a person with a zest for life, I have started to feel fatigued. I have difficulty getting up in the mornings.

I also find my old allergies have reappeared with a vengeance. Everything seems to make me sneeze. I have a sinus infection that doesn't seem to want to go away.

With some strange prescience, my husband, Al, observes: "You always seem to be sick these days, Bronnie."

Nonetheless I'm feeling fit. I'm running 10km twice a week. I'm refereeing and playing soccer nearly all day on Saturdays. Sick, schmick.

It's the sinuses that drive me batty. So in early July I take myself to the doctor and ask for the full suite of medical tests. .

She's happy to give me the referrals but when we get to the breasts, there's a disagreement.

I ask the doctor for a referral for an ultrasound to which she replies that a mammogram is adequate and I could have it done for free at Breastscreen Queensland.

"No," I say. "I am happy to pay for it." The doctor seems to roll her eyes and mumbles something like: "Well, I suppose, if you're rich."

I have the referrals but as it happens, my work gathers momentum and I find July and August slipping away.

In late August I finally manage to get to my blood test and by early September, I know that all is well in that department. My cholesterol is pleasingly low and apparently liver, kidney and lung function are fantastic. There's an issue with my haemoglobin - but I've been battling anaemia for years.

In the meantime - something alarming occurs with my left breast. At what clinicians will identify as 'ten o'clock', my breast is raised and sinewy. Google tells me not to be alarmed as breast changes are common in peri-menopausal women. But I have the referrals! My intuition tells me not to delay.

I have a mammogram and an ultrasound which uncovers a suspicious lump. It's a Friday though an I have to rush off to a meeting. I opt to return the following Wednesday for the biopsy.

In the ensuing days I try not to worry. I keep feeling the dodgy spot on my breast, imagining it growing.

My birthday comes. I realise how many friends I have. I feel sentimental and maudlin.

Two days later, it's time for my appointment.

The doctor numbs the breast with a local anaesthetic. A needle is inserted into the lump and a small tissue sample is pinched with a device that makes a noise like a staple gun being released.

In smaller lumps in harder to get to places, a needle is used and is dug in to the spot, over and over. It hurts.

That afternoon, I go for a walk with my friend, Lyndal. We don't go far - maybe five kilometres. But I'm puffing. I observe that I must be stressed. Since the biopsy my heart rate is elevated.

That night, I go to my usual Trivia Night with my close bunch of friends. We come second and win the bottle of wine :)

Now I must wait some more for the biopsy results. Two days move like molten lava as I await the bewitching hour. I don't know what to think. I stay cheerful and positive. I joke to my family about being nice to me as I'll be dead soon.

I make cracks about finally getting the flat chest I want.

I go to the gym as usual. I go for walks. I keep working.

When the doctor calls me in, my mind is a blank. She's a chinese lady and not given to jocularity so I think nothing of her stern expression until she says: "The News is Not Good."

We jump to words like 'radiation' and 'chemotheraphy'. Still, I'm not panicking. I'm watching events unfold in the third person.

We waste no time. That afternoon I'm the last appointment with the only local breast surgeon. His name is Dr Justin Lambley. He's in his mid-thirties, slightly built and with a gentle manner. He has three young children aged 5, 3 and 1.

Dr Lambley asks me how I found the lump. He looks at the ultrasound and comments on how small the lump is. He congratulates me on finding it.

He has me undress and feels my breasts. After the examination, he draws a diagram explaining what happens with a cancer.

He tells me I'll need a lumpectomy which may include the removal of one or more lymph nodes.

He says I'll also need radiation.

He knows this simply from looking at the ultrasound.

But what about that mammogram?

He places the mammogram screens on the light box. There is no sign of any abnormality.

My take home message today then is this: If you are a woman with breasts:

1. Check your breasts regularly.
2. If you are aged 40+ have regular screening.
3. Insist on an ultrasound.

In Australia, they cost around $300 up front but you receive about $130 back on Medicare, give or take a few bucks. What's $170? Is it worth your life?

The appointment with the surgeson is over. He directs me to the hospital where I must fill in the forms for my operation the following Tuesday.

As Alan and I leave we observe that we've received as close to good news as possible. The lump is small. It's early stages.

That night we go out for dinner with friends where we joke about breast reconstruction. Underneath the laughter, there is an undercurrent.

I can feel the tug of something inevitable.

As I leave the restaurant I receive a text message to tell me a good friend is by her mother's death bed in hospital. Her mum will die at 9 am the next day.

I realise that on Monday, my eldest son will turn 18. (On Sunday, Alan and I will toast the last day of his childhood with a glass of champagne).

I think about living and dying. I think about growing old.