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Monday, April 30, 2012

CT Scan

It's the end of April already and I wake late to a stunning day. It's a shame really because I feel tired and groggy after a terrible night's sleep. I took a sleeping pill but even that didn't seem to work. This business of menopause has one side effect I have failed to mention so far and that's frequent insomnia. If I don't exercise the previous afternoon, or have a coffee too late in the day, or find myself working too late into the evening at my computer, I'm screwed.

As a result, I'm almost afraid to look at my reflection in the mirror these days. I don't have bags but suitcases under my eyes and with only the vestige of eyebrows left and the tiniest clutch of eyelashes, I am a long way from my ambition to wake up in that universe where I really am Miranda Kerr!

When I finally drag myself out of bed, Al has left to work on the building in town, Ben has gone to school and Harry isn't home anyway as he stayed in town last night. (He had a gig at Uni, this budding deejay).

In the last couple of days I've really been aware of how sore my chest is. It's uncomfortable to wear a bra and I can't lie on my left side without wincing. The area where I have been radiated has turned a very dark colour. It is also covered in new freckles. Check it out:

Gross isn't it? It's such a shame I can't walk around with my bare chest because this would make my face look pretty good all things considered.

Apart from the chest, the feet continue to be rather sore, especially in the mornings when I walk like a Geisha with something stuck up her arse.

As she does most Mondays, like clockwork, Ethel comes over to do the office work she's been doing for Al's business for well, donkey's years. Pretty good for a 75-year-old I reckon! Ethel is a book keeper and has the lousy task of keeping track of Al's finances. It's a good thing she's his mum because I reckon she would have clonked him on the head with one of her hard-backed ledgers by now.

Most weeks when she's here, I can almost hear her gnashing her teeth as she rummages through the dismal pile of papers on Al's desk, seeking lost receipts, missing bank statements and loose figures for columns that don't add up. Here is a picture of how it looks tonight, in case you don't believe me:

If a messy desk is a sign of a genius then Al leaves Einstein for dead. From amongst this pile, my man creates graphic art masterpieces, manages fantastic properties, designs beautiful building and plans amazing ways of changing the world. So it may be a tip to me but to him, apparently it's inspirational!

My desk is a lot tidier and that's where I spend most of the morning despite feeling a little wrecked. The last 10 days have been huge.

Al, I and Ben travelled with Ethel to Sydney last weekend, then the three of us went on to Adelaide and Kangaroo Island. It was the Christmas and Easter break I didn't have - a chance to spend some time with Ben who has been sadly neglected over the past few months and I do think he seemed to enjoy having my attention.

We had a really lovely trip, full of fresh air, wildlife, good food and wine (or lemonade in Ben's case) and returned last Thursday.

On Friday, I did some errands, I visited Nim and had a quick drink at Elysium with Karen and Craig to toast the future whatever that might be. That's because Saturday was E-Day: the local government election I've been so diligently working toward for all of 21 months.

It was the rainiest day we've had in ages - in fact it poured non-stop and started with me picking up some supplies for Karen's celebration/commiseration party and driving a little old lady (Dororthy) to the polling booth. (She had lived in the UK, Wales, Africa and Belgium and greatly approved of my name, 'Bronwyn'.) Then I spent 2 hours at the school fete where I did bugger all at the 'African Food' stand. I basically spent the whole time chatting to some mums, including two ladies who are going through breast cancer like me. They too have both just finished chemotherapy. After that, I went home to pick up Harry and Al so we could go hand out how-to-vote cards in the drenching rain. Here is a very poor picture of Al, me and Harry at Redland Bay polling booth:

Guess what? Karen won. In fact, she didn't just win, she slew the opposition and I have to say it was a massive relief that culminated in my dancing my pattooties off at a Victory Party.

Yesterday, Al and I spent most of the day at a lunch at Nic and Tony's house and although I was whacked, after I went to bed I just couldn't sleep.

This morning I work on a thank-you ad for Karen that we are running in the local paper tomorrow.

The cupboard is bare so I do a huge shop at Woolies before hurrying home to approve the proof for the ad. It's pretty ordinary but it has to do.

Later, I have an appointment that I have been secretly dreading. It's the first of what I gather will be regular scans and check-ups.

On the form for Queensland X-Rays, Dr Choo has ticked CT Scan and written "Chest/Abdomen/Pelvis - L Mastectomy for Breast Ca - Exclude Metastatic Disease." In other words, the results are really important. Eek!

I have to say I am completely oblivious to what lies in store for me as I blithely present myself for the procedure.

I am asked to undress down to my knickers and sit briefly in the holding room as I sign a form. Apparently I'm to be injected with some dye and I could have some nasty allergic reaction. There is a very slight chance of fatality. One in 200,000. I think about the poor bastard who will be the 'one'.

The nurse, Trish, then leads me into a room where there is a machine that comprises a large circular loop attached to a bed. It looks like the MRI machine. I am informed that this procedure involves the insertion of a cannula and as soon as I hear that word, I feel my heart rate rise immediately. You may as well say "Constantinople".

There's another pretty blonde nurse holding my hand as Trish taps my veins and tut-tuts. She says she might go for the one in my hand but I remember how much that hurt so hopefully point to one under my forearm.

Trish seems to think that will do and before I know it, she's sticking a needle into me and I have to say it FUCKING HURTS. I am gritting my teeth and I feel like crying and the other nurse is stroking my other hand, trying to calm me.

But it's useless. "It really hurts," I whinge, knowing I'm pathetic but really, could someone have warned me about this before I came?

At this point Trish immediately suggests an ultrasound to help locate a vein. My arm is throbbing. God, I'd forgotten how much it all hurts!

They lead me into another room where a thin man with glasses puts an ultrasound device on my arm, he tells me he'll give me a local anaesthetic. At this point I am nibbling my thumbnail. It's strangely calming. I face the wall as I receive another needle and then, hallelujah, the bloody cannula is in. Trish tapes it up and then leads me back to the room with the CT machine.

When I lie down on the bed, she asks me to cross my wrists above my head. She says she will do two or three passes under the machine and I'll be told when to hold my breath.

She leaves the room and the machine whirrs to life. I'm startled when a robotic voice tells me when to hold my breath and when to release it. "Now-hold-your-breath"....The bed moves slowly through the loop, back and forth. "Breathe-Normally." Once, twice, three times.

Then Trish comes back in. It's time for the dye, she says, and moves behind me where I can't see her.

I don't feel it when the dye is injected. Trish asks me if I feel alright and I say yes. At least I think I'm alright.

I've been warned that I'll get a metallic taste in my mouth and feel a rush of warmth so I'm prepared. It's true. My throat fills up with heat, the kind you feel when you accidentally swallow a hot chilli, and it feels as if my windpipe is closing.

Trish has left the room but somewhere in a corner of my brain, I'm aware of a mild panic.

My heart is racing and I can hear my breath in my ears. And I'm praying, 'Dear God, please don't let me be the 'one'.

Then the machine starts up again moving my body upwards. It's all over in minutes if not seconds.

As I leave Trish tells me that next time, I should immediately request the ultrasound to locate the vein. She says thet if I come back here, there'll be a note on my file.

What a shame phlebotomists do not have access to these ultrasounds. It would have saved me so much anguish!

After I get into the car, I realise my arm is slightly swollen after the anaesthetic.

When I get home, Ben is back from school. I set him up with a recipe and ingredients to cook dinner as Ethel is coming over. We have Chicken and Chicpeas - a Moroccan concoction.'

I change quickly into my running gear and take Spunky for the walk we haven't seemed to have in ages. There's a cold win blowing and it's invigorating as I walk a brisk 7.5 kms.

When I return home, the house is suffused with delicious aromas.

Ethel arrives and Al and Harry return home. After dinner, we look at photos of our Kangaroo Island trip.

It's almost 11 o'clock now. Al is fast asleep and the house is so quiet all I can hear is the hum of my computer.

Tomorrow I have a blood test. On Wednesday, I have a bone-density test.

I have started taking the Arimidex that I am supposed to take every day for the next five years.

I already notice that one effect of these tablets is that it has made me that tiny bit more cranky. Oh well. As I explained to Ben as I snapped his head off for some minor infraction, it's either me in a bad mood or me in a box.

On Thursday, I have another appointment with Dr Choo. Hopefully she will have some good news for me and that box with my name on it can be ignored for another good few years.

For now, please forgive my impatience. And if you think I'm too easily annoyed, I hope you'll understand.

Thursday, April 19, 2012

Radiation 3

Exactly 7 months since my 48th birthday, I take myself to the Mater Hospital for the last day of my radiation treatment.

It is a beautiful day and, as I navigate the Willpower Mobile through the traffic, I have the windows down and enjoy the feel of a cool breeze through the fine cover of follicles sprouting on my pate.

I think: "It's great to be alive." And I talk to George. I have been doing that a bit lately because I'd like to believe he is still around, watching over all of us, especially Ethel and Al.

"Can you believe it?" I ask George. "Where have the last five weeks gone."

All in all, I seem to have weathered things nicely. The area over my scar is a deep pink colour and the nurses have said it may yet fester a few days after today. But I don't think so.

There is nothing unusual about the visit to radiation services. I park the car and, because I'm a little early, I mosey on down to the coffee shop under the hospital to get myself a coffee.

You wouldn't know it was my last day. It's the usual: check-in, chat, strip, chat, zap, chat, change, chat, out the door. Except when I leave, I shake the hand of Adam, the radiation therapist who has been at nearly all my treatments. I thank him and the other therapist.

Through the last few weeks I've picked up a bit of information about the process. Here are some gum nuts I have picked up: You can be radiated for weeks and weeks quite safely, because it all depends on the dose. You need a Bachelor of Radiation Therapy which you can do at QUT. They radiate for all cancers including leukaemia and can do your whole body at once if need be. The numbers they call out are calibrations to help them gauge the depth at which the rays enter your skin. It doesn't hurt when you're radiated - even if the skin is burned. The room is initially darkened so they can see the laser lights one the ceiling that help them guide the calibrations. Only in rare cases will people need to go through radiation twice.

From the man at the front counter, I also learned that some people they treat actually don't make it. Well, that bit's a downer.

As I leave the radiation room, Adam says I can dump the gown they have given me if I like or I can take it home. I choose to bring it home as I plan to have a ceremonial burning - something to put all of this behind me.

But I can't go home yet as I have to wait a few minutes to see Dr Cox and my nurse, Esther.

While I sit in the waiting room, I think about all the side effects I've been left with. Unfortunately, I believe most of these are permanent:

Firstly, I have vision changes, especially at long distances, things look much blurrier so I suspect I'll need to have the prescription for my glasses changed.

Secondly, I have pains in the joints of my feet. It is painful to walk first thing in the morning. I also have pains in my knees that I only notice when I jog, but not when I sprint. Also I seem to be cramping up a lot, especially if I had been sitting still for a while.

The allergies I had grown out of once upon a time are now quite chronic. Dust, mould, cat hair. So alas, I think I'll be keeping up my stash of antihistamines - but I hope this is for the short term.

My fingernails are like paper but I hope they will strengthen over time. They had six white lines across them which are slowly growing out. Each line, apparently, represents a dose of chemo which killed cell growth.

I imagine when my hair grows back it will have a different texture and also, it will be thinner.

As well, I have a persistent cough that I've had since I went to hospital. That's why I also have an appointment this afternoon with Dr Choo.

After my meeting with Dr Cox, I give her a hug. This is also a side effect of this cancer: I have become a hugger! Who knew.

The way I see it, life is too short to withhold your affection, to restrain yourself from such displays. Give love freely, I say. It's no use to you when you're six foot under.

As I leave Radiation Oncology Services for the last time, I realise the sky is a pristine blue, the sun is out. I really am very happy to still be alive.

I have a couple of hours in between meetings so I confess that I drive to West End without any real plan. I chance upon an Adventure-Trekking shop and go and blow some cash on a piece of luggage I want for my upcoming trip. I even sweet talk the salesman into giving me a 20% discount.

I get to Dr Choo's in good time and have to wait a whole hour before I get to see her. While I sit, I think about all the people who have helped me through this battle so far.

The experts are now finding that cancer patients go through some emotional turmoil once their treatments end.

During treatment, ordinary women who may often be unappreciated slaves at home are suddenly the centre of attention. People, professionals, strangers are caring about them, asking them how they feel and actually taking note of their answers. For most of us, this is a strange place to be. And you get used to it. It is someone's job to care about you. People listen to you talking about yourself, your aches, your pains, your fears.

Then all at once, there you are, your car keys in your hand, blinking in the sunlight and on your way, alone - possibly never to meet some of these doctors and nurses and therapists and receptionists ever again. You're back to being a schmo where most people don't get past 'How are you' and then, in my experience, you have to make it about THEM or you have no conversation. Most people are like this I find: lacking curiosity, one way talkers.

When I arrive at Greenslopes Hospital, I must walk past the Cyril Gilbert Centre and am strangely unaffected. It seems I have overwritten the bad memories.

It's lovely to see Dr Choo again and as I walk in, she laughs and says she's had good updates on my progress via Lee.

When I explain that I've come to see her about my cough, she expresses surprise that it's hung around for so long.

She pulls out her prescription book and tells me she's going to give me a steroidal spray for what she thinks is post-viral irritation of the airways.

Then she pulls out the forms I know too well - for blood tests. My heart sinks.

"I don't need a blood test, do I?"

Dr Choo explains that she has had several patients presenting with adult whooping cough, would you believe, so she wants to check me for pertussis.

Also, I'm to be checked for my white blood cell count, oestrogen & progesterone levels so she can determine whether I am truly post-menopausal now, and amongst other things, I'm to be checked for cancer markers.

As well, she's sending me for a chest X-ray to exclude metatastic disease and a bone density test. Hmmm.

Dr Choo tells me she is putting me on Arimidex and produces a booklet from her bookshelf.

From this I learn Arimidex is a hormonal therapy that is called an "aromatase inhibitor". In other words, it will reduce the amount of oestrogen in my body even further.

The common side effects include joint pain - that I can control through exercise (you beauty!) and fish oil - and loss of bone density so I must be religious about calcium supplements. From the booklet I learn that it can also cause upset stomach, lack of energy, thinning of hair, and headache. Fabulous.

I am to start taking this tablet after the weekend. I must take it at the same time every day ... for the next five years. Yes, I said FIVE years.

I can miss the odd one but it would be a worry if I missed, say, three in a row.

Since I finished chemo I haven't even taken a multivitamin. Now I am back to the world of pharmaceuticals. Yes, it's a bit depressing.

I am to check in with Dr Choo again in two weeks and after I say goodbye, I go down to the chemist on the ground floor and get my prescriptions filled.

The pharmacist is a pleasant Indian girl and she asks me if I've taken this medication before.

When I say no, she asks me if it's for breast cancer.

I say: "Yes, I'm worried about the side effects, but I suppose it's better than death."

I am grateful when the pharmacist explains that thousands of women take Arimidex and that to be considered "common", a side effect must affect one in 100 people.

She says: "It's all in the mind. Have a positive attitude and you might find you get no side effects."

I leave the hospital 2 hours after I arrive. It's peak hour traffic and a slow journey home - plenty of time to think.

So far so good. I've survived the rough seas and my ship has landed on a different shore.

I know life is a little different here but right now, I'm not entirely sure how. Chris has already told me that clarity about this will only really come much later in this journey.

Some people have already asked me if cancer has changed me. Physically of course it has. But I can't really be sure how it might have changed me in other ways although I am intuiting a little of it here and there.

Revelation doesn't come in one big flash. I am still piecing it together. The sliding door has opened and I suppose I'm on the other side. But it's all still pixellated. I am still deconstructed. At least I think I am.

When I return home, I leash up Spunky and go for a 5 km run. (My first in a couple of weeks!)

Al gets home and cooks a delicious meal of fresh salmon.

Afterwards he goes to his tennis night and I go for my weekly campaign meeting with Karen. Later the team pops over to Elysium for a quick drink. This is the last campaign meeting and we give ourselves a toast. We have done our best. That's all anyone can do. Win or lose, we have that to hang our hats on.

Karen and I work out that I first committed to helping her in July 2010. Oh my god! It's been such a long road and here we are today, probably best friends.

On Saturday, Al, me and Ben are going to Sydney and then to Adelaide - it's the holiday we didn't have over Christmas or Easter.

Next week will be the election - something I've worked toward for 21 months. Another big part of my life is ending. Who knows what will happen? Whether Karen will win or not?

I have finished the first part of my treatment. In two weeks, my blood test will tell Dr Choo what the result of my treatment has been. Whether the cancer is in remission or not?

For now, I'm crossing my fingers.

For now, I'm am still working out my new world.

I'll keep you posted.

Wednesday, April 11, 2012

Plastic Surgeon 1

Six months and 18 days since diagnosis and my hair has grown enough so I am again,a little Mao Tse Tung-esque around the jowls.

I wake to a beautiful breezy morning when I will set off for my first appointment with my plastic surgeon. I've been planning this visit for months. I was originally booked in the week I fell sick and ended up in hospital.

Afterwards I have another session of radiation so I know it's going to be a long day.

Since the Easter long weekend passed, my routine is all out of whack. I haven't had a chance to go to the gym and client and Karen commitments have made it impossible to get my afternoon walk in.

Perhaps it's a good thing because, as you may remember from an earlier post, I do need to cultivate some stomach fat if I am to have the chance of reconstructing poor dead Nicky in the optimal way. At least I think so.

This is what this visit is all about today. I need to know what my options are as far as breast reconstruction goes. I need to plan ahead because, these days, everything revolves around fighting or beating or managing this bloody cancer.

If I think about it too much, it really does get me down.

Lately, I've watched with dismay as days that may have been spent with my family are absorbed, submerged and eaten away by the fall-out of this disease.

Ben is on school holidays and, apart from a blissful three days spent away at our little shack down the Coast, there's been little 'quality' and not much 'quantity' to these precious times when I could be focussing on this boy - reduced to only-child status since his eldest brother turned 18 and regularly decamps to his girlfriend's hacienda.

Of course I feel sad. I know time is fleeting and madness takes its toll and all that. Ben is growing day by day while I am growing away from what was once normal.

As I bustle about, preparing to leave, Al offers to come with me, and Ethel rings too, offering to accompany me, but these eternal visits to one specialist or another are tedious. They involve long drives in the car. They suck precious time and it is best that only one of us is in debit in this department.

Al urges me to go with an open mind and without any preconceived notions about what I want.

I leave in good time for my appointment and set off in my temporary vehicle, the Willpower Mobile - a little Nissan that's emblazoned with Karen's campaign branding. At least there's one good thing about this repetitive commute: I'm getting Karen's face out amongst the traffic.

The drive takes me a good hour as I head to Sunnybank,and only make one wrong turn. Hooray!

At 10.30 sharp, I am sitting in the waiting room of a suite of professional offices that, I have to say, are rather schmick - all dark wood and shiny surfaces. It is clinical but luxuriant.

I don't have to wait too long before I'm ushered in.

Dr Lily Virtek is a pretty, slightly built Chinese lady who speaks, disconcertingly, with quite a strong Aussie accent. In fact, she's gorgeous.

A Plastic and Reconstructive Surgery specialist, I momentarily spare a thought for all the ugly and deformed who might present themselves to this vision of loveliness. How cruel must be the contrast!

After she takes my personal details, I explain to Dr Lily that I have come to see her early as I need clarification on where my body needs to be if I'm to have a reconstruction. I explain that, rightly or wrongly, I am thingy about my size. I don't want to be too fat and, as it is, I'm struggling with the idea of being five kilos heavier than is usual for me.

Please. Allow me this small vanity.

I accept that without surgical intervention I am stuck with my hideous crooked nose (that swells up to Aboriginal proportions after any hay fever attack), my spotted uneven skin, my short torso, and the clutch of wrinkles collecting on my face. I freely admit I'm no oil painting and that's okay.

But I won't be stuck with a fat body. I've never really had one other than through pregnancy so I just don't associate it with being, well, ME! Besides, I've always been a runner: I LOVE the chase of soccer and you can't really sprint unless you're built for it.

I'm just used to being smaller and now I have back fat and a belly that pokes out, and I've packed away the trousers I've been wearing for 20 years because suddenly, I'm not so much wearing my clothes as being upholstered by them.

That's why I'm here. Not just because it would be nice to have a matching set of boobs. I also want to know just how many donuts I need to eat to get myself a decent tit without necessarily ending up with a backside the size of Tasmania.

Dr Lily gets straight down to business the moment my now bigger backside lands on the chair by her desk.

She takes my personal details, then asks me what bra size I am. When I say 14D, she asks me if I want to stay the same size. She smiles softly when I say: "I want it as small as possible. Big breasts are overrated."

Then she asks me to clarify whether I REALLY want to have my remaining lone breast off.

"I can just do a reduction", she suggests but I explain that I don't want to as I'd be uneven and I am somewhat fond of symmetry.

I tell her I'd like it completely removed because of the high chance that my type of cancer could migrate.

She accepts that and, I don't know, but she looks a little sad. Funny isn't it?

Then Lily produces a small silicon cup with a kind of metal lid. She explains that this is an expander which will be inserted under the skin and gradually filled with millilitres of liquid. This is what is called a 'skin expander'.

Once the skin has expanded over a period of weeks, then a silicon insert is introduced.

Where Paris is concerned, the procedure will be quicker because I guess it's simultaneous with the removal of the beat.

Then Dr Lily asks me to take my top off and I stand there half naked as she squeezes Paris, much as one might test an avocado for ripeness.

She gets down on her knees in front of me and feels my stomach. My heart sinks when she shakes her head. It seems the news is not good.

As I put my top back on, Dr Lily tells me I have barely enough stomach fat for a B-Cup and 'even that would be a stretch'.

My heart sinks. I am about to say I'd be happy with a 'A' but I realise that really would be stupid.

You see, the operation I thought I would have is called a TRAM flap or Transverse Rectus Abdominus Musculotaneous flap involving what is essentially a 'tummy tuck'.

It's a major operation requiring 6-8 hours of surgery and you wouldn't go through with it for an A-cup. You just wouldn't. You'd be better off sticking two oranges down your bra and making do. Or two rolled-up football socks. But not ping pong balls.

Dr Lily explains the TRAMs are the 'Rolls Royce' of breast reconstructive surgeries but requires good tissue and good fat - but I'm simply not a contender because, believe it or not, I'm TOO THIN!

What! You have got to be kidding me.

"What about my thighs? My bum? I read you could suck some fat from there."

Lily chuckles. "You don't have any."

"But my stomach pokes out."

"Those are muscles. You must have been pretty fit before you got sick."

This is all well and good. Once upon a time, my head might have swelled to Jeff Fenech proportions at that point. But I need this fat.

"Couldn't I just eat a few more cakes?"

Here's the thing. For this kind of operation, stomach fat can't be 'cultivated'. Because once the fat is in, if I lose weight, I lose it from that breast. If I put on weight, it goes on that breast. Because it's STOMACH FAT you must maintain a size that's so consistent it maintains the breast in that size.

"You're going to go back to your normal size. I'm sure of it," Lily says.

"Can you transfer fat from the good breast?" She raises an eyebrow and smiles, humouring me with an answer.

"That fat could have cancer but yes, theoretically you could."

"My friends have offered to donate their fat?" I try. One last ditch effort. At this, she laughs out loud. Come on! I was really counting on that tummy tuck.

I don't know what to expect at this stage when Lily walks behind me and asks me to put my shoulders back. I feel her small fingers prodding my back.

She tells me that my only option is an operation involving the Lattisimus Dorsi muscle that is located on the back.

She will take this from the left side and apparently, it is kind of shifted onto the chest.

She explains she's done 100s of these and they're extremely successful with patients reporting few long term effects.

The consequences of this operation are only really critical for anyone involved in climbing cliffs or painting or anything involving heavy above-the-head work involving the arms - so if I was Spiderman, I'd be screwed.

I will have difficulty moving heavy objects from high shelves with that arm.

Who cares about that? What about the IMPORTANT stuff...

"Will I be able to raise my flag when I referee?" Yes.

"What about my golf swing?" We discuss this for a while. I don't even play that well but hey, in the unlikely event that I discover I am bloody fantastic at this sport one day, how the hell will this operation affect my backswing?

Basically, it will reduce the strength in my left arm and if I persist, I can work on that to increase its strength.'

"Can I go swimming?" Yes, "but please don't tell me you like the butterfly." So freestyle should be okay but I'll notice a weakness in that arm.

"Can I still work on my upper arms at the gym?" Yes. Even chin ups. Eventually.

And so, as my conversation unfolds, it's all about activity. That's just who I am.

A little later we discuss the potential timing of the operation. It takes a good six weeks to recover from the operation and I won't be able to move my arms much for that time. I won't even be able to walk for two weeks.

My only concern is that I will have reasonable movement by the time referee season starts. Maybe I can even return to playing soccer. Who knows!

The good thing about this operation is that the surgery takes a little less time (4-6 hours). It's not as major as the TRAM.

I guess another good thing is that I won't have another hideous scar on my torso to confront me in the mirror every morning.

Rats! I was really looking forward to, finally, getting the flat stomach we Sri Lankans are doomed never to have (damn my genes!).

Dr Lily then pulls out a folder and shows me some post-operative pictures of women of various sizes. I have to tell you I'm impressed!

I had no idea breasts could be resuscitated so well. Even the nipples stick out - so much so in the initial stages that, Lily says, you could hang your car keys off them.

By now, I think I've accepted that this is my only option. It's either this, or nothing (thank you radiation, you bastard).

From wo to go, the whole process will take up about six months of my life. What to do? It is what it is.

As we close the meeting, I joke to Lily that while I'm under, maybe she could fix a few more things - maybe a brow lift or a nose job.

Of course, I'm joking.

The truth is, if you'd told me 12 months ago that I'd be visiting a plastic surgeon this year, I would have laughed in your face.

The truth is, whatever my shape and size is, now or in the future, I am having to re-learn that thing called 'self acceptance'.

Sure, I'm a bit obsessive about not turning into a fatty but you know what? Give me time and whatever I am, I'll get there.

We are what we are. Whatever is meant to be, just is.

I have asked for a quote for this operation and will let you know in due course, whether I'll need to sell an organ to pay for this procedure.

Before I leave her, I ask Lily if the 'Virtek' of her surname means she married a Croatian maybe. Her maiden name was Lily Chen.

"No, he's Czech," she says.

"Do you have any kids?"

When she says "No" I think 'What a shame'. Because there's surely a one liner there: about the family of Chinese Czech-ers. Ha Ha.

As it is, I say my farewell and drive back to town.

I stop at Garden City and score myself a pretty fab David Lawrence dress at 'a further 25% off'.

I drive to the Mater where, once again, it's 'chat, wait, chat, change, chat, zap, chat, sign, off'.

I have just seven doses left when this tedious business of treatment will be over.

Afterwards, I meet Lee for a coffee because she works just across the road.

In the evening, I go to Trivia where we come third.

It's 10.20 pm. The evening has turned cold and blustery and I wouldn't be surprised if it rains tomorrow.

Today I have taken the first step towards clawing back to that person I loved: the person who was the old me.

I know I'll never look the same again, me with my Mao Tse Tung hair do and my scar.

Already I can feel the tug of that black water, drawing my ship away from that familiar shore where the old Bronwyn is waving, laughing. Living in her gym gear. Manic. Doing. Devouring it all. Imagining, foolish girl, that that was what it would be like. Forever.

How could she know then the terrors of all of this: the losing.

I'm trying hard to keep sight of her, the Bronwyn that was 'whole'.

Because I know that, when all of this is done, she will be overwritten.

And already, I miss her.