Decisions you never dreamt you’d have to make

One of the things that makes this “journey” so difficult is that you’re forced into making lots of decisions you never dreamt you’d have to make. And some of those decisions are really big.

One of the first things I had to decide following my breast cancer diagnosis in mid-July was whether to cancel our summer holiday or not. We decided to go ahead with it (It’s ok to cry). At the time that seemed like a big decision but it was nothing compared with what was to come.

Then I had to decide whether to have chemotherapy before or after surgery. At the time I essentially viewed this a choice over what to lose first, my hair or my right boob. I said as much to the consultant breast surgeon. I think I was still in shock. I can’t remember whether he found it funny. Unlikely, I would have thought. Anyway, I went with the recommendation of the surgeon and the oncologist and opted to have chemo before surgery. So I’m bald but very happy to have held on to (not literally) my breast for these extra few months.

I really didn’t have much choice over whether to have chemo or not. I was an obvious candidate, given among other factors the size of the tumour, the fact it had spread to the lymph nodes and was fast growing. For lots of women, it’s far less clear-cut. That must be a really tough decision.

Much the same factors make me an obvious choice for radiotherapy, which I’m to have after surgery. Lastly, the fact that the tumour is oestrogen-receptor positive means it should respond well to hormone therapy. So again, the decision on whether to take hormone treatment on a daily basis for the next ten years has really been made for me.

While some decisions were essentially out of my hands, there are plenty of others that weren’t. Many of these had to do with hair loss:

• Whether to try the scalp cooling in an effort to stop my hair falling out. I did (You couldn’t make it up & The torture of scalp cooling).
• Whether to have my hair cut short in advance of it falling out. I did (Long hair – vastly overrated?).
• Whether to stop the scalp cooling when my hair started falling out anyway or to persevere. I stopped (The moulting has begun).
• Whether to just bite the bullet once it did start falling out and shave my head. I did (Thanks, baby bro!).

Now I’m in the process of deciding whether to have breast reconstruction at the same time as my mastectomy and lymph node removal or whether to “go flat” first and see how that goes.

Some women seem to know almost instinctvely what they want. I thought I was one of them but it turns out I wasn’t. In the end, this has turned out to be a really hard choice. I started off determined to try the flat route, but the more time has gone on the more I’m coming round to thinking I should go ahead and have the immediate reconstruction. Believe me, I have spent a lot of time working this one through, quite often while lying awake in bed at 3, 4 or 5 am. Indeed sometimes at 3, 4 and 5 am on the same night. I can find plenty of arguments for and against both options.

The reconstruction that I’m being recommended is a DIEP flap reconstruction – DO NOT CLICK ON ANY OF THOSE LINKS IF YOU ARE AT ALL SQUEAMISH. Yes, it’s the one that involves moving skin, fat, and blood vessels from your abdomen to your chest and so it means that post-op “your belly will be flatter and tighter — as if you had a tummy tuck”. Strange as it might seem, I can honestly say that really does not figure at all in the debate I’ve been having with myself over this.

Crunch time for this big decision is fast approaching. I have an appointment with the breast surgeon to discuss my mastectomy in just a few days’ time, on 9 November. That’s just a couple of weeks before my final chemo session, which is on 25 November. It’s quite possible I could have the operation before Christmas.