Vivien Saunders
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BOOBS AND BITS 2006

Now this looks a frivolous piece, but is really the most serious issue on my website. In November 2005 I started on the road to being diagnosed with breast cancer. So this is an article for all women, with a few serious messages, wrapped up in my usual ridiculous nonsense.

My first thanks go to the wonderful consultant radiologist, Dr. Catherine Hubbard, at Hinchingbrooke Hospital in Huntingdon, who diagnosed my problem and through her good skill might well have saved (and certainly prolonged) my life (subject to other mis-haps). Her radiographers couldn't have been kinder and more diligent.

I didn't know I had a problem. They tell me that about 4 women per thousand who go for breast screening, with no thoughts of problems, are called back for re-assessment. Sometimes results prove negative, no doubt. But some don't. So routine screening is a must.

You don't know you have breast cancer and you don't know there is anything wrong. I had been for a mammogram a few years ago. But this autumn I realised I had a problem. (Sorry for the details - but if it encourages one other person to get a check up, that's good.)  Anyway, I decided to ask to see a nurse at the local doctors. Dealing with the receptionist is usually a more frightening experience than A' level physics. "The doctor can't deal with two problems at a time, you know.  He can syringe your left ear Monday week  and Thursday fortnight for your right ear."  You know the type. They have to ban dogs in the surgery or she'd be there with the Rottweiler. But mention the word "breast" and Whoosh. I was told that nurses certainly didn't see breasts and I was in with the doctor within an hour. He prodded me around, could feel nothing but made an urgent appointment for me at Hinchingbrooke a couple of days later (in late November).


DIAGNOSIS

This appointment was the first of six before the operation. I am afraid one can only get through these things if you look on the funny side. The registrar who first came to see me - another Edward - was delicious, with real film star looks. I really queried whether he was a doctor at all or just some out of work film star there to encourage middle aged women to call in at the hospital to have him massage their bits. What a wicked thought! Anyway, he could feel nothing. Nor could the surgeon, so I was routinely dispatched to radiology, where the mystery of my little tumour began to be unravelled.

First the mammogram. For those who have never had one - imagine your boobs trapped, one at a time, in something like a sandwich toaster - but cold. And as one friend quipped - yes, not just your boob, but half your chest as well. This is then followed with the classic encouragement "Now don't move". God that one could. Pop, first photo done. Then a few more. In with the next boob. Please don't tell me not to move; I'll giggle. Pop, a few more pics. And this is where it started. The X-rays were taken in to the consultant radiologist who saw something irregular. With my normal optimism I assumed it must be a peanut that had gone down the wrong way - well not quite that - but nothing sinister. I was called in for a couple more mammograms. I hadn't realised quite what a fantastic job the National Health Service does with records of our bits and boobs. My earlier mammograms were called up for comparison and sure enough there had been a change - a naughty tumour had crept in while I wasn't looking. Trust me to be awkward. So awkward that I suspect I made it onto Hinchingbrooke's Greatest Tits list.

And then another appointment for an ultra sound scan - my fourth appointment in a fortnight. Aren't people funny how they grumble. How long have you been waiting. It's not right. Don't know what they are all doing. I've been here an hour. Who really cares - an hour, two hours? These people are trying to save lives. You learn to take in the newspaper, a book. Or you just look at people - their comments are so funny. Why am I seeing a mister? I want to see a proper doctor. He's a surgeon. Yes but is he a doctor - I mean, with qualifications? Is that you snoring? That man's been here waiting so long he's gone to sleep. Why's that woman gone in before me? We've been here far longer. I hope they've got me transport back home. Don't you drive? Yes but why pay 3 for parking if they come and get you for free. Where you from? Wisbech. Oh, that's lovely. (Wisbech - lovely!) Oh, they've called me now. Sixty pence for tea and waste it. Isn't the Health service dreadful!

Isn't the Health Service wonderful. Anyway, while everyone else having scans seemed to be walking out with a picture of an expected infant in mum's tum I walked out with the knowledge, as Dr. Hubbard put it, that I had what was probably a cancer, but small and treatable. One has to look on the bright side. My mum died of a brain tumour and father had cancer of the throat - so, far better to get it in something you have two of rather than one - and can manage without! The problem seemed to be pinpointing exactly where the wretched little thing was so that it could be chopped out rather than chopped off. I guess a few years ago (and perhaps still in some hospitals now) it would definitely have been a question of right-tit-off!


THAT MRI SCAN

So, at great expense, to the NHS, I was given an MRI scan. Well, now that is something to experience. To the patient it seems like being buried alive or shoved in a tunnel. The table on which one lies is clearly set up for examining dangly bits - one bit for men and the other for women. I'm sure that's enough detail. The patient before me was a man; and so the table was adjusted. (I did give a short impression of the MRI scan to a friend, lying on my kitchen worktop, boobs dangling in the sink - and then hysterically  trying to hang them into two cereal bowls!) Then, in an attempt to make it less frightening I had to lie with my head tilted - presumably so I could keep breathing - with ear phones on. The most painful bit was my right ear bring crushed by the ear phones. Apparently only about 80 to 85% of people can manage the MRI scan. It is claustrophobic, but they give you a button to press as an alarm if you can't survive. The worst thing was the music; I didn't think repetitions of "Don't cry for me Argentina" was the most cheerful music to tolerate during diagnosis for cancer. But hopefully this irony would be missed on the good lady who thought Wisbech to be lovely.

Last trip before the final diagnosis was another ultra sound, wire inserted into the tumour to keep it in position (I guess) and then 5 or 6 biopsies. I got the giggles with the thought of the injection for the local anaesthetic. Doctor Shipman, I presume. Don't even think, just a little prick. Stop giggling. This is not funny. These clever people are trying to save your life and all you can do is get the giggles. Bang - like firing in a staple gun. Sorry if it hurts. "Bang. Bang. They shot you down. Bang, bang. "

And then the final trip for results. Obviously I am going to be alright. I feel fine. I do not believe in illness. I am not ill. I will not be ill. Actually that isn't quite the case. It's cancer, but treatable. Lots of words you don't understand. But cancer and tumour you do. Don't cry. Don't blooming well cry. Have a cup of tea and meet your Macmillan nurse. Do you take sugar? No ....... Yes ...... Yes please. They told me at Girl Guides it was good for shock. Hallo I'm Lorraine, your Macmillan nurse. Don't cry. For God's sake don't cry. Why is there a box of tissues and details of priests and churches? Leaflets. Information. Lorraine - absurdly cheerful. She must spend her days telling people about their cancer and their chemotherapy and their life expectancy. And so cheerful. So bloody cheerful. How do they do it? I will not cry. I only cry if I win a golf tournament. Oh, that's OK. My mum died of a brain tumour - so better to get it in your boob. Ha, ha! .... Ha, bloody ha. Just lucky. So very, very lucky. Lucky (or sensible) OK - lucky to be sensible(!!) that I phoned the quacks in the first place and got all this skill. I will not cry. Now let me take some details and explain what will happen. I know we have spoken about dates already, just in case. Ha, ha. Stiff upper lip. I will not cry. Yes, that's fine. A day for a pre-op. Yes, any day. Yes, much better to know before Christmas than not know. Great and I haven't cried.

Now, next of kin? Lorraine - I am going to cry. Excuse me. Blub, blub. Tissues, nose blow, blub, blub. You see it's like a bad joke. I just make this awful joke to people. I always say "ha, ha - next of kin - Edward Saunders. Relationship ...Cat". And now you are asking me. And I can't really say "Edward Saunders - relationship, Cat". Well, you could, but would Edward answer a phone? No Lorraine he wouldn't. Put down my friend XX - relationship none - that's N-O-N-E ... and not N-U-N ..... ha, ha! ... I feel better again, Lorraine. Yes, of course, I'll be fine driving home.

So pathetically un-fine, that I stopped at the garden centre for lunch. Soup. "Would you like a roll? " No I think I'm fine sitting on a chair! Sounds like I'm getting back to normal.

Ding, ding - "How were the results?" Not too good. Well, not good. Yes it's cancer. But my mum died of a brain tumour so better to get it in something you've got two of. Ha, ha. Ha, bloody ha! Say it often enough and you believe it.

Ding, ding. It's Lorraine. Remember if you need anything over Christmas we are always here for you. Either Linda or I - we're here. We are always here. And they were. Always there with a smile. And working so hard, so very, very hard. As I thoughtlessly remarked, "Working their tits off" - shut up. Another boob!

You know I said I couldn't come in as early as you wanted me - the 18th of January. I had that commitment to speak at that AGM in Cardiff. Well, can I change my mind? Thank you. Thank you so much. Yes, the 18th it is. And a pre-op day on the 11th. I'll be there.

Ding, ding. Hi, my name's Sue. We met at golf. I heard you've got breast cancer. I'm just going through it at the moment. Yes, had the op. Lump out. Feeling fine. Haven't swung a club yet. But soon will. Keep in touch. You'll find people are so kind.

Ding, ding. Hallo - it's Carol from the Golf Club. Heard you'd just been diagnosed with breast cancer. I went through it two years ago. Can I help! You'll be fine. Phone me anytime.

Knock, knock. Flowers - ladies from Cheshire. Can we help? Keep smiling.

Ding, ding. Viv - so sorry to hear about the breast cancer. It runs in my family. Are you on your own? Shall I come to stay for a few days and make you laugh? I'm laughing anyway. But do come. And bring vases! I'm going to need them.

Knock, knock. Hi Gary - post. Cards. No, not my birthday or late Christmas cards. How kind, how very, very kind.


PRE-OP

Pre-op day. Lots of tests. Hinchingbrooke Hospital has grown like Topsy. So, dressed in stylish patient's gear, feeling a real tit - sorry - I was sent to X-rays for a chest X-ray, for a blood test, for a swab test to make sure I wasn't bringing in germs, ( MRSA), a wee sample (God knows why - but God's looking after me!) and to be weighed. Don't you feel you want to make it as low as possible! Take off or out everything you can. Gosh, that's more than I thought. Must be those heavy contact lenses! More explanations from Mr. Benson (the surgeon) about the whole op, consent forms signed, friendly words of encouragement from Lorraine and then home for a week to prepare my thoughts!

Picked up the feedback form. Hinchingbrooke Hospital wants to know how we are performing. Please fill in this form and we will notify any concerns to the hospital trust. A real grumblers' charter. Nowhere inviting positive comments. Surely they never grumble about you in radiology or cancer care. Oh yes they do. Astonishing. Anyway, filled in the form and grumbled - grumbled about the form inviting the negative and not the positive.

This is going to be two weeks out of my life - in hospital plus recuperating at a friend's. Who's going to look after precious cats, Edward and Sophie for 2 weeks? No worries. The golfing community is wonderful. We'll be there. One good friend volunteered - 2 weeks of solid reading. Several others in to help her. Wonderful. Edward was instructed to be on good behaviour. No rabbits, squirrels. No body parts on the carpet, please - well just one mouse.

The day of the op arrived. January 18th. Taken in by a friend, unpacked, things in my locker, put on the pretty nightie - actually probably look better in that than in most things I wear. (The thing I look best in - sadly - is a boiler suit!) Anyway on  with the nightie. Filled in forms. Anaesthetist sorted me out. Explanation of how it would be. Just a little scratch - they don't say prick anymore. Explanation of oxygen etc. Phew! First port of call is going to be radiology with Dr. Hubbard again to get the little wire into the tumour. Any time now.

And then Mr. Benson arrived. Sorry, terribly sorry. Truly sorry. Can't do the operation today. Couldn't quite get the reason, but something to do with radiology. Think they wanted to use another special scanner that had only arrived that morning. Same time next week? Guess so. Off with pretty hospital nightie. Can you come and fetch me? Expelled for bad behaviour. Not pinching the doctor's bottom? Not one of your dreadful Shipman or Crippen jokes? No I'll explain. What about Edward and Sophie? All the arrangements? Never mind.

Ding, ding. Hi it's Lorraine. So sorry. To do with equipment. That's OK. - best to get the finest treatment possible. Can you do tomorrow? We can't delay a week. (Presumably some dreadful creature in the Ministry would close the hospital and turn it into an asylum seekers' centre if they got a black mark.) Can you be there tomorrow, Viv? Yes, I have no problem, no complaint.


OUCH!

Same place, same time, same bed, different nightie, different anaesthetist. So sorry, so terribly sorry. Who cares? Down to radiology to Dr. Hubbard and her wonderful team. New equipment - fantastic new mammogram gear - and then in for the ultra scan. Boob into the sandwich toaster. Pretty picture. Zap. Now we can rotate the whole thing and get every angle. You're the first person on this - I think that was the delay - rather more complicated to set up than a sandwich toaster! Fantastic.

Then off for the op. I didn't know what to expect. Hadn't realise they actually wheel you off in your bed to the operating theatre and then onto another one while you are there. God, I want to wee. No, might be sent home for bad behaviour. Hallo, just a little scratch, On with oxygen (perhaps in different order) - "Keep your eyes open" ....................  Hallo, welcome back to Rowan ward. 3 hours later - there's the clock. What's this? Oxygen. A drip. It's been done and I'm alive. And I haven't weed. Sleep, just sleep. 5 pills. Sleep.

Visitors' time. Just two. I've made it. I am so tired. So very, very tired.

Time to go to sleep. Can I have the sides up. I think I might fall out. Have to sleep on my back, with oxygen and a drip, and very painful on my side. Sleeping on my back makes me snore. Sleep, snore - whoops, wake up. Sleep, snore - whoops, wake up. Over and over again. Hope I don't keep Jenny on the other side of the ward awake. How embarrassing.

What's the time. I have never been very good at telling which is the little hand and which the big hand - at night. Is it 5 past 7 or half past one? Sleep, snore - wake yourself up.

And then a little voice from across the ward - "I just hope I didn't keep you awake with my snoring. All night I kept snoring and waking myself up. Did I keep you awake?" So, it wasn't just me. Better behave or we'll be out of women's surgical and into jerry-hat-tricks! It is morning.

Here's breakfast. It won't be what you ordered. There is always a delay in orders and patients matching up. Who cares?

( I remember when I was rushed in in the middle of the night with a bad back, which turned out to be kidney stones. I spent 3 days in Hinchingbrooke with no food. I thought I was fluids only. It transpired I hadn't filled in meal forms because I arrived in the middle of the night. On day 4 they found me a meal of someone who had died or been dispatched. "We've only got a skeleton staff". Well, you would be skeletons without food.)

There were beds for fourteen of us, with 8 nurses (or assistants). Now they don't wear fancy headgear you can't quite tell. (Remember Hattie Jacques as the fearsome matron in the Carry On films.) Not like that. And then of course nurses right through the night. Obviously must have three shifts of 8 hours and a bit of hand over. NO, NO NO. It is not like this. These nurses do 12 hours - plus 30 minutes of hand over. Yes, 12 hours. 8 in the morning until 8 at night. And then others through the night.


IT MAKES ME CROSS

It makes me cross. Quite cross. No actually very , very cross. Idiot pen pushers in Government and the Civil Service who are just parasites, the leeches of society doing nothing, want to reduce their wages. And these nurses do 12 hours 30 minutes a  day. Instead of Tony Blair sending young Euan off to be an intern in the White House why not send him to work in a hospital on 12 hour shifts to understand about real life. And what about all these MP's with their silly long holidays? Go and do work experience at the coal face and see what it's like. 12 hours 30 minutes. No one in authority does that - except the Queen and Royal family.  But there they were - Carol and Gloria, Grace and Ruth, Joyce and Jan, Lyndsey and Doreen - all of them. Working 12 hours and 30 minutes each day, ever smiling, ever helpful and patient.

During my trips to Hinchingbrooke I had treatment or attention from over 40 people I can name. Receptionists, appointment booking, Consultant radiologist, radiographers, surgeon, 3 registrars, 2 Macmillan nurses, 4 assistants in the cancer care unit, physio, pharmacists, X ray people, pathology for blood tests, 3 anaesthetists and 14 nurses, plus 3 catering people and the zoom, zoom guys with the trolleys. And the people in the operating theatre who, for obvious reasons I didn't meet! Added to that the Women's Royal Voluntary Service (which unlike the R and A is not sexist and now includes men) bring in newspapers and provide teas and coffees in the Cancer Care centre. So, 40 I can name and another 20 I can't.  And Ed the gorgeous filmstar (the warm up act) and David the trainee doctor ..... And no one sitting on their hands, busy bustling people there to save our lives - in this case, MY LIFE,

And it is all free. With cancer treatment, private insurance isn't much use. It doesn't accelerate your care or give you better care - it couldn't be better. And it is all free. When I was in for my kidney stones and asked if I owed anything for my accommodation in hospital, they laughed hysterically. Who is this lunatic?

When you go to a museum and see some artefact you don't appreciate or to an art gallery to see pictures you don't understand it is free. But a discreet little box asks for a contribution if you have enjoyed the experience. Actually art and culture are probably wasted on me, but you stick in a couple of quid, a crumpled note or the twopence you found on the pavement - or nothing, with sleight of hand to disguise your meanness.

But with hospitals there is nothing. Not anything easy. No little box to shove in 50 pence or 50. It requires effort to contribute - a letter, a cheque, correspondence. Who to?

And no one asks for your views, your positive comments. You can say over and over again, "THANK YOU". But you can't tip nurses like you do an even less than adequate waiter. There is only the grumblers' charter feedback form. Let us pass on your concerns. I did get a feedback form about the food. They obviously thought I looked the sort of appreciative gannet to make positive feedback about my food. 1 to 10 on quality, temperature, choice, cleanliness of cutlery, cleanliness of tray, staff. Oh and their daily allowance is about 2.05 per patient per day. Any other comments? Yes 10 out of 10 for everything. You picked the right person here for your survey. Delia Smith I am not. And my cookery bibles from Prue Leith and co are just on the kitchen shelf with the hope that culinary skills sink in by a process of osmosis. Any comments. Yes, the food is a lot better than anything I could cook myself.

But anything about my care. Any way of recording my thanks and appreciation. Not really. By the time I got round to writing to Carol and the wonderful team of nurses I doubt she would remember. (The one with sticky up hair and an irritating wit, humour and repartee.) But then it doesn't matter who thanks them. It just matters that we do.


THANK YOU

Anyway - home. Edward and Sophie had been purrfect pussies - just the one mouse and a shrew - and no gruesome body parts.

People have been so kind, so incredibly kind. I have had cards from over 100 people, from golf clubs all round the country, from golfing friends, from people I hardly know, flowers from two county associations (plus Surrey of course) just so much incredible support and kindness. Flowers from the LGU - oh, I don't know. And then the senior gang of England players were mostly away at the Portuguese seniors. Text messages, pictures. Wonderful - and a card that made me cry. Best wishes from the Irish, the English, the Swedes, Danes, French, Spaniard .....

Breast cancer can hit any of us. It is a frightening, hidden disease that can just creep up inside you without your knowing.

I have been a supporter of the Macmillan Fund for several years - with my clinics and golf days at Cambridge Meridian. Having met Lorraine, the Macmillan nurse assigned to my care at Hinchingbrooke, I am an even greater fan (obviously).

If this silly little article persuades you to go for routine screening then that's great. I was lucky and had it diagnosed early. As the doctor in charge of onward care told me, if I had waited a few more months I could have been looking at 6 months of chemotherapy instead of the month or so of radiotherapy I face - now at the Marsden Hospital in Sutton.

But if you a lady captain at a golf club, looking for a charity to support next year, please choose Breast Cancer Care or Cancer Backup or Macmillan. The world of women's golf has been so very kind and supportive to me as it is to any woman with this illness. If you choose Breast Cancer Care or CancerBACUP and would like me to come and do a golf clinic - a demonstration of shots, putting and other skills - do contact me and, God willing, I'll be there to raise some money. I have put in links to their websites.

There is just one positive thing to my treatment. The drug tamoxifen (which I look like being on for 5 years) has a particular side effect. It can affect your singing voice. It doesn't say adversely. I am hoping (as are my friends) that it will change mine. My cooking is awful. But my singing so bad that  people would pay me not to carol sing at their doors. Please will the tamoxifen give me a singing voice like Kiri Te Kanawa. Please.

The support from so many people has been a real tonic. And you have to laugh. My German (used to be a German) friend from Abbotsley, Valli Sims, gave me a real chuckle when she came to celebrate my return from the wonders of Hinchingbrooke - armed with two lovely cream cakes. Only a German could bring cakes like this and not realise the funny side.

Thanks everyone.

 

   Click the picture to see Annika, Viv's Cardigan corgi!