A Good Sleep

Fast forwarding to 2008 when my children were aged 4, 9, 10 and 13. I was back at work and their needs were constantly changing as they were fast growing up (too fast). The pain of sore breasts and sleepless nights long forgotten but I sometimes found myself mourning the loss of the babies they once were. Some people can’t wait to get the ‘baby’ bit out of the way. Not me, it was worth every second of lost sleep. I don’t however miss either potty training or toddler tantrums! Oh wait…..I think these morphed into very bad aims (boys and toilets) and teenage attitude in spades. It’s a close contest actually….

I’ll be completely honest, I can’t remember the details very clearly but I was getting undressed one day and noticed a blood stain in my bra. I wasn’t overly alarmed at first. I just thought I must have accidentally scratched my nipple. I couldn’t see any further evidence of that scenario but dismissed it at that point. However, it happened again and this time, on the opposite side of where my nipple would be in the bra but from the same breast (right side this time) there was also a sign of some kind of discharge. At this point I was beginning to feel a bit uneasy and did what people always tell you not to do….I googled it! There’s so much danger in self diagnosing. You either decide it’s not worth investigating or you convince yourself you’re dying. I’m usually the former but on this occasion and, with my mum’s history, decided to make a doctor’s appointment.

I was seen by a very nice female GP who I’d never met before. I don’t think she was unduly concerned but empathised about my fears around family history and referred me to the hospital.

At the hospital I had my very first mammogram. At 40 I was not yet eligible for regular screening. If you have not yet had a mammogram, I feel compelled to tell you all that it is not a horrendous experience which is something I had been told on more than one occasion. Why do people feel the need to do that? It’s such an important examination to have and even if it was particularly unpleasant (it’s not), it’s neither helpful nor necessary to share negative narratives about something you know could (and does) save women’s lives. It’s surely better to not comment and keep your horror stories to yourselves. Rant over…..

The mammogram was the first part of the investigation and as it turned out, the only screening I needed that day. In some cases it is necessary to follow this with an ultrasound but they needed no further information.

The breast consultant was lovely. She took her time to talk me through the findings. Normally they would just remove the affected milk duct but because there was more than one affected area she felt it would be sensible to remove all of the milk ducts from my right breast. She proceeded to recommend an operation called a total duct excision to find out the cause of the nipple discharge. This involves removing the end of all the milk ducts. The tissue that is removed during the operation is examined under a microscope. Fortunately my breast feeding days were well and truly over so I had no qualms about taking this advice.

In the majority of cases the cause is non-cancerous and is due to widening of the milk ducts (duct ectasia) which can occur with age, or a wart-like growth in the milk duct (intraduct papilloma). In around 14 in 100 cases, early cancer cells may be found. In this situation, it is likely further treatment would be recommended.

I was a day surgery patient and arrived bright and early. I have a few prominent memories of that day. The first was when I was taken into a room to be given an explanation of the procedure before signing consent forms. The first thing I remember was being told the risks of any surgery, of which there were many, but these were apparently uncommon – phew! I was then informed of the risks of my specific procedure – there may be a total collapse of the structure of my breast after the removal of the ducts, of which there are 12 to 15. It gets worse though – partial or complete loss of sensation in the nipple or, worst case scenario, due to a lack of blood supply to the nipple “ it may turn black and die”! Gulp! It’s just as well this information was imparted to me at a very late stage!

If that was an “oh my god!” moment, the next was a total “ground please swallow me up” one! Anyone who knows me well tends to associate me with the prolific wearing of flip flops. The beach is my second home in the Spring and Summer months and I have a considerable collection of suitable beach footwear. However, I do not restrict the wearing of said flip flops to beach trips. I basically live in them! More recently I have made the move to sliders but the toe-post style flip flops have previously been my preferred choice. So, when the list of items to bring to hospital said ‘slippers’ I thought nothing of packing my beloved flip flops as they basically double up as slippers when I’m at home. Having not had an operation for 20 years I had not anticipated the wearing of surgical stockings to prevent Deep Vein Thrombosis during and after surgery. Imagine my embarrassment when I tried to put my flip flops on over those attractive stockings. I’m sure no further description is needed of that particular challenge!

I also quite clearly remember being prepared for theatre. The anaesthetist was very jovial and asked me what my tipple was so he could add some to his concoction of drugs! I think I said Bacardi and coke because it seemed so lame to say tea! In those days you were still asked to count backwards from ten. I may have been too drunk….!

With a limited history of surgery and certainly nothing recent I had no idea how I would react to a general anaesthetic so it was a complete surprise to me that I in fact didn’t have a good reaction. I was first on the surgery list that day and the last to be discharged. At 8.30 pm (approximately 11 hours after surgery) they were still debating whether I should be allowed to go home. Not only was I unbelievably drowsy for literally hours, every time I tried to sit up the wave of nausea that came over me was like being on a ship in the eye of a storm. I’ve never been a ‘sicky’ person and can count on two hands (one would be unrealistic) the number of times I’ve actually vomited. So this intense nausea was quite incongruous with me.

My mum told me later that she had called the ward several times to check on me through the day and one of the nurses had said “this often happens with mothers of several children, they probably just need a good sleep!” Exhaustion is one thing but I am almost phobic about throwing up. I seem to recall them plying me with numerous anti-sickness drugs throughout the afternoon and maybe they eventually kicked in because it was finally agreed to discharge me. It was last chance saloon! To qualify to go home I had to eat, drink and do a wee without being sick, fainting or falling over. Thankfully I managed all three and was given my freedom!

The operation required me to have a ‘drain’ inserted. It is a device which helps to speed up your recovery, fight infection and to reduce post-surgery pain by collecting (draining) fluids away and out of the body. It feels quite strange but not painful. You have to make sure it doesn’t dangle freely. That’s probably the worst part, protecting it from getting pulled away accidentally. I only had mine for a couple of days then it was removed without incident by a nurse.

As for my wound, on this occasion the access was through my nipple. It’s all very clever. The scar is barely visible because it merely follows the line of the areola. There was a small darker red area for a while but it followed the curve of my nipple. Nowadays you’d have to look very hard to find it. So much care is taken to ensure that the end result is aesthetically pleasing and as unspoiled as possible. There is always something to be grateful for.

Again, on this occasion, I ultimately had confirmation that the areas of concern were benign. Another ‘high five’ moment…..