Lisahammond

A Day at the Beach Restores the Soul

What is it that draws me to the beach? There are physical things such as the beautiful views and the rolling waves of the sea or gentle ripples lapping at the shore but it’s so much more than that for me.

“The sea, once it casts its spell, holds one in its net of wonder forever” – Jacques Cousteau.

There is nothing grandiose about our seafront in Bexhill but it is classy in its simplicity. A mixture of modern, Edwardian and Victorian architecture with fascinating history and nostalgia. The promenade itself has many landmarks, the most famous and notable being the De La Warr Pavilion which is claimed to be the first major Modernist public building in Britain due to its concrete and steel construction. The building has grade I listed status and these days attracts a lot of interest to art and music enthusiasts.

Directly behind the De La Warr Pavilion is the King George V Colonnade which was built in 1911 to commemorate the coronation of King George V and designed to offer a sheltered venue for beachside concerts and amusements. The colonnade is a discernible part of Bexhill’s seafront and looks particularly stunning at both sunset and sunrise. You can stand at the top within the turret sections and admire the glorious views. I never tire of seeing the iconic classical domes standing tall and proud creating a significant landmark of the skyline.

On the West Promenade stands the Bexhill Clock Tower which was built to mark the coronation of King Edward VII. Rather less historic but nevertheless renowned is the Sovereign Light Cafe, made famous by the band ‘Keane’ in their 2012 single, inspired by their childhood growing up in the local area. The cafe has uninterrupted views out to sea to the Royal Sovereign Lighthouse, a decommissioned lighthouse marking the Royal Sovereign shoal, a sandbank 6.8 miles offshore from Eastbourne. On clear days it is possible to see the lighthouse with the naked eye.

There is also quite a bit of shipping activity on the horizon visible from Bexhill beach, ranging from container ships to cruise liners so it’s good to have a pair of binoculars to hand if you’re intrigued by what you can see sailing past in the distance!

Apart from a handful of what I call ‘moaners’ and ‘killjoys’ (mostly venting online) there is a very spirited community in Bexhill! Bexhill residents love an ‘event’ and they are plentiful. Many take place on the Dela Warr lawns, such as big screens for significant sporting events and royal occasions. There is an annual Festival of the Sea where you can sample and buy seafood and there are angling competitions and a mermaid pageant! There has also been a 60s Revolution, a medieval pageant and vintage fayres.

Live music can be heard regularly, ranging from folk bands, well known artists as well as locally-renowned bands and solo performers in various locations along the seafront. The Dela Warr Pavilion is the most notable venue, hosting ‘beach-side’ festivals such as the annual ‘Bexfest’ and Jo Whiley’s 90s Anthems. If you’re not worried about being in the thick of it all, you can just listen from outside the venue on the nearby beach or lawns.

April 2023 saw the opening of the newly restored bandstand on the east parade. Originally built as a bandstand in 1895 it was converted into a seaside shelter in 1906. In 2021 Rother District Council approved plans to lease the grade II listed shelter to Bexhill Heritage who assisted in the restoration work and in the long term plans to bring the shelter back to its original use as a bandstand. The restoration aimed to use the same design and colour scheme as when the building was originally built in 1895 and is now officially known as ‘Bexhill Coronation Bandstand’. There is now regular live music from the bandstand and at other times the public can just enjoy sitting inside with a cuppa!

Aside from the runners and cyclists, the seafront seems to be a popular place to exercise, whether it’s a group doing yoga on the beach or a boot camp on the lawns. The one I love to see though is the silent disco group! They are usually quite a big group, predominantly ladies, who basically just dance around freely to the music in their headphones and seem to be living their best life! It’s a joy to witness!

Forget dancing like no one is watching. Dance like a toddler. They don’t even care if there’s music!

With its relatively unspoilt seafront, it is easy to imagine the past. Despite the loss of a few old buildings there is still an abundance of beautiful architecture, particularly on the east side of the seafront. One of the residential properties, situated in a row of Grade II listed Queen Anne style terraced houses on De La Warr Parade, has been used for filming locations on more than one occasion, most notably for the Kiera Knightly and Carey Mulligan film ‘Never Let Me Go’. More recently scenes were also filmed at a beach hut on the same stretch of the seafront and also inside the De La Warr Pavilion for the 2018 mini series of Agatha Christie’s ‘The ABC Murders’ starring John Malkovich as Hercule Poirot.

In complete contrast, at the opposite end of the seafront on West Parade are six blocks of 29 seafront apartments all named after West Indian Islands – St Lucia, St Thomas, St Kitts, Grenada, Tobago and Monserrat. They were built between 1970 and 1980. A photo of two of the blocks of flats was used for the album cover of Keane’s 2012 album ‘Strangelands’ as mentioned previously.

On occasion you might see members of the Bexhill Classic Bicycle Group riding along the promenade. They are a historical activity group for Classic, Veteran and Vintage cycle owners. Occasionally they also wear vintage clothing for events ‘in the spirit of Edwardian nostalgia’. So it’s not too unusual to spot a rider on a ‘Penny Farthing’ weaving his way through the walkers in his top hat and tails!

“When the spirits are low, when the day appears dark, when work becomes monotonous, when hope hardly seems worth having, just mount a bicycle and go out for a spin down the road, without thought on anything but the ride you are taking” – Sir Arthur Conan Doyle.

Both sailing and rowing are high on the agenda of sea activities in Bexhill. Many join the Rowing Club, in particular, at a relatively young age and train for regattas. Rowing crews in training are a regular sight and when the sailing yachts are out to sea ‘en masse’ it is truly picturesque.

There has been an ongoing debate about the meaning of ‘Bexhill’. In modern times the ‘Bex’ was said to mean ‘windy’ but originally was known as ‘happy’. The second part ‘hill’ not being a physical reference but actually meaning ‘great’. So the original meaning of the name was ‘happiness’! Who knew eh? Anyway, my reason for mentioning this is that Bexhill is indeed a very windy place! It is rare to have no breeze at all but it is a comfort to have when it is a scorcher of a day! This makes it very popular with wind-related water sports. Windsurfers and kite surfers spend hours perfecting their skills and I personally could ‘waste’ hours watching them. The speeds they get up to are really impressive and they are seemingly fearless of the conditions on exceptionally gusty days. Traditional kites are also popular on the beach, controlled by both adults and children alike!

Nowadays paddle boarding and kayaking seem to be very popular leisure activities and the fact that there are inflatable versions of these available which can be folded up to the size of a rucksack makes them far more practical for people to transport. On a calm day when the sea resembles a millpond there will be a lot of people out on their boards. Sometimes you might catch a couple of jet skiers racing along the coast or you might spot a luxurious motor yacht. I also recently saw a lifeboat heading east and it’s the only time I’ve ever actually seen one in action from a Bexhill beach.

“Sorry I couldn’t make it, I had a board meeting…..”

Like any seaside resort, fishing is enjoyed on the beaches. When the tide is out you might see fishermen with buckets collecting lugworms for bait from the sand. During a high tide anglers will position themselves close to the shoreline, sometimes pitching a small tent. With Hastings just a few miles east of Bexhill, fishing trawlers can be regularly spotted. A major industry in Hastings, the fishing fleet remains Europe’s largest beach-launched fishing fleet.

“Fishing is much more than fish. It is the great occasion when we may return to the fine simplicity of our forefathers. ” ― Herbert Hoover (former US president).

From the sea to the sky – not only is Bexhill on the flight path to Gatwick, there is a lot of activity in the skies over the town. Helicopters are the most frequent flyers – Air Sea Rescue, Police and Air Ambulances are commonplace. During the summer months you can often spot military planes making their way to or from air displays. The Red Arrows usually fly over to Eastbourne in August for their annual display at ‘Airbourne’. Small leisure planes fly over regularly and there is one man who likes to show off his hand gliding skills to beachgoers by gliding close to the shoreline.

The majority of the beaches along the East Sussex coastline are pebble and shingle beaches. However, at low tide there are long stretches of sand and little water channels so perfect for little ones (or maybe bigger ones!) to build their sandcastles. As a child I can remember running all the way across the pebbles to get into to the sea but you wouldn’t catch me doing that nowadays! The children do seem to be quite immune to the discomfort though. I guess it’s a weight thing, lightweight little children barely feeling the ground beneath them! There are advantages to a pebbly beach though, no sand in your eyes, hair, sandwiches….! If you’ve ever bitten into food that contains gritty bits of sand you’ll know it’s not pleasant!

Low tides also present rock pools which can be a lot of fun! When our children and their friends were small they used to take their fishing nets down to the best ones and come back with tons of shrimps! Once or twice we cooked them in a frying pan or on a barbecue and they ate them! With an inherent level of salt they didn’t need any extra flavouring! Such a small thing but it always gave them a great deal of pleasure and excitement. Crabs are also plentiful, dead or alive, and children are thrilled (or sometimes petrified!) when they discover them. A couple of years ago my eldest son found one that was the size of his torso! Definitely the largest one we have ever encountered.

“Salt Is Born Of The Purest Parents: The Sun And The Sea” – Pythagoras (Greek Mathematician and Philosopher).

Cold water swimming has been a regular activity for some for many years but its popularity has revved up considerably in the last few years. Bexhill is no exception and the New Years Day dip in the sea for those who are brave enough to dare (or maybe just a bit crazy….) has attracted curious onlookers for years. Nowadays there are a lot of groups, formal and informal, of varying ages, who practice this invigorating (according to the participants) past-time on a regular basis. I have a few friends who have been bitten by the bug and who are all passionate about the physical and mental health benefits – increased metabolism, better circulation, reduction of stress and enhanced mood, better sleep and boosted immune system. The closest I’ve got to this was having cold showers in the morning after watching ‘Freeze the Fear with Wim Hof’! Maybe one day…..

You’re only one swim away from a good mood.

Sounds and smells are another great delight of beach life, mainly when it involves food! Seemingly everything smells and tastes better in the open air – ice cream, fish and chips, barbecues, bacon sizzling on a camping stove. Even a cup of tea with a slice of cake at the beach is divine! Add to that the delightful sounds of people enjoying themselves in the sunshine, children laughing and squealing, the rhythmic rolling of the waves mixed with the calm air of peace and tranquility, what’s not to love?

“Smell is the sense of memory and desire” – Jean-Jaques Rousseau (Philosopher, writer and composer).

Now, seagulls….they are both loved and hated! I can’t lie, I am a fan! Yes they are scavengers and food thieves but they are essentially hunters and survivors. Most gulls are ground-nesting carnivores which take live food or scavenge opportunistically. This is known as Kleptoparasitism. If you feed them, they will hang around. Why wouldn’t they? Live food often includes crustaceans, molluscs, fish and small birds. I love to watch them dropping shells of clams and mussels onto hard surfaces, one of their methods of obtaining prey. Seagulls are very intelligent birds and demonstrate this with some of their cunning behaviours, such as stamping their feet in a group to imitate rainfall and trick earthworms to come to the surface. I do regular seafront walks with friends and often in the mornings seagulls will be ‘sitting’ together on the pebbles in large groups on the beach. Apparently big wide open spaces allow the seagulls to group up out in the open in such a way that gives them a line of sight on both potential food sources and potential predators.

Seagulls can actually help the environment as they also eat insects. The fact that they consume insects keeps the insect population in check making them a natural pest control for farmers and gardeners.

However, I actually love their company and am generally unbothered by them. They are fascinating to watch, especially when they have their fledglings with them who follow them round begging for attention! They have a lot of character and are both tame and brazen but they have been around for over 30 millions years. They are an integral part of beach life and it was their home long before humans discovered the recreational benefits of the salty sea air and stunning views.

Today I will be happier than a seagull with a stolen chip!

I may or may not have convinced anyone to change their minds that these birds are not just ‘pests’ or ‘vermin’ but I will leave you with this thought…..

“The seagull is a symbol of healing, wisdom and tranquility. The belief that the seagull is a messenger from the creator has been traced back to Ancient Greece. In Native American symbolism, the seagull represents peace and prosperity, as well as emotional balance and strength in numbers.” – learnbirdwatching.com

The other species of bird seen frequently on our beaches are turnstones. Turnstones are wading birds that flit around rocky shores and gravelly beaches. The cutest sight is when they form a group and waddle across the promenade from the beach, sometimes stopping the pedestrian traffic!

Occasionally you get to see some less likely and random birds either flying over or just bobbing about in the sea. There is a park just one street away from the beach that has a small lake. I’ve seen ducks floating about and once I even spotted a swan on the sea! You might also see flying geese or a heron sitting proudly on the pole that marks the sewage pipe.

I am continually intrigued by the abundance of beautiful, perfectly intact shells on Bexhill beach. The most frequent finds are the Baltic tellin (small saltwater clam), common and slipper limpet, common cockle, winkle, oyster, mussel and whelk shells. I have quite a collection in my beach hut as children often collect them and gift them to me!

One last thing which is personal to me about the beach is that almost every time I am at my beach hut I am visited by a bumble bee. To my knowledge, bumble bees are generally not a frequent sight on our beaches. Being my ‘happy place’ I am most at peace when spending time there. My mum was allocated the hut space a few years after she passed away and we were very surprised when my dad was contacted about one becoming available. We like to think that the bumble bee is a sign from my mum! It often rests on us – arms, legs, hands – then flies off again. They are such beautiful creatures and very tame if you don’t overreact to them. Whatever the reality, it brings us all, but especially me, great comfort. Even our friends and family sometimes exclaim “Here comes Sally!” if we get a visit while they are there! I love to think my beloved mum is watching over us…..

Angels don’t have to speak to be heard, be visible to be seen or be present to be felt. Believe in Angels and they will always be near.

The past is your lesson. The present is your gift. The future is your motivation.

My journey began to slow down to a much more manageable pace. My appointment with the oncologist in August 2022 was really positive and now it was a case of taking the medication, annual mammograms and lots of self care.

My prescribed drug Tamoxifen (endocrine therapy) had an instant effect on me and I am still trying to adjust to the side effects. Acupuncture helped with the hot flushes but I still get them. They are less frequent though and I’m just a few degrees hotter in general. Occasionally I feel a bit awkward that I’ve got a glistening forehead or my hair is damp from sweating and I feel like I could be contributing to global warming but I manage ok! Three months after receiving the Sara Lee Trust complementary therapy, MacMillan can re-refer for some additional sessions. I will definitely consider either more acupuncture or maybe some reflexology.

Dear Mother Nature, please check the thermostat, someone has set it to HELL!

These days I am ‘infamous’ for my fan collection! I have a traditional fan in my handbag at all times when I go out. I own a few! I also have a portable handheld fan which is rechargeable through a USB port and a neck fan which looks like a pair of headphones! The reason behind that purchase is that I can use it hands-free when I’m working or crafting! The only problem is it’s very loud and I can’t hear much when I’m wearing it so it has its limitations! Finally, my husband fitted fan lights in all our bedrooms with remote control. They are an absolute game changer! Not only are they brilliant for keeping cool, they also help with my Tinnitus by overriding the sounds in my head. I’m not sure ‘Queen of Fans’ has the best kudos but I fear I’m in danger of being a contender!

I’m still hot…it’s just now it comes in flashes!

I was invited to my first annual mammogram at the Conquest Hospital on 15th December 2022. Only my right side needed to be screened and it was all very straightforward and efficient. I was told it might take a few weeks to hear back. Despite the opposite happening earlier on in my diagnosis I decided to take the view that the longer it took them to get back to me, the more likely it wouldn’t be bad news. That might have been what I told myself but the reality was it was another agonising wait for the reassurance.

My Macmillan nurse contacted me between Christmas and New Year to check that I’d had a response regarding my medication queries and she asked me how things were generally. I asked if she knew how long I would have to wait for my mammogram results and she kindly said she would check on her system to see if there was anything there. She was able to tell me straightaway that there were no concerns. Although she said I might not get this confirmed in writing for a couple more weeks, it was a huge weight off my shoulders. That night we had a big family Christmas get together planned so it was perfect timing and a great opportunity to celebrate. My husband often receives lavish gifts from clients and we had a bit of a champagne collection, including the likes of Harrods, Fortnum & Mason, Piper Heidsieck etc. What better excuse than to treat us all to the finest bubbles?

“Champagne! In victory one deserves it, in defeat one needs it.” – Napoleon Bonaparte

I had gone back to work in November 2022 on a phased return. Initially I thought I’d be ready before then but as I got nearer to the earlier planned date in October I just didn’t feel ready, both physically and emotionally, so it was agreed that I would start back after the half term. It made sense to start at the beginning of a new term anyway. I started at three hours a day with a gradual increase. The first morning was ok and I felt fine all day until about 8.30 pm when I suddenly started to feel really unwell. I wasn’t sure if it was something I’d eaten as it came over me so suddenly. I was up most of the night vomiting and felt completely wiped out the next morning. I now think it was more likely a sickness bug. Although I wasn’t sick any more that day I felt very weak and tired from the lack of sleep but I decided to do some work on my laptop from my bed! I was fine by the third day so in the end I did complete my first week of agreed hours. The following week was absolutely fine although I developed a bit of a tickly cough towards the end of the week. We had a face-to-face team meeting at the office where I met three new colleagues for the first time and it felt good to be back in the team. However, I spent a lot of the meeting trying to suppress the cough and drinking loads of water! By the next week I had full-blown flu. I ached from my head to my toes and ended up spending the best part of three days in bed. I did daily lateral flow tests but not even the faintest line came up so I could only accept that I hadn’t caught Covid for a second time. Ironically I was booked in to have my flu jab and fourth Covid booster that week. I also had to cancel my appointment with my plastic surgeon on the Friday. Unfortunately it was then delayed until February 2023 which was disappointing as I was at the point by then where I wanted to properly move on and put the whole awful experience in the past. I now know of course that, sadly, coming to the end of all the physical procedures does not tie everything up nicely and take away all the fears and anxiety. Nevertheless I will be glad when it’s been done. As much as I’m not overly concerned about that final stage of reconstruction, not having a nipple on one breast is a constant reminder of what I’ve been through and maybe it will be another step towards feeling more ‘normal’ again.

As I’ve mentioned, I was fortunate to receive some acupuncture to help ease my hot flushes. At the initial appointment the therapist took my details and she also informed me about the range of complementary therapies and activities on offer to cancer patients. She put my name forward for a charity called ‘Look Good Feel Better’ who offer confidence-boosting workshops. I went along with a friend of a friend who had also signed up for the same session. We were both a bit apprehensive but it was a very small friendly group and it was nice to be able to talk openly to others who were going through or had been through breast cancer. Apart from when I was a teenager I’ve never been massively into cosmetics and I wear minimal make-up even when I go out so it was an unusual activity for me to take part in. There were two lovely ladies running the session and they gave out goodie bags. We each received a large make-up bag full of treasure! They all differed slightly but essentially had similar products from a variety of brands, for example, we all got a bottle of perfume. Mine was ‘A Scent’ by Issey Miyake. There was an eyeshadow palette, blusher, concealer, mascara, foundation, lip liner, eye liner, lipsticks, brow pencil, moisturiser, toner, cleansing lotion, brushes and a ‘Chapstick’! The brands were amazing – Clinique, Lancôme, Estée Lauder, Morphe, Benefit, Tropic, Maybelline, No7 and Max Factor! What a treat! The ladies running the workshop took us through a basic make-up demonstration using a selection of the products in our collection. We were told that the charity has a huge storage space where they hold masses of contributions donated by cosmetic companies for all of their workshops. It’s such a great idea to help women get back some confidence after the trauma of their treatments and the visible side effects such as hair loss, weight gain/loss and surgeries.

When you feel good, you open the door for positive energy to reach you.

The other good thing about the evening was that I gained more information from the other ladies about other charities and support groups. For example, there is a charity called WOLO Foundation (We Only Live Once) which helps families affected by cancer in Sussex. They provide a range of services including therapy, legal services, childcare, cleaning, family treats, family photo shoots as well as purchasing resources/equipment from dehumidifiers, medical equipment and bedding to art and crafts materials, toys and mindfulness activities. This is a particularly good charity if you have children as they organise days out and events such as trips to the pantomime, woodland activities and sporting challenges for all ages. The list is seemingly endless and they have provided such amazing support to so many people.

A couple of the ladies had also joined the ‘1066 Pink Ladies’, a local support group who meet up once a month. I had heard about this while I was going through my treatment but I didn’t feel ready to listen to other people’s stories as I feared it might make me more anxious. I remember my GP advising me to be cautious of this as he said everybody’s experience of cancer is different to another’s and “your cancer is your cancer”. This was really helpful to me. I just felt that it would be better for me personally if I waited until I was through my treatment before hearing about anyone else’s. By the time I attended the workshop I was coming to the point where I felt I might like to join a group. However, it does pose a bit of a dilemma in that a group such as this one can provide reassurance and support but, at the same time, is another reminder of the cancer and potentially might inhibit my mental recovery. Anyhow, one of the ladies said she would pass on my name to one of the organisers and put forward my request to join the Facebook group which has to be agreed by them. I later received a phone call and had a nice chat with one of them. I told the lady about my many years of holding cake sales for MacMillan Cancer Care and she knew about and had previously attended our events! Following that, I was introduced via a post on the Facebook page and received lots of lovely welcoming comments. I still haven’t attended any meetings or events because so far they have clashed with other arrangements but I might go along and check it out for myself one day…

Coincidentally since I wrote the above I have asked a question on the 1066 Pink Ladies Facebook page. I had been getting mild cramp, mostly in my feet, for a few months but it has revved up lately and a couple of times I’ve had agonising pain in my calves. The worst time was in bed one morning when I literally cried out from a sudden and very powerful spasm and my husband advised me to stretch my leg and pull my foot up towards my shin. It actually made me panic a bit. I also struggled in my Zumba class that week when we were doing squats on the balls of our feet. Sometimes I can feel the tightness in advance and try to keep as relaxed as possible to avoid triggering a spasm. Other times there’s no warning and it happens suddenly.

The responses I received from the Pink Ladies community were helpful but sadly not very reassuring in terms of the longevity of the side effects. The practical advice was to always drink plenty of water and some suggested specifically tonic water and magnesium. I’m guessing the tonic water is because of the quinine content. I have done a bit of research on quinine and Tamoxifen and it seems that it would be safe if consumed in moderation. However, I can’t stand carbonated water of any kind as it makes me feel very sick so it’s not really an issue! I’ve been taking magnesium supplements for years now but I might increase the dosage to see if it helps to alleviate some of the leg pain.

These are a few snippets from the comments I got…

“I was on tamoxifen for 5yrs and never found a cure for the night cramps either. Just keep hydrated is all I can suggest”

“For the whole 7 yrs I was on tamoxifen I had awful cramp. Then went on to Letrozole for a further 7yrs and still had cramp. Just think it’s a side effect “

“…..I suffered from this too. I’m no longer on it and I haven’t had any nighttime cramps at all. Take some tonic water and try to stay well hydrated.”

“Omg! I didn’t tie the two up , but I thought my lower leg was going to fall off about a week ago & the residual pain is still there . I didn’t know that tamoxifen was the likely cause….”

If you’ve read my previous blogs you will know that I had to stop taking zinc supplements due to zinc being deemed an inhibitor of Tamoxifen. Consequently my finger nails deteriorated, splitting and flaking, to the point where it looked like I had bitten them down to the quick. After a lot of unsuccessful searching for nail remedies that do not contain any zinc I decided to give the age-old remedy of jelly cubes a go! I have been eating two cubes every day and after a couple of weeks I now have respectable nails again. I wasn’t sure what the science behind this was so I decided to look it up! It seems to be mainly due to the ingredient pork gelatine which is a high protein product. Protein consists of various amino acids, and gelatin contains several of these.

I also discovered a number of other possible benefits to gelatin. However, more research is needed to confirm whether consuming gelatin can specifically improve some of these suggested health benefits.

“Eating gelatin may help boost collagen levels and support skin elasticity. Gelatin contains glutamic acid, which the body can form into glutamine. This substance may help promote a healthy mucosal lining in the stomach and aid digestion.

Gelatin contains lysine which plays a role in muscle and bone health. It helps the body absorb calcium which helps keep the bones strong and prevents bone loss.

Gelatin contains high levels of the amino acid glycine. Some studies suggest that glycine may improve sleep quality and other neurological functions.

Collagen is a protein that helps form bones, muscles, and skin, and it is crucial to overall health. Companies process animal-derived collagen to make gelatin. Gelatin and collagen contain similar proteins, and laboratory tests suggest that consuming gelatin as part of a varied diet may provide comparable benefits to consuming collagen.”

(Ref: medicalnewstoday.com)

According to one older study gelatin may also promote hair health.

Interestingly I’ve had a lot of comments lately about how nice my hair looks and I don’t know if it has benefitted from the gelatin or if it’s because I’ve been in the sun a lot and it has turned much lighter. My hair is usually very healthy anyway but I do go through periods where it feels a bit dull so who knows….?

Whatever the reason I’m going to continue until hopefully I have nails I can undo screws with!

It’s been a few months of adjustment and awareness with ups and downs. My sleep quality varies but I am now drinking decaffeinated tea and coffee and I think this has helped. I seem to be getting off to sleep quicker for the most part but now I seem to be waking up in the early hours. Not always, just some mornings.

The mental struggle varies and I’ve had a couple of meltdowns but I think sleep deprivation makes it hard to manage your mental health, not to mention the roller coaster of hormones so I’m trying to learn to be kind to myself and to share how I’m feeling a bit more instead of internalising everything and saying I’m fine.

I’m only too aware that I’ve ‘dodged a bullet’ and I’m trying very hard to stay positive and gently get my mojo back, living life to the full as I did before life threw a huge curveball at me.

“When you arise in the morning, think of what a precious privilege it is to be alive – to breathe, to think, to enjoy, to love.” ― Marcus Aurelius (Roman Emperor 161-180).

Life is not about how fast you run or how high you climb, but how well you bounce.

Steps back to ‘normality’….easy right? I wish it was but as the saying goes ‘nothing worth having ever comes easy’ and I’ve had a lot of practice at dealing with challenges so I’m not going to give up after winning the biggest personal battle of my life so far.

I’ve talked in my previous blogs about the emotional aspect of my cancer journey. However, I had major surgery only a few months ago and it is also a long physical healing process. Once the initial convalescence period was over and I was mobile again, I began to experience the sensations of my body working to join the nerves, blood vessels and muscles back together. It varies from a small tingle to occasional sharp pain which stops me in my tracks. It is something I have to tolerate pretty much on a daily basis now. If I’ve had quite a physical day it can be a dull ache.

Having a DIEP flap reconstruction is often compared to a ‘Tummy Tuck’. DIEP flap breast reconstruction uses a patient’s lower abdominal tissue to recreate a warm, soft, natural breast following a mastectomy. In reality, the two procedures are very different in several important ways.

One of the main differences is that “DIEP flap surgery requires the expertise of highly trained microsurgeons. This is due to the extensive care and technique required to properly harvest the necessary blood vessels and sensory nerves needed to successfully transplant the abdominal tissue to the chest wall for breast reconstruction. Although seeking a highly trained and board-certified plastic surgeon is important for a Tummy Tuck procedure, no special care to harvest blood vessels or sensory nerves is necessary.

….Both procedures remove skin and fat from the lower abdomen and preserve the abdominal muscles. However, the DIEP flap is a more invasive procedure: the blood vessels (“perforators”) that keep the DIEP flap skin and fat alive travel just beneath or within the abdominal muscle. An incision is made in the abdominal muscle to access these blood vessels. The prepared tissue is then disconnected from the body and transplanted to the chest using microsurgery. The surgeons then shape the tissue to create the new breast. In contrast, the tissue removed during a Tummy Tuck is simply thrown away as medical waste.” – (Ref: PRMA -enhance.com)

Despite the first few weeks when even the slightest stretch was a feat and I was at the mercy of the limitations of my body, I was rather naive about the longer term! I always remained very positive about my recovery and genuinely thought that getting back to ‘normal’ at some point would be a breeze! I had exercised pretty much all my life, how hard could it be? I soon found out….

My initial rehabilitation was about gradually working towards doing routine household chores and getting out for walks. I was surprised that I could only manage short distances and walked a much slower pace. I don’t even mean compared to my old ‘power walks’, this was still less than a gentle amble! Obviously this has improved and I can do a ‘proper’ fitness walk now but power walking is on hold for the time being!

In terms of getting back on top of cleaning, ironing and anything that requires standing for long periods, this is still a work in progress. I break all of the chores up into smaller chunks now. It’s not just the stretching, sometimes it’s leaning against something to clean such as kitchen worktops and our very deep free standing bath. My husband was a legend with the ironing. He did it all for months. Luckily for me he finds it therapeutic! However, he is so busy with his business that I got to the point where I thought I should try doing a bit here and there, nothing too arduous or heavy. It was so much more strenuous than I anticipated though. I think quite a lot of factors came into play – leaning against the ironing board and lifting the iron while standing up. This would result in an upper abdominal pain, slightly different to the usual discomfort.

Be patient and don’t rush, you’ll arrive when you’re ready. The one who wins the race is often slow and steady.

I was supposed to have my follow-up appointment at the Queen Victoria Hospital in East Grinstead in November 2022 but unfortunately I had the flu so it had to be rescheduled to February 2023. It was the first time I had seen the plastic surgeon since she performed my operation in July 2022. She was very happy with the way everything looked and we discussed nipple reconstruction. Before my surgery I had thought a lot about having a novelty tattoo in place of my nipple but once I saw how amazing the reconstruction looked I thought much more about having the look of an actual nipple. This stage of reconstruction is usually done some time after the mastectomy to allow the reconstructed breast to settle into its final shape so the surgeon can position the nipple accurately and is usually around 6 to 12 months. Nipple reconstruction is usually done under a local anaesthetic and you can go home the same day.

“The surgeon will use some tissue, known as a ‘flap’ from the reconstructed breast and will stitch this together to form the projecting nipple. This will produce the nipple shape but the colour will be the same as the colour of the reconstructed breast.

The areola can be reconstructed using skin from a donor site; usually the upper inner thigh as the skin here is slightly darker and is a better colour match for your areola than the breast skin. This would leave you with a scar at the donor site, where the areola skin is taken. The scar will be a straight line about 5-6cm long and will fade with time.

Nipple areola tattooing on to the skin can be performed following a nipple reconstruction or on its own to produce a good appearance and colour match for the nipple areola complex. If you do not want a scar at the donor site tattooing alone can be performed to produce the areola colour.” – (Ref: cuh.nhs.uk)

I made my decision to have this procedure at the appointment and now I am on a list, waiting for an available slot. Apparently they are very busy and couldn’t give me any idea how long that wait will be. My surgeon did say she would like to do it herself and is hoping she can but wasn’t able to guarantee it. I am nervous about having it done while I’m conscious but I know the fear is almost certainly much worse than the reality.

As this was also a general check up I did ask my surgeon about some of the tummy pains I’d been experiencing as sometimes they are above my surgical site. I asked if it could be muscular and she agreed whole heartedly. Her response was “Well, we did have to cut through your muscles”. This made sense and put my mind at ease. I asked her whether I should avoid doing anything. She replied that I should do whatever I could manage and it wouldn’t do me any harm. That was what I was hoping to hear as I wasn’t looking for an excuse to give up on physical activities. At the same time, I didn’t want to do any unnecessary damage to myself.

Since then I have been gradually getting back into a bit of formal exercise but it has been a reality check. The first time I went back to doing a Pilates class on ‘Zoom’ I was perturbed by how hard I found it. I was restricted on how much I could stretch which is difficult as a lot of Pilates is about stretching. I have also lost a lot of flexibility in my left arm due to the lymph nodes biopsy. It feels very tight and tense. The worse thing for me though is how much weaker my muscles are. I’ve never been very flexible, despite many years of toning exercises, but I’ve always prided myself on how strong my core is and I’ve always found abdominal exercises well within my capability. However, I can no longer do a ‘roll up’ which entails pulling yourself up to a sitting position from a lying down position, using only your stomach muscles, either completely outstretched with your legs straight or with bent legs. I know it is early days in terms of my surgery but I’m not sure my muscles, having been cut through, will ever return to the same strength as I’d worked so hard to get them to over the years. There are a lot of Pilates exercises I am able to do though and I do as many of them as I can. I’ve only attended a few sessions since my operation and I’ve experienced quite a lot of abdominal pain in the days following the classes. I would expect to get the muscular pain but unfortunately I’ve also felt quite sore around my surgical site from stretching too far. It has made me realise that the healing process could take years before I am fully recovered and I will need to be very patient with myself (something I’m not very good at!).

“Not being able to do everything is no excuse for not doing everything you can” – Ashleigh Elwood Brilliant (English-born American author and cartoonist).

Recently a group of my girl friends decided to sign up to ‘Mum Dance’, a franchise offering a termly session of fitness classes involving dance routines to retro pop classics! Five of us have been attending these classes at the local college and we mostly laugh our way through them! The routines are very fast and involve a lot of rapid twisting and turning. Personally I think it’s all a bit too fast and frantic to do any of the moves well and I feel that the benefits may be outweighed by the risk of damage to our knees! The young instructor is lovely and encourages us to do what we can and improvise if necessary but sadly I think we laugh more than we achieve! The first week I came out wondering if I was Julia Walters or Victoria Wood as I most certainly wasn’t Jane Fonda or Arlene Phillips! The concept is great but the pace is too much for the amount of different moves. I’ve done years of high impact aerobics classes and they are more manageable because the moves are more simple and carried out for longer sections so it’s not such a problem if the music is fast. Don’t get me wrong, those types of classes are a killer but more because of the energy level than how complex the moves are. We thought we would improve after a couple of weeks but we’re all struggling and not finding it any easier. It was worth a shot but we’ve decided not to sign up for next term. We’re hoping to find something more suitable to our ability and fitness levels.

In addition to my post-op recovery I had not truly realised the extent of how much of an impact taking the Tamoxifen would have. My mum must have either breezed through it or more likely been her usual stoic self and simply got on with it. It’s not until now that I am experiencing the side-effects that I can appreciate the impact it has. I’ve now read online comments and questions from a lot of forums from women who have been taking the drug for some time and who can’t wait to get to the end of the five or ten year period, depending on their situation.

“Progress always involves risks. You can’t steal second base and keep your foot on first.” – Robert Quillen (American Journalist and Humorist).

The most serious side-effects are Thromboembolism (blood clot causing blocked vein or blocked artery) or a stroke. The risk of these occurring is just over double when taking Tamoxifen. However this also takes into account other factors, such as family history. Other less common effects are changes in the lining (endometrium) of your uterus. These changes may mean serious problems are starting, including cancer of the uterus. Liver problems and cataracts are also a risk. These risks are all much higher where there is a previous history or pre-existing condition so the important thing is to be vigilant about any signs relating to those specific dangers.

Any cancer treatment in women that lowers oestrogen levels can increase the risk of osteoporosis. Tamoxifen has been associated with reduced bone density in premenopausal women, although it is not known whether this may result in an increased risk of fracture. Premenopausal women taking tamoxifen should be advised regarding measures to maintain bone health.

“Guidance from a UK expert group recommends that women taking hormone therapy for breast cancer, who are at high risk of osteoporosis, should have bone density measured at:

• the start of treatment

• regular points throughout treatment

The test used is called a dual energy x-ray absorptiometry scan (DEXA scan) of bone mineral density (BMD).” – (Ref: cancerresearchuk.org)

I haven’t looked into this yet but I know that my maternal grandmother had Osteoporosis so it’s definitely something I plan to make enquiries about.

“If you risk nothing, then you risk everything.” – Geena Davis

As I said earlier, I hadn’t been prepared for the effect Tamoxifen would have on me and, besides the less common side effects, there are a lot of typical side effects.

The most common side effects of tamoxifen are:

hot flushes

vaginal discharge

nausea

mood swings

fatigue

depression

hair thinning

constipation

loss of libido

dry skin

Fluid build-up (oedema)

Leg cramps and muscle pain

Headaches

I am experiencing quite a few of the above, most notably extreme tiredness, sometimes feeling very down, hot flashes and joint pain/leg cramps.

The fatigue is the worst and not helped by how bad my sleep is at night. It can take me hours to get off to sleep and I’m so restless. I have quite a few hot sweats during the night which adds to the challenge of sleeping well. I’ve been through periods of insomnia before but this is on another level. I know that it is a typical symptom of menopause and many women suffer from it. Unfortunately it’s just harder to manage without being able to replace the oestrogen. Tiredness typically contributes to low mood as it’s so much harder to cope with anything when you are feeling exhausted. I’m hoping this will improve with time. I am currently in my ninth month of taking the drug so maybe my body is still adjusting to it.

I also experience a lot of ‘hardening’ of my breast and tummy. At night I still use the heart-shaped cushion I was kindly gifted from a breast cancer charity. It’s generally not painful but can be very uncomfortable. The worst thing is if I’ve got an itch and no amount of scratching will make a difference as my numb skin doesn’t react! It makes it feel like it’s an internal itch and none of my efforts to relieve it ever work! There is one area of my breast that has never gone soft since my surgery and sometimes it does cause me some aches and pains. I have been advised to massage the area but it doesn’t seem to make a difference. I expect I’ll just learn to live with it.

“The secret of change is to focus all of your energy, not on fighting the old, but building on the new.” – Socrates.

I get more hot flushes in the day now too but I was offered some complementary therapy via Macmillan Cancer Support. They referred me for six sessions of acupuncture with the Sara Lee Trust. The trust supports people in Hastings and Rother who have been diagnosed with cancer or another life threatening illness by providing free counselling, complementary therapies and group activities specifically designed to work alongside medical treatment. At my first appointment I was advised that I am eligible for free counselling and any of my close family members are also eligible for a limited number of sessions. They also offer, amongst other things, yoga, reflexology, massages and support groups.

A therapist contacted me and I had my first five sessions at St Michael’s Hospice where the trust is based and the final one was more local to me in one of their other centres. The therapist was lovely and very flexible, as I work and couldn’t always make the same slot each week. The acupuncture definitely helped but didn’t get rid of the problem altogether, not that I really expected it to. I don’t think there’s any quick fix to this predicament and some women try many different treatments before they see any improvement.

I regularly get cramp in my calves and the muscle goes into a spasm. I hadn’t made a connection to the medication but after it happened a few times I read up on it. Similarly with the joint pain. It is mostly in my fingers, hands, wrists, forearms, ankles and feet. There is a history of Rheumatoid Arthritis on my dad’s side of the family and my brother suffers from Dupuytren’s Contracture so initially I wondered about that but I think it’s more likely a side effect in my circumstances.

Despite all of this, I am aware of how lucky I am to be free of cancer at this time and that this is a way of lowering the risk of the cancer returning. The probable risk for me will always be there and oestrogen will never be my friend so it’s a lifetime change. As much as this medication may be affecting my overall health, I know I will be anxious when I’m no longer taking it, so it’s definitely a double-edged sword.

When you look back, don’t think of it as a year of pain but a year of growth. You made it through each day, You should be proud of yourself. You are a better you, despite all the hardships. Take a deep breath and enter with hope and confidence.

Fall seven times. Stand up eight.

Cancer-free. I fought and I conquered. You would think there’s an immediate feeling of elation at that moment but it’s not quite as simple as that. It’s so difficult to explain. Relief is the first emotion but everything else takes time to conceive. The best way I think I could describe it is that it’s like I’d been holding my breath for months and suddenly I could let go but I couldn’t do it all at once. I had to gradually release every bit of anxiety I had been storing and take time to process the whole journey. Having internalised quite a lot of my fears I couldn’t just turn them off in an instant. Added to that is the feeling of going it alone after months of regular appointments which marked the next step towards my goal of being free of cancer. Rather than being an annoyance, for me the appointments really helped me to break down the campaign by knowing what was happening next and ticking a box once I’d gone past that consultation or procedure towards another, in the hope that each one took me closer to putting it all behind me. Don’t get me wrong, each hospital visit, whatever it might be, invoked some level of nervousness and anxiety but each and every one was necessary and had to be faced so I counted each one as another step of progress.

I was wondering if I was being a bit silly for feeling like this until I bumped into a friend who has had her own cancer journey. We talked about where I was at that point and, before I could say it, she said the worst thing is when there are no more appointments and you feel like you’re now on your own. It was such a comfort to know that this appeared to be a ‘normal’ feeling in my circumstances. I have since spoken to other cancer survivors who have voiced exactly the same thing. Good. I could work my way through this without feeling ridiculous about it.

I also had the knowledge that I would be on the radar for a minimum of five years, the duration of the Tamoxifen, and annual mammogram screenings for the same period of time. In a weird way that actually put me at an advantage to many other women as the normal time between screenings from age 50 is three years. It felt like the safest place I could be at this time.

There is a positive side in everything. It just takes a positive mind to see it.

My next challenge was to try to get back to the life I had before my diagnosis. It would be unrealistic to think that everything would be the same. Life will never be quite the same for me again. I had been through a frightening and painful process and will always have an elevated level of fear to before. With my mum’s history I had always been prepared that I might one day face cancer but it hadn’t been an overwhelming feeling, more of a realistic possibility. Having that expectation realised, I now had to consider that I was vulnerable and susceptible to the cancer returning one day, as it did for my poor mum. I don’t want to live the rest of my life consciously worrying and thinking “what if….?” but it’s natural to worry. I will always be vigilant about any concerns regarding my health and of course if anything doesn’t feel right I will be apprehensive.

When I have a really bad day I find myself thinking “my mum only had nine years left when she was my age” or I hear about other unfortunate people who have had secondary cancer which can’t be cured. I am generally a very positive and optimistic person but I just have my days. It’s also still very raw for me so hopefully in time I’ll think less and less in that way. Cancer is an evil disease that destroys lives and it is hard to be completely free of the fear.

Coincidentally, just after I wrote that last paragraph a ‘fellow survivor’ shared a blog which totally summed it up! It says exactly what many of us feel post-cancer. It’s called ‘Don’t Ask Me to “Get Over” my History with Breast Cancer (In our minds, it’s never completely over)’, written by Dr Uzma Yunus and published by HuffPost.com.

This is just a few sections of that post:

“If you have ever wondered why cancer survivors bond with each other or connect instantaneously, it is because we “get” each other. We are able to relate to each other in ways others can’t. One of the biggest emotional setbacks that breast cancer survivors deal with post treatment is the expectation from their family, friends and caregivers that survivors should “get over it” and join life in its entirety.

In fact, the survivor-ship phase, which starts after all treatments end, is actually a very daunting and nerve wrecking time. Through cancer, we get used to regular appointments and medical oversight. But then when treatments end and the oncologist looks at you and says, “You are done. Go live your life,” most survivors feel lost. After six months to a year of intense treatments, we forget what it is like to “live life.” And just like that, with a statement and a pat on the back, survivors are pushed back into the world that is no longer recognizable to them. Many have mixed feelings about the word “survivor” since they are unsure if they truly have.

“Cancer changes everything” is an understatement. Those with cancer are no longer the same people when it hit them. We took an exit off of the freeway and then got lost for a long time on unfinished roads and unfamiliar streets. It’s hard to merge back into the fast lane. It scares us to see everyone moving so fast and, sure, while we feel we are just limping along.

Dealing with cancer is grief and loss at multiple emotional levels. Even though, after the end of treatment, survivors are told they are cancer-free, we are anything but “free” of cancer and cancer thoughts. We are ridden with feelings of anxiety and uncertainty and stalked permanently by the fear of cancer. Many of us hardly get restful sleep at night. I remember how fractured my sleep was on Tamoxifen and how my joints hurt every single day. Women after breast cancer are on 5 or 10 years of hormonal treatment and live quietly with these side effects. They don’t say much because they feel that their life was spared so they should pretend to be happy and just suck it up.”

As well as the emotional fallout of what I’d been through, I now had menopause symptoms to contend with and this hit me like a brick. I’ve suffered from insomnia for years which started with my grief when my mum died but, from time to time, improved. However, peri-menopause reared it’s ugly head and I haven’t slept well for a few years now. In terms of my mood and general mental health, like most women experiencing the drastic changes in hormones, it was a struggle. The ‘brain fog’ is incredibly frustrating and sometimes you wonder if you’re heading towards dementia. ‘Overthinking’ everything and being irrational is another aspect and one that you know is usually ridiculous but you still do it. I sometimes feel very panicky or irritable for no apparent reason, like a loss of control. It happens suddenly and randomly and is both a physical and psychological experience. Unless you’re one of the few lucky women who sail through, barely noticing these changes, it can feel like a sense of ‘impending doom’, like a black cloud hovering over you and blurring your reality on life – disorienting, bewildering and disconcerting. In my situation, it was hard to know if this was down to the menopause or a by-product of the cancer. I expect it’s a bit of both.

“And once the storm is over, you won’t remember how you made it through, how you managed to survive. You won’t even be sure whether the storm Is really over. But one thing is certain. When you come out of the storm, you won’t be the same person who walked in. That’s what this storm’s all about” – Haruki Murakami (Japanese author).

There is so much more acknowledgement and support of the menopause these days and the extent of suffering for many women. This includes medication and therapy. Menopause occurs due to a gradual decline in the reproductive hormones, oestrogen and progesterone, because of natural aging. Hormone Replacement Therapy (HRT) is a treatment used to replace the hormones that the body is no longer producing. However, if you have had breast cancer, some of the options are not appropriate. For example if, like me, your breast cancer was oestrogen receptor-positive you are likely to be undergoing endocrine therapy, also known as adjuvant therapy. In my case, this is a drug called Tamoxifen, taken for a minimum of five years. Tamoxifen blocks oestrogen from reaching the cancer cells. So, as you can see, it would be a contradiction to be treated by something which replaces the oestrogen when that is what would put me at risk of the cancer returning.

There are many other ways to treat menopause symptoms and not everyone chooses HRT so I’m not overly concerned about that option not being available to me. This was not my only interest though. Being unusually vigilant (for me) I thought that it would also be pertinent to check that the vitamins and supplements I had been taking for many years would not interact with the Tamoxifen. I discovered that some supplements can’t always be safely taken along with prescription medication as they can change the way medications and radiation work in your body and may make the treatments less effective. This was not something my oncologist nor any other medical practitioner had spoken to me about.

“Tamoxifen, as well as many other medications, interacts with the CYP2D6 enzyme. This enzyme plays a major role in converting tamoxifen into an active metabolite called endoxifen, which is what makes the drug effective.

Some drugs strongly inhibit the CYP2D6 enzyme, which prevents adequate production of endoxifen from tamoxifen. This would substantially reduce the effects of the drug for you.” (Ref: verywellhealth.com)

The reason these concerns came to my mind initially is that I’m aware, for example, that Siberian Ginseng, which I have taken for some time, can affect fertility and should therefore not be taken if you’re trying to conceive. I realised that this must be related in some way to hormonal activity. So I looked it up online and this is what I found:

“Hormone-sensitive conditions such as breast cancer, uterine cancer, ovarian cancer, endometriosis, or uterine fibroids: Siberian ginseng might act like oestrogen. If you have any condition that might be made worse by exposure to oestrogen, don’t use Siberian ginseng.” (Ref: rxlist.com)

After many hours of surfing the internet I didn’t feel particularly well informed as there were a lot of contradictions. Some sites stated that certain supplements were good for preventing breast cancer whereas others talked about the same supplements having the potential to cause or promote breast cancer. Feeling very overwhelmed by this, I decided to contact a friend who is a pharmacist. She kindly said she would see what she could find out for me. Specifically I asked her about: Siberian Ginseng; Green Tea; Zinc; Magnesium; B12; Cranberry; Vitamin D, Calcium and a herbal supplement for skin health called HRI Clear Complexion. This was what she sent me:

“HRI clear complexion: Tamoxifen can interact with anticoagulants which I know you didn’t mention as something you are taking but the HRI clear complexion contains burdock root which can affect blood clotting so I would avoid if possible.

Other supplements mentioned: NB All dietary supplements are legally defined as ‘food’ so the information on chemical interactions is limited and often conflicting.

However, when researching the individual supplements you mentioned, ginseng came up as one to avoid as it can reduce the effectiveness of tamoxifen or increase its side effects. Similarly with green tea. This can increase the level of tamoxifen in the blood with unpredictable results and an increased chance of side effects.

I couldn’t find much info on the other supplements but things like vitamin D are fine which may help with some of the side effects of Tamoxifen and there is some evidence that shows it might also inhibit breast cancer growth at a safe dose.”

The reference to anticoagulants was a surprise as I had no idea that Tamoxifen carries a risk of Thromboembolism. Thromboembolism is the name for when a blood clot that forms in a blood vessel breaks loose, is carried by the bloodstream, and blocks another blood vessel. This is a dangerous condition that can affect multiple organs, causing organ damage and can even be fatal. There is a small increased risk associated with tamoxifen treatment and the risk is higher for women with a personal or family history of thrombotic disease. Thankfully I’m not in that category.

While waiting for a response from my friend I also popped into my local ‘Holland and Barrett’ store, one of the world’s leading health and wellness retailers, to see if they could give me any advice. The lady I spoke to was very helpful and gave me a few snippets of information but it was a bit nebulous and I still felt I needed more clarity. One thing she did tell me though was that Zinc is a cell producer (hence why it is good for hair, skin and nails). After speaking to her I did a bit of my own research and this (in summary) is what I found:

“Zinc has long been known to play a vital part in human health. However, the mechanisms for delivering zinc into cells are not well understood. New research has identified one switch which allows zinc to flow. This has implications for a number of diseases, including aggressive types of breast cancer.

Dr Kathryn Taylor, of Cardiff University’s School of Pharmacy and Pharmaceutical Sciences, said: “We know that zinc, in the right quantities, is vital for development, our immune systems and many other aspects of human health. But when something goes wrong with the body’s zinc delivery system, it looks as though disease can result. In particular, our research has shown a link to highly aggressive forms of breast cancer. Our better understanding of how exactly zinc is delivered suggests if we can block malfunctioning transporter channels, we can potentially halt the growth of these forms of cancer. We believe this makes zinc, and zinc delivery, a high priority for future cancer research.” (Ref: Sciencedaily.com)

I also contacted my MacMillan nurse to ask if she could email the oncologist for me but she said I would probably have more luck by contacting ESHT (East Sussex Healthcare Trust) Medicines Information Team. Initially she gave me a phone number but it wasn’t recognised so she then forwarded my email to the team and they responded directly to me. This is the information I received from them:

“The data relating to the use of herbal medicines is really limited however we do subscribe to a complex database which does contain robust information.

The tamoxifen that you are on is cleared by a number of liver enzyme pathways. This unfortunately means that it is often the subject of many drug interactions.

The green tea, Siberian ginseng, cranberry and zinc are all documented as interacting with tamoxifen. We would therefore discourage the use of these. Vitamin D in high doses also interacts but this is dose related. If you are taking less than an 1,000 iu a day this is not thought to be a problem.

Magnesium and B12 as long as they are not in high doses have not come up as an interacting item.”

I also discovered that vitamin D levels may be linked to the effectiveness of tamoxifen and that levels of endoxifen tend to be significantly higher in women in the summer months which suggests that vitamin D may help fight breast cancer. As if I ever needed an excuse to spend time at the beach….

This brings me on to food and links with breast cancer. To be fair, that’s a whole other story and would need its own separate blog but, in short, there are also many contradictions around diet and breast cancer. One example is soya/soy protein. I have read lately that this is good for preventing breast cancer. However, it seems it’s not quite that black and white as it again depends on your individual diagnosis.

“Consuming soya remains controversial amongst those diagnosed with breast cancer. The concern often stems from the fact that soya contains what is known as “phytoestrogens” – chemicals which have structures similar to oestrogen. Because of the potential for these chemicals to bind to oestrogen receptors, it was hypothesised that they could potentially stimulate the growth of ER+ breast cancers. However, there is actually increasing evidence to suggest that soy consumption may be beneficial in reducing breast cancer risk, mortality and recurrence, even whilst on tamoxifen. Currently, there are no definitive answers to whether soy should or shouldn’t be included in the diet. With more human clinical studies, our understanding can develop.

There is no clear evidence to suggest that you should stop consuming soya after being diagnosed with breast cancer and whilst taking tamoxifen – it may even be beneficial. So, if you do regularly have soya, or cut it out because you thought it could affect your treatment, feel free to carry on consuming it as part of a well-balanced diet. If you don’t like soya or never included it in your diet before, there’s no need to start now, but if you would like to include it, talk to your doctor or nutritionist who can advise you further.

Like soya, flaxseeds also contain phytoestrogens, which have caused concern for women with breast cancer over the years. However, current evidence seems to suggest that flaxseeds are safe for people who are on tamoxifen. Not only are they safe, but also like soya, flaxseeds may, in fact, be beneficial to those with breast cancer and who are on tamoxifen, with studies suggesting that its consumption may reduce the risk, growth and recurrence of breast cancer.” (Ref: owise.uk)

It’s all a bit of a mine field and I feel all I can do is be very cautious. If in doubt I will avoid. So far the lack of zinc has had the most detrimental effect. My nails have literally fallen apart – splitting, peeling, not growing. I’m just relying on hand creams at the moment but it’s not helping much. All I can do is research an alternative remedy that doesn’t contain zinc but I am struggling to find one! I’ve never had great nails as I was a nail-biter until my late teens so they are quite weak anyway. I’m not even too bothered about having long, glamorous nails but, when they are so brittle and constantly break, they get scratchy and catch on clothing. Not the worst thing to have to deal with, in the grand scheme of things, but just another repercussion of my cancer experience.

“Getting knocked down in LIFE is a GIVEN. Getting UP and moving FORWARD is a CHOICE.” – Zig Ziglar (author, salesman and motivational speaker).

Patience is bitter, but its fruit is sweet. (Aristotle)

I had my post-op check-up with my breast consultant surgeon at the Conquest Hospital in Hastings on 8th August 2022. She was very pleased with my reconstructed breast. She then went on to talk to me about the post-op histology. This is the summary:

“Wide local incision showed 37 mm DCIS intermediate and high-grade with 4 mm invasive component, grade 2, no vascular invasion. DCIS was ER* positive 8/8 PR* 6/8 on the pre-op screening biopsy. Invasive component ER positive 7/8 and *HER-2 positive.

Left mastectomy pathology showed a further 30 mm residual intermediate to high-grade thus giving a total size of 67 mm of Ductal Carcinoma in Situ. A further 1.5 mm invasive component found in the mastectomy specimen either grade 1 or grade 2 ER AND HER-2 status on this tumour not reported.”

*ER – Oestrogen Receptor

*PR – Progesterone Receptor

*HER-2 Positive (human epidermal growth factor receptor 2): The extra HER2 protein encourages the cancer cells to divide and grow. Between 15 and 20% of women with breast cancer have HER2-positive cancers.

This was the evidence that a mastectomy had been the right decision. Not only that, had my consultant in Hastings not been vigilant and taken the precaution of an extra margin in my first lumpectomy, I might not be cancer free now and the outcome would undoubtedly have been considerably worse. The advice from the Park Centre in Brighton who carried out the initial biopsy, following many discussions between them and the Conquest Hospital, was that they were not concerned about the second area of cells. Although only a similar amount again was removed during the mastectomy, if left the HER2 cells would have spread. I will always be grateful that this advice was disregarded and that having found the presence of those cells after the first surgery, my Hastings consultant believed a mastectomy was the best and safest precaution.

At the same appointment my consultant went on to discuss the next stage of my treatment. She said that, in view of the results, it was possible that I would not need to be given Herceptin.

Herceptin is recommended if the cancer has not spread into the lymph nodes and the cancer needs to be estrogen receptor/progesterone receptor (ER/PR)-negative or have one high-risk feature. High risk is defined as ER/PR-positive with one of the following features: tumor size >2 cm, age <35 years, or tumor grade 2 or 3.

This put me in a borderline category. She advised that my oncologist would discuss this with me at my appointment with him which had been booked in for later that month. She did put my head in a bit of a spin by saying “I would advise that you still attend that appointment.” To me that sounded like the decision had already been made. I can’t imagine why anyone would not attend a follow up with an oncologist, even just for peace of mind, but I guess there may be people who, for whatever reason, would be satisfied that they were out of danger. However, those appointments are also about prevention, not just cure, and I think it would be quite foolish of anyone to not keep all appointments made for them.

The consultant’s words affected me more than if she’d kept the options open. I didn’t want to give myself false hope but, at the same time, I couldn’t help analysing what she’d said to me and feeling optimistic. At the time of my diagnosis, I was told that Herceptin was typically administered alongside chemotherapy and that was the only option at that time. She had informed me that trials were being undertaken to establish how the Herceptin could be given without the chemotherapy but this option was not available yet. So it was still a case of all or nothing. All I could do was get through the agonising two week wait for the oncology appointment.

Let your faith be bigger than your fear

By this time I was able to do a bit more. I wasn’t driving but friends took me out for coffee, we were invited to have dinner at our friends’ house and I managed to go out for a couple of birthday celebration meals.

My husband invited me to a work ‘outing’ on 17th August. He is an architectural interior designer and has his own practice. They had put together the designs for a complete renovation of ‘The Botanical Brasserie’ at Kew Gardens and the purpose of that particular trip was for photos to be taken and some outstanding bits that needed attention. It was also a leaving/birthday do for one of his designers and a chance for the whole team to see the fruits of their labour! We travelled to London by car. It would have been too much for me to go by train as it was still relatively early on in my recovery. It was lovely to be included though. I am a Co-Director of the company but only in name really! I just tag along for the fun bits!

I had a follow-up plastic surgery appointment on 19th August at the Queen Victoria Hospital in East Grinstead. Everything was as it should be and I would be booked in for another appointment in about three months to discuss the next stage of reconstruction.

On 21st August we went to Brighton. Our son’s girlfriend had bought us a voucher for Christmas to go on the Brighton i360 and afternoon tea at the Hilton Metropole. We also went jewellery shopping for my pearl ring, promised to me for our 30th wedding anniversary. We had looked around and not been inspired so far but then we remembered that there are a lot of jewellers in the North Laine in Brighton. It didn’t take long! We looked in a few windows before discovering a lovely little independent shop with a display of less conventional styles. All of the rings in the window were prototypes of rings that you can have made bespoke to your own taste. I chose one with the pearl set into a circle and two diamonds set in a square either side. We discussed all the metal options and I decided on white gold in its raw state. I didn’t know this but most white gold items you get in high street stores are Rhodium plated but you can have it without. Left non-plated it creates a warm white tone rather than shiny like platinum which is more the case with the plated white gold. We were both very happy with my choice. It would take around two to three months until I could pick it up but definitely worth it.

“Pearls don’t lie on the seashore. If you want one, you must dive for it.” – Chinese proverb

The day finally arrived – 24th August 2022 – when I would find out whether I would be undergoing further treatment. The clinic seemed to have overrun so I was kept waiting for almost an hour. Consequently my nerves were in shreds by the time we were called in. The oncologist was a lovely, straight talking man. We talked through the sequence of events and the histology. Also the potential role of chemotherapy and anti HER2 therapy because of the focus of invasive disease. He said that he was reassured by the sentinel node biopsy and, in his judgement, chemotherapy and Herceptin would give minimal benefit and risk substantial side effects. He added that he would not recommend adjacent chemotherapy and anti HER2 therapy in my situation. This was truly music to my ears! It was exactly what I was hoping to hear.

He did feel that there was a role for anti-hormone therapy, primarily for risk reduction on the contralateral side. He explained that this would reduce by half the risk of subsequent pre cancer or cancer developing on the contralateral breast, in combination with the surveillance mammograms, and felt this would be a good strategy for going forward. I asked how they can be sure that there had not been a stray/random cell that had snuck away to somewhere else in my body and he replied “Never ask a doctor to say never!” He said he was as certain as he could ever be with the information he had. I was satisfied with this, coupled with the fact that I would remain under the radar of the breast clinic for at least the next five years and would have annual mammograms on my right breast.

He gave me a prescription there and then for 20mg of Tamoxifen to be continued until Summer 2027. I asked about side effects and he said the medication was highly likely to send me straight into the menopause. I was 54 and a relatively late ‘menopauser’ but I had been peri-menopausal for at least a couple of years and felt I had only been months away from the full menopause anyway. I would also almost undoubtedly put on weight. He said if I carried on eating ‘normally’ without taking this into account, it was likely I could gain around half a stone. It’s a small price to pay and, to be fair, the same for the majority of women who enter the menopause stage.

“Necessity is the mother of taking chances.” — Mark Twain

On our way home from the hospital I picked up the prescription. It is a daily tablet. I took my first one that day and, no kidding, that evening I felt like I’d been catapulted straight into the menopause! I had hot flushes that night and the symptoms have steadily increased over time. I will elaborate on this in my next blog……

“Even the darkest night will end and the sun will rise” – Victor Hugo (Les Miserables)

Scars are tattoos with better stories.

Home sweet home. No better place. However, I felt quite overwhelmed to be honest. I never imagined I would feel like it but I felt ‘different’. I WAS different. I remember one of the nurses who brought me back from recovery squeezing my hand and telling me it was ok to feel sad and bereft and I didn’t have to be brave all the time. That made me cry. She described it as a grieving process. She was so lovely and held onto my hand until I was settled on the ward and it was time for her to leave. It’s very hard to explain the emotions as there are so many….relief, bewilderment, anxiety, loneliness, extreme tiredness, confusion, disorientation, none of which are at all surprising after such a large dose of anaesthetic.

It doesn’t matter how many times you get knocked down. All that matters is you get up one more time than you were knocked down.

Of course there were physical challenges at first. The best way to describe my tummy is that it was like being wrapped up really tightly with sellotape! I couldn’t straighten up for almost a week and had been advised not to force it. My breast caused me less pain initially, a bit sore and swollen but bearable. The worse pain was my back. You might think this a bit strange as my surgery had nothing to do with my back but I was warned at my pre-op appointment by the head anaesthetist that backache is the most common complaint after this type of surgery.

My husband had made the sofa up all comfy with a duvet to lie on, pillows and cushions. The heatwave was still intense and it was cooler downstairs. I ended up sleeping there for the first few nights as it was comfortable and made sense. I had bought one of those ‘cooling pillows’. The natural properties of the cooling gel keep you cool from the moment your face touches the pillow and slow heat absorption means that there are cool areas of the pillow available through the night. This was a game changer for me! You don’t have to cool them in advance but, as it was so unbearably hot during that time, I did cool mine in the fridge before using it.

I continued to take the paracetamol and ibuprofen regularly. However, my back pain reduced me to tears one day. After a few days of having help in the shower to wash my hair, I was confident enough to sit on a stool and do it myself. This was a painful process though. I wasn’t allowed to stretch my arms up too far and my back would be throbbing. I became desperate and ended up sobbing. In the end I contacted the ward at the hospital. They are available for a couple of weeks after surgery for any queries or concerns. The nurse I spoke to was very sympathetic and advised me to keep up with the Dihydrocodeine. I had started to take it less but was also low on supplies so I would need another prescription. She also said that I could start to straighten up a bit, taking it very gradually, as this would help ease the pain in my back. I also spoke to her about my breast as it was very hard to touch and I wanted to make sure this was normal. She advised me to massage the area regularly. I had been doing that but it felt like a rock and it was difficult to manipulate the area but I heeded her advice and continued to try anyway. My GP issued a prescription for the stronger painkillers too.

“Don’t let pain define you, let it refine you” – Tim Fargo (author of ‘Alphabet Success’).

The good thing about showering was the relief of not wearing the bra, control pants and compression stockings for that one solitary hour each day! I would lie on the bed for a few minutes while the dressings dried off and enjoy the freedom, just for a short while. On a few occasions during the six weeks of having to wear it all for 23 hours a day, I sat outside for about 20 minutes without the stockings and enjoyed some of the glorious sunshine. I was more mobile by this point so I didn’t think a few minutes would be too risky.

Ironically, the only underwear I wouldn’t have minded being stolen from my washing line was unlikely to ever be taken as, apart from the fact that it was far from sexy, I was always wearing it! Sorry, not sorry, but I couldn’t resist this….

A man was arrested the other day with more than 10,000 pairs of stolen underwear. Legal experts are expecting a brief trial…..(ref: a ‘dad’ joke!)

In terms of DVT (Deep Vein Thrombosis), I had the remaining 14 injections of Heparin to administer for the prevention of blood clots. I think the hardest part was remembering which side I did last (rather like when you’re breastfeeding!). I had said to a nurse before I left hospital that sometimes it was more painful than others and she said to make sure I inserted the needle at an angle or, better still, almost horizontally as that way I would be less likely to hit muscle. That was really good advice and from that point on it was definitely easier and less uncomfortable. It was a relief to do the last one though, not the nicest thing to have to do every evening.

Now for the ‘up close and personal bit’ – the result of my ‘new breast’. I don’t think any description can truly do it justice, it’s simply a work of art and incredible skill. Because most of the cancer was found to be behind my nipple it was decided early on that it should be removed. This is called a nipple-excising mastectomy. However, as I had a very tanned tummy at the time the surgeon used some of my skin to create a ‘nipple area’. It’s just a round circle, roughly the size of my nipple, without any of the other features. I call it my ‘chocolate button’! What I didn’t realise was that the access for the whole procedure was through my nipple. It was the same for my earlier lumpectomy but I just assumed it would be more invasive this time as they had to remove everything. I was expecting at least a scar on the underside of my breast. Incredibly they totally emptied my breast of its contents, including all the breast tissue which, if left, can leave a risk of the cancer returning, and replaced it with the fat from my stomach. Essentially I still have my breast with a few tweaks! I even still have the scar from my first lumpectomy in 1988 as it’s all my original skin apart from the grafted bit! I don’t have any evidence specifically of the skin being taken as it was part of the flap procedure (other than the dirty great scar across my abdomen!). The symmetry to my right breast is spot on and there is a very faint scar around the edge of the brown nipple area (areola). I am totally in awe of how sympathetically this surgery was carried out. It is so important for the majority of women that they still feel feminine and ‘whole’ and this is the perfect example of the amazing surgeons going the extra mile to ensure they get the very best result for the patient that they can in the circumstances. I will be forever grateful to them, not just life savers but people who truly care.

I can’t lie, my skin is a bit like a patchwork quilt these days with scars, old and new. They really don’t upset me though as they are a reminder, not just of what I’ve endured and been through, but that I survived and won the battle.

Never be afraid of a scar. It simply means you were stronger than whatever tried to hurt you.

After a few days at home I was up to having visitors and there were a lot! That really helped me through a time with so many restrictions and potential frustration and boredom! For anyone who was curious to see my reconstruction I invited them to have a look! The dressing on my breast was literally a square of microporous tape around the nipple area so the majority of my breast was visible. Everyone who felt brave enough to look was astonished at how brilliant it looked. It might seem odd to share such an intimate thing with my girlfriends (as my husband said a few times “Are you flashing your boob again?”!) but I truly believe it can help women to see that not everything about breast cancer has to be negative. I know I was unlucky to get cancer but I have definitely been lucky in many ways compared to some. Anyway, what’s a boob flash between friends eh?!

My tummy similarly had minimal dressing, just strips of tape right across. I couldn’t see what was underneath until my dressings were changed. I just knew it would be a big scar. In a DIEP flap, fat, skin, and blood vessels are cut from the wall of the lower belly and moved up to your chest to rebuild your breast but no muscle is cut or removed. The blood vessels of the flap are reattached to blood vessels in your chest. Because no muscle is used, the recovery is usually quicker and there is a lower risk of losing abdominal muscle strength.

Despite the potential pain the nurses had emphasised the importance of doing the exercises I’d been given. It wasn’t quite so bad for me because I had had my lymph nodes removed four months earlier so I didn’t have to worry so much about the effects of that. However, it is still wise to do them following a mastectomy as they help to regain arm and shoulder movement. I had laid on the operating table with my arms out to the side for almost nine hours so inevitably my shoulders were a bit stiff.

In terms of my gradual steps to recovery I was given a table of what I could do and when. It was for a minimum of six weeks. Initially absolutely no lifting, stretching up high (I can safely say that was not difficult to obey with my sore tummy), driving and most household chores. For the first two weeks I wasn’t even allowed to lift a kettle and beyond that time only if it contained just enough water for one drink. I could drive after six weeks but only if I felt safe enough to be completely in control of the car in any eventuality.

When the going gets tough, put one foot in front of the other and just keep going. Don’t give up.

I didn’t find my first week of convalesce too bad as I was very tired and didn’t have the energy to push myself too much. My first check up was a week after my discharge and back at the hospital in East Grinstead. I was seen by a different plastic surgeon who just made sure everything looked ok and then I was seen by a nurse to have the dressings changed. It was all very straightforward and she said that I would be able to change them myself from then onwards. She advised me to go to the hospital pharmacy to buy a roll of microporous tape and recommended that I cut small strips and overlap then across my abdominal scar.

I had ordered some crop top style bras from Asda to collect in store so we went there on our way back from the hospital. Originally I was going to stay in the car while my husband picked them up but I changed my mind and decided it would do me good to walk a few steps, albeit slightly bent over. There is a point to this story! First though, you have to be able to picture how I looked on that day. My daughter had French-plaited my hair in two sections to make it more manageable and I was wearing a summer dress which is a ‘prairie’ style – gingham check, puffed sleeves, ruched bodice, maxi length. Nothing too strange about that. However, added to the look were my dark blue/green compression stockings and a pair of trainers. It suddenly occurred to me that I looked like I belonged to the ‘Bruderhof’ community, a socialist Christian movement who live in Robertsbridge, just a few miles from where we lived! Anyone could be forgiven for mistaking me for a member of the commune! All I needed was a headscarf or bandana and I could have fooled anyone, as I shuffled around the supermarket bent over and holding on to my husband’s arm! I bumped into a lady I haven’t seen for a very long time and she said “You look well!” I couldn’t really blame her as I did have a good tan! I just didn’t feel like telling her about my cancer and she didn’t seemed to have noticed that I was in ‘fancy dress’ so I just left it at that! It was good to know that outwardly I looked better than I felt and not washed out and pallid.

“Keep your face to the sunshine and you cannot see a shadow.” – Helen Keller.

I am still amazed at how straightforward my recovery from the surgery was. The pain was manageable so long as I took the analgesics regularly and I gradually worked towards doing more physical activity. I was very tired for at least a couple of months and recognised when I needed to rest or just do less. One of the biggest challenges for me personally was wearing the annoying support wear in what were at times blistering temperatures so it was a massive relief when I was able to ditch the stockings for good!

In terms of any loss of sensation I was told that you can either lose all feeling, some feeling or none at all. I fall into the ‘some’ feeling category and this can vary throughout the day! For example, at night my breast is often very hard and can be uncomfortable. My tummy is also a mixture and if I get an itch and I need to scratch I often can’t actually feel anything so the itch doesn’t go away immediately! This is also the case at the top of my left arm where my lymph nodes were removed. It’s a strange feeling but I guess I will just get used to it and it will just be my new ‘normal’.

“After the rain, the sun will reappear. There is life. After the pain, the joy will still be here.”- Walt Disney

If your path demands you to walk through hell, walk as if you own the place

Following my third general anaesthetic in seven months I was getting used to that moment when you start to ‘come round’ with that fuzzy and slightly bewildering feeling and it takes a little while to adjust. This time was very different though. I was in a high dependancy ward surrounded by all sorts of paraphernalia – tubes, wires, machines, bleeps….

The main difference between intensive care and high dependency care is the nurse to patient ratio. Usually an ICU patient requires one to one nursing care, whilst a high dependancy patient requires one nurse to every two patients. I had my own room and bathroom which felt like quite a privilege.

The surgery had lasted just under nine hours but had all gone very well. There was a device around both my lower legs called an intermittent pneumatic compression (IPC) device. These are inflatable sleeves that are worn on your lower legs while recovering from surgery to keep your blood flowing, helping to prevent such problems as blood clots and deep vein thrombosis (DVT). So basically, every few minutes I had an automatic leg massage!

I had an oxygen tube for the first few hours (attached through my nose) but I wasn’t bothered by it as I slept for most of the duration of it being there.

I was covered in a forced-air warming blanket, sometimes known as a ‘Bair Hugger’ and its purpose is to prevent perioperative hypothermia. The best way I can describe it is a giant sheet of bubble wrap! It consists of two primary components, a warming unit and a disposable blanket. The warming unit is connected by a flexible hose to the single-use blanket. Warm air from the warming unit passes through the flexible hose and into the blanket. Once the warmed air reaches the blanket it exits through a series of micro-perforations on the underside of the blanket, warming the patient’s skin in an area that is not a surgical site. It was very warm and very loud! At the same time there was a free standing (pedestal) fan blowing cool air into the room.

I suffer from tinnitus in my left ear. It is a loud ‘white noise’ (continuous whooshing sound) and never goes away. This inevitably affects my hearing and when I had to keep asking the nursing staff to repeat what they had said to me I just naturally assumed that was why. However, the next day when the hose was disconnected and the blanket removed I realised how loud all the equipment had been and it wasn’t surprising that I’d had trouble hearing!

I had been fitted with a Foley catheter at the beginning of the operation, after I had been anaesthetised. I was relieved that I was unaware while it was being inserted! I had been very nervous about that.

Foley catheters are primarily used to keep the bladder empty during and after surgery. One reason is pretty obvious – that the patient is unconscious and unaware of the need to urinate. The anaesthetist had also explained to me that it’s not safe for the bladder to be kept full for such a long period. The catheter helps make sure the bladder does not fill up during surgery as having a full bladder can interfere with the surgery and cause potential problems. However, they are also used as standard practice for any procedure that is expected to last longer than one hour, where the patient is required to go to ICU (or HDU in my case) after surgery. It also means that for up to 24 hours or so the patient is not expected to get out of bed to go to the bathroom.

I also had two surgical drains, one inserted into my breast and the other in my abdomen. A surgical drain is a small plastic tube that is sometimes used after an operation. It is put inside you during the surgery and will stick out of your body until it is removed. It connects to a small plastic bag that collects any fluid or air that has drained away from where you had the surgery. The drains may also include blood, pus or other fluids from the operative site. Without them the fluid might gather up and cause infection. The surgical drain allows extra fluid to drain off harmlessly.

I was given a goodie bag from a charity called ‘RESTORE’ (Breast Cancer Reconstruction) who provide information, inspiration and support. It contained an eye mask, lip salve, a pack of mints, ear plugs, wet wipes and a few other bits. Once emptied out, the lightweight fabric bag also doubled up as a holder for my drains! Once I was mobile I had to remember that the drains had to go everywhere with me!

I was also given another heart shaped cushion which helps to get comfortable and provide some protection for the breast. The cushions are lovingly made by staff and friends of the hospital. I had been given one when I was discharged from the Conquest Hospital following my initial lumpectomy a few months earlier too. They are made with very pretty colourful fabric and definitely help with getting comfortable.

“No act of kindness, no matter how small, is ever wasted” – Aesop.

I had chosen to have the DIEP (deep inferior epigastric perforator) flap reconstruction as opposed to implants. This means that I had the breast tissue replaced with skin and fat from my abdomen. Consequently I had been cut from one hip right over to the other hip. The cut was similar to a a Caesarian but a little higher up and a much wider incision. The top of my underwear sits slightly below my scar. It measures 20 inches across.

I also had a dressing on my belly button and I wasn’t expecting that. I asked why and it all made sense when it was explained to me. I have also since discovered that this is a question that is typically not discussed with a surgeon priory to surgery which was the case for me. If you are particularly squeamish you might want to skip the explanation!

“It’s actually not a “new” belly button. It’s the same one you always had, it may just look a little different. Your belly button was formed from scar tissue left over from the umbilical chord after you were born. The belly button you have today is still permanently connected internally to your liver and therefore cannot be moved.

During DIEP flap breast reconstruction, two incisions are made over the lower abdomen: a football-shaped incision around the tissue that will be used to reconstruct the breast(s) and another around the belly button. The tissue is removed and transplanted to the chest to reconstruct the breast(s) and the belly button is left in its original location.

The abdominal surgical site is closed by pulling the upper abdominal tissue down to the lower abdominal incision, over the belly button. Since the upper abdominal tissue is now covering the belly button, a new hole must be created to expose the belly button.

Once the abdominal incision is closed, the surgeon identifies the location of the belly button under the skin and cuts the new hole for the belly button to pop through.” – prma-enhance.com

So I now have a pretty pattern from the stitches around my belly button which I’m sure will fade in time. Otherwise it doesn’t look a lot different to before.

“Opinions are like belly buttons; everybody has one. I never knock a man for his opinion.” – Shaquille O’Neal (professional basketball player)

I’ve always known that I have a high pain threshold (four labours with only gas and air) but this was an invasive procedure and unlike anything else I had ever encountered in my life. It would be unrealistic to not expect pain but I have to say, I managed it well. As I was being settled back on the ward a nurse put a handset close to me which was connected to an electronic pump and administered by a drip. This is called patient-controlled analgesia and allows a patient to manage their own pain relief. The infusion is pre-programmed and controlled by the nursing staff. The machine has a special safety feature which means it switches off for five minutes after giving a dose of morphine. This prevents you getting an overdose, so you can press the button as much as you need. However, I never actually needed to use the Morphine pump and, with my permission, a nurse disconnected it the next day. I was given regular doses of paracetamol, ibuprofen or dihydrocodeine at the appropriate intervals.

“Although the world is full of suffering, it is full also of the overcoming of it.” – Helen Keller

The steps of recovery happened steadily throughout my hospital stay. I had to demonstrate that I could walk a few steps in order for the catheter to be removed. Although I was lucky enough to have my own bathroom attached to my room I needed to be strong enough to get off the bed and make my own way to the toilet before they were satisfied the catheter was no longer required. So the day after surgery I was assisted to walk up and down the corridor (with my little friends in my shoulder bag!) and the nurse was convinced that I was ready to independently get myself to the toilet. Removal of the catheter was entirely painless so that was good.

The day after the surgery I was advised to put on my bra and control underwear. I wore the same bra which I had worn after my lumpectomy. However, when the plastic surgeon came to check me, she wasn’t happy with the shape of the bra. I said it was a post-surgery bra and she asked if it was from ‘M&S’. It was. She said that lately they had not been getting it quite right in this respect. Fortunately they held a stock of bras at the hospital which are donated by charities and they found me a suitable one. It was a crop top with a zipper front and I must admit it was a much more snug fit and cupped my ‘new’ breast perfectly. When I left hospital I gave a donation to the charity. The nurse had looked at ‘Amazon’ with me to find the exact same item so I could order a second one. They were very cheap considering the quality. I duly ordered one but it never arrived and I ended up getting a refund. Typical! The surgeon was happy with my high-waisted pants so thankfully I had got that right. From that point forward I would be wearing both garments, as well as the compression stockings, for 23 hours every day for six weeks, only removing them to shower.

I was on 15 minute observations for the first 36 hours then half hourly. With each observation they checked that my breast was warm as this is very important. They also did a Doppler test during every check. The first time this happened I asked what it was for and the nurse jokingly said “I’m just checking for the baby’s heartbeat!” and I replied “I hope not!” This made me laugh! In actual fact, although commonly used for that purpose during pregnancy, a Doppler test can also be used to check if there is adequate blood flow following operations or injuries. A Doppler ultrasound records sound waves reflecting off moving objects, such as blood cells, to measure their speed and other aspects of how they flow.

For the first few hours post-op my temperature and blood pressure were also checked as part of the obs, then less frequently as time went on.

The drains were also closely monitored for their output. The fluid that drains from the body after a mastectomy is called serous fluid. Serous fluid is the result of raw tissue and will slow its development inside the body when the tissue begins growing back together. Serous fluid is a natural part of the healing process and wants to come out and that is why drains are used to aid in that process.

Until the fluid output reaches a low level, the drain should be left in. For two consecutive days, this is usually less than 30cc per day. The level for both of my drains to be removed had been set at 20cc.

The drain in my abdomen came out first, two days after the operation. I wasn’t feeling particularly nervous about it as I’d had a drain removed in a previous surgery a few years earlier and I barely remember anything about it. When the nurse said to me “Take a deep breath” I replied “Is it going to hurt then?!” She just repeated “take a breath” and suddenly my relaxed demeanour switched to an ominous feeling. So I took a deep breath and thank goodness I did because, oh my word, the pain was excruciating! I almost left the bed as my body reacted! Even my high pain threshold could not have failed to feel that pain level. However, it was immediately fine again once the tube was out. It was just the process of removal that was horrendous. The tube was quite thick, about the diameter of a large drinking straw, and it went from my hip to my belly button so roughly ten inches in length. The nurse explained to me that this, combined with the fact that all the time the tube is in the more settled it becomes with your insides naturally starting to attach and grow around it, meant it felt like my insides were being ripped out! That sounds a tad dramatic to be fair but the best way for me to demonstrate why it hurt so much.

“Great things never came from comfort zones” – Neil Strauss (American author/journalist)’

The breast drain didn’t empty out at quite the same rate and ultimately it was the only thing holding up my discharge from hospital. By the Sunday I was getting bored and desperate to see everyone. I was initially told that I would not be allowed any visitors due to the Covid restrictions but on my third day in the hospital my husband had been given permission to come in and see me. It wasn’t so bad when I was very sleepy but it felt quite isolating once I was more alert. On the evening of the operation, just a few hours after I came round, my husband and children did a group video call. Two of my sons are incredibly alike and had the same hairstyle at the time. I asked why one of them was on the screen in two places and they all cracked up as they were both on there and I had just thought I was seeing double!

Although it’s better to be in a calm, quiet environment than too noisy and busy, it was a bit disconcerting over the weekend period. There didn’t seem to be many patients and you could go a long time without seeing a member of staff. Don’t get me wrong, I didn’t feel neglected as my needs were not as great by then as others might be but it was like the ‘Mary Celeste’! I literally could have been the only person in the ward, tucked away in my little side room, and I wouldn’t have known!

The debate around my breast drain was also due to the fact it was a weekend and the plastic surgeon was not working. Ultimately, although measuring a little above the required level, she agreed over the phone that it would be safe to remove it. It was completely painless this time, a much smaller and shorter tube, and I didn’t feel a thing.

A nurse came to talk to me with a big folder in her hand. It contained examples of realistic looking prosthetic silicone nipples. The nipples are attached to the body by using a medical adhesive which is strong enough for any day-to-day activity and is waterproof. We looked at the variety of samples to get the one that most closely resembled my remaining nipple. I wasn’t rushed into the decision and, once satisfied with my choice, she brought me the little set to take home.

I was finally ready to be discharged and the process was very straightforward with instructions around pain relief, dressings, leaflets about exercise and self-care. It was ok to shower, just not for too long. The dressings would dry off or I could use a hairdryer on them if necessary. I would be given an appointment in one week to return for the dressings to be changed and the wounds checked.

I was eventually ready to leave late afternoon on the Sunday. Considering the magnitude of the surgery I think three nights is pretty amazing! I was told at my pre-op that they don’t keep you in hospital for any longer than necessary as recovery is generally quicker at home.

I love my house but it’s not the place that matters, it’s the people, and I was so happy to be back safe and sound with my family.

“Home is a shelter from storms – all sorts of storms.”-William J. Bennett

Behind every strong woman is a story that gave her no choice

Our mini break in Rome had been more than just a holiday, it had been an escape from reality, just for a few days. A chance to forget about what I’d been through and what was still to come. I really did manage to do that for the most part but literally the moment we stepped through our front door back home the anxiety hit me like a brick.

I had a sudden feeling of dread and felt physically sick. In just a few days I would be undergoing major surgery.

“Without fear there cannot be courage” – Christopher Paolini (author and screenwriter).

Nevertheless I returned to work on the Wednesday to finish my working week, having missed a day as a result of airline antics. I’d made the decision to start my sick leave from the beginning of the next week. Although my operation wasn’t until the Thursday I knew my head would be all over the place and I would struggle to concentrate. I also had to go all the way to East Grinstead (28 miles) just to have the compulsory pre-op Covid test then self-isolate so my two working days would have been disrupted anyway. I tried to keep my mind busy but it was a struggle.

The night before, I had to drink two of the Nutricia Pre-Op drinks and administer the first anticoagulant injection (Heparin). I made the decision to try to do this independently so I wouldn’t have to rely on anyone for the period of daily injections once I was discharged from the hospital. I surprised myself at how well I managed it. It was to be alternate thighs as my stomach would not be an option once I’d had the reconstruction.

We had to leave around 5.30 am the next morning so I went to bed quite early. My bag was all packed and ready. It was a restless night and I woke before my alarm. I had to drink another four bottles of the special drink before 7.00 am. It was thick, sweet and sticky but bearable!

The journey was ok as it was so early and we arrived in plenty of time. We had to go straight to the theatre area on arrival and check in. Once I was called in I had to say goodbye to my husband as he wasn’t permitted to come any further with me at that point. I was on my own now….

“Courage is being scared to death but saddling up anyway” – John Wayne.

I was taken through by a lovely nurse who said she remembered me from my pre-op assessment. She had carried out the ECG, height and weight checks etc almost three months earlier. It was comforting to see a familiar face. I was taken to an area where they get you prepared and it was a huge room. I felt quite lost in it!

“Scared is what you’re feeling. Brave is what you’re doing.”- Emma Donoghue (author of ‘Room’).

And so it began…

I was given a gown to change into, fitted for compression stockings and an identity bracelet. Because of my earlier lymph node biopsy, I also had an extra bracelet on my left wrist to warn that no procedures (any needles, blood pressure monitoring etc) should be carried out on that arm due to the risks of lymphoedema.

I hadn’t been able to remove some of my rings before leaving home and thought they’d probably just put tape round the ones I couldn’t get off. This was not the case though, they were not allowed to leave any of them on. The nurse explained that my arms would be placed out to the sides for several hours and my hands could potentially swell making it unsafe to be restricted by the rings. There were three rings that I never take off which caused the most difficulty. One is a double ring that’s linked together but, although it took a few minutes and was a bit of a struggle, was the easiest one to remove. The other two were my late mum’s engagement and wedding rings which I wore on my right hand. It took patience, skill, determination, an abundance of lubricant and around 45 minutes to get them off! I really feared that they would have to be cut off which would have made me so sad as they are very precious to me but the kind, reassuring nurse did not give up and apologised profusely even though it was certainly not her fault that I have very chubby fingers! I couldn’t have been more grateful to her for not adding to my distress on an already anxious day.

One of the nurses labelled up all my belongings but there was a bit of waiting time so she advised me to hang on to my phone so I’d have something to do. I did have a book with me (obviously!) but I wouldn’t have been able to concentrate on reading it.

I was given a drug called Gabapentin. This drug is mainly used to treat neuropathic pain. With nerve pain, it’s thought to block pain by affecting the pain messages travelling through the brain and down the spine. The reason for its use prior to surgery is that a single dose of gabapentin can lessen postoperative pain and reduce the amount of opioids needed post-op.

I was also wrapped in a foil blanket and was told that it was really important for me to stay warm. This was all at the time of a heatwave in the UK but you couldn’t tell in the hospital. It wasn’t cold in the room I was in but it was a huge area and wasn’t particularly warm either. Apparently my body temperature could not be allowed to drop below 36° before, during and after the operation in order to prevent perioperative hypothermia.

“The perioperative period is the time surrounding a patient’s surgical procedure; this includes the period before surgery on the ward (or in the accident and emergency department), as well as during the operation and afterwards. Hypothermia means an abnormally low body temperature; that is, a ‘core’ temperature below 36°C. Your core temperature is the temperature of your organs, such as your heart and liver, and it is normally slightly higher than at the places where your temperature is usually taken, such as your mouth or ear.

….if perioperative hypothermia occurs unintentionally, it may cause:

• increased blood loss and a greater risk that you will need a blood transfusion

• a higher chance of wound infection

• a greater chance of heart problems

• an increased risk of bedsores

• a longer recovery period after the operation, which may mean that you need to stay in hospital for longer.”

⁃ National Institute for Health Care and Excellence (nice.org.uk).

One of the registrars also came to see me and basically drew all over me with a marker pen! She said that the plastic surgeon had told her I had a very nicely shaped pair of breasts and she agreed! I feel this would have been a very strange conversation in any other circumstances! Subsequently my plastic surgeon came and checked the markings, making a few minor adjustments to get it to her satisfaction. She said they were just waiting for the arrival of my breast surgeon and could get started as soon as she got there. I don’t really have too much concept of the time at this point but I got the impression she was quite late. Anyway, she eventually came to see me and we had a brief chat. The wait was finally over….

“Being nervous isn’t bad. It just means something important is happening” – Michael Jordan (reputedly one of the greatest basketball players of all time).

A nurse came to collect me and she was wearing what I can only describe as a full-face snorkel mask with a breathing tube. Don’t get me wrong, I don’t blame her but it was a bit surreal! It was more like I’d landed in the middle of a nuclear disaster rather than a post-pandemic situation. Maybe she was particularly vulnerable. At one point I feared that I might get the giggles but I was probably too tightly wound up. It was only a short walk to the operating theatre but we stopped halfway while the nurse went into another area and returned with a really hot blanket which she handed to me to swap with the foil. She said I would be covered up with the blanket throughout my time on the operating table.

The preparation was very calm and gentle. They really did put me at ease and I felt in very safe hands. They explained again that at regular intervals the nurses would be getting my arms and legs moving, wiggling my hips and just making sure I didn’t lie completely still for hours. I remember the general anaesthetic being administered but can’t remember too much of what else happened prior to that, it’s all a bit of a blur now.

I was now completely at the mercy of these incredibly skilled doctors….

“A strong woman looks a challenge dead in the eye and gives it a wink.” – Gina Carey

Veni Vidi Vici

On June 27th 2022 we celebrated our pearl wedding anniversary, 30 years of marriage. It wasn’t quite the celebration we had hoped for but we made the most of the possibilities. It was always going to be the year that we had our dream holiday but, with so much uncertainty over my treatment, we just couldn’t contemplate it. So we decided to take the pressure off quite early on in my diagnosis and shelved the idea for when we could enjoy it properly. At that time we had no idea when that might be.

The world is your oyster but you have to put up with the sand to make your pearl.

At the end of January 2022, three weeks after my first operation, playing it safe, we booked a UK break for July. At that point I had no idea that my diagnosis would change so drastically as I was still waiting for results and felt reasonably confident that the initial biopsy had been correct. We found a magical place to stay, a luxury woodland glamping pod in the heart of the Lake District. We couldn’t go for the actual date of our anniversary as my brother was getting married the day before so we booked the following week. Coincidentally we later found out that my brother and his wife-to-be at that time had also booked a hotel in the Lake District for their honeymoon and our stays would overlap at some point. They would have been a few miles from us but we had said we would try to meet up for a drink or a meal.

In February 2022 I got the results of my lumpectomy and they were not good. I was now looking at a much more invasive treatment plan over the coming months. We didn’t make any hasty decisions at first but eventually believed that my major surgery was likely to be end of April/early May. With this in mind we changed the Lake District booking to August in the hope that I would be far enough along in my recovery to travel and enjoy it. Unfortunately a series of events delayed my surgery and it was ultimately booked in for mid-July. With that in mind there was no way I would be well enough to go away in August, so it was back to the drawing board….

First I checked to see if we could go back to the original July date for the Lake District but the best I could get was only two nights. With a distance of almost 350 miles and a six hour drive that was not going to work for us so we had to admit defeat on that idea. After searching for ages for UK breaks, my daughter suggested that we could find somewhere abroad for the same price as some of the UK packages I was looking at. I had a few reservations about the idea. I had looked forward to not worrying about airports and the stress of packing to fly. Then there was the Covid risk. However, in that respect, I decided I could pick the virus up just by going in a supermarket and I was fully vaccinated so it was something I was prepared to think about. The advantage of opting to go abroad was that my husband would be able to fully relax rather than having to drive for a 700 mile round trip.

It didn’t take long to find the perfect choice for us. We booked a four night break in Rome (also on our holiday wish list). I can’t lie though, it wasn’t a cheaper option to the UK breaks I’d looked at but it was a very good deal! Our flight was on the Thursday afternoon but we booked the train to Gatwick for 9.30 am. Our youngest son dropped us off at the railway station and we were in good time for the train. Anyone who knows my husband will know that we do most things at the last minute and his time keeping is appalling. On this occasion he didn’t let me down and it all felt quite leisurely compared the the usual rushing in ‘by the seat of our pants’! Typically it turned out there were some issues with signals that resulted in all trains between Hastings and Eastbourne being cancelled. We couldn’t believe our luck, or lack of it! Luckily our son was available to take us all the way to Gatwick and kindly obliged at short notice.

Despite what I said about airports, I do enjoy a bit of a mooch when I’m there. It was lovely to have enough time for a bite to eat and to grab a few duty-free bargains before jetting off.

The outgoing flight was very slightly delayed but was otherwise non-eventful. We were met by our transfer driver and he walked so fast back to his minibus that we almost had to run to keep up with him! It was only the two of us on that particular transfer and, if we thought he walked fast, it was nothing compared to the erratic nature of his driving! Welcome to Italy! Thankfully we made the 45 minute drive in one piece and were safely deposited at our hotel.

The hotel was great. It was in quite an urban area and I suspect it is mostly used for business but it was modern and funky and the staff were very attentive. It was in the Marconi area, a little on the outskirts of the city. We were both feeling a bit tired and we had jumped forward by an hour so we decided to explore the surburb we were in and leave our city exploring until the next day.

First we had dinner in a little courtyard of the hotel which was nice then we walked it off with a short stroll. There wasn’t much to see as it was mostly residential but we located the Metro station which wasn’t hard as it was about a three minute walk from our hotel. The hotel was situated on a really wide busy main road with cars parked along the middle. As we were walking we noticed a couple of young girls who were very scantily dressed (I’m talking underwear!). We very quickly came to the conclusion that they were ‘working girls’. When we got further along the road we saw more of these girls who were hanging around a service station which appeared to be a ‘pick up’ point. It was so blatant! Not sure if it was an actual ‘red light’ district but it was by no means subtle. Rather than being shocked by this, I felt a little sad as they really did look very young.

We had a packed itinerary for the first two days then left the Sunday and Monday to be spontaneous. We booked guided tours in advance for the Colosseum and the Vatican. A friend advised us to pay the extra for a small group tour rather than just doing it independently with headsets. This was excellent advice. I feel that with just headsets we would have wandered around a bit aimlessly and it wouldn’t have been so interesting. Our first trip was to the Colosseum. We had to register and collect our headsets and wait for the guide. The headsets in this case were just so you could hear the guide clearly even if they weren’t technically within hearing distance. It worked really well as he was able to gather us up easily for talking points and we could always hear him, even if we were a few steps behind. Our ticket included the Roman Forum, Palatine Hill and the Underground. It was absolutely fascinating from start to finish. The guide was very funny and incredibly knowledgeable. He had a lot of anecdotal insight which brought everything alive and really set the scene for us. The history was mind blowing, especially when we went into the underground dungeons and heard the stories of all the wild animals.

As you descend into the underground of the Colosseum you can see various chambers used to isolate the wild animals before they were sent onto the arena stage. There are square arches used in the tunnel that lead to the underground elevator system which consists of a clever pulley system that was used to operate the trap doors. The dungeons were a flurry of activity during the shows on the arena stage. Someone would be responsible for directing all of the action and hundreds of men would be running around the area. All of the chaos was hidden in the Colosseum underground and the crowds above were blissfully unaware of what was going on.

If you’ve ever watched ‘Gladiator’ or any other films on that subject it feels very surreal to stand where it all happened in real life. Absolutely captivating but such barbaric times!

“Are you not entertained?” – Maximus (Gladiator)

The next day we visited the Vatican with the same tour guide company but a different guide who was also incredibly knowledgeable beyond the standard factual information and very funny. We had booked an afternoon slot and were very surprised at how quiet it was. We were advised to take our passports with us because the Vatican is of course an independent city state (or Sovereign state) so it is the same as entering another country. Because we were in an organised group though, we weren’t asked to show them.

The Vatican museums contain roughly 70,000 statues with around 20,000 on display, the earliest dating back to around 3,000 years ago. Our guide reassured us that she would not be talking about each one, just the most significant ones! Phew! I mean, how many ‘busts’ do you really need to see?! I wasn’t going to say that a lot of them look the same….but, let’s be honest, they kind of do! (Sorry archaeologists and historians!). There was one particularly interesting fact about the statues which is a relatively recent discovery and that is that they were once colourfully painted!

“The 19th century saw the first inklings of possible painted classical sculpture, but it was not until the innovation of ultraviolet light and special cameras in the late 20th century that finally provided unequivocal evidence of the painted marble. In fact, the mere idea that the sculptures were painted at all was considered laughable until the late nineteen-hundreds, when archaeologist Vinzenz Brinkmann proved beyond a shadow of a doubt that the statues were once richly painted.” (Ancient-Origins.net)

The Hall of Maps is very interesting and I personally hadn’t heard of it before visiting. It is situated within the Belvedere Courtyard. Instructed by Pope Gregory XIII, Ignazio Dante created the maps to be exhibited in the Vatican. The maps are an amazing perspective of the Italian states in the 16th century before Italy even existed as a country. The painted ceilings are also stunning. The gallery of maps is a visual wonder.

I guess the most famous attraction of the Vatican is the Sistine Chapel and its spectacular ceiling famously painted by Michelangelo. Did you know though, at that time he was a sculpture and did not consider himself a painter, an area he did not believe he was skilled in? At 13 years old, he obtained an apprenticeship from Domenico Ghirlandaio who was one of a team of painters who had been called from Florence to the Vatican to decorate the walls of the chapel. Believing himself primarily a sculptor Michelangelo was suspicious of who had convinced the pope (Julius II) to hire him. Ultimately Michelangelo was one of the leading lights of the Italian Renaissance and was without a doubt one of the most inspirational and talented artists in modern history.

Originally commissioned to paint the 12 Apostles, Michelangelo wanted a much grander scheme and went on to depict many more stories including biblical scenes from the life of Moses and the life of Jesus, biblical narratives from Genesis, the Ancestors of Christ, the Gallery of Popes, the Last Judgement and many more. By the time it was finished Michelangelo had painted over 300 figures.

“I couldn’t give you something mediocre even if that’s all you asked for” – Michelangelo

In the early 1980s one of the most significant conservation-restorations of the 20th century was carried out on the Sistine Chapel and was finally completed and approved in 1994. The reason I mention this is because what you see today is a very brightly coloured spectacle but they deliberately left a small area for comparison which shows it to previously have been very dull and lacking in depth, richness and intensity.

If there’s one other attraction I would recommend on a visit to Rome it’s the Pantheon, a former Roman temple which dates back over 2000 years! The monument which was rebuilt by the Emperor Hadrian to replace an older temple built in 27 BC is one of the most preserved of all Ancient Roman buildings and over time has undergone a number of renovations. Almost two thousand years after it was built, the Pantheon’s dome is still the world’s largest unreinforced concrete dome. The Pantheon’s large circular domed ‘cella’ (the central structure of a classical temple) with a conventional temple ‘portico’ front (a structure consisting of a roof supported by columns at regular intervals) was unique in Roman architecture. It’s a fascinating building and one of the most memorable bits of information for me is that at the center of the dome is an oculus, a hole of 9 meters in diameter that allows sunlight to illuminate the interior. But this also means that when it rains, it is able to enter the building. For this reason the marble floor slopes down into the centre into 22 drainage holes to allow water to leave the structure. Many of the Romans thought that the building had special magical powers or it was the work of the Gods as the rain never fell to the ground. What they hadn’t accounted for was the hundreds of candles used in the building back then which would have created a heat barrier and evaporated the rain before it hit the floor!

Wherever you might be in the city of Rome, the Renaissance period is the dominant feature. There are over 900 churches, many of which contain works by famous artists. I wanted to visit one particular church, the Santa Maria del Popolo which stands on the north side of Piazza del Popolo, one of the most famous squares in the city. It includes the works of Raphael and Caravaggio. We happened to go in just before they held a mass which added a suitably authentic atmosphere. I should add here that I don’t follow any religion but I respect those who do and I often feel the spirituality when I’m in a place of worship. I also always feel the need to light a candle for my mum. This strangely gives me some comfort even though I’d probably best describe myself as an agnostic. I’m neither a believer nor a non-believer and often a sceptic, preferring to accept a scientific explanation that can be proved rather than something based on tradition, authority or revelation. I don’t believe I’m an atheist. I choose to keep an open mind which is why I light a candle. Whether or not this has a spiritual reason, I feel that it’s a way of acknowledging the loss of my beloved mum. I hope that doesn’t make me a hypocrite. If there is a God and heaven does exist, I like to think my mum is being looked after by the angels. If there isn’t, well maybe I’ll never know…..

We don’t always have to agree with one another but it is important that we learn to respect each other.

It’s amazing what you can pack in to just a few days. We sat in the Piazza Di Spagna enjoying tea and cakes close to the iconic Spanish steps while ‘people watching’. There are always police officers ensuring everyone respects the rules and there is a constant sound of a whistle being blown when anyone stands or sits on something that isn’t allowed! It is also the hub of upper class Rome with multiple designer stores – Gucci, Prada, Bulgari, Hermès, Cartier, Louis Vuitton, Ferragamo, Max Mara, Jimmy Choo, Montblanc, Miu Miu, Dolce & Gabbana, and Céline among others! Definitely only a window shopping exercise for us mere mortals however! That said, I was treated to a few items made from beautiful Italian leather so I can’t complain!

“A piece of clothing should be like a work of art” – Rosita Missoni

The real ‘hubbub’ of the city is in the area of the Trevi fountains. The little lanes of restaurants, boutiques, gift shops and gelateries were bustling with tourists at all times of the day and night. The fountains are a sight to behold and refreshing in the 37° plus temperatures! We spent quite a bit of time in that area probably passing by there at least once on each of the four days we were in Rome. At night the fountains were beautifully lit up so it’s nice to see them both during the day and the evening.

On our third day we decided to have a bit of ‘down time’ in the morning. We booked the hot tub which was on the roof of the hotel. We didn’t pay to have it exclusively to ourselves but luckily for us we were the only ones there for the whole morning. It was the perfect way to give our feet a bit of a break from all those steps and to soak up some sun. As you can imagine the view was magnificent. Feeling fully relaxed and batteries recharged we got ready for another afternoon of exploring.

On the fourth and, what we thought was, our final day (more on that to come) we didn’t really have a specific plan. There was disruption and a number of restrictions on the Metro that day which meant we could only use one line. We made our way to ‘Termini’ which is where the main rail and bus terminals were. Then we just used our phone maps to find our way around. Some of the roads were extremely steep and were quite an effort in that intense heat but it was a great way to see landmarks that we otherwise might have missed. We literally stumbled across one such landmark! We were waiting to cross over a very narrow crossroad junction and I spotted a fountain within an elaborate Renaissance sculpture carved into the corner of one of the buildings. Then I looked around and noticed there was one on each corner, in four different buildings. That’s when the penny dropped! We were in via del Quattro Fontane. Of course, the famous ‘Four Fountains’! It is very subtle with no signs referencing it being there. We could easily have not noticed it!

We saw stunning architecture at every turn and, although we knew the general direction we were aiming for, we had no idea that we were ultimately going to arrive at the top of the Spanish steps rather than the bottom where we had passed or sat nearby on a couple of occasions.

We had to be back at the hotel by mid-afternoon for our transfer to the airport. Our luggage was being held for us so we only had to grab that. We were waiting by the hotel entrance looking out for our driver but the scheduled time passed and we started to worry. I called the number for the hotel transfer company and my call was placed in a very long queue. It got so late that we ended up having to call a taxi at a cost of 40 euros as we couldn’t risk waiting any longer for fear of missing our flight. We had every intention of claiming the taxi fare back but in our haste and anxiety about being late we forgot to ask the taxi driver for a receipt.

I gave up on the phone call and subsequently spent another an hour waiting in an online queue, throughout the taxi journey and continuing into our arrival at the airport. I finally had an online chat with the transfer provider who questioned us about being ready ten minutes before the pick-up time. I told him that we had been watching from the door of the hotel (rather than standing in the blistering heat) and the transport definitely had not turned up during that time. He was not helpful and insisted the driver had been there. Very poor customer service. However, if we thought that was the end of our travel troubles on that trip we were very much mistaken! Despite miraculously arriving at the airport on time for our flight our problems had only really just begun.

We queued at the baggage check-in and it wasn’t until we got to the desk that we were informed that our flight had been cancelled. Oh the irony of the transfer debacle! We were then told that we were being checked in to a flight with a change at Barcelona airport the following day. The airline staff were trying to get a hotel big enough for the passengers whose flight has been cancelled to stay in overnight. In the meantime we found out that the return flight had been cancelled six days earlier before we had even left the UK. Despite this, I received reminders on my phone that day about the original flight times. I now believe that this was the reason our transfer hadn’t turned up, we think they had already heard about the cancellation before we even knew and just didn’t bother coming to the hotel.

After approximately two hours waiting we were finally taken to a coach and seen on board by a member of Vueling staff. He told us that the hotel would have all the details of what we needed to do the next day. I’d say there were about 20 of us. We were then driven by coach back into Rome city centre and this is where it gets farcical. Firstly the driver couldn’t get the luggage area open and this delayed us leaving. One elderly gentleman had a mobility scooter so they couldn’t just load the suitcases inside the coach, they had to find a way to open the ‘hold’. Eventually we left but the driver kept encountering obstacles (such as poorly parked cars obstructing the road) to get to the hotel and we ended up passing the colosseum three times! One of the groups on the coach had been on a rambling holiday a couple of hours drive from Rome so many of them had not seen the city sights. Some got their phones out to take photos and were thrilled at this unexpected chance to view the iconic landmark, albeit very briefly! Silver linings and all that! After what should have been about a 30 minute journey, we finally arrived at the hotel almost two hours later! The shenanigans continued…

Whilst checking in to be allocated our rooms we discovered that the hotel staff knew nothing about our situation. However, they were very helpful and eventually managed to get the information we needed about our transfer the next morning. The hotel was pretty fancy but sadly our dinner wasn’t great. There were no choices so it was a case of ‘like it or lump it’. We were definitely not in the dining room of an A La Carte restaurant, more likely the conference/business area. We also discovered that a family who were supposed to be on the coach had been left behind at the airport because they had taken their young child to the toilet and the rep hadn’t checked that everyone was there before taking us to the coach. They were a young Italian couple who ended up having to get the train and had to fork out for the fares. I’d be absolutely outraged if that had happened to us but they seemed accepting of it. I had noticed them at the airport (I always spot cute children) and I just assumed that maybe they had chosen to go back to their home for the night.

Our room was very luxurious but what’s the point if you’re only there for a few hours? We walked off our dinner in the same area that we had walked round earlier that day but didn’t stay out long as we had to be up at 5.30 am the next day. Our coach was due to pick us up the following morning at 6:15 am. However it was over 20 minutes late and, guess what? It was a different driver and he couldn’t work out how to open the boot! He actually had to consult a manual. You really couldn’t write it! One passenger was delighted that it was the same coach though as he had accidentally left his hat on there the day before and it was still there. A good result for him at least.

The first flight to Barcelona was on time. However, there were two further delays for the departure time of the flight from Barcelona to Gatwick. Consequently we spent an entire day either on a plane or hanging around at an airport. We also ended up spending more money on food and drink at both airports. So what should have been a two-hour flight home ended up being two two-hour flights and a very long day. We both missed a day’s work and my husband missed a meeting with a new client but, despite writing a complaint and seeking some compensation, we didn’t even get a response let alone any reimbursement.

We could have let it spoil the trip but we’d had an amazing few days and it would have taken something much worse to take that away from us. We had made some wonderful memories and we would certainly never forget our ‘Planes, Trains and Automobiles’ adventure!

No journey is too long with the right company.

When you are grateful, fear disappears and abundance appears.

As we got closer to my surgery date we had a couple of significant events which I had prayed I could do.

Before I talk about those though, I had a very distressing situation to deal with. It was just before my foster brother’s wedding on 26th June. The men all took my brother out for stag drinks on the Friday night and us hens opted for a more quiet affair, a girls’ night in with face masks, drinks and nibbles.

I need to give this story some background though. In October 2015 I had to have emergency repair for one of my top front teeth. It had cracked and there was an almost perfect square missing at the bottom. Not massive but big enough to cause a huge amount of anxiety. Not only did I look like I’d been in a pub brawl but it was very sharp and left little cuts on my tongue. I managed to get an urgent appointment and had it repaired with composite bonding to fill it at what I thought, as a private patient, was a reasonable cost of £50. It felt strange for a bit but at least it was sorted and looked okay. Or so I thought….I’m not going to bore you with the years of anguish, not all the time but what seemed quite regularly, that I’d endured due to the repair not holding, having to get it redone or filed. I was told the original damage was most likely just due to wear and tear as my teeth were generally in good condition but the life of the individual repairs should have been at the very least two years. After two additional repairs, free of charge (on the first occasion), the whole thing broke away again a couple of years on. By this time I was four new dentists on and the practice had been taken over by Bupa Dental Care. The latest dentist seemed very keen to spend my money and, although he was friendly enough, I never really warmed to him. However, he managed to fit me in and do the repair. I explained the issues I’d had with repeated appointments to redo additional repairs and he said “Don’t worry, that won’t happen with me. I’ll do a good job”. So he did this second repair at a cost of £175! Gulp! I know costs increase over time but £125 in two years! That’s over three times the original fee. What could I do though? So it was done and I hoped I wouldn’t have to go back after the reassurance it would be a better job. Well, guess what? Two weeks later I was back there. I had felt gritty bits and a kind of elastic substance in my mouth on a few occasions. Fearing it was crumbling again, I went back. However, far from being apologetic or sympathetic, the dentist pretty much interrogated me! He was obviously looking for a way to blame me for the failure rather than his workmanship. He even asked me if I grind my teeth! I replied confidently that this had never been suggested and that normally it is something a dentist would observe and tell you about. I know this as my son had to have a night guard to protect his teeth for that very reason. He did the repair and, I felt reluctantly, didn’t charge me but the whole experience had put me off him. I stayed with the practice though and had a check up and a hygienist appointment once it was possible to go after the pandemic.

If you judge a book by its cover, you might miss out on an amazing story.

The most recent time was just a few months after my last check-up and I started to feel uneasy about it on that Friday. Although it hadn’t actually crumbled at that point, I know the signs and knew it was just a matter of time. With the wedding in just two days and a holiday booked just after that I was in a panic. I avoided eating all evening and couldn’t stop worrying about it. The next morning, the day before the wedding, we had a mad panic to try to get an appointment. I called an emergency number that had been given out on an answerphone message as it was a Saturday and was told it was not classed as an emergency because I wasn’t in any pain. I got to the point where I would have been prepared to beg! In the end my husband suggested looking up cosmetic dentistry. I said it would probably cost the earth and he just said we’ve got to get it sorted so let’s just phone up and see what we can get. We found one in Willingdon, Eastbourne and my husband called them. The call was to a mobile and was answered by the actual dentist. He didn’t ask many questions, not even my name, but gave us a time to go over there. My husband said it did all seem a bit bizarre and casual but we were desperate. I called a friend of mine who has worked for the Dental Practice Board in Eastbourne for years to see if she knew this dentist as I know she had previously been involved in investigations. Unfortunately she didn’t know him and was no longer working in that department. So I went to good old ‘Trustpilot’ to see what the reviews were like. They were all glowing and very complimentary and there were no negative ones so, assuming they were genuine, it gave us some reassurance.

We arrived at the practice in good time and there was no-one at the reception desk so we just waited. After a few minutes the dentist came out to greet us and take me round to the treatment room. He invited my husband to come too. He was a man of few words and had a really gentle approach. I asked him if he thought it would make sense for me to have a crown fitted as I had had so much trouble but he said the rest of my teeth were good and I would have to have both of my front teeth capped as the colour difference would be too obvious and wouldn’t look right. His view was that it was better to repair the tooth. I really appreciated his honesty as he could have jumped straight on that query and got considerably more money out of me. I couldn’t help thinking that if it had been my regular dentist he would have been rubbing his hands together in glee at the prospect of some costly cosmetic work. I had not enquired about the cost of that particular appointment prior to the treatment so we had no idea what we were going to be charged. He spent about 45 minutes carrying out the treatment and it was an emergency weekend appointment so we were expecting to pay a premium. We were very pleasantly surprised when he charged £125, £50 less than I had paid four years previously.

I think what resonated with me more than anything was the overall ‘feel’ of the place. The Bupa practice I was registered with is very business like and ostentatious, the kind of place where you feel like you’re making it untidy just by being there! In contrast, the Eastbourne practice could have done with a bit of attention in terms of the decor. There’s no question that it wasn’t clean but it was far less clinical and, in my opinion, much more inviting. Everything about the experience inspired us to consider a change. We were so impressed we called up the following week and asked to both be taken on as new patients. As we were already private patients this wasn’t a problem. We were allocated to a female colleague of the dentist we had seen, a lovely Finnish lady. So far I have only had an initial consultation with her but I really liked her. Again her treatment room wasn’t fancy but it was very inviting. Rather than stark walls or pretentious pictures, there were lots of children’s drawings around the room. I felt like we were going to be in safe, kind hands.

“And all is not golden that glitters, and not all that glitters is gold” – Aloysius Charles Swinburne

So, the day of the family wedding that we had all very much been looking forward to arrived. It was at The Hydro Hotel in Eastbourne. The setting was absolutely stunning, on a terrace with a backdrop of the sea. A beautifully decorated pagoda was the centre of the marriage ceremony with a string quartet playing. The weather was perfect and it was a truly happy occasion, not least because we shared the day with family. I am 12 years older than my brother and he joined our family at just five months old so I was as much a second mum to him as a big sister.

When we first walked out to the terrace I had a ‘moment’ and shed a few tears. My mum would have been so proud and happy to see her ‘baby boy’ finally getting married.

Everything about the day was wonderful but my brother’s speech was absolutely heartfelt. He’s always been very shy and quiet so public speaking really isn’t within his comfort zone but it was such a personal account of how he met his ‘future wife’ and he completely wore his heart on his sleeve. It was also very funny in places. Other speeches came from work colleagues/friends and it was evident that they all held him in high regard and were delighted that, at the age of 42, he was finally marrying the love of his life.

My brother has lived with his birth mother for several years now. He moved up to London and settled with her. Out of respect for the family I won’t talk about the background but it had been a private fostering arrangement and he was never in the care of the local authority. He saw his birth mum a few times a year so, although they didn’t have a close relationship while he was growing up, she wasn’t a stranger to him either. After my mum passed away I think it was good for him to get to know his Ghanaian family better.

His mum and one of her sisters attended the wedding, as well as a couple of their friends. They wore traditional outfits to the ceremony and brought a plethora of colour to the day. In the evening they ramped up the glamour another notch and all looked absolutely amazing in stunning evening gowns. They could have been backing singers for Shirley Bassey!

There was a lovely moment during the day when his birth mum came over to me and my dad and said she wanted to thank us all for the way we had all looked after him and how grateful she was for the lovely man he is today. From our point of view the pleasure had been all ours but it was really touching to hear that from her.

I particularly loved the multicultural feeling of the day with guests from all different aspects of my brother’s life. One of his friends proudly wore traditional Nigerian attire and looked really cool. It was such a fun wedding with the coming together of two very different family backgrounds and friends of the couple.

Later on there was a disco and the stunning bride had changed into a shorter white bridal dress. They had a very cute and romantic first dance as husband and wife and we all danced right up to the end of the evening.

My family have always been massively into music, all of the generations and, in particular, my cousins who we party with regularly. As we were waiting and being served food, the string quartet had repositioned themselves in the area of the wedding breakfast to continue entertaining us. The music was more pop than classical now and really good. They played a rendition of ‘Bohemian Rhapsody’ and my cousins started singing along. Before we knew it loads of the guests had joined in. This continued throughout the meal and even the musicians couldn’t help smiling! When it was time for them to leave they got a standing ovation with everyone whooping and cheering. As they walked past, one of them said ‘best wedding we’ve ever played at!’ Far from being embarrassed about the behaviour of my family I felt huge pride in their enjoyment in the small things and that’s why I always love spending time with them! Never a dull moment when we all get together!

“Music has the power to bring people together like no other art form” – Michael Franti

With such a rough few months behind me and more to come, this was the perfect occasion for me to appreciate my amazing family and let my hair down for a few hours. Not that I could ever forget but it was also a reminder that, amongst all the fear and anguish, I am incredibly blessed to have so many amazing people in my life.

Behind you, all your memories. Before you, all your dreams. Around you, all who love you. Within you, all you need.