Saturday, 31 October 2009

why don't I understand metric?

Am I showing my age if I say I only work in imperial? It suddenly occurred to me last night that 700mm can't be right. I mean that's 70 cm isn't it? That's bigger than I am wide! (or I'd like to think so...!) so I think it must have been 50mm and 70mm. Just in case anyone's still reading this and thought I'd turned into a walking tumour..

Have had the kids quite a bit during the day this week, which will change to after school next week, but they will continue to stay overnights with John for the while. Am improving though and reducing the painkillers gradually. There's a lot of improvement to be made with the physio exercises to battle against what they call "cording" under the arm. This is a pulling on the nerve that results from the movement of the muscle from the back and I have to pull on it for weeks with a variety of exercises 3 times a day to try and get it back to normal. Very tiring and time-consuming.

For those who haven't already heard this from me, the wonder of reconstructive technique these days is quite awesome, and the surgeon was very proud of his handiwork. What they do is:

  • remove the nipple (which is breast tissue so has to go anyway)
  • remove all the breast tissue through that opening - they make no other incisions to the skin of the breast at all so there are no other scars
  • put in an implant
  • make an incision in the back and remove an area of the muscle (known as the dorsal flap), but they don't take it out, rather they move it round underneath the skin and sit it over the implant (this is what can cause the cording). So what you end up with is the breast (rather swollen at first) with all the original skin saved and sensitive, with just the nipple removed. To cap it all (can't resist these puns, they just suggest themselves!) you can later have either a tattoo (I'm toying with the idea of a safety pin and chain) or you can even have a reconstructed nipple. Somehow I don't feel very drawn to any more surgery than is strictly required at the moment, but you never know, maybe in a year's time...

In any event, amazing thought it looks now, it will inevitably suffer damage because radiotherapy hardens the implant. It's a catch-22 because unless you have the reconstruction at the same time as the mastectomy you can't take advantage of the skin-saving technique, but they don't know for sure that you'll need radiotherapy until they've analysed the cancerous tissue. But they can go back in after the radiotherapy and patch it up, these clever bods.

I gather that not everywhere in the country has this wonderful option. I don't know whether people in areas where this is not on offer can ask to be treated elsewhere or how it all works within NHS budgets, but if you know anyone who has been diagnosed and would be interested please feel free to invite them to this blog.

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