Why the little c?

On 17 July 2013, I went for what I thought would be a routine mammogram – my first. All was proceeding as expected when the operator said “We need to take a closer look at this area.” Suddenly, it wasn’t routine anymore.

The atmosphere ramped up as people bustled around carrying films with knitted brows. After a lengthy ultrasound, I sent JP the following message:

Note: JP and I call each other Ted

The specialist who took the biopsy seemed very concerned. So I started to come to terms with the likely outcome. The probability of this has been present for most of my life, as I lost mum to breast cancer in the mid 1990s.

Back home, Google did what it does and filled in lots of gaps and five days later, the GP confirmed the probability was now an actuality. “You have high grade DCIS, ductal carcinoma in situ. So it’s abnormal cell activity but it’s contained within the duct. So it’s not really cancer.”

Well Dr. Google disagrees. All the information about this kind of ‘abnormal cell activity’ was housed on sites that mentioned the ‘c’ word:

where to find out about a "not really cancer"

where to find out about a “not really cancer”

But I take her point that as a non-invasive strain it’s less worrisome. So it’s cancer. With a little c.

Next steps for me is a consultation with a surgeon, which I’m lucky enough to have arranged for tomorrow. I’ll report back.

Thanks for the mammaries

Two years have passed since my first and last mammogram, where I found out that left to their devices, it was extremely likely my breasts were going to kill me. I’ve discovered anniversaries are a time for reflection, assessment and, in my case, getting into a right royal strop.

This came about because I was pondering how, if at all, to mark the occasion. Briony my (alternative-but-as-efficacious-as-any-traditional) medicine woman counselled that I should make an effort to acknowledge the date. This got me thinking how it was a shame any such celebration would be led by me, and wouldn’t it be nice if someone were to remember to reach out at a time of year which is so full of significance for me.

Ted is not an unkind person, but commemorations are not his strong point. So I had come to not expect it of him but what about my friends and family? None of them are exactly bathed in glory! No-one else cares. Poor fucking me. To my shame, before I knew it I’d worked myself into a Catherine wheel of resentment, and no-one was safe from my hot sparks of self pity.

Once I’d burnt out from being furious, I tried to work out ‘what the fuck brought that on?’ and as is my wont came up with a theory of sorts.

When I was going through the shit properly, it was the isolation that slayed me. I used to rail against the fact that not only was I awake at 2am contemplating my future, and the possibility of those I love living a life without me in it, I was also the only person doing that. Of course I was loved, supported and cared for, but I was alone. Anyone who has given birth knows what that’s like. And in fairness, having attended a birth, I also know what it’s like to want to help, and not be able to, plus I know about being scared to get a cup of tea in case I miss something, but really wanting that tea anyway.

Still my little pity party was a knock off of the original resentment towards the inevitable aloneness. Once I worked through that odd episode I turned my attention to marking the occasion and settled on a dawn walk alone to the Byron lighthouse, lunch with my best buddy, and dinner out with Ted where we could drink champagne to celebrate.

And then I realised, the cancerversary had actually come and gone. My massive ego was totally happy to chastise loved ones for forgetting, while not even remembering myself. Buddha was right, this was so perfect I tilted my head to the sky and laughed.

Still I will carry out my plans, but on 12 August (operation day) instead of diagnosis day, because there are so many reasons to celebrate. I am better now. I have sifted through the detritus and found the jewels. “What hurts you blesses you.” said Rumi “Darkness is your candle.” The experience turned on the lights to my spirit and I’ve enjoyed a rich (yet non-religious) appreciation of the sacrosanct ever since. I’ve woken up, and have learned to receive, to move, to forgive and perhaps most critically to not give a single bead of sweat over to the small stuff. Clearly I still lapse into martyr mode, slovenliness and, as this post testifies, dis-grace, but the not giving a fuck thing? That I have nailed, my friends.

Featured image

Saturday morning post-walk breakfast, one of my week’s highlights.

People who followed this blog have asked me why the writing stopped dead in its tracks. It’s because writing about cancer helped me through it, but once the treatment had finished, I needed to distance myself from it all. Everyone who encounters tragedy is in danger of letting it define them, and to continue writing here could have seen me fall foul of that.

But you know what they say about babies and bathwater, and one of the many treasures of cancer and this blog was it caused me to take the dust sheet off a craft I’d forgotten how much I loved AND was good at. The words helped me so and I’m finally ready to use them again in my new blog, Magic in Motion. In it I will explore how moving physically has transformed my identity from a hill avoider to a seeker of stairs.

So thanks for everything, littlec.org, but it’s time to move on up.

I’m better now.

Good grief

To recover, I’m learning, you need to tread a line between being defined by trauma, and ignoring it entirely. I incline towards the latter, preferring to keep on keeping on. At a consultation with an alternate medic, my attention was yanked back to the centre, when in a Good Will Hunting style scene, she held my gaze and said “What happened to you was dreadful.” And I responded blithely “Yes, it was rather”. And then she said “It really was, Sam” and three more probings in I was a puddle on the floor. Later, though, I felt lighter, better and more energetic than I had in an age.

I think that even when you end up at a point where you can say “Yes, this happened, but here I am.” you can still end up at the bottom of the slough of despond, where I’ve resided a couple of times of late. And in fairness I’ve been very much not there a majority of the time, but who wants to read a blog about rainbows and lollipops? Quite.

I’ve thought a lot about whether to share one particular grief as I’m concerned I’ll upset some of you but hey, this isn’t a pain-free situation so here goes.

On my recent trip to Europe (that scores a 9/10 overall btw) a surprising number of people didn’t bring it up for ages, if at all. I had expected to have covered it off in initial conversations and was confounded, confused and upset when it wasn’t. Others, meantime, had an opening gambit along the lines of “What a shit year you’ve had!” It wasn’t even the people far removed who stayed silent. Meanwhile one near stranger, a distant Italian relative of JP’s, acknowledged me by way of a squeeze of the arm and a certain look. I was so grateful for this. It wasn’t as if I wanted to deliver an oratory each time I saw someone for the first time in years, but some sort of recognition of what I’ve been through would have been nice and in many cases I didn’t get it.

Those of you who are parents, imagine seeing a relative for the first time since becoming a parent and not being asked ‘how are you finding it?’ or ‘how’s the baby doing?’ Closest analogy? That.

Now I know this wasn’t done in spite or with intention to hurt. I know you can rationalise not talking about it in a way that fits the English cultural preference to maintain a stiff upper lip. I know it is not an easy conversation and I know, because many did eventually pipe up, that it takes a while to scope out the situation and gather the courage to breech it. But while it didn’t get mentioned, I felt this very real fact of my life was ignored. Ignoring it doesn’t make it go away. I wish wish wish it did, and that I had the luxury of pretending nothing had happened.

But the lesson overall has been that expectations can bite you on the arse. Perhaps I’ll get that into my head once and for all, eh?

Another slump came just recently. I have a series of index cards with the date on the corner and each day I’ll write a couple of sentences about the day. Here are a couple of examples:

14 Dec
2012: Theo is all smiles! He is gurgling too and does the odd laugh. E and I went to Saya’s birthday party which was low key and lovely.

And

26 April
2013: Buggy chassis broke on way back from GP. Carried Theo home and he spewed down my back. At home, girls were massively whiney. “Living the dream”.

I’ve completed this small, daily action every day for 18 months and while I may skip a day here or there, I’m disciplined about it.

17 July 2013 says “Routine mammo – my first – turned scary with instant biopsy. In shock for day.”

And then the cards go blank for the next ten days.

Seeing those blank cards, I was so clearly reminded of the horror of that time. Boarding the medical train. Feeling the dignity of good health seep away. Talking with strangers, feeling dehumanised. Tests, needles, decisions, wondering what the fuck was going on. All against the backdrop of the possibility of leaving the kids motherless – a pain that usually dares not speak its name.

This is Major Tom to ground control… I’m stepping through the door.

Nothing can match the intensity of that initial plummet into ill health, the total loss of innocence which is so transformative you become a stranger in your own land, because how can the people you love know? They can fear for you, but they’re not you.

And the one person who might have been able to help perished two decades ago and wow, that was shit wasn’t it? How about another poke around in that ol’ wound? Am I going to be another chapter, one with a fatal ending? Are the girls?

There were hours within the days at the end of July where I focused on one particular worry, and other hours where I felt like I’d been hit by a nail bomb of worries, all simultaneously causing pain and shouting for my attention.

These worries, are for the most part, a distant memory. Many have been eliminated by the drastic surgery I was able to opt for. Things are different now, as they are for everyone a year on.

A card from last week: Took girls to ballet. At a quiet point, E reported “Mum, the greenie, it’s come out look!” At another A said “But what are they trying to say?!” Not likely to be culture vultures it seems. Met the boys after for ice cream. Theo ate all mine. It’s official, we are now a five ice cream family.

It’s a sin

Pride

Oh my. This has taken quite a beating. There’s the blindingly obvious loss of femininity that underpins this whole experience. Of course there is. I’ve not explored that topic in depth in this blog as it feels too lazy, although clearly I reserve the right to clutch at the low hanging fruit at a future date. But the loss of fitness? That is something I’ve harped on about as it really hurt me in every which way. It took a great big pair of bollocks to go back to yoga post operatively not once, but twice, and to have to return to the beginner’s class, too, when I had been going to the advanced ones was its own form of humiliation. But ironically, I was incredibly proud of myself for fronting up to those classes, especially when the gremlins were saying “Why bother?” I knew it’d be hard and confronting, but still went anyway. There’s pride right there.

Envy

I’ve noticed people feel awkward sharing their woes with me and if they do it’s often prefaced by ‘it’s nothing compared to what you’re going through’ but I can honestly say I’ve very rarely wanted to respond with a ‘you’re right, that is nothing, I wish that’s all I had to worry about.’ I don’t envy other’s health, rather I am nostalgic for mine. I’ve been envious of all the natural cleavages I’ve seen this summer but again, don’t begrudge others. I just hope they appreciate them.

Lust

In my experience, the human libido is a remarkably robust thing. And because I know my brothers and in laws are reading, I’m going to leave that there.

Wrath

Yeah, been there done that, I was mad as a cut snake for a long time. Once I’d adjusted to my reality, this dissipated. I’ve come to believe anger is fuelled by resistance to reality. Perhaps all those years of mum saying “Life’s not fair.” have helped as has the fact I am a pragmatist and optimist. I feel flashes of anger now but they can be seen off by a good sleep and/or a good laugh. Life’s not fair. But it’s still good.

Sloth

I was suffering with inertia before my diagnosis, however cancer saw that on its merry way. I’ve gone a bit manic, if anything. There isn’t a moment to lose! Which means I’ve become quite good at saying no, even when it’s uncomfortable. Hello boundaries! Where have you been all my life?

Greed & gluttony

I thought I was a relatively healthy person before my diagnosis, and in the wake of it I’ve found it confronting to consider where lifestyle changes ought to be made. Should I become a vegan? Eat only organic food? Give up alcohol and caffeine? I don’t want to do any of these things. Enter intermittent fasting, which is supposed to have long term health benefits. Here’s what Dr. Google says:

Between 2008 and 2013 there have been a number of research studies suggesting fasting can have significant beneficial effects with people trying to beat cancer, halting cancer progression, improving survival, reducing the side-effects of drugs and radiotherapy and even causing tumours to disappear.

Those are quite some claims, huh? So for the last two months, one day a week I eat 500 calories of protein-rich food, and then for the rest of the week I return to my normal diet. It’s not a highlight of the week, but it’s entirely doable, and ticks the Lifestyle change box. Ted does it with me, bless his heart, although he spends the day moping around like a teenager. Here are some other facts about fasting:

Average number of arguments per week: 3 Percentage of arguments that occur on fast day: 250% Kilograms lost collectively: 5

How long this will go on for? Who knows, although publicly declaring you’ve lost weight is a big call. You know when they say pride comes, right?

Tough tits

In the time since my operation my right foob has recovered beautifully. Initially swollen and tender and sore at the stitching site, it has settled down into a relatively squishy, comfortable part of my body which I know I will learn to live with and maybe even love. The scar, under the implant, is present but not obtrusive. The nipple is nerveless but, I’m told, responsive to touch.

Well done, right side. A round of applause.

Left side. *shakes head* Why can’t you be more like your sister?

Instead I’ve endured a red and angry scar that has been by turns very hurty and then very itchy. And s-l-o-w to heal – the doctor made me fill three scripts’ worth of antibiotics while it took its sweet time to fix itself. The radiation-damaged skin had seized around the implant, making it flatter and harder and at one point about two inches higher than the right side.

It hurt. A lot. I thought about writing  a dark and poetic piece about it, but listening to tales of pain has the same appeal as listening to other’s dreams, i.e. none. But in summary it stressed me out and made me grumpy and forced me to interact with my kids at arm’s length, as if I were a not-so-affectionate aunt.

One thing I’ve been told is tolerating pain is very bad for you. Much more effective to take pain killers and do what you can to get on top of it. You are psychologically stronger and recover more quickly.

I know this. But did I act on it? Did I fuck. We are part of a species whose actions often make zero sense. I got lazy and didn’t take the Nurofen and suffered because of it.

“I just want to hide in a cupboard!” I told Faye on the phone, through a river of snot and tears. As she has for 30 years, she listened and sympathised. She then urged me to talk to my doctor, who I wasn’t supposed to be seeing for a fortnight.

So I got an earlier appointment and went along. In fairness, the pain had tapered off on that day, but was still a major source of concern. After the routine inspection/photography-from-4-angles, I hit the file transfer button and start to download.

She listened patiently before telling me, in iron-fist-in-velvet-glove doctor speak, to take a teaspoon of cement.

“Radiated skin is always compromised. A degree of discomfort is to be expected.”

She goes on to offer a bit of comfort which I cling to like a drowning man. “While sometimes it’s chronic, other times it comes and goes. It’s still early days after the operation and it may just be things settling down.”

But of course when I call home with the summary, I headline for the sympathy “HTFU is what she said, Ted! I don’t want to HTFU! I’ve hardened up enough, haven’t I?” Back home he is tender and kind, and along with his mum they provide an excellent force field against the kids as I book more sessions in the oxygen tank and wonder how the fuck else I’m going to strategise my way out of this.

Then a strange thing happens. The next day I wake up and the pain is gone. The ghost of it lingers, but it’s largely gone. I am weak with relief, euphoric.

Another lesson: there is always room for redemption. Always. I shouldn’t believe in decline, and should fiercely believe in hope. Time was, and we’re talking last week here people, time was I’d think “Well this is it. The side effects of radiotherapy are here now. Still worth having the treatment was it? Can you live with this?” and then I’m released from pain prison and I realise there is hope for improvement and has been all along.

Maybe it’ll turn out the left implant is just a place I hold tension. I am certain it’ll play up again and aesthetically, it’s still hard and high. But I can also be hopeful any pain it causes me won’t be permanent.

In the meantime I salute/take my hat off/give a deep bow to anyone actually suffering from chronic pain. People call me brave but you… you are legend.

In like a lion

Optimism is marvellous in so many ways. It has helped me a great deal with this whole shit fight and I would choose hope and positivity over the opposite any day of the week.

But.

Sometimes, it bites you on the arse. I went into this surgery all swagger and swing and came out dramatically humbled. My expectations, shaped by the surgeon and me only hearing what I wanted to hear, went like this, as quoted from my last post:

It’s a far simpler procedure this time around, and while I’ll be under general anaesthetic I’ll be in and out in about an hour and can go home the same day. There will be no drains to manage, no complex pain relief regime and few restrictions to my mobility.

So on the day I swanned off with my half-charged phone in my pocket, zero painkillers and no change of clothes. My first inkling that this was to be no piece of cake came when I walked through the same frosted glass doors as I did last time I was operated on. First things first, the tags. A long identity check occurs before you’re given an impossible-to-tear-off tag on both your wrist and your ankle. It’s excessively cautious move and smacks of distrust. I’m told “You’ll need to put all your clothes in this bag. Now pop on this gown, here’s some paper underwear and you’ll need to tie your hair back and put on this cap.” The schung of the curtain on the rail while I do what I’m told, heart in my ears the whole time. Next I’m fitted with compression socks and paper shoes, then a dressing gown.

In the pre-surgery waiting room I see several geriatrics, all of whom look like they know the drill. But I’m not the youngest one there this time: there’s a man in his thirties who’s frightened and fidgety. I don’t remember fretting about it before, but today I’m overwhelmed by the depersonalising effect of everyone in their uniform caps and gowns. The others are slumped in armchairs watching infomercials, the younger guy and I have our backs to the telly. I watch his knee bobbing up and down and consider offering some reassurance. But what can you say? “You’ll be fine.” Will he? He could have stage 4 cancer for all I know. I could say “This is like The Island, isn’t it?” but in the end all I can manage is to catch his eye and give him a small “this is shit isn’t it?’ half smile and eyebrow raise before “LEADER” gets called by a porter and I have a little “I don’t need a wheelchair, thanks.” “It’s protocol Ms Leader, sit down.” exchange.

So far, so humiliating.

We take the lift to the bunker and I move to the bed I’ll be operated on. Four others are in the dim ward, all with caps and gowns and tags. Those damn tags. Every time you interact with a staff member you have to recite your full name and date of birth, while they regard the same details on your wrist. For fuck’s sake, the rigmarole you need to go through to prove your identity before they tag you up makes this constant checking a joke. At what point do they think you’re going to forget who you are? In the time I’m there I hear others share their details. Turns out the guy, Mark, is younger than me but only just – he’s 40 in two months. Richard was born in ’36, the same year as my mum, but, as the gag goes, by the time my mum was his age she’d been dead for 20 years. Ah, Susan is a Pisces, like me.

Eventually I’m wheeled into my own private waiting room, which is just next door to the actual theatre. On the way, we go through double doors and I survey endless bright lights above me “This is like the movies.” I think. The irrepressible Dr. Crilly (my anaesthetist)  has been reading her notes. “Theo’s 15 months now, right? Into everything!” I know she means well but I don’t welcome the talk of my youngest, most vulnerable child moments before I lose consciousness. But still the layers of socialisation enable me to say “Ooh, yes, he’s a right little bruiser nowadays!”

Then the lovely Dr. Moko enters with her permanent marker and makes her dressmaker/butcher markings on my chest. As before, her actions are like a moving meditation, but unlike before I respect this with silence rather than nervous wittering. I am surprised when she offers a broad smile and asks “Any questions, Sam?” “Good luck!” I respond. “Oh, and don’t put them in upside down.” She laughs and exits, allowing Dr. Crilly to come back in and fix the canula to my arm with huge amounts of tape. Then I am counting back from ten and the next thing I know I’m awake and being told all went well. I can feel the Hector oxygen tube in my nose. I try and move and wince and cry. This time, TWO nurses are there for the name/DOB/label check, a sign that the drugs they are about to administer are strong and good. As I wait for those to take effect, I panic at the thought of getting out of the bed and heading home and say so.

So I’m kept in overnight, in a ward and surrender once again to the care of the nurses. Some are shirty, some are gentle. I’m fidgety and on the cusp of asking Ted to come and get me. In the end I do stay overnight and he and Theo collect me first thing.

Three days later I’m still a bit sore and swollen at the site of the stitches, but have kept on top of the pain with paracetamol and it is diminishing as the days pass. The implants are firmer than I expected, more like my breasts aged 20 than 40, but I’m thrilled with them. What the surgeon has done with, essentially, skin and silicone gel is astonishing. The day after surgery, and powered by pure will, I even made it to book club to show them off but I will need a lot of time to truly recover.

I’m keenly aware that the person who exited the hospital was a good deal meeker than the one who sauntered in. Shakespeare said “Expectation is at the root of all heartache.” My expectations were so hopeful but this week I’ve discovered there are many, many lessons between that and the more confronting reality. Fair enough. But Ms. Life? Do you know what? This student has learned quite enough for now.

Switcheroo

A routine check up at the plastic surgeon’s this week, where I received some great news. The good doctor says my skin has recovered sufficiently from radiotherapy to proceed with what’s known in the game as ‘the exchange’. That’s to say the switch from the saline-filled implants – the tortoise shells – to the gel-based ones – the squishies. I am booked in for the operation next Wednesday.

Most surgeons flat out refuse to work on radiated skin, fortunately Dr. Moko is in the minority. I had prepared myself for months of waiting, however she is confident there’s no need to delay. On the day of my upcoming surgery, it will have been just eight weeks since my last radiotherapy treatment. Apparently my skin has shown remarkable resilience. I’ll never know what element of the care regime helped most – the Miaderm cream, the hyperbaric oxygen, the vitamin E oil (that made me stink like a docker, by the way) – but in combination, they’ve done the trick. And while problems could present themselves on the irradiated side at a later date, here and now I’ve plenty to be encouraged by.

It’s a far simpler procedure this time around, and while I’ll be under general anaesthetic I’ll be in and out in about an hour and can go home the same day. There will be no drains to manage, no complex pain relief regime and few restrictions to my mobility. I will have to look after the stitches, though, which I didn’t do very well last time, but I’ve learnt my lesson and will take it a bit easier.

The doctor will re-excise the cut under my right, prophylactically-removed breast and make a new cut under the left, irradiated side (the existing scar runs along the middle). This is disappointing in that I’ll get another scar on the left side, however it’s a relief too because the existing scar has healed well and I was concerned whether it’d hold up if it was cut open again. I know it’ll look okay. I’ve come a long way since my first encounter with the new me back in August. I can recall my horrified reaction and the brutality of the physical response it evoked – self-loathing manifesting as nausea and breathlessness. Yuck.

As surgery approaches, I find there are many familiar elements but the way I feel about it is totally different. The other day, I sat with the surgeon, calmly discussing which implant to choose, round or anatomical ‘teardrop’ shape. She recommends teardrop: “It’s a more natural look, and better if you’re leaner.” Breastless I may be, but I am all woman and am delighted by the compliment. Physically holding them, weighing them up, I had the sense ‘this is surreal’ but this time I could see the humour. The last time I held one, my ears were ringing and I was going out of my mind with fear and repulsion.

Next on the bizarre-but-now-normal discussion agenda – nipple reconstruction options, which would require a third surgery followed by a session with a specialist tattoo artist who draws on an areola. But Ted and I have discussed it at length and kind of like how it looks currently, so have decided not to bother. “That’s not uncommon. Nor is changing your mind. It’s completely up to you and a very personal decision.”

That it is. I want to look normal from the outside whilst living with the no-nipple deformity (horrible but accurate word). I can completely understand how some people would hate to look down and be reminded every day of What Happened. I, however, feel need to acknowledge it.

Plus I can’t be fucked with the extra surgery, choosing an areola colour and all that shit, no thank you.

Anyhoo, I take the well-trodden path from the surgeon’s office into that of the account manager’s, where I sign the paperwork and pay the (less eye-watering, but still significant) bill. I got presented with the admission forms for the hospital, and the foil-wrapped surgical soap I’m to use pre-surgery. Then the fasting rules. So far, so familiar.

Next a new twist: I need to sign the breast register. There is, ladies and gents, a centralised database with all the world’s falsies registered on it, presumably so should they explode at altitude, spontaneously combust or melt, they can do a recall. Here’s another ‘did you know’- a hallmark of any boob job (post mastectomy or not) is a lack of cleavage –  there will always be a gap between the two implants. This fact ranks about 18th in the Why This Sucks charts, but hey.

Later, I say to the man I love over his birthday cake “We’ve gone teardrop, Ted. That’s okay isn’t it?”

“Yeah, natural over porno.” cheeky half smile “I suppose that’s a good thing.”

It is indeed.

As is the fact that the surgical journey will be over in a week. That, my friends, is a very, very, very good thing.

Let them eat cake

Talking so openly (brazenly?) about cancer has, I very much hope, made it a bit easier for others with it to feel understood and those without it to understand what it’s like. So I’m going to talk a bit about the way my relationships and interactions have changed in the last six months.

As you can imagine, I find it hard when I’m treated very differently because of my illness. I am still me and want to be recognised  as such although often I feel as if I’m observed exclusively through the prism of cancer. While it’s a part of my reality, I do not want to marinade in there 24/7, thanks. I remain interested in other topics, even if they’re trivial, hell, especially if they’re trivial. So rather than discussing my treatment, how I’m feeling and all that, let’s talk about the Ashes, the weather, The Bachelor or the kids. Let’s, please.

I do understand that no-one wants to let you down and that there is a lot of fear about speaking out of turn. A lot. Which is not surprising, as it’s an inherently difficult situation. But while I don’t want to bang on about it, an acknowledgement of my reality is something I always appreciate. My favourite response to my news was from my friend Hels who was on holiday when it all kicked off. She called and said “Bloody hell woman! I turn my back and what happens? Couldn’t you make what goes on when I’m gone a bit less dramatic?” I could hear she was a bit nervous still, but I was so grateful to be treated ‘normally’ when life was about as abnormal as could be. Making light of it was, for me, infinitely preferable to saying nothing. If you know what’s going on, and I know you know and you know I know you know please do us both a favour and mention the elephant in the room. “I don’t know what to say” is a totally acceptable start. I remember mum finding the deniars ultra hurtful, especially those she thought were good friends.

At the other end of the spectrum, news like this can make others incredibly chatty. I’ve been on the receiving end of more opinions and speculation than ever before, apart from perhaps when I was pregnant. Have you tried intravenous Vitamin C/the alkaline diet/green juice? Again, I understand why – it’s a big deal and a major talking point but in the early days, particularly, these kinds of conversations would shake me up some. Afterwards I’d imagine the other person going about their day, deciding what’s for dinner perhaps, while the decisions I was stuck with were not so trivial (nor did the ‘what’s for dinner’ style decisions abate any, I might add). At the time, I didn’t want to be ‘fixed’ or encouraged but this seemed to be the nature of talk that came my way. I wanted to be allowed to be sad, angry and in shock. I heard lots of ‘I’m sure you’ll be ok’ and ‘be strong’ but it’s hard to listen to pseudo-positivity without feeling as if you’re being misunderstood. Mind you, I appreciated this far more than comments like ‘isn’t radiotherapy carcinogenic?’ or ‘you look terrible but it isn’t surprising.’

I used to love conversations and being the centre of attention, then I lost my appetite for all that. I found myself in many a conversational dead end because talking, really, can only take you so far. Also it’s hard to hear when your ears are ringing from the reverberating shock. I think in days gone by when communities were closer, interaction was less verbal and more physical. Perhaps your friend would let themselves in to your home and make a cup of tea and simply sit beside you. (Alan Bennett used to do this with Alec Guinness, after Guinness was widowed). Near silence, respect and presence really fit the bill in truly solemn times but our current ‘get well soon’ culture denies that some times are just hard on a (sometimes extremely) protracted basis and there’s an impatience for things to return to normal (i.e. a non-threatening reality). An impatience I shared at times.

I came across this graph which illustrates the cancer patient’s emotional journey and it is a fairly accurate reflection of how I’ve felt, with the red ‘x’ indicating roughly where I reckon I am now.

 Google Chrome

Nowadays I am able to reflect with a full heart on how incredibly lucky I’ve been to be on the receiving end of numerous gestures which speak volumes. Helen’s husband Joe made me a mix CD to listen to en route to radiotherapy treatment. Looking at the track list, I lost it when I saw Curtis Mayfield’s Move on Up on there. One friend set up a virtual bedside vigil on the night of my operation and played along via Facebook chat while I was ripped to my non-existent tits on opiates. Back home, friends and neighbours including Marissa, Amy and Michelle dropped around meals. This was always deeply appreciated because it was a true solution to the aforementioned small problems that coexist with the big.

Also, food is love.

Meredith baked me a cake a week throughout my six weeks of treatment. Ginger fluff cake one week, lemon and rosemary the next, followed by Armenian nut cake, coffee & walnut and chocolate & Earl Grey. She’d leave it at the front door and text me with its name and ingredients. This was genuinely healing, not to mention practically useful as it’d end up in the kids’ lunchboxes. This says in a very clear but not obtrusive way ‘I love you and am thinking of you.’ Sue sent me a quote a day – I came to expect and appreciate the cakes and the quotes… which were little pin pricks of light and stability amongst the dark days.

I also liked it when friends kind of forced themselves on me. So instead of ‘let me know if there’s anything you need’ they’d say ‘We’re going to the beach. Would your girls like to join us?’ I think I did reject this at first – this whole receiving thing has been a massive learning curve for me – but they were gently persistent and I got the message that they were determined to offer practical help.

In fact of all 2013’s lessons, perhaps the most emphatic has been how wonderful people around me are. Even when tongues are tied and faux-pas committed, the love and support I’ve received has been … well, you know. Thank you all for bearing with me and lightening the load by reading my warts and all account of this bitch of a disease. And take my hand, old toad, as we face the 2014 road. While it’s fine to hope for warmer climes it is perhaps more realistic to recognise that bang ups and hang ups may happen but because I had the little c and wrote about it, and you read what I wrote, both of us may be that bit more adept at dancing in any rain we may encounter.