Writer, mother and grandmother DIANE TREMBATH lives in Exmoor. After being given the all-clear three years ago, she has recently been diagnosed with breast cancer for the second time.
She has agreed to write a diary about her experiences for Live Better With - sharing her observations and insights, both practical and emotional. Here's part 7...
It has been interesting to compare this road to recovery with that of my first experience of breast cancer in 2010.
On that occasion, I had less invasive surgery but 15 rounds of radiotherapy; this time the surgery was more radical but I did not have to cope with a daily round trip of 50 miles - and an often lengthy wait - for my radiotherapy session, when one or other of the radiotherapy machines was out of action.
Many patients find radiotherapy gruelling and uncomfortable; I took the advice of a specialist nurse and applied organic aloe vera gel to the affected area each day and had no discomfort whatsoever and very little change to the texture of my skin. Nevertheless the whole process took several hours out of each day, although rarely at the same time, which plated havoc with any sort of routine, and after which I wasn’t good for much else, apart from walking my dog…
This time round, the emphasis has all been on recovering from surgery (and, briefly, from the post-op infection) and on pacing myself. Yes, it helped that, going into surgery, I was fit and healthy for my age but, at 72, I knew that I had to take things just that more gently. So I did as S, the nurse practitioner had advised and listened to my body. If I felt tired, I rested, and I rested (as in taking myself off to bed) most afternoons for the first three weeks after surgery and, occasionally, for the next couple of weeks. I didn’t always sleep but I found that I needed that time to switch off and relax. And, on one occasion, I allowed myself an entire duvet day.
Rebuilding a daily fitness routine
At the same time, I continued with the Breast Cancer Now post-surgery exercise regime and, by week three, I had moved up to the second level. Some days were easier than others but I made sure that I exercised only up to the limit and did not force myself to go beyond that. However, I did find myself missing my regular yoga class and practice so I gradually introduced some gentle yoga stretches. I’m now regularly using this excellent DVD, which was created specifically for people recovering form breast cancer treatment.
My Pilates teacher is also calling in once a week, after the local class that I would normally attend, to take me through some helpful Pilates sequences, and I’m finding this book helpful too. My aim is to build up my general fitness and strength levels and then rejoin both classes after Christmas – can’t wait! There are, of course, plenty of free online resources but my advice would be to check with your own yoga or Pilates teacher first; mine were happy to give me feedback or advice on anything I found online.
Regular exercise makes a significant difference to recovery but it has to be the right exercise at the right time and, above all – and because we are all different - it has to be right for you.
Walking makes everything better
Another essential element of my recovery programme has been walking; it helps if you have a dog – or dogs - of course, as they provide a great incentive to get out and get moving, whatever the weather. My dog is now almost 10 but as a Border collie / springer spaniel cross, she still has plenty of energy and is a demon swimmer and tennis ball retriever; I’d never get away with a 10-minute walk round the block, even if I wanted to!
But I have certainly benefited from walking in the nearby woods, across the fields or up on the moor, and being out in the natural world twice a day. Even though my post-surgery recovery period has coincided with something like two months of daily rain, as long as I am suitably dressed, I always feel better after a walk. Just as I can’t imagine life without a canine companion or two, I can’t imagine it without a daily walk either.
The bedtime nest
I had wondered whether my sleep patterns would be affected, as I have always been the soundest of sleepers and normally clock up eight to nine hours a night, without any difficulty. In the first few weeks after surgery, I found that I was ready for bed by 8pm - and often earlier - and I would be asleep in minutes, although these very early bedtimes occasionally meant that I was wide awake at about 2am…
Once the surgical drain had been removed, it took a while to readjust and find the right combination of pillows and supports for comfortable sleep but what worked best for me was an ergonomic pillow under my head and neck and then normal pillows, positioned vertically under the duvet along my left and right sides. This combination gave me some support and stopped me from rolling over suddenly and too heavily onto my affected side.
As post-surgery discomfort can come and go and can take different forms, I’ve found myself continuing to settle down to sleep this way; I call it my nest.
On the surface
Speaking of discomfort, although things have generally headed in the right direction, at four weeks after surgery, I found myself struggling with sore, dry, itchy and highly sensitive skin around the site of the main wound and at point where the drain tubing had been inserted. It occurred to me that maybe the surgical glue used on the wound was a factor, as I still seemed to have a layer of the stuff clinging to me.
An online visit to the Breast Cancer Now forum suggested that this might be the case, as the ingredients of surgical glue aren’t exactly a million miles away from superglue. My friend, carer and homeopath, J, suggested an appropriate remedy and, within 36 hours, the itching had stopped and the soreness had lessened. Meanwhile massaging the affected area twice a day with organic coconut oil has helped enormously by keeping the skin moisturised.
Altered states and the new normal
On reflection, dealing with post-surgery discomfort – especially the drain and surgical tubing - proved to be more of a challenge than coming to terms with my altered appearance. I made a point of looking at myself in the mirror within a day or so of surgery, more to check for possible signs of infection than anything else, and – much to my surprise – discovered that it was not quite the traumatic experience that I had anticipated. Had I been younger, had I still had a partner (I was widowed in my thirties), I suspect that I would have felt differently.
My surgeon had advised against breast reconstruction and I was quite happy to settle for a prosthesis but then struggled to find a suitable filling for my temporary softie – that is something that didn’t make me feel hot and itchy. Soft organic cotton turned out to a better choice than the original synthetic filling and I have continued to wear silk or bamboo fabric next to my skin.
At the moment, I am still wearing a post-surgery bra but In the next week or so, I’ll be having a fitting for a permanent mastectomy bra and then going back to the breast care centre to be fitted with a silicone prosthesis – and getting used to my new normal.
And speaking of normal, it’s now seven weeks since surgery and I’m pleasantly surprised at how things have moved on. I was able to get back behind the wheel of my car – an automatic, thank goodness – at the end of week three and, by week five, I was strong enough to drive J to Bristol Airport for her flight back to Portugal. It was a 130-mile round trip and I even managed to walk my dog in the parkland of a local National Trust property on the way home; but that was it for the rest of the day.
I’m more or less back to my usual daily and work routine, plus the current exercise regime, and for this I am most grateful. I know how fortunate I am that, yet again, my breast cancer was detected early, has not spread, has not required chemotherapy and has not, on this occasion, involved radiotherapy.
At the same time, I know how important it has been, and will continue to be, for me to do as much as and whatever I can to support my recovery. It is, in every sense, a work in progress because there are more hospital and medical appointments in the coming weeks and there’s a way to go yet.
To be continued
Diane with her beloved canine companion Pumpkin
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