A Setback, a Shower, and Some Silver Linings

Wednesday, 13th August 2025

I had stayed overnight in Birmingham so was in a Guest House that morning, fortunately the shower was detachable as I still had a dressing on the main wound.

I was on week 3 of my exercises which included laying on the floor and taking my right arm from down by my side to over my head with assistance from the other arm. 

There was no carpet on the floor, just laminate, so I chose to do my exercises on the bed - I knew I wouldn’t get much of an opportunity to do them when I was in the workshop today. 

I got an uber to ECHQ and arrived nice and early. I was attending a workshop about how to present well. It was from 10-5 but as I had to be back at the QEII in Welwyn 110 miles away at 5pm I had arranged to be collected at 2pm so I could get as much of the workshop in as possible. 

Frustratingly the lunch break was scheduled for 1-2 so in the end I left at 1:30 instead. 

My dad and I had a smooth journey home and I even had a bit of time before we had to leave to go to my appointment. 

Historically Wednesday appointments were always severely delayed so I went armed with my laptop and mum with her book ready for a wait. But when we arrived there was just one man in the waiting room (presumably waiting for his wife to come out of her appointment). 

I felt slightly nervous but not scared. I just wanted to know what the plan was going forward.

I’d had a couple of texts during the day from friends and clients saying they were thinking of me but I didn’t feel the enormity of a potential avalanche of bad news. 

I couldn’t believe it when the nurse came out at 5:01 and apologised for the delay! I’ve waited more than 90 minutes before - 1 minute was hardly a delay. 

We went through and met with Mr Cathcart, after the initial pleasantries were exchanged he got straight to business. 

He explained from the mastectomy side, all of the tumour’s out with a nice healthy margin. It measures 18mm which is a whole 10mm larger than was predicted from the scans. 

Grade 2 invasive ductal is what he called it. It had the non-invasive disease DCIS around it too which took the total size to about 2.2cm. Again with healthy margins all the way around. 

The receptors are exactly the same as they’d said previously - sensitive to oestrogen, HER2 negative. There was one lymph node that we removed as well and the dye tracked to. 

I could sense there was a “but” coming. I was right.

The good news was they couldn’t see any cancer cells within it, the bad news is they couldn’t see any lymphoid tissue in it either. 

Apparently this can happen sometimes, where the dye has tracked and then lodged in, basically looks like a hard, fat lobule, and it's tracked into that instead.

This means that although no cancer cells are present, the fact they can’t see any lymph tissue means that it’s not a true lymph biopsy of the area, the dyes haven’t tracked to the right spot. This happens probably once every other year - so really quite rare and unfortunate.

I asked him what this meant as I realised this meant they would need to get some lymph cells. Obviously now the tumour was out they couldn’t do the dye tracking again. He explained it would be a more traditional approach where they take a sample, (he did clarify it was not a clearance just a sample) where they go into the armpit and remove a clump of tissue where the central node would be. 

They will just dissect something out of the scar tissue from the area they were already in and if they can feel some lymph nodes in there that's great. 

The problem with this he said was you never know how many lymph nodes you’re going to take because it can range from zero again to 15 in a small area. The risk is the more they take the higher the risk of lymphedema. 

When I had my first mastectomy they took 6 lymph nodes. His aim is to get no more than a few this time around. 

The alternative is they don’t do anything about it, my scans look normal, but they know in 20% of cases where you remove a lymph node in the area and there can be cancer cells within it. Scans are great but not perfect which is why they do this test. 

As at 45 I’m still considered young (🥳) it may still change, so he feels it is necessary to go back in and do the procedure. 

I asked if it would be done as a biopsy this time and he said no, it would be another operation under general anaesthetic. It would be an incision in the armpit (which he’d been trying to avoid in my main surgery but was now unavoidable). 

If he were to do it under local anaesthetic it would be quite tricky as its a sensitive area, you could put nerve blockers near the spine to try and numb the area but notoriously they don’t work so its easier to do it under GA.

He explained it would be a much shorter operation - just about half an hour - and he could do it next Thursday (21st August). 

As the dyes that were put in last time would have filtered through, it's not very accurate to use that as a guide any longer so they will base it on the anatomy and take a lump of tissue. 

My initial feeling is frustration but to be honest if that’s the worst of the news I was going to receive today I could cope with it. 

The most frustrating thing about this whole blip is I now have to wait another two weeks after the next operation before I get any idea on the plan for the next steps. He confirmed I would come back on the 3rd September to get the results and a plan. 

He did confirm that the results of the node removal can truly change things. If the nodes are clear I’ll be looking at endocrine tablet medication and that's it. If the nodes are positive it's chemotherapy as well. I asked if it would be the same kind of chemo I had before that would mean my hair would fall out and he said potentially yes. 

This was a big concern of mine as losing my hair the first time round and having chemo was the bit that really made me feel like a cancer patient - losing the boob didn’t (and hasn’t this time either) made me really acknowledge the enormity of what I’ve been dealing with. 

As you know from previous posts the only thing that has been causing any grief is the nipple, so before I left Mr Cathcart checked it again. The scab is quite uncomfortable. It's hard to explain (and I’m not going to put a picture on here) but with an implant my nipple is permanently standing to attention. Following surgery the supporting bra is pushing the nipple to one side and causing it to lay on its side. The scab is now holding the nipple in this position even without a bra and healing in this place. 

This means I can consciously feel the nipple whenever I walk or move. It's not painful, just uncomfortable. 

He told me not to pick at the scab and to be careful not to catch it on clothes or towels etc, he gave me some dressings to use to protect it and said to keep it dry.

I still had the dressing on the main wound at this time and this meant I was still having to use the handheld shower head to wash rather than stand under the main shower to avoid the dressing getting wet. 

He removed this dressing and confirmed I could now shower normally - what a relief!

I had also been told I wasn’t to drive until after this appointment - he said I would be ok to drive now as long as I could look over my shoulder (I can), and wear a seatbelt comfortably (I could).

The fact my car is still in the garage aside - I am now allowed to drive - woohoo!

Before I left he went through the consent form for the next operation, confirmed the date it would take place on the afternoon of Thursday, 21st August (the same day Amber gets her GCSE results 😬).

I went home with mixed emotions - another operation - still no results - more time to heal - back to square one with my mobility.