The last few days, I have been a little overwhelmed by the events of the last couple of months. It all seemed to suddenly hit me like a sledge-hammer, but now I am ready to complete the last post for this category.

I have been surprised at how quickly I got to feel almost back to normal – physically. I have just a few mobility issues, but my strength needs working on as soon as I am allowed to. I do get tired more easily and often need a nap during the day if I want to not have to go to bed too ridiculously early in the evening. I do feel a lot less tired as in late winter and spring, as already touched upon in a previous post, and would urge everybody to pay attention to their general well-being, and not ignore persistent feelings of fatigue, no matter how diffuse.

My follow-up consultation with the surgeon (or one of them) was brought forward to 5 August. The final results were in, it was still good news, and the surgeon wanted to let me know as soon as possible.

No chemo (which would have been very unexpected and which I would not have done anyway), and also no radiation (which I had psyched myself up for, and would probably have done, but I am very happy not to have to make the decision).

BUT they are recommending hormone inhibitors for five years in an attempt to avoid recurrence, so that is a major decision to have to make. It has never taken much for me to feel that life was not worth living, and I have many “better-to-be-dead-then” scenarios. Chemotherapy is one of them, and the side effects of hormone inhibitors another. I have an appointment with my gynecologist to discuss this next week.

What I will do is lead as anti-inflammatory, and thus anti-cancer, a lifestyle as I possibly can (even if it means dropping red wine altogether 😊). With the growing awareness that diet and exercise can play a big role in trying to stave off cancer, that will be my project now that I have to decide what to do with my life in an age of pandemics, with – for now – no cancer, and – forever – no dog ☹.

I am considering consulting a naturopath, for example this one. I am also continuing the mindfulness meditation routine I started prior to surgery, and I have dusted off my infrared lamp and have started using it for scar treatment and general well-being.

Before surgery, I sold all my very heavy Canon and Sigma gear and bought a much lighter Fujifilm camera and – so far – two lenses. However, I am still waiting for the urge to take photos to reappear. If and when it does, the results will appear in future posts.

The day and night before the day of the surgery, it took a fair amount of deep, slow breaths in order to not freak out slightly, but when the time came, after the trials and tribulations since diagnosis, I was actually relieved to meditate myself far away and be knocked out cold by the anaesthetic.

The day before, I had been booked in, prepped, undergone the usual tests and interviews, and had everything explained to me in more detail than I actually cared to know.

Since then, I have been getting better and better. They take such good care of their patients here, especially the first 24 hours after surgery with very regular checks of blood pressure, temperature, drains and compresses all through the night. They also came round a couple of times to take me walking a few steps since I was still very dizzy. How women in some countries are sent home on the same day is beyond me, and most of them are even happy to. Perhaps that says more about the hospital than about the women ….. In the same fora I read about horrible post-op complications and I can’t help thinking there might be a correlation between the care and vigilance during the first couple of days and the rate of complications.

The first thing I checked after I woke up after surgery was the number of drains I had: Two. This was positive, since I had read that if during surgery they had needed to remove more than the closest lymph node, I would have another one or two drains. Shortly after I was back in the room, one of the surgeons (of which there were two, working in parallel, one boob each) came round to say everything had gone really well, no unpleasant surprises, and the main lymph nodes were clear. There is one test remaining which takes a bit longer to perform, but in my case that seems to be a routine formality. This morning the other surgeon came round with the same message.

I expect to go home on Monday, with a bit of luck sans drains, and – if things turn out the way they seem to be expecting, also sans cancer and – miracle of miracles – sans need for radiation. If that turns out to be true, I have been really lucky.

I miss Max. Although he was only with me for a year, he is such a character, and has left a huge void. Funnily enough, what I miss most is what I had “feared” the most when adopting him – the early-morning rounds. Although I have always been an early riser, I thought I would have to stay as immobile as possible and have coffee first thing in order to be able to start functioning, but with Max, I really enjoyed getting out – first thing – somewhere between 5.00 and 6.00, when the air is still (relatively) fresh, and not many people in the streets. When it was light enough, we sometimes went as far as Tiergarten and had a look at the many wild rabbits frolicking there at that time of day. Coming back home, the coffee tasted even better ……

Since diagnosis, I have not had neither the strength nor the discipline for that, but I am hoping to take that habit up again, even without Max, as soon as I can. I have no idea when that will be. For now, I go for shorter walks and do one or two of Gabi Fastner’s videos (linked to in several previous posts) in order to stay in some kind of shape.

Depending who you ask, it will take from a couple of weeks to several months or even years before I feel back to normal again after surgery, or at least normal enough to go on walks of any considerable length, and that is assuming I will not need any further treatments, which is what several people who know about these things seem to think. I am keeping my fingers crossed while trying to stay open to the fact that I may need radiation. If chemo comes into the picture, I am still undecided whether I would do that, but I don’t think so. That is like being in Hell, and then you die anyway.

A post-op stay in some kind of recreational facility has been suggested to me. My insurance would cover it, and I would love to get away from Berlin for a little while. If I can find a place that focuses on physiotherapy and gymnastic exercises, and even massage although I hate that, I would definitely consider it. Also healthy nutrition, which I am assuming would mean that it would be more likely to be in Poland than in Germany, but I will hear what they say at the hospital after surgery.

The sooner I can get back in shape, the sooner will I be able to visit Max in his new home and go for a walk with him and his new owner. There is nothing better than walking in the forest with a dog.

Some people are wondering why I am so adamant about a double mastectomy without reconstruction. I could have chosen a single mastectomy and perhaps reconstruction, and double lumpectomy in the other breast. I wonder what kind of mess that would look like, plus, the risk of recurrence in the remaining breast is very high. The second choice would be double mastectomy with reconstruction.

To those wondering about my decision – “going flat” as we say in our circles, all I can say is – well – google it, and check out some Facebook groups. To me, that decision very quickly became a total no-brainer. The further risk of complications and more surgeries, and the fact that “implant syndrome” is a thing – no thanks. And not only that, but I seem to remember a study a couple of years ago revealing a new form of lymphoma associated with breast implants. No thanks.

To me, a double – flat – mastectomy is not the end of the world, but I can certainly understand how it must be devastating news to many much younger women.

What really throws me is realising how many young women receive this diagnosis, and how many different types of breast cancer there are, and the number of variables within each type.

Young women with small children who go through years and years of chemo, lumpectomies, and radiations, and starting over again, knowing that their prognosis is not good, but with a young family it is important to stay alive as long as possible.

Particularly heartbreaking are the women who are diagnosed during pregnancy, who have to have the birth induced in week 36 in order to be able to start chemo as soon as possible. A newborn, perhaps a toddler at home, and chemo. Unfathomable. I have been looking for charities/organisations that focus on supporting women in those kinds of situations but strangely enough not been able to find any. Cancer is never part of anybody’s master plan, least of all when you are young and just starting a family, and coping with a serious cancer diagnosis must seem insurmountable at times.

I just had a couple of really dark days – about 48 hours where I could not stop crying, and then about 24 hours where I could not stop sleeping :-).

I guess it was not until my brother and-sister-in-law went back to Copenhagen that I really had time to reflect on the events since diagnosis on 16 June, and a reaction should not have come as a surprise.

The instant feeling of dread and panic when I heard the diagnosis – what was going to happen to Max. The hectic time activating all networks, and their networks trying to find a good home for an eight-year-old rescue dog, in a city already flooded with dogs for adoption, and now also from Ukraine, and the immense sadness at the thought of parting with him. The research – lumpectomy or bilateral mastectomy? The meeting with the surgeon to confirm: bilateral mastectomy. The bureaucracy of first waiting far too long for the cost estimate from the hospital, the misinformation from the sickness insurance as to what I needed to do (wasting several days trying to get that done – for nothing), the nightmarish day at the hospital where in the end surgery had to be postponed. The even worse nightmare of, for a couple of days thinking the shelter was the only solution for Max (even the shelter had to be persuaded after they told me they were completely full), until at the last minute, with the help of my neighbour-dogwalker Frank and Sabine, we found him a great new home. And one of the worst moments of my entire life: seeing him off to that new home in Köpenick (Frank and Sabine kindly took him in their car) (but which was of course a thousand times better than taking him to the shelter).

It all hit me a couple of days ago.

Many people do not understand why I decided that I would no longer be able to take care of Max. As if a cancer diagnosis and the uncertain future that comes with it were not reason enough. (Don’t even get me started about the response from the so-called adoption agency, House of Bitches – pure narcissistic evil, which also should not have come as a surprise since they had been monumentally unprofessional from day one).

Max is very strong, and still a bit anxious and reactive in certain situations. I can just about handle him with the upper-body strength I have now – strength that I will lose after this type of surgery, and – since I am not getting any younger – can’t be certain that I will ever regain. In fact, even hoping that I will not need debilitating treatments post-surgery, it is more likely that I will not be able to completely regain that strength, and that it will become irresponsible of me to take Max out in the streets around here. And Max is the kind of dog who needs a lot of exercise.

And all that, by the way, is also the reason why I did not “just get someone in to walk him occasionally”, as many have suggested. I don’t know how they imagine getting an experienced dog-walker in to walk a dog at least three times a day, seven days a week would be doable. The dog-walker I originally had once a day twice a week was a great arrangement, and luckily, since it was holiday time, he was able to include Max up to six times a week since my diagnosis, but that still leaves at least two shorter rounds every day. But as always, it is people who have never had dogs who are the experts and full of totally unrealistic advice.

I did have in mind to place Max in a dog pension until I knew more about what the future holds in terms of my health (chemo? radiation), but since this is holiday time, they were all full – or at least the ones in any kind of vicinity of Berlin. I was too exhausted to contemplate travelling with him to the other end of the country, even if I had been able to find him a place.

Even though I miss him very much, I do feel good about the solution we found, and would once again like to say that without my neighbours/dogwalker/dog trainer couple, I simply would not have been able to pull off this solution, and I am forever grateful for their help at one of the lowest points in my life. And the instant feeling of dread and panic I felt while wondering what would happen to him is something I never want to feel again. If I ever mention the possibilitiy of acquiring another pet – someone please shoot me.

In the coming week, I will concentrate on bringing my spirits up, eating as healthily as possible, go to a few exhibitions hopefully not too well visited and which I can reach without using public transport, staying away from people (I REALLY do not want to catch Corona right now ….), and keeping my fingers crossed that things will fall into place with the payment.

It is still, after a week, a “he-said-she-said” situation with the sickness insurance saying they have paid the bill, and that I am NOT to pay it myself, and the hospital saying they have not received the payment and suggesting that I pay the bill myself. Getting rather sick and tired of the whole thing and dreading any future similar situations.