Staying cool, calm and collected...

Today I had chemo. The chemo they weren't going to give me blah blah.

Yesterday I had my blood test to see if them there white blood cells have regenerated after the Taxoshit from 3 weeks ago.

I was the first patient in today. All I had to do was ask if my WBC was good-to-go at 9am and then I was first in the West Wing Cowshed for the chemo to be milked into me.

That was the plan...but this is Plaingoldband we are talking about here.

The fuckers 'lost' my blood test results. Yes, I dragged my sorry cancer-stricken ass to a nurse yesterday, had blood taken and sent to the RB Pathology lab and it got lost somewhere.

No blood test results = no chemo until more blood is taken.

So, at 9.15am I went up to the West Wing, explained the clinic nurse couldn't find bloods, asked if they would shove a cannula in early, take blood out of it, I would walk it to the other end of the hospital to Path Lab and then I would walk back and wait.

And wait.

And wait.

The bloods have to be checked. The results sent to West Wing. The oncologist has to ok them. Then the pharmacy will sort out the Taxoshit and send it up.

I waited in God's Waiting Room from 10am to 2pm. I saw other people come, have chemo and go.

Then I had my chemo. That took 2 hours, plus wash through.

I left with the nurses as they closed up the cowshed for the night.

I was there at 8.30am as the first patient, me being an eager beaver. I ended up being the last patient to receive treatment.

Yeah, I'll turn the lights off on myu wait out, guys.

Now, I was serene through this. You see it isn't the fault of the nurse Bernards. It isn't even the fault of Woolley Omar. It was the 'system'. The NHS that is not perfect.

But I spent over 10 hours (including travelling-to-hospital-time) to receive 2 hours of treatment.

Each Nursey gave me a hug and thanked me for my patience. I think most people kick up a stink if this happens, probably taking it out on them. Me? I don't like it, but it happens.

On the other hand, poor communication and being treated like a number by the oncologists is not ok by me.

See? I can discriminate in my railing. I don't just kick against all the pricks, particularly when it is not their fault. It was probably the fault of some snotty-nosed teenage undergraduate doing a summer job, who just happened to delete my blood test results off the system or something by mistake.

Hey, one thing I can report is I am now officially a bloody medical enigma! I am sure I wrote a long time back that chemo kills white blood cells in the bone marrow. It kills off the neutrophils first and without them, you are at risk of infection during the nadir, the lowest point before the bone marrow starts up again. You cannot have chemo if your WBC and neutros are not above 1.5. The more chemo you have, the less your bone marrow makes and many people find it hard to get enough after 3 weeks and often have to delay chemo until they have enough. Indeed, some need to have special injections to make emergency ones...this is why people get sick whilst having chemo.

I have had 5 cycles of chemo. By rights, my body is suffering right now. My neurophils should get lower and lower after each blood test, as the bome marrow is more and more suppressed.

From the very first blood test, back in April, my neutrophils have gone up.

Yesterday, my WBC and my neutrophil count was higher than when I started chemo. At 4.99, my neutrophil count is well within the boundaries of a normal healthy person, not a chemo-fried cancer patient. The nurses couldn't believe it at all, particularly as I was warned by this time I may have to have chemo delayed as my counts would go dangerously low...

I am either Popeye, or an alien. Obviously...

I should be so lucky, lucky lucky lucky....

It has been a very eventful few days. Well, I suppose you could say it has been a very eventful four months...

Where to start. Obviously, last week was a bit of a cock-up and I was frustrated and somewhat angry. Of course, the anger was really borne out of the fact there have been a litany of what I perceive to be cock-ups within the oncology dept of the RB. The odd cock-up is forgivable, but I feel I have been on the end of more than that and, as I received an apology for the very first one back in March when I 'fell through the crack' in relation to not being told about starting date for chemo, I think my frustration is bona fide.

If you have kept up with this blog, you are aware of all them. For those who skim it (naughty naughty), my frustration has not been with the actual treatment, which is excellent and second to none in the world, but with the organisation and, more importantly, the total lack of communication. The patient, it seems, is the last to know anything.

Last week was the last straw for me. The lack of oncologist to discuss chemo with when I was told there would be one within the meeting was the last straw for me. Having cancer is a pretty stressful situation for a person to be in; being kept out of the loop and being pushed from pillar to post doesn't really help much.

Actually, my experience is cancer is managable; I can handle cancer. I can't, however, handle being treated like I am not the most 'important' person in the menage a trois that is 'patient, surgeon and oncologist'. It has felt, to me, that I have no voice, no opinion and my feelings are of no importance. They seem to think the patient is not part of anything happening. Their actions confirm to me that they make their decisions (which I don't criticise and bow to their expertise and judgement) but don't discuss them with the patient. Indeed, there seems to me that they don't think discussion is relevant and, at its worse, that they don't need to convey information like 'you are not having anymore chemo' officially or 'this is your date for surgery'. I have to try and find out when!

It can be like trudging through treacle to know and understand anything that is happening.

Anyway, enough of my negativity. Let's talk about what seems like my monumental effort to sort this out has achieved.

Yesterday, I had a meeting with House. I was nervous. House if formidable. I am merely a patient. I knew what I wanted and I knew I had to be calm, yet assertive and articulate, yet polite to get it.

Imagine my surprise (not) when bloody Woolley Omar calls me in. He who answers no questions without fudging; he who tells me 'there will be a joint meeting' when there is not.

I took a deep breath. I thought of saying 'I was under the impression this meeting was with House'. I did not. I thought 'for fuck's sake, just do it woman'.

So I did.

For clarity and for ease of reporting here, I will split each part of this 40 minute meeting into subheadings:

1. No oncologist at meeting

I got an apology. Omar didn't understand why there was no oncologist available. There should have been. It was a 'joint meeting'. He understood the difficulty of being told by a surgeon 'no more chemo' when said surgeon does not have the ability to discuss why this clinical decision was made and what the consequences are.

2. My skin

I had a meeting with my derm last Friday. I was under the impression that part of the clinical decision to stop chemo was because of my worsening psoriasis. Silvano said 'they should contact me if they are making clinical decisions based on dermatology'. They have not. Indeed, they have not contacted Silvano at all, apart from the initial 'we want the patient to come off biological therapy for chemo' back in March. Silvano assured me that my skin should not be a factor in their clinical decision making. That it is his field and he will take care of me if my skin worsens to the point surgery might be difficult. He assures me it won't. I trust him completely.

Yes, said Omar, my skin was partially why they decided to halt my chemo. However, when I told him what Silvano said he acquiesced. He also admitted that the lack of communication with Silvano, as a whole, was probably not the correct way to handle the situation and he wasn't sure why no letters had been sent as a matter of course...

'Are there any other factors in your clinical reasoning for halting chemo' I asked. This takes me on to the next bit...

3. Colin the tumour, the little fuck

'Well' said Omar, 'ultrasound doesn't show a significant shrinkage of the tumour'.

'Does this mean Colin is chemo-resistant' I replied.

'Perhaps' said Omar.

'What about Scouse's clinical evaluation that actually, in his opinion, the tumour seems softer and that the chemo is actually having some effect, particularly as my ultrasound came very early in the cycle because of the timetabling of meetings?' I asked.

'Yes, Scouse has written this in his notes and, taking that with the early ultrasound and Silvano's directive perhaps we ought to give you another cycle of chemo...'.

'Perhaps' I continued, 'I could have another cycle of chemo and then Scouse could do another clincial grope of my tit in say two weeks and re-evaluate the situation then?' I continued.

'Yes, that would be a good way forward and, as your surgery is provisionally booked for 29th July, having one more cycle of chemo is possible and we could still keep that date if there is no difference in Colin and, if there is, perhaps we could do more chemo and then push the surgery date forwards'.

So surgery date is decided.

'Oh, do you not know the surgery date?' said Omar, with a look of surprise.

No, of course I bloody don't. You lot never tell the patient anything. I found out about my chemo date from a bloody text message. Hey, I bet I would have got another text message telling me 'Don't forget your life-saving operation to remove your right tit, which will have an enormous affect on your whole life @ the hospital in 29/07'!!!!!!!!!!!!!!!!!!!!!!

'No' I said calmly to Omar, 'but I know now'.

4. Second opinion on surgery

I have a friend. She just happens to be a nurse who works in a unit that carries out surgery on the breasts of women with breast cancer. I explained my options, as laid out by Scouse last week to her. She said it seems Berkshire PCT does not offer the 'full monty' of available surgery and reconstructions. Her PCT has both onco-surgeons and plastic surgeons. Perhaps we ought to get a second opinion, she said. I agree. But how do you go about this...

Said friend is finding out from her surgeon the options as he sees them with what she tells him. If there is a chance of an improved outcome I will try and organise a meeting with Mr Craven of the NEH PCT.

'I wish to get a second opinion with regards to surgery options' I said.

Omar looked surprised.

'Not.' I continued, 'because I do not trust the skills and judgement of Scouse, but because I think he is potentially bound by what this hospital can offer me'.

I explained, in detail, that there are other options available outside this hospital. Taking into conideration I cannot have my breast rebuilt at a later stage if I require full mastectomy (I will have to let you guys know all about this in another blog!), and that I have psoriasis (again, the significance of this I will go into another time) it might be pertinent to seek another opinion.

Omar understood and said to let him know asap so available notes can be sent to secondopinionMrCraven.

5. The importance (or unimportance) of Chemotherapy in Breast Cancer Type II

Feeling that the meeting was going well, or perhaps I should say that I felt I had some control of the situation and could get more information out of the lesser-spotted and rarely seen oncologist bird in its natural habitat of the RB cancer unit, I asked specific questions about the relevance of chemo and outcomes.

Turns out that some tumours are chemo-resistant. Sometimes it is not worth giving a patient chemo with my type of tumour. Yes, there is an increased risk of relapse and the re-occurance of breast cancer as a secondary, but the risk is approximately 10%. I cannot really claim to completely understand this statistic or where it comes from, but it seems to me that surgery and radiotherapy are the most important parts of cancer treatment for a person presenting like me. Chemo, used neo-adjuvantly (before surgery) is useful because it can shrink tumours (making for an easier surgery) but also because it can show whether chemo actually works. My thoughts that adjuvant chemo is a 'blunt intrument' and nothing more than a partial 'insurance policy' were correct. Some women have adjuvant chemo and it doesn't work, except no one knows it doesn't work because there is no mate of Colins left in them to measure it by. Boy, I am glad I had neo-adjuvant chemo. At least I know Colin is a fuck...many women go through gruelling chemo for nothing but never know it isn't working well.

'Taking all things into consideration' said Omar, 'adjuvant chemotherapy would probably be a waste of time with you'.

Lastly, I thanked Omar. I shook his hand and said 'Thank you, sir, for your time. It is much appreciated'. He looked relieved actually. It must have been gruelling for him to be pinned down. I am not sure they are used to it! But look at the result? I actually feel like I have been part of my treatment plans. I have made an oncologist change the treatment plan because I was able to point out 'we could try this and see what happens' and 'nothing ventured, nothing gained'. If I had said nothing and blindly did as they had said, I might not have got the potentially better treatment. Anything that makes Colin, the little fuck, smaller has to be better for my surgery options...

OK. Now I am going to hit you with the big mother of all eventful happenings of the last few days. I wasn't expecting it. It has been a bit of a shock and is going to change my life beyond cancer.

No, I am not pregnant.

I am being made redundant. I am going to be jobless and homeless come the end of October. I cannot and do not wish to say anymore on this. But it is very sad and no ones 'fault', it just 'is' and I have to deal with it.

Timelines of treatment should mean I am cancer-free by the end of October...

But hell, how unlucky can one woman be???

My old boss and I have a game. We like to outdo each other and see who has the worse life. So I get the text message from her saying 'car is broken down/fridge is broken/haven't got a birthday present for husband' and I reply with 'have you got cancer? No? So I beat you then...' and then we both laugh.

Cancer, jobless, homeless and titless and covered in psoriasis. People kill themselves everyday over lesser problems.

Me? I laugh at how ridiculously awful my life has become. It almost makes me feel like buying a lottery ticket because surely, surely, my luck deserves a break. A big one. I'd probably win and then find out I have lost the ticket....

“All of us have bad luck and good luck. The man who persists through the bad luck - who keeps right on going - is the man who is there when the good luck comes - and is ready to receive it.” - Robert Collier

Estados Unidos Mexicanos por favor...

Ok, a few days have gone by and I have had a good think about all that was said by Scouse on Tuesday, have done some research using an excellent book given to me by a Nursey Bernard and, perhaps more importantly, rationalised my initial feelings on the surgery.

First off, I have to say I have not thought about the surgery element of this whole cancer thing in any great depth. This is partly because chemo was up first and I needed to put my energies and brain matter into dealing with that and, I think, because I didn't really want to. It isn't that I haven't accepted this is going to happen. It was inevitable and definite. I knew this. I wanted to not confuse and stress myself out by taking on too much. Of course, the whole surgery thing was slightly up in the air because of the effects of chemo anyway...

One thing you all need to know is I am phobic of general anaesthesia. This isn't something that has come out of this situation. I have always had it. Always. And luckily, up to now, I have never had to have one! I have been fit and healthy all my life.

I have obviously thought a lot about this over the last few months. This is not a 'I don't like it' thing. This is a full blown 'I am going to leave the country long before my surgery date is up' phobia. This is a 'you come near me with any drugs that'll knock me out and I will get violent' phobia.

Totally illogical and completely irrational.

Best Friend said, when I told her, that she would lock me up and drag me there. I think, when I didn't smile and said 'I would not even be available for you to lock me up...I'll be in Mexico' she took me a little more seriously. When I asked her 'what would you do if I said you were going to be put in a closed box with spiders in a month's time' she realised that I am phobic. She is terrified of spiders. She gets it now.

I know it is not anything to do with fear of 'being awake and feeling pain' because they have screwed up. It is not fear of being poorly when I come round.

No, I know that it is because I want to be part of what is happening to me. It is my body, my tit. These people I don't know are going to violate me and I won't be able to do anything about it because I am not awake. That terrifies me. At its worst, it feels like 'rape'; something being done to me that I have no control over.

I have never passed out. I have never been knocked out. I do not know what it is like to be unconscious due to something more than natural sleep...

Of course, I can rationalise that these people are not 'raping' my breast. They do not intend to harm me anymore than they have to.

I think it is about a loss of control...

Aware that this is a problem, I have made an appointment with a qualified and registered hypnotherapist. I have to try and deal with this somehow and this seems a positive thing to do. I suppose I ought to also speak to Scouse when it is appropriate, not that I think he really cares all that much.

I have read that it is possible to do it the simpler WLE surgery under local, but no one likes to do it apparently. I have read a woman's account of mastectomy under local. She was also terrified of a general. She managed ok but the docs were puzzled as to why she would want be awake!

As to the actual surgery, I have my options and my gut reaction is to go for WLE with radiotherapy. This is what Scouse preferred when I asked him for his best advice, although he obviously pointed out he understood if I wished to have the full tit off too. I appreciate the risks of having to have second surgery and the consequences of this...

Now, I am going to say something that really is not PC. It is not sensitive and I apologise if I offend anyone. I do not wish to offend or upset.

I have now looked at real life pictures of mastectomy. I have purposefully not looked over the last 3 months because I was concerned I would have this reaction.

It is disgusting. It horrifies me. It offends me. It looks completely horrific.

Said it. I cannot express how much these pictures upset me.

It has finally hit me that I am going to be disfigured, whatever happens. No surgery on the breast, even with cosmetic surgery, can make it back to what it was. Even the most elaborate rebuilds cannot do this apparently...

...and I now realise that my right breast is fucked. Whatever happens.

Now, unlike the vast majority of women out there suffering like me I already have something that I perceive to be disfiguring, as you all know. At this moment in time, because of the severe rebound of my psoriasis my self esteem and my self worth are at floor level. Complete self-loathing. The thought of having to deal with this rebound and my right tit being fucked up? I am not entirely sure how much more I can take, psycho-emotionally. Add this to my fear of the general and I reckon Mexico might be an option. Who cares if I die because of it? Bring on the tequila and lets eat burrito and go out smiling, ladies and gentlemen.

At my lowest, I feel like it is all rather pointless. I will be worthless as a viable woman and human being because physically, I will be a mess. Do not think this as self-piteous. I actually believe I am not a moaner or whinger. I do not complain about my situation. I have not once said 'why me?' or 'what have I done to deserve this?'. I am aware there are a lot of people far worse off than me. I think I am rather courageous to write this. I imagine many people feel like this, but they do not open up and share the words with others. In fact, I am sure this is true.

But that is me in a bad minute. I swing a little at the moment. One hour I might feel like actually crying (something I truly have not done since this whole cancer shit) and one hour I just think 'it isn't so bad'.

I imagine this is normal behaviour. For me, anyway.

So there you go, Plaingoldband's thoughts at this moment in time. How lucky you are to see the innermost thoughts of a woman on the verge of booking a ticket to Mexico...

"Fear is a tyrant and a despot, more terrible than the rack, more potent than the snake." Edgar Wallace

What a cock-up.

Today was rather an anti-climax.

Actually, today was a complete and utter bloody cock-up if the truth be told.

Today was the day I was supposed to have a joint meeting with the oncologist (House or Chemical Ali) and surgeon (Scouse). This appointment was made for me by Omar, the woolley oncologist, on the day of my last chemo. It was to discuss all my options (chemo, surgery and radiotherapy) taking into consideration the results of my scan and the fact they are 'concerned' about my psoriasis.

Or so Omar the Woolley oncologist told me. Indeed, I distinctly remember, as Best Friend can confirm, asking him which oncologist would be in the meeting ('it won't be me' he said, 'perhaps House or Chemical Ali')

Crap.

First off, the clinic was running over an hour and half late. Or was it 2 hours? I lost the will to live by then...first hour was ok, but then it all became rather tedious and boring. You expect to wait, or so I have learnt over the last 3 months. But this was a very l o n g wait today,

Scouse came out, called my name. Best Friend and I duly followed him into a windowless room. And he went to find my notes.

He came back.

Alone.

No House. No Chemical Ali.

'We thought this was a joint meeting with yourself and the oncologist' we said.

Scouse looked blankly at me and then the Nursey Bernard.

'No, we are here to discuss your surgery' he said.

It was our turn to look rather blank. At each other. This was not what we had been expecting. I mean, we knew he would be there to discuss surgery options, but I didn't know what was happening with chemotherapy (Omar told me to make blood test and chemo appointment for next week as usual) and I need to discuss radiotherapy with the oncologist because of my skin. Scouse is a surgeon, not an oncologist.

'They have told you that they are halting chemotherapy, haven't they?' he asked.

Um, no. I haven't seen or heard from an oncologist since my last chemo. That was when an oncologist told me I was having this joint meeting. To discuss it. To discuss chemo. To discuss radio and everything else.

And this is what I told Scouse.

At this point, he looked at the Nursey Bernard and made a face. The kind of face that says 'what the fuck?. The kind of face that says 'this is a cock-up'. But with no words...

'Well I understand they are stopping your chemo because of your skin' he added.

Right. Thanks for that. Would have been nice to have heard this from the horse's mouth so to speak. To have had a discussion with an oncologist. To ask the perfectly reasonable question 'so have my chances of survival been reduced' or 'am I non-responsive or are my cancer cells resistant?'. To not have this information off a surgeon, who made it quite clear he can't answer any questions on anything but surgery.

When were they going to tell me then? By text message? I would have just gone next week for my normal chemotherapy if Scouse hadn't said 'You do know....'.

He said he would make an appointment to discuss all of this with an oncologist. Next week. Great. More time off work.

He ploughed on, clinically examining Colin (that's groping my tit to you) and telling me that actually, my tumour is nearer 5cm than the 1.4cm that the imaging showed. He was very good at explaining the difference; imaging is just one tool to try and get a handle on size and location. Groping is another, as is mammography. But until you get in that there breast, it is impoosible to know for certain what you are up against. Obviously, I haven't seen him since March 10th when he told me I had breast cancer. No one has discussed Colin with me other than to tell me the chemo hasn't significantly reduced him, so I learnt quite a lot from Scouse today.

I didn't have the opportunity to discuss the ductal carcinomas, the ones I read about in my notes. Oh well. It just seems to be one thing after another. I have partially lost the will to live, let alone take on the surgeon with regards to not telling me everything.

Anyway, depending on what my derm and the oncologist say with regards to my skin and radio, I have two choices. Wide local excision (partial mastectomy) or full mastectomy. I will also have to have all of my lymph nodes removed. That is absolute because one definately has cancer, they may be more and they never leave nodes behind if one is cancerous. That will be a 'Malcom has left the building' moment then...

Regardless of which surgery I have, standard protocol is to have radiotherapy. This is because it is the most effective way of killing any remaining cancer cells. This also means that if I end up with full mastectomy, I cannot have any rebuild for at least 6 months to a year afterwards. This is because radiotherapy can distort the new breast out of shape. And that means I would wake up with no right breast and have to live with it for a long, long time.

If I opt for WLE, there is a risk that I would need to have more surgery if pathology on the margin areas shows Scouse hasn't taken enough tissue away. There is also a risk that the second surgery would end up as full mastectomy if a lot of tissue needs to be taken and the remaining area isn't viable. If this happens, I end up with no breast for 6-12 months again. This is the risk you take in trying to preserve the breast with initial WLE.

I haven't thought about this in any great depth. I will. I will rationalise my feelings on this over the next few days.

Right now, I am still fuming at the total incompetence of the RB's Oncology department...

Dogwankingfucksticksbunchofimcompetentfools.

The Drugs Don't Work (Part Three)

I had my ultrasound today to see if Colin has got smaller.

If you remember, he hadn't last time. That is because I was non-responsive to my first lot of chemo (FEC) and my cancer was resistant to it.

I am also non-responsive to Taxotere and my cancer is resistant to that one too.

Colin has not shrunk at all, meaning my cancer cells just laugh in the face of Taxotere. They have stuck their cancery middle finger up to it. They have blown a raspberry to anything some oncologist thinks ought to work.

I am beginning to realise that this has all got terribly complicated and all very negative.

To be non-responsive to chemotherapy is just not cool. My chances of actually dying of cancer have increased...

It also means radical mastectomy and complete clearance of my lymph nodes (even though only one, Malcom, actually looks dodgy). The reason for this? I can't have rasiotherapy post-surgery because of my psoriasis. Apparently. I have read about this but a nurse I met (who has a mum with psoriasis) said it too. Radiotherapy causes a skin reaction and anyone with a skin disease is more at risk. It is not recommended to anyone with severe psoriasis.

So not only are my chances of relapse higher because the chemo has failed, they are also higher because I can't, apparently, have radiotherapy too.

However, I am sure this will all be confirmed on Tuesday when I see House and Scouse...

Pillarboxredheadedgoddess came with me to the hospital for my ultrasound. Except she is no longer pillarboxredheadedgoddess, she is ravenblackheadedgoddess because she has gone all gothlike in the hair colour department. She finished uni on Wednesday and came up by train to stay for a few days; I haven't seen her since Mother's Day. I was pretty chipper post-ultrasound. For her sake. I didn't not tell her the truth, but I did it in my usual Plaingoldband chipper way. I didn't want her to get upset...and she did a reasonable act of not being so. But she is.

What can I say? It's not great news. My chances of survival at five years have decreased I imagine (five years seems to be the 'magic' number; still alive at five years, more likely to live another).

I do not regret having neo-adjuvant chemo. If I hadn't, I would never have known the chemo didn't work, as there would have been no Colin to measure its efficacy by. How may women, I wonder, have surgery first and then have adjuvant chemo and think it is all a-ok, only to find they have secondary cancer in their liver/bones/lungs a few years later. At least, if I find Colin's babies in my liver/lungs/bones it won't be a total shock, will it?

I suppose the only thing I could possibly regret at the moment is having chemo at all. I shouldn't have had it. I should have had surgery then radio. I wouldn't have my psoriasis and I wouldn't have been any the worse off than I am now!

I shall sleep upon it and report back tomorrow...

Marmite experiment.

Well the side effects from last week are still apparent.

Mainly the hand thing. Weirdly, they turned bright red a few days ago. They looked and felt like they had been placed in boiling water. Very sore. The skin stopped coming off, but now it is back. So now they are red and exfoliating madly. They look absolutely awful. Awful. I looked up Taxotere/skin rash on Google and did indeed find a few images of what is on my hands. I am moisturising hourly, which makes them comfortable for a few minutes after the initial sting, but they start to exfoliate again soon after.

Mouth is better, but still no real sense of taste. Last night I ate a spoonful ofMarmite, right from the jar, just to see what my mouth thought it was. It didn't think it was anything. I couldn't really taste it. Marmite?!? That stuff is toxic!

Bones are ok and they were better by Monday, which I thought they would be. Tummy has been a little sore too. I imagine I am on the tail end of the worst it now.

All the above I can handle I suppose. I haven't felt 100% this week. I know Taxotere must be heavy duty if I have this level of side effects! But again, I am not complaining. I have still been able to work and, as it is Royal Ascot this week, there has been plenty to do, although I am glad most of my work associated with the biggest and grandest racing week in the world racing calender has already been done and I have had a reasonably easy time of it.

But the real news is my skin. Psoriasis has gone bananas and I am in a lot of pain, as well as looking terrible. Lucky I am not a posh bird and was not supposed to attend; imagine, all those beautifully turned out people in their beautiful clothes and hats and then me, with my boiled red hands and a bald head?!

I would think those of you who don't know anything about psoriasis think of it as a bit of dry skin, mainly on elbows and knees or perhaps the scalp.

I wish I was a mild sufferer. Right now I have about 40% coverage, but it is flaring, hot and incredibly sore. My clothes rub me raw. It hurts to sit down. It hurts to lay down. Sleep is difficult. I wake and find blood on my bed linen. My skin feels like it has had acid thrown over it. Every time I risk looking at my body, I see more psoriasis...

The physical side effects of psoriasis can be terrible, but believe me when I say the psycho-emotional ones are far worse.

Yes, there is a lot of self-loathing and low self-esteem at Plaingoldband Towers at the moment. Enough said on that, I think. Although I will say I am trying to put a brave face on it, as most psoriasis sufferers do. Few of us let people know how much we are really suffering. It is a very personal thing, psoriasis. I am trying to be chipper when I have to see people, although I am not seeing many on purpose. I don't feel like seeing people. But the truth is, I am not feeling very chipper. I am not my normal, happy-go-lucky, positive self. But if you met me right now, I would smile and crack a joke or two, tell you how it is 'ok' and how I am keeping it all going. That is what I do, even when I am dying on the inside. I am a bloody good actress...

Anyway, I think it is possible that even if the Taxotere is working, I will not be able to have anymore. I cannot imagine I will be fit enough with my skin like this and getting worse by the day, plus they were talking about early surgery anyway because they were 'concerned' my skin would prevent it. Bit late now. I think worst case scenario is going to happen and I might be too sick for surgery, if the psoriasis keeps going unabated. Next stage is erythroderma...

I also think radiotherapy would be impossible with such bad psoriasis. I understand it can make the skin sore. My skin is already sore. I cannot imagine how they can irradiate the area if it covered in flaring psoriasis?

I need to make sure I ask serious questions of Scouse and House next week. Have they ever performed surgery/given radiotherapy to someone with severe psoriasis?

James has asked about future psoriasis treatment and cancer below. Yes, I have thought about this, A lot. I do know there is a woman in the US who is taking a biological after having breast cancer (my derm did indeed do his homework). The only treatment I can use is biologics. I am non-responsive to everything else. There probably isn't much experience on any of this yet, as the biologics are such a new medicine. Hey! I have just realised I will be logged as a '41 year old Humira taker with breast cancer' in all the data on the drug from now on!

I have said this before in this blog actually: it is not about quantity of life, it is about quality of life.

I have no quality of life when I have severe psoriasis. I do not want to live life like this. I can't. If I have to choose to take a drug to keep my skin under control which might have consequences for a relapse of the cancer, I really have little choice.

Cancer can kill you, but psoriasis really makes you want to be dead.

Please, don't be concerned about me and suicide. I am not suicidal. I am just trying to be honest and if I can't be honest here, where can I? It is not easy to talk to people about this right now in real life; they would think it was the cancer making me feel so low, but it really isn't. I can deal with the cancer. I can't deal with the psoriasis.

Truth is, most of my thoughts are on the possible outcomes of both my scan tomorrow, my meeting next week with Scouse and House and an appointment I have with Silvano soon after...

Not many laughs to be had at Plaingoldband Towers right now. I apologise. I could do with a bloody good laugh and we all know, laughter really is the best medicine.

Ezekiel 37:1-14 (The Valley of the Dry Bones)

Post-Taxotere infusion side effects have hit and they are perfectly on time. Or at least, they have surfaced at exactly the same time as before. At least this shit is predictable...

I made sure I took some painkillers and a sleeping tablet on Friday night, seeing as the bone pain started on the morning of day 3 of the cycle. Lo and behold, 3am and I wake up feeling my leg bones again. I am not sure how effective the Tam is to be honest. I took it again last night and found myself awake in the middle of the night...

Bone pain ok. Long bones, wrists, ankles and knees just feel tingly and crampy. I am taking the prescription-only painkillers and although I can still feel the pain, it really isn't so bad. It wasn't terrible last time, just uncomfortable really. Certainly, I am not rolling around on the floor or anything.

It'll be gone in 24 hours or so, if it follows the same path as last time. I haven't taken any painkillers this morning and I feel ok. I don't want to abuse the tablets I have been given, particularly as I seem to develop some kind of resistance to things sometimes.

Tongue and mouth feels soggy and swollen. Like I have been chewing stinging nettles. Again, not awful, just uncomfortable. Absolutely no sense of taste or, indeed, appetite. I swig Difflam mouthwash, as this will prevent infection apparently.

I am still grateful that I have not suffered much, particularly when I read other womens' experiences and see how much they suffer so badly with the side effects. I am very lucky, all things considered.

Thing is, when I feel like this, I don't feel particularly sociable. I did not leave the house yesterday (even though I had plans). I prefer to be on my own and just deal with it alone. I have always been like this actually. I am quite a self-contained individual.

And anyway, if there was someone with me I might just start rolling around on the floor and milking it for all it's worth!

My hands are still peeling away. There seems no end to this and I imagine it will not go away now until I finish Taxotere. My skin generally is 'ok'. Obviously, a lot of psoriasis but I think some of the flare has lost its sting. The redness has diminished, as has the itch. This is pretty good and I hope it indicates I am not going to go erythrodermic, at the moment anyway. Mind you, I am covering myself in potent steroid at the moment...not clearing any patches (which is what it is supposed to do) and the risk of rebound is high if I stop it. Hah, caught between the devil and deep blue sea again!

I have calmed down significantly, as I knew I would. One thing I have not so much 'learned' about myself, perhaps more 'confirmed', is that when something angers/upsets me, or something happens that I have little control over, I need to rail against it. I need to swear (in private). I need to shout (again, in private). I just need to let it explode in my head. Then I can think rationally again and start figuring it out, making plans, accepting things.

I am not sure if this is what the average person does, but it is what I do. I would not criticise someone else's coping mechanism, so I hope no one criticises mine...

And I know, until I have the results of the ultrasound, that there is little to be done. Once that result in in, then things can be discussed and plans decided upon.

One thing I have noticed over the last few weeks is how people I hardly know are full of opinions. I mean, we all have opinions and some people like theirs to be known. Loudly. Look at the Jeremy Kyle Show...nothing more than people taking a moral highground and then letting their opinions on the personal matters of people they don't know personally, be known. On public television. I suppose if you do hang your dirty knickers out on ITV1 every weekday morning, then they will be rifled through!

I remember being pregnant. You kind of become public property then too and oh, how people liked to give their opinions on my choosing to have a home birth. People I did not know.

Some people are doing similarly with my breast cancer.

Why do some people think that their opinion is wanted? When it hasn't been asked for? When they don't know the full situation? And particularly when they don't really know the person they are giving their unwanted opinion to?

By the way, these people are not from here. I don't want you to think any of our happy Plaingoldband gang are self-opinionated, thoughtless dickheads.

Off to have my nails painted black again. So far, my nails are still attached to my fingers and toes!

Quote of the Day: "We have no right to express an opinion until we know all the answers" Kurt Kobain

Lord, give me strength to deal with healthcare professionals

I was too pissed off to write here last night.

It may possibly have been nothing more than rather a lot of swear words. I was very angry. Very pissed off. Very annoyed.

I didn't think it was a particularly constructive way to be, but I think I needed to go through it so that I could revert back to my more pragmatic self today.

First off, I didn't go into shock with my 2nd Taxotereshit infusion. I knew I wouldn't, of course, but even being a clearish-thinking and pragmatic Plaingoldband, I can't help but be a little human and think 'Oh lord'. It does happen to some, there is no reason why it shouldn't happen to me (I have fucking cancer, don't I?). But it didn't.

Shit day all round though. Best Friend and I were there for more than 6 hours. The West Wing was like the cattle shed I once described it as. The waiting room was full of cancer striken people queueing to get into the ward to be hooked up and the Domestos milked in. I think we waited a good 2 hours like this. Once in, the place was rammed with chemo-cows. One cow in, one cow out.

Consequently, the Bernards were stressed and overworked. No smiles or laughs to be had by them yesterday. Not even the home made brownies I brought in raised a thank you at first.

I had a right miserable and, dare I say it, rude Bernard. I haven't had her before. I hope I don't again. Best Friend and I did little faces at each other behind her back. I did check with Best Friend 'is it me, or is she a right miserable bitch?'. She wholeheartedly agreed, particularly when said Bernard quite literally shoved her out of the way to unplug a machine without even an 'excuse me' or' 'sorry'. Not even a Plaingoldband smile, joke and attempt at empathy changed her scowl.

Now, I wasn't in a particularly good mood myself (although I try to hold my bad moods to myself when dealing with people who have no part in why bad mood has occurred, like the overworked and stressed Bernards).

Saw Omar again yesterday. Last time I saw him, I felt he was woolly and dodged direct questions. Best Friend wasn't with me that time...I made sure I asked her this time if she felt he was a little woolly and she agreed.

Anyway, I was having none of it this time. Omar brought up my psoriasis:

"We think we may have to stop chemo and give you immediate surgery. This because we are concerned about your psoriasis".

Yeah, Omar, me and you both. Thing is, I tried to tell you 3 months ago this scenario might happen and you fucking God-complex oncologists patronisingly dismissed my very valid concerns, concerns based on 30 years of experience of having this disease and knowing what happens when I am unmedicated. But hey-ho, I am just the patient, right? What do I know? I didn't go to med school for 7 years and study to become God, did I?

OK, I am still a little teeny bit pissed off. I apologise. And it is not Omar's fault. He might be woolley and dodge asnwering questions, but it was not him who was so patronising. That was House.

So, they are now concerned that my psoriasis is going to get so bad it might not allow surgery to either happen, or be easy or effective in healing?

This is where it gets interesting. I asked:

"I have had 3 cycles of chemotherapy and 2 of these my body did not respond to. Surely stopping chemo at this point, when we don't know if Taxotere has been successful, when we know the other chemo wasn't, means I will be at risk of relapse?"

My logic here is sound. They wanted me to have 8 cycles of Domestos. This is based on the type of cancer, the grade of the cancer cells, the risk of relapse, my age blah blah. I believe they don't just blindly give you drugs. There is method to all this. Well, you like to think so, don't you?

"Well" said Omar, woolliness and inarticulation radiating from his body and mouth, "yes but chemotherapy isn't that important, your risk of relapse is only increased by 6-8% by only having a few chemo cycles".

6-to-fucking-8-% ???

I thought I misheard him. I should have asked 'so what were the approximate percentages if I had not had chemo at all then?'. But I didn't. I was still cogitating this when I realised he was moving on to something else.

"Surgery is far more important than chemo" he said.

"But another reason for having neo-adjuvant chemo was to shrink the tumour to make lumpectomy possible instead of full mastectomy. If I have early surgery, this won't be possible' I replied.

Wooliness abounded some more.

"Well, we will have you in for your ultrasound and then we will have a meeting with the breast surgeon" he said.

I haven't seen Scouse since March 10th. He has nothing to do with oncology.

"But unfortunately, this will have to be 13 days time as this is the only time we can all meet up, which means you will have to have the ultrasound next week" he added.

You normally have the ultrasound as late as possible in your 21 day chemo cycle. This is obviously because the last chemo you had needs that long to work and for it to show on your tumour. Me? Because of timetabling, I have to have the ultrasound on day 5-9. It won't have had time to do anything. Potential upshot? They will be judging the reduction in Colin's size based on 1 cycle of chemo. Upshot of this? Pretty much no hope of having a nice easy lumpectomy. But more of this later...

That was that then. Off to make appointment for ultraound and then off to God's Waiting Room.

Obviously, the whole 'chemo is not that important' line of Woolly Omar was on my brain. So was the 'increase chance of relapse only 6-8%' line. Even Best Friend was thinking what I was thinking here.

If you are a regular reader, you will know that I had a bit of a wobble the Sunday before I started chemo (4 April). I asked Best Friend 'Why am I actually having chemo?". I was obviously concerned that I had just been told 'you have to have chemo' and no doctor had told me why...no numbers, no percentages, no real reason other than it can reduce the lump.

Best Friend said 'because you will die if you don't'. A very fair comment based on what we understood from the oncologists and specialists.

But now we realise, with some research, that this isn't true. Yes, anyone can relapse and their cancer can come back. Even those who have had radical surgery and full quota of chemo. But actually, chemo is a little bit of a blunt instrument.

For many women with my type of cancer, it is nothing more than an 'insurance policy'. The worst might happen still but you feel better knowing the chemo might have annihalated that odd stray cell looking for a nice liver or lung to settle in an cause problems 5 years down the line.

In fact, it is possible my chance of my cancer coming back if I hadn't had chemo could have been as low as 10% or so, may be a little more. As long as I took the Tamoxifen afterwards and particularly as I only have one enlarged lymph node.

Ladies and gentleman, if I had had that information, I may have considered my options. But I was never given this information at the time and I didn't know enough, understandably as everything moved so fast and House only spent 10 minutes with me, to ask. It all seems so bleedingly obvious now!!!

Something else. You know I have Colin the tumour? A Grade 2 adenocarcinoma? I read my notes again yesterday. Properly. And guess what? Underneath Colin are a number of small 'ductal carninomas in situ'. These are no invasive and unlike Colin, they are in my milk ducts. Many women do not even have treatment for these, although it isn't a bad idea to have them out, because they can get a whole lot bigger.

I have never been told about them. Not a word. I have two types of breast cancer. And no one told me. Moreover, I now see why Scouse said 'your tumour area is actually bigger than the 1.5cm it looks like'...

Yes, Scouse, that's because there are a number of little cancerous cysts sitting under it. But you omitted to tell me this part, didn't you? You didn't tell me this when you were going on about chemotherapy and breast surgery on March 10th.

OK, I am not as over my angry mood as I thought. Need some more time to let it all go and become clear thinking again.

Dogwankingfuckstickhealtcareprofessionals.

Two quotes of the day today. If you know me by now, and have read the above, you'll see why:

"Speak when you are angry, and you'll make the best speech you ever regret" Dr Lawrence J Peter

"Holding onto anger is like grasping a hot coal with the intent of throwing it at someone else...you will be the only one burned" Buddha

"This is a snakeskin jacket! And for me it's a symbol of my individuality, and my belief... in personal freedom"

So Round 4 of Fight Club is tomorrow morning. Technically, this should be the 'half way' mark. It all depends upon the result of my next ultrasound. If Colin, the little fuck, is smaller, I will keep going on the super strength Domestos Taxotereshit. If no smaller or (gulp) bigger, then I am in trouble...instant tit-off territory.

And then, who knows...chemo won't have worked and I may be left with the odd stray cancer cell roaming at will around my body looking for a nice liver (without fava beans and a nice chianti) or a lung to make a new home in....

But I get ahead of myself...

I have heard that with the Taxotereshit infusion 2 there is a slightly increased risk of going into shock. Hurruh! Something to look forward to tomorrow then.

To be honest, I am more concerned with my hands at this point. I look like a snake shedding its skin...both hands are skinned, right up to the finger tips now. I have never experienced anything quite like this in my life...and even moisturising them every 30 minutes does nothing. They look awful (unlike a snake, which looks gorgeous underneath) but I am happy to report that there is no pain or soreness, which is strange, because they look like they ought to be sore. I look like I have an extremely bad case of sunburn!

Some women pay good money for a 'chemical peel'. My experience of chemicals and peeling is a complete rip off...

I think it will be a challenge for the nursey Bernards. I am not sure where they can put that there needle tomorrow morning...my veins are covered up with this rash and the peeling skin.

The steroid I am applying, a moderate-to-potent one, is doing nothing. Anywhere on my body. That is 7 days worth of application now and I don't think it is going to do anything now. I kind of knew this already to be honest. I have never responded to the most potent of steroids. Blame it on using so much of them throughout my life for psoriasis.

It is all getting so very 'complicated'. Why can't I be the chemo patient who gets to suffer the bog standard nausea, fatigue and runny tummy? Nope, I have to be the bone pain and 'skin rash' patient. Typical. I always liked being 'different'.

I have just so much to look forward to over the next 5 days, don't I? I wonder if the England v. USA can distract me from it all...

So long, farewell, Auf Wiedersehen, goodnight...

Quote of the day: "I feel like I want to crawl out of my skin..." Skeet Ulrich

Imaginary Flashing Signs...

Feeling a little more accepting today. Not really. I am trying to be positive and that means fooling myself into believeing I am accepting it. I reckon this cunning plan might eventually work...

About to jump in the bath and then cover myself in a potent topical steroid. Hurrah! It's like be dipped in an oily chip pan, except you don't smell like chips, you smell of chemicals. I have banished my Cowshed and Laura Mercia body moisturisers to the back of the bathroom cupboard. I will have to use prescription-only emollients now. Hurrah again...

I hope the steroid will at least get my hands into some kind of fit state for chemo Fight Club Round 4 next Wednesday. There is definately something odd going on with my hands. There is some psoriasis on them, but they are oddly shrivelled and peeling. This must be the Taxotereshit. This is not normal psoriatic reaction in my experience.

I have just realised that all of this makes me sound like some kind of freak. Really, I am a pretty OK looking person in real life. Just not right now. I have made myself sound like some freakish monster with shivelled hands and flaking skin. I think it all looks far worse in my head than it would if you looked at me right now. You probably wouldn't notice all of this unless I pointed it out to you, a bit like those people who get a spot on their face, cringe about it, go out and then tell anyone looking at them 'don't look at my spot', then the person looking says 'actually, I hadn't noticed it until you pointed it out...but now you come to mention it you have a got a spot!'.

People are really not that observant. I know this. It's just when you know something isn't 'right' with you, you think there is a sign flashing above your head screaming 'LOOK AT ME!'. I am sure everyone knows this feeling, right? Not only do I believe people stare at me because I have no hair, I now believe people stare at me because I have some spots and shrivelled hands. They probably don't. But I feel they do, and it makes it a whole lot worse...

I don't feel sociable. I don't want to go out. I don't want people to look at me (even though they probably aren't). This is normal behaviour I think. Well, normal for someone who feels they have a flashing sign above their head and smells of chip pan chemicals, anyway...

I now have a date with a topical steroid.

It can get worse...really.

OK, a new side effect reared its head last week.

I seem to like the ones further down the list of potential side effects, such as bone pain for example. Let's add a new one, shall we?

'Skin rash'. Yes, down the list of possible Taxotereshit side effects, slightly above bone pain but a long way down from the usual suspects of nausea/vomiting/fatigue (which I don't have), is a 'skin rash'.

I know a lot about skin. I get psoriasis. Except I haven't suffered with it for a long while because I used to take a targeted biological intervention. Thing is, as a drug which suppresses the immune system (even a tiny part), I am not allowed to combine it with chemotherapy.

Anyone who knows anything about psoriasis knows something called 'rebound flare' can occur when you stop taking a treatment. Also, anyone who knows anything about psoriasis knows about the isomorphic response the psoriatic can experience when the skin is in any way damaged, commonly known as Koebner Phenomenon.

Anyway, for the last few months I have been waiting for my rebound flare from coming off my biologic at the end of March. House et al all said, rather dismissively when I attempted to discuss my psoriasis with them, 'You won't have any problems with your psoriasis because the chemotherapy will keep it away'.

I have had psoriasis most of my life. I am an expert patient in it. I know more about psoriasis than your average General Practioner, who probably didn't take a rotation on skin during their training. Indeed, I have gone all over the globe as this expert patient person: I have trained derm nurses; lectured consultant dermatologists; written many papers on patient perspectives and the like on psoriasis and its effects on a patient. I know my Ciclopsorin A from my Methotrexate; my mometasone furaote from my clobetasol propionate; my narrowband from my broadband phototherapy.

"I do hope you are right" I said to the oncologists back in March,attempting to be diplomatic and knowing both my skin and what drugs don't work (I have taken large amounts of Methotrexate, an immuno-suppressing chemotherapy drug and it didn't touch my skin) "but if I do rebound, it could potentially affect your treatment of me".

When I rebound, I can end up with large percentage coverage, swelling of the limbs, a temperature and need in-patient care as I can become erythrodermic. Best Friend laughs when I say this word. She thinks it sounds like a character off 'Heroes' -"Watch out! She's going erythrodermic!".

But the truth is, erythrodermic psoriasis is potentially life threatening. The body cannot control its temperature when a large proportion of its largest organ cannot 'breath'. The kidneys begin to shut down and immediate ermergency care is needed.

Early last year, after coming off another drug, my skin went crazy. I was quite poorly and was a whisker away from this. The only thing that prevented it was another biological drug...

...the one I came off at the end of March pre-chemo.

The oncologists, who probably know less than your average GP, patronisingly dismissed my concerns.

I accept one shouldn't overly worry about something that hasn't happened yet. I don't think too much about being non-responsive to the FECshit and having to go on Taxotereshit early and this not working too...I thought of the possible scenarios and need to take two cycles and have an ultrasound, hoping that Colin gets smaller before dealing with the worst case scenario.

But I am now covered in psoriasis. It all began 5 days after starting Taxotere. It presented, at first, like a lichen planus skin rash but has now gone on to be psoriasis. Perhaps it is rebound; perhaps it is Koebner from the initial 'skin rash'. Either way, my body is covered in hundreds and hundreds of little red spots, which will get bigger and bigger until I am consumed with it. And then it begins...

...having chemo will be difficult, surgery similarly. Currently, a nursey Bernard would find it difficult to get a cannula in my hand because of the psoriasis.

I saw my lovely dermatologist this week. His name is Silvano and he is Italian (did you know there are more dermatologists per head of population in Italy than any other country in the world?). I love Silvano. He is an excellent dermatologist and he and I have an excellent working relationship. We are a partnership in my care. We discuss treatment options and outcomes; he treats me as an equal.

Perhaps you can now see why I was and haven't been overly impressed with the way the oncologists speak with me? No discussion or looking at possible treatment plans and outcomes. I am no expert patient in oncology (although I reckon I know a lot more than I did pre-Colin), but I am perfectly capable of holding a discussion with a consultant oncologist and understand drug therapies, plans and outcomes. Unfortunately, they seem purposefully keep you out of everything. Perhaps it is because cancer kills, where as psoriasis just makes you look and feel like you wish you were dead? Perhaps the average person with cancer deosn't want to discuss anything other than 'am I going to die?' with their oncologist. Hey, you know my attitude to all of that, don't you?

Silvano's hands are tied. He cannot give me UV, systemic drugs or biologics. I am allergic to vitamin D analogue and coal tar-based topicals. I am non-repsonsive to even the most potent steroid topicals, although I am currently covering my body is one to see if it can help enough to get a needle in my hand next week.

Silvano looked crestfallen. The only way we can treat the psoriasis is to come off chemotherapy. If I come off chemotherapy...well, that isn't an option either. But the untreated psoriasis may get a lot, lot worse to the point where chemo and surgery will be difficult.

Can you see the position I am in here? Devil deep blue sea? Rock and a hard place? Up the stream without a paddle? Fucked?

I can handle cancer, people. Cancer has a treatment plan and it may or may not work. Cancer can be cured, psoriasis can't. I would rather go through this treatment for cancer than live with psoriasis. Don't think me crass. Psoriasis severely diminishes quality of life to the point where more people with psoriasis suffer from suicidal ideation than other disease group patients, including those with terminal cancer (Gupta et al, 1993).

I have breast cancer. I now have my psoriasis back. Truthfully, life isn't so great right now. I am bald, bloated and I look like I have a very bad case of measles. Within a month, I will potentially look like Philip Marlowe, the main character in Dennis Potter's The Singing Detective and no, not even Joanne Whalley-Kilmer could make me feel better...

So, I am currently attempting to 1. accept I have my psoriasis back and will look extremely shit over the next 6 months 2. accept my cancer treatment might get affected 3. trying not to see Nembutal as a solution.

Well, #3 would be a solution to #s 1 and 2, wouldn't it? Don't worry, I am not depressed. I am just trying to adjust...

...bloody Kylie didn't have to deal with bloody psoriasis as well as breast cancer!!!

Cancerspotter

I have slept, without drugs, for 2 nights now. Life is so much more managable when you have had some sleep...

I don't seem to have suffered any further side effects from the last chemo. There was just the 3 days (Sunday to Tuesday) last week. And it would have been oh-so easy if I had pain killers and some sleep. I reckon I did pretty well really, seeing as most people suffer for the few weeks and then feel ok the last week of the cycle.

I can live with it.

One interesting thing has come to my attention over the last week or so. When people see the headscarf and look at me, they smile. I think they see someone with cancer and their immediate reaction is to smile at me. People didn't smile at me like this before cancer. People were just people. But I know I am not imagining this. People serving me in shops seem friendlier too.

I wonder what they think when they see me? Do they think 'poor woman'? Or do they think 'thank god that is not me'?

I can spot another chemo person a mile off too, even if they are wearing a wig. I just know. Strange, isn't it? I never noticed them before. I suppose I may have smiled at them too, in my life before Colin and Fight Club. I wonder what I thought when I smiled at them? Can't bloody remember...

I saw they may have found a breast cancer vaccine or something like that. It works on mice apparently. I suppose, like cancerspotting out and about, I now notice how much breast cancer is mentioned in newspapers and in the news generally. I know it is the most common cancer in the western world and the most common cancer in women. They now say 1 in 8 women will get breast cancer in their lifetime. I suppose I am getting it out the way early! That will leave me time to get something else, won't it? You know, Parkinsons or Hodgkins Lymphoma or some such disease. 1 in 8 is pretty awful odds really, isn't it? I can see why it gets so much press and so much cash for research, for it seems to touch so many people; their mothers, their sisters, their wives and girlfriends.

I am trying to research jumping-out-of-an-areoplane-for-charity. Best friend plus 2 other slightly mad people I know are doing it for cancer charities: one will do breast and prostate; one will do Macmillan and Best Friend is doing it to raise some cash specifically for the West Wing. They need some decent headphones for the DVD players they have. Yes, they have DVD players, but no decent headphones that work. Best Friend and I reckon that would be a good thing to buy with her sponsor money. It will make a difference. I like the idea of spreading the cash around non-breast cancer charities too, which is why we want to do Macmillan and prostate. You men, you really are rubbish at publicising and raising money for your own unique little cancer, aren't you? So one of the mad women is going to jump for the prostate!

If anyone knows anyone who does cut-price-jumping-out-of-planes-for-charity, do let me know. The local airfield to here wants to charge 250 quid each!