BRCA1 doesn't only increase my breast cancer risk; I also have a lifetime ovarian cancer risk of about 60%.
This is the statistic that scares me, ovarian cancer is a silent killer; it is notoriously hard to detect and patients with ovarian cancer are far less likely to survive than those diagnosed with breast cancer.
But there are things I can do to tackle this risk.
Today I had an appointment with the gynaecologist. I really didn't know what to expect from this; would we be talking about my options? or going straight in for the internal exam?
Turns out it was a bit of both, the clinic was running 45 minutes late so the gynaecology registrar seemed to take advantage of my medical knowledge and kept explanations brief. I was fine with this; I know my risk, all the options available to me, the risks and benefits of each and I know exactly what I want to do.
It was reassuring to have the registrar agree with and support my plan for tackling my ovarian cancer risk.
I will have yearly blood tests and internal ultrasound examinations. The blood test is a tumour marker and the ultrasound will allow the doctor to view my ovaries and detect any anatomical changes.
I will have my ovaries removed aged 35-40, at this time I will have completed my family and won't be inducing menopause too long before its natural onset.
After our little chat the gynaecologist asked if she could conduct an internal exam.
This involved me undressing from the waist down and laying on a medical couch with a blanket over my lower half.
The registrar then looked inside my vagina with the aid of a speculum (a plastic tool that looks like a duck bill and opens up the vagina, making it possible to see inside). After this she used gloved hands to feel my ovaries by placing one hand inside and the other on my lower abdomen, this allows her to press my ovaries again my tummy and fell their shape and size.
This wasn't something I would like to do every day but it wasn't all that unpleasant. It was never painful, the speculum was slightly uncomfortable but over very quickly.
I had my blood test straight after my appointment with the gynaecologist and now I just have to wait for an appointment to have the internal ultrasound scan.
I don't really know how I go about getting the results...I presume, because of the sensitivity of the information, an appointment will be made to discuss them? I guess I will just wait and see!
On Wednesday I was due to meet with my surgeon to be measured for implants and ask any outstanding questions.
When I got to the hospital it turned out he wasn't working and I would be meeting his registrar instead. After Sean and I had walked all of 5 minutes from our house to the hospital we were very disappointed!
I didn't really like the registrar; she was nice enough but a bit more abrupt than my surgeon. As I said, I had loads of questions, I asked a few of the more pressing ones but her answers were curt and it seemed she was rushing me so I didn't ask the others.
The lovely breast nurse was there again though and her presence was reassuring as ever. She tried to fill out the registrars answers and this made me feel a bit happier with the whole consultation.
After I had asked a few of my questions the registrar took me behind a curtain where I took off my top and bra and put on a very flattering hospital gown. She then measured various parts of my breast...from my collar bone to my nipple, the width of each breast etc.
Then I got dressed again. I thought she would be measuring me like they do when you have a bra fitted...back size and cup size, but the surgeon will pick size of implant based on my current bra size. She said they take these measurements to help the surgeon deicide what type of implant to use, rather than what size.
After all this the registrar said that my surgeon would probably like to repeat these measurements when he next saw me anyway, so the whole thing seemed a bit pointless, but hey ho!
She also mentioned that he might want to consider using expanders before inserting permanent implants, when I last saw him he seemed certain that this wouldn't be necessary. I was really hoping to get the whole thing done with just one surgery so I hope that the registrar was wrong! I have another appointment to see the surgeon on the 25th April, so I will clarify that point with him then. The nurse has told me to ring ahead and ensure that my surgeon is actually in the building!
After the appointment I wandered down to town to do a bit of shopping. I decided I would pop into John Lewis and see if they had any post-surgery lingerie. After wandering round a bit aimlessly, not really knowing what the hell I was looking for, I decided I needed some help.
Thankfully the wonderful John Lewis lady knew exactly what I needed and found me a nice soft sports bra. She was so nice to me that I left feeling a bit tearful, that is the first surgery related item I have bought and it made it all seem real.
I'm actually going to do this, in five months this will all be over and I will never have to worry about breast cancer again. I'm excited and scared and sad and happy all at the same time, its quite exhausting!
Its 5 months until my surgery, I set these wheels in motion 7 months ago and those months have just flown by.
I have found myself getting a bit restless in the last week. I have become OBSESSED with everything to do with mastectomy...I devour blogs, trawl youtube for video diaries and make a million lists of what I might need when the day finally comes. I hope this is just a phase because its exhausting!
Overall I feel quite calm about the surgery, my main fear is the lack of control that anaesthetic and strong pain medication afford. I like to be very much in control at all times; I rarely get drunk, I could never contemplate drugs and when I was poorly recently I struggled even to allow my boyfriend to make me dinner two nights on the trot!
I'm worried that I will wake up and not know my boyfriends name, or say something out of character, or god forbid show strangers my new boobs!
I also resent the fact that someone will have to help me shower, cook me tea and generally run round after me while I lord it up in bed!
That someone will be my wonderful mum and boyfriend. I know they are happy to look after me those first couple of weeks, I don't think I could stop them, but I will still find it difficult to relinquish control.
I see the surgeon again tomorrow and thanks to my recent list making I have a million questions for him. He is measuring me for implants and hopefully I will also get a firm date for my surgery. Until then I will continue with my obsessive research mission!
My partner Sean and I are medical students, we have exams in a couple of weeks, two 4000 word essays due in the next couple of months and we have just entered the real world where you have to pay bills and do your own asda shop and stuff!
Its all getting a bit stressful at our house.
At this time all I want is for it to be the summer holiday, 3 months with no exams, revision, assignments or medical stuff. Bliss.
I said something along those lines to Sean...he tells me he is dreading summer because that is when I have my surgery.
That made it hit home a little.
Sean and I are very new, we have been together just a year and haven't known each other much longer. He has taken on my burden without even blinking an eye. I find him more amazing every day.
It kills me to think that I am causing him extra worry, on top of everything else that he has to tackle at the moment. This is our last summer holiday, next year we start work in the hospitals and 3 month holidays are not a luxury that medical professionals are afforded.
I think I have trouble separating my worry, I'm scared to death about exams and assignments but I can't think further ahead than that.
I plan to play this to my advantage by keeping myself as busy as possible until my surgery date.
My last exam of the year is 30th May, Sean's birthday is the 31st. My surgery is currently pencilled in for the 12th June. That gives me 12 days, during that time I have to find a new house and buy a car. I think that should fill my time!
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