I’ve been back at work for nearly 2 months and I have never been this tired. They say 6-8 weeks off work is the norm for mastectomy with immediate implant reconstruction. I’m “young and fit” so I might have expected to return sooner, but everyone warned me not to underestimate the psychological toll of breast cancer during Covid-19 and to take as much time off as I needed. I’m glad I heeded their advice as I feel permanently exhausted. I head to bed at 9pm every night as I can’t stay awake. My “phased return” rather went out the window as we were a doctor down when I returned and I had to take up the slack. Add to that all the “Covid contingency plan” decisions which had been made at the Medical School during my absence and I was playing catch up, big time.
My first few days back at work, though daunting, were a pleasure. The team were all so delighted to see me, it felt very positive. I also knew that it was time for me to move on from being a “sick person” to being a “recovered person”. But oh my, I wasn’t ready for how tired I was going to feel.
Should I write a book?
Oh yes, I also need to mention that in my spare time I’m writing a book about my cancer/Covid experience. Who needs another book about breast cancer? Probably no one, but I just can’t help myself. The words are just spilling out of me! We’ll see if it ever gets published. I’m toying with titles such as “Physician heal thyself: a doctor’s memoir of cancer and Covid” or “Cancer in the Time of Covid” in homage to Gabriel Garcia Marquez. Hm, not sure.
Regaining my fitness
I’m now up to running twice a week or so, and wild swimming as often as I can, as well as a day each weekend hiking up mountains. My VO2 max has gone up from 36 to 41 which is good (was 43 pre-op), but it’s not half been a slog to get my fitness back. I still don’t feel as though I’m anywhere near as fit as I was before I had my surgery. My implant seems fine when I run, as long as I wear a mega-supportive bra, but my pectoral muscles on that side are sore to the touch. I experience a very sharp pain when I press on the muscles above and to the side of the implant. I’ve got the tiniest bit of cording, but nothing which even bears a mention. It’s not restricting me. Am I getting a bit of capsular contraction? Who knows. The pictures which I have found online all look horrendous and mine looks nothing like that, but it does feel very tight. The swelling which I originally had around the implant has subsided and it now looks very pert and much less droopy than my normal breast (and I have zero ptosis!). No sign of any sensation returning to my salvaged skin yet, but my armpit is gaining a little more feeling.
I couldn’t hack the tamoxifen. I managed to take it for 3 months and then sacked it. Quite apart from putting the kibosh on my sex life, it just made me feel glum all the time. I was existing in a state of grimness. Now, I know what it’s like to feel depressed as I suffer with recurrent depressive disorder, and it felt nothing like that. I just felt as though I was living in a grey world. And I felt frustrated and irritable. Now, given that the PREDICT tool told me that tamoxifen would improve my 15 year survival by 0.5%, I decided that feeling grim for 5 years was not a good trade off. Okay, I know that it reduces my risk of having cancer in the other breast, but I’m not willing to put up with feeling less than human for 5 years for the sake of something which may never happen. Does it sound awful to say that I’d rather take the risk of having to have another mastectomy than to have to take tamoxifen? I’d rather take my chances and hope we catch any incipient cancer in the bud with a yearly mammogram.
I’m still convinced that the best thing in the whole wide world is wild swimming. I’ve invested in a neoprene hat, socks and gloves and intend to keep going right through the winter. No wetsuit! Coldest so far has been 8.5oC, in Angle Tarn near Hartsop. I have discovered a run/swim route which involves running up hill for 35 minutes from Staveley to Gurnal Dubs, swimming for 15 minutes then running back down. Whenever I see a body of water I can’t resist stripping down to my underwear (or birthday suit if there’s no one around) and plunging in. Bring it on!