4. Altnagelvin Breast Screening Unit

7 June 2023 the long awaited, dreaded, day arrived. We got up and I got ready to drive to the Breast Screening Unit in Derry. I tried not to think too much about what was ahead, but as much as I did that I couldn’t help but wonder what the outcome of the day would be. When I received the appointment letter, a week beforehand, in it was a leaflet explaining what happened at Altnagelvin Breast Screening Unit. It is a one stop shop where you can go through the different stages of testing during one appointment. The first stage is a mammogram. You move to stage two if there are concerns identified in your mammogram, this is an ultrasound. If concerns remain you move to stage three an aspiration test, where they take fluid from cells. The final stage is the biopsy stage. So before going I knew there were four stages, I also knew that if I was to progress along the stages there was a greater likelihood I had cancer. I just hoped I would be sent of home after stage one.

The morning was one of fear and hope, fear of the unknown and hope it wasn’t cancer. I kept thinking how could it be, I’m moderately fit, I eat relatively ok, I don’t drink much (anymore). Something in me was telling me different though. When it was time to leave the house, I said my goodbyes to Paschal and Bella and on leaving, I turned to look at them as I closed the front door and I thought to myself, today could change everything! I drove out of the park and I put on my sunglasses as my eyes were filling with tears. The fear, the unknown, the anticipation.

I don’t really have a memory of the drive to Derry, it’s a road I drove many times a month as I had foster carers there. I could drive it with my eyes closed. The one thing I do remember were the fleeting thoughts of there’s a 50/50 chance this could be cancer and then the thought don’t be silly, don’t go there, you don’t know until you know, just wait and see.

I arrived to Derry, early, that’s not like me at all. I didn’t know Altnagelvin Hospital at that time, it felt huge, and extremely busy. I got to the Breast Screening Unit, a prefab just off from the hospital. It was a really small car park. I’d brought a sandwich with me, so I decided to sit and eat it and see if a space became free. Low and behold someone driving out, excellent! I parked and in I went.

The experience was something quite surreal, it may be different for others, but I found it very surreal. I announced myself at reception and took a seat. I was called after a short time and brought down a corridor, to a small room and was told to undress the top half of my body and put on a pink wrap around jacket, leave my belongings in a locker and take a seat in the waiting room. Ok, pre-step one done, I was there and got changed. I walked down to the waiting room. It was one of the most overwhelming experiences I’ve had. The waiting area is split into two rooms, one at either side of a corridor. Both rooms were filled with women, of all ages, all wearing pink wrap around jackets. Are there really this number of women being screened, I thought? I couldn’t believe the number of women there. I took a seat, I looked around and I thought today some of us are going to leave here with bad news. It felt like I would imagine purgatory to be. White prefab rooms, clinical. It was quite warm that day, so windows were open to try and keep the rooms cool. There were leaflets on shelves on the wall, all relating to cancer. It was all just so overwhelming. I took my phone out of my bag and tried not to think about where I was. Women were called for their appointments and, to my view, the majority of people seemed to be walking out in good form. There wasn’t a sombre feel to the room.

The was a low murmur of chatting in the rooms. Some people had a support with them, the rooms were so overcrowded that the people who were there as a support were asked to sit in the reception area to make sure there were seats for the women waiting to be screened. I didn’t seem to have to wait too long until I was called for a pre-step one. I was brought into a consultant’s room. I just remember it seeming to be very small. There was a nurse present also. There was some discussion about the lump, where it was and the consultant asked if her could examine my boob, he didn’t say boob, but I will be referring to it as a boob! He examined the area with the lump and using a marker marked it with an X and I was told to go back to the waiting room.

It was only a short time after that I was called for my mammogram, the first step, this would be fine I thought. I went into the mammogram room. The person there was very lovely telling me to take off my wrap around jacket. Bearing in mind how uncomfortable this was for me it’s funny how quickly you adapt to what you need to do when you’re being examined for potential cancer. I removed my jacket and moved over to the mammogram machine, I was told where to stand, what was going to happen, my right boob and then my left boob would be examined; oh and it would be uncomfortable, to let her know if it caused pain. Listen, getting my boob clamped in a big machine was the least of my worries that day! It didn’t take long and when it was over I was told to go back to the waiting room and I would be called again to let me know the results.

I returned to the very packed waiting room. Alongside the low murmur of chatter, as in all waiting rooms, one person arrived and talked over everyone else. All I could think was myself, nor anyone else in that room wanted to hear this conversation. I sat half fearful that someone would start a conversation with me. It’s not that I’m not sociable, or I don’t like talking to people, there are just sometimes I’m not sociable and I don’t like talking to people and this was one of those times.

I was called again, by the person who did the mammogram. I thought this odd! She asked me if I remembered she said she might have to do a follow up mammogram to check things. I said that was ok, but I was thinking she didn’t tell me i might be called for a follow up mammogram. I had a very strong feeling at this time there were concerns. After this I was told to return to the very packed waiting room. As it was very packed, and I was on my own, I didn’t show any emotion because I didn’t want to upset other people, plus I didn’t know anyone. However, I also thought I didn’t know for sure at that stage if it was anything. All I could do was wait!

My name was again called. I was brought to a different room. One that had a bed and machines. It was dark too. There was a nurse who asked me to get undressed above the waist and to lie on the bed. I did as I was asked. I was now at stage two the ultrasound stage. A doctor came into the room, introduced herself, I don’t recall her name. She explained she would be doing the ultrasound, on went the gel, which was cold, but fine. As she examined my boob she told me the lump I discovered was 2.5cm and there were three other lumps that needed to be investigated also. What?! And I thought it was nothing. She said she would have to do, stage three, aspirations to determine if it was cancerous. She left for a short time, I lay on the bed talking to the nurse, about anything and everything not to allow my head to go to the place I knew it would have to go.

I realised the value of Bella at this early stage as I talked quite a bit about her, everyone loves to talk about a dog, well I think so now that I own one! The doctor returned and said she was going to have to give me a local anaesthetic as they has to do biopsies. This was stage four! I was certain then I wasn’t going to be going home with the all clear. There were four lumps they needed to check. The big lump I had found and three little lumps that I didn’t know were there. I hadn’t a clue what biopsies were, but holy sweet jesus did I know after that. It was really uncomfortable. I had to lie on my left side with my right arm over my head. The nurse came over to me and took my hand for comfort. She asked if I had someone with me. I told her I was on my own. I kept thinking, don’t think about what’s going on, don’t cry, don’t make it all about you, don’t be a drama queen! Every now and again I’d feel a tear trickle down my face, but then I’d shift my thinking and gather myself. The doctor said that everything might be ok but it was better to check everything at that stage rather than have to bring me back again. I was glad for her to do what she needed as I didn’t like the thought of having to go through the process again. The two of them were great and kept the chat upbeat. It was probably one of the most difficult and lonely times in my life and I’m someone who’s not afraid to be on my own.

I was told that my boob might be very sore in the evening, to take paracetamol. After the biopsies were complete, blood was trickling out of the area that had just been pummelled to get whatever cells were needed. The area was dressed and I was told I could get dressed and wait in the waiting area.

I came out from having the biopsies done, and the once packed waiting room was now empty, I was the only person left. I sat on my own trying not to think about what had just happened, trying not to think about what it meant, trying not to think about what I might be told. The doctor who I had just been with was changed and ready for home. As she walked passed the waiting room she looked in and said the consultant wouldn’t be long before he’d see me.

The consultant wasn’t too long, or not long enough.  He called Miss McGlade. My first thought was that’s not me, he’s got the name wrong! But it was me, bloody hell I was the only person there. He brought me into his room. Again, a very small room. A nurse was present also. He began by saying he had a lot to tell me. Then said that the lump I had found was cancerous, but they needed the results from the other lumps to determine if they are cancerous too and to decide my treatment plan. It could be surgery, it might be chemotherapy. I broke down crying, I knew it. It was the weirdest feeling, I think the body must go into an automatic state of shock. I asked about work and if I could continue to work, he said we would have to await the treatment plan, but we’d see.  I knew by his hesitancy it wasn’t an option to continue to work. I was told treatment could be surgery, it could be chemotherapy and surgery, it could be chemotherapy, surgery and radiotherapy, we’d have to see. I just remember saying over and over again, that’s ok and thank you. To me now this is an odd choice of words, but I was in shock.

I left the room with my breast care nurse, I said I knew it wasn’t going to be good news and broke down crying. I was told my next appointment was on 19 June when I would be told my treatment plan. I was confused and I felt alone and just thought I’ll get through it. I asked what I should tell people. She calmly said I could tell them I’d been told I had cancer and I was waiting to hear my treatment plan.  All I could do was cry, none of it made sense.  After speaking to the nurse, I left to drive home and begin my new life. A life with cancer!