Hilary - Interview 10

Age at interview: 67

Age at diagnosis: 66

Brief Outline: Hilary was diagnosed with DCIS in 2007, aged 66. She had a mastectomy and immediate LD flap reconstruction. She was awaiting further surgery to match both breasts.

Background: Hilary is a married, retired secretary with three grown up children. Ethnic background / nationality' White British

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Hilary has always attended for routine mammograms. In 2007, when she was 66, she was recalled and, after further tests, diagnosed with DCIS. A mastectomy was recommended and Hilary felt shocked and upset, particularly as she’d had no symptoms so had never suspected a problem. After being given some information about breast reconstruction, she decided to have immediate reconstruction because she said she didn’t want to wake up after surgery and have no breast. Hilary had an LD flap reconstruction, which involves moving a large muscle and some overlying fat and skin from the back of the body to make a new breast.

 

Before surgery, Hilary was anxious because, at 67, she had never had an operation before and wondered how she would cope. After surgery, Hilary spoke with someone who had had similar surgery, and found this very helpful. However, she said she would have really liked to talk to women of a similar age. 

 

At the time of interview, Hilary was waiting to have further surgery which would match the healthy breast with the reconstructed one. She also planned to have nipple reconstruction, possibly using skin from her leg. 

 

Hilary praised the care she had received from doctors and nurses, and advised women to be positive throughout their treatment and recovery.

 

Hilary was interviewed for the Healthtalkonline website in 2008.

Hilary is planning to have her healthy breast reduced and nipple reconstruction using tissue from her leg. She wasn't at all worried about it because everything had gone well before.

I saw [the plastic surgeon] on the 31st of January and said, “Oh I don’t need to see you now for another six months.” Where I’m going to have, what do I call it to the girls? Oh my boob done on my left one. Which again I was quite surprised because when [the plastic surgeon] first saw me he said, “Oh we’ll do your left as well.” And I thought, “Ooh.” I just thought they’d take this one off and that would be it.

 

But no, quite concerned that yes they would match me up. And if I wanted it increased, well not increased but decreased, I could if I wanted. But no, I said no because I went in a 38DD. We all laugh about it now because I’m a DD this side and an E this or I think it’s a C this side or something [laughs]. So no that’s everything really. So I go back in July, July the 31st now to see [the plastic surgeon] about all the other things I’ve got to have done. Which I’m not really, no I can’t say that I’m worried about it, you know, because of, as I say, my first experience of being fine.

 

I’m going to have a new nipple put on as well. So, as I said, again, because I was told, I wasn’t left, I felt quite at ease with it, you know.

 

Yeah. And you’ve discussed with him that you’re going back, are you, to have the other breast matched with that one?

 

Yeah.

 

Yeah. And when they did the surgery, did they ask you then about matching the other one?

 

Yes. I, yes before, well before the surgery. My very first visit I saw [the plastic surgeon], he discussed that.

 

Yeah, so you knew then …

 

Yeah. That was my choice. I needn’t have it done if I don’t want to. But, as I say, I’m going back to see him the 31st July where we will discuss all this then.

 

Yeah. And then you’ll probably go into hospital again for a short time to have it matched.

 

To have that done, yeah.

 

And when would they be able to put the nipple, it’s a tattoo, isn’t it, a nipple?

 

That’s, well the actual nipple they’re going to put an actual nipple on. Again, I had a choice of that. I could have had the stick on ones or whatever. But I said, “Oh no, I would have that.” So.

 

So, how do they, it’s an actual nipple is it?

 

Yes, I think what they do is take something from the inside of your leg and sort of make the nipple. And then, as you said, they do tattoo the aura is it, yeah around. They do that. That was all explained to me well before surgery.

 

Yeah. And did they say how long afterwards you would have the nipple put on?

 

No, he just said he’d see me again in six months and I presume then if everything’s OK you know, he’ll say when he can do it, when he’ll be able to do it. I must admit we’ve not really sort of gone down that lane yet. You know. So, as I said, he did say when I saw him in January that he would put right the bit of a scar that I’ve got. Whether that was due to the fullness of my breast, I don’t know. That’s something that I will ask him and no doubt he’ll tell me.

Hilary knew straight away that she wanted breast reconstruction. She felt frightened at the thought of coming round after surgery and having only one breast.

Going back to when I was told what I’d got to have done, the mastectomy and the alternatives, straight away I said reconstruction. I didn’t, because I just thought I can’t have a mastectomy and wake up and look at nothing. That’s what was frightening. That frightened me that did, I must admit. But even though some people have said, “Oh I couldn’t have coped with the reconstruction.” I said, “No, I’ve got to have that.” And as one lady said on the forum, “You go into hospital with two breasts and you wake up and you’ve still got two breasts.” And the astonishing part of it is, the breast you’re looking at is still yours because the skin there is still yours. It’s only the inside that’s, well it’s, that inside is still yours because it’s come from my back.

 

So it, yeah, it came from …

 

Mine came from my back. Yeah.

 

So you were given all the information from the breast care sister, and you took home all the information. How did you decide this is the operation that I want, from the back? Did you decide that or did they help you decide?

 

The plastic surgeon examined me and he said straight away, he sort of touched my back, the fleshy bit, “Oh you’ve got plenty there” he said. In fact, I think he said, “Oh you’ve got a good kilo there.” He says, “So that will be OK.” I was sort of hoping that I’d have it off my tummy because I’ve always had a big tummy but whether he thought perhaps, because it is a lot longer operation, so when he said that about my back I thought, well, you know, that’s what I went for.

 

And he showed you photos or pictures?

 

Yes he did. Yes he showed me photographs, yeah.

Hilary had a biopsy on three different occasions but didn't mind. The staff were friendly and apologetic every time.

They also did an ultrasound on my breast, also on my left breast. There’s nothing at all on my left breast. And they said they would do a biopsy. And I innocently thought, “Oh, I’ll be called back later.” But no they did it that day. But I was quite comfortable. Everybody was fine. And it was quite almost a social thing because we chatted and everything.

 

Two days later I went back for the results. And I was told unfortunately I’d have to have another biopsy because it wasn’t quite, because it was deep they wanted to find more information. So I had another one done again. And in another couple of days I went back and again unfortunately I had to have a third one. They were most apologetic about it. It wasn’t their fault I know. Again it was quite a comfortable thing.

Hilary was anxious about having surgery at 67. Although she felt groggy after coming round, the operation went well.

I had my appointment for the 4th of December for my operation on the 5th. Again I was a bit worried because I’m sixty-seven. I’d never had an operation before. How am I going to cope? And little things like I’ve got false teeth. And I’ve got to take my teeth out and things like that [laughs]. Which I know is silly but, you know. Anyway the day came for me to go in. My temperature, my blood pressure went sky high. And I’m thinking oh they’re not going to do the operation. Anyway all that was levelled out.

 

And then on the Tuesday the nurses said, “Would you like to walk down to the operation theatre?” And I said, “Yes fine.” So down we went. And they were chatting to me. And got me on the trolley in the room before I had my anaesthetic. And everything was good. I went down at twelve o’clock. I didn’t come back until seven. But I wasn’t aware of anything going on. I woke up to se all my family around me. And they were fine about everything. I was still a bit…. But that evening was a bit, not hairy. But I suppose thinking back, it’s when you think back that you think, “Oh gosh.” But I didn’t, as I said, they were so wonderful, the nursing staff there. They were there for me. Naturally you’re confused. I was, I felt sure that my daughter was still there. And of course she wasn’t, she’d gone home at seven o’clock.

 

The next day I was fine really, a bit muzzy but enjoyed my first cup of tea. And then I came home on the following Tuesday.

Hilary is happy with her new breast. She plans to have nipple reconstruction, and surgery on the healthy breast. Scarring on her reconstructed breast will also be improved at that time.

There is a little bit of scarring and I was told that straight away. Because the breasts that I’ve seen don’t look quite like mine but, as I said, the one, Alex her name was, she did say to me, “Yes Hilary, there is going to be a bit of scarring but don’t worry about it.” Which I didn’t. But I honestly think if she hadn’t have told me I might have gone a bit, you know. And then when I saw [the plastic surgeon] on the 31st of January, he said, “Yes, there is scarring there but don’t worry about it. I can put that right for you.” So he can do that cosmetically by the sound of it. Plus I’m going to have a new nipple put on as well. So, as I said, again, because I was told, I wasn’t left, I felt quite at ease with it, you know.

 

Yeah. And you’ve discussed with him that you’re going back, are you, to have the other breast matched with that one?

 

Yeah.

 

Yeah. And when they did the surgery, did they ask you then about matching the other one?

 

Yes. I, yes before, well before the surgery. My very first visit I saw [the plastic surgeon], he discussed that.

 

Yeah, so you knew then …

 

Yeah. That was my choice. I needn’t have it done if I don’t want to. But, as I say, I’m going back to see him the 31st July where we will discuss all this then.

Hilary was happy with the care and information she got but would have liked to speak to other women in their sixties.

I think it was [person’s name] the breast support, she gave me a card, Butterflies Support, which is the plastic surgeon, he started all this up. So because I’d got my computer I went up on the computer and I sat and read all that. Again reading other people’s experiences but still not saying to myself, “Well, you’re one of those now.” But that, and again that was a good support. And the first time I met [person’s name], who’s the co-ordinator of Butterflies, she was again wonderful. She’d had both hers [breasts] done and she says, “Would you like to look at my breasts?” And I said, “Well, yes. “ And she showed me and everything, like she’d actually had the reconstruction like myself. But she was younger and I’m thinking, “Yeah, but I’m 67” [laughs].

 

I think that’s what I missed. I would have liked to have been in touch with somebody of my age group. The nearest I got to was a lady of 57 who lived locally. And I did speak to her and she assured me about the hospital treatment and everything.

  

I would have liked to have found that more people of my age group, because at the very beginning that’s what, well you know, am I the oldest person that’s had this, you know? Is it necessary for me to have this? I felt it was because when the doctor said about it, I thought, well, everything they’d explained to me, I would have been silly not to have, to done that, you know. But, yes, I would have liked to have had somebody of my age group, say in their 60s, I suppose I’m really nearly 70 now aren’t I? But yeah.

 

And in terms of the care that you had in the hospital and before and afterwards, you’ve been happy with that?

 

Yes, I can’t say there’s, no I can’t honestly say there’s anybody, everybody’s been fine. And the cleanliness at the hospital I was in was excellent. Everything.

 

Yeah. And you’ve been happy with all the information that you were given?

 

Yes. Yeah.

Hilary felt a bit tired when she first came home. Her arm was stiff, though she kept exercising it. It took her about three weeks to start feeling better. Her husband helped her with the housework.

You mentioned that a district nurse was coming every day to the house?

 

To the house, yes, for the first week.

 

Yeah, once you were back home?

 

That’s right. Once I was back home. Because I just felt, I must admit I just felt tired and I really couldn’t understand why I felt so tired. But then I thought, “Well it’s probably the anaesthetic that I’d had.” So, well I mean I sat down a lot the first week. I didn’t really want to do much. Of course, Christmas come along as well so I was at the hospital Christmas day morning, which my son took me down. But no.

 

And when you came home, how did you feel physically then in terms of moving your arms and …?

 

My arm was very stiff. I used to do my exercises and I could sort of only raise it a little bit. But over the, and I think the massaging of my back really helped that. And because I hadn’t had anything done on the lymph gland, because I understand if they have the lymph gland done it makes things a little bit worse. So, yeah, I could just, you know, I couldn’t reach, naturally I couldn’t reach anything, couldn’t carry anything so …

 

So who, was anybody at home? Your, was your husband at home with you?

 

Yeah, my husband was with me. He drove me everywhere. And then I used to have to go and visit the doctor. And then he used to take me. Christmas Eve I tried to do a bit of Christmas shopping but after I’d walked for a little bit I’d had enough [laughs]. So, it is quite, it does sort of take your energy a little bit.

 

Yeah. And how long did you feel you needed to kind of rest and, you know, do your exercises at home, not take on too much?

 

I think it was a good sort of three weeks. Yeah, a good three weeks. I think it was about six weeks when I started driving again. I’ve got an automatic so I hadn’t got to worry too much, well, my right hand, you use the left anyway. But no, I felt happy, quite comfortable to drive after about six weeks.

 

Yeah. And you could do more around the house, or pretty much back to normal?

 

Yes, even now I’ve to be careful if I’m pushing the vacuum. If I, I know when I’ve done too much and this is when you sort of read your own body really I suppose. Again because I’d never, I’ve been so lucky in my life, I’ve been so, I’ve never had any sort of, well I haven’t had any illnesses at all. So that’s when I was, I thought to myself, “Yes, my body’s telling me to stop now.” So I used to just do a little bit, perhaps a couple of hours and then that was it then. So, you know.

 

Yes. And well, was there anybody here to help you with the housework or you, you know, you managed?

 

Yes, yeah, I managed, yes. My husband was very good, he did the vacuuming. We laughed really because Christmas Eve I was just pottering a little bit in the kitchen, Christmas day I should say. And I couldn’t cut my cauliflower because that was just using my arm [laughs] and we laughed about that. I had to shout, “Would you come and cut this cauliflower please?” [laughs] But no.