Update on Resilience, My Word of the Year

Update on Resilience - My Word of the Year

Improving my Resilience is My Goal for the Year

My word of the year is resilience.  I thought I would update my readers on how my goal of improving my resilience is going.  Resilience means to keep trying despite setbacks, to never give up.  I chose this as my word of the year to inspire me even when I feel like giving up.  

One Year After Being Diagnosed with BRCA2 Genetic Mutation

It is one year since I was diagnosed with BRCA2, a genetic mutation that increases your risk of cancer.  Since I was diagnosed with BRCA2 my life has been altered dramatically.  A year ago I was a productive member of society with a job, and pretty good health.  As soon as I got that diagnosis I knew that I wanted prophylactic surgery.  There was no doubt in my mind.  I have looked after patients with ovarian and breast cancer my entire career and I always had in the back of my mind that I would take any steps to avoid either of them.

What is BRCA2?

Because BRCA2 increases your risk of cancer by so much, and if you do get cancer it’s usually the most aggressive kind, the best treatment is to avoid it.  I had been screening yearly for 10 years leading up to this, and there’s almost a feeling of inevitability about it.  You’re waiting for them to tell you that one of the areas they’ve been watching has become cancerous.  So there was really no decision to make – I was going to have prophylactic surgery.

BRCA2 Mutation Cancer Risk infographic.  For women, the cancer risk is 40-84% of developing breast cancer, 11-27% ovarian cancer and 2-7% pancreatic cancer.  Source: Ovarcome
BRCA2 Mutation Cancer Risk infographic. For women, the cancer risk is 40-84% of developing breast cancer, 11-27% ovarian cancer and 2-7% pancreatic cancer. Source: Ovarcome

I expected both surgeries to go well.  You never consider that there could be complications, the only thing on your mind is getting rid of the offending organs that could give you cancer.  First cab off the rank was my ovaries – a relatively low risk, minimally invasive operation because I had already had a hysterectomy.

Suffering Surgical Complications 

The complication from this relatively small, keyhole operation is rare, but has changed my life.  I went into bladder retention – my bladder was stretched beyond capacity and has not sprung back into shape.  I have an atonic bladder now – it doesn’t work.  It’s probably permanent because the nerves were damaged and the muscle fibres stretched beyond their limits.  Even corrective surgery by a urologist hasn’t made any difference.

There is one positive – because I’m a nurse I can self cathetarise so I don’t need an indwelling catheter.  To be able to pass urine I need to insert a cathetar.  I get really upset about this because at 54 years old, I don’t want to think my bladder is completely stuffed.  But the reality is that it IS stuffed.

More Surgical Complications Post Mastectomies

The complication after the bilateral mastectomies was also rare.  This was another life-changing complication that I’m still dealing with.  I haemorrhaged on the left side post-operatively.  My blood count dropped really low and I needed several blood transfusions and emergency surgery to locate the bleeding area.  The swelling remained for months afterwards.  I needed even more surgery to wash out the cavity and treat  the area for infection.

Lifetime BRCA1 and BRCA2 Cancer Risks for Men.  Many people do not realise that BRCA1 and 2 affects men as well.  Prostate cancer runs in my family with my grandfather, father and brother having it.  Dad also had pancreatic cancer.  Melanoma also runs in my family - brother, sister and son.  Source:  Basser Research Centre for BRCA
Lifetime BRCA1 and BRCA2 Cancer Risks for Men. Many people do not realise that BRCA1 and 2 affects men as well. Prostate cancer runs in my family with my grandfather, father and brother having it. Dad also had pancreatic cancer. Melanoma also runs in my family – brother, sister and son. Source: Basser Research Centre for BRCA

The Physical and Mental Affects of a Prolonged Recovery

My recovery has been prolonged because I wasn’t allowed to do any exercise apart from walking until the swelling subsided.  That meant six months without using my upper body for anything more strenuous than lifting a cup.  When I was finally allowed to do yoga, my muscles went into spasm and I was in severe agony.

I knew that I wouldn’t be able to improve my upper body strength without professional help.  My GP was very understanding and supportive and has much more insight into patients returning to work after injury or surgery.  He referred me to an exercise physiologist to build up my physical strength.  Because I was struggling with the emotional fall-out from all of this, he referred me to a psychologist as well.

Improving Mentally and Physically

It’s approximately 3 months since then.  Emotionally and mentally I’m so much stronger.  My psychologist helps me to look at things from a different point of view, and has given me strategies to deal with the grief and stress.  She doesn’t pat me on the hand and tell me it’s going to be alright.  I need more than that.  I need to work through the emotions that have come up from these surgical complications.

Physically, it’s been a hard slog.  The exercise physiologist can’t increase my exercises too quickly because it can result in severe muscle pain.  I do an hour long program that she gives me, three times a week.  I see her once a week to ensure I’m doing the exercises with the correct technique, and to learn new exercises.

The ultimate goal other than improving my resilience, is to return to work.  My boss has offered to reduce my hours to two shifts a week which will at least enable me to return to my job.  She has been incredibly supportive throughout the whole ordeal.  I couldn’t wish for a better boss.  If I continue to improve at my current rate, I will return to work in April.

Lack of Understanding From My Surgeon

Today I had a post operative visit with my breast surgeon.  There is always a little bit of anxiety leading up to these appointments because I’ve had so many occasions where I felt really upset.  Usually his first question is  “Are you back at work yet?”.  Despite me explaining that my employer won’t let me go back until I am back to 100% capacity and able to do CPR and heavy manual handling, he never understood.   I always felt like he was judging me for it – as if I didn’t want to work.  He even asked me straight out a few times if I wanted to work.  

Not once has he ever taken the blame for what happened to me.  In his opinion, my post-op haemorrhage couldn’t possibly be his fault.  He tried to shift the blame, even sent me to see a haematologist to find out if I had a bleeding disorder.  

Post-operative Complications Can and Do Happen

As a nurse, I know that post-op complications can happen.  When they consent you for any procedure large or small, part of the consent process is to discuss the complications that may happen.  I’ve only seen a haemorrhage after breast surgery once in my career and it was as dramatic as mine.  

I’ve been unlucky to suffer a few complications post surgery previously so I have a better understanding than most people.  That is why I’ve never blamed the haemorrhage on my surgeon.  But the fact that he tries to shift the blame to me has worn thin.  I’m not contemplating getting compensation for this, or suing him, but a lot of people would. 

The Cost of a Prolonged Recovery 

This has cost me a massive amount of money in lost wages and medical expenses and I’m just lucky I had income protection insurance through my superannuation fund.  I don’t live my life with regrets usually but there have been times when I’m really depressed because of the way my life has changed in the last year.  

BRCA and cancer - BRCA1 and 2 increase the risk of cancer for both men and women.  Source: Penn Medicine's Basser Research Centre for BRCA
BRCA and cancer – BRCA1 and 2 increase the risk of cancer for both men and women. Source: Penn Medicine’s Basser Research Centre for BRCA

Even though the last year has been difficult, and my quality of life has changed, I’m still able to be positive about the future.  I wasn’t willing to accept that I would not be able to work again.  At times I have wondered why I try so hard.  Then I count my blessings.  My parents both died of cancer, and it looks like my brother will too (he has advanced prostate cancer).  I have beaten cancer and don’t have that hanging over my head.

Being Resilient and Looking to the Future

Even when things seemed hopeless, I still had the power to change direction.  I wasn’t willing to let fate decide that I would never be well enough to work again.  I sought help.  And I continue to work hard to get back to the person I was, changed in many ways but the old me.  That’s what resilience has meant to me in the last year.

If you would like more information on BRCA genetic mutation and cancer risk, these are the other posts I have written:

Shared on Weekend Coffee Share Linkup on Natalie the Explorer’s blog, Life This Week Linkup on Denyse Whelan’s blog and Senior Salon Linkup on Esme Salon’s blog

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