P is for… Preparing Yourself for Treatment and Surgery

Don’t be scared – take some control back and be prepared! Being prepared for each stage of my treatment and surgery gave me back some control and helped ease the anticipation and fear of the unknown. It also helped keep me busy and passed the time in the run up to the next daunting stage of treatment. We’ll obviously all have different needs, but I’ve made a few suggestions below as to things you can do or buy to feel more ready to face your surgery or treatment.

Surgery

• Ensure you understand what to expect. When you have your pre-op meeting with your surgeon make sure they explain the procedure, where to expect scarring, how long you will spend in hospital, the expected recovery time, how long you should take off work, how long until you can drive, recommendations for post-surgery clothing and physio and ask any other questions that have been weighing on your mind. Also make sure you understand why you are having the suggested procedure and that you are happy with what they are suggesting. You are entitled to a second opinion, particularly if you are unhappy with your assigned surgeon or had been expecting or had hoped for a different procedure (such as immediate reconstruction or a lumpectomy instead of a mastectomy) – another surgeon may agree with you, or simply agree with your current surgeon, at which point you can be confident that it is the correct surgery for you.
• Work. Discuss your recommended recovery time with your employers and ensure you understand where you stand and your rights. Hopefully your employers will be understanding and compassionate, but if you face any challenges, Macmillan can help with offering advice.
• Post-surgery underwear. Your surgeon should be able to advise you on this. They usually suggest firm control, non-underwired cotton bras (very UNSEXY!). I got mine from good old M&S. Let the vendor know that it is for post surgery as they should then take off the VAT. If you are having a full clearance you might want to consider a front-fastening bra as you might struggle with arm movement for a while, meaning putting on a back-fastening bra is a bit tricky.
• Front-fastening  pyjamas or nighties are useful as it can be sore or difficult to lift your arms and you have to constantly show the site to the consultants – it’s much easier to undo a few buttons than try and struggle out of a top. Make sure they are a good, natural, breathable material. I have a good selection on Not Another Bunch Of Flowers.
• Similarly, some front-fastening clothes can be useful for when you leave hospital in case you struggle lifting your arms. I bought a few button-up shirts and cardis.
• Some cosy bed socks or slippers for your stay in hospital to keep your tootsies warm in bed and while shuffling to the loo on the cold floor.
• If you are having a mastectomy without reconstruction, you might want to get a nice scarf or cardigan to drape over you for when you have visitors as it will be a little while before you are able to wear a prosthesis.
• Ear plugs and eye mask for a less disturbed night’s sleep and for napping during the day. The best I found were by Daydream.
• Wipes to freshen up.
• Dry shampoo if you are in for a while.
• Moisturising lotion – I always find my skin is very dry – maybe due to the air con or heating.
• Entertainment – whatever floats your boat to pass the time! Load up your kindle, download films or TV series onto your tablet or laptop, buy some books, magazines or puzzle books, or take up a new hobby.
• Transport. Plan how you will be getting to and from the hospital.
• Luggage. Consider a wheely bag if you don’t have someone accompanying you to carry your bag as you wont strain yourself

This isn’t a definitive list of what to pack – don’t forget undies and your toothbrush etc!

Chemotherapy

• Dentist. You are recommended not to visit the dentist during chemotherapy as your immune system gets very low and you could pick up an infection. Most units make you book a dentist appointment before starting treatment to ensure that you don’t have any underlying problems that could be exacerbated by chemo. If you do this in advance you wont risk holding up treatment. Besides, everyone loves a trip to the dentist, right…?!
• Visit the chemotherapy ward. Arrange to visit the ward either as part of your pre-chemo assessment or with your nurse. You might think it will be more scary seeing patients hooked up to beeping machines etc, but it honestly isn’t as bad as you imagine it will be and visiting in advance removes the fear of the unknown, making it much less scary. I was terrified before I saw the ward, my imagination ran wild, but I was immediately put at ease by the comfortable surroundings and lovely, kind nurses. It also gives you the opportunity to ask any questions that have been keeping you up at night. 
• Work. Again, it is usually best to discuss your treatment with your employer so they understand how your treatment will affect you and when/whether you will be able to work during treatment, and for you to understand what your employer expects of you. Hopefully nothing more than taking it easy!! Do take it really easy for your first session at least – this will give you an idea as to whether you will be able to work during the following sessions. Some of you will be keen to continue as normal and work throughout treatment – but be careful of putting too much pressure on yourself. Macmillan’s cancer support specialists will be able to offer advice on this subject.
• Arrange for help with school runs/dog-walking etc following your first chemotherapy session to enable you to take it easy for a few days while you work out any side-effects. Keep a diary of these as they tend to be the same for each session and you will soon figure out which days you need extra help and which days you’re up to doing everything yourself.
• Buy a digital thermometer. If you feel ill during chemo you will be told to go to hospital if your temperature rises over 37.5°. It’s easy to get a bit  OCD with taking your temperature with the first session – but you’ll soon relax about it!
• Buy some antibacterial hand soap and gel to keep those nasty germs at bay both at home and on the move when your immune system is low.
• Headwear. Unfortunately most chemotherapy agents cause hair loss and you will feel a bit more prepared for this if you have a nice scarf, hat or wig at the ready. Annabandana are pretty  good value. Bold Beanies was set up by one of my friends who has had breast cancer and sells lovely soft, cotton beanies. I wouldn’t go overboard at the start as it’s not until it happens that you work out what works best for you. I had a drawerful of sleepcaps, buffs, a couple of wigs, loads of scarves in different styles and colours and in the end used about 2 of them. Maybe get a cheap buff and scarf initially, and then buy more when you’ve lost your hair and know what you feel more comfortable in. Your hospital might have free wigs – but if you don’t like any of them, ask for your NHS voucher which will give you discounts from specialist shops such as Trendco. It is very difficult to find one that looks like  your current hair, so best not to have expectations of that, but you will hopefully be able to find one that suits you and that you feel happy in. Some ladies actually end up preferring their wigs to their normal hair! If it’s not quite right, it can be tweaked, thinned out or shaped. My New Hair is a charity run by Trevor Sorbie who does wig-shaping for free. You might even get a session with him! You could also invest in a pair of cheap clippers for when the moment arrives. Your scalp gets quite sore, so shaving it off is less painful. You might want to shave the fluffy bits regularly through treatment.
• Hairdresser. Whether you are planning to use the cold cap or embracing the bald look, it is worth booking an appointment with your hairdresser to cut your hair shorter which will make the hairloss less traumatic. I used the cold cap and got my hair cut in advance into a short bob and dyed back to its normal colour so that my roots wouldn’t look too awful during the following 5 months when I couldn’t colour it.
• Enrol on a Look Good Feel Better workshop. This is a fantastic service that gives you a real boost. It is free and they teach you skincare and make-up tips including painting on your eyebrows and enhancing your eyes if you lose your lashes – and you get a wonderful goody bag full of cosmetics and smellies from the likes of Clarins, Clinique and Estee Lauder. There is often a bit of a waiting list, so if you book on before you start treatment it will give you something to look forward to.
• Stock up your food cupboard with a few items that  are good for nausea (plain biscuits, ginger biscuits, ginger beer), some healthier treats to help tackle the steroid munchies without piling on the weight and some goodies in case your tastebuds start playing up (pineapple chunks, ice lollies or juice worked well as did citrus sweets and coke). You might want to stock up the freezer too for the days you can’t be bothered to cook! The anti-sickness meds can block you up a bit, so prune juice, fruit and veg are good at naturally helping this. And fruit squash can be useful to ensure that you keep up your water intake when your taste buds go funny.
• Arrange transport and company for your appointments. Make sure you have people to drive you to and from your appointments and to keep you company (if you want it).
• Entertainment – Load up your kindle, download films or TV series onto your tablet or laptop, buy some books or magazines or take up a new hobby. Anything to make the time pass a bit quicker while you’re waiting around or receiving treatment and to take your mind off it.

Radiotherapy

• Ensure you understand what to expect. You will most probably see the radiotherapy unit when you go for your planning session a few weeks before you start. At mine, a lovely nurse took me aside to discuss the procedure,  told me how to look after my skin during treatment and talked through various logistics like parking.  See Z is for… Zapping those Cancer Cells with Radiotherapy for my experience to see what to expect.
• Work. Again, important to have the discussion with your employers as to whether you will be working during treatment. For some of us, radiotherapy will be the last part of treatment and while you might be super keen to get back to normality and work – radiotherapy can take its toll on you and make you feel quite tired, so don’t commit to too much if you don’t feel up to it or need to, otherwise you might end up making yourself ill in the long-term and end up having to take time off work anyway.
• If you need to wear a bra buy a soft, non-wired cotton bra or crop top. You don’t want to wear anything that will aggravate your skin. I just went braless (ooh la, la!).
• Entertainment – Again, load up your kindle, download films or TV series onto your tablet or laptop or buy some books, puzzle books or magazines. Sometimes there’s a bit of waiting around! (And sometimes A LOT of waiting around).
• Toiletries.  Advice on this varies so much from unit to unit. I washed with Simple shower gel and moisturised generously and regularly with E45 and Organic Aloe Vera Gel and avoided deodorant. My skin held out pretty well – nothing more than a little pinkness like a mild sunburn. There is a new organic and natural skincare range that is forumlated especially for people facing chemo and radiotherapy. The best oil to use during rads is the Defiant Beauty Soothing Skin Oil.
• Support. Line up some supportive friends or family who can step in and help if you feel  you need it. Some people feel fine but others feel very fatigued or ill – in which case it would be nice to know that you have someone you can rely on to pick up the kids/walk the dog/do the grocery shopping if you’re going to need a little rest.

Tags: coping with chemo, coping with chemotherapy, preparing for chemotherapy, preparing for radiotherapy, preparing for surgery