My child is starting kindergarten. It’s a change, a move into primary school, from the ideal three-hour morning nursery of six children and two adults.
I’m not sure about this change. I’m supposed to be having an operation in a few weeks, and I’m bone-shakingly anxious about how the child will react during the week I need to be in hospital. I want everything to be as routine as possible. As it is, I keep changing my mind about how to schedule the surgery around the older children’s shifting lives; around the alternate weekends with their other parent.
The kindergarten head, calm in the face of fury, thinks my child is ready for the change and should start with the rest of the age group. Without my hair, head swaddled in a scarf, mind muffled by chemotherapy, I feel the way I do in countries where I don’t speak the language, an inaccurate version of myself, when I meet these new teachers.
There are many days now that I don’t recognise myself. I hear a voice screaming at my 16-year-old daughter in a way I’ve never sounded before. “Either you tell me exactly what your plans are, or I’m cancelling your ticket!” Even as I shriek at her over the stairs I’m shocked by the rage spewing from my mouth. It’s not what I’m saying, so much as the eruption of it. A mad, foaming fury. My daughter looks white, mutinous, at the bottom of the staircase. I go back into my room, sit on the bed, shaking, and I can feel the heat rising through my body. I touch my cheeks and they’re red-hot.
Somewhere along the way I’ve read that chemotherapy can start the menopause. I can’t even say when the hot flashes started - I’ve just vaguely noticed that from being a person who’s always cold, these days I’m periodically suffused with heat. I raid the freezer. After three weeks without milk - no coffees, soya gloop on cereal - I eat a Cornetto, followed by a Wall’s bar. I’m dreading the fourth chemotherapy, starting that round again of feeling sick, and like you’re doing everything - school rounds, making meals - while swimming against mud.
Julie, the wonderfully batty nurse, is back on duty. “I had a patient who had a mastectomy,” she says, “and then she got a great, whacking tattoo over the entire area.” After this fourth chemo, it’s time to see Glenda Kaplan for a mammogram and scan, to find out what effect the treatment has had, other than the panoply of side-effects. Peter Ostler has been looking disconsolate - his tape measure hasn’t shown much reduction in the lump size: 5cms, still a biggie. Dr Kaplan, therefore, is visibly pleased when her considerably higher technology shows that the lump has responded. “Just about three centimetres now,” she says.
It’s back to Mr al-Dubaisi’s rooms, after this three-month break for the chemotherapy. We talk round and round the question of whether to have more drug medication before surgery. The original plan was for four rounds of chemotherapy - adriamycin and cyclophosphamide - followed by a mastectomy, to be topped by four further rounds of a different chemotherapy drug called taxotere.
Should I have more chemotherapy before the operation in an attempt to shrink the lump further? “Not everybody responds to chemotherapy,” Mr al-Dubaisi says, in that way doctors have of not telling you the important stuff till after it’s happened, “but Dina has done.” Having more chemotherapy is “certainly not contra-indicated”.
“Here’s what I will say,” he adds. “If the lump shrinks to the point where I can no longer feel it, then I will do a lumpectomy, instead of a mastectomy.”
Really the only thing between me and more chemotherapy is that I’m part of the TAC trial, comparing the effects of the two different types of chemo drug and their use pre- and post-operations. If I have more chemo before the operation I will have to come out of the trial.
This column appears fortnightly.
Dina Rabinovitch will be answering readers’ questions on Tuesday March 22 at theguardian.com/liveonline
18 March 2021: this article has been edited to remove some personal information.
