8 Days to Go!

No appointments in the last week YAY! 🙌 But I have spent lots and lots of time at the hospital over the last couple of weeks on the other side, doing what I love and learning how to zap people with x-rays. That's okay though because its my happy place and nobody is poking or prodding me! In fact its me poking and prodding those poor patients to feel for surface landmarks and get them where I want them!

I have worked my butt of these last few weeks while I've been on clinical placement to get all my work finished before my operation which is creeping up on me! I have done it though and I'm bloody proud of myself!

I have also done so in a way that means I now how this week before my operation to chill, catch up with friends, spend time with my boys and enjoy my last week of been well for a while. So this week I'm trying to fit as much in as possible before I have my Covid test on Sunday (27th) and have to isolate. I know, I literally DO NOT sit still.

These last few weeks seem to have absolutely flown by and all of a sudden my operation is next week and I'm sat here like ermmmm have I got everything sorted? what do I need to get? omg this is the last week of having these boobs. I have started noseying around Instagram and Twitter and have found other people going through Cancer at a young age. The downside to that (aka reality check) is that I've come across lots of posts about the real things that happen during treatment, during surgery and beyond Cancer. I wouldn't say I was naïve to start with but I've gotta admit, its shit me up. Maybe because its happening to me in a matter of days not just 'at some point' or what. I dunno. I've come across posts about how they sometimes inject radioisotope into the nipple for Sentinel Lymph Node Biopsies and its making my toes curl! Soz for that one guys. But you know what they say, a problem shared is a problem halved and all that... so hopefully now I've wrote it down it'll half (hahahaha who am I kidding?! I'm still gonna get stabbed in the nipple while I'm awake next week).

For those that follow that are geeky like me, here's the science behind the nipple stabbing AKA radioisotope injection. Its actually rather clever and is known as Lymphoscintigraphy. This is classed as Nuclear Medicine which is a branch of Radiology. In the case of Sentinel Lymph Node Biopsies in Breast Cancer, this is how it works:

1. The patient is injected with a radioisotope (a radioactive liquid that can be detected because it is emitting radiation - usually a substance called Radiocolloid such as Technetium-labelled sulphur colloid) under the skin, into and around the tumour (intradermally & peritumourally) or via the nipple/areola (posh name: retroareolarly) but this depends where the tumour is in the boob. This tends to be the day before surgery.

2. The idea is, is that the tumour will take up the radioisotope and eventually drain it out and into the lymphatic system. So, during surgery, the surgeon should be able to identify the Sentinel Lymph Node(s). This is the lymph node(s) that the tumour has been draining to and therefore is most likely to be the place that the Cancer will spread to first if it is going to do so.

3. The Sentinel Lymph Node(s) are identified by using a Gamma detector or camera which is a probe that will indicate where the radioisotope is. The surgeon will identify the place that gives off the highest signal as the Sentinel Lymph Node(s) and then remove them and send it/them to the lab for testing - to check again for the presence of any cancer cells.

Most people undergoing this procedure will also be injected with a blue coloured dye (usually a dye called isosulphan blue) so the surgeon also has a visual indicator and a way of double checking which node is the Sentinel Node(s) because as we well know, science very rarely works 100% of the time, no matter how clever the theory behind it is. I'm not having the dye though as I have strange allergies to food colourings so my surgeon doesn't want to risk it. The people that undergo this are stained blue for a while.

Here's a little pic showing that too:

* Disclaimer - I am obvs not a Dr or a qualified medical professional (yet!). Just a gal studying Radiography who has a degree in Biomedical Science. So if there is any inaccuracies, I apologise but this is my interpretation from the literature and my personal experience!

That's enough for this week I think. I'm supposed to be writing a reflective essay on one of my image interpretation forms but not getting very far at the moment! Gonna get a brew and crack on.

Thank you all for your continued support, love and encouragement. I have no idea what the next few weeks are going to bring but knowing I have people behind me every step of the way is something I can be sure of 🤍

Kirst x

References for the information above:

• Vu, H.N., O'Connor, P.F., Shoemaker, R.R., Wan, W., Fratkin, M.J., Bear, H.D., 2013. Intraoperative Injection of Radiocolloid for Sentinel Node Biopsy in Breast Cancer. Journal of Nuclear Medicine Technology 41, 263–267.. doi:10.2967/jnmt.113.129460

• Borys R. Krynyckyi, Chun K. Kim, Martin R. Goyenechea, Peggy T. Chan, Zhuang-Yu Zhang, and Josef Machac., 2004. Clinical Breast Lymphoscintigraphy: Optimal Techniques for Performing Studies, Image Atlas, and Analysis of Images. RadioGraphics. 424:1, 121-145

• https://www.cancer.gov/publications/dictionaries/cancer-terms/def/sentinel-lymph-node-biopsy