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Role Reversal

LizORiordanby Liz O’Riordan MD, Living with Cancer

 

“I’m a consultant breast surgeon, and I have breast cancer”. That’s something I never thought I’d say. I was diagnosed in July 2015, and it’s fair to say that life would never be the same again. I noticed a lump in my left breast in March, and all the scans were normal at the time. Three months’ later, when I got another lump, I went back to the breast clinic. My mammogram was normal. The radiologist asked me if I wanted to see the USS. I said yes. I turned my head to look, and in that split second, I knew. No learning curve. It was cancer. I would need chemotherapy, surgery and radiotherapy.  I knew all the side effects of all the treatments, and all the risks of recurrence.

 

I was incredibly lucky. My results were rushed through in three days, quickly followed by an MRI and CT. There aren’t many benefits to being a doctor, but I was very glad of this one. The two nights I spent waiting to get the results were some of the worst of my life. I’m still not sure how I got through my clinics and an operating list. I can now truly sympathise with my patients who sometimes have to wait two weeks to find out if they have cancer.

 

Sitting in the waiting room of a results clinic is not something I want to repeat. I was reminded of something a patient once told me. She had a skin recurrence, and I went to see her with my Breast Care Nurse (BCN). Before I could introduce myself, she said, “It’s come back, hasn’t it?”. She said she knew because the BCN was in the room. If it had been good news, I’d have come alone. My husband and I were called in by the BCN…

 

The plan was to start neoadjuvant chemotherapy in a week. Everything was happening so quickly, it didn’t have time to sink in. It wasn’t real. I had just cycled 100 miles. How could I have cancer when I was so fit?

 

It was strange being treated as a patient in a hospital where I had worked as a breast junior doctor, in the breast unit, and where my husband is a consultant surgeon. I was asked if I wanted to be treated under a false name, but said no. I ‘came out’ on Twitter and went public with my diagnosis. This meant that my husband could get support at work, because everyone would know what we where going through. And I could get virtual support from Twitter, which has been a godsend. There’s always someone online at 3am when you’re awake due to steroids and hot flushes.

 

I was given photocopies of leaflets about all the side effects of chemotherapy, but I didn’t read any of them. In this electronic age, my husband and I found the Breast Cancer Care and Macmillan websites, and downloaded the same information so we could send to our family. I dream that one day all the information and consent leaflets we give our patients are also available on the hospital website, for every illness, so patients and their family can easily access them. One day…

 

How to treat a doctor who’s also a patient

On the whole, I’ve been treated like any other patient. When you’re told you have cancer you don’t think and act normally, and I was glad to be reminded of things I might have otherwise forgotten. I did have a bad experience when I was admitted with sepsis during the 2nd cycle of chemotherapy. I think the junior doctor looking after me had stage fright. Firstly he wanted to speak to my husband (who had gone home as it was 2am). His opening line was “So I gather you know that you have breast cancer”. Well, I was bald and had been admitted for neutropaenic sepsis following chemo, so yes, that’s a given.

 

When I told him that I was a breast surgeon, he then asked me to explain why I was having chemo first as he’d never heard of that. And his parting line was “Why did you let it get so big…?”. I was gobsmacked! The medical consultant the next day then asked me if I could explain my blood results, as obviously I was the expert. I’d never had a complication of chemo before – how on earth would I know? I actually found the answer by asking an oncologist I knew through Twitter. It’s a powerful tool.

 

A hospital is the worst place in the world to get a good night’s sleep when you’re poorly. Every doctor should try it so they know what it’s like for their patients – hourly observations, the incessant ‘bing bong’ of the infusion pumps, elderly confused patients with dementia. Worse still is when the consultant comes around at 9am, all bright and chirpy, and you’re exhausted because you haven’t slept and can’t think straight to answer their questions.

 

The language of cancer

I have been made acutely aware of some of the phrases I’ve used in clinic when breaking bad news. A lot of women get recalled from breast screening with very small cancers, and I’ve said “If you’re going to get breast cancer, this is a good one to have”, or “You’re lucky that we caught it early”. All of these phrases were said with good intentions to try and reassure those women that they were unlikely to die of their cancer. However, no cancer is good. No one is lucky to get cancer. I will pay close attention to what I say to patients in the future.

 

Exercise and Breast Cancer

Before I was diagnosed, I interested in what we tell patients regarding exercise and surgery. A friend of mine was in training for a 100 mile bike ride, and wanted to know how soon she could get back on the bike after surgery. I had no idea what how to advise her. As an athlete myself, I searched for advice about how much exercise I could do during treatment. Every website said to ask your doctor. I’m a doctor, and I’ve never had any formal teaching regarding this.

 

After talking to several athletes on Twitter who have had chemo for breast cancer, they did what they wanted. They trusted their bodies to tell them when they had done too much. I walked every day, did weekly 5k runs and even did a sprint distance triathlon halfway through chemo. The sheer joy and sense of achievement I got from being able to exercise was hugely important to me.

 

Being a patient in my own speciality has opened my eyes to a lot of little things that could be changed to improve patient care, and I look forward to starting to tackle them once I’ve finished treatment.

 


Liz Ball ( I work as Miss Ball, but am a patient and Twitterer as Liz O’Riordan) MBChB PhD FRCS PGDip (Oncoplastic Surgery)

aka

Liz O’Riordan liz.oriordan.co.uk @Liz_ORiordan

Liz qualified from the University of Wales College of Medicine in 1998 and trained in South Wales and East Anglia, followed by a National Oncoplastic Fellowship at the Royal Marsden Hospital, London. In 2013 she started working as a Consultant Oncoplastic Breast Surgeon in Ipswich.  In 2015 she was diagnosed with Stage 3 breast cancer, and started blogging about her unique experience as a doctor and a patient in her own speciality (liz.oriordan.co.uk). She was runner-up in the British Medical Association’s 2015 Top Doctor of the Year on Social Media. She is a keen triathlete, cyclist and baker.

 


 

 

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