Taking some Healthy Steps

Belly dancing? Donning top hats and dancing canes? Swaying to the Hawaiian hula? It’s all part of an exercise programme that is making a real difference in the lives of cancer survivors and those living with chronic medical conditions such as Parkinson's, arthritis and fibromyalgia. It has proven benefits and above all, it’s a lot of fun.

Auckland Lymphoedema Therapist Michele Urlich is started offering the 6-week Healthy Steps programme (one hour-long session per week) at the Auckland Cancer Society (who is subsidising the courses, making them very affordable at $5/person/session) and invited me to come along to a session In November to have a look and write a story for her. I've written about Michele before with reference to kinesio taping.

Also known as The Lebed Method, it was designed by American woman Sherry Lebed Davis - find out more by visiting the 'go Healthy Steps' website.

I was delighted to be there. I've been a course facilitator for the YWCA Encore Programme since 2006 and noticed that some of the Healthy Steps exercises are very similar but there is far more movement and much of it to music which makes it a lot of fun. Michele uses an array of 'props' as well for use in the exercises, for example small balls, Top Hats and canes, belly dancing coin belts, Hawaiian leis and boas ... it's jolly good.

The other point of difference is that Encore is only available to women who have experienced breast cancer whereas Healthy Steps is open to both men and women cancer survivors and to those who are living with othre chronic medical conditions. There is also a version open for children.

Healthy Steps shares a similar focus to Encore by offering exercises that give the lymphatic system a good work-out. Many of the women attending the Healthy Steps session I was invited to were experiencing lymphoedema to varying degrees as a result of treatment for either breast or gynaecological cancersand all felt the exercises were very beneficial.

Healthy Steps makes a real difference for those attending - feedback includes increased mobility and energy levels, better sleep, reduced pain and stress levels, improved quality of life ... but above all, it is bringing back a sense of joy, happiness and hope to lives that have been impacted by a health crisis. As one older woman attending said to me, "I come here and laugh. My husband drops me off and when he picks me up afterwards he asks, 'did you laugh?' and I say 'Yes! Lots!'"

To find out more about Michele's programmes, visit her web page for details.

Ten years ... and counting

On 13 October I will celebrate the ten year anniversary of my breast cancer diagnosis. Marking this occasion takes on greater importance than my birthday - and I know I'm not alone in this because so many other women sharing my experience do the same.

I might even go along with those who say there is 'BC' and 'AC' - Life Before Cancer and Life After Cancer because life certainly changed on that day, no doubt about that.

It was Saturday afternoon, the appointment was for 3pm in Royal Oak. I remember it very clearly. My friend Katherine was with me and we'd had lunch in Onehunga beforehand, browsed through the music store and I'd seen an old friend there who asked how I was. "Fine," I said. "I'm off to the States on Monday!" and indeed that had been the plan, to head off to the USA for 6 months to travel about and do some writing.

But you know, I just knew something was wrong. I knew the appointment would bring bad news. I'd spoken with the surgeon, Belinda Scott, on the Thursday prior and whilst she would not give me results on the phone, she did make sure I could see her as soon as possible (on a Saturday! What does that tell you?) and I was to bring someone with me.

So I knew it was not going to be good news but yet I think, like most of us, I was ready to deny all of that and imagine I'd be told it was a benign something-or-other.

How naive I was. Gee whizz. I feel like a wise old thing now, as if I have acquired all the wisdom in the world. Such is hindsight eh.

Indeed it is a journey one embarks upon because after a diagnosis of cancer - or some other life-threatening condition - life is never quite the same. It never feels as predictable or certain, ever again. And one takes on a more adventurous, living-for-the-moment-and-the-rest-be-damned approach because you realise there's alot of living to do, and maybe not quite as much time to do it in as you'd once believed.

When I think about that day, it's as if I had been walking along a wooden floor that was good and solid. Then all of a sudden, I hit a bad patch and just fell straight through, with no warning at all, and lay huddled up and shocked all to crap down below. Now, I walk a floor that isn't as solid as before, but is solid enough for me to pass. I don't trust it though, I don't just walk confidently along, not like I used to. I always think there could be another rotten patch and I'll fall through. I keep an eye out and I've learned to recognise some of the signs where things might be a bit wobbly and I can navigate around them.

But don't get me wrong. I don't live in fear or anything like that.I keep on trucking, as we all do

Ten years is a huge milestone and it will be celebrated at a seaside villa at Papamoa Beach with a bottle of Dom Perignon. Can't wait.

I wish my Mom was here to celebrate it with me because she stood right there with me throughout the whole thing and I miss her. She always enjoyed champagne, a sense of occasion and she loved the beach.

I reckon she'd think ten years was pretty darn good.

The value of exercise

I attended the Wellington Cancer Society's one-day Conference 'I'm still standing ... Life after Cancer' on 20 August in Wellington - and one message came through loud and clear.

The value of exercise.

After cancer treatment, as we embark on what is essentially a solo journey into survivorship, we are often told by our medical profesionals to eat well, exercise and enjoy life. Great!

Actually it's good advice and no one disputes it but what researchers are saying now is, bring exercise into the equation far earlier, don't lump it in with nutrition and living well, make it a subject all to itself and make it a prescription, a more formalised part of cancer recovery.

Bring in the subject of exercise at the time of diagnosis, highlight the benefits it will bring as patienst progress through their treatment and highlight the fact that exercise is actually making a measurable contribution towards overall survival - in a good way!

Exercise offers benefit to all parts of the body affected by cancer treatments: nervous system, musculoskeletal, cardiovascular, respiratory, metabolis, endocrine and immune systems and overall psychological health. The barriers we feel as patients for exercising are fatigue, pain, emotional and cognitive issues - exactly the things that exercise can help with.

Keynote speaker Professor Bogda Koczwara, Medical Onoclogist from Flinders University in Adelaide Australia promoted the importance of exercise in her talk - and I was also pleased to hear her say that chemotherapy can cause up to a 35% reduction in cognitive function plus memory loss - 'chemobrain' is actually a real condition!

I'll be featuring other topics from the Conference on this page, over the next little while, so do check back from time to time.

Talking to someone who has 'been there too'

We're hearing more and more these days about the value of peer-based support for those experiencing breast cancer. Sometimes there is nothing better than sitting down with someone who knows how you feel, has 'been there too' and can listen with understanding and empathy.

Counselling from professionals can also be extremely helpful but talking to another woman who has experienced breast cancer and can relate to your journey on that personal level is often 'good therapy'.

As part of my work with Breast Cancer Support, I answer the 0800 Help Line (0800 273 222), a national toll-free number that women can call from anywhere in New Zealand. Often they are seeking services in their local areas but sometimes they just want to talk, to know that they are not alone and be reassured that there are so many others out there who have been diagnosed with this disease, have made it through and have futures.

Last month I wrote about the BCAC online videos which are proving to be an invaluable resource.I hear almost daily from someone who has seen them, received comfort, reassurance and information from the words of these wonderful Kiwis who have shared their stories so openly. I often think that a willingness to speak about your own journey to someone who is just starting out on theirs is the best gift you can give them.

There are so many breast cancer organisations out there these days, one for almost every aspect of this dreadful cancer, from prevention to searching for a cure. All make valuable contributions but the sheer number can be confusing and this can add to the difficulties of those recently diagnosed.

Pick up the phone and call your local division of the NZ Cancer Society - or call us at Breast Cancer Support. We can  help. Always remember that you are not alone and there are people out here ready to help when needed.

Kiwi men and women tell their breast cancer stories

The telling of our personal stories can provide inspiration, comfort, and reassurance to those who are sharing similar journeys and challenges. Such stories resound with the hope, courage and determination of the human spirit.

A remarkable series of online videos produced by the Breast Cancer Aotearoa Coalition (BCAC) captures the emotional upheaval a diagnosis of breast cancer can bring. Fifteen New Zealand women and men speak with candid and poignant honesty about their journeys with breast cancer. Partners and family members contribute their perspectives as supportive caregivers witnessing the traumas of diagnosis and surgery, the struggles through debilitating treatments, the joys and sorrows, the recovery of health and hope for the future.

This month (July 2011) I had the pleasure of attending a special screening of the videos at the Rialto Cinema in Newmarket to celebrate the completion of a project that began as an idea a few years ago at a strategic planning day (over a few glasses of wine, apparently - most excellent!). We settled in with glasses of champagne, ice creams and pop corn to enjoy the show!

Dr Chris Walsh (BCAC Deputy Chair and producer of the videos with director Emma Robinson) says the web videos are a first, giving New Zealanders the opportunity to see and hear the breast cancer stories of fellow Kiwis at the click of a mouse. "The stories of these courageous New Zealanders are compelling, emotional and informative.  They will touch people, whether they have breast cancer or not, and we hope they will inspire others to face a breast cancer diagnosis with determination and the knowledge that they are not alone." Dr Walsh will give an oral presentation on the project at the upcoming Reach to Recovery Conference to be held in Taiwan later this year.

I worked for BCAC up until a few years ago and helped to write and publish the first edition of Step by Step. in 2008. It's wonderful to see this resource now available throughout New Zealand and featuring so prominently in the videos - excellent!

The fourteen short videos focus on all aspects of the breast cancer experience, from diagnosis to surgery, chemotherapy, radtaion therapy, and breast reconstruction. Those interviewed relay their experiences in a poignant, personal and yet very informative way providing tips on how to cope - and most importantly, how to adjust to life after breast cancer. Well worth a look. cncerwomen and one man feature in the videos, telling us of their experiences of all aspects of the journey, from diagnosis and treatment through to recovery, survivorship and beyond.

Nine years ago ...

Whenever the 13th of October comes around, I celebrate.

On Saturday 13 October 2001, at about 3pm sitting in Auckland breast surgeon Belinda Scott's consulting room, I received my diagnosis of breast cancer.

My good friend Katherine was with me and I still remember the look on her face when Belinda told us the news - and I can only imagine what I looked like.

As we walked back down to the car afterwards, I threw a folder of loose papers Belinda had given me against the concrete block wall of the parking garage and to this day I don't know why I did that. I think it was because I felt I needed to do something rather dramatic and Hollywood-ish, something self-indulgent and petulant. Anyway, the papers went everywhere in a very stunning fashion and poor Katherine picked them all up.

It seems strange to celebrate on the day of one's diagnosis but many of us who've experienced a diagnosis do. It means that another year has gone by and we've been blessed with the gift of time. I never thought much about time and how much I would have for my life until my diagnosis. Then time became a precious thing, its availability something to be treasured and the store of time we have each been given something not to be taken for granted.

I decided in 2002 that on each anniversary I would do something I had always wanted to do or be somewhere I had always wanted to be. I was sick with some ghastly chest thing on my first one but in 2003 I was at our famous Pupu Springs looking at some of the clearest water in the world. 2004 I was at the Sydney Opera House watching a performance of La Boheme at the Opera House. 2005 I was in Melbourne, hanging out drinking the best coffee and eating everything I could get my hands on. In 2006 I went to Kaikoura to see the whales. And then ... well ... I began to slip a little. From 2007 on I haven't been keeping my promise to myself.

Life tends to slip back into familiar grooves after a while, in spite of the big fright we get when diagnosed. We remind ourselves of the promises we made but think, well, I'll make a big fuss next year for my anniversary ... but then next year comes along, and we go, uh oh.

Watching my Mom slip away reminds me that life will reach its inevitable end but we must make the most of it while we are here. On my anniversary this year, I was right where I wanted to be. I spent a great afternoon with Mom. We talked about that day nine years ago and how she said we would get through the experience together and by golly that's just what we did. We had some laughs, held hands, looked out her window at the wisteria that is growing madly and wildly and in glorious profusion up some trees, saw the clouds drifting by and the birds flying about.

When I look back on the last nine years, it seems like a series of moments, snapshots I can conjure up from my past. I can still see that look on Katherine's face and the papers in the folder falling all over the place; I remember coming home very late that night and my Mom was waiting up for me. I can still see her in a nightgown with an old blue sweater over her shoulders and how she gave me a big hug and said we could do this together. I see a panorama of fun times, places visited, sights seen, people coming, going, staying ... difficult moments when life came down to hours of a day ... and all the joyous ones too when the sky was the limit.

So here's to nine years and counting. Each anniversary I look ahead to the next so today I say, "Let's make it TEN!"

When the going gets tough, the tough get drumming

For five or six years after my diagnosis of breast cancer in 2001, it seemed like every annual checkup brought something to worry about. Things kept happening, the way forward was not clear, the path was not smoooth.

Maybe the mammogram would show up an irregularity that needed further investigation. Aches in the bones would warrant a bone scan. Hormonal, post menopausal headaches prompted a brain CT scan... on and on until I thought gee, there is literally no place these specialists haven't been ...

I was relieved my medical team was being so careful, checking so thoroughly but each time there was an investigation, back I'd go to that place where Jane the big girl would become Jane the little child with blonde hair and pigtails, cowering in the corner.

It'll be nine years this October 13th. After those first five or so years of 'rocky road,' things did settle down but just when you think, phew, maybe we're clear of it all ... that old parrot starts to squawk and kick up rough again.

That's how a work colleague described cancer - as an 'ugly parrot sitting on your left shoulder.' I think that's a great description. I can just see this manky old pirate's mate of a parrot, all nasty feathers and lots of bald patches, hanging on with his old gnarly claws, one eye stuck shut and the other always watchful, always looking for an opportunity to screech out, "I'm still here, yah know!"

I've been having some aches and pains and a cough for some time so off I went yesterday, back to the oh-so-familiar radiation place, to be bone-scanned and CT'd. Put on the funny gown, run about in my socks, be injected and scanned, sent away for two hours, come back, be scanned again and then pay mega amounts of money and go home.

Go home, stay home ... and wait for results. Aaargh! This is the hardest part and everyone agrees on that one.

I wrote about waiting for test results in one of my books, that feeling of having stepped out of the river. You're sitting down on the riverbank while life, people, action, fun ... everything ... flows on by without you. There you sit and you wait and as hard as you try, you cannot do much more than dip a toe in the river, despite the feeling of wanting to leap back in and flow on as usual. The nasty old parrrot loves this. He digs in his claws, screeches out his old sea-faring ditties and makes life a bit tough.

So when the going gets tough, and the riverbank is the place for now, the tough take up drumming.

I'm fulfilling a long-held desire to learn to play the drums. When I got home after all those tests yesterday, I sat down behind my Pearl drum set and had a good bash. My first lesson was The Basic Rock beat and that's enough for me right now. I'm perfecting the beat, adding some flourishes of my own, and I've noticed that the manky old parrot doesn't like the noise.

He flaps, releases his grip, falls off - and loses a few more feathers.

Lymphoedema and Kinesio Taping

A potential side effect of lymph node removal as part of surgery for breast cancer is lymphoedema. The removal of nodes from the armpit can impact the proper drainage of lymph from the affected arm, causing fluid to collect in parts of the arm, chest and back. This swelling is called lymphoedema.

The lymphatic system is our under-appreciated rubbish collection and disposal system! It collects toxins and other waste materials from throughout the body and also works to fight infection. The lymph vessels are located in the skin and have 'junction points' throughout the body where lymph nodes collect and filter fluid (e.g. in neck, armpits, groin). In surgery for breast cancer, lymph nodes may be removed and checked to see if they contain cancer cells that have drained from the breast. This information helps to determine the extent of the cancer and additional treatment that may be required (e.g. chemotherapy). For more information about the lymphatic system and lymphodema, visit the Lymphoedema Network NZ website.

As part of our ongoing health care post surgery (especially if that surgery involved lymph node removal) we need to look after the arm(s) affected and be mindful of any symptoms that could alert us to the onset of lymphoedema. Once diagnosed with lymphoedema, the condition is permanent, requiring degrees of ongoing treatment and management dependent upon the extent of swelling so it's better to be proactive rather than reactive in this case!

Symptoms may include swelling, a heavy feeling in the area affected, discomfort and a deep aching. Having a lymphatic massage can improve general well being and help to clear any fluid that may be collecting. Keeping the skin well moisturised is important and ensuring that we protect the arm from scratches, bruises, burns and needles (for blood tests or injections) to minimise risk of infection is also vital. When flying, a tight compression garment is advised. The artificial atmosphere of an airplane can place extra load on our bodies and a compression garment will help reduce any swelling and keep the lymph flowing.

I have not had even minor swelling but do from time to time experience the feeling of heaviness in my arm and aching in the forearm.I don't have a lymphatic massage as often as I'd like but recently I went along to see my therapist Michele Urlich (pictured) and had some treatment.

I was first referred to Michele by my Breast Nurse, Janice Wood, not long after surgery. Janice suggested a wide range of services and options, all of which would help to support me over the months to come and seeing Michele for a lymphatic massage was one of the best. I was so impressed with Michele that I wrote about her in my first book, Welcome to the Amazon Club.

I was quite fragile at the time, at an emotional low and still recovering from surgery with chemotherapy looming. Michele was very kind and gentle and gave me valuable information about how to care for my arm and also how to perform lymphatic massage techniques on myself.

Michele has a lovely treatment room upstairs at her home in Auckland's Mt Albert. It is small, light and warm with a window that looks out onto the tops of trees - like being in a treehouse. Sun, clouds, birds, sky, trees moving in the wind and some quiet music playing in the background make for a lovely hour and when the massage is over, the feeling of relaxation, warmth, delightful tiredness ...

Lymphatic massage is delivered with about the same pressure as stroking a cat. It is very gentle and there is no pain. Michele has been a therapist for twelve years and is now an internationally recognised authority on lymphatic massage and treatments for lymphoedema. On my recent visit, I asked her about Kinesio taping which is the latest therapy for treating minor swelling. Michele completed her training in this technique this year and is now qualified to teach the application throughout New Zealand. “Lymphatic taping and multi-layer bandaging along with lymphatic massage can often reduce pain and swelling,” says Michele. “I teach family members and caregivers a few simple drainage techniques too so they can help in a positive and useful way.”

The tape is the same as that used by atheletes to treat sports related injuries. It is the same thickness as skin, adheres to it and works by lifting up the skin to facilitate better drainage of fluid.It comes in four fashionable colours! Michele applied tape to my arm, demonstrating the technique so I could see how it worked. The different colours follow the lymph vessels in the skin.

The tape was not uncomfortable to wear. I kept it on for two days and then gently peeled it off under the hot shower, using warm baby oil to help with areas where it was stuck tighter. It certainly was not difficult or painful to remove and Michele has had alot of success with the taping of seroma (post operative swelling) and minor lymphoedema conditions. As a qualified instructor, Michele will travel throughout New Zealand to teach other medical professionals how to apply the medical tape.

The secret to managing lymphoedema is to catch it early. If left unattended, it can cause considerable discomfort as fluid presses on nerves. The good news is that qualified practitioners like Michele are using the latest techniques available and treatments are becoming more effective. Awareness of lymphoedema is also increasing as women learn more about the risks of developing it post surgery and how they can prevent it.

YWCA Encore

I've written about YWCA Encore before in my website Journal - it's a great gentle exercise programme for women who have experienced surgery for breast cancer. It's free, available to women of all ages and there are programmes running throughout New Zealand from Invercargill to Whangarei.

I've been an Encore Programme Facilitator for a few years now. I attended the first training course for Facilitators held in NZ (2006) and since then have conducted four programmes up here on the Hibiscus Coast. I've written extensively about Encore for various publications and talk about it every chance I get because it's wonderful and it works. Women in our programmes report real benefits, have lots of fun, regain confidence that can often be lost after a diagnosis of breast cancer and make new friends.

The exercises were first developed by a ballerina who experienced breast cancer and are designed to help restore flexibility and mobility that can be lost after surgery. Each programme consists of eight weekly sessions of two hours. Floor and pool based exercises are slow and gentle with an emphasis on diaphragmatic breathing. Women participate to the extent they feel able. Weekly 'homework' encourages participants to do exercises at home, encouraging longer-term practice and benefits.

The exercises are also very good for the lymphatic system. During breast cancer surgery, lymph nodes under the arm may be removed in some cases, inhibiting the flow of lymph in the affected arm. This can cause swelling (lymphoedema) which can be uncomfortable and requires ongoing care. Encore can relieve the effects of lymphoedema and help prevent the condition from occuring at all by improving circulation.

After breast surgery some women find it difficult to get back into a bathing suit and into the water. All Encore programmes are conducted in quiet, private venues where women can feel comfortable, be amongst others who 'know how it is' and enjoy a supportive and caring environment. Each weekly session also features a half hour over a cup of tea either with a guest speaker (presenting on a variety of topics from health and fitness to Laughter Yoga!) or a general group discussion about an agreed topic.

Last year we had the first In-Service Training programme for all Course Facilitators nationwide. Held in Auckland, the training brought us all up to date and provided wonderful opportunities for networking, exchanging ideas and listening to stories from all over New Zealand.

If you'd like to know more about the programme, visit the YWCA Encore page for information and programme dates and locations. It's free, lots of fun and offers real health and wellness benefits!

 

Georgea's Scrapbook

My local breast cancer support group is very fortunate to have Georgea (pictured) as a member because she always brings her camera to our lunches and events and takes great photos.

Georgea joined our Breast Friends about two years ago and she began a scrapbook, taking the best of our group photos and placing them into this wonderful book.

We've had some great times together as a group and one ot the things we do best is go out for lunch. We've frequented most of the local establishments and needless to say, we are quite well known about the place - and much welcomed, I must add, as a lovely, personable group of very fine ladies!

Georgea also makes cakes - divine, decorated delicacies to celebrate birthdays and other special times.

The scrapbook is a wonderful testament to the spirit of sharing, support and fellowship that our group enjoys.The book brings back memories of good times we've shared together and celebrates the contributions and lives of those women who are no longer with us.

Georgea's Scrapbook is beautifully done - a work of art and a real treasure!

 

Asking for help

When I was diagnosed with breast cancer, I knew right away that I wouldn't be able to do it alone. I'd need help. Overcoming my natural instinct to not ask for help was the first hurdle I had to get over.

Sometimes I think it's a 'woman-thing' not to raise our hand and say, "I need some help here!" We're always so busy helping everyone else! Aaargh!

When a life-threatening situation occurs, we gather together those resources and strategies we've used before to deal with a crisis. Adjusting those skills to cope with a big, new, scary thing can sometimes be too difficult for us to handle alone. We need help to sort ourselves out, discover strengths we never knew we had, pick ourselves up, dust ourselves off, make a game plan and keep traveling on down the road.

There can be nothing better than speaking with a woman who has 'been there too'. Recently diagnosed or some years down the track, it helps to talk to someone who shares a smiliar experience and can see and understand things from your place and perspective. We can be surrounded by excellent medical support, loving partners, family and friends - and yet still feel so alone. A chat with someone who 'gets it', who understands, can be of great value.

Please don't go through breast cancer alone. Ask for help when you need it. There's nothing wrong with saying to yourself, 'I just can't do this - I don't know how.'

If you live anywhere in New Zealand and would like to speak with another woman who has experienced breast cancer, please call Breast Cancer Support toll free on 0800 273 222 (0800 BreaCanSupport) or the Cancer Society of NZ toll free help and information line 0800 226 237 (0800 CANCER). If you have recieved a diagnosis of secondary breast cancer, please call Sweet Louise on 0800 112 277.

We're here, waiting to help, so please let us.You don't have to go through breast cancer alone.

 

Living in the moment ...

If there's one thing an experience with serious illness teaches us, it's to live in the moment and make the most of every day.

When we're ill and frightened, lIfe seems to draw in. We live minute by minute, hour by hour. Then, as we get better, life expands again and we take those little steps towards living day by day, week by week.

The one thing we all need when we're ill is hope - hope for a positive outcome; hope for a full recovery; hope that each day will bring something nice, something wonderful to be enjoyed, to look forward to. When we're very ill, we hope for less pain and the warm comfort of family and friends.

Hope can teach us about living in the moment. When I was having chemotherapy, I'd look forward to things during the day, like sitting outside on the deck under the big umbrella, watching people at the beach, kids riding bikes in the street, birds flying high in the sky. I'd hope to receive a phone call from a friend or a card in the post. On a fabulous day, there might be some flowers that I would enjoy for hours, looking at the rich colours, the delicate shapes, smelling the scent. Then of course every morning I'd hope that Betsy the cat would play with Mom and I. She rarely disappointed. We'd make paper tunnels for her to run through, throw little balls and fuzzy mice around and she would chase them, hurling herself about the livingroom with the full and proud knowledge that she was the star of this show and her high-flying antics would brighten my day.

Friends and family want to help a woman experiencing breast cancer but they don't always know how. Helping her to make the most of every day can be a good place to start. Sometimes that's as easy as popping over to help with the laundry, or doing some grocery shopping, tidying the garden, cleaning the windows or waterblasting the front path! Being able to look through a sparkling clean window out onto a tidy garden can bring hours of joy. Going out for  morning tea on a good day, or quiet companionship on the not-so-good-days -little things that can mean so much.

Making the most of every day can also involve some major adventures and spending lots of money on something you've always wanted .Why not, I say! In my book, The Pink Party, Manon decides she will do something spectacular to celebrate her recovery from a second breast cancer diagnosis ... I hope you enjoy this excerpt from The Pink Party (view as a pdf) and can share in Manon's celebration of being spontaneous, joyous and living in the moment.

Breast Cancer Awareness Month

October is Breast Cancer Awareness Month here in New Zealand - and in many other countries - because breast cancer is a global disease. It affects women living in every country and in spite of all the research that's going on, we still cannot say with absolute certainty that we understand what causes it.

In New Zealand, over 2500 women are diagnosed every year. That's about one in every eight Kiwi women - and that's not too flash. Over 600 will die annually from breast cancer. The good news is that mortality rates are decreasing as treatments become more effective and targeted.

I've seen breast cancer from many angles now. I've had it myself. I was diagnosed on Saturday 13th October 2001 at around 3pm by Auckland breast surgeon Belinda Scott in her office with my best friend Katherine sitting next to me. The irony of being diagnosed during Breast Cancer Awareness Month was not lost on any of us!

The diagnosis came at a time when I'd finally taken back control of my own destiny - I'd left the corporate job, had 18 months off and was going to the USA on the 15 October 2001 (yes, two days later!) to write best-selling sex and violence potboilers. Thinking back now, I know that sometimes in spite of our plans, 'life' happens and within a minute, you're off in another direction that you never planned for or ever even imagined.

After I recovered from my treatments, I began volunteering in the support area to help other women newly diagnosed (Breast Cancer Support, BCS). I worked within the advocacy area too, alongside a group of very dedicated women who tackled our government and fought a long and tough battle with NZ's drug funding agency PHARMAC to gain funded access to Herceptin for our early stage HER2 positive girls (Breast Cancer Aotearoa Coalition). I now work for Sweet Louise, an organisation supporting women whose breast cancer has spread to other parts of the body (known as secondary or metastatic).

I've written two books about my cancer (Welcome to the Amazon Club and The Pink Party) , numerous articles and have given many talks about my own experience with breast cancer and yet I sit here this morning and say yes, we have accomplished so much, but I still feel so helpless because our beautiful women keep dying from this bloody thing.

This afternoon, I will walk up the hill to our local Baptist church to farewell another of our wonderful ladies, Mary. I've known Mary since about 1998. She and her husband ran the airport shuttle and Mary would drive me down for business trips. If there were no other passengers, I'd hop up into the front of the van to sit beside Mary and we'd have good chats and laughter about family, work, all the usual. We both loved driving - I shared my experiences as a courier driver with her and she would tell me of her adventures behind the wheel and the people she'd meet during the course of her busy days.

A month or so after my diagnosis I was invited to attend the local breast cancer support group and, fortuitously, just in time to enjoy their Christmas lunch. Who should pull up in her shuttle bus to take us to lunch but Mary. Imagine the mutual surprise when we saw each other and realised that we both belonged to the 'pink club.'

Mary had lived with secondary breast cancer for many, many years. Her life had been full, busy, blessed with close familiy and grand children too. Her contribution to our local support group was of immeasurable value. She was much loved and an inspiration to us so when her cancer began to progress, it was a shock to everyone and we rallied around her. She came to the group as often as she could but the treatments were hard and as the cancer developed, it became difficult for her to walk and her energy levels were low.

I visited Mary at home a few times. We'd sit and chat. I'd bring some bread for Rosie the part Kune Kune pig (Rosie lives in the back paddock at Mary's place) or Mary would have me go into the kitchen and fetch something to give her. I'd call Rosie and up she'd come, trundling through the paddock and the glorious mud for her treat.

I saw Mary about a week before she passed away. She was very ill but we still managed a laugh or two and she said, 'Go into the kitchen and get something for Rosie.'

A mutual friend called this week, on Wednesday morning, to say Mary had gone. My friend had been on her way to Hamilton when she received the call. 'I had to pull over and sit for a while,' she said. 'I just couldn't take it in.'

It still comes as a shock - a moment of disbelief when you hear the news, a response of no, this can't be right - I only saw her last week and I was planning to see her again tomorrow - in fact we'd actually talked about it and she'd said, yes, please do come by and see me.

I miss Mary. I miss her laugh and her smile. I miss her brightness, energy, her irrepressible sense of humour. She always asked about my Mum and she'd offer to host our support group ladies for a special morning tea each January. We'd sit in her garden pergola or out on the back deck, looking down over the fields to the river and of course feed Rosie delicious cakes and goodies.

I'll miss our lunches, shared over a glass of wine and good, strong coffee.

Mary made sure I arrived at my destination safely, on time and she was always there to pick me up again when I came home.

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