What is lymphoedema?

What can I do?

Lymphoedema is the build-up of fluid in soft body tissues when the lymph system is damaged or blocked.

Lymphoedema occurs when the lymph system is damaged or blocked. Fluid builds up in soft body tissues and causes swelling.  Lymphoedema usually affects an arm or leg, but it can also affect other parts of the body. Lymphoedema can cause long-term physical, psychological, and social problems for patients.

    

The lymph system is a network of lymph vessels, tissues, and organs that carry 
lymph throughout the body.

The parts of the lymph system that play a direct part in lymphoedema include the following

v Lymph:A clear fluid that contains lymphocytes (white blood cells) that fight infection and the growth of tumors. Lymph also contains plasma, the watery part 
of the blood that carries the blood cells.

v  Lymph vessels: A network of thin tubes that helps lymph flow through the body and returns it to the bloodstream.

v  Lymph nodes: Small, bean-shaped structures that filter lymph and store white blood cells that help fight infection and disease. Lymph nodes are located along the network of lymph vessels found throughout the body. Clusters of lymph 
nodes are found in the underarm, pelvis, neck, abdomen, and groin.

The recommended treatment for lymphoedema is a treatment plan called complex decongestive therapy (CDT). It is also known as decongestive lymphatic therapy 
(DLT).

CDT is not a cure for lymphoedema, but it can help control the symptoms of swelling and 

pain. Although CDT takes time and effort, it can be used to effectively control your 
lymphoedema.

Complex decongestive therapy (CDT)
There are four components to CDT treatment:

·         Manual lymphatic drainage (MLD) is a specialised massage technique designed to stimulate the flow of fluid and reduce swelling.

·         Multilayer lymphoedema bandaging (MLLB) uses bandages and compression garments to move fluid out of the affected limb.

·         Remedial exercises designed to activate muscles in the limb to improve lymph drainage. 

·         Skin care is required to prevent infection.

Each of these treatments is described in more detail below.

CDT begins with an intensive phase of therapy, during which you may receive daily 
treatment for up to six weeks. This is followed by the second phase, known as the maintenance phase. During the maintenance phase, you will be encouraged to take over 
your own care using simple lymph drainage techniques (MLD administered by either 
yourself or a carer) and exercise while wearing compression garments.

You will then have regular six-monthly review meetings to check how your treatment is progressing.

1. Manual lymphatic drainage (MLD)

During manual lymphatic drainage (MLD), your lymphoedema therapist will use special massage techniques to move fluid from the swollen areas into working lymph nodes where it can be drained.

It is important you receive MLD from a trained lymphoedema therapist and not a regular masseur. This is because the technique requires a detailed knowledge of the lymphatic system to be performed correctly.

Your lymphoedema therapist will also teach you a range of massage techniques you can use during the maintenance phase.

MLD may not be suitable if you have certain health conditions. For example:

·         current or suspected deep vein thrombosis (DVT)

·         a blood clot in one of the deep veins in the body

·         swelling in your legs due to heart failure

·         cancer in the affected area

2. Multilayer lymphoedema bandaging (MLLB)

Unlike the blood circulation system, there is no central pump, such as the heart, to move fluid around the lymphatic system. Instead, the lymphatic system uses the massaging effect of the muscles surrounding the lymph vessels and nodes to move the fluid.

The aim of multilayer lymphoedema bandaging (MLLB) is to support the muscles during 
exercise and encourage them to move fluid out of the affected limb. MLLB is often used after a session of MLD to prevent fluid accumulating in the limb again.

You will be taught how to correctly apply your own bandages and compression garments so you can continue to use MLLB during the maintenance period.

3. Remedial exercises

Remedial exercises are designed to strengthen muscles involved in lymph drainage. You will be given an exercise plan tailored to your requirements and ability.

This exercise helps to prevent or reduce temporary swelling in the arm. Take a small rubber ball or similar object in the palm of your hand and make a fist around the ball, squeeze gently and relax. The ball should be firm enough to have to exert some pressure but soft enough to give a little when squeezed.

4. Skin care

Taking good care of your skin is important because it will reduce your risk of developing an infection, such as cellulitis. You should be given a daily routine to follow, where you are required to meticulously clean your skin and check for any cuts, abrasions or signs of infection.

All is Well That Ends Well!

Quietly finishing a sandwich, Mandy turns to look at me in response to something I have said  (what that was, don't ask, It's not important, and I don't recall it at all), and I think "am I seeing this right?" 

So I look again. Mandy's eye is a mass of blood. I tell her that her eye is, and I use the wrong phrase, "bloodshot" "oh" so she says, "  it will be alright" I tell her no, it is really bloodshot, and she continues to tell me to stop worrying, it is fine. I tell her to look in the mirror, but she tells me to stop worrying. No, I tell her, " you are not getting this" " it is really bad" " it will be fine" she says. So I get a mirror and make her look. 

Then she understands that she needs to take medical advice. Medical helpline leads to another medical helpline leads to A and E leads to inspection by opthamologist. 

The main thing is that he could see nothing behind the eye of concern, although he detected early stage cataracts, not so good, but manageable I guess.  Perhaps this is another chemo affect, who knows? 

 We are now waiting for the results of blood analysis which should be available next week. 

In the meantime the Dr whilst looking into Mandy's eyes is going Wow, wow, I have never seen this before. Wow, there are really crystals in your eye, they are shining like Swarovski crystals" and his face is beaming all over.  "  Yes" Mandy says, " they are writing this up and have already taken photos to put into medical journals"  He calls the nurse to have a quick look because she will probably never get a chance to see this rare condition again. 

I doubt that Mandy will be able to get them extracted to be made into a necklace, but at least it gave her something to smile about. Still as she always says, she does not want to be rare, she wants to be normal, but it is entertaining to see the excitement on eye doctors faces when they look into her eyes!

It's not over yet!

I'm happy to know that the chemo is now finished but treatment is not over yet! Ten days ago i started the next phase of treatment, hormone therapy, anastrozole  One tablet every day for the next few years, at the moment the number of years I should take it is not certain. I was supposed to take tamoxifen for ten years the first time round but after six years I developed a very rare side effect which effected my eyes by where the tamoxifen crystallised on my retina! So they advised me to stop taking it. By this time I had already developed a lump and the cancer was back! Hopefully with the surgery, the chemo and now the hormone therapy underway everything should be in place to keep this awful disease away for good! 

Sometimes we all need a helping hand to keep us feeling strong!

A shower of flowers

How lovely to have been thought of by so many caring friends and family during my time of recovery

Post chemo cycle six and feeling crap!

Each of my cycles of chemotherapy have been scheduled at three weekly intervals.

Why you have chemotherapy in cycles

All the treatment you are offered is based on years of research. The combination of drugs your doctor suggests will be the best of all those tested. The drugs aim to kill the cancer cells while causing as little harm as possible to normal, healthy cells. You have chemotherapy as a course of treatments over a few months because  

• It allows the chemotherapy to kill more cancer cells
• The rest between treatments allows your body to recover from any side effects

At any one time, some of the cancer cells will be resting. Chemotherapy only attacks cells that are in the process of splitting into two (dividing). So resting cells will not be killed. Some of the cancer cells that were resting during your first treatment will be dividing by the time your second comes around and so they will be killed off. Normal cells usually repair the damage from chemotherapy more effectively than cancer cells, so damage to cancer cells should progressively build up without causing permanent damage to normal cells. There is more about this in the section about how chemotherapy works.

The effects of chemotherapy are cumulative and I would say there has been a noticeable drop in my energy levels particularly since chemo number three although between the rest periods I have felt energy levels return although more slowly with each cycle. After number five I haven't felt that I've had chance to regain strength, energy or fitness before they administered number six!

Six days post chemo number six and I have probably felt at my worst throuout the whole treatment with ongoing side effects becoming much more severe. The weekend has left me completely drained with a lack of energy to the extreme of having great difficulty in even claiming the stairs to bed and having to resort to getting up half way and having to continue on hands and knees! 

Conversation and the ability to understand and make decisions can feel like a quest in itself including following the thread of a conversation, and retrieving words. A difficulty multitasking, comprehending what i've just read and with simple tasks becoming increasingly more difficult to concentrate on!

The last four nights have been nights of sleep deprivation, spending the last two nights mostly in the bathroom sat upon the toilet going from constipation to diarrhoea! Yes, sorry, not what you may want to be reading but these are the facts and I want to be honest in telling it how it really is, not very pleasant I know and I can tell you it hasn't been pleasant for me either!

I had an appointment today at the lymphoedema clinic at St. James hospital and first thing this morning with the way I felt honestly didn't think I would be able to make it but with determination and the fantastic support of my wonderful, amazing husband I was, with a great effort able to attend!

Mystery flowers solved

'm happy to say the mystery of the anonymous delivery of this beautiful bouquet of flowers has now been solved. The flowers were sent by my mother and father in law, Eileen & Barry and I have now been able to thank them personally! 

What's more I have also learned that the purchase of this particular bouquet of flowers from M&S means that a percentage of the price is donated to breast cancer too!

A beautiful bouquet. Thank you Eileen & Barry x x

The Ribbon

This is Charlotte Halley. Maybe an unfamiliar face but she is the person who introduced the ribbon into the "fight" (not my favourite term) against cancer, but not in the way you might think. For her, the ribbon was a symbol of her protest AGAINST  The National Cancer Institute in America because she had found out that less than 5% of its massive budget was actually used for the benefit of those with cancer. Her ribbon was peach and she held on to it. She would not allow it to be used as a commercial promotion, so lawyers advised a change of colour. And the colour chosen was pink. But let us never forget Charlotte and her protest still valid today. 

I would like to see legislation passed making it illegal to raise funds for charity without prominently displaying the number of pennies that goes to the end user/ the cause, for every pound paid. 

Beautiful gifts of flowers

How lovely to be thought of with beautiful gifts of flowers! After finishing a gruelling four month regime of chemotherapy.

Firstly from my breast sister Sharon I have received a card from her arriving a day or two before each of my chemos, a fantastic surprise weekend vist travelling all the way up from Wiltshire before having chemo number six and then a further surprise of a delivery of flowers timed perfectly the day after completing chemo along with a card which she had left to be handed to me on her behalf.

Flowers from Sharon

My next flowers were hand delivered this morning from a friend and colleague I have had the pleasure of many times, since soon after my operation back in May! Donna has been a great friend with regular visits of support. 

Flowers from Donna

Now onto my mystery flowers, a beautiful bouquet which I was thrilled to take delivery of also today. Unfortunately there was no details of the sender, such a shame as I would really like to thank them personally but have no idea who it could be! Perhaps they may see this blog and realise they had left the card that came with the flowers blank! Whoever you are I'd really like to say thank you they are beautiful as you may be able to see! 

Mystery flowers
Who could it be?

One dozen

I'm happy to say that on Tuesday 13th October I completed yet another course of chemotherapy! Twelve rounds in six years! 2009 was my first regime which began in January and consisted of six cycles three weekly of EC90 that was a combination of two drugs ( Epirubicin & cyclophosphamide ) 

My second regime of chemotherapy  after my reaccurrance this year which I began in June 2015 consisted of six cycles of Docetaxel

Cycle  six of Docetaxel

After achieving my five year mark and celebrating, then further going on to being six years cancer free and beginning to become more confident about putting this all behind me it was yet another wake up call to not becoming complacent about this awful disease!

I really don't want to have to go through this all again and am hoping and praying that from here on I will stay cancer free! Wouldn't that be great! So let's hope this is it, my real road to recovery! 

Having already made some healthy life style changes after the first diagnosis, perhaps it wasn't enough?! After a second diagnosis I have already made more healthy lifestyle choices and in my recovery am even more determined to make many more! I really don't want to repeat another journey like this! 

Talk about all the fun of the fair, I really hate roller coasters and would be completely happy to never have to embark on another one of this magnitude ever again! I now need to try to get back my positivity, gain confidence and strength, hopefully I will get the continued support of everyone all around me to keep me focused in regaining normality and helping me to become the healthy, happy cheerful bubbly person that is still within me! I know I can do it with your help and support! 

Causation by Statistics

Never before have we had so much information. The most expensive bananas in the world are in Australia. I do not know why I need to know that but it was so easy to find out. 
We have pretty pie charts, bamboozling bar charts and excel spread sheets on everything from every angle. My brain hurts! 
And when you start accumulating data, you get the ability to correlate facts and that means that you can draw conclusions. 
I am sure that if we collected data on the colour of people's tea shirts in Asda, and their buying habits, we would soon discover that if you put on a white tea shirt, you are more likely to purchase bananas than apples, but that the incidence of people buying apples, increases when they wear a red tea shirt. Or can it be that our fruit diet affects our choice of clothing?

This week we have been told that the taller you are, the higher the risk that you will get cancer! An "expert" on TV admitted that the reason for this is not yet known, but perhaps it is because a tall person has more cells to go wrong. Am I buying this explanation? It sounds a bit like saying that any 2 legged men, who want to reduce the  risk of cancer, can do so by having one leg amputated! 
And yet inspite of all this data, and all these correlated patterns, a hospital doctor admitted to us yesterday, that we still do not know why people get breast cancer. (It can't just be height, Mandy doesn't quite make five foot!)

To be honest, I blame computers. It doesn't mean we should, just because we can. 
Anyway, statistics are deceptive. It is true say that world-wide, and in every single country in the world, people on AVERAGE  have less than 2 legs.  Fact.

Oh, and just one more thing, as you read this you should be aware that you can do so because you have an above average number of eyes. And the chances are too, that you have an above average number of legs. 

Visitors!

I love having visitors and thankfully they have been like buses recently last  weekend  we had visits  from a colleague and her lovely fiancé , Shelly & Paul  and we had a lovely relaxing evening  great company and conversation and we even had Nick playing guitar and singing us  a small selection of his original songs which did get one or two of us a little emotional, but in a good way. We need to do this again! 

Also that weekend we had the pleasure of our eldest son who travelled all the way down from Aberdeen on the Thursday evening and stayed until Monday morning! It's always so lovely to see you Dean, so proud of the man you've become and of what you have achieved for yourself. Love you to bits and can't wait to see you again soon.

This weekend I had a surprise visit from my breast sister Sharon and brother in law Andy. II have spoken about Sharon previously on this blog regarding her own journey with breast cancer, she has been a great source of inspiration to me full of great advice and understanding. I'm really happy to tell you all she is now coming up to being TEN YEARS CLEAR! Please can I join your club Sharon? We had a lovely time together and  Saturday evening we were joined by my eldest sister Michelle and  our bro in law Simon. It was lovely to all get together, the boys all went out together to do boys stuff, pub & rugby! Whilst us three girls stayed in and had a lovely time catching up relaxing all cosy at home! 

On the Sunday friends, Ross & Debbie called across from York to spend a couple of hours with us, it was lovely to meet up again and catch up, I feel so pleased and cared for that so many people make such an effort to come and spend their valuable time with us. It will be lovely to see you both again.

Later on Sharon did an excellent job of cooking a delicious Sunday roast with her trusty assistant, the wonderful Nick by her side, I was sent to sit down feeling quite guilty but also recognising that I was struggling with my breathing and joint pains in my legs, I knew I really did need to just be able to sit down. It's not always easy to accept help but sometimes it's the right thing and there are times when you just need to step back and be thankful it's on offer! The weekend went so quick and early Monday morning Nick kindly drove Sharon and Andy to the train station for their 08:11 train. Then for us yet another appointment in pre assessment with Proffesor Dodwell my oncologist who is in charge of dishing out my "poison" as he calls it!  Bloods taken and picc line dressed ready for my last chemo to go ahead today! Yippee! 

Yesterday late afternoon/ early evening I had the pleasure of another couple of lovely ladies, friends from work, Salma & Jodie. I was so pleased that they had managed to come and even more pleased that they stayed for some time. We had a lovely catch up it was so nice to chat and I felt so lucky they spent so much of their time with me especially as they had both been busy at work all day then on top of that I know Jodie has quite a drive before she gets home so it would have been very late for her. Still it was great they were still here when Nick arrived home, he would have been sorry to have missed them and he could immediately see the lift their visit had given me! It works every time! 

So to anyone reading this, I know it's my last chemo today, but it's not over! There is still 
lots of healing to be done both physically and mentally! I still need your support and if 
you have any free time please don't hesitate to get in touch I'd be really pleased to see you and would always welcome friendly faces! Don't be shy even if you haven't yet been one of my visitors so far it's never too late and it would be lovely to see some new faces so come on surprise me! It's great for my recovery!

All visitors welcome!

Tablets

Mandy has never been one for taking tablets and I have to agree with her, if you can get by without taking a tablet, then don't take a tablet. It has been this way for years. Now she is making up for it. She needs to do what she is ordered to do. So how many tablets of different types,  has she been prescribed to take tomorrow? 

Answer = 30

Starting from far right to left, morning, lunch, dinner, bedtime!

That's right, you read that right, 30

Thank you Carol Galloway

Well nearly there now. 

Today is the last pre chemo blood check. Mandy in true Mandy style has taken down all the numbers so she knows how the chemo has affected all the various levels. 
It would be quite remiss not to give the very lovely Carol Galloway a mention. She has been absolutely fantastic, always with a friendly smile and reassuring voice answering all of Mandy's questions and going the extra mile to make sure that Mandy is well looked after.  Mandy feels safe with any treatment she has received from Carol, and it is a big thank you from me too because I have also felt so much more relaxed knowing Carol has everything in hand.

Mandy calls Carol the " the Queen of pic lines" 

Nearly Through Chemo

5 down and one to go. That should happen next week. Ok it has been an increasingly steep hill to climb and legs are hurting, breathing is hard work and it's tough. But the top of the hill is in sight, and then the ground should start to flatten out, and gradually the breathing and everything else  should get easier. 

Mandy has been surprising us with her knitting skills, a rabbit with floppy ears, an elephant in a dress and a snowman. Who knows what will appear next. 

Thank you to everyone who has been there to support Mandy through this climb. It gives her the strength to keep going in good spirits. 

A Reminder to Ourselves ......Things We Say / Things We Don't Say

1. "I am fighting cancer"  Really? Yes really. Fighting is aggressive. When has aggression been the answer to anything worth having? It often comes from anger. Anger is a negative emotion. When someone says they are kicking cancer's butt they are telling themselves that it is about fighting. We say "cancer is leaving me, it is leaving this sphere, it is not coming back".

2.  "Today is going to be a good day" with or without cancer, the deal is always the same, we only Have so many of them, the past does not exist, neither does the future, one is a memory, the other is a creation of our imagination. So we will enjoy today.

3.  " I can't" ... This may be perfectly true, but it does not apply to everything. It is better to say " I  can"  and to concentrate on what I can do. There are lots of them.

4.  " People will be looking at me /with pity/ dislike/ etc -  pick loads of negative ideas... The truth  is that even if a person going through cancer may look different in some way such as a loss of hair, Etc. their heart is the same, the person is the same, any changes are merely cosmetic, and True friends don't care about the cosmetics, those who are not inclined to be friends would not  care either way, they have more important things to focus on like their own friends and families. Their own lives. We say, " I am me, I am a good person, with a good heart, and my friends know that"

Right, that's enough thoughts for now.. I have to go to work to have a good day! Have a good day yourself if you have got this far.

Good News, lots of Phews!

Mandy has just about had the fortnight from hell, with the many effects of chemo, the onset of lymph oedema, and then discovering the serious concerns of the doctors over the possible cause of the lymphoedema and concern that cancer may be  causing the problem. Understandably, at times she has been mentally, physically and emotionally stretched, but has tried so hard to protect me from all of that by saying she is fine, when I can see that she is not. 

Well,  the appointment we were almost hoping would never arrive, had to be faced today. We were getting the results of the scans on the area of the last operation, and received the news that the scan did not show anything. Fantastic news, and such a relief, because at times like these the mind goes all over the place.

Tonight feels much different to the way we both thought it may feel. 

Thank you everyone for your kind support. It is getting Mandy through all of this.

Sorry for moaning!

Having not posted for some weeks I had hoped that there would have been great improvements in my emotional and physical wellbeing so as I could write a somewhat more humorous and positive post. 

The past weeks have been quite tough with the dreaded and unwelcome onset of lymphoedema! Which has been a great cause of emotion, worry and concern. This has meant yet further hospital appointments, examinations, blood tests and scans. 

After seeing a lymphoedema specialist it has been decided that part of the treatment and therapy needed is to be fitted with a compression sleeve! This is something I have at present been advised to wear throughout the day, every day! jOY! So now I await it's delivery!

Just when I thought I was doing amazingly well throughout this diagnosis, tests and surgeries followed by the chemo and feeling so positive and in control of my state of mind, it would seem together with the lymphoedema and build up of a variety of side effects from a combination of the surgery, chemotherapy and the medication my emotional state of mind is at present being tested to it's limit!

Added to my worries are the fact that in a matter of weeks i shall be financially compromised too when i have to accept the fact of being forced into having to go on to half pay even though I have yet to endure another two more cycles of chemo!

I try not to complain but the following are just some of the things I have been putting up with from day to day! 

Aching limbs,
Peeling hands,
Sore feet, 
Numb toes,
Numbness in tips of fingers,
Constipation,
diarrhoea,
Lose of taste,
Dry eyes,
Dry skin, 
Swollen arm,
Aching joints,
Aching ribs,
Sore mouth,
Tightness in arm,
Tightness, aching in breast,
Stiffness in shoulder.

One or two things at a time is manageable but an accumulation of many, only then needs that one more small thing placed on top to bring everything crashing down!

Nick is unbelievably the most amazing person in my life! Throughout everything, he is there constantly by my side doing all he possibly can, whenever he can or whenever I'll allow him to! He couldn't physically or emotionally give any more support than he already does! He has and is being pushed to the limits and to be honest tries far too hard at times! 

Always thinking of others and never of himself he has carried a lot of weight along this journey we have walked together. It has been made all the easier because of his strength and support. He is the most beautiful, selfless, kind hearted man I have ever come to know and I count my lucky stars that we have each other's unconditional love for all time! 

Words are not enough to express how thankful I am to be so blessed to have someone so wonderful in my world and to know without doubt that I am truly loved and cared for and that I too have the most wonderful satisfaction and  tremendous overwhelming feeling of love for someone so special to my heart. 

North v South, East v West

When the going gets tough, the tough keep staying. The last week has been one of the toughest Mandy has had, with quite a lot going on. On the other hand, this journey constantly brings us into contact with inspirational people, a true testimony to the strength of the human spirit.

 4th chemo done today, only two to go now. 

Mandy inspires me to be a better me, a more courageous me, not to see the glass half empty or even half full, but to simply see that it is a glass with drink, and that the quantity is s somehow irrelevant. at the same time, our approach to treatment is North v South, East v West, we are poles apart. Mandy likes to know all the details, I prefer the blissful head in the sand approach, maybe it's a woman v man thing, I can't stand hospital reality shows either, and don't even get me started on Shows like " embarrassing Bodies", I mean why would you? 

Somehow however, I think this combination makes us a strong team. At least I would like to think so, and that keeps me positive.  

What's your poison? Chemo #3 conquered! Time for thanks too!

This is how I roll, from a stone to a boulder! Haemoglobin, platelets, neutrophils and white blood cell counts all down from last chemo but still within the safe range and no waiting around today for blood results to come back, they were ready and so my docetaxel was already prescribed by the doctor and ready to go with checks that I had started my steroids and anti sickness medication, other checks were made, always by two chemo nurses that the correct medication dose, etc is being given to the right patient. 

Today was the first time Nick had been unable to attend my chemo appointment as he had an investment course to facilitate for which no one else was available to do on this occassion although I must say his company and team have been a brilliant support to Nick and myself, they have all been simply wonderful. We are both so very grateful to them for their incredible support which has really made an enormous difference to helping us both through what can be at times a tough and emotional journey.

Thankfully a very dear friend of mine stepped into Nicks shoes today and gave me the support by coming along to my chemo session so I didn't have to go it alone. So I'd like to say a special thank you to you Steph for being there for me it just made things all the better having the love and support of a friend, not having to go it alone! Girl Power! We rocked!

I'd also like to say thank you to my beautiful granddaughter, my very own special princess Ellie-Mae, probably more than a year ago now she gave me a bracelet, she had two the same and wanted me to have one so we would have the same! This really touched my heart and the bracelet is now very special to me as I feel it has a special meaning and brings me a feeling of a close bond even when we are miles away, I can always feel closer at times when I wear it. I try to especially make a point of wearing it when we travel to Suffolk to see the grandchildren! With all that has been going on unfortunately we have not been making our regular trips to see the children and I miss them so terribly and so I decided I would wear Ellie's bracelet every time I have a round of chemo I suppose creating the bond of feeling her near and giving me good luck so chemo goes well for me without too many bad side effects or delays.

More thanks going out to a very thoughtful friend of mine for the gorgeous bouquet of flowers that filled my living room with a beautiful aroma, put a lovely smile on my face and gave me a warm fuzzy feeling over the thoughtfulness! So a massive thank you to a very dear friend from old times, we don't often see as much of each other as we did in the old days but it just goes to show that out of sight is not out of mind, never ending friends! 

Just a note, not forgetting my breast sister Sharon who is now 9 years clear of breast cancer and has been a great source of support to me though out the past six years, she has been my guide and inspiration giving me much needed support and  having a great deal of knowledge which she has shared with me whenever I have needed it. So thoughtful when I had chemotherapy six years ago she sent me a little card just before each chemo was about to start, like a count down crossing of each cycle. 

Once again she has been so thoughtful to do this again for me, putting lovely little messages in each one understanding how much these little things mean at times like this as she too has been through her own difficult journey so understand these things first hand. So card number three came through the post yesterday right on time even though she had set off on her holiday, she still remembered to make a special effort, thank you so much Sharon I really do appreciate your kind thoughtful efforts, it means so much! 

I am so lucky to have such thoughtful family and friends giving love, support and encouragement along the way, giving up time to make an effort to be there for me at times when I just need a little support with something or just a bit of a boost to keep me feeling strong! Thank you to everyone who has made that special effort big or small you've all helped more than you can know!