Getting to know Annet - 6. To save... or not to save?

This has been the toughest blog... I have ever had to write... 

Partly because of the realities of which Annet has had to face and the decisions she had to make (whether she had a choice or not) and partly because when writing about it... you live through the emotions with her.

I feel guilty admitting that I've been avoiding to write this blog like studying for an economics exam during my second year at university and would rather close the books than look at it. Or like a small child not wanting to clean their room and rather closing the door than dealing with it, because 'if you don't see it then it's not there'.  I have been avoiding to write this blog so that I did not have to share in the emotions which Annet has been forced to live with.

The reality is... whether you close the door or not, it is there and Annet had to and still is... living it. 

I have undertaken to tell Annet's story, not only because she is facing her challenges with so much grace and positivity that I am in awe of who she is, but also because it helps put the things that really matter in life (family, friends.... health!) into perspective. 

So for Annet and all the other strong and brave woman who still look after their families and support their friends while facing the shocking truth of having to amputate body parts so that they could share a life with those they love... I have written and now share this story.

Here follows Part 6 of 'Getting to know Annet':

Annet wasn't able to complete the whole chemo cure. She had too many issues with Neuropathy (damage to nerves). Because of this, the last 4 chemo sessions were replaced by 1 AC Cure (the 'red' cure - which were the toughest chemo sessions due to the after effects). On 24 November 2015, Annet's chemo sessions were completed. 

On the 4th of December 2015, Annet had a MRI Scan.

The MRI was to measure the affect which the chemo has had on the cancer cells. 


One week after the MRI, Annet received the results.


It was a long and stressful week... but... the results were very positive! 

Annet's tumor which was large and about 5-6cm in diameter, had shrunk to less than 1cm!!! What a great relief!!!! The chemo had worked! 

Annet said that this was better news than what she could have EVER dreamt of! 

Due to the size of her tumor, she was expecting from day one, that she would have to have a mastectomy, but now... she had a choice of having surgery to remove the tumor and save her breast! What incredible news and what a relief!!!!

Annet speaks of the surgeon also being happy with the outcome and informing Annet that there is a very big chance that the surgery (to remove the remaining tumor) could be a success and that Annet might not need to loose her breast at all (but that could only be determined after the surgery). What wonderful news! 

Annet went straight home and informed her parents. What a relief for all... 



The surgery was scheduled for 28 December 2015. 

Annet was nervous about the surgery and what worried her the most, was the long pins which needed to be placed inside of her breast to locate and mark the tumor.

Luckily the placing of the pins in the morning of the operation were not as traumatic as Annet expected and it went quite well. She then had to wait for the operation in the afternoon and was thankful that her son and his girlfriend were present to keep her company and distract her. 

(Special thanks to Leon vd Werf, Annet's son, for taking the images below as I was unable to attend).

Luckily, the operation had gone to plan and she was even able to go home that same evening. 

Annet had to wait just over a week (until 7th of January 2016) for the results of the operation. At first... she wasn't nervous at all but as the days passed waiting for the results... she became more and more nervous. The day before she was due to get the results, she starting worrying about what the outcome would be. She was getting more and more worried that it was not going to be good news... 

She felt disappointed in herself for worrying and kept trying to comfort herself that it was all going to be ok and that she should not doubt what the outcome would be. 

When the day came and Annet was given the news... her worst fears became a reality... 

The results showed that Annet's tumor had split into loose cells and that many loose cells were visible throughout the removed tissue as well as in the edges of where the tissue was cut. This was not good... as this meant that the loose cells from the tumor would also be present in her breast.

Annet said that she was not surprised as she was expecting the news to be bad. She could recall the surgeon being disappointed when explaining the results to her. 

She was given the option to have another operation to try and save her breast but this time... Annet didn't want to make a rush decision and she knew about that the risk of cancer staying behind in her breast. She didn't want to go through this whole process again just to get some more bad news... 

As difficult as it was... Annet decided that her breast HAD TO be removed... 

Following discussions with both the surgeon and the MammaCare nurse, Annet now knew what she was facing.

First, the amputation needed to take place and then... they would determine how the reconstruction would happen. 

The days following the news about her breast amputation, Annet was very sad and she had to focus on not allowing herself to get depressed. This was the most difficult time for her during her whole breast cancer journey. I can't imagine what a rollercoaster of emotions she must have been feeling... After staying so positive and strong throughout the chemo and recovery, emotionally preparing herself for the surgery to remove the tumor which would save her breast and now... having to mentally prepare herself for a longer journey of having to have her breast removed and then planning the reconstruction.

Annet couldn't stop thinking about the next operation and she was questioning everything about the process. Annet was panicking over the reconstruction... Would it be possible in the way that she wanted it to be done?! Would they be able to use her own tissue?! Or would this not be possible?! 

You need healthy blood vessels to be able to use your own tissue for reconstruction. From her arms this would not be possible... does this mean that the vessels from her abdominal area could not be used either? She had a c-section with the birth of her son, would the scar be an issue? She had all these questions which she needed to be answered... 

The MammaCare nurse put her in touch with a Plastic Surgeon. The surgeon explained all the options and informed Annet that blood vessels in her arms did not reflect what the blood vessels in her abdominal area would be like. She was also informed that her scar would not be an issue as it was not in the way. 

After the conversation with the Plastic Surgeon, Annet decided not to go ahead with the original planned operation, but to arrange for the operation to take place at another hospital where a surgeon could remove her breast and the Plastic Surgeon could immediately place an  'expander' (which stretched the skin over time to make room for the  final implant). This would deliver a result preferred to Annet. 

Emotionally, the period between the two operations and up to a week after the second, was one of the most difficult times in Annet's life. Luckily she had her sister and girlfriends around her who not only supported her but understood how difficult this all was for her. She said that she had visitors daily and that some had driven long distances to come and see her (even from Den Haag and Eindhoven to Emmeloord). 

Over the coming months... Annet needed all the support she could get...