Once you have decided to have chemotherapy (if you can get past the humungous list of possible side effects) then there are couple of things that need to happen. Firstly, you must go and have an ECG to check that your heart is strong enough to take it. Some chemo drugs can damage your heart by weakening the heart muscle so it’s crucial to check your heart is ‘good to go’.

I went for my ECG 5 days after seeing the oncologist and it was an interesting experience to say the least. I had gone presuming it was just a tick box experience and felt pretty confident about the results. By the time I came out of the appointment I was questioning whether everything was normal but I think that was more to do with the clinician I saw. She was a youngish girl who had a very serious disposition. She asked me to take off my clothes to the waist and lie on my left side on the bed. This was the first time I had to get my scarred breasts out for a relative stranger (outside of the breast cancer care unit) so I had to take a deep breath before doing it.

Once I was on the bed, she asked me to lie on the very edge so I was a close to the machine (and her) as possible. Quite frankly my swinging breasts were virtually on her knee! She then used a probe to go all the way around my left breast (a little bit like a scan you have when you’re pregnant). All of this was fine, what was disconcerting was the faces she was pulling whilst she was looking at the images! She did a lot of frowning and squinting – I thought she either needed her eyes testing or she had seen something most unusual.

She then put the probe on my neck and just at the bottom of my cleavage. I asked her what she was looking at from that position and she simply answered ‘it’s just a different view of the heart’ – that’s me told! She didn’t really chat to me at all so at the end when she’d finished, I got dressed and said to her ‘so does everything look normal to you’ to which she replied ‘I can’t tell you because the report isn’t finished yet’. I understand they can’t get into detailed conversations there and then with patients, but it did leave me feeling a little uneasy.

As it happens it was fine, so I needn’t have worried – it was probably a sign of me being on high alert for any medical surprises (let’s face it I’ve had a few).

Secondly, you have to decide how you are going to have your chemotherapy administered. You have a few different choices, you can have a cannula put into your vein each time you go, you can have a PICC line which is a very thin tube that is inserted into your vein and stays there until your chemo is over. The third option (that I know of anyway) is called a port. This sits just under your skin permanently and needs to be inserted with a small surgical procedure.

I think the majority of people probably choose a PICC line as it saves you having a cannula every time and it also saves the chemo travelling through the veins in your arms to the one near your heart where it gets quickly dispersed around your body. I think people choose ports if their veins aren’t very good in their arms or they play sports that require their arms to go over their heads or move a lot.

My initial thought was that I would like a port, the main reason being that because I have had both sets of lymph nodes removed from my arms, I don’t have what they call ‘a good arm left to use’. People who have had breast cancer on one side (97-99% of cases) would only possibly have their lymph nodes removed from one side too leaving them a totally health arm.

It is thought that putting lines into an arm with no lymph nodes may contribute to a condition call Lymphedema which can happen years after surgery and which I am desperately trying to avoid. It’s where your arms swell and you then need to wear compression sleeves – not something I want to be contending with when this shitty journey is over.

Anyway, to cut a long story short, the oncologist said I could discuss all options with the chemo nurses when I saw them. The problem was that by the time my appointment with the nurses had come through they immediately told me I didn’t have time to have a port surgically inserted in Coventry if I wanted to start my chemo on the planned date of 6th December.

If I’m honest this sent me into a real spin because I didn’t really want a PICC line in my arm and was then left with the Hobson’s choice of risking a PICC line or delaying my start to have a port fitted – neither of which I wanted.

This really upset me and if I’m honest I felt a little like no one had even thought about, or understood, the possible risk to my arms. Bilateral breast cancer is so rare that I am starting to realise that if I want my arms looking after I am going to have to advocate for that myself, but if I’m honest I don’t really know what’s best either. I haven’t seen a lymphatic consultant to advise me on the best way to look after my arms as I navigate my way through all of these medical procedures so I’m only going off the little I can research. This whole issue sparked a big debate within the oncology unit, but it didn’t change the outcome for me – there wasn’t time for a port before 6th December.

My choices were:

1) Have a PICC line inserted and hope that it doesn’t get infected and cause problems to my arms

2) Have my first lot of chemo through a cannula straight into my veins and get booked in for a port for sessions 2-6

I didn’t want the chemo to go up through the veins in my arms as apparently it is very corrosive stuff and can cause damage to the veins and tissue, so this didn’t feel like an option.

I opted to have a PICC line inserted after much deliberation and many tears.

Understandably, the nurses won’t make decisions for you or even give their opinions and I totally appreciate that it’s not worth the risk for them. However, I’m finding it really difficult to make important decisions about my health when I feel ill informed, but it just has to be done.

So, I’ve opted to have a PICC line to be inserted and I am just keeping my fingers crossed that it doesn’t get infected and cause problems down the line with my arms!