Nana Dalton’s ‘getting back on my feet’ blog: shattered dreams and misery

I was originally booked in to have my double mastectomy at the end of the eventing season 2015, a few weeks after my sister had the same procedure.

That year I went through many consultations/passed physiological tests for it etc and had a green light to proceed… so why didn’t it happen then? Because the surgeon refused to operate on me when she discovered I was long listed for the Rio Olympics! We had a heated debate over it — I was optimistically adamant that everything ‘would be fine’ but she insisted that if there were any complications, she wasn’t prepared to have on her conscience, potentially risking a once in a lifetime opportunity. #SheWon.

Then for the double-edged sword — one uber proud moment standing for the National Anthem after I had taken the individual top spot and won the Nations Cup in Belgium while representing Team GB, was counterbalanced by devastation when we discovered that Abbeylara Prince sustained an injury and had to miss the 2016 season. Dreams of the Olympics shattered. Too late, by then the surgeons diary was full and so the operation was postponed.

Miley at Badminton. Credit: Alesha Christian

In 2016, my marriage broke down and so in a nutshell, the operation slipped down my list of priorities.

I have the BRCA1 gene — a hereditary mutant gene. Of my immediate family, all four of my father’s sisters had breast cancer, one has survived it. My eldest sister was diagnosed with breast cancer when she was 40 — she had treatment and then the mastectomy and is now thankfully A1 ok. It is the same faulty gene that Angelina Jolie has, which prompted her to have the preventive mastectomy after losing her mother to the disease.

I have known I’m a carrier for a long time — but have actually felt that knowing this put me at an advantage as for the past 20 years I’ve had annual MRIs to monitor my breasts so if there were any changes things would be picked up early. More recently they’ve been every six months and with my big 4 0 looming, I wanted to stop the roulette wheel spinning and didn’t want to risk putting off the op any longer. Simplistically, I’ve felt lucky that I’ve been able to choose the operation date on my terms rather than the merciless lack of control and timing should the big C invade.

The best therapy — hacking with my son!

Originally I was going to have reconstruction using silicone implants (the same process as my two sisters), but with huge medical advancements even in the past three years, I had more options available to me and I chose to have my own tissue for the reconstruction using tissue from my legs.

I hadn’t however planned on having a head injury during the summer — I met with my surgeon two or three times… but he might as well have been reading the shipping forecast to me for all I understood from our consultations!

I knew I needed to deploy the ‘game face’ that I referred to in my previous blog — the one I have going into the start box of a cross-country course — with planning , prepping, training and warm-up all done the focus switches purely to the job in hand.

The disconcerting thing however in this instance, as I was on another planet for the prep work… I really didn’t know or understand much of what was to happen… and was too nervous to admit this in case they delayed my operation again. So I resorted back to another tried and tested method — trust the surgeons like I’d trust my horse… and WING IT!

This proved to be a sound system — the surgeons have done an absolutely incredible job. Tracey Irvine did the mastectomy taking 570g of breast tissue off. Adam Blackburn was the plastic surgeon who masterfully reconstructed my breasts using 500g of fat and muscle from my inner thigh leaving 16inch long scars… and roughly translating to me now being half a cup size smaller than I was. It was a 10-hour operation which also included removing sections of my ribs to make way for easier access plumbing in vessels to the new breast tissue.

When I came around from the anaesthetic, I thought I must’ve been hallucinating when I heard them saying I needed gamgee put on my breasts — although this is an old school essential in my vet box, it turns out that gamgee is also standard issue essential kit in the NHS for keeping new boobs warm post-surgery!

An unwelcome side effect of having such a long anaesthetic with arms stretched out to the side, was that within the first 24hours my shoulder dislocated twice — a pre-existing weakness but it had gone a couple of years without ‘popping’!

The next indignity was after the catheter was removed… my first trip to the loo resulted in me having a fall — as I gingerly sat down on the booster seat provided, it unceremoniously slipped and bucked me off! My left boob slam dunked straight on to the side rail and my right thigh slapped hard onto the rim of the loo both obviously having direct hits on the stitches/scars. Everything hurt like crazy and felt so weird but being in such unfamiliar territory, it was difficult to differentiate between what was ‘to be expected’/‘normal weird’ and ‘not so good weird’.

Hours after the loo seat tumble, my left boob started crackling with air bubbles — a disconcerting feeling which I can best compare to baby Toby giving a big kick inside my tummy. I was wheeled off to X-ray to make sure the air wasn’t coming from a punctured lung (apparently something they could’ve done when removing sections of my ribs!), but all was fine and settled down after a week or two.

The operation was on Monday and I was out of hospital by Thursday, although for the first two weeks I stayed on my sister’s sofa as I wasn’t able to make it up any stairs and she has a downstairs bathroom. My nearest and dearest have been simply amazing throughout, but she really did go beyond the call of sisterly duty, lifting me into the bath and washing me/my hair — all dignity well and truly out the window.

My parents live in Scotland but my mother came to live with me, to care for me and look after my son, Toby and me 24/7 for seven weeks. I simply don’t know how I’d have coped without the phenomenal support of my wonderful family and fabulous friends.

Throughout this time, Toby adapted admirably. He made us all extra proud by being awarded a special prize at school that term. It was three weeks post-op and it simply didn’t cross my mind not to be there to see him receive it… but I had completely underestimated the reserves I had to draw on to get to that assembly.

Before a big competition or the start of a cross-country, I would say that I am pretty measured and am very good at managing my nerves. However the process of trying to get from the safety zone of my sofa to the school that day, meant I experienced what I can only imagine some people feel about riding/competing and so on.

An hour before we needed to leave, I started getting quite apprehensive — by the time I got in the car, I was feeling physically sick and shaking. I tried to breathe through it and manage myself, but it was beyond my control. I limped very slowly out of the car, standard wear gamgee under my top and clutching my pillow for padding/security but by the time I made it to the school hall, I had involuntary tears streaming down my cheeks — it was a horrendous feeling, very embarrassing and I said to my mum at the time that it was a zillion times more terrifying than walking to the start box at Badminton!

For Toby’s nativity play the following day, it was basically an action replay experience. I was feeling pretty miserable and a prisoner to my physical limitations; largely bed-bound, reliant on other people, bored of daytime TV, full of medication and stuck too long in my own thoughts.

Four weeks post-op, Miley had his shoes back on after his winter holiday. I asked my mum to drive me to the yard and asked Emily to tack him up for me — to their credit, they humoured me and helped me clamber on. My legs instantly went into cramp but I adjusted my position and began to feel that wonderful hint of freedom, independence and strength that comes with being sat on a horse. I managed a little walk, which was the best medication I could’ve had at that time.

It’s now been 11 weeks since the operation. Things are definitely getting easier all the time — I have had a couple of set backs which I’ll go into in my next blog, but in the great scheme of things, am making really good progress and am still very much on track and determined to ride in the St Michael’s Hospice charity race at Hereford on 26 March and the Mitsubishi Motors Badminton Horse Trials in May.

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In the meantime, I am still quite protective of my boobs and legs — despite heaps of painkillers, everything is still very sore and I do feel every manhole cover and vibration on the road while driving… so while most people will be focusing on the intricacies of pre-season training at the moment, having now entered Miley for Tweseldown on 7 March, my biggest challenge will be attempting sitting trot with minimal jiggling and wearing maximum sports bras/compression cycling shorts!

Despite my efforts to keep this condensed, I’m aware I’ve rambled on a bit but there is just one last thing that I’d like to add. I’ve taken enormous strength from chatting to a couple of people who had been through similar experiences and so if in any small way I am able to repay this by helping anyone going through similar experiences, I’ll do the best I can to do so.

Nana

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