BreastCheck – an appointment – a diagnosis early cancer August 2017


‘He who has the why to live can bear almost any how’

Traumatic brain injury 1993.

Medical history in detail and to date by Michelle Clarke can be found on old – title is the above quotation.  Link below.

Why such detail about my own personal health?

Traumatic brain injury “TBI” is an unknown. It is about the Brain. Today January 15th 2017 my fear of dementia advancing to Alzheimers is outlined and thanks to the aspect of the internet that is about information and value content, I make this available to readers who may be interested.  We know about what the computer can account for and data analysis but this is a little bit like a patient’s attempt to keep a log of what it is that they encounter as distinct to what is gathered on the HSE/private healthcare sources computer records especially when you have lived in the UK and in Zimbabwe, Africa.

July 2017 update:  Alzheimers/dementia is displaced as my most dreaded fear.  Cancer is the next phase on the ever ending cycle of health related conditions over a period of 20 years.  Today August 1st 3.45 pm, Michelle my case worker from BreastCheck has just phoned with the results of the Cat Scan…the cancer has not spread. The operation will go ahead August 17th.

The BreastCheck mammogram letter has resulted in a cancer diagnosis and an operation in August 2017.  Today I met with the Anaesthetist to review medications and plan for the anaesthetic (as I take a “cocktail” of medications related to bipolar/anxiety) this needs attention of medical people concerned with the operation.  I cannot begin to say how lucky I am because it is so easy to ignore these appointments for screening and in my case to forget about them.  This is a letter I wrote to several people the day I met with the Surgeon to be told about the cancer.

Michelle Clarke – a call back within days to BreastCheck St Vincent’s University Hospital Dublin 4 yesterday.

All I can say is if only the rest of the HSE could adopt the model of medicine, care, hospitality, kindness of your BreastCheck service at St Vincent’s University Hospital, many lives would be saved and there would be far better patient outcomes.  Another programme worth mentioning is Tilda  – the research arm is based at Trinity College Dublin which provides a dedicated location base(s) similar to BreastCheck and it too works with great interaction, efficiency and most importantly makes older people realise that all does not rest with the professionals, the person has to engage with the professionals and take some responsibility in relation to their health outcomes and if this happens, healthcare has a future in this country.

My partner KT met Mr Crown (Oncologist) at the supermarket the other day. He spoke of BreastCheck being a very successful programme with many lives saved. I met Mr Gerraghty yesterday having interacted with many staff from radiology to ultrasound to those who bravely gave me the needle biopsy. At every stage there was someone to explain and because of TBI and memory issues I was treated with exceptional diligence. I was even offered a second cup of coffee. Notes and leaflets were given to me.

Only one or maybe two suggestions: I note you are on Facebook. Twitter is also an excellent means of communication. Secondly: when we left the clinic there was man with a loudspeaker on the other side of the road. We decided to talk to the quite elderly man,  for his endeavours, but dedicated to making his point. BreastCheck works so very well because when you get the letter about your appointment, you don’t have to reply, you have to just attend.   But for this man the system proved ineffective.  He never realised that his wife had received 5 letters and most likely fear meant she did not attend the clinic on any of the occasions. She got a pain in her back but it was too late – secondaries had set in and she died.  All John is  trying to say to the Clinic please find a way of encouraging women to attend, and if someone does not turn up for say two appointments, make contact in someway with a family member or the GP.

Again I say thank you to those who work so diligently and compassionately at BreastCheck.

Being aware and diligent about your health, two other programmes deserve attention here: Tilda – because it is making massive inroads into making people aware and not afraid about their health; Trinity Neuroscience also and the person is Sabina Brennan. Dementia is reaching crisis levels as we age now and live longer. Memory deficits mean a very rigid routine; this makes it most probable that health checks are the bottom of the list and so often forgotten about.

Again thank you so much for returning faith in certain departments of the health service that others could most definitely learn from. Silos cause harm and great inefficiencies.

Michelle Clarke

Source: Nietzche ‘He who has the why to live can bear almost any how’ Traumatic brain injury 1993. Medical history in detail and to date by Michelle Clarke

The quotation which for me is particularly significant and when you read through the above link, you will know that my life is around a daily routine, no holidays, nothing that leads to un-necessary confusion; it is called Groundhog Day but it works for me and this resulted from traumatic brain  injury.  The quotation is from Lewis Carroll (writer but mathematician) ‘It is a poor kind of memory that only works backwards’; add in my case, or planning going forward.  I live each day and in the day using my writing abilities to record my life lived in the day with that of my pre-accident memory and in particular my childhood.  It is my intention to create a timeline and I have already bought at Tesco my pink file to keep all documents and to make my journey through this cancer caught in time but in need of extraction in the hope that someone else will be helped by reading my personal journey.

Time Line:  May, June, July, August…..2017

No symptoms.  Fatigue yes but many years suffering from chronic fatigue, meant nothing serious about fatigue.

26th May 2017

A letter, via An Post, arrived from BreastCheck (The National Breast Screening Programme) with the Heading “The date for your free breast x-ray” is 29th June 2017 at 2 pm in the Merrion Screening Unity located at: BreastCheck, beside St. Vincent’s Hospital, Merrion Road, Dublin 4.  KT who puts the order in my life ensured that I entered the details in my diary; and he placed the details in his diary so that I would attend.  The letter is comprehensive.  The onus is on you to attend on the date at the time stated.  You do not have to confirm.  (This in my case works well as the less complicated events are the better I understand what to do).  The letter was signed by the Clinical Director, Professor Ann O’Doherty and covers the relevant details such as if you use a wheelchair or have breast implants; or have had a breast x-ray in the last year; if there is a wrong address and some other details.

The final paragraph deals with the Why?

“Breast cancer is one of the most common causes of death from cancer among women in Ireland.  Although there are a small number of  cancers not detected by mammography, by going to regular screening, if there are changes they will be found as early as possible.  Services like BreastCheck have significantly reduced the number of deaths from breast cancer in other countries.  Please read the enclosed leaflet to find out what happens at the appointment.  I strongly encourage you to take this opportunity to look after your health.

The National Screening Service is free.  What is free we so often place no value on it.  I recall when I first moved to live in Zimbabwe being so shocked by the poverty of the local people I tended to give away clothes.  I listened to the ‘Monologue’ ie those who lived there for many years and it was simple.  Take some money otherwise the gift has no worth or value.

The following are available:  I am sure many know little about it but it is a good idea to be aware.  BreastCheck, CervicalCheck, BowelScreen, Diabetic RetinaScreen.

I must be honest – I have continually avoided the CervicalChecks. It is true fear in my case.  Now I must admit this is acting recklessly.

6th July 2017 (Strictly Private and Confidential: To be Opened by Addressee Only).  For reasons explained previously, KT opens my post and organises my day.  The letter asked if I needed an interpreter for this visit but in my case KT attended with me.  The appointment was for 12th July 2017 at 8.15 am.  This letter gave more details about staff who could be contacted and their telephone numbers.  This letter includes point by point details of what the Recall Assessment is about.   It also included the BreastCheck Information leaflet about ‘Core Biopsy and Fine Needle Aspiration’.  It stated the telephone and fax number for the Radiology Department at St Vincent’s University Hospital.

12th July 2017

2 waiting rooms; those on the outside and those within.  20 ple recalled all dressed in gowns and not a word spoken.

X-rays taken by two very pleasant radiographers.  Being deaf in one ear and getting confused with instructions, they understood.

The Ultrasound.  Dr Pender consulted with another Doctor to confirm that there was a small abnormality.  They then proceeded with the needle, the biopsy.  They had a most compassionate approach.

Then KT was called into a meeting room.  We were given coffee and a booklet was given to me with areas highlighted that related to me specifically.  My case worker is Michelle G.  She organised for me to meet with Mr Gerraghty the Surgeon.  Before leaving I was given several tasks to complete; some on the day.  Bloods were taken at SVUH and I had a heart check also there.  At the main hospital on the ground floor the Irish Cancer Society have an office.  Shocked I spoke to a very nice woman who assured me that supports systems were in place and BreastCheck had an excellent track record.  There are lots of brochures but it is a relief to know that there is a free 1800 200 700 to the Centre Nurseline.

18th July 2017 10.30 am

Again KT was there to support me.  I met with the Anaesthetist. We discussed medications I was taking and it was agreed she would liaise with my psychiatrist Dr John Cooney.  Mr Gerraghty (Surgeon) had already written to him about my case going forward.  It was decided I would make an appointment to see Dr Cooney and KT organised this for 31st July 2017 at 3.30 pm.  Boots Pharmacy  provide a Blister pack with my medications which details the generic drugs I take for depression and anxiety.  I gave this to the psychiatrist and another one to Michelle the case worker.  The next part of the process – Computer Tomography Patient Information leaflet.

24th July 2017 letter from St Vincent’s University Hospital.  The appointment for the CT Chest/Abdo/Pelvis appointment on Friday 28th July 2017 at 11.45 am.  The letter explained that cases from Intensive Care Unit or from other hospitals must be accommodated and these may cause long delays.  It also provided details for women in the reproductive age.  I was to take the letter with me to the appointment.

Friday 28th July 2017:   A number of people were in the waiting room; some from other hospitals and there was one/two from ICU.  I was given an orange flavoured drink to take at intervals over 1 hour.  Then I was brought into radiology and the scan began.  We arrived at 11.30 am and we were out of the hospital by 1 pm.  Staff were friendly and service most efficient.

Monday 31st July 2017

Appointment with Dr John Cooney re medications.  Paramount for me is that my mood remains stable and no onset of depression or elation.  Dr Cooney understands my approach of 1 2 3 4 5.  Tasks in sequence so I remember what to do; and taking each day in segments, neither looking forward or looking back.  The irony is with a cancer diagnosis, this is what the medical team would want to foster in people to stop them fretting and worrying.  My cholesterol is high at 8 and statins may have to be added to the prescription.  This could be caused by the Olansapine.  Also it is necessary to avoid if possible diuretics and anti inflammatory drugs.  Next appointment is 4 months time.

2nd August 2017

Michelle phoned.  Nothing appeared on the scan.  Next is operation on 17th August 2017.  KT took the call.  Time to tell family and friends that the cancer is contained.

Michelle (case worker) phoned KT.  KT confirmed that Dr Cooney will be responding to Mr Gerraghty’s email.  Fortunately, my Mother confirmed that she still had her eldest and only daughter (approaching her 60’s covered by VHI ie Voluntary Health Insurance so this gives me an advantage that some 50% of the people in Ireland do not have and that is private health care.

8th August 2017

Letter from Clinical Nurse Specialists in Breast Care re: admission to Hospital on August 17th 2017 in St. Vincent’s Private Hospital, Dublin 4.  Surgery to take place later that day……


Important to note:

  • Please come to the Merrion Screening Unit (BreastCheck) at 8.00 am on the morning of your surgery.
  • Please contact the hospital the day prior to your admission between 9.30 am and 10.30 am to confirm bed availability: the contact number is 01 2638000
  • Surgery may be cancelled if you come in sick with e.g. sore throat, chest infection, therefore if you are feeling unwell please contact the Merrion Screening Unit or the Hospital.

Then it deals with exactly what has to be done for Pre-Operative guidelines starting with: You can have tea and toast at 6am but please fast after this……….

If you are taking medication (which I am), please bring this with you.  I take a mix of medications and it is at times like this I really appreciate Seana and the staff at Boots in Upper Baggot Street and the weekly “Blister Pack”.

13th August 2017

Support from people is overwhelming.  Stories, narratives, are so much appreciated; I have just continued as normal, which if you read my site ‘Neitzche….’ will show that each day is a routine – no holidays, just the same every day.  Get up, a few chores, computer, email and Twitter (quotations prompted by the day’s articles are read and then I re-tweet them as I think appropriate.  @canisgallicus.




August 2017 onwards

Sub-Section: Scrolling daily the computer, I am now adding Cancer as it specifically relates to my case, and aim to include the links I feel are relevant to this site.

Recommendations:  To anyone interested in Cancer and its diagnosis and patient acting as their own advocate to help others.


The Medical profession and people warn don’t Dr Google it but I cannot do this.  I am going to take advantage of my inability to form memories as a result of traumatic brain injury and as I did in 1993 I kept using the computer and moved along gently from writing letters via email, to Google to find out as much as I could about TBI and memory problems, to  You-Tube, to Twitter (which is the way I endorse my deepset belief system by reading quotations and tweeting them; while at the same time using the Twitter to augment my memory and hence make it possible for my engagement at a social level.  So now I am taking the same approach towards the diagnosis of Cancer.  I will outline articles, the content of which I will forget and likewise documentaries, interviews which I will immediately forget but the system and this site will outline what I have engaged with and what impressed me, in a period of being most vulnerable but due to memory deficits not to the same level as others so diagnosed or for my partner KT, family members and friends.

Michelle Clarke to be continued.  Very tired now but not to the same degree as Chronic Fatigue which impacted on at least 6 years of my life, post TBI and Bipolar.

I watch TED Talks.  Short Sharp Incisive information.  I have never noticed a talk on cancer but  I recommend the following:-


Jimmy Lin: A simple new blood test that can catch cancer early | TED  – July 2017…/jimmy_lin_a_simple_new_blood_test_that_…


I watch Charlie Rose, Bloomberg TV).  I first started watching Charlie Rose (Eric Kandel, Nobel Laureate) in connection with the Brain series and interviews I could connect with.   I now follow on to Charlie Rose and Cancer.

Siddhartha Mukherjee

Monday 04/03/2017

A look at the future of automated medicine with Columbia assistant professor Siddhartha Mukherjee, the author of a new piece in The New Yorker,

“The Algorithm Will See You Now.”

Personal comment:

This doctor speaks about ‘regulations and patterns’.  It is easy to learn off a list of regulations but my experience of 2 GP’s who made a most accurate diagnosis, (Dr Alice Murnane re TBI contrecoup; and Dr Martin Callinan re lithium poisoning) come to mind as I listen to this doctor talking about AI.  It is beyond the list and into the sphere of good observation, experience and yes regulations but more so it is patterns and confidence to say enough and refer to a consultant.  A general practitioner with a keen eye for diagnosis in the medicine of the 1970’s, 1980’s would often gain the keen attention of the Consultants to whom the patient was referred. 



About Otis Brawley

Otis Webb Brawley, M.D., is the chief medical officer of the American Cancer Society, responsible for promoting cancer prevention, early detection, and high-quality treatment through cancer research and education.

War on cancer, year 40: who’s winning?


The Times of Israel

Simple drug regimen could help prevent cancer recurrence, Israeli …

5 days ago – Israeli researchers said they may have found a way to reduce the risk of post-surgical cancer recurrence through the use of a drug regimen that …






Recommendations:  To anyone interested in Cancer and its diagnosis and patient acting as their own advocate to help others.






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