When she put this to Reza – “could we rob Peter to pay Paul?” – she “could literally see the cogs whirring” in his head.
He recalled being speechless at the idea.
“I had never seen or heard of such a procedure being talked about or published.
“I wasn’t even sure at that stage whether I would be adding to Nicola’s care or taking away from it.”
Reza said it was very unusual to have a patient come up with such a radical idea.
“Kudos to Nicola because she’s amazing.
“I had extensive discussions with colleagues all over the UK who are all experts in flap reconstruction from the abdomen. The conclusion was maybe it is possible and just go ahead with it.
“This is not run of the mill mastectomy we’re talking about,” he said.
“We’re removing the whole of the footprint of the breast [on the right]. It is a very, very large area of skin and to be able to close it you have to borrow from somewhere, some skin and tissue, that can withstand future radiotherapy.
“Left is a side that’s easy to reconstruct in future, because it’s not subject to radiotherapy and all other treatments, and the cancer itself.”
SBUHBWhen Nicola went into the surgery, she knew she could wake up to very different outcomes – a successful left to right transplant, or an LD flap reconstruction on her right side after all if he decided the transfer would not work, with the left breast removed anyway at her request.
She gave Reza her blessing for any outcome. And her outrageous gamble paid off.
“What makes it a world first is that the tissue has been ported to two different sites,” she said.
“We didn’t know if that would be possible or probable, the microsurgery of actually sewing the vessels together – if it would work or if it would be so scarred that it would be completely impossible.”
She is starting a few weeks of radiotherapy, and around Christmas time will have reconstructive surgery on the left side using a saline implant.
She will be on hormone therapy for the next 10 years to manage the risks of recurrence but has been given the all-clear in terms of this treatment cycle.
For someone who has been through such gruelling experiences, she is remarkably upbeat. How does she stay positive?
“If I am having those moments when I feel ‘oh my god this is awful, why has this happened to us?’
“I let myself think about it for a minute and then move on to the next thing. If you don’t allow yourself to think about it, it won’t get you down.
“I have to sit back and think ‘this is life. Worse things can happen’. I’m lucky that I’ve had incredible treatment from the word go, and an amazing team who I trust.”
She added: “Both the kids were just the best distraction ever. It’s hope isn’t it? When you see little children. You think there’s hope for the future.”