A friend just Twittered me to ask if my Doctor's appointment yesterday resulted in plans to "take stuff out, put stuff in, or move stuff around."
Pretty accurate actually, on all three counts. My one year "cancerversary" came and went uneventfully enough. But recent events have had me thinking that it might be time to revisit the idea of breast reconstruction.
For those not in the know, I had my left breast removed last year in August when biopsy results were unclear about what kind of cancer I had or how far it had spread. It was very difficult and messy to decide between having an amputation vs having a lumpectomy. The lumpectomy would have required follow-up radiation for 8-weeks, but the mastectomy did not require any further treatment, assuming the cancer was contained in the breast (it turned out that it was).
I remember vividly in 1984 when my Mom was being treated with radiation for her cancer. It caused her misery beyond description. Think about having a very painful burn, and then being burned again and again on top of that burn. That was no good and definitely not for me. So, I chose amputation instead. I wasn't at peace with the decision and was questioning myself even as I was being rolled into the operating room.
One year later, I am okay with the decision (what's the alternative, to not be okay with it?) However, now a messy new decision has arisen. Breast reconstruction. My less astute friends ask, "What's to decide? Get a new rack!" Oh how I wish it were that easy.
Not being a plasticky surgery kind of a gal who is not really okay with putting foreign substances into my body, this was a hard one. I learned in this year that there were "flap" procedures where you could have your own body tissue moved and molded into a new breast. I even heard that would result in a tummy tuck as well. Welllll okay, that was interesting and required taking in no foreign objects, so I looked into. Tummy tuck was definitely an inducement.
Several hundred Internet viewings later, I decided not to go that way. I didn't like the resulting look and I didn't want to sacrifice any other perfectly good body part for the cause. (I learned that the "tummy tuck" wasn't truly that, and that abdominal muscles would be removed and relocated. Definitely not for me.)
So, armed with this info and a million questions, we (the cancer army of angels who stick by my side) went to see Dr. Kristina Cheng, a highly recommend plastic surgeon and breast reconstruction specialist in Salt Lake City yesterday.
Of course, I was terrified to go. And for no good reason, by the way. Just cancer saying, "Ha ha! I got you BEFORE when you weren't expecting me and I'll get you AGAIN! ::: Evil Cackle ::::" For my uncancered readers, that is how cancer keeps a hold of you forever, even if it isn't in your body any more.
So with more than a little fear in tow, I showed at my appointed time with Dr. Cheng. I liked her right away. She listened, which is key. In fact, I was there for over two hours exchanging information with her about my health, my desires, and her recommendations. Turns out, I am getting what I knew would be right for me all along. After the struggle I had last summer, that was totally awesome.
For the squeamish, this is where you end. Trust me.
If you feel that you must go on from here, I'll show you in picture form what I have chosen to have done and what will happen next to me.
I'll be receiving a silicone implant placed into the left side, underneath the muscle. This is not enough to hold the implant in (because I have no breast tissue there, only skin) so my surgeon will be laying in a cellular mesh that will hold the implant firmly in place. This tissue is made from human protein material, and the plan is that my body will accept it as its own (hopefully).
On the other side, I will get a smaller saline implant into my good breast. This is simply to match what is going to happen on the left side. Since we don't really know what it all will look like, Dr. Cheng says I will be in surgery several hours while she fixes, prods and pokes to make them as symmetrical as possible. That is the last surgery (hopefully) and will take place in February 2010.
The first surgery will be in October when an expander will be surgically placed underneath my left side skin. Then at one week intervals, the Dr. will increase the amount of fluid in the expander by 50 cc's or so. She will do this by shoving a needle through my skin and into the expander itself. Sounds fun, huh? She promises it doesn't hurt too much.
The skin stretches and grows accordingly until there is room for the implant. That will take from October to February, although between you and me, I will make that a lot shorter because I have races I want to run next spring.
I did a lot of research on this topic because many women chose not to do any reconstruction, but instead to remain with one breast and a prosthetic, which is what I use now. Actually, that works out surprisingly well as long as I am on constant "bra patrol" making sure the thing doesn't move everywhere. It's been okay, but working out is harder, swimming is simply not an option, I had to sacrifice many of my shirts and tops, and many activities in my previous life are not a option when you are "one breasted."
So, I am doing what I never thought I would do ... buying a new rack. It certainly seems painful, and after looking at endless pictures, I now know that the result is generally not symmetrical, or even pretty. But like my dear friend Jill once said, "Do it and at least you'll look fantastic in a sweater." That is actually what swayed me. True story.
So now everybody asks, "What size are you going to be?" Tempting question for this lifelong double A-er. Probably a really chubby B. Not any bigger because just today I saw a woman jogging while trying desperately to keep her chubby C's from bouncing all over. Meh, don't want that. So chubby B's it is. I suspect any bigger would interfere with my golf swing anyway.
The Doctor, tactfully alluding to my ... ahem ... age, said "We will try to get some of the droop of your other breast into the new one." To which I said, "Droop is not in the picture, sister. Make 'em nice!" To which she said, "Will do." Hey if I'm going to pay for it and go through the pain, I'd better get something to show for it, right? (And by the way, a Federal Law requires that breast reconstruction be covered by insurance after mastectomy due to cancer. SWEET.)
I'm posting some links now, and I am telling you, they are hard to look at. None of these pictures is me, but I literally do look just like the before pictures. We all do. It is interesting and something that nearly all of you will likely come across eventually in your wives, sisters, mothers, friends and lovers. Might as well get your first look now.
It's simultaneously very difficult for me to put such personal information forward to strangers and at the same time kind of freeing. This is *MY* reality. Know I am SO grateful to be alive and living this reality. Thank you for living it with me.
This blog post is dedicated to Lori Stauffer Wood and her Mom, Pat Stauffer, who died from cancer this past weekend.
Love life like there's no tomorrow people, have no more resistance to what is good, get your mammos, and I love you from the bottom of my heart - Jen
1. Mastectomy before and after pictures. WARNING! Clicking this will bring up breasts! LOL
2. A great "picture documentary" of what I'm going to be doing, as demonstrated over several months time by a brave young lady who had a double mastectomy 2 months after getting engaged. She wanted to be "whole" again for her wedding. Her story is so inspiring.
3. Most Doctors Do Not Talk About Mastectomy Options (Mine didn't, I had to Google everything. The state of women's health care in Utah is atrocious. But that is another post.)
4. The bottom picture is of a friend from my favorite forum, Crazy Sexy Life. She had a double mastectomy and chose not to reconstruct. She is a hero of mine. Bless you Deb for the open and honest picture. I am busy spreading the word ... AN EARLY DETECTION MAMMO SAVED MY LIFE. Hear it. Do it.
UPDATE: After all of that talk and then more research, I didn't do the reconstruction and have no immediate plans in the future to do so.