The Bionic Woman? Will We Build Her Better Than Before?

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.

Paix.

36-Year-Old Christina Applegate - Double Mastectomy

I thought that this article about Christina Applegate was interesting. (Article on MSNBC). After her diagnosis with Breast Cancer, she decided to have a double mastectomy after also learning that she tested positive for the BRCA1 gene. This meant that she had her healthy breast removed at the same time as her cancerous breast. In the article she jokes that after her reconstruction is finished she'll have the perkiest breasts around!

I really commend Christina for making that decision. I'm sure it was agonizing to make. I will also be tested for the BRCA1 gene and if that test is postive, it is likely that I too will have my good breast removed and then do reconstruction on both of them.

But unlike Christina, I wasn't ready to say goodbye to both of them. I am glad that I still have one. Maybe it is baby steps, but it was right for me.

My hat is off to her and others like us who are forced to make such difficult decisions, and then do it with grace, style, humor, and positive energy. We are pretty amazing women if I do say so myself.

I feel great today, how about you? Be sure and give yo momma a hug today, okay?

I see my Oncologist later this afternoon. I'll report in about what he says.

My love to all - Jen

www.jenniferbunker.com

Home From the Hospital and Doing Great

Thanks so much to everybody who called, emailed, and brought flowers and cute teddy bears. I don't know what I would have done without my sisterhood through this.

I am back, one boob short of when I left. My family jokes that maybe I lost a pound (due to my famously small breasts). Jeepers, everybody's a comedian!

Like all my hospital stays I had a great experience. What's not to like? Nice nurses bring you warm blankets and keep you from barfing after surgery. They are kind and sweet and even reminded Sara why she once wanted to be a nurse.

I have had literally NO PAIN at all. We don't know why, but I did not need my pain meds in the hospital nor have I needed to take any percoset at home. I am taking 2 Tylenol for swelling and that is it. Why a person would have an 8 inch gash/amputation and not feel pain is beyond me. I have loads of energy and I feel great. I even managed a shower this morning.

My boobless area is bandaged tight. I see the surgeon next Thursday to get that off. That will be a low moment, but was the right choice.

I woke up in the hospital and realized with a start .... I am free of cancer. I won, you dirty bastard! Even if I had to give you a boob to do it!

(Actually, that is hopeful thinking, because we really won't know if the cancer was invasive until the I get the pathology back sometime next week. If it was invasive, we are talking a whole other ballgame. But we'll talk it then, not now. Today, in my mind, I am free of cancer.)

So, here's the details of my surgery, if you are interested. If not, you are done here. :-)

What strong woman doesn't have strong women behind her? Liz and Sara postponed their lives to be with me through 18 doctor's office visits and one mastectomy. They prepared my home before I left, secured any doggies and kitties and made me one heck of a hospital basket of soft comforting goodies. Precious adorable Josh has been checking in when he can even through the excess of estrogen and emotion. He is to be commended for his continued love and support. Love you, son.

I headed off for surgery at 7:15 a.m. on Thursday. With entourage and many pillows in tow, I arrived resigned and ready to get on with it. They checked me in and gave me the world's worst hospital gown along with the poofy hat. I didn't don the hat out of defiance and they let me get away with it, for a while. The girls toddled along behind my bed as I was pushed around the hospital to my various stations. (Note: They push you through the halls where regular people are walking. I would have been mortified to see someone I know!)

My first stop was to have radio active dye injected into my breast. This is done to check the sentinel modes for any cancer. The dye is injected, then you must wait two hours before it makes its way to the nodes. You are totally radioactive and that time, which is worrisome. Once the dye "seeps" to the right place, the surgeon uses a Geiger counter while in surgery to test the nodes. Because this kind of cancer attracts the radiation molecules, if there is cancer in a node, the Geiger counter will find it and then the surgeon removes it. I probably didn't explain that right, but anyway, I waited my two hours with my faithful servants, and finally it was my time for surgery.

I liked my anesthesiologist who listened carefully to my heart issues and made the appropriate notes. A resident who told me he was just finishing up medical school then rolled me into the operating room. On the way, he told me I was going to get the best "margarita" ever and that it would make it so that I just didn't care any more. He was right, I saw the stark white of the operating room and everybody in masks, but I just didn't care. They asked me to move myself to the operating table, which I happily did. Then, the best part ever ... I just went black.

In previous operations I had to play the game ... "Now count backwards from 100 ... here we go ..." That's when you know you are going out and it causes such anxiety in those two seconds before you go. This time, the wonderful med student simply filled my IV with the juice and didn't say anything as he did it. Bless his heart for that.

The surgery took 2 hours and then (for reasons we don't know yet) I was in recovery for two hours longer than we expected. This caused the girls some anxiety as somebody had told them I would be in my room shortly, but I then didn't show up for several hours. However, I woke up feeling fine in the recovery room and and had no pain at all. They wheeled me to my room where my nannies were waiting for me.

I immediately had the best nurse in the world, a guy who asked me if I felt nauseous (I did) and did I need some meds (I did). He took care of my and though I was dozy I noted that he talked at length with my girls and answered their questions. He was kind and sweet and that means a lot.

The rest for me was a lot of napping. Josh visited later that day which is a big deal for him as he hates hospitals. I had low blood pressure issues, 88/50 through the night along with a high heartbeat. It was concerning but the nurses kept a good eye on it all while I dozed. I slept all night long and woke up already to go around 7 a.m. I never saw or talked to my surgeon even though I asked all day long to talk to him. That is how they roll in Utah, and it is kinda sad. But, he did what I hired him to do and I guess that is okay enough.

I have a drain which is such a drag and kinda gross. I will get that out on Thursday. I'm already anxious to go to the nice ladies at the one-boobie-bra store and see what they can fix me up with. I just feel ready to get back to my life.

I need strong prayers that my pathology shows the cancer was not invasive. Then, I need prayers that my insurance will not be any more mean to me than they already have been. Then, I need my clients to call me cause I am ready to get back to work.

Thanks AGAIN, there are no words to describe how much your support means to me and my kids.

Love (the one pound lighter) Jen

www.jenniferbunker.com

Canser is Messy

I've put off blogging for some time now while I pondered a big decision I had to make. When I started my blog, I wanted to be honest and open and it's been really beneficial for me, more so than I originally anticipated actually.

But for a while I just needed to hang back while searching for an answer that truthfully still hasn't come with any real clarity. Normally confident and decisive, I don't know what's been toughest to bear, the decision that I have to make or the indecisiveness that I still feel in making it.

It just goes to show that cancer is messy. There are no clear answers. In the end, I had to trust my gut and instincts in order to move ahead.

So today, after many agonizing days of thought, I decided to have a mastectomy instead of a lumpectomy.

I would equate the difficulty of coming to, and accepting, this decision along the lines of when you have a cherished pet who you decide to put to sleep. You know that you must do it, but there is no peace in the decision, and the days leading up to the final event are filled with what-ifs, a zillion mind changes and second guesses.

Ultimately, I had to choose from two horrible choices. One just happened to be a little less horrible than the other and that is why I chose it.

Cancer is messy. The decisions are agonizingly difficult. The friends are dear. The waiting is torture. But I choose to live and so I do what I do.

My surgery is Thursday the 7th. I am as uneasy and as unsure as I have ever been about anything. I'm not sure which is worse, surgery or the resulting aftermath. But like many people before me, I'll troop into the hospital and do what I have to do. And I know that I chose life.

Cancer is messy.

http://www.jenniferbunker.com/