Archives for category: Prophylactic mastectomy

I’m feeling a little less like all of my internal organs were removed, put in a cocktail shaker, vigorously tumbled, and put back into me without my knowledge. The first 48 hours were pretty brutal. I had to stay in bed, with only positional adjustments, up through today. That felt a lot like getting beaten with a baseball bat and told to lie down so the pain could really set in.

My JP Drains are as awful as I’ve read they were. I rolled over on them yesterday and my physical therapist almost completely yanked my two left drains out of me when trying to toss my menagerie of blankets off of me. She failed to appreciate that those “pesky blankets” were actually my drains she kept pulling on and trying to throw over the opposite the edge of the bed. It was horrific and both times I had a ton of pain both radiating from and almost down into my incisions.  I have a pain medication push button that I hit every time I see a doctor, nurse, janitor, or anyone (really) head my way.  If they’re not here to poke or prod me, they’re here to empty my drains, which is uncomfortable or worse when someone careless is doing it.  I also have to have blood drawn for labs every day – at least it seems like every day.  A phlebotomist is not called in to do this every time; I wish they were.  Some of these nurses couldn’t find a vein if I were split open on an operating table.

I’ve been felt up a out 200 different times by 200 different surgeons, residents, attendings, and my ICU nurse. They come into my room about every 2 hours to do checks on my flaps.  I have doppler wires inserted into the bottom of each flap, and they come in, turn on the audio speaker and press against my flaps so they can hear the “whoosh whoosh whoosh” of blood flowing into and out of them.  This is to ensure that the transplanted blood vessels and tissue are still up and running smoothly.  I’m told my mini muffins (because they were born from the muffin top) are looking good and healing fantastically. But they feel like hell.

It is hard to sit or lie down with my arms to the side, it hurts to take deep breaths but I have to so that my lungs clear, and I also cannot use my arms for much of anything. This is life for the next 4 weeks and no me gusta.  The ICU nurses are kind enough to come in every now and again and try to adjust my pillows to help me.  The time spent adjusting hurts; the ability to rest in a different position is nice.

They’ve been trying to get me out of ICU and into a regular patient room since last night. I’ve already had one roommate nearly die since I’ve been in the ICU, which was sad and scary but also very intriguing to see the entire ICU staff working on that lady. My roommate now has been sedated almost the entire time because she is physically combative whenever they take her out of twilight. Word on the ward is that she has been waiting for a liver transplant for several years, has hepatitis c and was still drinking until she was admitted the other day. Some sad things going on around here. But I lived through my surgery and get to have pain medication pretty soon here. I’m not stoked that they’re already talking about taking me off of dilaudid and giving me just Tylenol. I feel like that warrants me peeing on this floor a few times until they get the hint (I’d yell but my voice is still hoarse from intubation). In the interim I’m just taking pain induced naps, watching videos of our girls, and trying to stream Netflix in this shitty wi-fi.

Beware. Scary pics attached.
May I introduce to you the newest members of the GM cereal line: BooBerry, Count Chocula, and Frankenboobies.

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Awake. Lots of pain. No voice. Thanks for all the sweetness.

Tonight’s the night babies! Look at me getting ready to be filleted tomorrow morning! I’ve been meaning to sit down and write, at great length, about what a complete shit show I’ve been the past two days. But I’ve been busy being a shit show. Monday was the last day of my “regular” eating because today I needed to eat only light foods that are easily digestible so I don’t have to have a super sexy enema first thing tomorrow. HOT! So on Monday I really got wild and had the mini tacos from Rancho Bravo on Capital Hill. Today I’ve had bran muffins, bran cereal, fruit salad, a baked chicken breast and some couscous. I feel like a geriatric on death row. I also had a chance this morning to work off some of this anxious energy this morning with Paul, my trainer. He took it easy on me, but it was good to work some of this crazy out before I continued on with my day. I spent the rest of the day trying, mostly, to feel really prepared to leave our girls for 5 days and have someone else care for them. Sad. We hung out at home, my friend Haydn braided my hair for me so it’s out of my face for surgery, and then I spent as much time with our girls as I could before their bedtime. I tried not to be too anxious or weepy around them because they already know something else has turned me into a crazy ass this week. And that’s not what I want. I want them to be happy, carry on with their days, and miss me a little bit…but not miss me like I’m going to miss them.

I check in at the UWMC Surgery Pavilion tomorrow morning at 5:30 a.m. Before that time, I need to finish packing my surgery stay bag, find something to put on my Kindle, figure out a way to smuggle my phone and charger in with me, as well as lozenges (for the sore throat post intubation), a toothbrush, a red velvet cupcake from Trophy, and some lip balm! Apparently I can’t take any of these things with me because they’ll “get lost” while I’m in ICU for the first 48 hours. I take this to really mean, “Someone here is a kleptomaniac and will steal your breath from your sweet lips while you sleep if they can. We don’t care to find out who that someone is. Also, no pictures.” I can’t remember the last time I’ve gone more than an hour without my lip balm. Do you think I can pay someone to apply it for me whilst I’m under? I’m less than 8 hours away from my check in time and I’ve obsessed over the many other things in my life so much that I’ve now narrowed it down to worrying about lip balm and smuggling electronics. Let this be a good thing.

I feel like I’ve dedicated enough time to mourn the boobs, worry about this being my first surgery, and worry about my family’s well being while I’m in the hospital. Will I feel like this in the morning? I don’t know, but it’s where I am right now and I’m just trying to go with it.

Please ask the universe not to let any freak accident, Grey’s Anatomy season finale type shit go down during my surgery. I am full of life and doing this to live a LONGER and HEALTHIER life. Smooth sailing only. Quick recovery included.

I won’t have my phone while I’m in the ICU, so I won’t be able to easily contact or communicate with anyone until I’m moved into the regular recovery unit. So, until that time, thank you so much to my friends, family, and everyone for your kind words of support and encouragement. Thank you to everyone who has brought us food, volunteered to help with our girls, offered to come over and take care of me, or anything else that I’m forgetting. Thank you to everyone who didn’t notice me giving you creepy “goodbye boob hugs” and squeezing a little too hard and too long. Or thank you for noticing and not caring, or being kind of into it and just letting it happen.

I wanted to say something meaningful here before this part of my life (natural boobs) was over and the next part of my life (no more than 7% risk of breast cancer!!!! + reconstructed boobs) begins. Hopefully I’ve achieved that much with my whopping 6 (or 7?) posts. If not, stay tuned. I’ll come up with something. And if you come see my husband and my girls while I’m still in the hospital, tell them “Shera/Mommy loves you!”

On Saturday night, we had a wonderful Boob Voyage party and said “sayonara” to my boobies with a gaggle of friends.  It was something that I had thought on and off about doing for a while.  When my anxiety about my surgeries continued to grow, I felt the more I talked about this whole thing, then the more I would talk the fear out of myself.  I didn’t want to pick up the blower and start dropping my Debbie Downer news on everyone one-by-one, so I decided to have a party and throw a little fun and “Fuck it” at the whole situation.  And it has worked.

There was such a great mix of people from my life with us Saturday night.  I won’t rattle off an entire list of attendees, but there is a handful worthy of specific mention, because everyone should know someone like them.

Of course my wonderful husband and wonderful daughters were here with me.  Mike is and was a wonderful host, husband and father.  He was gregarious, doting, and fuzzling with the best of ‘em despite a long hiatus from the sauce.  He really brought his “A” game, but that can be expected of him.  He’s very competitive.  The girls decided to wear their “beautiful gowns”, which are actually just new Spring skirts I bought them that morning, and had a great time with the flurry of activity and new friends to play with.

My friend, Bill, who I have known the longest, was here with his amazing wife, Kelly, and their two kids.  I met Bill when I was 19, still in college, and dating his then Navy shipmate.  The seaman and I eventually split up (but remain dear friends), and I got to keep Bill in the dating divorce.  He is a great guy.  (That is an understatement.)  And then came Kelly, who is just a New Jersey gem of woman (he’s from Pittsburgh), and she swept everyone who knows Bill off of our feet.  We have seen each other through some funny and unfortunate situations.  Bill and Kelly have known (by proxy) my beloved boobies through their prime, into the Great Deflation of 2010, and into the present farewell stage.  I look forward to them seeing me through the new set, and well into our deep set wrinkles.

I met Bensen a few years after meeting Bill.  We all worked together at an indoor sports facility in Redmond, but our friendship didn’t really come into bloom until maybe a year or so later.  Bensen is an amazing person and friend whom I am so lucky to know and have had in my life through so much change.  I look back at the people we were when we met and the people that we’ve become over the years, and I’m so proud of us for being so good to each other through it all.  Everybody should have a Bensen, but this one is mine.  Bensen’s ladylove is Cate (the great!).  Cate is a California Gurrrl transplant and, as of very recently, has become our part time nanny.  She is a phenom of a woman, friend, and soul.  Everyone who meets her likes her.  TRUE STORY.  I am glad that Cate and Bensen are an item, and lucky to have them both in my life.

Monell is part of our trifecta, f/k/a the Triple Threat, f/k/a The Breakfast Club.  I met Monell through Bensen, who were hockey buddies and friends.  Over the years our friendship has gone from casual, to buddy, to the next level.  When I was pregnant and into my post partum period, Monell was jokingly, on more than one occasion, referred to as my stunt-husband.  She is reliable.  She is and has been here for me.  She has an excellent ear, offers a terrifically supportive shoulder, and is also a surprisingly great keeper of secrets.  Not that I have any; it’s just the word on the street.  She has been called on to take me to one than more doctor visit, and one definitely scary trip to the emergency room.  She has been a great best friend to me.

Jenna used to be my #1 co-conspirator in my early 20’s.  We got into a lot of trouble together, but that is a great base for many long lasting friendships.  We don’t see each other very often, but when we do it is a sweet embrace that lasts a long while.  As my surgery date has loomed closer and closer, she has been a much more frequent flier on this roadside.  Some friends are just good like that.  They sense a heavy weight, and they come around to lend support as often as they can.

Muh’ bookclub Boos. Everyone should have a book club like I do.  These ladies have filled more households with amazing food, remarkable gossip, hilarity, and genuine warmth than you find on network television.  You generally cannot find this type of camaraderie amongst a group of women who have come together very perchance.  I was a late arriver to the book club but these women welcomed me with open arms, full plates and goblets, and friendship.  I am lucky that once a month I get to muck it up amongst this group of remarkables.  Thank you so much letting me be a part of this monthly communion and all of the belly goodness (food, drink, laughter) you bring me.

The Jacobsons are just good people.  We met Thomas in 2006 when my not-yet-then-but-now husband was looking for a contractor to remodel his (our) first home.  Thomas did a tremendous job in a really difficult situation, and he has been here ever since.  He has since built my husband’s office and, just recently, the house we are living in now.  Along with Thomas came his outstanding crew, both workers and family.  His wife, Holly, is a youthful yet old soul.  She is easy on the eyes, a whiz in the kitchen, and an absolute joy to be around.  She oozes love and nurturing.  Or at least I feel like she does.  Maybe she just really likes me and only me and not you.  She seems so worldly to me, and is, what I imagine to be, an A+++ mother and wife.  Thomas’s work crew is also tremendous and impressive.  The job foreman at our current house identifies as an existential humanist.  That is not something you’re used to hearing from a contractor.  It seems that everyone that has something to do with Thomas has picked up on his energy and his intent, and that is why they are all so great.  Thanks for sharing your greatness with us.

I didn’t specifically call out these people to make anyone else feel left out or like their friendship is held in any less esteem.  It’s just that these people have been extremely good to my family and me.  And while I can’t say thank you enough for the love, friendship, and support that they have provided (and continue to offer) to adequately reflect my appreciation, I can publish this post on the World Wide Web and make it searchable on the Internet for all to see.  And envy.

If any of you are feeling competitive for a position on my next friendship blog, I created a webpage that lists days, times, and things with which we’ll need help while I’m high as LiLo.  The URL is http://www.whatfriendsdo.com/SheraPRocks.  You will have to create a log in and password yourself.  Then contact me if you want to sign up (because you’ll need a password to sign up and verify you aren’t on the FBI’s Most Wanted list).  We may need more help than is listed from 3/26 through 4/6.  Cate is going to be out of town and our previous nanny said she would come back to help.  But that won’t be the case if she finds a new family to work with before that time comes.  We’ll keep you posted.  AND THANK YOU SO MUCH!!!

Like almost the entirety of this past month, last weekend was a little less crazy, still emotional, but with a side of acceptance and a heaping helping of gratitude.

On Friday I went to Nordstrom to get fitted for my post surgical camisole.  My breast oncologist (Dr. Javid) wrote me a prescription for this top, which is a combination compression top, mastectomy bra, drain holder, and camisole.  In case you were wondering, it is almost exactly 0% sexy.  I went to the lingerie section of Nordstrom and was taken back to their secret sad-story lair.  It actually was quite nice (and not really all that sad), private, full of breast cancer survivor magazines, all things pink, and very much related that very popular trademarked purpose, which I shall not mention because DON’T SUE ME.  I had a choice between a top that zipped down the front and one that I could step into and pull up to my body.  Since I’m having the DIEP reconstruction, the zippered cami was really the only viable option.  I understand the other top is a very good option for mastectomy patients, but I’ll have the large, hip-to-hip incision and drains which I don’t think I could manage pulling a compression garment over.  The private sales woman was very polite, helpful, and not too “Oh, I’m so sorry you’re here” faced.  She filled out all of the paperwork so that Nordstrom could bill my insurance directly, and she also let me know that my insurance would pay for three new bras after my surgery (and Nordstrom provides a free fitting).  I was really quite surprised and pleased that Nordstrom provides this service.  I didn’t know Nordstrom had a Prosthesis Program and was glad that such a service exists.

But, of course, the emotional kicked in when I was standing there waiting for the sales woman to come back with my paperwork and I thought not about myself, for once this week, but about my sister.  My sister, Alyssa, had the support and resources of her husband, her oncology center, and a plethora of physicians and nurses during her surgeries and treatment.  Alyssa is married to a pretty amazing man.  I know that he went with her to as many appointments as he could manage (with his work and their family to tend to).  A parade of family supporters (her mother-in-law, our mom, and our two older sisters) was able to go, to Idaho to help her and the kids, but I couldn’t go.  I couldn’t be there with her for any of her journey, to help her, hold her hand or empathize, like she is going to be able to for me.  At the time of her diagnosis and treatment, I was a brand new mom and, as much as I wanted to, I couldn’t pack the newborn twins in the car and head to Idaho to be with her. So, standing there in Nordstrom’s lingerie section, I thought about how isolating this feels and how I hoped that she never felt alone during her process.  Because, while there are hundreds of thousands of women who go through a version of this process every year, it can feel like you’re an island.  I hope my sister, or any other person going through something similar, never feels like that.  Alone.  Isolated.  Even I felt a little twinge of that standing in the middle of Nordstrom, looking at fancy underthings and butt floss that I couldn’t even begin to figure out how one would get on.

I also thought about how different it’s going to be when I come back here to buy new bras.  I often wonder if I’ll be self-conscious about my scars and how my reconstructed breasts will look in the women’s locker room.  I wonder if, when they’re older, my girls will ask to see my scars and reconstructed breasts and if I’ll be brave enough to show them.

And, here again, is when I think about my sister.  I think about how grateful I am that she was diagnosed at such an early, treatable stage of breast cancer.  About how painfully lost I would be if this disease took her life instead of her breasts.  I think about when I saw her after she was done with chemotherapy and recovered from her mastectomy and hysterectomy, she showed me her scars.  She was a little bit shy, a little slack in the shoulders, and maybe a little self-conscious.  She stood in my bedroom with her shirt off, changing her clothes, and said, “I look like a prisoner of war!”  I remember laughing at her joke and great sense of humor, but just wanting to sit there and cry for a minute.  I thought about telling her that she was still beautiful and amazing and more than her scars.  That day, I saw that she was there in front me, tactile, alive and well.  And I didn’t see her scars because I saw, instead, her life before me as well as her days full of vibrant, healthy life ahead of us, and it was one of the most amazingly beautiful sights I’ve ever seen.  I hope that I am able to see myself in this same light after all of this is said and done.

I am smart enough to recognize, and be eternally grateful, that I am lucky enough to be proactively removing my breasts.  I get a very rare chance to prevent breast cancer instead of treating breast cancer.  Too many women never have this opportunity.

And Tuesday.  And Wednesday.

Monday and Tuesday were two totally crazy, emotional roller coaster days.  On Monday, I went to Seattle Cancer Care Alliance to meet with my surgical oncologist, Dr. Sara Javid, to discuss her portion of my surgery – the bilateral mastectomy.  Dr. Javid has a great bedside manner.  She’s very petite (and pretty), and she comes across as a neatly packaged powerhouse of kindhearted genius.  This appointment consisted of reviewing my medical and family history with Dr. Javid’s surgical resident, her answering my litany of questions regarding the surgery, and a talk about the mastectomy itself.  I will not go into the list of questions I asked Dr. Javid (or the P.A. I saw at the UWMC); I will post them separately.  The things that I feel were most important to me were:  a) how they would screen my breast tissue once it was removed (and when we would get results), b) what would happen if there was early cancer found in the breast tissue, and c) what part of the mastectomy would cause me the most post operative pain.

Dr. Javid explained that once all of my breast tissue was removed, it would be sent offsite for pathology.  The pathologist would then take multiple slices of the breast tissue, view them under a microscope, and look for cancer cells.  I can expect my pathology results within 6 to 10 business days.  If there are any signs of early cancer, then Dr. Javid and I need to meet again to discuss and schedule axillary dissection and removal of my lymph nodes.  I wouldn’t be able to have the sentinel node biopsies, like women who have not yet undergone the mastectomy, because the dye that is used for that screening is rendered ineffective after mastectomy.  So my lymph nodes would have to be removed and screened in pathology.  Whatever the results yielded would dictate my treatment plan from that point forward.

Dr. Javid said she believed the most postoperative pain related to the mastectomy was the tissue removal from on top of the pectoral muscles.  Since her goal is to remove the breast tissue as completely as possible, and reduce my risk as much as possible, she will basically scrape breast tissue from my muscles.  Yummy, right?  Other than that, the majority of my pain will relate to the reconstruction (because my nerves in my breasts are being removed with the tissue).  The J.P. drains are a well-known foe to post surgical comfort.  I’m sure you could go through innumerable blogs similar to mine and find an ark full of complaints about the discomfort of the drains, the stitches that hold them in, and the seemingly never ending, immeasurable length of the drain tubes inside the body.  I think in my recovery posts I shall refer to them as “ye old dreaded drains” (or maybe just “dreaded drains” in the interest of brevity).

After that, Dr. Javid and I briefly reviewed the potential incisions for the skin sparing mastectomy, and she also double checked with me that I was positive that I do not want the nipple sparing mastectomy (and I still don’t!).

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I was truly disappointed to find out at my appointment that I wasn’t meeting with the surgeon performing my DIEP reconstruction (Dr. Louie), but was instead meeting with his P.A., Jennifer Flannery.  I don’t mean to come across as I need to see THE surgeon himself or no physician at all – it just would’ve been nice to be told in advance that I wasn’t seeing my surgeon.  Why?  I don’t know, exactly.  Maybe it’s because I’m looking for any and every familiarity and comfort in this situation; maybe because consistency is really convincing; or, maybe because I’m freaking the hell out that the countdown is on and this is a very big deal to me.

After the requisite introductions and preliminary questions, I had a brief physical and then started in with my questions about the DIEP flap reconstruction.  I was surprised that in this meeting was the first time I was told that if the blood vessels (the “deep inferior epigastric perforators”) were awkwardly situated or too difficult to retrieve without removing part of my abdominal muscle, then the surgeon would go ahead and remove a small portion of my muscle in order to retrieve the blood vessels.

This is why it is a good thing to be hyper vigilant and semi-neurotic (full blown neurosis gets your surgery cancelled) about researching your surgery.  In all of the other blog posts, videos, forum discussions I’ve come across during my personal research and preparation, I hadn’t read that this was a possibility.  So while the purpose of the DIEP flap reconstruction is to keep the abdominal muscles intact, it is still a possibility that a portion of the muscle has to be removed.  This, obviously, would impact recovery time and the integrity of the abdominal wall.  Bummers.  Something else that I was unaware of:  the surgeons will have to drill small holes in my ribs to connect the DIEP vessels to the blood vessels in my chest.  Jennifer told me that the holes were not of significant size to worry about the integrity of the ribs themselves, but this part of the procedure does cause an increase in post surgical pain in the chest.  According to Jennifer, the majority of my pain will come from the hip-to-hip incision made on my abdomen for the fatty tissue and DIEP flap.  There will also be discomfort when trying to stand straight up, which may take some time to do.  The other bummers:

  1. There is no quick road to recovery.  I’ll be down for at least 2 weeks, very likely 4 weeks, but should plan on 8 weeks of completely depending on other people for help “just in case”.
  2. I won’t be able to pick up anything weighing more than 5 lbs for at least 4 weeks.  My daughters each weigh at least 26lbs.  My cat weighs 8 lbs.  My hand, where my middle finger resides, thankfully weighs less than 5 lbs.
  3. I have to be medically cleared for any exercise other than walking.  Running, jumping, cycling, weight lifting, plyometrics, punching people in the face…all off the table for at least 3 months.

Also a surprise:  I didn’t know until poking around on the Internet today (the day after my meeting at the reconstructive surgeon’s office) that Jennifer Flannery handles the areolar tattooing after nipple reconstruction.  I assumed that Dr. Louie didn’t do it, but I didn’t know that Jennifer was the lady in charge of this part of the reconstruction.  Had I known, I would’ve hit her with all of my questions regarding that “little” procedure.  Like:

  1. How best to get a pigment match for my areolar tattoos?
  2. How is my pigment determined and matched for the areolas?
  3. How frequently will I need to have the tattoos touched up?
  4. Exactly what color(s) do you think make up a Buttery Nipple?
  5. Do you lean more towards the quarter or the silver dollar?
  6. Do you want to take pictures of my natural breasts and pigment for a match and comparison?
  7. Are you sure you don’t want to take reference pictures?
  8. How about if I take reference pictures and bring them to you?
  9. What amount is a good amount of reference pictures of my natural breasts?
  10. Are you sure?  Are you sureARE YOU SURE?!?

I would also like to note that I have made some really fantastic strides in my strength, health, and fitness these past six months with my trainer, PDiddy a/k/a Paulie Walnuts, a/k/a Pauly Shore, a/k/a DJ Pauly D.  (But he prefers to go by Paul Won.)  I told him when we started working out together about this surgery, and that I wanted to be as healthy as possible before I went into it.  He helped me achieve this and so much more.  I lost the last nagging 20+ lbs of my pregnancy weight.  I can finally do pull-ups.  I can jump atop plyo boxes without killing or severely injuring myself.  Today I broad jumped 7 feet for the first time ever in my life.  I achieved all of these things with his help.  And after my surgeries, I’ll pretty much be back at square one.

So, I left my appointments at the UW more than a little disappointed and very sad.

I love taking care of our family.  I get an all time high hugging our daughters, squeezing them, even carrying them around and wrangling their octopi limbs down during a temper tantrum.  Every single one of my days revolves around them and I absolutely love that about my life.  I love feeling and being physically strong and independent.  Hearing, yet again, that I need to plan on not being able to do these things and feel very differently for a couple of months is upsetting, to say the least.  So while I’m saying goodbye to my “natural breasts” and to my very high risk of cancer, I’m also saying goodbye to these parts of my everyday that I love so much.  Ergo, the sadness, the disappointment, the fear, the bummers.

I have a case of the bummers.

It’s been about a week since I’ve been able to gather my thoughts enough to compose a blog post.  Basically, my “free time” during the past seven-ish days have been this frothy mixture of crazy and pure lunacy:

  1. Read pre-surgery paperwork for the one-millionth + x time.
  2. Freak out about the lack of useful information on these worksheets.
  3. Continue freaking out, but switch subject matter to the closeness of my meetings with the surgical team to my actual surgery date (2 weeks’ time).
  4. Conclude paperwork related freak out by repeating, several times, “I can’t have coffee or chocolate for two weeks before or SIX WEEKS AFTER surgery!”
  5. Have minor aneurism; take 20 – 45 minute panic induced nap.
  6. ~ MOTHERHOOD INTERMISSION~
  7. Watch too many videos of mastectomy and DIEP reconstruction surgery online.
  8. Bore my husband talking about all of the universities that have videos of the surgery.
  9. Walk into the bathroom, take off my shirt, and look at my boobs for 5 to 30 minutes in various poses and postures.  Realize that I appreciated them more in our “heyday”.
  10. Return to bedroom and lay on the complete opposite side of the bed from my husband lest he get any ideas about touching these precious little time bombs.
  11. Roll around in bed for what feels like an eternity trying to decide if choosing to have reconstruction with implants will make me feel any less like Frankenstein’s Monster than having the DIEP reconstruction.
  12. Fall asleep and dream about all of these things in some foggy, subconscious context.

Despite this insane ritual I’ve developed as of late, every morning I wake up and know that DIEP reconstruction is the one for me.  It was an adventure in researching reconstruction photos, videos, and recovery timelines online.  I got more than an eyeful and I, somewhat, sanely reached this decision on my own.

Truth be told, I like the aesthetic of the reconstructed breast with an implant better than the DIEP reconstruction.  I like the aesthetic of the nipple-sparing mastectomy than the DIEP.  I also like the look of my natural breasts better than the DIEP.  But with each of these alternatives, there is increased risk.

With the implant reconstruction, there is increased risk because it is referred to as a “life long” surgery.  As anyone with implants will tell you, the implants can fail and have to be checked and/or replaced every 10 years (some with more or less frequency).  And still, even in this day of advancing technology and medicine, every time you replace an implant you are running the same risks of when you first receive the implants.  Being that I’m 31 now, that leaves a lot of potential replacement surgeries, risks, and the recovery times.  I am not interested in repeating that cycle of hardships several times over my lifetime.

I also have a very scary, not-so-little secret that I’m looking forward to being rid of, courtesy of this unfortunate situation.  Not just my risk for breast cancer, but what is commonly known on T H E G O O G L E as “twin skin” (Note, that is not my belly; if only!).  This may come as new to you, (because I’m sure I never mentioned it one or a billion times already) but I have the world’s most wonderfully amazing twin daughters.  They are the highlights of my life.  They are also the reason I have so much skin to spare for this surgery.

When I was trying to get pregnant, I looked like this.

On our way to the opera.

When I got pregnant, I looked like this.

Starting to show

When I was REALLY pregnant, I looked like this and everyone that saw me in public openly wept and pitied me.

While my pregnancy weight gain was not at all the norm (I gained just under 70 lbs during my pregnancy), I certainly didn’t just let everything go to hell and eat any and everything.  I couldn’t because my pregnancy was high risk, or else I would’ve probably tried.  I worked out three times a week with a trainer, and then when I couldn’t anymore I still swam.  But, alas, here I am now in the not so glorious “twin skin.”  But, I digress.

Out of all of this, I am glad to be a) reducing my risk of breast cancer, and b) ditching this scary ass “twin skin” belly of mine.  See.  There’s some light at the end of this bat shit crazy tunnel of mine.  Now, if you’ll please excuse me, I have to go put some lotion in a basket for a special house guest of mine.

 

Last night I dreamt that it was the day of my surgery.  I was already checked into the hospital and in my very glamorous hospital attire.   I was surrounded by family, a few friends, and a random selection of people that I recall flashing my pert, early-to-mid 20’s boobs in order to be cast on an MTV show.  (Not really, but kind of.  It could happen.)

In my dream, however, there next was a very devastating moment.  We were all embracing.  I was going through the assembly line of emotional supporters, taking in words of encouragement and well wishes.  Everyone in my family was telling me everything would be “ok”.   Mike was telling me that he loves me very much and that our girls were being very well taken care of and safe at home.  Then a guy that I had a somewhat deep, unrequited love with in my early 20’s told me (jokingly), “Don’t worry about losing your boobs.  They’re on their way out anyway.  It’s a good time to swap ‘em out.”

Now that I am awake, lucid, and recalling this dream, it is funny.  This is something that I am truly learning to love about myself.  That no matter how anxious, emotional, and neurotic I get, my sense of humor pops up.  I think it’s a fat-kid defense thing that has survived my many attempts at self inflicted, permanent brain damage.  I like that amidst being in the throes of this very strange, very emotional and scary dream last night, my subconscious lets a joke through.   And, also, that I tried to tell myself that I don’t need to totally mourn my boobs.  Because, honestly, the air went out of the tires once I started breastfeeding twins.

By having this prophylactic bilateral mastectomy, I am moving on to something better. But right now it doesn’t feel better.  It feels scary, intimidating, and like a breeding ground for a whole new level of self-image insecurity.  I am worried about the pain of both the mastectomy and reconstruction, as well as the effects (and side effects) of being on pain medication.  I am worried about the seconds, minutes, hours, days, weeks that I will not be able to hold on tight to my daughters, hug them, pick them up, or play with them.  I am sad about missing the leaps and strides that they are taking every single day in growth and development because I’ll have to rest my body,  “take it easy,” and not go with them on their regular, somewhat mundane, daily outings.

I hope that while I am stuck at the hospital recovering, missing my family, trying to not to freak out about being alone in a place that I dread, wishing pain and discomfort away, that my drug addled mind (please, please, please let it be drug addled!) let’s one of these quips slip out.  They say laughter is the best medicine.  I just hope it isn’t one of those crazy, riotous types of laughter.  Because I’ll have just had a good portion of my anterior plane sliced and diced…and the last thing I want to do is split a stitch up in this bitch.  Oooh, snap.

 

Like many stay-at-home moms, I have tried to figure out what I should be doing with all of this “leisure time” that I have during the middle of never, and blogging seemed like it might be an interesting adventure new to me and no one else on Earth.  I didn’t want to join the masses and start a blog that was simply a sounding board for all of my gripes, moans, Pinterests, and things I would say to myself anyway if I didn’t have a blog.  And, just as I needed an exposition for this blog, things happened in life and the answer to, “What should I bore people about?” revealed itself.

On February 18, 2010, my sister, Alyssa, was diagnosed with stage 1 breast cancer. As with everyone that loves, knows, or has known someone affected by cancer, this was devastating news.  At 30 years of age, Alyssa was (and is) unusually young to have breast cancer.  (I am beyond happy and thankful to report that she is very much alive and well, having finished her chemotherapy on June 7, 2010.)

Her team of physicians worked very well and very quickly with her because of both her age and the aggressive type of breast cancer she had.  Part of their initial work was advising that she have genetic testing done to see if she was a carrier of one of the “breast cancer gene mutations”, which she is.  Once Alyssa received her results as being positive for the BRCA1 gene mutation, her geneticist advised that our mother, me, and our other two sisters get tested.  As the odds have it, our mom and two of us girls have the BRCA 1 gene mutation, and two do not.

I decided this was the right time to start my blog for a couple of reasons:

  1. The anniversary of my sister’s diagnosis is coming up in the next few days; and,
  2. My prophylactic, bilateral mastectomy and DIEP flap reconstruction are a month away.

My initial purpose for creating this blog is to be a nuisance to others trying to hoard Google hits about breast cancer and images of boobies.  My second purpose is to allow other women who are considering either of these surgeries to preview the process from beginning to end.  I intend on blogging through as much of the process as I can, with the time immediately after surgery and initial recovery being the most questionable as to my ability to blog.  I hope to get my physicians’ permission to post photos and video about (and of) my surgery and recovery.

I will also post about how the surgeries and recovery impact my usually busy, everyday life.  As a stay at home mom to twin toddlers, there is going to be a lot of struggle to get back to 100%.  This is further complicated by the fact that Mike and I have no family in town, and we are going to have to rely heavily on a rotating schedule of caretakers for me and our girls.  How long and how hard these struggles will be are totally unknowable until I’m on the other side of it.  I hope that my blogging about these various experiences will help someone similarly situated, and maybe make some others throw up.