Monday, March 31, 2008

just down ...

I am down now. Just down.

I had a major meltdown in the Gander Mountain Sports store

I went with John to the store and was looking at some of the exercise tops. Trying them on, I realized that, even with reconstruction surgery, I will never look normal, or be able to wear such things. The fake breast is higher, and with so much “cleavage” everything looks lopsided.

And I still hurt.

When I was diagnosed with 2 cancers in one breast, I wanted to have 2 lumpectomies with radiation, rather than a mastectomy. I got Dr. Rimmer to admit that my chances for recurring cancer would be the same with the lumpectomies (with radiation) as with the mastectomy, and that the ONLY reason for going with the mastectomy was cosmetic. He insisted that with 2 lumpectomies, I would end up with a deformed breast that I would never be happy with.

When I spoke with my cousin’s husband, who is an expert on breast disease, he said that 2 lumpectomies on one breast would be “out of protocol” and that I would have a hard time finding a surgeon who would do it.

Well, I have a deformed breast now. And 2 breasts that are very scarred.

I try to look at the bright side (I don’t have cancer), and I feel childish whining about the cosmetics, wishing I had my old breasts back. I will adapt, I guess.

But that’s the way I feel today. Disappointed.

Monday, March 24, 2008

privilege

I am one of the world’s “privileged”.

Because I have health insurance, and because I live in a country where medical care is readily available, I discovered my cancers early. No expense was spared to properly diagnose and treat me. I have had the best doctors and care that could be given to me, anywhere in the world.

This is not the situation for most of the peoples of the world. I did nothing to “deserve” this privilege, it was merely an accident of my birth.

Had I not had this “privilege”, my cancers would have spread and I would not live to see my 60th birthday.

This thought humbles me. Healthcare should be available to everyone in the world, not just me. Why should I live, while others must die?

Saturday, March 22, 2008

as soon as I can swim ...

As I heal - and the tightness, pain and swelling go down, and even though it all still feels and looks rather wierd to me - I have to admit that I am somewhat astonished (and pleased) with the reconstruction surgery.

My native breast is beautiful, the perfect shape. Like when I was 25 years old. The other breast (I still haven't decided what to call it - the "silicon" breast?, the "new" breast?, the "alien" breast) is trying hard to fall into place and be a companion.

I still worry, though, that the space between the 2 breasts is wide enough and stable, and not going to pop out. I guess that in time I will trust this new arrangement of things.

I developed a bladder infection last week and had to take another round of different antibiotics. Tonight is my last one, and I am almost feeling back to normal. As soon as I can swim ...

Tuesday, March 18, 2008

healing ... again

It is good for me to be told: no you cannot exercise, no you cannot swim, no you cannot work.

I am free to do nothing. To sit outside with Jubilee and watch the wind in the trees. To be empty, and quiet.

I am healing … again … I think both emotionally and physically … from the trauma of being diagnosed with breast cancer, having my breast removed, and then “reconstructed”. In time, I want to write a little more clearly and decisively about this experience, and in a way that will directly address the way the medical system and the culture responds to breast cancer, and the way that the patient gets sucked into that mindset.

Reconstructive surgery is touted as either “no big deal” or the greatest thing since sliced bread. It is neither. It is both painful and disfiguring, even if you have the best plastic surgeon (and I do).

I know that I will adapt to my new breast, but I also know that I will never be “normal-looking” again. I wonder if I could have had the guts to be a uni-breast, if it had been more encouraged, more accepted.

My cancers were very small (the invasive cancer was detectable only by MRI) and early stage. There must be a way to stop cancers at this stage without resorting to removing the entire breast. I have read somewhere about an infrared (I think) beam that could be directed at the tumor, and kill it from within. However, it needs further testing and research. I would have gladly volunteered to be part of that study.

And I will get photos up here of my new breasts – I’m just still feeling a bit too swollen, wounded and vulnerable. So I return to the backyard – to heal.

Saturday, March 15, 2008

body reverence

I have renewed reverence for my body now.

I can’t eat things that are not real. Like 7-11 food. I barely can eat meat, unless I am fairly sure it is “clean” (organic, no hormones, no pesticides). I look for the best vegetables and fruits. I can't even drink cheap wine.

I look at myself more gently, no longer criticizing, or trying to “correct” the flaws.

For the rest of my life I will have this “altered” chest. It is not beautiful like the perfect breasts of a young woman. But, for some reason, I feel a profound tenderness for it.

Friday, March 14, 2008

my new breasts

My, my. I had my first look at my new breasts this morning.

Hmmm.

I had to carefully remove all the gauze and stuff, and I was expecting everything to be bruised and stitched and swollen.

Instead I have these lovely 2 small breasts. Maybe a little battle scarred - but mine.

They are not quite balanced or even, but Dr. L says that it will be a few weeks until everything settles out.

I am impressed with my native breast. It looks like it did when I was 25 years old. Perfect. The other one is not as large as my native breast, and not exactly natural looking. The silicon is definitely much softer and more comfortable than the saline expander.

Even though I would never elect to have this surgery, I can see why people who have the money would do it. I think that Dr. David Lickstein must have some kind of special gift for creating beauty.

I'm still a little tired and I run a fever every afternooon and kind of ache. But I've taken a shower and am dressed. It does feel good to have this over with.

Thursday, March 13, 2008

breast reconstruction surgery

The morning before my surgery I weighed myself. 147 pounds. I figured I might lose a few pounds during this venture and I wanted to see how much. This morning I weighed 154 pounds. I only ate a half a cracker yesterday and gained 7 pounds. Go figure. It must be all those bags of water that they kept dripping into my veins.

Other than the nausea and headache that goes with anesthesia, things went well. Incision pain was bad yesterday, but that means that I still have nerves in my nipple (yeah!). And I only took 2 pain pills, then decided that the headache pain was worse than incision pain, and switched to just Tylenol. Now, less than 24 hours after surgery, I’m on nothing.

I’m still wrapped in a surgical bra, but they look about the right size. Actually the left breast (my native breast) looks a little larger, but Dr. L says that could be due to swelling. And they look even. I’ll get a better look tomorrow when I take this gauze bra off and take a shower. The right breast feels a lot better than when the expander was in – softer and somewhat lower.

Thank god this is over with. I don’t want to ever go to surgery again in my lifetime.

Monday, March 10, 2008

surgery jitters and more drugs

The woman before me in exercise class this morning was tall and thin. She used the high step and kept up well with the instructor, so she was easy for me to follow as well. When I looked at her in the mirror, though, I noticed that she had very high (and large and round) breasts. She wore a low top, and at times her breasts looked like they were going to jump out!

My gosh. Why do women do this? And yet here I am, 2 days away from “doing it”! I called my plastic surgeon’s office this afternoon and spoke to Leah again. I won’t end up like this, will I? I mean, I’m almost 60 years old, and breasts like that would make me look like a freak. Leah assured me that Dr. L knew what I was expecting from the reconstruction surgery, and that I would not end up with such exaggerated breasts.

Last minute jitters, I guess. I am nervous about the surgery – more about the anesthesia than everything else, though.

I saw my oncologist today and complained to her about the femara. The hot flashes are so pronounced through the night that I don’t get a lot of sleep, and end up very tired most of the time. Along with my bones and joints aching more, I’m pretty cranky. She suggested an antidepressant – Effixor – says that it will relieve much of the night sweating and help me to sleep better.

I’ve never taken an anti-depressant before. Even though I have my moments of feeling “down”, I’ve never considered myself to be clinically depressed. And I’m hesitant to take yet another drug to cover the side effects of a drug.

Anyway, we’ll see. I’m going to get through this next surgery, with all the pain pills and antibiotics that go with it, before I consider taking another drug.

Tuesday, March 4, 2008

nothing left to do but trust the doctor

I had the pre-op appointment with my plastic surgeon today. Signed a mountain of papers and asked every question I could think of about what would be done during the reconstruction surgery and what to expect afterwards.

Basically, the expander that was put where my right breast was will be replaced with a silicon implant. The implant looks rather large to me, but Leah, the physician’s assistant, says that they just look large outside of my body.

Then, on the left size an incision will be made around the nipple and then down the lower center of the breast. (Ouch!) A small implant will be placed under the muscle and then the skin will be pulled together at the bottom to “lift” the breast to match the other one.

And the table will be rotated up and down several times so that Dr. Lickstein can balance and even them up. I'll be just like a corpse.

The surgery will take 3 ½ hours – but Dr. L says it won’t seem that long to me. Ha ha.

Anyway, I guess I’m ready. I know that it has to be done, and putting it off and worrying about it isn’t going to help. And I trust my doctor – he is careful, and pays attention to detail. He understands the way the body works and heals, and he takes pride in his work. Most of all, there is something "real" about him. I sense that he cares.

There’s nothing left to do but trust him.

Saturday, March 1, 2008

I dreamed that I had 2 breasts (reconstruction)

I dreamed that I had 2 breasts, nipples and all.

I don’t know what to expect from my reconstruction surgery. I have now an expander in the place where my right breast used to be - a round area of stretched skin that is higher than where a natural breast would be (and rounder). It still feels a bit tight, but mostly the tissue feels like it has adapted to this foreign “thing”. Sometimes it feels like I (my chest wall) am behind it, pressing against it. When I take off my bra, I feel like I still have something on.

The only time I notice it hurting now is when I swim. The water is still fairly cold, and I can swim for a half and hour or more. Later, for a day or so, there is a deep ache in the non-breast area and under my arm.

Below the expander is the mastectomy scar and a strange accumulation of skin. Just after the mastectomy this was the area that was filled with fluid (the seroma). Now it feels mostly numb and hard, like perhaps it has become some kind of scar tissue.

Most of the time I feel ok with the expander – it doesn’t feel natural, but I can live with it. I know that I don’t like the way that it looks though, and something has to be done.

I have no idea how Dr. Lickstein will shape this into a cavity into which he will place a silicon implant.

Then he will have to “lift” and augment the other breast to match the implant.

I don’t like the idea of messing with my good, natural (and healthy) breast. But I know that there is no other way that I could look balanced, or halfway normal.

The surgery will take 3 ½ hours. I don’t even want to think about what will be done to me – my breasts – during that time. Like, how will he know if they are even? Will he sit me up, like a corpse?