rethinking reconstruction (a year too late)

Well, it seems as I’m not yet finished, as I pronounced the end of this blog in the previous post.

It seems that I still have a lot of things related to breast cancer to find my way through. Maybe there is no end? Maybe I have only just begun?

Today, I wish that I had never had breast reconstruction surgery. I wish that at the time of my breast diagnosis, I had been given more choices as to how to treat the cancer. In particular, I wish that there had been some support for having the breast removed without having to have a fake breast to replace it. I wish that there were more women walking around with one breast, and that they supported other women who did not opt for reconstruction.

How did we all get sucked into the reconstruction business, anyway?

Before my mastectomy, I asked again and again why 2 lumpectomies couldn’t be done on my one breast. Because you wouldn’t have much breast left, I was told. It would be better to take the whole breast off and reconstruct.

Now, one year later, I don’t think so. I would rather have a small, radiated 2-lumpectomied breast than what I have now.

Both of my breasts still hurt. I have fluid behind the nipple on my left breast that was “lifted” to match the strange round silicon thing that replaced my right breast. It hurts. I still have fluid around my right silicon breast. Some days it all just hurts. I find myself wishing I didn’t have any silicon in me. I would rather just be half flat chested.

I’m not sure what I’m going to do about any of this. Removing everything, at this point, may make it worse. It means one more surgery.

I’m also a bit chagrined that I got suckered into the whole breast implant phenomena. That I would look “great” – as in sexier, younger, whatever.

I'm thinking more and more about DECONSTRUCTION.

things are getting better

Things are getting better.

For one thing, I think that some swelling is going down in my right (silicon) breast, so that I don't feel quite so freak-y looking. This all may work out without an additional surgery.

For another, I have an appointment with my primary surgeon on Monday. It's really just a final followup from the mastectomy surgery in Decemeber, but I also need some reassurance that everything, anatomically, is stable and ok - like, are you sure that that little strip of skin going down the center of my 2 breasts is not going to pop out??!

And ... I had lunch with 3 friends yesterday (2 women and 1 man) and they all told me that my breasts looked fine. Maybe a little lopsided, but nothing that was overly obvious.

I'm ready to let go of my hyper-sensitivity and move on.

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?

hurting and healing

I still hurt. I wonder how long it takes to heal. I wonder when this seroma will go away. My mastectomy surgery was 4 weeks ago tomorrow, and it seems I should be further along the in healing than this.

I decided to keep this blog public, because when I search for answers to my questions, like “how long does it take for a mastectomy seroma to heal?” the most I get is research answers. Like: “the study shows that the length of time that drains were left in does not affect the incidence of seromas.”

mastectomies, not a thing of the past ...

The thing that bothers and surprises me is how quickly and definitively my own breast cancer was deemed a case that warranted mastectomy. I mean, this is 2007. I thought that advances had been made so that options were available for women with breast cancer that would preserve the breast, and that mastectomies were becoming a thing of the past.

I was talking today with my cousin’s husband, who is a doctor in Arizona and an expert on breast disease. It seems that with MRIs, more and more small, previously undetected, breast cancers are discovered. Twenty years ago, the site of my 2nd site of cancer cells would never have been found. I would have had a lumpectomy and then radiation. Would the radiation have killed the 2nd small site? Who knows? Maybe.

So it seems that now with the super-sensitive diagnostic testing, more 2nd cancer sites are discovered. And the protocol, at this point, is that if 2 primary cancers are detected in the same breast, mastectomy is the answer – no matter how small the cancers are.

Because more 2nd cancers are detected, more mastectomies are being done than before. Is this "progress" saving lives, or just generating more surgical business?

It seems like overkill to me. There must be a way to remove small cancers on the same breast without having to remove the whole breast. If we are going to detect earlier and smaller stage cancers, there must be a way to treat them without surgery. However my cousin's husband said that, in this day, I would have a hard time finding a doctor who would risk it.

And then there are the women in my breast cancer support group who elected to remove their healthy breast, and who had mastectomies when only a lumpectomy was required. Perhaps I don't know enough about cancer.