deconstruction

I am ready to be deconstructed.

Four and a half years ago, after a mastectomy that removed my right breast, 2 silicon implants were placed in my chest.  The one on the right replaced the breast that was removed.  The smaller one on the left was supposedly put it to make it more "match" the fake right breast.  The left breast needed a lift.

It didn't work out so well, cosmetically.  Actually, the lifted left breast "looks" pretty good, but it doesn't even come close to matching the silicon blob that protrudes from my right chest.  The right implant never "settled", so it sits high on my chest, almost to my collarbone.  I've heard the doctor say that it is "too large".  I think he means large, width-wise, because every time I extend my right arm I feel a pinch in my underarm area.  This is especially annoying when I swim.  

For the last year or more my breasts have become more and more painful.  There is a constant ache around the right implant.  I recently had an MRI to check and see if anything was wrong, but that came back with a diagnosis of "everything looks fine" in there, meaning that the implant was not leaking.  I suspect that it is muscle pain, because the implant is actually under the pectoral muscle, and the muscle feels stretched and strained.  It is especially painful when it is cold outside.

Anyway, I've had enough.  I want the implant(s) out and am ok with being flat chested on one side.  I'm not sure how the left breast will look with the implant out.  Like a deflated balloon?  But a plastic surgeon should be able to do something about that, shouldn't he?

Much as I don't like the idea of someone cutting on me, I want this done.  I can't wait to be free of my silicon chest.  For more than 4 years I've felt like I had a plate of armor weighing down on me.  I don't hug people closely - I always hold them just a little bit a part from me.  I'm protecting myself and I'm embarrassed by this barrier that is in me.  I'm afraid to be touched on or around my chest.  This all makes me sad.  

I'm ready to let it all go.  The silicon, the fear.  I want my body back, even if it is wounded and flawed.

I want to touch and be touched.

My appointment is on Tuesday, and that is when I will schedule the surgery.

[My gosh, I notice in the post below, written more than 3 years ago, I am saying much of what I say today.  Funny that it has taken me 3 years to get to the place where I am ready to go through another surgery.]

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.

a place to put my hurt

First, a confession: I can be quite neurotic – hypersensitive, over-dramatic, lacking in objective perspective, even downright loony.

Perhaps I am still “processing” the whole ordeal of losing my right breast. Or maybe I'm this way all the time, but won't admit to it without an excuse.

I do not want any of the feelings that I write here to reflect on the professionalism and skill of the doctors who have treated me. Even though I have not quite come to terms with my reconstruction surgery – things are, in fact, still changing – I consider my plastic surgeon to be extremely competent, responsive, and perhaps a genius.

I am getting used to my new breasts – even starting to feel that they look good, despite not being perfect matches. The right breast is falling more and I don’t feel so strange looking.

And because I’m more healed, I’m not afraid to expose my breasts anymore. (Yes, I make love with nothing covering them now – yeah!) What is it about the way I do not want others to see my wounds - to see where I hurt? I bet a shrink could make something of that.

Maybe part of my reason for writing here is to have a place to put my hurt.

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'm stuck

I am confused. I am a mess.

The only way I know to work my through stuff is to write. Or at least write first, so I can have some idea of what’s going on.

I need to get beyond all this breast stuff. I’m hung up on the cosmetics of it all. How I look. I’m embarrassed with this big round silicon boob that sits high on my right side. I make sure my clothes cover it up, which isn’t always easy in Florida. I have no idea what I will do about wearing a bathing suit in public. I will have to get something very high and loose – do they make bathing suits like that? I am not naked when I make love with John anymore; I always have something covering my chest.

And I'm embarrassed with being so obsessed with it all.

Some people tell me that I should go back to surgery and get it fixed right away. Others tell me to wait, see if gravity and time will help.

I don’t know what to do.

I feel silly being so hung up on how I look. One woman said to me, “I never knew this part of your anatomy was so important to you.”

I didn’t either.

Someone recently pointed out something I wrote in 2006 on another blog about silicon implants. Boy, have times changed.

Am I over-reacting? Do I need to just think about something else and move on? How do I do that?

another surgery??

I woke up this morning, climbing out of my depression, knowing in my bones and soul a spirit that can face breast cancer and everything that goes with it – including a lopsided chest.

I met with my plastic surgeon, Dr. Lickstein. He seems to think that I am healing well, and I can get back to exercising in a week (yeah!). He also thinks that we should watch the fake boob for a couple of months to see if it will fall some. If not, he suggests another surgery to exchange the implant with another smaller one. This would be a simpler surgery – 45 minutes he says – with little pain. But I would need to go under anesthesia again.

I’m open to the idea.

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.

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.

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.

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.

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.

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.

the decor of a plastic surgeon's office

There were new silver chairs in the lobby of Dr. L’s office today. And new curtains.

There was some art on the walls: A black and white beach scene, with large rock-like things in the foreground of the picture that were like the green pod-like things on the table. It appeared to be a cross between a photograph and a painting. In the examining room there was a picture that reminded me of one of my weed photographs. The veins of the leaves were a beautiful blue.

I’m fascinated with the décor of this doctor’s office. It’s a nature theme, but also with subtle silvers and golds. The receptionist said that it was supposed to be “calming”, and it is.

The beauty of nature and that of the human body is clear and obvious, yet somewhat understated. I like that. There were a few black and white photographs of women in the hallway. I wish that there was at least one of a man’s body.

What I don’t like are the cosmetic advertisements that are in the shelving in the lobby. I would like to see abstract sculptures there. I’m annoyed by the cosmetic advertisements in all of the doctor’s offices these days anyway. Reminds me of snake oil.

the basketball on my chest (the "expander")

I just had the 3rd injection of saline into my “expander”. I call it the basketball on my chest. According to Dr. L, there is now 380 cc’s of saline in there. He wants over 400, so that means another injection next week.

It’s not that it “hurts”, but it is quite weird, especially for a couple of days after the injection. I always feel a little shaky after I leave the office. Like my body is just a bit shocked. This week I came home and just laid down. It definitely feels “full” and tight (and big!).

I am starting to get anxious to just get this done, even though it means another surgery. Dr. L says that after the last injection, I will need to wait at least 3-4 weeks so that the stretched tissue can settle down before he can put in the implant. And he says that lifting and matching my native breast will be the challenge for him. I told him that he needed to be like God, and make them beautiful.

And then there is the complication that chemotherapy would bring to this whole schedule. But I’m not thinking about that now …

re-thinking plastic surgery

There is a peculiar intimacy (or chemistry) between a surgeon and patient. Surgery opens up a whole new level of trust that you have to have with your doctor - your body is literally in their hands.

I always watch a surgeon’s hands. I know people who have “brains” in their hands. I do not, but I know people who do. My friend, Nancy, is always doing something with her hands. She will be talking to me and then all of a sudden hand me a wonderfully complex and beautiful paper sculpture that she had been making while we are talking. I am amazed.

So I look for this gift in a surgeon’s hands.

But I also look for “relatedness” and ability to “connect” with others as individuals. I like to think that my surgeon is aware that there is a real person (me!) that is way down under all that anesthesia.

Plastic surgery adds yet another dimension to this patient-surgeon chemistry. Until I ended up in a place where I needed cosmetic surgery, I always pooh-poohed it as a frivolous luxury for the rich. Why mess with what God made? Why want to look forever “young”?

Now, I’m having to re-think all of those attitudes.

Beauty and art enter the realm of science and medicine.

When Dr. Lickstein “reconstructs” me, I want beautiful breasts. Like God made. They don’t have to be perfect. I don’t want large breasts, I never had them before. But I want them to look “real”, whatever that means.

I guess I’m asking for a lot.

ohmygosh (looking at myself)

Ohmygosh – look at me. That’s my reaction at looking at my chest and the site of my mastectomy surgery, and I don’t make the effort to look. On the one side is this beautiful, soft, natural breast. On the other … scars, bulges of skin, a hard round something (the expander). This is my body? This happened to me?

It’s been a good week, though. For the first time, I am beginning to not actively hurt – though there are still places of soreness. Dr. Lickstein gave me the first injection of “new breast” (saline into the expander) and it was no big deal. I had been expecting the worst. He told me not to worry about the seroma and to get on with exercising my arms. And the seroma does seem to be getting better.

It has been a month since my surgery. Tonight I asked John a lot of questions about what happened on that day of surgery. Funny how little I remember.

I went to an exercise class this morning and it was just wonderful. I was able to pretty much keep up with all the ladies and I left feeling flushed with endorphins. I’m going again Monday. I was able to do most of the arm exercises using low weights.

And I made an appointment with the oncologist for next Thursday. Finally I guess I’ll face the facts about my cancer and what I need to do now.

Dr. L's new office

Dr. Lickstein is my plastic surgeon. He is the doctor with whom I will be dealing the most from here on out. I will see Dr. Rimmer one more time, and I need to make an appointment with the oncologist, Dr. Bertrand. But I will be seeing Dr. Lickstein every week or so for the next few months as he “reconstructs” me.

“David” is his first name. He looks like a David. At first glance, he seems a bit “nerd-y” to me – scholarly. He looks to be about 45 years old. He also seems dependable, up early taking care of details. He does not seem like the kind of doctor who caters to the rich. But I bet that's what the rich people like about him, his scholarly and medical grounding and his apparent disregard for trendiness. He came to me by way of recommendations from women who had used him.

They have a new office, and boy is it swanky. Actually, I love the décor. Modern, with a lot of glass, but like a forest. The flooring is a mix of pebbles and carpet patterned with a hint of fern. There is a water wall in the lobby, and a large arrangement of green pod-like things. It doesn’t look like a doctor’s office, but more like a high end architect or legal office.

I think it is appropriate that a plastic surgeon’s office be somewhat artsy. When I mentioned to Dr. Lickstein this morning that the office was “swanky”, he seemed a bit embarrassed, saying that he was still finding his way around. This office, though, is more in my neighborhood – I can walk to it if I cut across a construction site. And it is Lickstein’s neighborhood too. In our casual conversation this morning, as he was pulling out a drain, I learned what temple he attends and where he lives – both nearby.

It’s interesting to be going to a “high-end” cosmetic surgeon. It’s obvious that this office is made to appeal to rich women who pay upfront for their services. It doesn’t look so much like a “medical” place. This morning (Christmas Eve) he was only seeing a few patients like me who had a medical urgency (like getting the damn drains out). Still there were a couple of glamour girls in the lobby (how can you call such a sophisticated place a “waiting room”? There is a climate controlled refrigerator with water, china, tea, etc.)

Dr. L’s old office had some modern art on the walls of the waiting room, and when I commented on them to Dr. L he said that they belonged to his partner, Dr. Pinsky. I wonder if Dr. P is the inspiration behind this new décor?