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.

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?

$39,070.61 for a boob job, and this isn't over yet!

The hospital bill came last week for the Breast Reconstruction Surgery that was done last month. $39,070.61. And this was an outpatient surgery. My gosh. How do women who are not breast cancer patients afford these boob jobs?! Or do they charge more when it is covered by insurance?

My insurance (for which I pay $1200 per month) is covering all but $1405.23. But I’m not sure if this is the end of it. It seems that these bills keep creeping in for months after the affair.

And it seems clear that I will need another surgery. Will my insurance cover that? We can barely even afford the insurance. (Actually, we can’t afford it.)

Yesterday I was visiting with girlfriends and I showed them my breasts. This is the first time that I have uncovered myself to people other than John or doctors. Both Lynda and Deb think that the way I am now is unacceptable. The left (native) breast is fine, lifted and slightly augmented with silicon at the top. The right breast, the silicon implant, is very high and round and much larger than the left side, at least on the top. So that I’m both lopsided and imbalanced. More and more, I’m beginning to think that taking out all implants, and learning to be as I am – a unibreast – is the best solution. But I’m not sure if I’m brave enough. I’m self-conscious enough of my strange looking chest without clothes on, how would it be to look so “different” with clothes on?

Before the surgery, Dr. Lickstein told me that 25% of Breast Reconstructions require further “procedures” to make things right. I guess I’m in that 25%. At the time I thought that meant a little tuck or something in the office. Now I realize that it means another surgery.

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.

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.