Your brain can adjust to any situation, no matter how awful. Just because someone is in a grave place, when thoughts of death lurk in the shadows of her brain, it doesn’t mean she doesn’t snap at her kids for arguing at the dinner table, or that she doesn’t look in the mirror and curse the grey hairs creeping into her brow line. Cancer doesn’t turn you into a noble person; it just makes you feel incredibly guilty for having petty thoughts. I’ll share mine with you, since I love to barf my personal feelings at your feet.
I met my plastic surgeon on Monday. Dr. Mehling (the potential Babe the Big Blue Ox to my lumberjack Dr. Olson) had me meet with his partner, Dr. Schembri. The name is pronounced “Scam-bree” which, to my addled brain, sounds too much like “scampi” for me to ever remember to refer to him as Dr. Schembri ever again. So until I get to know him better, I can only remember his name as either Dr. Shrimpy or Dr. Scampi. He looks like a younger, smaller version of my Paul Bunyon. He even wore a plaid shirt. He introduced himself to me by apologizing for Dr. Mehling’s absence, saying that all 3 men will be operating on me at the same time in the operating room, and the only difference between himself and Dr. Mehling is that he is a taller, hairier version of Dr. Mehling. Later, I got a glimpse of Dr. Mehling, and the description is dead-on. Dr. Mehling looks about 4 feet tall, is super skinny, and has a shiny head as bald as a cue ball. I’m glad I got to meet the furry one; furry men please me. Anyway, Scampi explained all the different options for breast reconstruction to me. Dr. Olson had referred me to them because that is mostly all they do; they primarily work to help women rebuild their breasts after they have been damaged by something awful like a cigarette-smoking, beret-wearing, stinking Parisienne pickpocket named Barnard.
Breast reconstruction has moved light years beyond slapping a ziplock baggie full of silicone into your chest cavity and sewing it up. For you newbies out there, those are called Implants. Babe the Big Blue Ox and his partner Scampi specialize in Autologous tissue breast reconstruction. This means that they use your own body parts to repair your breasts. It’s a beautiful thing. They can take tissue, fat, and muscle from your back, your bum, or your abdomen, and re-connect the blood supply in your chest. If all goes well, you are all you, in the end. Don’t get me wrong, nobody will walk out looking like a Playboy bunny. There are really vicious scars that will make a permanent smiley face across your entire abdomen or your back, and you will not have nipples unless you choose to have them reconstructed in a separate surgery down the line, and get them tattooed to look “normal.” But the goal isn’t to get pretty boobs. The goal is for you to feel whole, for you to feel good in your bra, for you to feel your usual silhouette in your clothes. It’s done so you can tell yourself, “Okay, Barnard took part of me, but I am whole, still.” Yes, there are women out there who choose not to have reconstruction after their mastectomies, but I am fine admitting that my breasts are part of my identity. They may have outlived their function as baby-feeding machines, but I still need them to be me. Without them, I would feel less of a person.
Back to the making of bionic boobies. Scampi and I both agreed that a DIEP flap reconstruction would be right for my body. Free Deep Inferior Epigastric Perforator (DIEP) Flap reconstruction is where they will take my abdomen with a small piece of muscle, remove it and and rebuild my breasts. They will reconnect the blood supply in my chest and the tissue will eventually heal and become my breasts. After a short discussion, Scampi asked me to hop up on the examining table and lie down, then proceeded to grab huge handfuls of my tummy as he eyed my breasts. Essentially, he was trying to gauge how much breast he could make to match my current cup size. I had to laugh, expecting him to start grabbing the boobs to compare to the handfuls of tummy. He told me that during surgery, Dr. Olson would be working removing my breasts, while the Babe the Big Blue Ox team would be working on my abdomen, then they would move up to my chest for microsurgery that would take up to 10 hours. As he was pinching and calculating, I stared up at the ceiling and started trying to count how many times I’ve had to flash my boobs to strangers in just the last month. I counted 10 people. That’s more than 3 times the number of people who ever got to play with my boobies for recreation in my entire LIFE. And it turns out that those might be the last times I will ever feel anyone playing with my boobies in the future. The new ones will not have the nerve endings to make playing fun on my end – they will just feel like my arm getting squeezed. Part of the package. The Six Million Dollar Man Steve Austin had both legs, his right arm, and his eyeball replaced. I bet he never felt his girlfriend playing footsie with him under the table, but he appreciated the thought, and it never stopped him from playing the rest of the game. Yeah, I’m comparing myself to a fictional person because I have yet to meet a person in real life who would talk about this with me. I’m going to be the first person in YOUR life who will be frank. I’ll keep you posted.
After all of that detail, talking about recovery, about the ickiness of excess fluid coming out of my breasts and my abdomen, of draining tubes into plastic pouches, of possible infection, of fat necrosis, I thought, “hey, there can’t be anything worse this guy can tell me.” Then he drops the bomb: if my sentinel node surgery comes back positive for cancer, they will have to treat my lymph nodes with radiation, so I would have to delay my reconstruction. That means walking around flat-chested until after radiation therapy (about 5 weeks typically) and until I can be scheduled for reconstruction surgery after that. The current delay for plastic surgery is 1-2 years. This is because after a mastectomy or lumpectomy, you are technically considered “cancer-free.” You then get lumped into the rest of the regular plastic surgery patients waiting for new boobs (i.e. the women who just aren’t happy with their little boobies and want big jugs so they can fall out of their bikinis in Vegas). And all those women get bumped on a daily basis for women exactly like ME who have active cancer and want immediate reconstruction; meaning they may wait forever! I knew this in advance (from my research online), which is why I had insisted on mastectomy with immediate reconstruction. By law, they have to perform immediate reconstruction upon request during a lumpectomy/mastectomy because the cancer bumps the woman to the top of the list. And now I find my evil plan could be thwarted by my own sentinel node. Traitor.
Since first discovering the lump in my breast, I have been able to move forward by focussing only on short-term goals. First, it was “just get to the mammogram/ultrasound; it could be nothing.” Then, “oops, it’s something. Ok. Just get to the needle biopsy. The tumour could be benign.” Then, “Oops, it’s malignant. Ok. Just get to the surgeon. It could just get cut out, you could get rebuilt, and you could be normal by summer.” Now, “Oops, it could be in your lymph nodes so you might not get your breasts back for a looooong time.” OK. New Goal: Just get to the sentinel node surgery on April 3rd and wait for a week for the results. They could be negative for cancer. They could be clean and beautiful and cancer-free. Or, as my husbands’s new battle cry puts it: “Sentinal NO!!!!”
So here is my petty thought. I really love my breasts. I love the way they make my furry man’s eyes light up, then narrow with purpose. I loved the tug my nursing babies gave them. I loved the rush of milk letting down to nourish my sweet infants after the initially painful suckling. I love the gentle swell of my cleavage when I am in a beautiful dress and ready to dance the night away. They were works of art in my youth, only second to my legs as my favourite parts of my body. As I have aged, they have headed for my knees, making me a perfect cover girl for National Geographic. But ptosis or not, they are soft, they are lovely. They are where I hug a crying child. They are where I cross my arms or clasp my hands when I am heartbroken or worried sick. They cushion my heart. They still have purpose. Without them, nothing comes between my heart and the outside world, to insulate me. Without them, I feel vulnerable. If I could have reconstructive surgery, I wouldn’t have my original breasts anymore, but I would have acceptable substitutes. I don’t want to not have breasts. So there you have it. I expect you now have the same stunned expression that my husband gave me when I confessed this to him a couple of days ago. He slowly said, “But. You. Will. LIVE.” You see why these thoughts are such shameful secrets? How can my mind betray me by getting so used to the idea of possibly dying from cancer, that it lets itself get bothered by THIS?! I know I should let all the little things in life just roll off my back, considering there are much bigger things to worry about. I can’t help it. Remember, cancer hasn’t turned me into a noble person; I’m as silly as I ever was. And if you know me, you know that’s what I am, a bundle of everything all jumbled up inside. I have serious thoughts, but this little one is in my face right now, and I can’t shake it. Help me out. On the count of three, please join me in chanting my new mantra. 1…2…3… SENTINAL NO!
Letters From Narnia 