What Not to Wear (Ch.5)

Tomorrow is Bodacious Ta-Ta Tuesday. And I thought having babies required planning and organization…ha. So far, I have 3 surgeons, 1 anesthesiologist, countless residents and nurses, and one hovering furry man on my Away Team, here in Edmonton. On the Home Team in Jasper, we have our 21 year old daughter Emily as Captain, and Hanna and Simon on Defense. They’re holding down the fort, feeding the dogs, going to school, doing their chores, and trying not to fight with each other while they wait for us to come home next week. And for Home Team support, we have Coach Aunty Lori and Uncle Rob driving 4 hours from Banff to bring Easter and home cooking to our kids this weekend. My freezer is stocked with labeled tupperware full of food I cooked for the Home Team, my hospital suitcase is packed, my furry man has a stocked mini-fridge in the hotel room, and all we had was a pre-admission clinic and a pre-op consultation to attend today. I thought I had prepared myself for everything. Little did I know that fashion actually matters in such a situation. There is such a thing as what not to wear to the plastic surgeon’s office on the day before your planned surgery. Consider this a learning moment for you.

The 4 hour drive from Jasper was the usual scream. This time, though, we broke up the trip with a stop at Tim Horton’s in Edson (for those of you planning on exploring beautiful Alberta, Edson can be skipped. Unless you need to pee or need some coffee at Timmy’s. Seriously). I splurged on a honey-glazed donut. Best 15 minutes of the entire trip. I figured, if there is any time to indulge in my life, this is it. I am going to lose 15lbs worth of boobs tomorrow – one glazed donut is nuthin’!

Back at the Mac (the elegant Fairmont Hotel MacDonald) we got our usual room 538 with a river view and the extra mini-fridge that Markus had requested. He’ll be living here while I am luxuriating in the fabulous Misericordia Hospital all week. Visiting hours are 9am – 9pm and he’ll be coming back to his room for delicious bowls of cereal on many an occasion. We went to bed, but I tossed and turned all night long, thoughts just piling up in my head. I had go to my bedside table and make notes in my phone just to empty out some of those thoughts. I really wanted to sit up and write everything down in full form, but didn’t want the scolding from the furry man. I forced myself to keep my eyes closed, and waited for the sun to rise.

This morning we had an appointment for a pre-admission clinic at 8:30, so we drove to the hospital. I thought this would be a quick meet and greet with my little Dr. Ing from my sentinel node surgery. Nope. A gangly man in full scrubs shuffled into the room, mumbled that he was Dr. Xanadu, and plopped a giant binder on the table. The giant binder was me. Every little detail from every doctor and nurse, leading up to this moment, was in that binder. We spent some time talking about meds, but most of what he was saying kind of went in one ear and out the other…Dr. Xanadu?!!! There was no way I was that lucky. He left the room, and I whispered to Markus, “REALLY?!” Markus was like, “I KNOW! Is that a real name?!” I replied, “I fully expect him to enter the operating room on roller skates, singing like Olivia Newton John tomorrow!” Then another nurse entered and shattered our fantasies when she asked, “Did Dr. Nadu take all your meds?” Damn. You know I’ll be humming Xanadu when they wheel me in tomorrow…

OH, learn to read upside-down, ladies! While the nurse (Peggy) was going over my binder and prepping me for admission, I happened to read a letter from my internist, Dr. Hossein, to my general surgeon. He remarked that the cancer is in my left breast, and that my sentinel node surgery would consequently be in my left breast. STOP! I have breast cancer in my RIGHT breast and had sentinel node surgery in my RIGHT armpit. MORON. I remember during that particular doctor visit (to discuss whether my current meds would cause trouble during surgery), wondering why he wouldn’t make eye contact and why he was such a pig. His desk looked like the messy room of my teenage daughter. The only thing missing was old cheese and oranges tucked into his underwear drawer…I mentioned this to the nurse, wondering if his untidiness was an indication of his carelessness in noting important medical details on my record. She replied that she had heard similar things about him and just shook her head. So be your own best advocate and know your diagnosis inside and out, ladies. And maybe don’t go see Dr. Hossein, if you can help it.

During the pre-admission clinic, Nurse Peggy went into my hospital visit in great detail. We got to meet the little Jackson Pratt drain that I will have hanging from my breasts, my armpits, and my abdomen. She taught us how we will be draining them and measuring and logging the (gag) fluids that will collect in them. The drains look like the plastic tubing that you use to aerate your fish tanks at home. At the end of the tubing (the other end is stitched into your body) is a soft clear rubber bulb, where the fluid will collect. It’s about the size of the bulb they use to pump up a blood pressure cuff. There is a loop on the bulb, and it gets pinned to the hospital gown. Fancy hospital jewelry.

Following that appointment, my honey and I had a romantic lunch in the West Edmonton Mall. Hey, not everything has to be roses and candlelight. When a mall lunch is followed by a restful nap in a Fairmont bed, snuggled against a warm chest, wrapped in loving arms, I challenge anyone to claim that wasn’t romantic.

At 2:30pm, I called the surgery appointment desk to find out my surgery time for tomorrow. I was asked, “Who is your doctor?” I replied, “I have multiple doctors: Olson, Schembri, and Mehling.” She exclaimed, “OOOHHHHH, you must be Sue!” My cousin Gaby always teases me when I’m at home when I visit the hotel for something and I try to blend into anonymity, not wanting to use Markus’ job for asking favours. She puffs up and puts on a royal voice, “Don’t they know who you ARE?! You need to say, ‘Don’t you know who I AM???!!’” and then we all dissolve into silly giggles. Well, it seems Gaby called ahead to the Misericordia Hospital… The nurse said, “Sue Treppenhauer? You’re going to be our first patient and the big one all day. Come on in at 5:45, honey.” At least there won’t be any rush-hour traffic…

The last appointment of the day was for a visit to my plastic surgeon, Dr. Schembri (remember Dr. Scampi?). This was the first time my furry man was meeting him, and it didn’t occur to me how very awkward it would feel. First of all, I was handed a gown and a pair of very teeny tiny panties to change into, gown open in front. Then Dr. Schembri (the furry little boy who looked like he just graduated from university) came in wielding a blue Sharpie, and started drawing lines all over my breasts and abdomen. Then he started showing us (by tucking in my nipples and squeezing the breasts) how the lines would guide him in reforming my reconstructed breasts. A light went off in my head, and I was like, “HONEY, did you ever see Mad Magazine when you were a kid?” My German furry man looked at my quizzically. I had to explain how the back cover of the magazine had a picture that you had to fold a certain way, and if you did it just right, you ended up with a totally different picture. By the time I was done explaining, Dr. Schembri was laughing hard and nodding his head, “Yup! That’s exactly what I’m doing!” Then he had me lying down so he could draw more on my abdomen and do the whole grabbing-giant-handfuls-of-fat thing again. I can’t even imagine what my husband was thinking. After that, I had to stand up in just my teensy panties and subject myself to a photo shoot. Dr. Schembri swore he wouldn’t share them with anyone. Markus didn’t make the same promise, however. yikes. When I was allowed to wrap my dignity in my front-opening gown, we sat down for a talk. He explained to us that he would see me around 7am right before surgery, and my lumberjack would be there too. While Paul Bunyon was removing my breasts, Dr. Schembri and Dr. Mehling would be working on my abdomen, removing the tissue and blood vessels needed to reconnect to my chest. Once Dr. Olson had one breast removed, Dr. Schembri and Mehling would move up and begin connecting the blood vessels and working on that side of me. Then he stopped and looked at Markus and said, “Okay. I have to tell you. About halfway through all this, we will be taking a break to have lunch. It’s going to be a long day, and we will need some food. I’m only telling you this because I neglected to say it with another patient years ago, and I bumped into the husband while I was in the cafeteria. He looked at me in a panic and was like, ‘Wait. Who is working on my WIFE!!!’ If you see me in the cafeteria, Markus, I promise Sue will be ok. I just need to get some nourishment. She will be being taken care of, I promise.” You never really think about that stuff, do you? Finally, Dr. Schembri handed a blue Sharpie to my furry man, and asked him if he wouldn’t mind going over the lines after I take a shower in the morning, in case I washed anything off. He has no idea what a stupid move that was. It took everything in me to convince my furry man not to draw on me last night, before going into the office today. He wanted to draw smiley goodbye faces on my breasts. Now that he’s had to sit through watching a furry teenager-looking-man squeezing bits of me that are Reserved for Treppenhauer Use Only, I wonder if I’m going to have No Trespassing written all over my boobs in the morning…

So here is where my fashion advice kicks in. For this last day before Bodacious Ta-Ta Tuesday, I had chosen to wear a v-neck blouse that showed my cleavage in all its glory. I figured my girls deserved one last day in the sun before going to Heaven tomorrow. That’s all very well and good, but if you expect to be covered in blue magic marker, you might not make a similar fashion choice. As soon as I put my shirt back on, Markus burst out laughing. I had what looked like a blue tree growing up on the skin of my chest, blooming out of my cleavage, just above the v in my v-neck shirt. There was no covering it up. We headed out to the parking lot, passing turning heads (“hmmm, interesting tattoo on that lady…”). We had planned on a quickie splurge on junk food for my Last Supper, so we walked into McDonald’s. Now, with all the freaking weirdos of the world eating at fast food joints, with tattooed and pierced faces, screaming babies, etc, you would think I would blend right it. Not. And they didn’t even stare inconspicuously. It was straight on ogling. I was so embarrassed, I sat in the only booth facing a wall, waiting for Markus to bring our deliciously salty french fries and my chocolate shake. With his crinkly eyes and laughing face in front of me, I could momentarily forget my appearance. On the way back to the car, I saw a few more heads turn, and pulled my sweater off and held it up against my chest. Markus opened the car door for me, then went around to sit in the driver’s seat. Driving back to the hotel, I held my sweater to my chest to cover up the blue markings, totally embarrassed by the funny looks people had given me, dreading walking through the hotel lobby. Markus turned to me with a fierce look on his face and said, “FUCK them. They don’t know how lucky they are to NOT have a reason to have the blue markings on their chests. Fuck. Them. Let them stare. I am proud of you.” Then he turned back to the steering wheel and drove me back to the comfort of our hotel room. In the elevator, he took one picture of me, after teasing me about my blue tattoo, telling me that I was going to want to remember the funny things. And a v-neck shirt for today was certainly funny, if not well-planned.

In the hotel room, I sat down to write this last entry for my blog, before I meet fabulously new drugs tomorrow. You might not hear from me for days, even though I know Markus will update my friends and family on Facebook. The hospital nurse told me that the powerful anesthetic would alter my senses and my judgement for days. She cautioned me against making any important decisions on legal matters, and I’m guessing writing my blog might fall under that warning. While I was plugged into my writing music and I was swimming in my words, seated in our hotel room easy chair, I saw a movement at the edge of my field of vision. I looked up to find my furry man with a shy smile on his face, standing there shirtless, with my identical blue Sharpie markings all over his chest. Solidarity at its finest. What is love? Love is coaxing someone to laugh through the fear of becoming Frankenstein. Love is being there to relieve pain. Love is furry. And right now, while my heart is brimming over with it, I will bid you goodnight. It’s time to cup my breasts and to say thank you for a wonderful 30+ years of life-giving nourishment, of sex appeal, of giving comfort, and Love. Tomorrow is Bodacious Ta-Ta Tuesday. And ByeBye Barnard; don’t let the door hit you in the ass on your way out.

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An Ode to Breastesses (Ch.3)

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!

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