Friday, October 11, 2013

Pink Ribbons ~ The First Visit with a Plastic Surgeon

This is a copy from my journal dated October 2010 while I was going through treatment for breast cancer.  I opened the journal to share with others who are going through treatment or have loved ones doing so.  It is not current events and it does not substitute for medical doctors.

Tuesday morning, my birthday - was difficult.
  I was getting dressed, putting on makeup to give me the confidence to speak to a plastic surgeon. Let me tell you that is intimidating...knowing how often they look at perfect bodies. In the process I found that sometime between Sunday and Tuesday I had lost nearly all the eyelashes on my right eye. It stinks! I can draw a fake eyebrow but I still have eyebrows. They are lighter but quite adequate. 

But the lashes...I have like 10 lashes total left. The left eye has lashes missing in spots.  There are blank spots but when I add mascara you see the blank areas very clearly. Ever tried to put mascara on one eyelash? It doesn't happen. It was deflating. I felt like everyone at the hospital was looking at me and wondering “what is wrong with her eye!”

We loved Dr. Puckett.  I had been told by some of his patients they loved him.  Then others told me was kind of serious and reserved.  Totally not that way with me.  The resident noted it was my birthday and told me it was also Dr. Puckett’s birthday.  He came in and I sang Happy Birthday to him, and told him it was mine too.  In seconds, we were laughing, joking with each other and I thought he was pretty spectacular. 

His resident was very good too, so cute and that was awful. Picture a cute man picking up your boob cupping it and lifting it up to wherever it should sit. (Apparently laying across the tummy isn't the desired position.) lmbo But it was uncomfortable to have a Matthew McConaughey lookalike playing with your boobs with icy hands. Of course the girls perked up...the betrayers. I told him his hands were freezing – like this was the reason! He agreed it was cold thank goodness.

He was clear. He explained Dr. Puckett does the surgery I want - implants. He went over the other options tummy flaps, back flaps...I told him I wasn't interested for a couple reasons. It was a much more painful recovery and longer. You have to be in ICU for 2 days to make sure the flaps blood supply stay intact.  But also I said I have to lose weight again to lose more estrogen in my belly. And I lost boob bulk from losing 70 lbs. I don’t want to do those surgeries and lose my new boobs in fat loss. He agreed that could certainly happen.

The other reason...I have gone through pain, nausea, vomiting and the two - three surgeries.  I want, no I DESERVE perky boobs as my reward for getting through this.  The resident’s name was Dr. Daniel. He tried to not chuckle but I told him he could. So he did and he told me that it was just as valid as any other reasons.

So what happens is during the reconstruction, they place the spacers behind the muscle walls. Then they inflate the spacer with a small port (I will have so many freaking ports in my body.) using saline at that point.

I want a c cup at finish. So every week they will pump up the saline a bit more until I get to a c cup. Then we wait for 4 months… FOUR months. You decide in that time if you like the size...are they placed well. Are they symmetrical? And your body takes the time to adapt to the change in anatomy. After the FOUR months, you go in an outpatient surgery to have the spacers pulled out and silicon implants are replaced. Then after you recover it sounds like you are done. That was the good.

Now the not so good.

I had one lymph node biopsied and it was positive. I don’t understand the roll of chemo if not to kill cancer cells. So isn't it feasible that since it was only a few cells that chemo could have eaten the whole cluster? I know you aren't qualified to answer.

So I learned that at my surgery they will most likely do an axillary dissection and send the whole section of lymph nodes off to be checked. It will take 5 days to get the results from the pathology. What the plastic surgeon prefers to do is to NOT to do immediate reconstruction at that time.

For the BEST results he wants to wait and get the axillary lymph results. If I don’t need radiation then we would schedule a new surgery about 8 weeks later to start the reconstruction. :( However under that same plan...with no tissue stretcher in place, if I do need radiation, he will not touch me until I am a YEAR post radiation!!!!! I held it together there but I was dying inside. They don’t have experience with my oncologist or surgery doctors.  Dr Puckett is an University physician so he’s only used to University doctors.
I asked about going ahead and placing the expanders.  Going ahead and doing a little expansion to give me Something for my clothes. He said we could do that. But he said often the radiologist will request they be removed for radiation. :(( sigh 

He said there was also the concern of how my skin would react to radiation. It could get hard and encapsulate the expander, making further expansion difficult. If he places the expander, he can pump me up a bit, let me do radiation. But I would still have to wait an entire YEAR for the final expansions and implant surgery AFTER the four month settling time. He said there was the risk I could wind up with a hard gnarly boob...not the best results.

So I talked it over with Kel. He is the only one besides doctors and nurses who see my boobs..although right now that seems like a few hundred people. My final desire is to wear pretty bras and look normal in clothes. If I have a hard gnarly boob...undressed won’t bother me.  So K and I decided that we were okay with the less than the plastic surgeon’s ideal results.

So I called Dr. Bryer, the radiation oncologist. HE said he has never had to ask for a spacer to be removed to complete radiation. He's never asked someone to go for wait for reconstruction. I asked about encapsulation. (An inflexible pocket around the expander or implant). He told me there is the occasional issue but to keep in mind women who do not have radiation also have had the complication. It was up to DNA and skin type. IF I had to have radiation it would be the arm pit and skin, not deep into tissue like with a lumpectomy.

So it is crucial that I not have radiation. Please pray with me it will not be needed. However we have decided that I have will have the reconstruction and expanders placed. I will believe in faith that radiation won't be required. If it’s God's plan to me to have it anyway...well I will have a little boobies made of saline for an entire freakin’ year before I get the real thing. But it will be something!

I read a case of a woman who had not done a reconstruction. I don't know why. But she was extremely anal about being seen without her "boobs" on. One night while on a business trip the fire alarm went off at her motel. She threw on her clothes and ran out to the parking lot. She looked around and everyone else was in pjs and robes. She realized it had been more important to be seen with her boobs than dying in a fire. She then got a reconstruction.

I told K I didn't need perfect looking boobs. I just needed to feel womanly in a bra and in a dress. Mom goes without her boobs at home. But if she knows company is coming she’s hitting the bedroom to put them on. I don't want to have to think about them that much.  
So I have all that to think about.

The day got worse when we got home.  Our sweet, old Pomeranian Bandit was in respiratory distress.  He had been struggling for 2 years, having the occasional seizure that was awful to see.  He had been on prednisone for serious skin allergies over the years and we knew that would shorten his life.  He was a pretty special, our pomeranian we had him since he was 8 weeks old. He died that very night.  Yes, the night of my birthday.  I don’t know if we will ever celebrate anything again. That was wretched.  He died in hubby's arms.  

We didn't know he was that close to death, but knew he was not doing well.  We made arrangements for the vet to put him down and then Bandit acted a little perkier so we thought maybe we made a hasty decision.  But he quickly decompensated and died before the vet could arrive.  It was awful to watch, and Bandit was more hubby's personal companion than mine....he sobbed.  I cried and I'm sad, but his heart broke.

It’s been such an awful week. I'm weepy and sad. It doesn't take much to get me crying. My sister sent me a picture mail of mom sitting up in her hospital bed and grinning. Yep I lost it!

Sally - well that's really crappy about the lymph nodes....that’s scary.   Praying you don't need radiation.    I saw this today and thought this might give you a laugh.  Boob hats for breast cancer awareness.

Rosey - that is crazy. I have thought about baking boob cakes when I can get back to ladies bible study. Wonder how they'd like wearing boob hats too. lol 

Tricia - Continuing to pray about the things you stated...and I just have to tell you, the part about the eyelashes really got to me.  I'm so sorry for you about that.  There are hats and wigs and things for our heads, but eyelashes?  That's just not right. Just my opinion. 

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