Surgical Plan and Lessons to Remember

Heard the results of my MRI from the surgeon yesterday...

...while the chemo has helped and things looks better, in her words, they aren't "great".  Specifically, the tumor is still fairly extensive; importantly, it is very near the nipple.  For those reasons, she recommends mastectomy to insure that the cancer is completely removed. 

So I'm losing a boob.

I was a bit relieved, as I'm somewhat glad the MRI pushed us in a given direction, rather than feeling like I actually had a decision to make.  And, while a mastectomy is more extensive, like everything, it comes with it's own sets of benefits: the risk of having to have 2 operations (in the case of a lumpectomy is margins turn out to not be 'clean'/free from cancer) is gone; reconstruction options abound; and there is slightly less of a risk of local recurrence (vs. lumpectomy). 

The surgeon left a message in the morning and we played some phonetag throughout the day, but I was able to chat with her after my psychologist appointment in the afternoon.  Seeing the shrink ended up being pretty well-timed, and it had been since before the holidays, so was a good opportunity to vent a bit.   I didn't have too many questions for my surgeon, other than asking about a referral for a second opinion on plastic surgeons.

The reconstruction issue is still somewhat in the air...I've been doing some research...

Hooray for institutional access!

 

specifically, reconstruction options when post-mastectomy radiation therapy (PMRT) will occur.  It seems like a topic that there's much discussion of in the literature.  Even in the evidence-based guidelines for practice from the American Society of Plastic Surgeons, the use of implants in the case of PMRT is lacking significant research.  There are some thoughts that any reconstruction, including the use of a tissue expander (inserted prior to the permanent implant to stretch the skin), can compromise radiation therapy and increase complications.  A few papers seem to suggest that the autologous tissue transfer procedures (using fat, muscle and skin from another part of the body), can lead to better results. 

 

So the plan moving forward in regards to reconstruction will be: 1) call to schedule a second consult with the guy I've already seen.  My surgeon does think he's the best, so now that I actually know what my surgery will be and can have a more directed conversation, I think it's worth talking to him again.  And, since I hate the phone, it's worth the trouble and copay to go into the office.  Plus, I plan on bringing what I've found so he can see why I may have some hesitation about any immediate reconstruction, which I think it what he recommended based on our original conversation...it was hard to keep straight with so many options.  2) I'll hopefully get an appointment soon with the other referral and see what they say as well.

 

Can you tell I'm trying to distract myself with the details and stay focused on the facts?  Don't worry, I've been trying to deal with the emotions as well.  I can't say I'm thrilled about the whole process, and am sure I don't really know how everything will feel.  As the reality was sinking in yesterday, I "coped"...put on sweatpants, emotionally ate, and did some masochistic movie watching...

 

 

Thanks Amazon for the ability to spend $2.99 to stream this.  It's based off the book I had already read, so I knew what I was getting myself into.  It worked, I cried a little...it helped things sink in  Lifetime knows how to do movies???  By the way, I have 4 licenses for download if anyone wants to watch it, let me know.

 

I ignored the calls from my sisters and wallowing in my self-pity for an evening.  And now it's the next day and I'm trying to move on.  I got my ass out of bed this morning for a bit of a workout.  While I've told the sob story, I also want to write something else, mostly at the urging of the shrink.  I've talked a bit about things that all this is teaching me and the lessons learnied and what better time to write some of those down than now.

 

Some Lessons I've  Learned So Far...

 

I used to say and think I was fat and out of shape...I wasn't.

How can I say this with some confidence?  Because right now, I am fat and out of shape.  Way more so that even those points in my past life when I felt this way.  I won't get into the dirty deets, but there are difference in how this size body feels compared to what I always thought was too big.  I will try to remember this in months when I'm back closer to my normal weight and frustrated about not being a "skinny" girl.

 

I am capable of relinquishing control and asking for help...and the world doesn't end when I do so.

Just yesterday I had to send an email to the old lab folks in Colorado about some additional data we're collecting for a paper that got rejected asking for resubmission.  Essentially I said "looks great, trust you guys, let me know how it goes", which was not easy because I'm a control freak.  But, I don't really have the energy and the time to invest in this particular venture more than that.  So yeah, giving up control, not easy but possible.  Regarding the help, while I've been fortunate to not need much, starting in the beginning and missing my first physiology class and having to ask someone to cover for me, it is possible for me to ask for help and people are willing to give in.  In fact, as I discuss with the shrink, it can actually help people to be able to help.  Everyone likes the feel goods. 

 

You don't know what you've got till it's gone. 

Any time you can quote an awesome 80s power ballad, you have to take it, right?  This is a pretty cliché lesson, I realize but that doesn't make it any less true.  When I lost my Dad I had similar thoughts, and this isn't different, although feels much more superficial.  Facing the fact that I'll lose a breast makes me think about "last times" on a lot of levels I definitely won't post about (Hi Mom!), but in general, I need to remember the unpredictability of life and loss and appreciate the moment.  Easier said than done, so a written reminder seemed wise. 

 

I'll likely keep adding to this list, but for now I'll stop there.  It's a new day.  There's breakfast to be made and eaten and work to do. 

 

I shared this video on Facebook but I'll include on here because it makes me smile and is one song I can't help but dance a bit to.  These kids are great and I especially like the freestyle part...we can all use a little of this in our lives, right?

 

Post by Heart North West.