Archives for posts with tag: Mastectomy

This post is from 7/31/12, the day of my first visit to a plastic surgery office. It was surreal.

This afternoon I met with Drew Welk, M.D. a plastic surgeon at the Polyclinic. We had a good meeting and it was interesting to shift from a physician who focuses on disease treatment to one who focuses on aesthetics. I found out that my incision is not in the best place to which I replied, “Yeah, my cancer insists on being all kinds of inconvenient.” To his credit, he laughed at my ribbing. I did learn that I have very favorable “breast geometry” with only a little post-partum loss of muscle tone. Yay, my breasts got complimented! They’ve been a little starved for positive comments lately, especially the right one, which is currently looks like a more than a  little like a dented tin can these days.

Dr. Welk is talking to Dr. Beatty tomorrow to share his input regarding the best way to make incisions for the mastectomy so that he has something reasonable to work with later after the fat has been removed from my skin, the latter of which I get to keep. He took pictures in the clinic photography booth, which was set up like the DMV, except for the fact that I was partially disrobed and he had his choice of three different expensive looking cameras. (Or maybe the other cameras belonged to other surgeons. That makes more sense.) He took the last picture after he’d drawn a little incision map with a Sharpie.

It wasn’t as bad as I thought it would be and I liked him. Plus it was a surgery day for him so between his energetic demeanor and the fact that he was wearing scrubs, he looked like a surgeon action figure. (Not to be confused with 1973’s surgeon Barbie and yes, she was real; click the link. Also, not to be confused with an action figure for the character, Surgeon from Hellraiser 2. Mom don’t go to that link: That surgeon doll is heinous.)

Okay, so Michelangelo is probably not the best sculptor to reference in this post. He was criticized for the way he sculpted breasts, basically that it looked like he’d thrown a couple of softballs on top of a suspiciously manly shaped torso. A better sculptor might be the 20th century artist, Lachaise. That man knew how to sculpt realistic breasts on refreshingly substantial looking women. Hmm. “The Lachaise of La Twins”? I’ll stick with Michelangelo for the alliteration. My cousin, Beth favors Bernini breasts herself. Bernini’s sculptures are absolutely breath taking but the first thing that comes to my mind is “the Rape of Persephone”–not the image I want in my head when thinking about my breast reconstruction. Beth conceded that Bernini tended to show women on the run.  But I present exhibits A, B, and C for your consideration:

One of Lachaise’s fabulous, “Standing Woman” I think this is a clear winner. Unlike “Dawn”, Lachaise’s sculptures of women actual look like a woman modeled for them. Also, Lachaise’s women look like they could fend off a Greek god or random creep in the bushes, unlike Bernini’s stunningly beautiful but nearly defenseless damsels.

Bernini’s Apollo and Daphne. This is Beth’s submission. In this case, Daphne is so desperate to get out of Apollo’s stalkeresque clutches that she turns herself into a tree!

Michelangelo. This is a sculpture I’ve seen in person. It’s from the Tomb of the Medici’s in Florence. This figure is supposed to be “Dawn” Looks like a man named “Don” with softball boobs, am I right?

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Not surprisingly, breast cancer is not big sexy time.

When I learned that I had breast cancer and needed surgery, I expected the anti-sexy impact of stress and surgery. I did not, however, expect to have six surgeries and counting.

When I started taking hormone blocking medications, I expected to go into early menopause and to perhaps have hot flashes, not to mention the impact of having almost no female hormones on a woman’s sex drive. I didn’t expect that for a few months, every time my husband did as much as put his hand on my shoulder that I would immediately have a hot flash.

Last October, my medical oncologist asked me what I using for birth control in the couple of months before the Lupron injections had done their work in rendering me infertile.

I told her. Her response? “Wow, most women laugh in my face when I ask them about birth control use during breast cancer treatment.”

So maybe I’m “big sexy time” for a breast cancer patient.

I had my first follow-up mammogram this morning. Lefty looked good. Righty got to opt out because it is no longer filled with breast tissue.

I wasn’t sure how much this visit would stress me out but it was fine. And I’m not sure if I was imagining it but the compression on lefty seemed awfully tight. Maybe once you’ve had breast cancer, they turn the screws extra tight. But it was still tolerable and obviously, they were squeezes for a good cause!

Yes, I was looking at swimsuits on the Land’s End website today. I have a complicated history with swimsuits. I have avoided wearing them for the most part. Additionally, swimming bothers my eczema. But my skin is doing much better on this wheat free diet and I have dreams of getting a hot tub in the back yard. By summer, I will have a permanent right breast, too, instead of my empanada-shaped temporary one. Woo hoo!

I know that breast cancer changes a lot of women’s view of their own body. We tend to dwell on the negative aspects of loss. They are real, don’t get me wrong. I have to say, though that I like my new outlook on my belly fat (hey, you are going to be transplanted north in 6 weeks) and the fact that I am kind of looking forward to swim suit season, even though I am unlikely to have a backyard hot tub or go to the tropics any time soon.

It’s just good to be looking forward to another season with all of my surgeries behind me. And I do feel better in my body. I eat well, I exercise, I meditate, and I see all of my wonderful care providers. The fact that I have not been reduced to a pile of tear-soaked rubble makes me feel powerful and strong from the inside out.

I’ve been struggling with water, the gift of life, aqua, good ol’ H2O.

There was leaky pipe in my office last Saturday, which would have created a deluge had my office mate not been there to see it so a plumber could be called to fix it.

Yesterday, as usual, I went for my three mile long walk. It was rainy, which is not unusual for this time of year. I donned my Gore-Tex armor, which has served me so well-Gore-Tex hat, Gore-Tex hiking boots, Gore-Tex parka, Gore-Tex boots, Gore-Tex pants.

If I lived a considerable distance south of these parts, I might even call myself a Gore-Texan. The rain at night, lasts a fortnight (clap, clap, clap, clap). Deep in the heart of Gore-Tex!

I came home from my walk, my boots squeaky, my socks soggy, and soaked through my coat, insulated long-underwear shirt, t-shirt, and bra! Only my Gore-Tex pants managed to maintain my faith in the magical rain shedding powers of Gore-Tex.

I took my smartphone out of my ZIPPPED Gore-Tex parka pocket. Uh-oh. It was covered in water. The screen was flickering! I quickly turned it off and opened it up. It was wet on the inside! I dried it off but being fool hardy, I tried to turn it back on even though my brain was telling me, “Leave it off and call AT&T.” It turned on but was frozen on the “Samsung” boot up screen. So I turned it off and broke it down again.

“My precious! My precious phone! My extremely complicated work, medical, family, personal life calendar is on there! The names of all of the new patients I will see between now and March 5th are on there!”

“Golem, I feel your pain,” I thought to myself. “I am a psychologist. I am not addicted to technology. I am an excellent problem-solver. Get a hold of yourself, woman!” I took a deep breath and called AT&T.

A very sweet technical support rep named Shannon answered. “Oh, I just did that. I was so worried. I keep EVERYTHING on my phone. Surround your phone with rice to get it to dry out. Leave it for at least a day. I’ll call you tomorrow and see how you are.”

Shannon has felt Golem’s pain as well. I confirmed with her that if the phone didn’t dry out, it was curtains for the information on my phone. (And yes, Google is supposed to automatically back up my calendar but that stopped working and I’ve been procrastinating about figuring out a fix for that problem.)

“My precious! My precious! God, you can take my breast but not my SMARTPHONE!” I was again, I’m afraid, losing some perspective. So I then imagined the Albert Ellis section of classic 1960’s psychologist training film, “Three Approaches to Psychotherapy“, also known as “The Gloria Films”. Gloria, a real person with real life problems, agrees to be taped seeing three super famous clinical psychologists (Fritz Perls, Carol Rogers, and Albert Ellis), one at a time. Pioneers in fields can be kind of extreme. The Gloria films illustrate this quite nicely. By the time I saw the film in the 90’s, it was for historical purposes. The film served up unintentional hilarity with a side of guilt since Gloria was a real person with real problems. They were not getting addressed.

So what does this have to do with my meltdown about “My precious”, you may ask? Albert Ellis was a brilliant psychologist who developed Rational Emotive Therapy (RET), which is the foundation of modern cognitive therapy. The goal of RET is to use reason to reduce psychopathology. However, Ellis did this in the absence of stuff like, you know, demonstrating empathy and establishing rapport. He also had a rather distinctive nasal northeast accent. Combined with his lawyerly therapy style, it was pretty funny. “I can see that your situation in inconvenient, but it is not terrible and awful.” Or my favorite when Gloria puts her self down and he responds by telling her that if she makes a mistake it does not make her a “no good-nik”. The sight and sound of Dr. Ellis trying to use 60’s-era hip slang was double hilarious. Check it out for yourself here.

“Elizabeth, your anecdotes require too much exposition! What does this have to do with your phone?”

Thank you, patient readers. Basically, I tried to reason with myself as I often do, but this time I remembered Albert Ellis, and it made me laugh.

That pulled me out of my tizzy and I went about recreating my schedule, piecing it together from memory, emails, and other non smartphone dependent methods.

Today, I took my phone out of it’s rice bed and it awoke!

Thank you, Albert Ellis. Yesterday was inconvenient and more than a little stressful but it wasn’t “terrible and awful.” I hope you forgive me for laughing at you and for being able to do a dead-on impersonation of you. You were definitely not a “no good-nik.”

I have a wonderful support network, including you lovely folks who read this blog. And by and large, I have experienced very little unwelcome advice concerning my breast cancer treatment. Very little. Much less than I expected.

There is one little arena into which some unwelcome advice has crept. I have gotten some negative feedback about my choices regarding breast reconstruction. A couple of voices have opined that I should skip reconstruction. I’ve also fielded the opinion that I should opt for an implant rather than a TRAM surgery (transplantation of belly fact and some abdominal muscle to make a new breast) because the former is a simpler surgery and the latter involves a more major surgery (abdominal and breast).

While I haven’t been floored by the opinions and no one has been super insistent, I would be lying to say that they didn’t bother me. I did examine the part that bothered me to make sure that I’m not doubting my own decision. I concluded that based on the information I have now (since I can’t predict the future), I made the best decision for ME. Also it is a little extra annoying when the opinions have been stated AFTER I’ve already done a number of steps, including two surgeries, which are prepping my body for the TRAM surgery. If I had chosen an implant, which I think is a fine option, by the way, I would have had different procedures done.

We are fortunate to have a number of options regarding breast reconstruction. All of the options have major pluses and minuses. Not all of the options are available for every breast cancer survivor due to finances, particular breast cancer treatment regimen, body weight, smoker/non-smoker etc.

My personal opinion is that there is no perfect solution but there are a number of alternatives, often more than one of them being satisfactory for a given individual. But the ultimate choice is individual so folks, if you would kindly keep these typically well-intended opinions to yourself, we breast cancer ladies would be much obliged.

P.S. I know that I have also lost 31 pounds since May. My plastic surgeon assures me that I still have enough belly fat to make a new breast. Yay, belly fat!

I had a visit with Dr. Welk, my plastic surgeon, today. Although I have another bandage (one of those tiny round ones), I received a great award today. I do not have to see him again until February 28th! I saw Dr. Lucas, my naturopath, last Friday. I am not scheduled to see her again until February 22nd! And my next mammogram and medical oncology appointments are not until next month! I do have other healthcare appointments, not to mention the fact that I am planning to start acupuncture to address the sleep and menopause symptoms, but I have to tell you that it is a huge boost to me for these appointments to slow down some. Since my screening mammogram on May 7th of this year, I have had 70 healthcare appointments, only two of which have been unrelated to my cancer treatment. Five of those visits included time in an operating room. (I’ve had six surgeries but two of them were done on the same day. If you think I’m cheating, both surgeries hurt like Hell and also remember that I’m counting my mastectomy, which required overnight hospitalization as one healthcare visit.)

Seventy appointments is a lot for a 7 1/2 month period of time. Some people call the kind of cancer that I have, “cancer light” because I did not do chemo or radiation. And believe me, I am incredibly grateful to have skipped chemotherapy and hope to avoid it altogether in my life. I am here to tell you that there’s no such thing as “cancer light.” I’ve seen a couple of women’s blogs where they were apologizing for complaining about the inconvenience of cancer treatment because “other women have it much worse.”  This reminds me of one of the mom’s of my patients. She said, “This has been a really hard summer.” I said, “Yes, it has.” Then she apologized for complaining since I had been in cancer treatment all summer. I told her, “You don’t have to have the shittiest summer to have a shitty summer. You definitely had a shitty summer.” (I don’t normally curse but with some folks it introduces humor.)  So I may have “cancer light” but it’s still shitty.

How did I get on this tangent? Back to my story. Hooray, hooray, hooray! I have fewer doctors’ appointments for awhile! I have none at all during Christmas and New Years’ weeks!

 

I notice that I often unconsciously place my hand on the spot where my breast used to be. It’s sort of like a breast, at least more so than right after my mastectomy. As I’ve previously mentioned, there’s a calzone-shaped tissue expander in there right under my skin. I do it so often that I’ve begun to worry that I’ll be talking to one of my patients and suddenly find that I have put my hand under my bra without even realizing it.

I have to admit, it’s a pretty good hand warmer. Since I don’t go around topless, it’s well insulated by clothing. Plus, it’s located near the nuclear reactor part of my body, where the hot flashes seem to originate. And since the skin over the expander has no sensation, it is not unpleasant to touch it with an ice cube cold hand.

But mostly, I think my hand is just doing it’s version of, “What the Hell are you? Why are you shaped like a savory turnover? Why do you feel like a Tupperware lid?” Followed repeatedly by, “Oh my goodness, are you still there? What are doing here. Are you still shaped like a turnover? Yes, you are. Do you still feel like a Tupperware lid? Why yes, you do.”

It’s kind of like the relationship between my tongue and a crown that was put on one of my teeth about five years ago. When it was first placed, my tongue was on it constantly, like it was a foreign object that didn’t belong in my mouth. I still find that without realizing, that my tongue has a little habit of checking it out, probably at least once per day. And I think my friend, Lisa was right about my cat doing the same thing when he took a nip at my right breast some weeks back. It was his way of saying, “What the Hell is that?” My cat is about as smart as my tongue so I think this is a good hypothesis.

So now I think I’m going to do an Internet search for portraits of Napolean and see if he’s wearing a little pink ribbon in any of them.

No pink ribbon but based on the hand position, I surmise that Napolean battled sagginess in addition to Waterloo.

No pink ribbon but based on the hand position, I surmise that Napolean battled sagginess in addition to Waterloo.

I just lived an entire month without a surgery. When was the last month that this was true, you ask? The last surgery free month was May. Here’s a list for those of you keeping score at home.

June 27-Lumpectomy 1

July 18-Lumpectomy 2-Undiscovered Country

August 8th-Right-side Mastectomy

September 26th-Delay Procedure and tissue expander placement

October ?-Skin graft.

My next surgery? March 11th, for my TRAM reconstruction. Yay! I will make the best of my months off!

Lindbergh High School Reunion '82, '83, '84, '85

Join us this summer for our reunion in Renton, WA!

George Lakoff

George Lakoff has retired as Distinguished Professor of Cognitive Science and Linguistics at the University of California at Berkeley. His newest book "The Neural Mind" is now available.

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