Back to the drawing board. May 1, 2010

Saturday, May 1, 2010 8:11 PM, CDT

Back to drawing board:

The last few weeks have been interesting, to say the least. The MRI results came back and there is good news.  The tumor does not appear to be attached to the chest wall as originally thought.  Bad news, there is another (tiny, itsy bitsy) tumor in front of the known one.  What this means is the lumpectomy would have to be more severe and wouldn’t leave me with much of a breast.  So, back to the drawing board.  Let’s throw all the plans, appointments, schedules and treatments out the window and start ALL over again.  So what does this mean?

Recommend the full Monty:

It is now recommended to go with the simple mastectomy.  Okay. No chemo? But I have all these adorable hats!  No radiation? Well maybe chemo, maybe chemo and radiation, maybe radiation only maybe, maybe, maybe.  It all depends on the lymph node biopsy during the surgery.  If the cancer is present in the sentinel nodes, then more nodes will be “taken” and sent to pathology (results in about a week). If no cancer then maybe this, or maybe that. Maybe, maybe, maybe. It all depends.

So I can’t fret over all these maybes.  I will just forge ahead; ask questions but stay off the internet. But I couldn’t help myself. I read up on reconstructive surgery and decided it was an option I needed to consider. Why not?  If I’m a good candidate (healthy in all other respects), my insurance (by law) has to pay for it…let’s think big!  The full Monty.

What are we talking about here?  Dolly Parton? I think not.  How about a little lift and a little extra on top?  Just once I’d like to show a little cleavage. So I contact my navigator and ask her to set me up with an appointment.   OOOOppps – there are a lot of maybes thrown at me. 

As time goes by:

Okay, so I started this adventure April 1st. It’s now May 1st.  I still have my lump, my breast, my hair, my poor sleeping habits and a growing anxiety.  I’m now so impatient I want to strip naked and walk into the hospital and shout “take it, take it off-get me out of the this cancer suit”.  If the cancer doesn’t get me, the waiting will.  I realize the whole mastectomy thing is really very simple. If it were my gall bladder (what is a gall, anyway?) I wouldn’t hesitate or be fearful, but the removal of a breast is so visible.  Am I starting to fear this operation – well, give me enough time to dwell on it I will. 

It’s funny to me. We see it every day, pink this and that.  We all know someone with breast cancer and yet we continue to celebrate the boob. Hooters, Jugs, fun bags, rack, etc., etc., etc., yet it’s these mammary glands that are betraying women everywhere.  The hormones that make us the nurturing mothers, compassionate care givers and domestic protectors of hearth and home are killing us.  So after we nurse what do we need them for? 

They just look so nice in a bikini! 

Yeah, but what about my butt?

Cup in hand:

Tom and I visited the plastic surgeon.  Good Lordy-Be is he ever adorable.  Thirteen years old, amazing blue eyes, full head of (Kennedy) hair, beautiful teeth and smile-not too big, simply adorable.

The nurse, however, was SCARY!! 10 feet 26 Inches tall, witch black hair all poofed up and cascading down her back (very long hair), obvious work done on her face – it was good work, but she looked like a Barbie doll – couldn’t see any expression.  Turned out, though, she was sweet and found the opportunity to comfort me during the photo session.  YES!!! The medical community now has lovely color images of my dense little breast front and sideways.  They better not show up on YouTube someday.

So Mr. Kennedy-Hair pulls up a chair and with practiced sincerity goes through the pamphlets, drawings, molds, models, and diagrams.  Tom studies the drawings with only one question in mind.  Will he be on standby for same day reconstruction should the lymph nodes prove to be clean of cancer? Yes. He will be there.  Good.

So this is how it works:

With my surgery scheduled for Tuesday, May 3rd I check in at 5:00 am.  No food or drink after midnight the night before -  Like what would I do, eat a box of Cheese-Nips?, maybe.  What I understand is the doctors come in and sign the breast that is to removed so there is no confusion on the table.  But first I have a topical numbing ointment applied to the breast in preparation for some injections around the nipple. A toxic substance is injected around the nipple that will travel through the lymph system mapping the location of the nodes. During the surgery the doctor uses a hand held detector to locate the nodes for removal.  The sentinel nodes (the first 3) are removed and biopsied immediately. If no cancer is discovered the plastic surgeon will step in and implant an expander (after the removal of the nipple and breast tissue).  The expander is a hard plastic breast implant with a port.  After recovery I will return on a regular schedule to have fluid pumped into the implant.  After the desired results are achieved, a second surgery is scheduled to remove the expander and implant the soft breast implant.  At this time I can have the “good” breast augmented to match the new and improved one.  Neat.

If cancer is discovered in the lymph nodes (maybe, again), this type of implant won’t work if I require radiation.  Since radiation changes the cell structure of the skin, healing is difficult and infection almost certain.  And so, back to the drawing board.  Reconstruction is postponed for after radiation and/or chemo therapy and a whole different technique that includes skin and muscle removal from the back and grafted to the chest.  Now…I hesitate. Do I really need a boob? I haven’t worn a bikini --- EVER! I wonder if my insurance would approve a buttectomy.