Plastic Surgeon Appointment

JUNE 28th, 2006~Today was my appointment with the plastic surgeon and DH went with me. I left the kids with my Mom because I figured the conversation and topic would not be appropriate and also because we would probably not get a chance to talk with a 6 and 3 year old present.

I liked the Dr a lot and I have heard great things about him. I feel comfortable with him and thats whats important. He filled me in on what is going to happen in the OR after the mastectomy takes place and what he is going to be doing. If this is TMI for everyone you can skip ahead, I understand.

After they remove the breast tissue (they try to spare as much skin as possible but they have to take the nipple because its breast tissue where recurrance of the cancer can take place), they then place "expanders" under the pectoralis muscle and skin. They are using a special tissue called Aloderm to aid in forming the shape of the new breast without pulling in another muscle (cant remember the name). If they do it without this material there is more discomfort involved and the breast doesnt look as good/natural as it can look. The Dr explained that many people get grossed out about this stuff because its harvested from cadavers BUT the cells are washed, sterilized and go through a process where the DNA and other stuff is removed or something like that and this 'tissue' actually becomes part of my own body because my cells grow into it like a mesh. Then they place drains into you for a week or two to drain extra fluid that accumulates. I had one drain after my lumpectomy and this time I will have at least 2, hopefully no more than that. They are also going to be removing my port-o-cath during this surgery which I am thrilled over and wish I can get it out tomorrow after my last treatment. After a 3-4 day stay in the hospital they allow you to heal for 2-4 weeks and then begin to inject saline into the expander to stretch the muscle and skin slowly so there is the least amount of pain involved. They usually inject about 50-100cc of saline at once and this is done once a week to once every 2 weeks depending upon how well your body adjusts to the expanding. After you reach the size you are comfortable with (this can take anywhere from a few months to many months) they let you remain with the expanders in for a few more months to make sure the tissue is stretched enough for the next procedure. The next procedure is called an 'exchange' or 'swap' surgery that is done as an outpatient. They remove the expanders and replace them with the implants. I am almost 100% decided on gel implants otherwise known as silicone. The Dr went over all the studies done and that they are just as safe as saline and actually he recommends them for women with mastectomies because they feel and look more natural than the saline implants. Women who have implants for cosmetic reasons still have breast tissue that the implant is behind so there is no issue with how natural it looks. With a woman with a mastectomy there is nothing there but some muscle the implant is under and the skin on top. I did my own research and I was in total agreement with all that he said to me and so was DH which means a lot when he agrees also. The last procedure is done anytime after you are healed from the exchange surgery. It can occur 2-3 weeks after or anytime after. I have heard of women waiting up to a year to do the last procedure. This final procedure involves making the nipple part of the breast. They take tissue that is darker in color usually from the inner thigh area or other private areas (I'm not to sure of exactly where) and use that to form the nipple. After that is formed they do tatooing of the area to make it appear more realistic. I was undecided whether or not I wanted to do this but after seeing the Dr today I think if I have come this far then it makes sense for me to complete the job and have nice looking breasts even though they arent the ones I was born with.

When it comes down to it I would take my 35 year old saggy breasts over implants any day but I am happy that I will have breasts to wear clothing and not feel uncomfortable if I wanted tro wear something a bit revealing. Heck, I might be able to wear things I never was able to wear before! I gotta look at the bright side of things here otherwise I would be crying my eyes out at the loss of my boobies. The breast surgeon said something to me a few weeks ago when I went to see her to discuss the surgery. After I was crying my eyes out in her office explaining that I have an emotional attatchment to my breasts because I nursed both my children for 2+ years each and when I think about them as infants I think about the times I sat in my rocking chair nursing them. She said to me that at that time in my life my breasts were my friends and they fed my babies and made them grow into happy healthy children but now they are the enemy and not my friend. They need to be dealt with appropriately so I never have to go through this hell again. Since she said this to me I have been thinking like that but let me tell you how hard it is. They are a part of me being a woman and I am a bit attatched so I am working on changing my mindset. I have 6 weeks to do that. Surgery is scheduled for the middle of August so I am working on viewing my breasts as the enemy and losing a few pounds so I can go into this surgery a bit healthier. I gained so much weight with all the steroids I have taken during chemo that I have blown up quite a bit. I know that I will lose it because I already did it once and I am more determined than ever. I am waiting for my NutriSystem to arrive and I am starting my diet after the 4th of July.

I thought the day would never come and it seemed so far away when I began my treatment in March. Tomorrow is the day of my last chemotherapy treatment. I am not sure if I am excited about it or not. I feel kind of indifferent about it because I feel like I should be doing something else to help myself. Unfortunately since my tumors were whats called Triple Negative (it means that the tumor is estrogen, progesterone and Her2 receptor NEGATIVE and cannot be treated with tamoxifen, arimidex or herceptin because it wont respond to them). Being triple negative has its good and bad things about it. The bad is that if you are triple negative you have the highest rate of recurrance within 2.5-5 years. After you have reached the 5 year mark you actually have a lower recurrance risk than the people who are positive for any of those 3 receptors. What many people dont understand about breast cancer is that there is no 5 year rule like other cancers. With most other cancers after 5 years they say you are cancer free or cured (many dont like the use of that word because there is no 'cure' for cancer) but with breast cancer they cant say that because you can have a recurrance 10, 15 or 20 years down the road. When I first read that I was stunned because I didnt know that but I made up my mind not to dwell on statistics and numbers because everyone is different and they cant classify you or throw you into this group or that group of women with BC. Mark Twain once said that there are 3 types of lies: Lies, damned lies and statistics. This is so true because with all the medical problems I have had I was supposed to be in the higher statistical range and not have the disease but I did. Thats why I hate numbers and statistics.

Well, I got to get to sleep because tomorrow is a big day and I have to see the pain specialist AFTER my treatment. I had no choice because he didnt have an appointment available before my treatment. I also have to do something nice for the nurses so I think DH and I are going to get some pastry for them. I want to do more but dont have enough time in the morning plus I have to think about what I want to get them. They were all wonderful and I love every one of them.

A special thanks to my "THREE MUSKETEERS" who came through for me today with a surprise bouquet of flowers in celebration of my last treatment. But more so than the flowers and gifts given to me, they have shown me such support, love and compassion throughout this entire time I've been treated that it cant compare to any material gift. What they have given me cant be bought in any store. I love the three of them with my whole heart and they will be with me tomorrrow as I start another journey in my life.