Thursday, June 26, 2014

It's not just the cancer that's a bitch...

it's everything else that goes along with having a double mastectomy at 38 years old.  When I was 38,  I'd birthed two beautiful children and, if I say so myself (and I do), I had some amazing boobs.

NO, NOT THESE BOOBS

NOTE:  This blog is full of TMI...if you can't deal with that, then I suggest you stop reading now and go back to a world where breast cancer is just a cute pink ribbon.  Otherwise, keep reading for a real dose of Breast Cancer Awareness...

Background, very long background:  I had a double mastectomy in November 2007 after 6.5 months of three nasty-ass chemos.  Dr. Suzanne Kilmberg told me that because of the size and location of my initial tumor (10 cms;  going from the nipple all the back to my chest bone, but not actually invading it, thank goodness) that they'd have to remove my nipples.  I was okay with that.  Dr. Yuen, the plastic surgeon, would then put in what are called 'expanders' and I'd go back to him at regular intervals and he'd fill them with a bit of saline so as to stretch out the skin.  Finally,  we'd do an 'exchange' where the expanders would be removed and the breast implants inserted.

So imagine my surprise when, after 8 hours of surgery,  I woke up with nipples!  At this point in my career as a novice breast cancer patient, I didn't question it.  I just figured that there was no cancer actually in the nips and so Klimberg was doing me a favor by allowing me to keep them.

Here's the thing about expanders; they hurt.  Your boobs are rock solid and they hurt.  You're stretching out your skin for goodness sakes.  It's a dull, never-ending pain. And it seems that once the pain subsides, it's time to go back in and get another 100ccs or so of saline injected, starting the dull aching all over.

Let's pause here for some math...100ccs is equal to 3 1/3 ounces.  That's over three shots.  Let me help you picture this:  Imagine these glasses filled with tequila and then putting them in your body...oh, and then imagine drinking one more that's 1/3 of the way full.

Three+ shots...Heisenberg, he's the one who knocks...ouch!

My boobs were so hard during this time that it was obvious by the looks on people's faces when we hugged that they knew something was amiss.  Unconsciously, or maybe consciously, I started doing a little sideways hug.
Like this:

From the mastectomy to the exchange surgery was a 7 month process for me.  Big, round, hard grapefruits on my chest.  Not attractive.  At.  All.


Fast forward to June 2008 and the exchange surgery.  When I was able to get a good look at my boobs after the exchange, I was horrified.  I knew going in, because Dr. Yuen told me so, that I was not getting a 'boob job' but I was having 'reconstruction' and I wasn't to expect movie star quality boobs.  Fine.  I'm ok with that.  For the most part.  If that's what I'd gotten.  But I didn't.  

TMI ALERT:  Pre-reconstruction I had really, really nice boobs, especially for a 38 year old mother of 2.  Yes, it bears repeating because that's how awesome they were.  I shit you not...they were amazing.  My nipples were the perfect size, they pointed straight forward as they should, and they were not too big or too small.  However, admittedly and in all candor, regardless of much I liked my real boobs (but for the fact they tried to kill me), they were not movie star quality.   But I am not ok with is nipples that point directly to armpits.  And I at least expected them to be level...is that too much to ask???



Over time, my boobs became more uneven; they rippled underneath, one is noticeably higher than the other; one had a dent, for lack of a better word, in it; and the nips...well they are pointing further and further towards my armpits.

Also, during this time, I'd been diagnosed as Stage 4 with mets to the liver and bones.  At one point, in 2010 I believe, I was NED (No Evidence of Disease), not to be confused with being in remission or being cured; but I was able to go off chemo and after being off chemo for almost a year, I told Dr. Makhoul, my medical oncologist who I love to this day even though he's no longer my medical oncologist (again for reasons that have nothing to do with my treatment plan, but has more do with his nursing staff who, with the exception of one nurse who had taken a two year leave, are woefully inept) that I wanted to have my boobs re-done.  He told me we could schedule a consult with Dr. Yuen.

Mmmmmm......

By this time, I was getting in control of being my own patient advocate and I told Dr. Makhoul that Dr. Yuen would never touch my body again and that I was going to go see someone else as long as he thought it was okay to go ahead with the procedure.  As always, Dr. Makhoul supported me 100%.  I made an appointment with Dr. Ed Love.

I told Dr. Love that I didn't care what he did so long as he removed my nipples and made me level again.  He thought that was doable and surgery was scheduled.  However, two weeks before my scheduled surgery, the cancer was on the move again and I had to go back on chemo.  And, but for three months after that chemo regimen, I've been on chemo ever since.

As you probably know, being on chemo compromises the immune system which means 'elective' surgery is out of the question.  I was screwed.  Or was I??????  Hell no.

Well, because I am Wonder Woman.


Fast forward to 2013-14 and my boobs look more awful than I ever could have imagined.  Mind you,  reconstructed breasts don't 'give' like natural boobs, at least mine don't, rather, they are pretty stationary.  But now they have migrated so far apart that they are interfering with my golf swing.

That's right guys and gals, go duct tape a grapefruit to the part of your chest and so far over to side where it actually touches your arm and try your golf swing.  I physically have to adjust my left boob before every swing to get it out of the way.  So much for my PGA dreams...shattered...(DISCLAIMER:  I've only actually golfed 18 holes maybe three times in my life, but I do enjoy an annual trip to the driving range.)

What I imagine I could look like playing golf...
What I actually look like playing golf...with sincere apologies to the late, great, Payne Stewart...

You can now (almost) drop a half-dollar coin piece, or at least a quarter, down my cleavage, one breast is about an inch higher than the other (and remember they are stationary, so a bra is not not going to fix that for appearances), and my right nip is all but under my armpit.  Hideous.  No one wants to see that.  Especially me.  Every stinking day.  There's nothing like lopsided, rippled breasts to remind you every fucking day that breast cancer is not a pink ribbon.

If my breasts were a pink ribbon cookie, they'd look like this...in fact, even though they aren't cookies, they sort of look like this!
Just to give you a little visual



But I digress...

So, I am NED again, but am staying on chemo in the hopes of being NED for MANY, MANY more years, I again approached my new oncologist about having surgery to fix the girls.  We decided that I could take a one month chemo break and have the surgery.  So, I made the consult, scheduled the surgery and stopped the chemo.  Again, I told Dr. Love that I wanted one thing...I needed those nipples gone. I was tired of wearing padded bras that I only wore because they hid the monsters we call nips.  I also told him I needed my girls closer together because of the issue with my golf swing.  He agreed we could do all of that.  We also decided that I'd go back to my original size.  TMI ALERT: During my first reconstruction, I'd opted to downsize to C cup.

So here's what happened when I had surgery Monday:  When Dr. Love removed the nipples, there wasn't enough skin left to do the implants.  I'm back to having expanders.  I'm back to going in every few weeks and getting them filled until I can have the exchange surgery.  I'm back to having rock hard boobs.  I'm back to having the nagging pain associated with having my skin stretched.

And I'm ok with that.  Because in the end, I know my boobs will look better than before.  There is no way they can't.  I may not want to show them to anyone else, but I have to see them and that's why I'm doing this.

Carry on.