Today saw two hours of travel (on this bright sunny and cyclone free day) to see my surgeon for the results of an ultrasound for the lumps in my side and armpit. It has been a long time between visits.
These “lumps” have grown since October when they were thoroughly assessed last year at my local hospital as scar tissue.
It’s hard not to be paranoid. So in light of the increasing size of these palpable lumps, and considering my oncologist is “da bomb” they were reviewed. Except this time this was done in the big smoke.
On arrival at my big smoke hospital, I waited another one and a half hours beyond my appointment time to be seen, which is the usual experience. Finally, I was called.
I entered the consult room and was greeted by a friendly registrar.
Today, my original surgeon who I have watched for much of the clinic time taking new patients into their consults happens to be too busy to see me. Sadly, the tide of newly diagnosed breast cancer patients keeps rising.
This not seeing my surgeon is supposedly a good thing. It must mean I don’t have cancer!
I am shown to a chair and the registrar begins.
“You were operated on Jan 2013 and also had a prophylactic mastectomy in August. Is that correct?”
It’s as though two years of torment can be neatly wrapped up into one teeny tiny sentence.
The registrar asks me how I am.
How am I? Does she really want to know?
I explain about the pelvis issues with Tamoxifen and my impending surgery. She asks me who is seeing me.
“Dr Claudia Karvin”.
She continues… “Well the good news is your ultrasound is unremarkable. It’s scar tissue!”
Bless me, I’m cancer free!
I strip off and my breasts are inspected. My armpits and the skin and nipples are checked since I don’t actually have breasts anymore. She runs her hands gently over the skin looking for lumps and irregularities. She palpates the lumps in my armpit.
“Oh good you’ve had reconstruction”… says the registrar.
“Yes I’ve got expanders” (I’m so lucky!)
I am supremely disappointed and I cannot hide it. The registrar can sense my displeasure for being stood up.
“I am a surgeon too!” she tries to reassure me.
“It’s not that, it’s about expectations and patient relationships. My surgeon and I… it’s been a long journey”, my voice wavered.
So I asked her … “Does it happen often that patients travel for many hours and then wait a long time and don’t get to see who they intended?”
“Yes, yes, all the time. It’s a good thing it really is!” she tries to provide further reassurance.
But I feel like I came all the way to the big smoke for lunch with an ex, and I got stood up, while they dined with someone else at the table opposite me.
I left the hospital feeling totally dejected.
I should be skipping down the street with this benign scar tissue news. But I’m not.
The total mind fuck of it all.
I contemplate that she didn’t want to see me. Or it’s not necessary to see me. She is simply too busy with other patients. My surgeon.
Deeply perplexed at what had transpired, I nearly walk in front of a moving car.
I don’t think anyone can understand what that feels like.
Letting go of one’s dependence on a medical expert who you viewed with such intensity, while they saved your life for well beyond a year is difficult. Releasing my vice like grip on my heroine.
Couldn’t she just look in for thirty seconds just to make sure I was okay?
Okay, so in the meantime, I will only be seen if I have the misfortune of presenting with a another tumour. If not, I will visit again in twelve months for review. I should have known it would end like this. It’s the way it plays out and I should be thankful.
I asked the registrar about the wait list for my exchange surgery.
The registrar said the list is now at two years from the previous estimate of eighteen months.
I’ve been looking forward to completing this journey in May. Now it could be November or beyond. By then, it will have been nearly three years with these painful, hard and ghastly things.
I sit and I watch women roll through this shittytittie journey. They have surgery, recon, chemo, rads. Whatever path it takes. It’s different for everyone. At the completion of their treatment they have reconstructive surgery if that’s the path they have taken. Some only have to wait months. Some years.
It’s hard not to get pissed about my own predicament.
Incredible friends have said go private! They would generously chip in. “Just go and have the pelvis and breasts completed so that you can get on with your life!”… they said.
But the idea of presenting the money to pay my way to a faster solution disgusts me. Healthcare (or the right to a good education) shouldn’t be about your financial position in life. It’s a philosophy I’ve always held dear.
So wait I will.
My breast surgeon breezes out of the consult room and calls another patient in. Through all the heads in the waiting room she finds me and waves, and there is even a smile. She is obviously glad to see me again. You can call me delusional but I speak the truth. This is my second visit to her in the last 2 weeks after my second mastectomy and immediate recon with tissue expander. It’s breast inspection day and there will even be a saline fill from my bearded plastic surgeon after our consult.
In the 8 seconds she appears outside the consult door with patient file in hand, I drink in as many details as I can. Her hair is lightly tussled. She is dressed in a black tailored jacket with a very short cream frill layered skirt with black sash trim. There are those impressively elegant legs that are finished off with canary yellow stilettos with silver toe plate detail. Spring is here. Gone are the black tights and designer boots of winter. Simultaneously, the track below begins to play in my head like we are in a movie scene. Press play, go on, do it now. Okay, you can pause that at any time.
After a short wait I am called. As I walk through the door I nervously blurt out how fabulous she looks. I am greeted and inspected with the usual efficiency. The operated breast looks good just 16 days post surgery. She snips a stitch that hasn’t broken down. She has taken the cancer, 22 lymph nodes and 2 breasts. Her job is mostly done with the exception of a visit in 6 months and then annual reviews for the next 5 years. Simple.
Next my bearded plastic surgeon enters the room wearing a hospital fundraising, cancer charity, cycling jersey over his usual business attire. As he steps towards me his mobile phone rings with the opening chords of a “bad to the bone” ringtone. Mr Cool and I break out in laughter. He inspects his handy work looking at both tissue expanders that have been inserted six months apart. They are considerably different in size but he isn’t worried.
The exchange surgery next year may include using 2 different sized silicone implants to get visual symmetry. He is happy that the nipple looks like it will survive, making the same comment as the breast surgeon minutes prior. I hadn’t even given that a thought this time. As it blackened from the trauma of the mastectomy and was at risk of infection I just assumed it would be safe like the last time. Then he asks me if I would like a fill inserted into the new tissue expander which is noticeably smaller than the one done back in February. I nervously giggle and nod for I am about to get ‘a bigger one’.
He leaves the room and returns with a 1 litre bag of saline and an enormous syringe and needle. He asks me to lay down on the hospital bed bare chested. He uses the magnetic port finder to locate the port, marks a spot with purple texta on my chest which is still tender from last fortnight’s mastectomy and recon surgery. He then inserts the enormous needle on saline into my breast, piercing through the skin into the port. I don’t feel a thing and he proceeds to fill the expander. First 20, 40 and then 60mls and I begin to feel tightening and constriction in the pectoral muscle across my chest and just under my armpit. I wonder if I can breathe. So I take some breaths to test the vice grip that is tightening around my rib cage.
He says “Make sure you tell me when you are uncomfortable. I don’t want you to be a hero.” I nod conservatively. The sensation of filling fools me into thinking it is possible my chin might just hit my breast when I nod. Lying on the hospital bed I’m not sure what I can tolerate so I laugh. He keeps filling to 80 mls, and I exhale and say… “Yes, yes I think that is enough for now!”
As the pressure mounts it’s like a tightening in the pectoral muscle accompanied with knife pain extending round under my armpit into my back. Very, very painful. He backs off and takes out 10mls and there is instant relief. The volume of two teaspoons. Together we then decide to take out another 10mls which is more tolerable. When he withdraws the needle it feels like I am a rubber mannequin. The body isn’t mine. The needle catches and as it withdraws the expander holds onto the needle tightly, vibrating and pulling.
He has inserted just 60mls in total, the equivalent of 2 shot glasses or 3 tablespoons, depending on if you are a bartender or a baker. I think of those women who have fill after fill of half a litre in each expander and greater. And those women who go through this process for cosmetic reasons. Cancer brought me to this point so I feel a little differently. I am left with 144mls in my first expander from February and today I lay with 280mls in my right expander. Interestingly, the February breast is much bigger. He assures me the mathematics is not important. The final exchange will work out the symmetry.
After the procedure, I need help getting up off the bed and look at my chest in the mirror. The breasts now look quite even. Mr Cool helps me with dressing as my arm and chest are not sure how or if they should be moved. We very slowly walk out of the hospital as I experiment with new strategies for breathing. We dawdle to one of our favourite city lunch spots. On the way Mr Cool and I debate about who my plastic surgeon was speaking to when he answered his bad to the bone ringing mobile. I envisaged him talking to his daughter about his grandchild going to sleep. Mr Cool felt it was a patient going to sleep in surgery. It doesn’t matter who is right. We are hungry and I don’t know if I can even lift or move in particular ways or even eat with the sensation of just 60mls. I wonder how on earth I will make the 150km journey of bumpy roads home? For now, the breathing, is okay though. And I intend to return post radiotherapy for another very small fill in late October.
There has been 2 and a half weeks of post surgical pain and recovery. There has been a very conscious attempt not to get addicted to serious pain analgesics. There has been careful management of an Exudrain surgical drain which I am now free from. There have been daily nurse visits to my home, and persistent post chemo and surgical drug induced digestive woes. I have been fortunate enough to have had some wonderful visitors in my home including my mother and sister in law. They are now gone and life is moving forward.
Very soon I will post the retrospective blogs I wrote in the last three weeks. While high on Endone and OxyContin and suffering the after effects of five months of chemo, surgery and the dizziness of low haemoglobin, I lost my blog voice and could not concentrate for any length of time. But I am back with a clear mind. So stay tuned.
I’m having a mastectomy tomorrow. My second one for this year. That will be more mastectomies than Coq au Vin’s for 2013.
Tonight, on the eve of getting my second breast removed, we have come to the big smoke to see a comedy show called “Laugh Your Tits Off”. If only it was as simple as laughing uncontrollably for a few hours. The show is at a theatre a few blocks from my surgical theatre. How could I not attend? Mr Cool and I booked a swanky hotel in the city, left the kids with the Grandies, and rallied 14 awesome friends to come to have dinner with us on a cold Monday evening in Melbourne.
I couldn’t think of a better group of people to share this night with. All of them have been key features in supporting me through this story. There are my “sole sisters” who came and ran a 10km fun run with me in the 14 days between my lumpectomy and before my mastectomy back in Feb. They have been incredible sources of inspiration to me this year as I have continued to watch them aim higher with their running achievements. This makes me want to get off my arse when my treatment is complete and work hard to getting fit and healthy again despite my starting place being a little different and the new hurdles that await me. Breast cancer with all of the changes that it creates is not going to defeat me.
There are my dearest and longest high school friends who have been with me right from the beginning. They were the first people I contacted when I got news of my diagnosis and they have offered so much emotional and practical support I am wary of wearing them out. There is so much love and meaning in our friendships dating back to 1987. I tear up just thinking about this group of people. Although we don’t catch up a huge amount throughout each year we have shared some wonderful and not so wonderful times and when we see each other it really counts. Our group has grown as we have met partners and had children. These people know me so well and respect me with all of my oddities unconditionally.
There is the sister I only became acquainted with last year before my diagnosis who turns up at my house with her humour and a week of home cooked meals. Sometimes she brings coffee. Sometimes she arrives with a 15 year old fruitcake that she has claimed from helping someone else organise their pantry. You know when you meet someone who just ‘gets you’? She is one of those. Often we Facebook comment when watching creepy body part shows and gross everyone else out. We connected before my diagnosis. She oddly has been in this position before, connecting a few years ago with another young mother who shortly after they met was diagnosed with cancer and was taken far too young by it. So the timing of us connecting and me being diagnosed with cancer is a little weird to her.
Strange how we are drawn to particular souls at various times in our lives. I am so grateful that these individuals were available on this night. The universe works in mysterious ways indeed.
So, there is nothing like a bit of laughing your tits off with awesome friends the night before a prophylactic mastectomy. Six months to the day between these two surgeries yet the first was filled with fear and was a hurried race towards the urgent removal of a fast growing cancerous tumour. The night before was sleepless, stressful and filled with worry. This time, it’s a meaningful celebration, shared with great people and great food. Tomorrow, breast tissue shall be gone!
So Mr Cool and I are walking to a pre show dinner to meet great friends when Mr Cool’s phone rings. It is my breast surgeon who has been trying to contact me. I had a missed call minutes earlier but had not been able to answer my phone as I had just painted my fingernails and couldn’t reach into my pocket for it. Mr Cool put on his best voice for the woman his wife has an intense one way relationship with and he hands me his phone.
I apologised for not answering the call the first time and my breast surgeon said “Oh it’s okay you were putting nail polish on. You know Lise, I always say to my patients if I can wear nail polish during surgery then they can too, but only if it is red.”
I looked down at my fingernails and my nail polish wasn’t red, it was mint green. I contemplated finding a late night chemist to purchase some red nail polish in preparation for our meeting in the surgical theatre tomorrow and then told myself to stop being ridiculous and listen to the point of the call. I would be taking my nail polish off in the morning as per the hospital pre surgical instruction pamphlet. The breast surgeon was still on the line and she continued… “Has your plastic surgeon called and spoken to you in previous days?”
“No, no he hasn’t.” I answered.
“Well, he was going to call you and discuss the prospect of not exchanging your first tissue expander in tomorrows surgery. After looking at the research literature, speaking with other plastic surgeons and considering your particular case he has decided it is better to radiate the tissue expander and then exchange it at least 6 months to give your tissue and skin time to heal from the radiotherapy.”
I had suspected this would happen. I too had been researching and there are not many cases of radiating silicone implants because of the risk of scar tissue complications so I was kind of relieved that they finally got around to making a decision. The damage to the skin and tissue from radiotherapy will be the same for expander or implant, the effectiveness of the radiotherapy will be the same regardless of whether a tissue expander or silicone implant is radiated. But it will be better to preserve the integrity of the implant if capsular contraction is to occur.
Of course, this now means a fourth surgery next year or whenever the public list calls my number to exchange the two expanders for implants. Damn these awful expanders. Tomorrow, I’ll have two and I hoped to have none.
I hung up the phone and Mr Cool and I continued walking. I was a little confused at the change of plans and took a few minutes to process the conversation. I rattled on to Mr Cool as we crossed major intersections, oblivious of where I was, my mind fixed back with the conversation with the surgeon. I respect my surgeon and plastic surgeon a great deal. They know what they are doing so on we roll. We met with our friends for some great food and then walked to the show.
“Laugh Your Tits Off” was a hilarious comedy show with some of Australia’s most loved comedians. All proceeds from the show were donated to the “Love Your Sister” project to raise money for the Garvin Research Foundation. Samuel Johnson is a much loved Australian actor, and his sister Connie has stage IV breast cancer and has been given a short prognosis time. Together they embarked on a journey to raise funds and promote awareness for cancer research. Connie has two little boys like myself and was diagnosed about 3 years ago with breast cancer. Incredibly, this is not Connie’s first experience with cancer – at age 11 she fought off a very rare and aggressive bone tumour in her leg. Then at 22, she overcame a tumour in her uterus. Then, at 33 Connie was diagnosed with breast cancer and this time it spread to her lungs, liver, pelvis, spine and knee. At the start of this year when I was diagnosed, Connie was given a life expectancy of between 6-12 months.
Connie’s legacy will be an incredibly meaningful one. While I sat in my hospital room a few days after having my first mastectomy, Samuel started his journey to unicycle around Australia departing from Federation Square in Melbourne. I remember watching his departure on my hospital room television screen and wishing I could have gone. Since then he has ridden nearly 10,000 kilometres crossing Australia through desert and past breezy coast, on bitumen and red dirt, past B Double road-trains. As well as riding the distances Samuel is stopping and doing dares along the way. He has raised over $750,000 so far, with the ultimate goal is to ride 15,000kms and hit the million dollar mark.
When I met Samuel pre show, he looked at me and with such sincerity asked me how my treatment was going. I blurted out it had been a crazy journey but was made easier in watching his attitude and achievements in spite of the hand that his sister has been dealt, and that the love he has for his sister is inspiring. We embraced and I wiped away some tears and everyone raced off to start the show.
After a few hours of hilarity Connie and Samuel took to the stage and received a huge standing ovation. There in a very raw moment, the laughter was silenced and I was reminded that through all the laughs and glitz and awareness raising and the “pinkification” of breast cancer, there is this brutal and unforgiving reality that people, mothers, sisters, daughters, lose their fight to this disease every day. In fact, thirty percent of women who get a breast cancer diagnosis will develop metastasis which will shorten and reduce the quality of their lives and this is irrespective of stage, grade, tumour size, hormone status, nodal involvement, or their treatment pathways. This figure has not changed despite all of the fundraising or awareness raising or screening for breast cancer.
Samuel left the stage and Connie cut a solitary figure in the spotlight on that large stage. There was another standing ovation. Once the clapping had settled she began to speak. She explained the aim of “Love Your Sister” was to ensure that “no young children have to lose their Mum’s to breast cancer.”
Tears streamed down my face. I could see some of my friends wiping away their own tears. And I heard my friend Bevan Lemon who was sitting next to me take a really long, slow and deep breath. A few days later he sent me a text…”I mean she just gets up on stage at the end and spoke and I felt all my stuff I was feeling selfish about, like my trip to the dentist where I felt nausea that day, and my cold, the kids feeling like crap, just fade and get normalised. Thanks for the invite.”
No, thank you for coming. Thank you all!
I think I am in love.
Today she listened to me. Smiled at appropriate times. There were even outbursts of laughter. I know she would have brushed my hair from my face if I had any.
For this consult she had researched some literature for my individual case. “I know that you like statistics so I’ve done some research for you” she said.
See, she is thinking about me even when we aren’t together. She even answered all of my questions in great detail. Time stood still.
There was an acknowledgement that going straight to implant with this next mastectomy might be difficult. “You fit types with strong pec muscles make it hard for plastic surgeons” she said.
Oh she does make me blush!
She again said “We want you to be around for a very long time.”
Let’s not kid ourselves. She wants me to be in HER life for a long time. That’s essentially what she meant. No illusions necessary here.
We lingered longingly, even though other women had already waited too long in the waiting room.
There was an apology about her criticism of my nipple position at our last consult. “I was getting ahead of myself” she said. She is just beginning to truly appreciate my uniqueness.
This was by far our most successful encounter yet!
I wouldn’t be surprised if I get a post date text message tonight. If only I wasn’t living so far away and wasn’t married, maybe, just maybe we would have a chance. Another life perhaps.
She is mesmerisingly and extraordinarily impressive and out of respect for her privacy, I’m not posting a picture of her shoes today.
Can’t wait for our surgical date! August 13th is just so, so far away.
The image below depicts installing a zip to the side of my breast, criss crossing it with black pen, and watching black arrows explode from my nipple. Well not really. More like location of the incision site, removing all of the breast tissue and scraping the inside of the nipple to test for cancer while still in surgery, and taking it off if it tests positive for cancer. That my friends is a nipple-sparing subcutaneous mastectomy right there.
On Friday morning, Mr Cool drove me 2 hours to the big smoke specialist cancer hospital, and despite arriving on time, I waited in the waiting room for another 2 hours for a 12 minute breast clinic consult. I was quite annoyed, especially since a friend of mine who had a later appointment was seen before me and I sat for another hour. Of course, when I went in my breast surgeon apologised for the delay and
I gave her a piece of my mind I didn’t mind, cause she is mesmerisingly impressive worth waiting to see. So all was forgiven.
In the small consult room we gathered, myself, the breast surgeon, the plastic surgeon and the breast care nurse.
After dutyfully stripping off, the plastic surgeon took a close up picture of my breasts with his iPhone doing my best breast pose. Naked from the waist up and with my hands on hips I nearly said cheese as he snapped away. Luckily I’ve been practising in the bathroom mirror for months.
I love the feeling of being photographed topless by a 60 something, hairy faced, balding plastic surgeon and this photo then sitting in his iPhoto collection along side thousands of other breast pics. I’m hoping he doesn’t leave his phone on a table in some random cafe. These pics I assume, will be safely guarded and used as a reference in surgery.
In four weeks, I will be having my preventative prophylactic mastectomy. Tests show no cancer in my right breast. But the risk of recurrence or new cancer is quite high and right from the diagnosis I made a decision to have the second breast off. If my tiny breast can have as much cancer as it did, then I don’t want any breast tissue on my body. Especially since the cancer is strongly Estrogen positive. This decision has not wavered since the January diagnosis.
At the time of this second mastectomy, they will put in a silicone implant and make a dermal flap to hold it in place and stop it from bulging out the top of my pectoral muscle which is pulled off the ribcage to make room for implants to sit behind. In the same operation, they will remove the tissue expander from my left breast that has been there for 6 months, and replace it with a silicone implant. I might ask if I can keep the tissue expander as a souveneir. Could be used as a paper weight or something. After a hostile start, we have become friends, the little Asian sized expander that was never expanded.
Working together, the breast surgeon will perform the nipple and skin sparing mastectomy and a possible sentinel node biopsy, they will turn the nipple inside out and scrape and freeze some cells and hurry them off to pathology and wait for the result in ten minutes. I’m not sure what they will do while waiting. A quick round of Candy Crush perhaps? If the result is negative for cancer I get to keep the nipple. The plastic surgeon will then take over and build the breast with my new implant and give me a bit of hollywood shoozhing. I will be in hospital for 3-5 days and will come home with Exudrains again. You can see a picture of what they looked like last time I had them here. And again a nurse will visit me daily to check the dressings and drains. For a month I will sleep sitting upright in bed as I can’t lay on my sides or stomach. And like last time, I wont be able to run for about 5-6 weeks, perhaps longer given I’m so low from chemo and I will have already commenced radiotherapy 2-4 weeks after this surgery.
They are very happy with the work they did on the left Shittytittie cancerous breast back in January and February. It has healed well and looks nice and perky and radiotherapy should take care of any cancerous cells that may have been left lingering.
With the exception of nerve damage to the breast and arm from the mastectomy and full axilla clearance back in February, I love my new breast, and am quite happy with the 3 o’clock nipple. (Refer to Diagram B below) But in this meeting the plastic surgeon and breast surgeon had a little conversation between themselves while I sat bare chested and listened…
BS : What are we going to do about that nipple?
PS : What do you mean? How far to the left side and how high it is?
BS : Yeah. We definitely need to fix that!
Me : Oh thats okay I have always had nipples that point sideways.
BS : No we really should do something about it.
PS : If she is happy we can just leave it and make the other one the same when we do the mastectomy and insert the new implant with a dermal flap.
BS : Or you could just move it slightly to the centre with another incision.
My Plastic surgeon nodded while closely studying my left breast.
PS: I’m more concerned with this swollen scar tissue at the surgical incision line at the side of the breast. It is very tight. We’ll need to free it up a bit. We could drag it round to make the side of the underarm more streamlined, and that would change the position of the nipple.
Me: What about the top of the breast? It’s very tight when I raise my arm.
PS: Oh don’t worry about that we will loosen that up in the next operation.
The plastic surgeon left the room.
- BS = Breast Surgeon with the amazing shoes and largest diamond I have ever seen on her ring finger.
- PS = Sincere Plastic Surgeon with the hairy face.
- Me = Me with the wonky arsed nipples.
So there is just this small dilemma of the nipple placement. For 37 years I thought my nipples were you beaut perfect. Turns out, the surgeons think they out of the ordinary. Extraordinary even. I have never had front on “beamers” (For those not in the know, Beamers refer to hard nipples, visable through one’s shirt) My lights have always shone out to the sides. Always. But with a lumpectomy and mastectomy and with a tissue expander inserted, my nipple is considerably higher than it once was and it points to the side – like to 3 o’clock if you get my drift. (Refer again to diagram B). The yet to be renovated breast has a nipple that currently points to 8 o’clock so there is considerable work to happen to achieve symmetry. Symmetry is everything in the plastic surgery world. I am a geographical person also, so another description of nipple orientation might include compass points. My left nipple sits east north east and my right nipple currently points south west and the perfectionist breast surgeon would like to see them even and centred. I’m not sure I even care.
For your amusement, below are some annotated diagrams outlining the dilemma. I’m a visual person and I like pictures, but I’m not putting photos of my breasts on this website. Just letting you know now. So below is as good as it gets.
Diagram A: Pre cancer nearly 40 something boobs that have breastfeed two children. These were my “Rocks in Socks”. But they were good rocks, in good socks and they were mine. Before cancer moved into the building.
Diagram B: Post cancer lumpectomy, mastectomy and tissue expander insertion. Here the left breast is perky and larger than the original even though it was never filled or expanded, with a 3 o’clock pointing nipple. Right breast (my right) still the original. I have always liked 3 o’clock, it’s a great time of day.
Diagram C: August planned prophylactic (preventative) right breast mastectomy with immediate reconstruction with silicone implant, making breasts the same with a 3 and and 9 o’clock nipples. Cue circus music. Hideous, someone cover her up! (I thought they would look great!)
Diagram D: August prophylactic (preventative) right mastectomy with immediate reconstruction with silicone implant, making breasts the same with extra incisions to move both nipples more to the centre of breast so that they look like beamer headlights (point forward). (Yawn, can’t be bothered, I thought I looked good already. Mr Cool will find other reasons to leave me than my outward pointing nips.)
Now I am left feeling a little confused by the options for my wonky nipples. Is it really a problem? I can’t have people sniggering at my high and sideways pointing nipples when I go topless on St Kilda Beach after all of this is said and done. Maybe I need a tummy tuck too? My stomach points to the sides as well. Can they do that at the same time? I’m guessing I’ve got two weeks to decide whether I want them touching and moving my nipples when I next meet them and sign consent forms for the surgery. These first world problems get more ridiculous as we ‘advance’ as a society. Advance being a highly debatable word.
For this fortnight, that concludes the great nipple position, freak show, circus saga.
On a more serious note, I will be back to the big smoke in two weeks to see a psychologist about undertaking my prophylactic mastectomy. Apparently anyone who has one must see a psychologist first. Not to approve or deny the mastectomy, but just to talk though the issues around the taking of a breast that doesn’t yet have cancer in it. Do I see it as an amputation of a body part? Will there be any adverse psychological effects of this decision? I had a breast removed already, and I am very ready to let the other one go as well once chemo is complete.
My pathway through treatment has been complicated. After I was initially not likely to require radiotherapy, post mastectomy pathology revealed I probably should have it (Multifocal, grade three, one node, tumour close to chest wall, want to live as long as possible, have young kids etc) which has put a bit of a spanner in the works for how we move forward.
I am presently unable to have an MRI on my breast because I currently have a tissue expander with a metal magnetic port in my chest. Being in a MRI machine would be a bit like sitcking a ball of metal in the microwave. I have had mammograms and ultrasounds of the second breast. They have come back clear. Yet the surgeon has twice raised the prospect of doing a Sentinel Node Biopsy (SNB) to be sure to check the lymph nodes. She said I would be very unlucky to have cancer in the lymph nodes of my right arm given I am on chemo at the moment , but it does happen even when no cancer is detectable in a mammogram or ultrasound. Once the mastectomy occurs, diagnostically they cannot do an SNB because that involves injecting the breast with both radioactive contrast and blue dye and imaging it prior to surgery and then removing the nodes involved to check for cancer (see my previous post “Blue Dye” for a description of this procedure), but there is a risk of lymphodema occurring in the right arm, and I’ve already had all of the nodes removed from the left arm. So having two arms at risk of lymphodema is not a great prospect. The alternative is to take a chance and do nothing with the nodes. So another decision to make as well.
Of course, I am wondering if the surgeon’s picture will be used in some hideous nipple placement photographic presentation at some plastic surgeon’s circus convention. Roll up, roll up to see the lady with the mismatched 3 o’clock and the 8 o’clock pointing nipples! To be fair though, someone who was wearing designer 6 inch fluorescent pink stilettos (kicking myself I didn’t get a picture) has created this uncertainty about my nipples in my mind and it wasn’t my hairy plastic surgeon. To move or not to move. It’s not like I have any breast sensation left post mastectomy anyway.
Just call these growing waves of unsettled thoughts I have to make decisions about my “Nipple ripples”.
Cue circus music now.
Driving to the big smoke this morn to have boobie two squeezed in the prized George Foreman grill. This will be my LAST EVER Mammogram! I can hear your jealous minds ticking over… “Lisey will be free of mammograms… wow wish that was me!” See, a breast cancer diagnosis has some merits. Wouldn’t want to squeeze implants in one of those things. They could burst like a pubescent zit! Ewwww!
Then, I’ll move onto a little cold lube up for my last breast ultrasound before my prophylactic skin and nipple sparing mastectomy surgery next month. Four weeks post last chemo infusion (this Tuesday peeps – mark it on your calendars!) I’m back under the knife, back in theatre with the bearded nurses and the drugs that make me hallucinate. Yee hah! Unless they find cancer today, and then I could drop the “prophylactic” term from my sentence. Which would be great cause that word is hard to type on an iPhone.
I can’t wait to do all of this dressed only in my undies and a hospital gown that opens at the front. Especially since I’m wearing a pelvic belt after Taxotere chemo has giving me the worst sacroiliac sprain and arthritic flare in my lumbar spine of my life and I’ve been hobbling around for 10 days. I spent a few days worried that breast cancer cells had moved in and metastasized. Just call me a “cancerchondriac”. If the mammogram lady asks me to contort myself like a Russian gymnast there is going to be trouble. Does anyone know any Russian swear words?
I visited the surgeon for a breast review 5 long weeks ago and we had conversation that went something like this… “You know Lisey, you can take photos of my shoes but I don’t want them to go on the Internet or anything.” So I’m guessing this will be the last one.
Wish me luck.
Goodbye, boobie two’s day, who could hang the blame on you… Girl I’m gonna miss you.
I’ve been waiting for months to revisit my breast surgeon, since our string of regular surgical dates and reviews was completed and she sent me on my way to heal. I grieved a little for the finality of the first part of treatment farewelling so many characters which had been such a feature of my life in the early days of diagnosis; the breast care nurses, the plastic surgeon, and their side kicks. The familiar surrounds of the hospital. As I returned to continue the treatment plan at my local hospital.
Today is breast review day back in the big smoke. She will inspect her handy work, the scalpel cuts that are four months along, the Asian sized tissue expander as well as the armpit with no lymph nodes. There is the small matter of radiotherapy to discuss before plans for the second mastectomy and sentinel node biopsy can proceed. All of this dialogue might occur in a fifteen minute meeting which I am happy to make a four hour round trip for.
I have not forgotten the scent of her perfume. Or the excitement and anticipation I felt when I saw her clothes and shoes each time we met. Time has moved through two seasons since our beginning. Today I’m expecting some wintery attire. Stilettos would be unlikely. Perhaps long leather boots?
I am a little excited for this date. Despite feeling unwell, I have put some makeup on my bloated steroid infused face and chosen one of my favorite headscarves. But it is a very different woman that will meet the surgeon today. I wonder if she will remember who I was? Maybe she could remind me.