Three years ago I asked my plastic surgeon if I could keep my tissue expanders when they were to be removed. He laughed, and discreetly filed that request next to a lot of the other stupid things I asked in our brief consults.
I’d planned to keep them and use them as paper weights, cause let’s face it, one can never have enough paper weights. I’d also invisaged I’d get them out at parties, or let the kids take them to show and tell. Can you imagine? Oh the horror!
Last night, as I rolled into theatre, I thought I’d revisit this request. My plastic surgeon mumbled something about infectious diseases and hospital policy.
Then grasping at straws I asked… “Would you photograph them on your iPhone?”
I waited for the “No!”, but to my delight he replied… “Sure. Not me, but I’ll get someone else to do it”.
I didn’t expect for him to follow through with his promise. Theatres are serious places with very rigid procedures.
As I drifted off to sleep under the cloak of Fentanyl and anesthesia pulsing into my veins in the theatre I’d already had three surgeries in, I remembered fondly the original bearded nurses I met back January 2013, and the familiarity of the weird 70’s vinyl looking wallpaper. I briefly contemplated how far I had come from the fear and dread of three years ago. Then before I knew it I was out like a light.
I don’t fear the cancer returning now. Because I’ve played that thought over and over in my mind a million times. It’s almost boring to think about. If the cancer comes back one day, so be it. There is no rhyme nor reason to who develops mets. Despite our best treatments and people’s health status at diagnosis, it just happens. Shit happens.
I’ve seen a lot of cancer in recent years. The worst of the suffering and the best of the love and compassion that comes. How profound and utterly terrible the disease can be at the same time. With four to a room at this hospital, you get to meet people at varies stages and types of cancer. You see a lot of cancery crap.
I will never forget the time an emaciated man laid opposite me when I had my first mastectomy. He had stage four bowel cancer and he looked and sounded like my own Dad in his own late stages of cancer. That was really confronting and I found myself having to escape the room and walk the halls of the small ward, carrying my surgical drains full of blood to get some separation from such a confronting association.
Then there was that lovely lady who I chatted quietly with through the depths of the nights after my second mastectomy. We spoke quietly about our children, careers and travels. There was no discussion of death despite it being the white elephant in the room. And in the mornings she conversed with the doctors and nurses so cheerfully and with such positivity, despite having endured two primary cancers. She was now facing her imminent death from the second. They gathered round her listening to her stories, almost vigil like. I was taken aback when a doctors voice waivered when discussing her predicament. In the whole week I was there, no family visited her.
It’s hard to be an early stage cancer patient and be present while all these devastating and heartbreaking conversations occur around you. Despite ones best intentions at privacy. The guilt is huge. Why am I okay?
Take for example witnessing the desperate play that happens on a daily basis in cancer wards, when nutritionists visit to try to make a difference to patients who are very clearly wasting away as their disease grips them so tightly. Or the look on family members faces when they visit and see their loved ones fading. Such heartbreak!
To think, it could be me one day? Or maybe not.
The new hospital will be set up with single patient suites which will avoid these confronting moments. But in a way, patients might miss out on the chance to share and connect over what they know of their disease. These moments in the middle of the night. Where sharing a room makes the experience less lonely.
Last night, my plastic surgeon did his best to make me feel more ‘normal’. But it’s been no easy feat.
Back in February 2013 my cancer side tissue expander began the process of contracting into my chest after a nurse accidentally closed one of my drains the night after surgery. That begun the inflammation and scarring that would form a capsule around the tissue expander and compress it. Radiotherapy later in the year further exacerbated this.
The plastics surgical team worked hard to cut out the scar capsule and try and restore the shape of my chest. As a result what should have been a simple “exchange” surgery from expanders to implants, has meant more trauma than anticipated.
I have surgical drains again and will have to stay in another night because the drain output hasn’t slown down enough. It feels like I’ve had a third mastectomy pain wise. The other side, is peachey creamy.
The wonky 2 o’clock and 8 0’clock nipples I’ve written about many times have almost moved to 3 o’clock and 9 o’clock. Down the track when my new teardrop implants settle in to my body, my plastics doc may look at some corrective procedures which may include injecting fat from my stomach into the radiated side. Apparently the stem cells in it can improve radiated skin so that it resembles baby skin. Remarkable!
My plastic surgeon visited me late this arvo. He came good with his promise and came to show me the images he had someone take.
So here they are… these expanders got carried around inside me for three years. They went to Indonesia and Hawaii and they weren’t used to smuggle drugs. There was lots of pain and not a whole lot of love for them. But I’m glad they are finally out of me.
Home tomorrow if all goes well to celebrate my kids birthday and Mr Cool and my wedding anniversary.
To end on a silly note to celebrate the completion of this surgery and the ridiculous nature of what me and my breasts have been through, here’s a lame tribute to Benny Hill.
My Dad loved Benny Hill. Rest in peace Dad!
“I can’t believe it’s taken so long to get to this point!” said my plastic surgeon as I entered the big smoke hospital consult room this morning.
“Oh well, I’m still alive!” I replied.
“You are awfully cheery about this.”
“Yes cheery today, but there’s been plenty of frustration too.” I sat down.
Three years ago he inserted the first tissue expander into my chest immediately after my breast surgeon completed my mastectomy.
Way back then he wore a tie with a black and white feathered pattern that matched his facial hair. Six months later, with my second mastectomy, I missed his tie because he was already in his surgical scrubs when he came to mark me up with purple texta.
He shook his head and said softly “Just ridiculous!” as he opened up my file.
He went on with some sort of attempt to explain what had transpired…”it’s all left up to the bean counters you see! Category three should take up to twelve months, but there isn’t the same consequences for not meeting category three targets that there are for say category one and two. We’ve got patients with serious disease and they should be able to live out the final years of their lives feeling as normal as possible!”
The frustration at the system is thick all round.
“Okay, So what am I going to do with you? ” He scratched his head.
I take off my shirt, roll down my tank top to my navel and sit on the bed bare chested.
I’ve done this so many times it’s like I’m just being asked to simply take a seat.
“Hmmm, can I take a photo?”
“Sure!” I replied.
He reached back to the desk and picked up his iPhone and snapped a picture of both expanders. (I wanted to write breasts, but they are nothing like breasts). I smiled as if I was posing for a headshot.
“Can I take a photo of your tie?” I asked. “I love it!”
“Thanks! I got it from Russia” he said.
The passage of time has done damage to his work. By damage he means my road train weight gain, the lack of symmetry, the capsular contraction of the first expander and the poor blood supply to the radiated side.
He starts to formulate the plan…
“I’ll need to hack away at the capsule that’s formed. I don’t want to take the front off it though cause your skin is thin. So I’ll hack away at the back of the capsule and the other scarring that has formed around the original incision sites and try and free it up the a bit. How does that sound?”
Anyone who thinks this is a cosmetic boob job is an idiot. Mastectomies and radiotherapy are no picnic. The body is left tight and sore. There is scarring and fibrosis. There are lumps and tenderness and the nerve pain and pulling are a constant reminder of the trauma of having body parts amputated. Add to that the surgical clearance of all the nodes from your armpit.
This lack of any pleasant sensation from my chest weighs me down at times. The sensations are numb and painful at the same time. How is that even possible?
“What about the 2 o’clock and the 8 o’clock nipples? Can they be moved?” I inquire.
He is straight to the point. “Look, I can’t do anything about the nipples at this stage. Better to complete the double exchange and then see what we are left with. See what we can do down the track when it all settles.”
When he suggested he could probably get 200-300 cc sized teardrop shaped implants in my chest I nearly fell off the chair. I’m happy with small ones thanks.
In the beginning I had a minuscule 142 grams of breast tissue removed. There wasn’t much put back in. The one and only time he tried to expand me he put 80mls in, but had to take 20ml out because it was just too painful.
He says he may also do some sculpting around my chest to remove some body fat that wasn’t there when all of this cancer lark began.
I wont touch your stomach though!
“Drats!” I sighed, and again we laughed.
I will see him for the big op in a few weeks. Excited … yes, but acutely aware that this might not be the moment of completeness that I hope it will be. There is a lot riding on this process. For it is as if this reconstruction operation can wipe away the struggles and somehow make me whole again. Which is no easy feat after three years feeling broken.
Imagine my surprise when I received a letter today that said “Your treating doctor requested that you be placed onto a surgical wait list to undergo BILATERAL EXCHANGE FROM EXPANDERS TO IMPLANTS”
Placed onto? What the fark???!!!!
The letter continued … “We aim to deliver the best and most timely care to all our patients as quickly as possible.”
Most timely? Quickly? Pfft.
I understand the issues with public health, I really do. But Pffft!
You see, I was PLACED on a surgical waiting list back on the 1st November 2013. True.
It’s been nearly three years since I had my first expander jammed in my chest. And 2.5 years since I met the second one. I was so appreciative of the work of my surgeons. They removed my cancer and gave me an instant chest. I went onto the surgical list a few months later. And there I have sat with these uncomfortable, lumpy, rotten things since.
For all of this time, its been too painful to lay on my stomach. So I’ve neglected visits to the chiropractor, the massage therapist, and bodyboarding with the kids.
I guess I’m supposed to feel lucky that I’m still alive and even need my reconstruction finished. There’s plenty who didn’t get this far. Plenty!
So after I mustered up enough strength to hide my disappointment at this letter and not get prematurely upset, I rang the hospital. Turns out, the lovely Elective Surgery Access Manager felt my pain and put me on hold.
When she returned to the telephone, she offered me an apology for having me wait on the phone so long. Then she gave me a Plastic Surgeon surgical consult date (I’ve had two of these already) and an implant exchange surgery date. I didn’t know what to say.
So I said “Wow! Thankyou so much!” or some similar drivel.
Now the question is, what will they look like when finished? I’ve spent so long in this body that doesn’t feel like my own anymore. My rock hard, contracted, scar effected mounds, with nipples that point in such grossly different directions will need a lot of work to look reasonable.
And what will be of the 28kgs I’ve gained through hormonal treatment and chemically induced menopause since these Asian sized expanders were inserted? At least they were in proportion when all of this cancer treatment lark started.
What I’m looking forward to most will be the delight for my children when they snuggle and discover my chest is no longer like hugging a concrete freeway bollard. That will be the best!
Happy 41st Birthday to me. It would appear I’m (actually) having exchange surgery!