Tuesday, June 14, 2011

I know, I know


OK, OK, I know… It has been two months since my last blog update.  I keep thinking about it…  Then it was three weeks and I still hadn’t done any writing so it would be really long and rambling, so I didn’t write anything.  Then it was five weeks and I thought, how do I make up for my five week absence, so I didn’t write anything… and so on and so forth.
After my 5th chemotherapy, things were going fine.  I met with my surgeon, Dr Bitar and had my 3-month surgery follow-up.  She checked out my rack and said it looked really good.  She sounded a bit more surprised that I expected when she said how good it looked.  I guess she thought it would appear more concave with all the tissue she had taken out.  Ummm, OK, thanks, I think.  Later that week I met with Dr Santoro, my plastic surgeon and we discussed the various options for reconstruction after chemotherapy.

Let me go back a bit.  In my particular case I have two routs I can take.  Option one involves a lumpectomy (which I had in December) combined with radiation therapy.  Option two is to do a mastectomy and reconstruction.  If I do a mastectomy I can have reconstruction one of two ways -  an implant under the chest muscle, or something called a TRAM flap procedure.  The TRAM procedure is where they take a tummy tuck sized piece of flesh and tissue from the abdominal area and mold it into a breast and reattach it underneath the skin at the breast.

I'd really rather not do radiation because I am terrified of the long-term side effects.  Even though the breast is radiated at two different angles so it misses most of the chest muscles and non-breast tissues, it still hits a part of the lung tissue and part of the heart muscle.  The radiation scars the lung tissue and part of the heart muscle which, long term, can lead to all kinds of (rare) problems.  I’d rather skip radiation and not have to deal with this type of damage, especially when I’m older and my body is less able to handle it.


What to do?  What to do? 


One of my doctors finally pointed something out to me that helped sway me towards my final decision.  She pointed out that the cancer cells had found a way to grow in two separate places in my breast tissue.  This small but important fact gives me a higher chance of recurrence.  So I decided to do a mastectomy and reconstruction… but what TYPE of reconstruction?    

When I first began thinking about reconstruction options in December, I was dead set against an implant for a couple of reasons.  An implant would be a foreign object in my body, and it would look and feel different from my natural breast as gravity takes its toll.   

And with the TRAM procedure, I'm worried about the seriousness of the surgery and the pain involved in recovery.   I've read blogs of women who have had the implant surgery and some who have had the TRAM surgery.  The TRAM surgery has me really worried about the amount of time I'll need other people to basically do everything for me.  And, did I mention the time for recovery?  There are just so many variables that can cause problems...

With the implant procedure, I'm worried about leakage and having to do additional surgery down the line if there were problems.  I think, weighing everything together, I started considering the implant reconstruction much more seriously because it has a shorter recovery time and will be less traumatic for my body.  

So, after a lot of careful consideration, I have decided to do a mastectomy with an implant.

Now, the doctor will have to do reconstruction on my right breast, too, to make it match my left breast.  Now I needed to decide what to do with that.  A few things weighed into my decision for my right breast.  I had to consider that the cancer had found a way to grow in two separate places in my left breast, increasing my risk of recurrence.  I also had to consider how stressful the chemotherapy process had been on my body.  I do not want to ever do that again.  I also needed to consider how I would feel with one implant on the left and not on the right, feeling lopsided, and feeling self-conscious about them being different.

So, I decided to have a bilateral (both sides) mastectomy with implants.  It may seem like a drastic decision, but I know it is right for me.  By removing the breast tissue from both sides it leaves me with an all but zero chance of the cancer coming back.  If I don't have any tissue for the cancer to grow it, it can't, well, grow.  By having both sides reconstructed with implants, they would be more similar than just having one done.  I could heal all at once.  And I wouldn't worry about every little bump or inconsistency in my right breast.

That's all for now.  I'll write more later - there's a lot that goes into this whole breast implant procedure (for breast cancer patients, at least)... tissue expanders, drains, bleah! 



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