Turning a Corner
October 20, 2010 21 Comments
Where are those toothpicks when you need them? For the life of me, I cannot figure out why doing nothing more than going to just one doctor's appointment per day is so exhausting. I'm not even making the appointments or in most cases, driving to them, yet they wear me out. Perhaps it is the idea (and action) of rehashing my life's story for the past two months (they always want to hear your version) or just the anticipated stress of the visit.
Today was the first of two visits to local plastic surgeons. I will likely identify the chosen one at some point, but for now, since we are undecided, will let him/her enjoy their anonymity and will call the first Dr. X. We had a long list to choose from, but there were two who were starred and have worked hand-in-hand with my breast surgeon on numerous occasions. Both come highly recommended and not surprisingly, have offices in McLean. Our first appointment was at 2:00 p.m. today and not only did we arrive with paperwork completed and in hand, but 30 minutes early. This is apparently when they decide to make you wait 45 minutes in the waiting room.
There's nothing like sitting in a waiting room, surrounded by numerous magical elixirs, line-removing facial creams, uber-dressed up fancy moms and ads for every type of plastic surgery under the sun. I had long since decided this doctor was my #2 choice and was really just going through the motions for Peter. Honestly, even GOING to the appointment was a huge step for me. I am sure the receptionist, patient liaison and doctor quickly figured this out when I noted that my reason for being there was "POSSIBLE breast reconstruction". Oh, yes, I most definitely used all caps…remember, it's all about choices for me.
Finally, as I was about to nod off for the 18th time, I was called into a room by the receptionist. We stepped into the room and the first thing we noticed? The counter was covered in various styles and sizes of implants. I just stood there, stunned. I looked and Peter and he just shook his head, and said, "I know, it's okay." I couldn't believe the insensitivity…leaving these out knowing why I was in the office that day. Then, a funny thing happened. Curiousity got the better of both of us and we began to look and, yes, I even poked a "Memory Gel" implant. It was difficult, at best, to imagine that tucked inside my body.
I was still miffed, though, and finally sat down to pout and ignore them. Two minutes later, there was a knock on the door and the patient liaison teetered in the room in her high heel boots (I dream of wearing such boots on a "fancy" Jen day). She took one look at the counter, gasped in horror, started apologizing and shoved the implants and a special bra into the drawer. She finally turned around, apologized again and then indicated that she wanted to review my history (oh, yippee, AGAIN?!…Say it's not so!!).
We went over it, yada, yada, yada and, as usual, I peppered the conversation with "ifs" not "whens". Peter answered as much as he could, especially when I seemed to lose steam and the questions were a little more difficult. At that point, she realized it was time for the doctor and practically insisted I have a glass of water. A few minutes later she came back in with the doctor in tow and just as I suspected, he was an older gruff doctor who….
Well, no.
I had reviewed the website and perused the waiting room, but missed the photo section. I was expecting a gruff, grandfatherly type who was going to share war stories and tell me to suck it up, that I should be grateful options are available these days. Instead a young (okay, our age-ish) surgeon walked in and…he just seemed…kind. Whether he had been forewarned that I seemed on the verge of a nervous breakdown, I can't say. However, Dr. X was very soft-spoken, said he was sorry, but he would like to hear my history one more time and then wanted to know what options I was considering IF I went through with the surgery.
At this point, Peter mentioned that we were primarily considering the Diep Flap, ahem, IF, this were to happen. A brief review of my body style indicated that not only was it possible, but I was the perfect candidate for the Diep Flap/tummy tuck* procedure. Since I have no interest in implants (it's just me), this was what I was hoping to hear should it happen. However, he also pointed out that right now we were hoping to keep the surgery as non-invasive as possible. A lumpectomy would be ideal and what did he think about reconstruction as far as that goes?
(Insert slightly uncomfortable throat clearing by the doctor.)
Dr. X very delicately danced around the subject and mentioned that while each case is different, sometimes it is very hard to do a lumpectomy when the other surgery (the only one the breast surgeon recommended) is really more necessary. If things are too widespread, it simply isn't possible to reconsctruct something from nothing. Peter then questioned about certain skin-saving techniques and queried about numbness/sensation issues. It may sound trivial, but I don't like diving into anything without knowing exactly what I could be facing at the bottom of the pool.
It was at that point that Dr. X faced me and said, without indicating that my case was problematic, that it simply may not be an option. As much as it would be nice to leave as much skin as possible intact, there was no guarantee it could happen. Everything is dependent on the cancer and getting it all out, of course, trumps the 'beauty' portion of the procedure. He then went onto explain that it may well be possible that if I chose the more drastic surgery (yes, the "M" word..), radiation and chemo could be avoided. He knew from having worked with the other doctors that it could be very possible to have a complete removal of the cancerous areas and avoid even more medical procedures. If I chose to go with the lumpectomy, there was no guarantee and either chemo or radiation would be a must, not a possibility. He looked at me with gentle, kind eyes and just a touch of sympathy…
and it hit me that this was NOT the end of my life.
I suddenly realized that this could be a new beginning. No, it's not perfect and it's not ideal. This is not the road we envisioned for us a year ago or even six weeks ago. However, when my brain really started processing everything he said in that "you don't have to do anything, this is all your choice" tone, I knew my decision was made. There may still be other tough choices, but for now, I have accepted that I will likely do the single "M" and I will be okay with it.
It's my decision and as hard as it was to make, I know that it is the best one for me at this point in time. I also know there is no guarantee that other tough decisions won't pop up over the next few weeks. However, at least I know that my acceptance of this new reality might get me through tomorrow's appointment with the breast surgeon (barring anything unseemly with the MRI results…). I am hoping (for the moment) that we might all be on the same page, and that alone is a huge weight off my shoulders.
*Yes, a tummy tuck. No, I am not a 'plastic surgery if not necessary' type person. However, this is a BOGO of sorts, so who am I to look the insurance company in the mouth? It might also come in handy on a future weekend away (one that I have been recently promised, pending treatment plans). You know, the kind that involves swaying palm trees, cabanas, fruity beverages and skimpy swim attire (well, not that skimpy). It's all about the bright side…
Wow, Jen, a huge turning point for sure. It sounds like he really talked frankly with you, which is great. I’m so glad you’re feeling like there will be life after this because there will!
Also, I remember having a conversation with my plastic surgeon where she was explaining how they could reconstruct a nipple later on, and I was like, “I’m losing my nipple? I thought this was skin-sparing procedure??” And she goes, “Yes, skin sparing, not nipple sparing.”
Oh. You learn something new every day.
I know these have felt like the longest days of your life. I hope you can get some rest having made this decision. xoxo-b
Such tough choices you’re facing. Thinking of you over here as you make all of these decisions…
Also thinking of you. So much to think through. Glad you are both there together figuring it out. I am so impressed by the strength you show here. You are awesome. Thoughts and prayers for you.
Sometimes it takes hearing what you need to hear from the right person to help put things into a different type of perspective. More importantly, it’s great that YOU were able to come up with YOUR treatment plan – and feel comfortable about the end result.
I’d say that’s worth its weight in gold.
So glad you are feeling secure in your decision. Apart from the washboard abs, I am praying that the “bright side” will feature fewer doctor visits. Unless, of course, you get addicted to plastic surgery. It IS No. VA 🙂
Sounds like this was just the conversation you needed. A doc who talks with you and not at you. Even your writing seems more positive. Good for you!
Ooh, this is an exciting post indeed. Brave, bold step! You go girl!
You are brave. You are strong. Tummy tuck + no chemo = a WINNER in my book!
Thinking of you, praying for you – so glad you updated and shared this!
I think that a nice vacation with palm trees, fruity drinks and an almost skimpy binkini is well deserved and an absolutely perfect idea.
Oh, Jen, what a terrific post! I could sense the change in your attitude. You are coming to terms with what happened and you have decided how you are going to tackle it. That’s HUGE!!!
This is the attitude of a SURVIVOR, Jen! And your attitude is crucial to how everything unfolds from now on. Because, you are right, this is not the end of the world. It’s incredibly hard and will take a while but you will make it through it and you will be stronger for it! Just remember to take it one day at a time!
I hope this decision brings you some much needed peace and comfort. And I hope the time when you can go on that tropical vacation comes before you know it because you totally deserve a little piece of paradise…
You are in my thoughts!
Good girl … on all counts! Proud of you!
I am so happy you found a Dr that made you more comfortable with the treatment options on the table. That makes all the difference in the world. As for tired I would imagine it is sheer stress and anxiety wearing you out. Keep on hanging in there and thank you for sharing with everyone.
Oh Jen, you had your MOMENT!!!!! I teared up reading this post! Behind the clouds, the sun is indeed shining! I loved my plastic surgeon so I hope you find the one you feel most comfortable with. My hubby and I went to an awesome B&B before my surgery and it was wonderful. ~Laura
I’m so, so happy for you Jen. Sometimes a great Dr makes a world of difference.
You are brave and amazing. I’m sad that because of the urgency you can’t grieve at your own pace, but so glad that you are getting control of the situation. That Doctor sounds like a gem, and BOGOF is pretty cool! My parents did a cruise after he recovered from surgery for a brain tomour- they liked it so much they’ve done a few more since then. Thinking of you.
I’m so glad you’ve made a choice, and that you can be at peace with it. I think, for me, that’s what I would have to choose, I would never want to look back and “what if”.
I wish that sense of peace for you about all the decisions ahead.
That weekend away sounds like a wonderful thing to look forward to.
I was really happy to read this post. I’m so glad that Dr. X was kind and understanding and straightforward. Been thinking and praying for you!
Me, too, re all that’s been said! Wonderful to “see” (because of your great writing) your “Aha!” moment, and how wonderful to find Dr. X! Hugs…
What a positive experience and a positive post. I am so happy to read that Peter is with you now too. Keep on keeping on. You are in our thoughts and prayers.
Jen, that’s good news on the PET and GREAT news on the genetic test.
I know it’s none of my business but my advice after being through everything but chemo….GET THE MASTECTOMY if it means that you won’t have to do any more treatment. OK, I know this may be more than what you want to hear now, but beleive me, it will shorten the agony SO MUCH. If a mastectomy is all you need, then the experience will be over with in one surgery!!! (Sometimes two if you decide to reconstruct later.) I repeat, it will be so much shorter, and you can get back to your life.
Regarding mastectomy vs. lumpectomy, they won’t know until you’re on the table how much they have to take out (which is how mine turned out to be a partial mastectomy vs. a lumpectomy). So you’re not going to have complete control anyway.
And you are going to lose some sensation in the breast anyway if they do a lumpectomy. I’ve had 3 and had nerve damage every time. Hasn’t stopped me from enjoying anything. It’s not like it’s numb to the touch, just less sensitive.
And, one more thought….truly, really, from someone who’s had multiple surgeries in multiple places, removing a breast is one of the less painful surgeries. Your breast is basically just sitting on top of your rib cage, connected by skin and tissue, so there’s no bone involved. Also, you do not need your breast to move around (by which I mean that if you have, say, abdominal surgery, you have to use some of those muscles to get out of bed. Neck surgery, gotta move the surgical site to turn your head or eat. Foot, ankle, arm…you get it. You HAVE to move them at some point. But the breast – remove it and all you need is a super-de-duper bandage and support, you don’t have to USE that area for anything.) Not that you won’t be sore, but believe me, it’s one of the better surgeries.
One final note….how many nodes are they going to check? The one complication that I hear of regularly from other breast cancer survivors is lymphoma. There are lots of treatments nowadays, but be aware of it. It totally depends on how many nodes they remove and how your individual body reacts.
Good luck,
Teresa
I’m so glad that you are starting to really own a decision and be comfortable with it. Continuing to think positive thoughts for you!!