I have decided I would like to keep a visual diary of my experience. So, I reached out to a friend of mine that I trust and know will capture the essence of this experience, Joanna Etshokin with Joanna Grace Photography. I met Joanna a little over a year ago and I am constantly amazed at home many times and ways our lives cross paths or parallel each other. Joanna has agreed to come into my very intimate world of breast cancer and treatment. Thank you, Joanna!
Well, now on with the update. This past Wednesday I met with my plastic surgeon to discuss the results of my abdominal CT scan to see if I am indeed a candidate for the DIEP flap surgery. It turns out that one side of my abdomen is perfect with easy access to the arteries and such which are removed and attached to the chest/breast. However, the other side was not as easy to see and access and would require removal of part of my abdominal muscle in order to get to it. For most this is common and really not a big deal, but for me this adds concern since I care for my non-ambulatory daughter who is already 50 lbs and will continue to get heavier over time. When you remove the muscle you are at greater risk for hernias. Since I am constantly lifting a child who does not help hold her own weight at all, I am at a much greater risk of developing a hernia and then needing surgery to fix it. Yuck!
Also, while discussing the DIEP flap process I was informed I do not have enough belly fat to recreate at least the size breasts that I have now. Since I am slightly smaller than I would like to be due to insurance having control over how much breast tissue was removed for my reduction surgery, I was bummed to learn this. We joked that I can gain some weight between now and my surgery date (10/24/14), but that's not really a reality. The DIEP surgery is crazy long (anywhere from 10 - 12 hours) and requires at least 5 full days in hospital, so to have this taken off the table is not the end of the world.
I got a chance to look at and handle the BRAVA device. It was HUGE!! I looked at the domes and also the sports bra that goes over it while you wear the device for 10 hours each day. I asked more about the process and it turns out two patients at the clinic just finished their process of going through this. One of the women ended up getting implants in the end, which is not very encouraging to me. The concern is having both enough stretch in the breast tissue AND enough fat to liposuction from other parts of the body to recreate breast tissue. I'm sure I have enough fat, but after seeing and feeling these HUGE domes I am not sure I can commit to the 600 hours of wearing it in order to achieve my end goal. This is a program that if you do not do your end of the process it will not work. Knowing my level of tolerance and hypersensitivity to certain textures and such I know this is not a good path for me. I also learned that this process is likely to take an entire year from beginning to end, which is crazy long in my world!
At this point I was beginning to feel overwhelmed and like I was back to square one. The two procedures which would take me down a more natural path were now being taken off the table as options. I was then faced with the decision to have no reconstruction at all or implants - which is what I was trying to avoid. I asked to see and feel the different implant options (see photo below of choices). I was able to hold the spacer and see what that would be like and then feel the different saline and silicone options.
After feeling all of the options I think I may be closer to a final decision. My concern with the implants is that they look so round and not natural to me. So, the plastic surgeon brought in a tear drop implant that has a more natural appearance. I was also concerned of the appearance of breast with the implant inside. I have looked at so many photos of women who have gone through breast reconstruction and you can many times see the ripple of the edge of the implant. I personally don't want that. The doctor said that I can have fat grafted and injected into my breast to create a more natural and soft appearance of the breasts including a more natural cleavage. Well, so maybe the implant process won't be so bad for me if this is the case.
The next day I got a call from the lady who handles the coordination and scheduling of the doctors and operating room. She was quite rude to me saying that she has been holding 3 doctor's schedules and the OR for me for over a month now and that I need to make a decision on which surgery route I am going down. I was both pissed and also started to cry. This woman was so insensitive and I explained that the plan was always to do the big surgery up until the day before when my plastic surgeon reviewed my CT and once again looked at my amount of belly fat and said it wasn't possible. Now this crabby lady was removing the human part of this decision so that she can open up schedules for a doctor that I have never even talked to - that apparently was part of the DIEP flap surgery. She then proceeded to tell me that she wasn't sure if I could even have my surgery that day - even though I booked it more than 10 weeks out. Really?
After being transferred to a much nicer more compassionate person, I was able to confirm that my surgery will in fact still be on October 24, 2014. I will be going through a double mastectomy, biopsy of my right armpit lymph nodes, and placement of spacers to hold and build the space for silicon implants to be placed at a later date. I will be in surgery for approximately 4 hours and stay overnight 2 - 3 days at Regions Hospital.
This path was completely not what I have expected.