Post Lumpectomy Thoughts: Three Weeks After

It is weird how the fates work. I honestly had pretty much zero interest in breast cancer until I found out I had it. Breast cancer gets way too much attention, in my opinion. And so much of that is, of course, because, well duh. We live in a society obsessed with breasts. What better way to fuel the obsession than to pretend we are really worried about women who have this disease? Even before I had breast cancer - or at least before I knew it - I found a certain amount of disgust in watching NFL games, with everyone decked out in pink and wearing pink ribbons, interspersed with commercials with large-breasted women advertising I don't even know what (of course, that's the point, right?). Then again, I do enjoy a good football game, so, eh, whatever. I went to an all-female college where the prevailing attitude was that if you aren't angry about something, you aren't paying attention, which was fun in my 20s, but has faded in the years since. Call me lazy, but at a certain point, being angry takes too much energy.

As I educate myself on issues surrounding breast cancer, one interesting thing I've noticed is that people talk about mastectomies as if they are no big deal. Perhaps some of it is the Angelina Jolie effect, but I suspect that a lot of it has to do with the fact that breasts are somewhat superfluous. One can continue to live without breasts without having to make major lifestyle changes the way that someone who loses an arm or a leg or even large intestine has to make. There is also the option to have your breasts reconstructed, and apparently some surgeons are quite skilled at this these days. I read in my surgeon's biography that she is an expert at nipple-conserving mastectomies. I assume that's exactly what it sounds like, though I have to admit that I hope to never find out.

Ever since I found out I have breast cancer, a few people have suggested, with definite bravado, that having a prophylactic mastectomy is actually a sign of strength; it shows that you are secure enough with yourself to live without the very object or objects that make you a woman, and that your relationship with your partner is strong enough that you will not feel like any less of a woman. Or, if you don't have a partner, it shows that you are confident enough with your scintillating personality and beautiful looks that it will never affect your romantic life, and because you are so self-assured, you will never feel awkward bringing up the fact that you are missing a boob or boobs, or that you have a fake boob or boobs, to potential future partners.

I really don't want to get into personal choice here. Some women have mastectomies because the cancer has spread throughout their breast; some women have mastectomies because they have a mutation that puts them at high risk for breast cancer; some women have early stage breast cancer and opt for a mastectomy for X, Y, or Z reasons. It really doesn't matter. Every woman who opts for a mastectomy has her reasons, and every woman who opts not to have a mastectomy has her reasons, too. Sometimes those reasons have nothing to do with how much she loves her breasts, how secure she is with herself, or how strong her relationship with her partner is.

Which brings me to the point I want to make, three weeks post-lumpectomy. For just one minute (or at least until you finish reading this, so maybe 2-3 minutes depending on how fast you read), I challenge you to try to ignore the fact that this is breast cancer we are talking about, and just imagine cutting off a body part. Amputation. That's what a mastectomy is. It is a breast amputation. And an amputation is a big deal. I am not even talking about the social or even functional implications of an amputation; I am just talking about the surgical and medical implications.

And the reason I'm thinking of this is because I am three weeks post-lumpectomy, and I'm still feeling a lot of pain and discomfort. Perhaps it is my fault for not educating myself enough ahead of time, but I was fully unprepared for how much this was going to hurt, and for how gross my scars were going to be. (Seriously, it's a good thing I'm not a stripper, or a topless dancer, though I'm sure there is a niche for dancers with frankenboobs somewhere.) I think because so many people view mastectomies as no big deal, that lumpectomies are seen as even less of a big deal, and, after all, it is outpatient surgery, so how bad can it be?

Three weeks post-lumpectomy, here are some of my thoughts based on my experience:

• I felt really crappy for at least five days post-surgery. I had constipation followed by mad diarrhea. I also had no appetite. Maybe these things were just stress, but I have to assume that anyone who has cancer is going to be at least slightly stressed out, no? Any type of surgery causes physical and psychological stress on top of whatever stress is already there.
• I felt a lot of pain for at least 48 hours post-surgery. I could not move my arm without extreme pain. I took pain pills every 4 hours the day of surgery and the entire day afterward.
• Moving my arm hurt for a good 10 days after the surgery. I actually made a sling out of my graduation hood until a friend lent me a real sling from when her husband broke his elbow. 
• I have yet to regain feeling in a good portion of my breast; it is still numb. I have mixed feelings about the numbness. I've noticed over the past week an increase in my pain, which makes me think WTF? However, I then realize that the pain is because I'm regaining feeling. 
• It is still very difficult for me to raise my arm above my head. When I do this, I feel shooting pain all the way through my ribs, as if I've been kicked in the ribs. I still have to psych up to put my contacts in in the morning.
• Wearing a bra hurts because it rubs on my incisions, but not wearing a bra also hurts because, well, there are reasons people wear bras. 
• Admittedly, I've been a little lazy about rehabbing because I know I'm having another surgery and sort of feel like what is the point when I'm going to have to start over in 10 days? 

The point of this is not to be all woe is me, but to hopefully quash some misconceptions about this type of surgery. Regardless of how you feel about the necessity of breasts, the surgery itself has all of the effects of any surgery, all of the pain involved in making 1-2 inch incisions in flesh, and all of the pain involved whenever you remove an ice-scream scoop's worth of tissue from a body. It is not easy, and the recovery is longer than you might think. At any rate, it is definitely longer than I thought it would be. One of the things that sold me on Dr. M was that when I told him I had had the lumpectomy two weeks ago, he said, 'Okay, so you must still be really sore; I'll try to be gentle and not to hurt you.' Like, he got that I'm still hurting, a lot.

The first wave of bills for my trip into Cancerland has just started to come in, and according to my insurance, I did not have a lumpectomy, but a 'mastectomy, partial.' Based on my experience thus far with 'mastectomy, partial,' I can imagine that a 'mastectomy, total,' comes with double, triple, quadruple, whatever more pain than a simple 'mastectomy, partial.' Given that I was totally unprepared for the amount of pain involved in a lumpectomy, and especially the sentinel node biopsy, I just wonder if women are fully prepared for the pain of a mastectomy - both the immediate and possible long-term pain that seems to be overlooked while all the attention is given to the fact that you can live without your breasts.

Of course, deciding on a treatment route is very personal, and I do not want to question anyone's motives for choosing one route or another. I do feel, however, that because of the nature of breast cancer, too much attention has been given to the body part involved, and not the effects of the surgery itself. If I haven't articulated my views clearly, I think that Ann Silverman does an amazing job of this on her blog, and explains the reality of mastecomy much better than I can. If you are interested in this, please read this: http://www.butdoctorihatepink.com/2014/08/the-wrong-approach-to-breast-cancer.html.