DIEP Reconstruction Aftermath: 24 Days

It is Friday, so I feel like I should be making the trek up to the University Health Clinic to see Dr. T. However, at my last appointment, he said things looked good enough that I do not need to go back for another month, which is actually going to end up being more like six weeks. So hopefully he meant it when he said everything looks good, and complications this far out from surgery are rare. My fingers are crossed.

At any rate, today was a big day for me (insert slightly sarcastic tone): I ran errands! First I went to the post office to mail a package, then I went to the pharmacy to finally have my prescription for tamoxifen filled. While I was waiting, I went to the liquor store and bought three bottles of wine, a bottle of sake, and a bottle of port, because we are having friends over tonight and I was indecisive about what we should drink. I'm pretty sure that carrying these out to the car violated my lifting restrictions, but sometimes sacrifices have to made in the name of alcohol. LOL.

So now, I've got a bottle of tamoxifen sitting on my kitchen table, and I just need to grow some balls boobs courage and start taking it already. Ugh, ugh, ugh! Have I mentioned that I fucking hate cancer?

But the good news is that it feels really good to be getting back into the swing of things. And while running errands is not particularly exciting, it is exciting to not feel trapped inside the house anymore. Until today, the most I had done was drive my son to preschool and drive myself to go get a massage. Granted, I don't see any long trips to the mall in my near future, but it's nice to know short trips are completely do-able (and I almost never go to the mall anyway).

All in all, this is far less down time than I had imagined - or at least far less complete, lying-on-the-couch down time. Heck, I ordered a whole season of True Detective and have only watched three episodes. I feel good enough that I want to start setting some goals to get myself through the end of the year, and start laying the foundation for my 'new normal.'

The Last Day

Today is a weird sort of day. I joked all weekend that we were into bonus material; anything I accomplished was extra. I've accomplished a lot in the past few weeks, but there is still so much more to do that I know I won't be able to do for a long time. I can't decide if I want to run around like a chicken with my breast cut off today or just... chill. And enjoy what I've come to think of as The Last Day.

The last full day of my old normal.

My last day with my two God-given breasts. It's a weird feeling. I feel... I don't know. In a way, I'm so sick of all of this, I have no energy left to feel. I just do. But the anticipation of how I am going to feel after I wake up tomorrow with a hard lump where my breast used to be and a drain with bloody discharge leaking out of it is what has me the most worked up. I've had a long time to contemplate this - two months - so you'd think I'd be over it by now, but I'm not.

Because the reality is that you just don't know how you are going to feel until you are actually there. Maybe I'll feel fine afterward. Maybe I'll be one of those people who bounces back right away and is driving within a few days, returning to work, and moving on with life. Maybe I'll feel so fine I'll cancel the reconstruction. Maybe I'll be able to let my family go on the trip they were planning for this weekend. Or maybe I won't. Maybe it will be even worse than I'm expecting. Maybe I'll sink into a deep depression and want to kill myself. Maybe I will feel anger and self-loathing every single day for the rest of my life.

So many women declare with such bravado that they would definitely have no problem having their boobs cut off and living the rest of their lives happily free from wearing a bra. They say this because they think it will make me feel better, but it doesn't, because I know that it's not true. I also know they aren't lying; I just know that they don't know what they would actually choose if it were really them. And in the end, very few women choose a bilateral mastectomy with no reconstruction. Even nipple reconstruction, which seems like a lot of trouble for such a trivial body part, and one that I despise no less, isn't completely off my table right now, in the event that I end up losing my nipple. I never would have guessed even six weeks ago that I'd desperately want to save my nipple.

People react to their cancer diagnoses so differently. For me, it took a long time for the reality to sink in. My parents and my husband took my initial diagnosis much harder than I did, mostly because I was too stupid to understand how truly life-changing this would be. Even when there was a very real possibility that the cancer had spread into my rib, I wasn't that worked up. I was just thinking there must be a quick fix for this. Ribectomy, anyone? (Who needs their rib, anyway?) I didn't know that this would technically put me into Stage IV, terminal. Others seem to react with more hysteria initially; the visceral OMG GET IT OUT OF ME! GET IT OUT OF ME! reaction that leads people to get bilateral mastectomies for 0.5 cm, stage 0, grade 1, ductal carcinoma in situ within a few weeks of their diagnosis. It is the treatments that give these people comfort, whereas for me, it's the treatments that I loathe. I don't know if I will ever feel that elation over 'having the cancer gone' that some describe after a mastectomy. Then again, maybe I will. I don't know.

Some people have told me it's too bad I've gone through all of this, only to have it end this way. I could have had this done in May, and I would be all recovered now, happily getting monthly shots to put me into menopause, taking an aromatase inhibitor, and in the middle of a lecture this very moment, instead of at home. But the truth is I wasn't ready back in early May. Even after lumpectomy #1, I wasn't ready. Even after lumpectomy #2, I wasn't ready; I honestly would have considered a third re-excision if every single one of my doctors hadn't counseled me otherwise. I actually feel pretty strongly that I have cancer in my right breast, too, I just know it. I probably ought to proceed with a bilateral mastectomy, but I'm not ready for that. It's easier for me to wrap my mind around having to go through all of this again sometime in the near future than it is for me to wrap my mind around a bilateral mastectomy, and since none of my doctors counseled me to have the double, I continue to proceed one conservative step at a time. All of this is part of my 'new normal' of living with cancer.

I started praying for my surgeons ever since I had a date for my mastectomy, and I feel that God must be mocking me in some way by doing this to me. Nonetheless, I will keep at it.

Blessings

• I'm grateful to be back in the hands of Dr. L, and thankful for who she is. After she was so helpful to me last Tuesday, I sent her a thank-you e-mail, and concluded with: Please take care of yourself this week. (No darts please!! :)). She replied: You are so sweet, I'm so glad we could help out. (...) I absolutely plan to stay away from darts, especially now! Gives me the willies just thinking about it!! See you next week! Jane
• I continue to be thankful for the love and support from my family, friends, and colleagues.  
• I'm thankful for a new Chair who has worked tirelessly to make my work situation as minimally stressful as possible, complete with the e-mail he sent me last Thursday: I met with [The Dean], [his administrative assistant] and [the head or HR] today about your leave. The bottom line is you are totally covered and will receive full pay for the semester. Even if you don't do another minute of work for ABC College this semester, you’ll still have at least 5 days of sick leave left. You might even have 10 if you continue to accrue sick leave days over the semester – [head of HR] is checking into the official policies on this. If you want to come back before the end of the semester and work on "other duties", you can stop drawing as much from sick leave. Everyone is very happy to be flexible with how we structure your leave, so don't worry about it. We'll sort it out when you feel ready to come back. For as much as I complain about work, this is a true blessing.

Hopes

• I pray for Dr. L, for her safety, health, and clear mind tomorrow. I ask the same for Dr. G, the plastic surgeon who will be assisting her. 
• I pray the surgery goes as she planned, that she will be able to do a nipple-sparing mastectomy.
• I pray for clear margins, that after all of this I won't have to do radiation or chemotherapy.
• I pray that I will make it through with no complications, and that the pain will not be too horrendous. And if it is, I pray for the strength to get through it.

I realize a lot of people have life-changing things happen to them without the luxury of contemplating them. Sometimes people are thrust into things full force, waking up the next day with a 'new normal' that is so devastating it boggles the mind. But people are shockingly resilient. We often admire the strength of others, not believing that we have it in ourselves to behave the same way, but I believe we do. At least, I pray that we do, that I do. While I'm thankful for the time I've had to come to terms with everything that is happening, I need to stop circling and start moving forward again. I pray this surgery happens tomorrow. I pray that all of my mourning is done, and that I will wake up feeling happy.

Peace be with you.

I had a perfect evening.

A friend came by after work and we had a late-afternoon mojito (part of my get fat quick plan), then after she left, we went out to dinner as a family at a lovely restaurant downtown - a gift from my brother and sister-in-law. As we were enjoying our meal, my husband asked if it was a Christmas gift or birthday gift or what, and I said, 'No, it's a cancer gift.' Since they live far away, they sent us a gift card instead of bringing us a meal like so many others have.

Afterward, we went to a Johnny Cash show - one of those imitation bands. It was a little late for the kids, but they know Johnny Cash, because I make them listen to him in the car when I get sick of listening to the Frozen soundtrack. Going to shows like this is not really my top choice of activity, but my husband really wanted to go, and I'm glad we did. I think the average age of the audience was, like, 65, though. LOL. The band brought A LOT of attention to the fact that we had brought our kids, saying how great it was that some parents were introducing the younger generation to the great musicians of the past. It was sort of embarrassing.

I absolutely love Johnny Cash. About 20 minutes into the show, I was overcome with an overwhelming sense of peace. Everything is going to be okay. I know it. I feel so calm, happy even.

I am so lucky. I have insurance, good insurance, and my husband and I have good jobs. We have money in savings, and what better use for it than life-saving medical treatments? I just ate dinner at a fabulous restaurant that someone else paid for, then went and listened to some of my favorite songs ever all night. Really, what is there to complain about?

I think part of the reason it has taken me so long to get to this point was just the horrible timing of my pathology report coming back when Dr. L was on vacation and I was getting ready to go on vacation. When I met with Dr. M just before leaving, he did encourage me to see a plastic surgeon ASAP and now I understand why. At the time, I knew this was tough but I didn't realize just how much easier it would have been if I could have met with a plastic surgeon before we left.

After I got home on Wednesday, I sent Dr. T a slight emo e-mail, letting him know how happy I was to get to meet him, that I had full confidence in him, and that he was the answer to my prayers. I thanked him for making an appointment I literally felt sick about into a very uplifting experience.

He replied early the next morning:

Waning,

Thanks so much for the email. I think it's unfair for women to receive news like that without an opportunity to discuss reconstruction with a plastic surgeon. So, I was very glad that we were able to meet after you met with Dr C. She is outstanding, by the way.

Attached is an information sheet that I put together based on some feedback from my patients. It will outline some things to consider when you get home after the surgery.

Please use this as a resource and reach out to me whenever you have questions and concerns.

Best,
Ty Tahm, MD

I feel so full of peace right now, I want to bottle the feeling up and carry it with me through the next few weeks leading up to surgery. It reminds me of my church-going days. One tradition in our church was greeting the people next to you with a simple shaking of hands and, 'Peace be with you.' They reply, 'And also with you.' So, dear friends, peace be with you, as it is also with me.