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The New Tatas Timeline

January 18, 2012

In the super, amazing, epic news that’s actually epic column, I’m cancer-free! To say I feel thankful and grateful would be an understatement. After the doctor left the examination room, I put on my clothes and cried many happy tears.

It’s interesting that as elated as I am, I’m not in a celebratory mood. That might stem from the fact that I don’t look in the mirror and like what I see post-chemotherapy. Or, and more likely, I know – with 99% certainty – that my journey isn’t over.

If I take the doctor’s news and do nothing medically, I have a 30% chance of my cancer returning within four years. Typically, when cancer returns that quickly, it spreads beyond the area of original diagnosis. After those four years, I’d have a higher chance than the average woman of having breast cancer again. The genetics specialist believes that my mom and I have a gene that has yet to be discovered. (There is much talk of a Breast Cancer Gene, but there isn’t just one single gene that causes breast cancer.) And, I’ll need more biopsies based on the fact that I have fibrocystic breasts and many abnormal calcifications. In the past 12 years, I’ve had 13 biopsies. Eight of those were in the past four years.

When my breast surgeon recommended a lumpectomy over a mastectomy after my diagnosis, there was the assumption that I could tolerate hormonal medications after treatment. As it turns out, I can’t.

So, here I am…cancer-free…going to consultations about mastectomies and reconstruction. Tears of sadness and fear have replaced my happy tears.

Things I learned after meeting with the reconstructive surgeon:

1. 70% of women who get mastectomies with immediate reconstruction end up going in for a second corrective surgery. Out of the remaining 30%, the majority of women override their doctors’ recommendations to have a second surgery, instead choosing to live with noticeably disproportionate breasts.

2. The surgeon wouldn’t recommend me getting immediate reconstruction for several reasons:

a. I’ve had four lumpectomies over the years on my right breast alone. Scars impede blood flow to the skin. Immediate reconstruction would stretch the weak skin and jeopardize blood flood throughout.

b. I couldn’t get implants larger than a ‘C’ cup because the skin wouldn't be strong enough to support more than that. I haven’t been a ‘C’ cup since I was a teenager, and given my current size, I wouldn’t feel comfortable with that.

c. There would be an increased risk of infection for any patient, especially those with other health issues like me.

3. I will need more surgeries and the process will take much longer than expected. The general timeline is as follows:

a. Mastectomies – leave from the hospital with drains that I need to empty and clean myself and keep in place for two weeks. [Insert wincing expression here.]

b. Expanders – I will have expanders put inside my breasts that will help stretch the skin out to my desired size. Each week, I will go into the surgeon’s office, and she will inject saline into each breast to expand them. I will be awake for this. [Insert more wincing expressions here.] She estimates that it will take four-six weeks for this process. I'm larger than a DD now, but I feel like I'll be saying, "when," by that point.

c. Wait a minimum of four to six weeks for everything to settle.

d. Have another surgery to put the permanent implants inside.

e. And, once the scars have healed (in a relative sense), have surgery or an appointment with a tattoo artist to have nipples put on.

Because of my teaching responsibilities, I won’t be getting the initial surgery until May or June, and I won’t be getting the implants put in until December. The psychic saw more surgeries in my future, but said to view them as rebuilding and strengthening. I like that in theory, but I'm going to need some time to wrap my head around that.

I’ve said before that being cancer-free doesn’t mean being done with cancer. Last week exemplified that. The thought of the expanders evokes a visceral response from me. The thought of losing my big naturals saddens me. The thought of really being done with this in a year calms me. And, when those buoyant DDs are inside me, I’ll sigh with a fair amount of relief that I have only a 5% chance of getting breast cancer in the left breast and a 12% chance in the right breast...for the rest of my life.

Comments (16)

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Posted by rajbill on 02/02/12
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Sending so many prayers and well wishes your way! I know you will get through this next step with so much grace and optimism. You are so wonderful. I hope this is the end of your cancer journey.
Posted by Grace on 01/19/12
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Thanks Grace! I do, too. If this next year is it, then this was all well worth it. xoxo
Posted by City Girl on 01/19/12
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This is obviously a personal decision, but here's my 2 cents given that it's a public blog: size C breast are awesome! And usually more perky than giant boobs. And size C is plenty big by almost any perspective. Why torture your body more than necessary to take it backwards in time instead of meeting your body where it's at now?
Posted by margot on 01/19/12
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Thanks as always for your comment, Margot. I think doing a numerical list on this blog was confusing. (My bad.) The doctor doesn't recommend me to have immediate reconstruction because of the scar/dead skin issue and the overwhelmingly likely need for a second surgery. I was just trying to add all the reasons why immediate reconstruction isn't as simple as the media portrays.
Posted by City Girl on 01/19/12
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Like TeacherGal said that's a lot to take in. I can't even imagine making those decisions. I'm also happy and sad for you. The part about tattooing on nipples is very intriguing though. I know you are frustrated but I want you to know I'm thinking of you.
Posted by Kat on 01/19/12
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Thanks Kat for your support and for being a friend! xoxo
Posted by City Girl on 01/19/12
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Wow, that was a lot to take in for me as a reader and friend so I know that your head must be spinning. I know that this process will be long and hard, but at least there is some light at the end of it. This might sound strange, but if they have to stretch your skin to put in the implants, wouldn't it be so much easier to just get smaller implants? I know you are used to a DD size, but a C is still big (very big to many women). Just a thought as that stretching part sounds awful. Whatever decision you make, I will be praying for you always. You are so strong. I know you will make it through this with your head held high!!
Posted by TeacherGirl on 01/18/12
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Thank you for being a wonderful friend, TG! I tried to do an outline for this post, but I couldn't indent things. Sorry if I made the post more confusing. The doctor doesn't recommend me to have immediate reconstruction because of the scar/dead skin issue and the overwhelmingly likely need for a second surgery. I was just trying to add all the reasons why immediate reconstruction isn't as simple as the media portrays.

And, I updated the post since I'm bigger than a DD cup. I don't think emotionally I would be happy with any smaller than that, given what I'm used to. xoxo
Posted by City Girl on 01/19/12
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Stumbled upon your blog as a link from another...have not had time to read from the start...so a little unprepared to discuss anything but your most current post. I am truly sorry to hear about your uncomfortable (yeah, an understatement) situation. I rejoice, however, in your current diagnosis. My partner has had her thyroid out due to cancer and I had a radical prostatectamy. Both much easier cancers to treat. And the gods willing, we'll continue to have good results with our followups.

I sense that many, many women face your situation, or one quite like it. I don't know enough about you to know if you have a supportive partner or are in "dating" situations and have to deal with body image from the perspective of feeling less desirable or not. Just know that men can be uncomfortable about your discomfort--more than at what they see when your are naked and vulnerable-- and that just being yourself and owning your reality can reassure them that you are happy to be intimate with them (him).

If you have questions around this issue feel free to respond off-blog at my email address. WD
ps. I can't wait to try your chocolate chip cookies formula. Blessings
Posted by WD on 01/18/12
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So many highs and lows. At the end of the day, I"m happy and sad, just like you. Happy that at this point you are free. Whatever that means. But sad that you will continue with uncertainty. But also happy that you get to continue.
Posted by the chaser on 01/18/12
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That's how I feel, Chaser! Last week was an emotional roller coaster. Overall, I'm happy, though. Just don't like what lies ahead. xoxo
Posted by City Girl on 01/19/12
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Wow, I bet that was a lot to take in and stomach all at once. I am glad the thought of being done in a year calms you, and as always, I support whatever you decide regarding reconstruction! XOXO
Posted by jobo on 01/18/12
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Thank you, Dear Jobo! I appreciate your support and friendship. xoxo
Posted by City Girl on 01/19/12
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As a fellow big-boobied girl, my mind can't even go where yours is being forced to go. But, as Christina Applegate said after her double mastectomy, "I'm going to have cute boobs 'til I'm 90." She also said she doesn't have to wear a bra anymore. Maybe not exactly a silver lining, but praise the Lord for an effective treatment!
Posted by Mary El on 01/18/12
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Thank you and well-phrased, Mary El! It is the most effective strategy at my disposal at this time. I need to do whatever possible so I don't have to deal with this again. xoxo
Posted by City Girl on 01/19/12
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