January 5th 2012

Well I have my official PBM surgery date...January 5th 2012.

My visits with the surgeons were surprisingly great. I felt extremely comfortable with both doctors. The plastic surgeon, Dr. S, was very confident that due to my good health, being in shape, and young (ish) age, that I would have really good results with the reconstruction. I am also glad to announce that I am a good candidate for the one step-straight to implant  procedure which I am hoping will mean a quicker recovery time. It also means I won't have to have several trips to the plastic surgeons for fills nor a second surgery to place the implant. Very excited about that!  I have chosen to have silicon implants rather then saline. Dr. S talked about the pros and cons and I decided I wanted the silicon for the more natural look and feel. I actually got to hold one and feel it. It is odd. Squishy. I will not be doing the nipple sparing mastectomy, but rather am choosing to have those removed as well. They are breast tissue and even though the risk would be low in keeping them, I figure if I am going to make the decision to do this surgery to reduce my risk as much as possible, then those suckers have to go! Besides, the plastis surgeon said he could make me some great ones, better then mine now :) Gotta find the pluses!


The breast surgeon, Dr. B, was also very encouraging about everything. He feels confident that he will be able to remove enough tissue to change my percentage of getting breast cancer from 90% to possibly below 1%. UNBELIEVABLE.

After a morning of feeling sick and anxious, I finished out the day feeling encouraged and even more confident about my decision.

So today when the scheduling nurse called to tell me that my pre-op day will be Jan. 3rd and my surgery day will be Jan 5th, I didn't feel scared. I felt like I was making a huge positive step into enjoying many pumpkin spice lattes from Starbucks, drinking martini's with my husband for anniversary's to come, planning future vacations with my family and friends, toasting champagne at weddings...my son's. I am making a huge positive step for eveything in my future.

And to think, all along these wonderful future adventures, I will have great looking, perky "foobs" (fake boobs)! Pluses are everywhere, just gotta look.

To the surgeon's I go

I have this horrible habit of not sleeping before stressful events. So on top of being stressed about these two appointments, I have been battling an ear infection and sinus infection and have not slept well all weekend. I am exhausted and nervous.

I am trying to stay focused and positive about the knowledge that I am going to hear today from two gifted doctors. 

But the only things that I am able to stay  focused on, are that today I might have a date for the surgery. And I continue to be scared.

So I am going to make a giant cup of warm, steamy coffee. I am going to put on my big girl panties. And I am going to do my best to un-invite myself to this pity party I have attended this morning.

Hmmm, maybe I will make that two giant cups of coffee.

Making a list and checking it twice (or three times. or four times....)

As a mom I have become a pro at making lists. Lists for stuff to bring to daycare. Lists of items to buy at the grocery store. Lists of the lists that I need to write. So it's no big surprise that as I prepare for my visits to the breast surgeon and general surgeon this upcoming Monday, I have begun quite an extensive list of questions:

1) What is my recovery time going to be? Because I have a toddler who pretty much thinks that mom and dad should be playing with him at all possible moments. And I should mention that mom and dad LOVE to play with him at all possible moments so I need a super quick recovery time!

2) How long will it be before I can lift things? Again, baby. Wants to be held. Mom wants to hold him.

3) What are the possible complications? This is always a touchy question to ask any doctor as 9 times out of 10 "death" is one of the outcomes. When I am feeling positive about things, I like to think that one of my outcomes to the surgery will be life rather then death. Lets hope Monday is one of those positive days!

4) Will the doctor be able to code the surgery correctly so that my insurance company will cover it? I am not trying to make my doctor out to be an idiot at our meeting. I just want them to remember that this is not a cosmetic surgery. Fake boobs can look pretty amazing, however, if my genetics would have been better,  I would have chosen to just keep my floppy ones.

5) Can I have a one step straight to implant procedure or will I have to do the expander method of filling up with saline every couple of weeks and then having another surgery for the implant? It is going to already be RIDICULOUSLY difficult for me to sit and do nothing for several weeks. I am not a sit and do nothing kind of girl. So the sooner that this whole thing can begin healing the better.

6) Should I have a nipple sparing or a non-nipple sparing mastectomy? Until all of the researching that I have done, I never actually realized that nipple's are considered breast tissue and therefore in a preventative mastectomy they normally remove them. However, due to the face that all my testing came back negative (still doing the happy dance about that one!!) it might be an option for me to save my nipples in the surgery. It's a tough call though. If I am going the extreme to rid myself of as much of a risk as possible, should I just get rid of everything I can. Or should I try to retain some semblance of "normalcy" and keep one small part of me? It's an odd thing to think about...nipples or no nipples?

7) What are the different kinds of implants and what are the pros and cons of each? A conversation I NEVER imagined that I would be having. It seems so very Playboy. Oo la la!

8) One of the most important questions I can think to ask...How much will this reduce my risk of getting breast cancer? After the surgery they take away all of the breast tissue that they have removed and send it away for pathology. They check for pre-cancerous and cancerous tissues. Based on those results they will be able to let me know how much I have reduced my risk. An amazing thing to know.

9) Number 9 will be the hardest question to ask though as this will make everything real. When can I schedule my surgery?

"I'm scared"

My neighbor's little girl has started walking around saying "I'm scared." We are pretty sure she really doesn't get the concept yet of what she is saying, but I can totally relate. I am scared. I have done pretty well the past week or so. I have been feeling fairly confident in the choices that I have been making in regards to all of this BRCA 1 stuff. I think that my fears are beginning to resurface due to the fact that when I look on the calendar, I see my appointment with the breast surgeon and general surgeon are coming up in a week. And based on how those appointments go, I may be picking a date for the surgery. So it becomes real again.

I think that I have become pretty good at pretending normal in the past two weeks. So now in a week I am going to have to face reality again. I want to be brave. I want to be 100% sure I am doing the right thing. I want to not have to go through something painful. So in the words of my sweet little neighbor, I am scared.

Vanity

As a female it has been ingrained in me from a very early age that beauty is hugely important. Open any magazine (and I open a lot!) and one is instantly swept away with images of beauty. Beautiful ladies. Beautiful hair. Beautiful clothes. Beautiful bodies. You don't see many models without their breasts that's for sure.

I would be lying if I said that it doesn't bother me to think about removing mine. And how my body is going to look afterwards. I think about my (extremely supportive) husband and how he didn't sign up for this when we married. I worry that he will find me unattractive. I worry about how I will look in clothing. Or a swimsuit. What will my scars be like.

I do plan on having reconstruction immediately after the surgery. There are several options. I won't know which one will work best for my body frame until after I talk to the surgeons on the 21st of this month. There is a single step procedure which involves removing the breast tissue and then inserting an implant underneath the chest muscles. And then there is a slightly longer procedure where they remove the breast tissue and insert expanders. Every so often I would have saline injected into the expander stretching the skin. Once the desired size is chosen, they preform what is called an exchange surgery where they remove the expander and insert the implant. I don't know the pros and cons yet of these, but I am thinking that I would like the single step. I am hoping that it would mean for a quicker recovery, a quicker time period of not being able to hold my sweet baby, a quicker time period to start feeling like an attractive woman again.

I have spent many hours pouring over other peoples blogs. I have spent hours looking at their pictures of before, during, and after. Sometimes I feel like it's all going to be okay. Their scarring isn't THAT bad. Their breasts look pretty normal. And then there is the time when my vanity kicks in and I want to vomit. What am I thinking?! I have healthy breasts! Why do I want to mutilate my body?! And then I look up and see my baby using his new skill of wobbling/walking towards me with his big semi-toothless grin. And then I see my husband doing a ridiculous dance in the kitchen to make me smile. And then I get a card from one my many sweet friends saying " hello, you are on my mind." And I think, Oh yeah. Screw vanity. I want to live.

My first thoughts

I am creating this blog for family and friends. And myself really. It's going to be a tool for answering questions, venting, explaining decisions, and remembering.

A couple of weeks ago, after canceling five previous appointments due to my fears, I decided to have the genetic testing done for the breast/ovarian cancer gene. I chickened out the first five appointments and only gained courage after one of my younger sisters had it done (she tested negative!). After meeting with a genetic counselor, I took the mini bottle of Scope mouth wash, swished, and spit into a vial to be sent away. Two weeks later, my world was rocked. BRCA1 positive. Even though deep down I knew that it was going to be positive, it didn't stop me from sobbing uncontrollably for many, many, many minutes.

What does that mean? It means my risk increases for breast cancer from the normal population's 8-12% to 87-90%. Yes, that says 90%.

The people closest to me know that I watched my mom battle breast cancer for 9 long years. She passed away when I was 16, after the cancer had spread to her lungs and brain. It was a very painful struggle that she went through full of multiple rounds of hair loss, bloating, chemotherapy, radiation, surgeries, etc. I DO NOT WANT TO GO THROUGH THAT. I do not want my 11 month old baby to watch his mom go through that.

In the past 2 weeks I have been to 5 doctors appointments. I went to an oncologist to talk about my options. Even just walking into something called "the cancer center" sent my stomach into cramps of anxiety. She turned out to be a wealth of information and encouragement. She set me up to have a blood test and ultrasound of my ovaries to test for Ovarian Cancer. Both tests came back clean! I also was set up for a breast MRI and a mammogram to test for Breast Cancer . Both tests also came back clean! This was a very, very good thing as I had been feeling like I was just a walking body full of cancer since I received my results. 

So now in two weeks, I meet with a plastic surgeon and general discussion to discuss my PBM (prophylactic  breast mastectomy). I have all these questions and after researching, a whole new vocabulary of words to go along with these questions...expanders, nipple sparing mastectomy, DIEM and TRAM flaps.

I have researched online, read blogs, participated in message boards, watched (scary) videos of surgeries, talked with women who have been diagnosed with cancer, and talked with women who have tested positive for the gene and have had preventative surgeries. I have talked to multiple doctors about options. Everything that I have read and everyone that I have talked to have pretty much had the same consensus: surgery is the way to go. Women who are fighting cancer tell me that if they had the choice, they would have 100% had the preventative surgery rather then fight the horrific battle of cancer they are currently engaged in. Women who have had the surgeries tell me that there has never been a regret.

So I am going to make the choice of removing my perfectly healthy breasts as a preventative measure. I am choosing to rid myself of the 90% risk, hopefully reducing that risk down to 5% or below. I am choosing not to spend my life screening every 3 months in hopes that cancer hasn't grown in my body. I am choosing not to have to fight a disease that has caused such sadness in my family.

I am choosing life over my boobs.