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Breast Cancer - A Loving Fight

Stand Up 2 Cancer (4 days to go) – Final meeting with Reconstruction Surgeon

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“Be your own miracle”

– From “Stand Up” by Beyonce Knowles

Four days to go and the reminders seem to be all around us.  There were women walking in all shades of pink around the city in their Walk against Breast Cancer.  Our daughter asked why mommy was waiving at them,  “Because I am one of them and they are walking for me”, she said.  Then tonight was a major event for the organization Standup2cancer.org.   I think it was a landmark event.  It took just an hour but it was a fundraiser to bring ALL cancer research together.  Some crazy stats:

  • Cancer takes so many forms and one person in America dies from cancer every minute.  
  • Every other person in this world will have some form of cancer 
  • 500,000 Americans will die of cancer this year (1500 each day)

I actually watched the show alone as it was uplifting to the point of shedding a tear.  My wife is going through so many emotions right now we agreed to Tivo it and let her just watch it after the surgery.

I also didn’t go with my wife to her last meeting with the reconstruction surgeon.  I just thought it better that she ask her own questions and give her my questions on paper (of course she didn’t ask them).  I mostly worried about her balance and how steady she might be although I know most people are walking around the next day.  He had some good recommendations about relieving the pain and making sure not to let the drains hang too low as that is why they are painful.  He said that ticket holders (hey my profession comes in handy) are great to put them in  so they don’t pull on your skin.  He also said that the tissue expanders aren’t as painful as some people think.   It was a relatively short meeting so I think it came out okay.  My wife had a few other personal questions about the recovery but the doctor seems to have given her all the right answers or at least the ones she wanted to hear.  He told her that most of his work would be done two weeks after the surgery and just to watch under the bandages for any swelling or infections (redness).

At the end of the day we are exhausted once again, but it always is nice to catch up.  It has become our daily ritual to check in with each other and see where we are mentally.  She’s still a bit anxious, but more anxious to get this cancer out of her body and move on.  Me, I feel like I’ve been managing the emotions of two people and she knows that.  I told her that I’d rather be on the table next Tuesday unconscious because I don’t think I can spend 5 hours waiting around.  I’ll need to buy a new pair of running shoes.

Breast Cancer - A Loving Fight

Skin-Sparing Mastectomy – A Loving Fight Against Breast Cancer

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“Inspiration comes in many forms.  Let’s keep our eyes open.” – Today’s email to my wife

Actually something less formal like “Keep on Truckin'” might have been a more appropriate word of the day as we headed into this Labor Day weekend.  We are both working the late shift getting major projects done and trying to keep our lives as hectic (normal) as possible.  We still keep getting the “How are you doing” phone calls which we politely respond to, but then have to cut short not only because we are so tired of telling everyone, but also because we have so much to do before the surgery.

The surgery itself is fairly new but even moreso is the reconstruction.  The following photos from Breastcancer.org describes the basic procedure:

Skin-Sparing Surgery Image from Breastcancer.org
Skin-Sparing Surgery Image from Breastcancer.org

 

 

 

 

 

 

 

 

 

 

 

 

 

A pink line indicates “keyhole”–like incision

B pink highlighted area indicates tissue removed at mastectomy

The major difference for my wife is that the “A” incision will be done above the nipple and not around the nipple thus sparing the nipple as well.  We were told that this can only be done if the nipple has not yet been exposed to the cancer as some tissue is left around the nipple.  This is a surgery more recommended for women who are early stage.  My wife was also told that she did not have enough tissue from other parts of her body to pull from her tummy or her back shoulders so this was probably the best way if she wanted reconstruction.  Each side takes an additional 45 minutes.

Many husbands might be adverse to the feel etc of implants, but for me I think this is the woman’s choice.  Many believe that reconstruction will best leave them with a mental state that will help them adjust to life after cancer.  This is truly the woman’s decision and I think that every spouse or significant other should try to stay out of the reconstructive decision and not pressure their spouse to do it.  While I wanted my wife to choose reconstruction, I feel better that it is her choice that she made and fully understand her reasoning.  I also think the doctors believe it is the right decision for her and she is making it for the right reasons.

I know some people might  think I’m full of baloney on this, but one of most inspiring stories I ever witnessed was that of Dave Dravecky, the SF Giants pitcher who lost his arm to cancer.  I happened to attend that game when he lost his arm.  I heard it snap.  I cried for him and still cry when he comes back for Giants reunion games. It wasn’t just any arm , but a million dollar arm that earned him a living.  Did he choose to wear a prosthesis? No.  He says sometimes he still dreams that his arm is still there.  But that is not the end of Dave’s story.  he has gone on with his life as a pitching coach and inspirational speaker for those not only diagnosed with cancer, but those he need to be inspired even when they lose something so important and identifiable as who they are.

While my wife’s chest is not the same as a pitcher’s arm, for her it is part of her identity internally.  Only she knows that and there is no way I will be able to relate to that.

At the same time, my wife is wondering how I can be so unselfish about this.  She has always laughed about my infatuation with the human drama of sports.  I do have a bit of a ridiculous man-crush on my idols, Jerry Rice and Joe Montana and she never got it.  I often told her the story of Dave Dravecky and his inspirational life.  She never got it until now.  Now she knows how I feel about her.  Things do come full circle and our inspiration can come from many places and might have been with us all along.

Breast Cancer - A Loving Fight

Meeting the Plastic Surgeon – Alternative Breast Cancer Options

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” I’m sorry for being selfish.  Cancer is affecting both of us more than I let on”

We had our first disagreement since my wife’s diagnosis with breast cancer and it ironically happened after meeting with the plastic surgeon.  Stepping back, my wife has been given the opportunity to have a surgery that is not offered everywhere to everyone.  In fact, it was not an option we were aware of until we met with our breast cancer surgeon.  4 years prior when my mother had breast cancer, the skin-sparing mastectomy was not readily offered.  When originally told my wife was eligible for a lumpectomy, we both felt relieved, yet my wife and I knew that this is something we wanted to be overwith since both of our mothers had chosen for mastectomies and were doing fine (hers ahad a double or bilateral and my mother only had a single).  We chose for a bilateral mastectomy given all the options and our doctor told us this was not unusual for people our age.

It had been about 10 days since my we met with the cancer surgeon and now we were meeting with our plastic surgeon.  The process was very complete and they had typed up our laundry list of questions (recovery time, how is it done, infections, time of surgery, pictures, etc.).  As a husband, you are wondering who is this guy?  What does he look like?  Is he some slick tanned golfer?  A pervert? Actually he was perfect.  A no-nonsense guy and very matter-of-fact.  Interestingly enough there were more people in our room for the plastic surgery consultation than in with the cancer surgery consultation.  This is where my diagreement with my wife occurred. 

I am in this strictly for my wife and mother of our children.  If she had decided against reconstruction that is her choice.  It is her boday and I’d be happy with it.  We’ve had many discussions on this topic in private and she knows I am with her every step of the way.  Before diagnosed with breast cancer my wife had been undergoing therapy for a bad back as caused by her size DD breasts.  Ironically a mastectomy would reduce that weight and hopefully help her.We had both come to the conclusion that if she wanted to have reconstruction that a smaller size would be great as long as it was good for her.  I told her that I was in agremement as long as it was up to her.

What many men don’t realize that this is a very serious topic and not the same as some starlet getting new breasts.  Check out this idiot’s article in Glamour that upset my wife today!  This is my wife and I am not some kid in a candy shop.  If you had asked me before I would have told you I’m a leg man.  BUT, my wife’s breasts are part of her identity whether she hates them or not.  Without them she’d probably be off balance emotionally as well as physically.  I think that the average large breasted women are more inclined to say that they want reconstruction (at a smaller size) after their surgery because they know what is is like.  I don’t know about smaller sized women who want bigger breasts (post-cancer surgery).

Anyway, my wife is the typical person who asks me questions all the time, but this is not the one time when I wanted her to do that.  The plastic surgeon and his team pointedly asked me questions several times and I deftly pitched them to my wife saying it is her decision.  I felt like the team was trying to make sure I wasn’t some “pig” husband trying to push his wife into getting a fake rack.  My wife kept coming back to me and saying.  Should I have a “C’ or a “D”? 

Look, “This isn’t like choosing shoes or trying on clothes”, I yelled at her afterwards. “These people are trying to make sure YOU want this and that I am not pushing you to do this.  I want YOU to show them this is your decision and not OURS!  The only thing I want is for you to be happy with whatever you get”.

To my wife’s credit, she wasn’t focused on my thoughts and predicament.  This was the normal way we made decisions everyday.  We have always been a 50/50 couple.  She didn’t realize she was putting me on the spot in front of the surgeon and his team.  She forgot about my feelings and the stress I was under as well.  I reminded her that because of costs, you can’t change your mind 50 million times when shopping like she does at Target.  I might not go to any follow up meetings with my wife and the plastic surgeon as I don’t want to be on the spot again and I don’t want to be scrutinized like that again.  Society does that to you.  I know there will be people in the future who will look at my wife and say, “Oh, she has a fake rack.  Her husband must be a pig for doing that”.  I even might have been one of those people.  Never again. 

Other than that the consultation did provide some eye-opening informations.  Overall it is only adding 45 minutes to the total surgery.  Each mastectomy takes about 2 hours.  His part takes 45 minutes.  Once the cancer surgeon is done with the first breast, and moves to the second breast, he can start.  Recovery should be two weeks and they say not to drive for 2 weeks because you likely can’t react for several weeks fast enough without hurting yourself.  Then (depending upon any radiation or chemo) you get pumped with saline in 4 weekly sessions.    After the sessions, you get the saline replaced with silicone in a separate procedure.  If there is radiation and or chemo involved, they wait until after the treatments to swap out the saline.  They say infections do occur within 20% of the patients and that is because of the radiation most likely.

The skin-sparing surgery my wife is having is the most interesting and newest part of the procedure.  it must be done at the same time as the cancer surgery.  It preserves the nipple and is done through a crescent shaped incision above the nipple.  In the past, this incision was done with the nipple removal.  This surgery thus does not require nipple reconstruction or tattooing.  Amazingly enough in looking at pictures provied by the pysician, he showed us some photos which were amazing.  in 2 of the 3 that he showed us, the woman had chosedn to get a lumpectomy and then later had to have mastectomies.  That sealed the deal.  It told us that my wife was making a very informed and yet not -so radical decision to have the bilateral mastectomy.

Next up: The MRI and genetic testing