Round 7 – week 2 – day 3
Well I think I actually heard “nice size books, nice shape, no fat, not much I can use anyway, strong abs”, after that I went to my happy place. Not enough usable fat to make C cup boobs, I remember telling the plastic reconstruction surgeon, I’m going on a cruise so can eat more (and Todd chuckled, coughed, spat behind the curtain) – I think because he knows how much I ate on the last one. So we came to an agreement – I keep buying fat pants till 2020 and she will agree to no implants for either breast, 1 tummy tuck, a B cup for both breasts, and advocate to Mastectomy surgeon for double at same time (as I won’t need any skin expander that could get effected by radiotherapy cause I am not having an implant in the “prophylactic right breast reconstruction” )(prophylactic = preventative)
So with all the joking aside, both oncologist and plastic surgeon are for and advocating for double mastectomy in same op. Now I have had all reconstruction options represented to me, and made aware to Dr I have no desire for huge boobs but a real fear of artificial implants (that only have up to a 10 year life span) she was pleased to agree that my “breast” (lol) course of action is a Flap Reconstruction, where muscle tissue, skin and fat is taken from my lower abdomen and attached to the site of the hole left from the mastectomies. The fat around my upper abdomen is not able to be used, as it is fat under the muscle dangerous to get to. This unfortunately for me can only be lost through weight loss. The fact that I have very little loose skin around my torso is the reason she said I have ‘little’ usable fat – dam those f*#@ing ab workouts while eating PIZZA
While my mastectomy operation should take only a few hours and few days in hospital, the flap reconstruction will take up to 10 hours if all going well and a week in hospital including 2-4 days in ICU. (This is a very complicated procedure with multiple surgeons involved versus the breast implant tissue expansion option, but it does mean I can have both breasts off at the same time AND only have to do this once). Now this is a scary prospect. With all the health issues I have had, I have never really had a real operation. Many little ones here and there, but certainly nothing ever longer than an hour under general anesthetic – I hope they have good recovery nurses as good as you Meredith!
The reconstruction involves a lot of micro vascular surgical techniques to reconfigure blood vessels, and dealing with the unknown until in there, will determine if they attach groin blood supply to chest wall blood supply, or supply from the lymph region, or ultimately they might need to use rectus muscle from the upper abdomen (and replace with mesh) which would mean no more ab exercises as mesh don’t move . By the time I have my knee reconstruction you can call me Bionic woman (without any bionic powers but).
Recovery from this will involve monitoring of heart rate, blood pressure, breathing, clotting prevention, drainage for both breast sites and tissue donor site, blood supply, wound healing, surgical tubing, catheters, copious stitches, and the usual surgical risks. Drains will be removed around 1-2 weeks post surgery and stitches around 10 days post. Normal activity could take up to 6 or more weeks to resume. Risks include loss of blood supply, fat necrosis (death of constructed breast, which would mean removing it), fluid collection, weakened abdominal muscle and or loss of full movement in the arm or side of breast.
Nipple reconstruction generally happens another 4-6 months down the track, and again involves a whole other set of decisions.
Now if that doesn’t scare you into prevention being better than cure I want to give you some cold hard facts about breast cancer, so you can be aware, not alarmed and make full informed decisions about your own health care, as I assume most of you reading my site are women between 40 & 55 years of age:
Now I am not a researcher, a medical expert or any kind of health care professional so I am only sharing what I know about MY cancer.
I have Stage 1, Grade 2 Invasive Ductal cancer – 70-80% of all women with breast cancer present with Invasive Ductal cancer (meaning it has originated in the duct of the breast (behind the nipple). Stage 1 involves up to one lymph node, grade 2 is a middle grade breast cancer.
I have breast cancer which is hormone receptive. Not all women have hormone receptive breast cancer. I am ER & PR positive (ER & PR are proteins). This means those proteins attach to estrogen, which helps the cancer cells grow. I know this first had because as soon as I was told this I ceased the contraceptive pill immediately, and my mass by feel alone, reduced by one 3rd in 1 week. (more on this later)
I am also HER2 Positive – only 25% of women fall into this category. This protein also facilitates cancer cell growth, by stimulating a gene mutation. This makes my cancer slightly more aggressive than if I didn’t have that protein, however medical miracles as they are, have a targeted drug (Hercepton) to assist in blocking this protein.
So to recap, the reason I have my personal cancer treatment plan is
- 1st chemo (done & dusted) to stop the fast growing cancer cells
- 2nd chemo to block the slower growing cancer cells
- Hercpton to block that HER2 positive protein
- total mastectomy to stop the fucker coming back
- removal of a suspicious lymph node (or lympectopy = partial removal), to ensure it doesn’t go anywhere else in the body
- radiation therapy to ensure any lingering cancer cells in the skin are KO’d
- oral hormone blocker treatment for the next 10 years, so the ER / PR proteins do not have any chance to feed any possible estrogen lingering in my body.
This is why every single woman’s diagnosis and treatment plan will always be so very different. But I’m here to tell you about the risks, which are always the same
1 AGE – the risk of developing breast cancer roughly doubles for every 10 years of age, commonly diagnosed over 50
2 WHERE YOU LIVE – genetic/environmental factors and rates vary between counties
3 FAMILY HISTORY – close family members particularly if they were aged under 50 when then were diagnosed.
Personal opinion – Get the details of what they were diagnosed with
4 BEING CHILDLESS
5 PREVIOUS BREAST CANCER
6 NOT EVER HAVING BREAST FED YOUR CHILD
7 Early age of periods
8 CHEST BEING EXPOSED TO RADIATION
9 HAVING MENOPAUSE OVER THE AGE OF 55
10 TAKING CONTINUOUS COMBINED HORMONE REPLACEMENT THERAPY (HRT) for several years over the age of 50
MY PERSONAL OPINION IS WOMEN ARE ENTERING MENOPAUSE MUCH EARLIER THAN 50 SO I WOULD BE ON THE CONSERVATIVE SIDE AND START THINKING ABOUT GETTING OFF HRT EARLY 40’S. DESPITE BEING TOLD (BY 2 GP’S AND A HORMONE SPECIALIST) I WAS GOOD FOR ANOTHER 5 YEARS ON THE CONTRACEPTIVE PILL I’D BEEN ON FOR 20 YEARS FOR HRT SINCE MY ALLOGRAFT, I BELIEVE IF I’D REDUCED OR CEASED IT 5 YEARS AGO, I MAY NOT BE GOING THROUGH THIS NOW. IF YOU ARE 40 & DONE WITH REPRODUCING & HAVE ANY OTHER RISK FACTOR ABOVE, USE A CONDOM AND LET YOUR HORMONES DO WHAT THEY NEED TO DO NATURALLY. HRT INCLUDES CONTRACEPTIVE PILL AND OTHER HORMONE CONTROLLED MEDICATION. GET OFF IT.
11 EXCESS ALCOHOL
12 I’M ADDING NUMBER 12 MYSELF – SMOKING
As you can see, I have possibly 6-7 of the 12 risk factors, you can’t change the past, but you can change the future. And I didn’t know these risk factors until after I was diagnosed – go figure.
So, If you are advised, because of medical family history, to remove your breasts – DO IT. If you have family history of the BRCA Gene, get tested.
If you are concerned about your hormone replacement or your early onset or late onset menopause, insist on information from medical professionals who will listen to your concerns.
If you are generally unwell and can’t put a finger on why – insist on blood tests until you find answers.
Live well, get sun, fresh air, find a hobby, love lots, give not to receive, love yourself, be authentic, keep it real, be proud, find self esteem, thank your body everyday for breathing life, appreciate what you have, do everything in moderation, don’t procrastinate, take risks, have Happy Days xxxx