Monday, February 27, 2012

Extreme Make-Over: Random Edition

WARNING: This post may stray to the side of TMI for some readers. Read with caution!

So, in the weeks since my surgery I have been asked a lot of questions about about the surgery and my upcoming treatment. Some questions have come from friends bold enough to ask the intrusive questions that everyone is wondering about, others have come from acquaintances who are dying to know details but feel awkward about asking and still others have come from readers who know someone who was recently diagnosed and need to know that everything will be okay ... eventually.

 I have written about the funny side of dealing with incisions, drains and wound care but not much about the details of the surgery itself. I wasn't sure how much to share and how I would feel about everyone knowing everything about this journey but Mr. Awesome and I have always said that "shame is the enemy of success." So with that in mind, here we go.

I have a surgery called DIEP flap, which is the way they reconstruct the breast after a mastectomy. Just to back track a little, the decision to have a mastectomy was made because of the size and rate of growth of the tumor. A few people have commented that a mastectomy seemed extreme and barbaric but the mastectomy saved my life and the reconstruction saved my dignity.

So .... here's the graphic part.

The biopsy I had in October showed that I had a invasive mammary carcinoma (meaning breast cancer that has spread past the point of origin). In fact, I had two types of breast cancer; one in my milk glands and the other in my milk ducts. At the time of the biopsy the tumor was 2.5 centimeters and my lymph nodes were unaffected. Six weeks later, at the time of my surgery, the tumor was just over 5cm and 16 of my 26 lymph nodes on the affected side were cancerous.

The surgery took about 4 hours. During the surgery one doctor removed my nipple and about two centimeters of skin and tissue around it. She then removed all of my breast tissue through that opening. She also made 6 inch incision under my arm and removed my lymph nodes. All of that tissue was sent to pathology to confirm the type and grade of cancer (turns out the type was consistent with the biopsy results but the cancer was at stage IIIA, which means that there was in fact a tumor and my lymph nodes were affected).

Once the first surgeon was done a plastics oncologist stepped in and did the reconstruction. The first step was what is essentially a tummy tuck. I have an incision that goes from hip to hip along my abdomen where the doctor removed about 10lbs of stomach fat and tissue. He then pulled the remaining skin (that used to reside above my belly button) down to meet the remaining skin along the bikini line and stapled them together. He also made an incision to pop my belly button through my new, flatter stomach.

The surgeon then took the 'flap' that he had removed and scouted out a section with good veins and arteries and, thankfully, minimal stretch marks. He chipped the cartilage away from my breast bone, hooked up the vein and artery (to keep the new flap viable) and then stuffed the  flap into the cavity that had previously been my right breast. So, in essence, my right boob used to be my lower abdomen.

This surgery is a miracle and I am so thankful that we have doctors here, in our province, who are skilled in this technique. It is less traumatic physically and psychologically that the types of surgery they used to do for women with my diagnosis. And although I no longer have a nipple (they can reconstruct one complete with natural looking tattoo colouring) I do have a breast and I do have my life.

The next step in chemotherapy, which starts tomorrow, and with that hair loss and the possibility of premature menopause. I get a lot of questions about how I am doing, mentally and emotionally, with all of these changes and honestly, for the most part, I'm doing really good.

My life is more than my breast, my hair or my physical appearance. My scars, whether they are stretch marks, from childhood mishaps or from surgery, tell the story of my life. They are battle scars, each one hard earned and in their own way, precious to me. The stretch marks are gifts from my children, an outward sign of the mark they have left on my heart. The childhood scars tell of days full of adventure, tree climbing, crazy spinning, bike riding adventures. And my surgery scars are a map of my fight and victory over breast cancer.

This is my body, scars and all. This is my life, full of laughter, joy, loss, heart ache and healing. And the transformation that is happening with my body is no different than the make-over that is constantly happening in my heart and soul, as I daily strive to grow, learn, be more and do better.

Although the world is full of suffering, it is full also of the overcoming of it. ~Helen Keller

**This post was meant only to educate my readers and friends to my journey, not to promote a specific course of treatment nor to open a debate on treatment options. Each individual walking the cancer road must make their own, informed, decisions about treatment ... and be respected for the choices they make for themselves.
If you have any questions, don't be shy ... ask away!

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