I Have No Idea What To Do

So this topic hasn’t been written about for a while. I got some news while friends were in town and then we were moving to New Orleans and it’s been a continued whirlwind. I have no idea what I’m going to do about my reconstruction fix surgery. No idea. This is also one of the more personal things that I’m going to write about, so do me a favor and don’t bring it up in person unless I do. I’m cool if you want to email about it or write comments about it online, but in person it’s a little tougher for me to talk about. It’s weird talking about my boobs with people face to face. I’m writing about it for three reasons: I don’t know what to do and am tapping the larger network for experience, I’m trying to log all of the experience with this because I think it’s educational and may be helpful to someone else, and it helps me to get it out and not keep it all bottled up.

The alternative title of this post was going to be “the surprise needle” but that was back when I had my appointment with my plastic surgeon in October and more has happened since then. So to recap: I had a tram-flap reconstruction (use google) and I was told by my physical therapist there was a lot more stiffness than there should be in my recovery and she thought there was necrosis and a cyst. Necrosis is exactly what it sounds like, some of the new tissue dying which sucks. Physically the area feels really hard and it actually keeps me from having full motion of me left arm, I have about 85% I’d say. Back in October I had my appointment with my plastic surgeon which I was very keen to do so I could find out what the situation is what my next options were. I was freaking out a bit because the only info I really had to go on was from google which is a scary place. The appointment happened to be on the same day that our good friends from SF were coming to visit so we picked them up and then headed to the hospital. We figured it would be a quick appointment and I was really looking forward to a doctor’s appointment where no one did anything bad to me for a change, like say, stick a needle in me (I’m sure you see where this is going).

So a sarcastically amusing thing about plastic surgery is that it is a money maker for the hospital so their equipment and digs are much nicer than the cancer or PT areas. The table they have you sit on is super fancy and my doctor looks like she just stepped out of a fashion magazine. I think it’s obnoxious that the physical therapy area is in a windowless basement with old equipment and this is how the other half lives. Patient care shouldn’t differ based on whether or not you perform elective surgeries. Chalk it up to another fucked up thing about healthcare in America.

Anyways, my doctor agrees that there is necrosis that will need to be removed and that there is a cyst. Then she tells us that she wants to drain it right then. Like that moment. Apparently though that was code for A. and I sit in the room for a half an hour until she came back with her nurse which sucks when you’re sitting around waiting for someone to stick a needle in you that you were expecting. Surprise needles are the worst.

So she comes back and the procedure is to use a little needle to numb the area and then a big needle to suck the fluid out. Totally gross right? She tells me not to watch because it can be disturbing, not a problem. A. watched and regretted it. It was quite a bit of liquid (I looked after she was done and was not grossed out) and kind of fascinating physically because it was visually very noticeable in a good way when it was done. Then I got a “pressure bandage” which basically means a big wad of gauze tapped down forcefully over the site. Super comfortable. Keep in mind all of this was totally unexpected and our friends are sitting outside waiting for us having no idea it would take this long or that I would end up having a minor procedure done. Welcome to my life.

Then she told me her plan for fixing it all which basically is moving things around to be in the right area and injecting fat into the area on top that is kind of a dent right now to fill it out. And no, you unfortunately can’t volunteer to give me your fat, I wish you could, trust me, I’m tired of getting poked.

Then we headed home and I got to not shower for two days to let the surprise attack heal and had to deal with dressing around the pressure bandage during that time. It was a great look. Definitely made me feel even more normal than usual.

Then unfortunately the cyst filled again and I had to make another appointment with my doctor before we left for down south. I think I saw her three days before we left it was such tight timing. Apparently what can happen (and did) is that the area can create a vacuum so that once it’s drained it pulls more fluid into the area and will just keep doing this until surgically corrected. I think I have breast cancer BINGO at this point with all the weird shit that’s happened. She said she could drain it again, but I politely declined to get stuck again with another giant needle since it would just happen again. The time in between these appointments was a little over a week.

So then we moved to New Orleans (more about that in future post). Once down here I asked my oncologist to make a plastic surgeon recommendation so I could see what my options are down here. He made two recommendations and one of them never got back to me (thanks lady) and the other is a group of plastic surgeons that specialize in reconstruction surgery, Center for Restorative Breast Surgery. This was a whole new ball game since the only plastic surgeon I’d ever met was mine through Dartmouth and connected to a hospital. This was like Nip/Tuck come to life. The first weirdness was in the very nice lobby. There is a display of rhinestone shirts that say “Restored by ….” with the surgeon’s name, all in rhinestones, and a pink rhinestone ribbon. Yes, your plastic surgeon will rhinestone sign your boobs for you. We haven’t found out if these are free with reconstruction or if you have to buy a rhinestone shirt calling out that your boob(s) are fake and the person who made them for you. Something everyone woman aspires to share.

The next clue that this was a different ball game was the fact that we first went into a very tastefully decorated small meeting room rather than an exam room to meet with my potential surgeon. He was great actually, he went to great length to explain everything to me and even sketched things out which was really helpful. My complaint with the Dartmouth plastic surgeon is that she did not explain much to me at all and I feel like I was grossly uniformed about what my surgery would entail in short term and long term. She’s good at what she does and I trust her to do it well, but being informative is not something she did well. I had no idea that my bellybutton would be gone and I’d get a new one (weird). Way more importantly, I had no idea that most of my stomach would be numb after the surgery and most likely permanently. This is something that would have caused me to think about my choices more, I probably would have made the same one, but I can’t really know that and I’m a bit resentful of it.

In his explaining things shit got nip/tuck weird. He told me that while they were doing the fat grafting they could easily do liposuction on any other areas that I wanted cleaned up. I told him I’m doing just fine. Then he asked me three different ways if I wanted bigger boobs. I told him I really like my remaining boob and would have happily kept the pair as is. Seriously, I had nice boobs. They weren’t large boobs, but they were quality. I’ve had several different lesbian friends tell me I have nice boobs which I think is the ultimate compliment, I mean who knows boobs better than lesbians? It would be like if you were a guy and your gay friend told you you had a nice looking dick. They should know right? Sorry Mom.

Anyways from there I went to the exam room and things continued to get weird. I got a nice robe to put on, disposable undies, and fuzzy socks (that I totally kept). Then I went to get photographed. This is normal for plastic surgery because they want a before photo and also there’s usually some time between surgery and the consult so they reference those to make sure they know exactly what they’re going to do. Normally you take these against the exam wall and they photograph whatever the area is without your face. Well Nip/Tuck has a photo studio. We went to the photo studio down the hall where there was a little stage for me to stand on and a background that reminded me of school pictures. They also had a professional camera with stand and a mini fireplace style heater. A. was with me the whole time which was hilarious because I’m posing in this bizarre situation with him sitting in a chair and the nurse lady taking photos. It got peak weird when I had to turn around and be totally naked because my booty is an area they may need to potentially graft fat from. Awkward. I am sort of proud that neither of us started laughing, it was a struggle.

Then I met with the doctor in the exam room and he agreed with me that I don’t need liposuction. Thanks bro. He then proceeded to tell me that the scar on my torso is slightly crooked and that he could fix that for me. Not just could, but wanted to fix that for me and showed me the photo of it and I found myself saying “sure” from politeness and weirded-outness. I am not going to do this because who the fuck cares. I don’t think anyone but a plastic surgeon is going to look at my scar and be like, um, hey, so you know that’s a little crooked right? Seriously, let someone open me up again so they can fix my crooked scar!?!? Anyways then we moved on to the good stuff. He told me that my left boob is “perfect”. That’s right. A guy who looks at and fixes boobs for a living told me my remaining boob is perfect. BAM! (That’s for everyone who thought I was being conceited earlier or overselling them). Validation. And yet another reason why getting breast cancer at 30 was fucking lame.

Ok so I’ve skipped over details from both plastic surgeons so I could do the wrap up below and not be too repetitive. Below is why I have no idea what to do and it’s really hard because there isn’t a right decision. There’s possibly a more wrong decision, but I’m not sure it’s entirely possible to figure out which one that is. I want to make a decision early next year because it can be hard to book plastic surgeons and my goal is to get surgery in late February so I can move on with my life from all this. Waiting isn’t going to make it easier, every day I face the complications from my first surgery multiple times a day and part of moving on for me needs to be getting that fixed so it’s less of an in my face thing. It’d also be sweet to get back 100% range of motion with my left arm. You know, no biggie. Here are the issues/scenarios:

1. Getting my surgery at Dartmouth with my original surgeon

Pros: She’s got a clear plan, she did the original surgery so she knows exactly what she has to work with, she is covered by insurance, I’ve been treated there and feel good about the hospital and her, she wasn’t concerned about the amount of necrosis needing another flap surgery to rectify.

Cons: She’s in NH so I wouldn’t have her for followup, she said there’s a good chance I’ll have a lot of issues with pain again and I wouldn’t have her there to manage it, I’d have to fly home still recovering, A. wouldn’t be able to stay up there with me (probably about 2 weeks), VT in February is a nightmare (cold and dark), If there were any complications with necrosis or anything else I’d be in LA and she’d be in NH, she wants to cut across my boob and I am very anti this because I don’t want a scar there (I’m going to ask her if she could do it cutting underneath like my original surgery and that will be a make or break for me)

2. Getting my surgery done in LA

Pros: The doctor was really thorough in explaining everything, my doctor would be local for pain management or followup care, I could recover at home and it’s much warmer here and light out longer, A would be around the whole time, my doctor specializes in repairing reconstruction issues, he was fine with cutting under the boob and not across (avoiding new scars)

Cons: Out of network, doctor is concerned there is too much necrosis and I’d need another flap surgery to have enough tissue (I’m not sure I want to go through with that due to the numbness but I also don’t want an implant after everything I’ve gone through to avoid that and I’m concerned that he’s up-selling based on all of the up-sells he offered in the consult)

So yeah… This continues to not get easier. If you know someone who has gone through something like this with their reconstruction I’d welcome any advice/knowledge (specifically people who had issues with reconstruction, not the general implant vs natural debate).

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One comment

  1. OK, I have zero experience with breast reconstruction but I do have a bit of experience using DHMC for a ‘specialty’ procedure, and then getting a follow-up at that-celebrity-place-that-does-nothing-but. I feel like if I’d gone to the celebrity office in the first place, I’d have what I’d wanted and not the nothing I have now (for full disclosure – this was for IVF, and yes, DHMC docs are very knowledgable and do a good job, but they’re not specialists in the way that someone from a major metro area is – esp. in the realm of plastics and reconstruction. It’s just sheer volume, you can do the math). Anyway, my two cents is do it in LA. Let the boob gurus work their magic, because they do it a million times more than any NH surgeon – people have their tits out 12 months out of the year in NOLA. xoxoxo

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