• Another 100 Days of Good Karma: Day 144 (A Peek into the Breast Reconstruction Process)

     

    beingstrong

    Tuesday, December 2, 2014

    Run/ Walk/ Bike/ Elliptical (Today:  2.5 miles;  Running Total: 59.15 miles)

    Day 144 of *Another* 100 Days of Good Karma.

    [WARNING: Graphic diagrams below.]

    I met with the plastic surgeon for the first time.

    Every doctor’s office has diagrams in it to describe something. This office was no different. Here are some of the diagrams I saw.

    This diagram shows the timing of reconstruction. I am having the ‘immediate’ mastectomy after chemotherapy is over.

    Timing of Reconstruction:  Immediate vs. Delayed.

    Timing of Reconstruction: Immediate vs. Delayed.

    There are several types of reconstruction.

    Reconstruction using saline implants.

    Reconstruction using saline implants.

    Reconstruction using the back and buttock muscles.

    Reconstruction using the back and buttock muscles.

    Reconstruction using tissue from the stomach.

    Reconstruction using tissue from the stomach.

    There is also nipple reconstruction to consider.

    Nipple reconstruction and tattooing.

    Nipple reconstruction and tattooing.

    The office also had props. Here are a couple of examples of saline implants and spacers.

    Types of implants and spacers.  Clockwise from the top left:  A spacer, a saline implant with texture to prevent movement in the breast, a smaller spacer, a saline implant with a smoother texture.

    Types of implants and spacers. Clockwise from the top left: A spacer, a saline implant with texture to prevent movement in the breast, a smaller spacer, a saline implant with a smoother texture.

    Holding the textured saline implant in my hand to give you an idea of the size.  Of course, there are many size options.

    Holding the textured saline implant in my hand to give you an idea of the size. Of course, there are many size options.

    Here’s a general outline of the plan:

    About a month after chemotherapy ends (I don’t have a set surgery date yet) I have the mastectomy. During the mastectomy the plastic surgeon steps in and they put a spacer in.

    In the clinic after surgery the spacer is ‘inflated’ with saline (I think it’s saline anyway – I forgot to ask). I’m sure ‘inflated’ isn’t the medical term, but that’s how I thought of it. The inflated spacer creates a pocket beneath my skin. This stretching process sounds painful but the doctor said I’ll likely be numb on that side so I won’t feel much (if anything) after surgery.

    Then before radiation begins the bag is ‘deflated’.

    I go through radiation with the empty spacer in place. After radiation the bag is ‘inflated’ again and I keep the spacer in six months to a year after radiation to allow my body time to heal.

    Radiation has a way of contracting the skin and turning it leathery. This contraction and change in texture makes it much harder to create a pocket after radiation. The spacer isn’t designed to be left inflated during radiation, so inflating the spacer before radiation makes reconstruction easier after radiation is complete.

    After my body heals final reconstruction surgery happens.

    It’s too early to say how that will be done yet, whether with my own tissue from muscles in my back or if it’ll be a saline implant. The reason we don’t know yet is because we don’t know yet how my skin will look after radiation.

    I’m hoping for the saline reconstruction as it has a faster recovery time, but might need the back muscle reconstruction depending on how my skin reacts to radiation.

    The meeting caused surgery anxiety, and a lot of it. Also, I was disappointed on multiple levels.

    It was good to hear a plan but he said there would always be a marked difference in how my breasts looked with my clothes off. He said he’d do the best he could to make them ‘pretty’ and no one would know with clothes on. He also said he would give the other side a lift to help make them match as much as possible (because, let’s face it, I’ve had two kids and they don’t exactly sit where they used to).

    I know it’s only Justin seeing them, but still… it was a disappointment.

    The timeline was disappointing too. I was crushed to hear I’d need to wear the spacer for six months to a year after radiation was complete.

    This is only an estimate, but if the mastectomy happens somewhere around the beginning of February 2015, then radiation happens after that. How long after that I’m not sure, but I’m guessing there’s time to heal between surgery and radiation.

    So say radiation starts in March 2015.

    Radiation lasts for 12 weeks, I think, which puts me in June before radiation is over.

    Which means the spacer will be in at least until December 2015 before I go back for the reconstruction surgery.

    Also the port can’t come out until my oncologist is confident that no further chemotherapy is needed.

    Cancer… it’s just the gift that keeps on giving.

    I guess I went into this appointment with unrealistic expectations. Now I have three wishes:

    1. I wish for my surgical team to make my breasts as pretty as possible. This might sound shallow, but goddammit I’m going through enough. I at least want to be okay with how I look.
    2. I wish for the least morbid reconstruction option. I’m hoping for saline implant and no removal of back muscles because I want the fastest recovery possible. Also, the saline implant route typically only keeps you in the hospital for one day after surgery.
    3. I wish and hope and pray to God I never, ever, ever have to go through cancer treatment again.

    I voiced these wishes to the plastic surgeon. He said he’d do his best with the first two. As for the third, he said it’s unlikely that cancer would come back in the same location. If it comes back it would be much more likely to come back somewhere else in my body.

    This is just the uncertainty I have to learn to live with.

    Today’s silver lining: I know more today than I did yesterday.

    What’s your silver lining today?  I love comments!

    Don’t want to leave a comment, but have something you want to share?  Send me an email at gettingthewordswrong(at)gmail(dot)com.

    xoxo,
    Meghan

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5 Responsesso far.

  1. Pam says:

    Wow. That is a LOT of information to take in, and it sounds like (as usual) you are admirably tough and honest about all this stuff. What a timeline….

    Of course you want your breasts to look pretty! You’re a beautiful woman who takes awesome care of herself. Your breasts should–and will–look pretty.

    Hugs and Sincere Thanks for sharing,
    Pam

  2. marriannad says:

    Thank you for the update. I’ll continue to keep you and your team in my prayers. I appreciate you documenting the process. Blessings.

  3. Annette says:

    My silver lining is you know more today then you knew in the past. Happy for the plan. 🙂

  4. […] discussion on the reconstruction process with the plastic surgeon has been on my mind a lot since […]

  5. Cindy Smith says:

    You deserve to look pretty after going through this hell! I hope and pray they can accomplish that for you.

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