September 19, 2014 - Finely tuned lens

I have the luxury of working with children with a cancer diagnosis (plus fatal genetic diseases). It’s amazing how much you can glean about life simply by spending the day with a child, and parents of such, who is facing death. They, both parent and child, are a special breed of human. One that in a single hour of time when the diagnosis is confirmed finds that their lens of life becomes a little clearer. A bit sharper and more finely tuned. Pin point on a single subject and less blurred with the mirage of previously worthy landscape. Some things fall completely off the canvas all together to be replaced with more worthy brush strokes. The all-consuming just became the trivial.  The unimaginable becomes the everything. And the people of your life circles suddenly become more transparent and more intentionally chosen. It could be an incredible life study, these subjects, that could glean a wealth of guidance and insight in finding that “purpose” our culture is so notorious for “hamster wheeling”. There  contains a few examples of the human spirit going terribly wrong, but there are oh so many examples of the human spirit doing life as purposed when confronted with the uncertain.

It’s so easy to get caught up with the to-do lists of this life, the struggles of day to day adulthood, but 1 hour with these kids can bring you to your knees in awareness of what this life is all about. You become better at doing life by observing them navigate theirs. These are a few things I have learned in the process of brushing up against their lives and by navigating it myself a few years back:

·       IV poles are made for decorating and riding on for the IV pole parade.  Nothing more, nothing less.

·       Anything can be made into an arts and crafts activity, including Band-Aids and IV sets.

·       Bugs Bunny Band-Aids are the only way to go.

·       Folding 1000 origami cranes can give you “luck” when you think you are going to die.  And a 9 year old will spend every waking hour accomplishing it.

·       A simple lab result can make or break your day- and you hold your breath from the 30 minutes from when it’s drawn until resulted.

·       One sentence from your healthcare provider can either devastate you or help get you through one more hour.

·       It’s totally fashionable to wear two different colored socks and as many ruffles as your tutu skirt will hold.

·       You will never know what you will choose until that very moment. No matter how much you think you know yourself.

·       In their mind every cough or sneeze is a potential relapse. Don’t down play that.

·       Time doesn’t always heal wounds. Time does provide opportunity to make memories that help sooth wounds.

·       Bald heads represent triumph- not old age.

·       IV lines, bruises, shunts, g-tubes, and rashes all at the same time can be badges of honor.

·       Getting the gas bill in the mailbox when you know you have to pay for daily appointments for the next month can bring you to tears.

·       Parents relish having one more day where the kid drops the puff cereal all over the carpet.

·       You can never talk about poop too much.

·       Elmo is universal despite language barriers.

·       You can never eat too much ice cream.

·       Marriages can be lonely when chaos is in your realm. Not every marriage will survive. Some come out stronger.

·       All teenage girls want to go to the prom…with hair. All teenage boys want to go to the prom with a girl…with hair. Wigs have come a long way!

·       Santa can show up any time of the year and princesses are magical.

·       Siblings need time to process.

·       Parents can find delight in hearing their children fight, because at least that means they are still alive.

·       Healthcare providers cry after work too. Tears don’t always make everything better.

·       “Rainbow Connection” is the absolute perfect song for a memorial service.

·       Time at the art table with play dough can motivate you to come back in for one more infusion.

·       You will put purple dye on your tongue to kill infection if I successfully convince you it is like you “just ate Barney”.

·       Big clown shoes make you laugh.

·       Your job isn't even 1/8th as "sucky" as you think it is, these parents would give a million dollars to trade shoes with you.

·       20 medication doses in a day are 19 too many.

·       This event is a stress for parents that parallels little else. They won’t tell their friends, but trust me.

·       Choose friends you actually want to endure life with.

·       3 a.m. is the perfect time for a game of hungry hippo.

·       Kids are more resilient that adults will ever be.

·       Even a bottle of Tylenol can break the bank.

·       You never really have it all figured out.

·       An hour with a child facing premature death can teach you more about your own character than anything else imaginable.

·       Children can vomit six times a day and still find a way to pull every topping of the pizza slice in order and with purpose.

·       Music therapy with a paper cup, ukulele, or bongo drums can be the highlight of the clinic appointment.

·       You can never give out or receive too many hugs.

·       Giggling can turn to tears and back to giggling in 20.4 seconds.

·       Footed pajamas carry spectacular cute factor when combined with a bald head.

·       Surround yourself with people who get it and want to positively influence your life. Remove yourself from people who don’t.

·       God doesn’t always promise healing, but he does promise the opportunity for incredible positive impact on those involved.

·       An empty bed is heart breaking.

·       Grief is life changing. So is laughter.

·       Angels and warriors come in all shapes and sizes.

·       Being surrounded by these kids is totally worth devoting your life to!

Click  www.tradinginthetatas.blogspot.com to access other posts. 

September 6, 2014 - Boots and boobs!

I have to say I am looking pretty sexy right now. A skirt, newish boobs, freshly styled hair, polished nails and toes….and wait for it… a new highly fashionable cast boot! It’s black, sleek, velcro-covered with a matte finish. Style at its finest. And the timing for such style and sophistication is just perfection.

You will recall when I found out I had to have mastectomy surgery number 5 for the failed implant that I really wanted to wait until after swim season since I was doing daily physical therapy in a pool for my foot/ankle. Also, I had my summer vacation planned with a trip to the beach. I really wanted to go on that trip and not have water restrictions that come after surgery. So we got the surgery scheduled for early October and decided to finish out the summer and my beach trip intact, sagging boob and all, before scheduling the surgery.  That plan was going perfectly well until I started noticing my foot was not only not improving despite multiple interventions but actually was becoming more constant and severe. I had experienced exactly 1 pain free day in 4 months, and this past week I had several days where I was moved to tears by the time I not so gracefully, just shy of face planting, hobbled my way to bed. On a few occasions, no less than five, I woke up in the middle of the night for a bladder piddle and slammed myself into the door frame to keep myself upright. I decided this could go on no more and me retain any sanity on the other end.

Schedule an MRI. Wait 3 hours for results. Land myself back at the orthopedic office the following day to get steroids injected into the interior side of my heel (and let me complain that I didn't even get a sticker or lollipop). Splints to wear while sleeping followed by the Provider pushing me to get a hard cast for the foot.  While I was super excited to try absolutely anything to get me some relief. I was drawing the line at the cast. Step away from the spatula and Plaster of Paris, Woman!

I begged and pleaded explaining how I had successfully delayed imposter surgery for this beach trip and how I very much needed this trip to happen with me at least dipping my toes, if not a full submersion, in the tepid surf. She saw her reflection in the pools about to spill over from my lower lid and found herself guilted into not a plasterized masterpiece, but instead a sleek new booted accessory of black overlay with the subtle aroma of plastic undertone.   We agreed I would wear it off and on while on my trip, but then commit to embracing it full-time at my return home. So I’m lugging this boot everywhere I go, currently sitting under the car dash next to a lone flip flop as we traverse the interstate. It’s excited to see the coast for the first time. I’m excited to get there so I can take it off and chunk it into the back seat. I haven’t told him as of yet that this is his fate. Our secret.

Disclaimer: I truly am thankful for the boot (and wearing it as much as possible) considering the alternative is a cast, and I’m even more grateful in that it gives this foot a full month to heal before I have the boob surgery because a bum foot and a bum boob at the same time will make me a little more frustrated than either alone.

As my boss said earlier today, “Sally, you have the best luck!” (and that most certainly is true, but who else can claim a boot that matches their beach chair - though admittedly black goes with anything). She’s absolutely right! I am a masterpiece of health ( hardly). A pure specimen of genetic perfection (not even close). My body celebrates change and transition with such frequency that the compass is in a constant spin. It has an uncanning ability to keep myself and those around me always guessing at current state. It would be an absolute marvel, if it weren't such a bummer.

Boots and Boobs. They seem to go hand in hand.

August 31, 2014 - Milky white propofol

As promised, here is another re-visit for those of you that joined my journey late. Warning, It's rather emotional. I teared up reading back through it just now. This tells the story of the 24 hours around the actual mastectomy. You may have read this if you have followed me from the beginning. If not, here you go! (Note: it used to be 2 posts, but I've joined them together for one). 

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Day 0 Part 1: 

I realize I never captured the actual day of the mastectomy. Early on, I didn't yet know if I could commit to going public with this specific journey. I wanted to advocate, but was I truly ready to put it all out there, particularly something so very private by most standard? It seemed all to personal a topic. It seemed foreign. It seemed unreal. Well it quickly became very real when we got in the car that morning to go to the hospital. I don't even recall what we talked about in the car. I do recall my saying everything is going to be different when I wake up and I warned Ron I didn't know how I was going to react. I'd pictured it a hundred times by now and I knew it would be not so good but reality is powerful. This part made me very nervous. 

When we got there and walked in, there sat my mom, dad, sister, in laws, and sister in law. That got me! Just to know they came out of support for this decision we had made. It made my moment. It got me through the waiting room doors. 

"Mrs. McCollum, please come to the registration desk." I had put off signing in to the very last minute. I didn't want them to know I was there early for fear they would take me back earlier than planned. Delay, delay, delay.  There sat the kindest looking lady at the registration desk. She asked my name, address, etc. Then verified I was in for a double mastectomy. Well, darn it! Hearing that word "mastectomy", and I busted out into blubbering tears. The precious lady responded with "you're beautiful now and this won't change anything." And she had this watery look in her eyes as well. She knew to treat me as fragile. I could have kissed her cheek had I not been wiping my face so frantically. I knew that revelation that mastectomy wouldn't change my beauty, but boy was that kind for this stranger to say to the girl crying at her check in counter. Angel, I tell ya.

I had to go back by myself at first. I left everyone, including Ron in the waiting room. I was crying the whole way down the stupid cream colored hallway. They're always cream you know. Hospitals adore cream! And then there stood the poor intake nurse. She must have not even known what to say to me, the girl obviously all messed up in her hallway. She just shined her kind smile at me and held my arm. Another angel. Then, we are at the cubical room. Get changed into the lovely air conditioned gowns I adore. The scrub cap. Get my vitals. Start the IV line (it only took four attempts. I'm an iv line nightmare.) Then wait...By myself...While my mind wanders...Wait some more...Wait...Look at the monitors...Notice my super high blood pressure...Wait...Count the heart beats...Make up a song to the rhythm... Wait....Curse the iv line that is killing my arm...Curse Hodgkin's Disease that got me here...Curse medical literature...Curse me reading the stupid literature.....Wait.

Finally, there I see Ron smiling at the cubical curtain. He gets to come back so we can have our final consult with the Lead Breast Surgeon who also just walked in. Off comes the gown I so pain stakingly had just put on fashionably tying it in three places. Out comes her lovely black magic marker to start her art work on my chest. By the end of this, I look very much like a tattoo artist's playground who was testing every pattern available to a wishy washy client. Dots here. Lines there. X marks the spot. She even signed her initials on her handiwork. This is a requirement for all surgeries to verify patient and MD agree what is happening. She is amazing, but really there is NO dignity in this journey. Next, a chat with the anesthesiologist (she knew I was a medical clinicial) and in the end a spinal block would be my best friend and fate along with another arsenal of inhaled agents. 

Then, they ask Ron to leave. Now, why did they have to go and do that? Here come those stupid tears again! I'm a sap. A true sap. For the record: I didn't cry even once with my knee surgeries. If he leaves this room I'm going to lose it.

Lights, camera, action! I'm in the OR with about 12 clinicians all doing this and that. It's like an ant farm! Last thing I remember is the syringe of the eye catching milky white propofol being hooked in. They know I detest the taste and smell of milk, right? Wonder who that lady is that is holding that tubing? There are those cream walls again. Wonder what Ron is thinking.

Day 0: Part 2: 

Cream colored ceiling. Strange lady sitting next to me writing in some blue binder. Weird tight feeling on my chest. IV line hooked to a clear bag above my head. Awful sore throat. Beep. Beep. Beep. Must-sit-up. Super bad idea. Lady leans over to guide my head back to the pillow. Faint realization.... I must be in recovery and this strange lady must be my surgical nurse. More realization...Oh no, it really happened! Where is Ron???? I really needed him here when I woke up. That was so important to me. Where is he??? (you can see my flight of consciousness as I am coming out of anesthesia and realizing what is happening).

Glancing down, I can see every bit of my abdomen. My pelvis. My leg. My foot. But NOT my breasts! They really are gone. What in the world happened to those two humps! They don't just get up sprout legs and walk off! My thoughts were not of how great this is to no longer be at risk for breast cancer. Nor of how great it is that we have these medical advances available to women like me. Not of God's unfailing provisions. My thoughts were instead of my selfish human perspective of "they truly are gone." Under this surgical vest, there lie absolutely nothing. Nada, zilcho, zero. Instead, scarred leftover tissue that made the cut for use later in reconstruction. Deflated pouches of nothingness. 20 years of development gone in a poof! Abra cadabra. Zippity Zam. 4 surgical hours. Gone! Fast shallow breathing. "I need you to get my husband!!!!" "Please, I need Ron!" It wasn't frantic, just a super strong request that got her attention.

There is a lot of grey here. I remember bits and pieces. Some of this, some of that. Rolling down to my hospital room for my overnight stay. Climbing out of bed to go to the bathroom with four nurses helping my transit (I was super groggy and wobbly). I honestly didn't fully know where we were. That grogginess had an intense hold on me. Then, the unthinkable...vomiting. Nothing like vomiting while walking. Vomiting after chest surgery where every movement can be felt down to your toes. Vomiting on someone else's shoe. Vomiting when you haven't eaten in 12+ hours. Now, desperately wanting to make it to that bed two feet away without face planting myself in a drunken stupor on the not so soothing cream color vinyl floor. Why is my backside so cold? Please don't tell me I walked down the hallway with my gown wide open. Please, I know some of these people! I did NOT just flash these nurses! Tell me that! Chick-fil-A. Wonder if someone can get that for me? Can someone PLEASE make that beeping sound stop! (See, anesthesia really messes with your mind).

We made it through the evening with my thoughts slowly returning to rational with each passing hour. I did get my chicken sandwich, but I guess the airway tube scratched up my throat so much I couldn't really eat it. But, not for lack of trying. Then, it got dark. I have no idea what time it was, but Ron was sacked out in a recliner beside my bed. A faint yellow light trickled in under the door and blue lights from my infusion pump making the room an odd greenish hue. It's funny to me that I remember that so vividly. I lay starting at the ceiling wide awake feeling pretty lonely...and weird...and different. (Recall: I'd had a lovely four hour drug induced surgical nap earlier in the day so I felt no need to sleep.) Once again groggy from the repetition of pain meds every three hours. Because the continuously infusing IV fluids, I was ringing the call bell every 2 hours or less for yet another wobbly shuffle back to the bathroom. Surely, I was becoming a high maintenance patient nurses talk about out at the front desk. "Oh no, there's Old Lady McCollum's bell again. How many times can one person need to go to the bathroom? All she says is 'Get me this, get me that'. Rock, paper, scissors. Karen loses and heads to my room. But those nurses were oh so kind when they crossed my threshold. Happily getting me ice chips, or meds, or escorting me back and forth for the umpteenth time. Always smiling despite it being three in the morning on a super long shift with all rooms full. Grateful was I. Grateful. And I tried to consciously remember to thank them at every turn. I wanted to be low maintenance. But those stupid IV fluids...

Then, at six a.m, in came the surgical fellow and I lit up like a Rockefeller Christmas tree. See, I knew that surgical fellows meant morning rounds and that was the only thing standing in my way from a paid ticket out of here and a car ride home to a comfy cozy no more wide open surgical gowns, IV lines, loud beeping noises, too tight compression stocking living room! Come in, say what you need to say. Blah, blah percocet every four hours, blah blah sponge baths, blah blah this and blah blah that. Surely Ron was getting all of this down. Come on very nice fellow, can't you be any quicker? My couch is calling my name.

Fellow : "Mrs. McCollum, I need to take off your vest so we can check the surgical incisions..." SCREECHING halt!!!!! Slam on the brakes! Hold all your stinking horses. Wide eyed terror filled expression (Me, not the fellow).

Me thinking: Huh? What??? Where's my lead surgeon who told me not to even THINK about opening it and looking? You are doing what and why? This very minute?

Background: Lead surgeon was brilliant in instructing me not to open it for any reason. She knew nothing good could come of me seeing her master piece (it's common knowledge surgeons love to show off their work.) Yet she, being the heart felt clinician that she was -as you would have to be working in breast oncology- wanted to save me from seeing the aftermath. She knew from my very first consult appointment that I was overly grief stricken about the period between surgeries. She had seen the tears as she described the before and after. She even got watery eyes with me. So she brilliantly disguised the true intent (salvaging my sanity) with medical lingo and reasoning to camouflage the plan. "Sally, do not look under this bandage".

Fellow: "It's policy for me to check the incision sight to ensure you are safe for discharge."

And there in lie my quandary. If I want to go home, I have to let this 20 something young man, fellow in training might I add, open up this surgical vest for him, myself, and Ron to view it's content. You see, I had absolutely no plans to let ANYONE see this handiwork. Surgery #1. Stay all bandaged up for two weeks. Surgery #2. Voila! Normal chest again! This silly surgeon wanna-be is destroying my brilliant, sanity saving, well devised and lead surgeon approved master plan. What-is-he-doing???

The unmistakable sound of Velcro. (Insert the now famous fast paced shallow breathing.) Right side off. Left side off. All I could think was Holy Moly! That looks awful. More than awful. Devastatingly awful. Unrecognizable. Not of this world. Embarrassingly horrible. First, one tear down this cheek, then their watery salty friends join in for good measure because they hate to be left out.

Super delightful fellow in training closes the vest back up, hands me my paper work with last minute instructions and quietly walks out the door with well wishes floating in the air behind him. I, however, sat dazed and speechless staring at my now closed vest. What once was a well concealed package with mysterious and only faintly imaginable contents now became a fully discovered, undeniable, messed up reality. The image now burned into every single memory cell of my brain ready to cause me anguish for some time to come. Don't get me wrong, Fellow was delightful and under any other circumstance extremely likeable. Professional and thorough. Rule follower. But at this very second, he was Judas with a shiny new coin in his hand after the last supper. And now my heart, my positive demeanor, and master plan sat crumbled on the hospital floor. And there sat my amazing Ron, who had just seen the unfolded package himself, holding my hand.

Afterward: As irony would have it, 15 minutes later the lead surgeon walked in with her trade mark friendly smile to check on me. "Sally, don't forget to just keep it all bandaged up until our next appointment. There's no need for you to ever open it or look at it. It will heal best if you just leave it alone until our next appointment." - She had driven in super early in attempt to beat the rule following fellow to my room. I tell her it's too late. She had just missed him. Her face falls when I told her he checked the incision. Now her well intended thoughtful master plan for me lie crumbled next to my pieces on the hospital floor. She, too, stood holding my hand.

In hindsight, I imagine God even had a purpose for this expecting unveiling and for this Judas. I'm still sorting what that might be. Maybe I needed that experience. Maybe, I require a true vision of the mastectomy leftovers to better prepare other women that might struggle with the emotional adjustments of delayed reconstruction. Or just maybe that event wasn't even for me, but rather for something in the kind Fellow's journey. After all, I've always thought a Christian's life is rarely for the benefit of self but more about becoming a vessel focused on impacting the life of others. I may never know the true why of that morning. But I do know God has purpose. He has a strategic kingdom impacting plan. He sees my big picture and he sees your big picture. Even in the "awful".

August 29, 2014 - Provision even through Imposters.

I decided to revisit a post from this exact moment 2 years ago. Some of you may have already read this. To others it may be new to you if you joined me late in this journey. I found it to be a great reminder of God's provision in foresight, but now in hindsight. Happy Reading. And thanks for still being here 2 years later.

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Day #22: Yesterday, marks three weeks since the double mastectomy. I've had 21 days to contemplate each individual day of this experience. The day after the mastectomy which set my mental course (post # day 0 part 2), the first shower (did I even post about that?), the miserable little drain suckers (that's in about every post), but it wasn't until yesterday in the waiting room and then last night la ying in bed that I stepped back and looked at it all in one big album, instead of individual snapshots.

What have I done? Did I really make this radical controversial decision to have two breasts I had worked so hard to grow (smile) removed? Did I just allow two surgeons I had met once before decide what the physical future of my new "breasts" would become? These impostors I'm now supposed to know and love. Am I now a woman who has had a mastectomy? Equally as shocking, am I now a woman who has implants? The big picture feels life changing -at least temporarily at this very moment. It affects my marriage, my faith, my personal medical course, my topsy turvy emotions of today. It certainly, hopefully only for the short-term affects my view of self. It even affects me view of you.

Somehow, I'm supposed to return to work and the rest of the world and function as though I am who I was when I left August 3rd. Some people at work don't even know this happened. I have to admit I am changed. And I'm going to need time to transition. Time to settle out. Time to fit this new chest and all that comes with it back into the world. (Maybe there was some hidden rationale in my surgeon demanding I be on house arrest these last three weeks.) How did I even get here?

Back in June, on a Thursday, I was sitting in clinic waiting to see a patient. The Attending Physician I work with had just returned from a national oncology conference and was giving us the low down on some of the hot topics of discussion of the past week. Now let me step back it's interesting to note I'm only in clinic two days a week. The rest of my week I'm in another building with another life. So had this physician returned on a Monday, I would have missed this discussion in it's entirety and be none the wiser for some time to come. So the timing of these events this is lost on me. He was telling us about all the new pediatric oncology research that focused on exposure to radiation therapy and long term outcomes. We've always known radiation therapy is a yin and a yang, particularly when used in children. It's a terrific modality for curing certain tumors, but it carries it's own potentiallu negative risks while propagating the positive curative ones. Historically, Hodgkin's lymphoma patients received very large doses of radiation to the chest region, where primary tumor most likley lived. And we've always known these large doses, while needed for tumor kill, can lead to secondary risks later in life. For female teenagers, breast cancer is one of these risks. We've known this for years. What we didn't know was the magnitude of that risk. Back to the meeting highlights, the Attending Physician began quoting off the new statics on the radiation data.

Well, let's just say my ears perked up when I heard numbers that were much higher than previously published. (I had been treated for Hodgkin's Lymphoma when I was 16 so this was not only professionally relevant but personally relevent.) I simulataneously, while he conversed, went online to the meeting abstracts to pull the data myself. And there it read females treated with 20gy radiation doses are at least equivalent in risk for breast cancer as women who carry the brca gene for breast cancer. As I continued to read, and mentally calculating my own dose of 40+ gy being double that number, light bulbs start going off in my head like that on the red carpet. Percentages ranging from 30% up to 90% as you advance in age. What?!?! We had thought it like 10-30%. That was a risk I had known and even prepared for. Roll the dice, it may happen, but more likely not. I've done cancer once, surely not twice. But 90%???? Are you kidding me? That's a whole other ballgame. That not a statistic, that's a prediction! That's.............awful!

I quietly try to gather my wits and think rationally about this data. I formulate an email to a breast oncologist I work with in my other job. (Reminder, this life altering conversation happened on a Thursday when I happened to be present, I started working with a breast oncologist as of six months ago in my brand new job, I have access to brand spanking new medical literature..."I'm here God, it's me Margaret"?)

Email out: "Breast Oncologist, have you seen the new breast data that was just released for Hodgkins patients? What do you think about me doing yearly mammograms in addition to the yearly breast MRIs I'm already getting? I had lymphoma and was treated with more than 40 gy doses of radiation to the chest as a teenager."

Email in: "Sally, yes, I saw the data. I didn't realize you were a lymphoma survivor. I think you need to see a breast surgeon......"

And at that very second I mentally checked out. Stopped reading. Had tears pool at the bottom of my eyelids. Excuse me? What in the world did he just say??? A breast surgeon? What do you mean a breast SURGEON? Didn't you mean to say "yes, please schedule a mammogram at your earliest convenience."? Why in the world are you mentioning a breast surgeon? Ok check back in, compose yourself. Wipe the fluid from your eyeball and retype the email.

Email out: "Breast oncologist, did you mean to write the word surgeon in your email? I'm a little confused. Did you mean to say oncologist?"

Email in: "Sally, I think it would be wise for you to meet with the chief of breast surgery to discuss mastectomy options. Let me talk to her today about your case and I will get the appointment set up for you as soon as possible."

Hyperventilate. Mind racing. Punch in the stomach. Oh my gosh, please don't let me throw up right here in my laptop in front of everyone. Hold it together. Pull up your boot straps. Got-to-get-some-air-now. Walk out of the room to the bathroom and ball your eyes out. And then it also hits me while standing in that bathroom....Ron!

Let me insert here that all of this unfolded in a matter of about 3 minutes from the time my attending walked in all excited about the conference he just attended to me being set up in an appt with a surgeon. How does that even happen? Email Ron frantically. Email my sister frantically. Wait for response from oncologist. Pull up data on brca gene. What in the world a prophylactic mastectomy? Women actually do that????? I really don't think I had any idea that women were finding out about brca gene results and scheduling mastectomies. Why do they do that? And why would I do that? That is radical. That is crazy. That is taking matters into your own hands. Do I not trust God's plan for my life? If I'm destined to have breast cancer, we just deal with it when it comes. I'm not someone to run from trouble. I like to roll the dice and trust God in the decisions in life. I've got this. Mastectomy, no way. (This, another free flowing train of thought spanning about 45 seconds). Keep reading the article, Sally..unlike brca gene patients "hodgkins survivors, having already reached the maximum doses of radiation, will have limited treatment options for secondary breast cancer...(paraphrased)"

Let me re-read that. Again. One more time. Frantically email Ron a second time. Desperately watch the clock. I've GOT to get home! This room is closing in on me. I'm of no use to these patients today. Devastated. Confused. Frightened. Surprised. Blow to the stomach. (Little did I know that Ron was having the the exact same experience sitting at his work desk as he later told me).

So it was no longer IF I was going to get Breast cancer, but more likely WHEN. And when that were to happen, my treatment options would be limited to no radiation. Long story made semi short. Two weeks later, I'm sitting in an exam room with two surgeons discussing my mastectomy plans. Two weeks! Who gets an appointment with the chiefs of breast surgery and plastic surgery in two weeks? God does, with a little of "it's all who you know" thrown in for balance. By the end of the appointment I had a surgery date scheduled for August 7. The delay only because one of the surgeons was headed away on vacation for two weeks. Those four weeks would become very challenging for me with me subconsciously processing the what was to come. The radical procedure was going to happen! I chose the crazy option!

I should insert here, I'm a unique case. I got massive amounts of radiation as a teenager. Dose is everything. Timing and age of exposure is everything. Not every radiation patient has these risks. There is a lot of data that has to be sorted through for any given patient. I am NOT advocating mastectomy for radiation patients. I'm not even advocating mastectomy for hodgkin's patients. I'm advocating that you research the data. Determine your risk. I'd bet for most women, mastectomy is a bit drastic for your statics. For me, it became a very reasonable option that dropped my risk from up to 90% with limited treatment options down to about 5%. Less than that of the average reader reading this post.

I'm advocating support for women who choose this crazy life saving option. This is a radical life changing choice, and women need support in that. No judgment. No gossip about the "did you hear". No questions about implants and a boob job. Don't ever ask "how big are you going?" Please only allowed yourself to offer Support! Encouragement. Belief that this hard choice is able to be done successfully. Cheers of "you can do this" should be shouted through your telephone, your open front door, across the restaurant table as she sits there telling you her incredible delimma and suppport that she can be open about this extremely personal journey. Understand that this is an awful decision to have to make and that this surgery is not knee surgery. I know, I'ev done both. She needs Love. She needs to know what she feels is justified, even if on some levels it seems trivial.

What she (now me) is feeling is something I never previously understood. Fear of the what ifs. Guilt for her thoughts of vanity. Shock that this is happening. Concern over her spouse and what he may think. Disappointment over reconstruction options. Guilt for feeling that disappointment. Shame that having no boobs affects her like it does. Shame that this journey impacts her like it does when she didn't even have breast cancer like some women have to struggle through both Breast Cancer and mastectomy. Confusion as to why this affects her so drastically. Worry that God may have wanted her to choose differently. Frustration over the physical limitations now present. Anger at her lack of control. And the list goes on. Trust me, it's best to justt sum it up and say "She feels a lot!"

Anyway, back to the original point of all if this. In order to process the big picture, I have to understand how those first few weeks played out. How timing is everything. How God chose a Thursday for this discussion to take place. (Reminder, this was brand new literature your average person would not know about for quite some time to come. I work in oncology.) How God, not even six months before crossed my path with that of a breast oncologist that I work on several projects with. That God would grant Ron and I wisdom to recognize His role in placing me at the right place at the right time and his offering this option to us. That Ron would make his decision that I should go through with mastectomy before I would and that they would match up. Maybe God had a specific plan not only to save me from a tremendously difficult journey with breast cancer, but to change me, challenge me, grow me. Was Sally going to let fear of a drastic surgical procedure guide her? Was Sally going to trust that God had big plans for her or even someone else by choosing the hard road? Who was Sally going to put her faith in? I'm changed. I'm challenged. I'm broken. I'm restored. I'm accepting my new breasts...as strange as that sounds. But most importantly, I'm allowing this journey to be whatever vessel God chooses in growing His kingdom. I may kick and scream along the way, but I'm still moving forward. I take steps back. I doubt things, but I'm committed for the long haul. Come what may.

Now, pray that these next few weeks are smooth. I have a great bit to accomplish in a short amount of time. Pray for my transition back into life. Monday, I start removing some of my restrictions. In two weeks, back to the surgeon to assess everything. Will the skin survive, is my mobility and strength back, have the impostors settled in their new home. Is the swelling and pain gone. Can I handle going back to work? Can I drive? Can I shower in my own without falling apart emotionally in the process? A lot happened in three short weeks. More than I could ever have imagined. I hope to be a better person on the other side of this. I hope you found a new understanding of preventative mastectomies. And maybe you saw a glimpse of God's provision in the awful (and incredibly amazing.)

August 11, 2014 - BAMMM, smack upside my head!

This has been a challenging few weeks for me. It seems one thing after another rolls itself into my front door. I have a door knob lock. I have an additional dead bolt. I even have a glass door on the outside with its own latch and key. Yet muck seeps in under the door like a sly stealth spy to find me. I don’t even hear it coming, but BAMMM smack upside the head there it sits on my shoulder whispering not so sweet ridiculousness into my demeanor.

Last week Ron and I set out to celebrate a few milestones. I was hitting my 23^rd anniversary of my lymphoma remission and simultaneously the 2 year mark following double mastectomy and the birth of Boob 1 and Boob 2 (now 2.2 after a quick switch out last year). We had arranged dinner out at a local restaurant that had this great outdoor patio setting. I got there a little early to scope it out and found a great little booth on the edge of the patio where we could get the cool breeze we have been having this unusual August. Ron arrives a few minutes later and we start the magnificent evening. Menus investigated, selections placed, and sit back and wait for the delights to arrive. Wait for it….wait for it… food arrives and immediately boxed right up as Sally decides she would like to add an emergency room visit to the festivities. What romantic dinner out is complete without a visit to your local ER? Nothing says celebration better than one eye in absolute acute pain (as in came in about a 2 minute span), tears and red goo streaming down your face. Slide out of the booth and into the bed gurney with grace and excitement. Diagnosis: something had flown into my eye from that amazing cool breeze –which we never discovered what- and scratched the surface of my eye and conjunctiva. Eye ointment, eye rest, and a boatload of money later and we are back at home with a deflated demeanor. The following morning, I felt worsening and headed back to the ophthalmologist to discover the eye was now infected and in need of $100+ of steroids and antibiotics (24 hours, 3 MD visits, and 3 pharmacy visits later). I was mad, I was cranky. I was feeling entitled. Best milestone celebration ever!

It became very obvious to me as we were going through the last few weeks of new “surprises” (upcoming imposter surgery for slipped boob, eye infection/abrasion, dishwasher failure leading to warped kitchen floors, foot MRI, house projects gone astray, etc), of how we as a culture allow every single tidbit of life that enters our orbit throw us off kilter no matter how trivial or how great. We are a culture of passive impact. Dropped spaghetti bowl can shoot us into major strife. An unexpected bill can catapult us into major collapse. The boss asking us to resubmit a form can lead to 3 hours of cubical complaining. We feel every single rivet of life with passion and intensity and at times have difficulty getting one foot in front of the other after a celebration dinner was interrupted.

I am feeling eager after some sharp perfectly timed conviction to step back and compare my warped 2’x2’ section of kitchen floor to walking out into a city park in Iraq and seeing the speared head of a 4 year old who was decapitated for religious beliefs. Or hearing the sirens across town at 3 a.m. knowing you have to get your family down to the bomb shelter in the next 5 minutes, but you can’t find little Sara who you know was brushing her teeth on the back stoop with bottled water only 5 minutes ago. Or the friend whose husband was handed a lymphoma relapse last week when all he was hoping for was a single stretch of 3 months year of normalcy without a visit to the MD. Kimberly is facing divorce. Tonya is wondering if her Marine husband has been found.

We are constantly comparing our body shapes. We live in a world of “her hair is just so much better”. We compare pay stubs to vacation houses and children’s honor rolls to soccer tournaments won. If we are so good at comparing the lively aspirations of life to each other, why do we not compare our assumed turmoil as well to see how ridiculous we can be at times? One look at national and international news quickly reminded me that my eye infection now almost healed is a “trouble” over half this planet would greatly trade in for without a single tear and instead shout a hoopla of winning the lottery.

Dear God, thank you for continual reminders of perspective. May I find my life so full of these riches you have already allowed me and these perceived “setbacks” a moment to show your grace and triumph. What can I turn into an opportunity to model goodness? Show me to be satisfied with little bumps in my day. What can I quit complaining about so that I have time to hear of and help someone else walk through their real life events? May the joy that comes with a life so richly blessed trump all trivial circumstance. Focus me to understand the true word of “trouble”.

John 16:33 - "I have told you these things, so that in me you may have peace. In this world you will have trouble. But take heart! I have overcome the world."

July 29, 2014 - Introducing "The Imposter Collection"

I’m done being frustrated I think. It’s been a week and the news has settled in. I only cried twice. Once the day of when I told my mom. She tends to bring out my emotions from deep down in my hiding box. Second, when my cousin so thoughtfully asked me if I had set a surgery date. That one shot out of me like a bolt of lightning. It didn’t even ooze up to the surface and out like it did with my mom. Instead, it just flew out of my tear ducts with no warning at all! But no more, I think I am done. I’ve moved to the acceptance phase that there shall indeed be yet another surgery. Surgery #5. It has grown on me. The Imposters are at peace. Well Boob 2.2 is anyway since he doesn’t have to be involved at all in this one. Boob 1…outta luck. (I won’t remind 2.2 that the last time we went in for a singular lipomodeling surgery, both got roped into it before all was said and done.) We are adjusting.

It helps that a few of my friends made a game out of it and spontaneously threw out reasons as to why Surgery #5 landed in my lap. My favorite…Lead Plastic Surgeon subscribes to this blog and likes seeing his name in print over and over again. Other front runners…this surgery gives Ron an opportunity to get his RN degree in 2 years without having to do additional practicum. And last, Hallmark needed more cases to justify a “hope your boob is looking up!” tagline. Feel free to contribute to the game by adding your reason in the comments below (click the word comment at bottom of post on). I’d relish in your humor indeed.

Today is the perfect day to remind me why I need to get this done and to pump me up (no pun intended) for setting that surgery date. Not only is there a risk for further slippage if I don’t fix it, there are also a few wardrobe malfunctions lurking in the closet. This morning I threw on a summer maxi dress that has an empire waist. Well, let’s just say the image in the mirror was all but “put together”. One high, one low. Calamity! I was at risk of causing coworkers to fall in the hallway thinking their vision was distorted. Back to the closet for some adjustment and only 10 minutes late leaving. It’s a hoot if you let your mind get past the scariness of it. Scary, well to me and my vain self. Probably not all that scary to you. Comical (when I’m not tearful) to us both.

This time two years ago I was preparing myself for my last week of work before mastectomy surgery. August 7, 2012 was a date that had me shaking in my boots! I had not even come out in the open to most of you. A handful of people (immediate family, a few select coworkers, and my bible study group = less than 10 total I’d say) were all that knew what was about to go down. I was all the things you would expect me to be. Embarrassed, worried, naïve, unsettled, self-conscious. I knew taking these breasts off was absolutely what I needed to do, but there were a good many emotions straddling my certainty. I remember trying to figure out how in the world my mind was going to make it through the 10 days of “no breasts”. But none off those thoughts prepared me for the reality of where my mind would go. Upside-down. Inside-out. What in the world is going on!?!  I found this picture below from a post in August of that year. Not that you can tell, but I had no boobs in this picture. I was off to my first appointment after mastectomy (10 days later) and I had my jacket zipped up basically to my chin and underneath was a surgical bra stuffed full of white fluff. It was August people and sure over 90 degrees outside with 200% humidity as we seem to specailize in here, but I was not about to let it be known I was walking around boob-less. I recall that day standing in my closet wondering what in the world I was going to put on to make this visit even remotely possible. I was to be walking into a waiting room of women who were in similar fate, but that didn't mean I was ready to make myself known (and I work with these people, most of whom had no idea what was going on). I found this hot pink velore-ish type jacket crammed in the back corner of the closet and then some jeans. I quickly ditched the jeans when I realized there was absolutely no way I was going to be able to pull them up with my immobility from surgery. The jeans morphed into black pajama bottoms that could pass as athletic gear. I changed as best as I could (not doubt a spectacle to observe!) and walked back into the living room where Ron and my mom were waiting. Mom snapped this picture below and even now I recall the beaming face both of them had on talking about how great I looked. “The pink makes you glow!” Boy could I have eaten them up with a spoon. I will never forget that moment. They had not seen me crying in my closet desperately flinging clothes this way and that trying to find something that would mask the underneath. Somehow they knew exactly what I needed to hear.

I didn’t comment that day in the post about what I was feeling. I wasn’t really "there" yet in my blog with being open and honest. Only seven days before (3 days after mastectomy) was my very first post and it was puny and low key. I was just trying to get through a post those days. Transparency came later. Anyway, I say all of this as a testament to where I’ve come.  August was a very long month with me hiding behind chin-high pink velore-ish zipup jackets in 200% humidity to now talking with little reserve (but still respectfully, I hope!) about lopsided boobs. I’ve come a long way! I’m here. I’ve arrived intact with Imposter 1 and Imposter 2.2 in tow.  

I’ve set a date. October 16^th. I've even set a post-op clinic date. Oct 22. Boy, do they offer full boob service! It’s going to be here in no time. But I admit I will think about it every single hour of every day between now and then. Just yesterday I remembered the surgical bra again. Oh bother, I am going to get another one. I should have kept them all for a collection. I’d have 5 you know! Those things have a long way to go in the fashion world. But having 5, couldn’t that be a “collection” that I could name and sell on the black market? “The Imposter Collection”. High dollar, my friend! Open to the highest bidder...which I am sure will be backed by Victoria's Secret.

July 24, 2014 - Pink sharpie

Well, I've got some good news! I'm excited to report I did not have to pay the usual $45 for my doctor's appointment this week. I got a deal- buy one lipomodeling surgery get one clinic visit free! Woo hoo! Yep, that's the good thing I have to report. Bask in it, relish it, roll around and enjoy it. Free visit!!!! Learning to find the silver lining in these Imposters and getting pretty dang good at distraction.

I sat in the waiting room for a bit over an hour (Lead Plastic Surgeon was running behind schedule). Next to me was this adorable lady in her late 60s, if I had to guess, who had recently undergone mastectomy and she had not yet entered the reconstructive phase (if she had plans to at all). She was wearing her infusion pump on her waist and she and her husband where happy little larks just chatting away about their activities of the week. I kept thinking to myself that she was the perfect example of finding peace in circumstance. I wanted to get into her head, hear about her journey, and I was secretly hoping she had chosen to NOT have reconstruction. Here she was prancing into her appointment with no effort to distract from her concaveness. I want to be that confident – or at least that is how she seemed. While she was sitting there content with her day, my stomach was all tied up in knots. The irony of that. Me = no chemo = all tied up in knots. Her = chemo= happy as a lark.

I wasn't at all upset that he was running, almost an hour by now, behind schedule. The longer I sat in that office chair, the longer I was away from that examining room and what I knew deep down in my heart was the inevitable. I actually laughed at myself for being so nervous, but sometimes our subconscious rules the roost. Then came the nurse out to get me and in I went feeling like I was going to lose the contents of my stomach all over my little slipper shoe and her pink scrubs.

Lead Plastic Surgeon was so kind and thoughtful. He could tell I did not want to be there so we chatted about work before we got down to the nitty gritty. Follow-up from the lipomodeling was a great report out. The area looked as expected, and so far there was little to no fat reabsorption (remember: sometimes the fat reabsorbs over time and you have to have the procedure repeated over time). Off to a good start. Then the dreaded news…option #2 was the winner. The implant has slipped out of place. You may recall that when he put the implant in, he had to attach a mesh sling to hold the implant since the pectoral (chest) muscle wasn't large enough to do the duty. When we went in a year ago for the cellulitis infection surgery, he noted that on the right breast, the sling had never incorporated into the tissue like it was supposed to. So now we are wondering if that happened on the left side as well, therefore leaving the implant unsupported. It happens sometimes and it looks like it happened to me. And it won't fix itself and could worsen if left unattended. Hello, Surgery, so very nice to see you again. I've missed you so.

We both are nervous about opening up the breast again. Each time we touch and expose the implant, we increase the risk of infection. And since I've already "been there done that" with the left breast, we don't want to risk that with the right. So, he has come up with this beautiful plan of manipulating the skin to lift up the implant. This way we don't have to expose the implant during surgery. Picture a water balloon. Squeeze the bottom of the balloon and the water is forced up to the top. Water = implant. Balloon = skin. We will cut out a portion of the skin at the bottom and then suture it back up in hopes of lifting the implant back into place. As Ron says, it's a bit nauseating to think about, but it gets me a much easier surgery and much quicker recovery time. And I get a new battle scar! (You will recall this is the part I detest, so I'm having to get used to that idea of a new prominent scar.) But I score all of this with no DRAINs so a woman will celebrate that silver lining.

I won't lie to you. I'm bummed. I may or may not have walked around the house a little preoccupied this evening. I may or may not have called my mom and cried a little. It seemed inevitable with the drunkard boob appearance, but I really wanted to be wrong. I had prepared myself for this outcome, but when it was confirmed I felt a little heart (and stomach) drop. Nothing to do but pull myself together and look forward to our very LAST boob surgery. #5 is a charm, right?

We haven't set a date yet. I have a few things I need to try and work around and I need to build up some time off. These surgeries have run me dry! The terrific news is surgery should only last about an hour. A few days off work. And then about 3 weeks of restrictions so the scar doesn't open up. He gave me permission to take some time to enjoy the summer for a bit before I enter the water restrictions that come with surgery. Another silver lining. They are all around if I search enough. My outlook is good (after the last 24 hours of not so much). My best friend recommended we drown our sorrow in a tattoo. She's a giver isn't she? I landed on a pink awareness ribbon on the side of Boob 1. Don't worry, Mom, I'm gonna do it with a pink sharpie.

Jeremiah 29: 11. "For I know the plans I have for you..." Now for me to be faithful and to do my part.

July 22, 2014 - Catch 22

This week is the week. I’m headed back to the dreaded plastic surgery office in a few days. Just to make sure I had not imagined anything, I took a peak again…and yes, they are still as lopsided/off-kilter/definitely-not-twins as I had remembered. I actually hadn’t done an inspection since early June, so a girl could be hopeful that the magical fairies of yonder boobie-land would embrace July and bring greatness again, but alas...those fairies must be at the beach with the rest of the working force. Nothing more fun that getting to go in for yet MORE poking and prodding and wonderfully entertaining pictures that can be floating around wherever those such things end up. Rolling my eyes at some of the absurdity and loss of self-dignity that can occur with breast surgery.  

I fondly think back to a year ago when I went to what was to be my very last surgical appointment. Bahahaha! Psych! Gotcha! Loser! Made ya look! Surgery #4! Oh to have that last appointment once again and that feeling of “done”. I promise I’m not bitter. More kinda just over it. But I have this very sneaky suspicion that boob surgery #5 is not only a very realistic choice but also something I need to prepare myself for if there is any possibility of twin peaks again. I’m going to beg for pink duct tape. I might even allow hot glue. But that scalpel, I loathe him. He has taken his silver edge to me one time too many! Sadly, the drunkard state of the implants leaves me equally as unsettled for the long term. Catch 22.

I’m learning a good bit about long term outcomes of radiation treatment this week. First there were the boobs and their probable fate thus propelling me to mastectomy. Second, I’ve been dealing with dental consequences. Many moons ago, we prophylactically sealed all of my teeth to keep them cavity free. Radiation causes all kinds of dental problems that I won’t go into here for sake of keystroke, but google is your friend if you are an overachiever like myself (smile).  Well, let’s just say I’ve had cavities between every single tooth over the last 10 or so years. And it seems like at least yearly I have to get a filling dug out and replaced. Ten guesses as to what I am doing August 12^th. I’m wondering if I should go ahead and start saving for dentures. SURELY, I’m too young for dentures. I should be turned into glue, but as my sister says…”Sally, forget it! You won’t stick!” (Not a reflection of her love for me in anyway.) And then there is the summer heat asthma in the beautiful stifling State I live in (and truly adore).

I’ve actually got it so easy. And I shouldn’t be complaining even a single syllable. I see the realities of malignancy on a daily basis. I see TRUE struggle in my clinic. I see third world problems littering my computer screen.  Mine is laughable, and therefore I laugh. But there are some days when my prideful and selfish self finds a little pity stuck to the bottom of my shoe. Thankfully, my reality hears that little voice reminding me that God has purposed even this. Every incision, every tooth, every cleft lip provisioned to be an opportunity for me to point to His grace. Hopeful that I remember that as I step up on that exam table. Otherwise, you might see a shoe fly across the room. “Why hello, lead plastic surgeon. Don’t you look handsome with that tred mark on your fore head. You got some botox for that?”  

Not praying for an outcome, praying for an outlook. Sometimes that fixes the outcome all together.

June 28, 2014 - Unsightly...calamity.

I've got this newly formed unsightly asymmetry. And when I say "asymmetry", what I really mean is a lopsided-awkward-completely-unsatisfying-asymmetrical mess of boobage. And we have no idea how it got this way. I didn't notice it prior to my last surgery, or if I did I didn't note it to be noteworthy. Nor did the last surgery of lipografting have any reason to produce such a visual calamity. It's nearly impossible as the area of comparative disfigurement is in no proximity to where the lipografting occurred. Each impostor in and of itself standing alone looks relatively boob-like, however when set side by side - where they happen to be all the time- a stark shocking discrepancy is made apparent.

I can't help but laugh. You, too, would laugh if I were to let you peer into my mirror view. Even Ron, after some very strong encouragement as matter of life and death from me to give his opinion, stated "I admit I wouldn't be satisfied if those were mine." (Rest assured,he followed it with the kindest of words to let me know they don't bother him as spouse. He's a gem you know). It's as if one was shifted off it's orbit after a close encounter with some kind, and the other was squashed after a close encounter with another kind without rebound. There is it stuck in it's squashed state while the other sits on a newly re-programmed yet off kilter orbit. Thankfully, you will never pick up on this hilarity of appearance as for the most part I can neatly disguise the mishap with underwire. Oh the miracles of underwire. We loathe them, but we must love them. However, in other attire, "objects in this mirror.....".

Here's my first unofficial diagnosis from my feeble mind: Both Boobs are out of sorts.

Boob #2.2 - cellulitis surgery resulted in  long-term collateral damage. The scar, which by that surgery had been open and closed 3 times, is now tightening with scar tissue thus pulling itself up in squashed state.

Boob #1 - implant dislocation resulting in a new center of gravity and resulting in an unfortunate and untoward orbit. My saving moment being when I realized it could have been worse in that the implant could have found itself at my knee cap instead of simply being re-positioned a little lower than intended. Boob #1 is not my concern per say, but rather it is in my awareness.

Here's my second alternate unofficial diagnosis: Only One boob is ou t of sort:

Either Boob #1 or Boob #2.2 (which, to be determine) is perfectly normal and the other alternate boob is the calamity of nature. But because they reside in tandem locations, they both look drunkard and rather "Twins' Schwarzenegger and DeVito-like" disparate.

This could not have happened overnight.
This most certainly could not have been a result of a meteor impact as surely I would have detected such a force.
Nor could this be a result of a change in earthly centripetal force for surely wouldn't we all have found ourselves in a awkward stumbling gait during readjustment.

But what in the world?!?!?! Boobs gone bad! I emailed Lead Plastic Surgeon. He confirmed my "this was not a result of lipgrafting" hypothesis. He wants an exam. I want a promise of no more surgery. We are both standing our ground.

May 14, 2014 - I hope I didn't offend you.

I hope I was not too crass. I hope I was not too “out there”. I hope I was not too in your face with my saga. But most of all I sincerely want you to know that in no way did I want to offend you. I’m sure I did in some small or maybe even big way. I spent day, months, and now years talking about the breast. I named them (boob 1 and boob 2). I cartooned them and gave them personalities of their own. I made fun of them and their quirkiness. I described them in great detail leaving very little to the imagination. For those of you who have never faced mastectomy, I may have brought some humor to your day or provided some insight to something currently foreign. But, I realize this may be too much for older generations not used to such open and public discussions of anatomy. I realize this may be too informative for those just trying to go through everyday life.  I also realize this may have come across as trivial or lighthearted to someone in the middle of the fight against breast cancer. You, who are just trying to make it through the moment, unable to live by the big picture, but rather wrapped up in the struggle of trying to simply get to the next hour these words in this series may have done you, so very dear to my heart, an injustice. I had no intentions of offending you. Though I realize intent does not always change perception.

When I started this blog, I so very desperately wanted to give you insight without fear, into a rather difficult choice. If you know me outside of this screen, you also know I tend to attempt life with a positivity and jovial demeanor at all costs. I truly believe that life can be traveled more effectively when approached with a grateful heart despite circumstance, purpose and humor. So it is only natural that I would find consolation and hope in the personification of the breast. “Impostor” made this silicone container tangible. “Boob” made this synthetic replacement more endearing. It allowed me to project love and acceptance onto something I feared I would very much reject, detest and blame. It seems very trivial as I did not in fact have breast cancer, but taking off the epitome of all things female turned out to be very real and more challenging than I ever imagined possible. These two seemingly inconsequential sacks of adipose carried with it the sense of sexuality, the emotions of completeness, and the security of self. One never really understands that until she finds herself laying on that table in the operating room. So when you find yourself struggling with up from down, you seek out ways to process, connect, and cope for fear that the opposite prevails. For me, that came in the form of writing. I couldn’t speak these words in person. Just as soon as you approached me I found myself desperately seeking an out. But on this page, I could process trying on 13 bras that no longer fit, unstoppable tears over a concave chest, and the surreal aftermath of what I had just done. I could better understand why something that on paper seemed trivial, in reality sent me into a whirlwind. No one can prepare you fully, though I desperately wanted to try and do that for you. There is power and triumph in camaraderie. There is healing in “I have been there”, and there is validity in encouragement. You may have thought me attention seeking, but my intent was rooted in healing and empowerment for myself and those already there or yet to come.   I chose to be transparent. I sought to be candid. I risked offending someone simply so I could become better on the other side.  And above all I wanted you to know there is no shame in mastectomy. There may be tears, there may be ongoing bewilderment, there may even be a little laughter when you find yourself piled up on 14 pillows and still unable to find a sleeping position that even remotely resembles anything worthwhile, or hilarity when you pass by a mirror and quickly walk back to see who that was. But there is no shame.

Mom, I apologize for publically airing out our dirty laundry of caregiving (you took it is such great stride!) Grandma Sarah, I apologize for saying words your generation would never have dreamed of uttering in public. Ron, I apologize for taking the personal and making it anything but (and for taking you through the most overwhelming emotional roller coaster. I don’t know how you did it so well.)  Women who are facing a terrifying path of navigating breast cancer, I apologize if my words brought you any offense. I don’t make light of or take for granted a single moment of fighting for your next second as have been there myself with lymphoma. Instead, I hope you find that every event in life can be navigated with a head held high. That God can repurpose any possible moment, no matter how devastating, into the most incredible impact either for yourself or someone you come in contact with. We simply have to be open to the possibility. And if cartooning a breast into an Imposter gets you to the next day, then cartoon away! Instead of offense, we might find laughter and triumph. So please know I’m cheering you on to your next hour!  I’m laughing us through the awkward. I'm advocating for the pillow wedge to keep you safe and upright when the 14 pillows slip off the side of the bed.

All implants unite in advocacy for a head held high during mastectomy. Mine included.

P.S. I’ve made it past surgery #4 related to this mastectomy with flying colors. Almost 3 weeks out. The pain is more than tolerable and really only when I reach for something or hit the counter top which I seem to do on an all too frequent basis (smile).  Bruising has faded to a luxurious yellow green and incision sites are closed. Another notch on my mastectomy post. Conquered!

May 5, 2014 - Day #7 Post Op Bruising (Warning: Contains pictures)

Day # 7 post operation and you can see below one of the lingering spots of bruising on the abdomen. This spot is about the size of half your palm.  Again, I ask myself why anyone would want to choose go this route for cosmetic reasons, but I guess maybe the means justifies the end? Also, I guess none of us truly know what we would choose until we are in the situation. No judgment here, just saying boy is it a full week of uncomfortable and some nasty bruising. I share this picture as an FYI for anyone who finds that they need this procedure following reconstruction.

Each day is better than the day before and I can actually walk upright now and with some sense of normal speed without someone asking me why I'm all hunched over going at a snails pace. I do guard myself a good bit though since yesterday I accidentally brushed up against the counter and sent my pain receptors into terrible disarray.  Rule of thumb for daily activities: Keep everyone and everything at arms length. I couldn't push the grocery cart, but I did go grocery shopping with Ron after work today. I have to remind Ron that I still can't vacuum. I think that should last several months at least. (grin)

As a side note:  it's odd to go in for breast surgery and end up having another part of your body hurt more than breast.  Almost there!

May 1, 2014 - It's time.

Just a quick update that as of our check this evening Franklin (the red spot) is stable and doesn't appear to be growing. While he also isn't receding, I'm quite confident I am not dealing with cellulitis as it certainly would have expanded into badness by now. I'm hopeful instead that maybe he is skin a reaction to tape or something of that sort. Currently, he sits covered in dots outlining his border to ensure we know if he expands. Totally wish you could have been there for that comical event- me lining myself up in a mirror and applying dots to his border with a black Sharpie Marker. trying to do it correctly since I was looking at a mirror image. Easier said than done, my friends. You can't make this stuff up. Or also there with me tonight when Ron saw what he thought was a tape string left over from our bandage removal earlier in the day  and decided to yank it off. He quickly figured out his mistake (when I let out a rather intense yelp) that he had just pulled out a suture (stitch). Holy Moly! Saying ouch is such an understatement. After the tears dried up we laughed (sort of) at the "how could that happen" moment. The night before it was crazy talk about salsa. Tonight pulling out a suture. The new rule, ask before removing. But I am so grateful that we are still laughing.

It's time, according to the "outline for what you can expect following lipomodeling surgery", to get back to life. I am packaging up the Impostors and taking them and my bruised abdomen to work tomorrow. I don't know who made those rules of time schedules but I am quite confident it was some medical person who had never actually had this procedure done to them. In fact, I was recommended to go back yesterday in the  formal standardized paperwork. Are you kidding me? I couldn't even contain my drool (exaggeration) yesterday. Well, I decided to give in and make it happen on the 4th day. I'm actually super nervous about driving and about my stamina. I just don't have any reserves this week. Everything is an effort and I crash and burn after any little thing. I'm still blaming the anesthesia- well that and the fact that my body just went through a less than pleasant ordeal only 3 days ago. Then there is the little known fact that very few people on this side of my job know what is going on. So it's going to be rather odd seeing Hunchback Sally saunter at a snails pace through the hall. I envision a good many questions. What is also going to be weird is that I work in the exact same building and the same floor (just separated by a wall) from the OR suite I had surgery in. That's strange in and of itself. Rise to the occasion, pick up your chin, high ho, high ho and follow the paperwork instructions.

This is all very close to being behind me. One more notch on the Impostor rope.

May 1, 2014 - Introducing Franklin

Yesterday has been my worst day by far. For whatever reason I am taking forever to clear out all of the anesthesia. I'm even laughing at myself walking around in my zombie like state. It seemed to be never ending. This grey fog floating around in my head making every task 10 times harder than it had to be. By mid day, I gave up fighting the fog and just slept the rest of the day away. I THINK I might have less of that fog today. It sort of comes and goes.  I woke up feeling about 75%,  now I'm back to 50%, but high hopes for the afternoon. One positive note is the abdominal pain and chest pain is a good bit less today. So that is a huge score. Hopeful tomorrow I can go to my office job and start swinging back into life again. I'm ready to have this notch on the boob rope float into the past.

While my mental fog is somewhat less, we have a little spot we are watching on Boob 2.2. I have the overachieving ability to become a foster parent to spots. You will recall a spot last October 2012 when we introduced you to Barkley. Barkley had planted himself at the bottom of my incision scar and worked in a desperate attempt to make me miserable. He finally did seal  himself over after a few weeks, much to everyone's delight as we were afraid he would be a source for infection. He came, he went, and all was happy. Then in April 2013, THE SPOT make himself known. Full blown cellulitis that spread in a 12 hour period to cover the entire right breast leading to emergency surgery and the replacement of Boob 2 with Boob 2.2. Three weeks of antibiotics and good bit of frustration later, the spot was terminated. I have a lot of spots currently, some are incision marks with stitches, but the most are deep purple bruises scattered about. But there is this one spot that is like no other-  Spot #3,  introducing Franklin. Ron found Franklin last night when we were switching out bandages. Me squealing with every tweak of the tape. I hate removing bandages. I feel sure you had picked up on that about me before. I used to be a rock star with anything medical, but since the mastectomy I don't tolerate my very own medical procedures so well. Well after the squealing on my part, Ron finds Franklin perched in the outer quadrant of Boob 2.2. He measures about 1 inch x 1 inch and is the perfect deep red color of cellulitis. I snapped a picture of it and sent it to Lead Plastic Surgeon for some input. Gotta love tele-medicine. He replied that he too didn't know exactly what Franklin was but that we needed to watch it very closely for any sign of change, growth, or fever and we then head straight to the ER. I have to say I am not that worried about it. That's because it hasn't grown in 12 hours. And remember, last time in 12 hours I went from a 1 x 1 spot to an entire breast becoming fire engine red and painful. None of that here as of yet. I can't even feel the spot, so I am very hopeful it's just a reaction to something. Franklin will be my friend instead of my foe. My star foster child.  But at the same time  I have no problems at all with each of you praying Franklin to a new Foster home. I've enjoyed my time with him and now I am ready to release him out to spread his wings on on his own. For my sanity. I will also add that my surgeon is out of the country right now and if this thing progressed, I would be working with a substitute. Not that I don't have faith in that new person, but me a lead plastic surgeon have come so far and I'd like him to stay on board with anything that might arise. He's has promised me an ongoing contract of "best work ever" and I have worked hard to hold him to that promise. No guarantees for the substitute. Ok, so I'm not going to think about it anymore. Done! But I sure do wish you guys could see me and Ron with his engineer scale ruler drawing a box around the spot. You would get a great chuckle. The things he and I have had to do during this boob journey. At least we can still laugh. And at least he didn't yell out again "it looks like salsa!"

Oh what fun it is.

April 30, 2014 - Post Op Day #2 - Where's the olive oil?

We made it 48 hours post surgery. It’s to be celebrated. We are all in one piece and still speaking to each other.  Actually, in usual fashion Ron has been such a trooper.  From his perspective he would probably say this has been the easiest surgery as of yet – did I say no drains!?! He has been able to be pretty hands free this go round. I suspect he is very delighted in that. I’m still feeling the groggy feeling so you will have to be patient with me as I type today. No promises you will find complete sentences.

Yesterday was slow moving for sure. I’m laughing that I look like I am 9 months pregnant trying to get up out of a chair or shuffling through the house. It’s almost impossible to bend at the waist, so if something gets dropped on the floor, it stays there until Ron comes by to pick it up. And I’m actually fairly comfortable as long as I sit perfectly still. At times, I forget I’m “injured”. But that goes away as quickly as it came when I have to reach for something or head for a bathroom break. There is no way I can get dressed by myself yet, but it will come maybe later this week. The shoes will be the last “success” as there is no way I can reach my feet. For now, it’s flip flops.  We spent the afternoon yesterday removing bandages, eight in all. Two on the lower abdomen (this must be where he inserted that awful suction tube that gave me nightmares), then 3 more on each boob. I’m a little baffled by the 3 on the boobs because I can very easily see all of the injection spots that number at least in the teens, so I’m not sure what the 3 extra holes were for on each side. They have stitches in them so I can only assume maybe suction tubes were there to remove extra fluid. But I do know I don’t like how they all weep fluid. Thankfully, that is much less today and when I go to change today’s bandages I am hopeful all but one will now be dry. I also don’t love that I have gained an extra belly button.  My new claim to fame and maybe a future source of stupid human tricks. The main insertion sight (my new belly button) is located a few centimeters below my original belly button. It freaks me out a tad. This was also the culprit of the majority of the drainage I had yesterday. I learned that when they do liposuction they also inject fluid into the area to help break up the fat cells. This fluid also needs a way back out of the body. Hence the new “belly button” hole. Isn’t that fun? Oh my. My stomach churns just thinking about it. Surely this thing will seal itself off in no time. It has to. My nausea persists with a force and these wounds don’t help that.

The bruising is a good bit less than we expected. They are scattered on both impostors and across the lower abdomen but they aren't near the darkness we expected. But the pain is there and a reminder of what I have done.  Last night, I reached out to my friend Becky, as we will call her here. She had this procedure a few months ago. I wanted to see how long this pain was going to last, hopeful she would say a day or two. Well NOOOO, she had to break my bubble. Really tough pain for at least a week, followed by several weeks of “uncomfortable”.  Well that is just delightful, Becky.  Sort of wishing she had lied to me. = ) Well, we keep trucking on all the same. I’m supposed to be back at work tomorrow. Hum….I certainly can’t imagine driving or walking around to see patients. Maybe a miracle will happen in this next 24 hours.

The best comedy comes with Spanx. Yesterday when we changed the bandages we also changed out the pressure vests. Saying they were uncomfortable is an understatement. Think corset without the lovely dress to accompany it. I shed both vests and switched over to a pair of Spanx. Well, we all know Spanx are next to nearly impossible to put on a normal body without lubing up with olive oil. Imagine trying to work them on up over your legs and hips when your pectoral muscles are retaliating and your abdomen wants nothing to do with the task. There was a little laughter and a few tears, but finally we accomplished the task and I will be sporting some Spanx for the next few weeks.  This is supposed to help with recovery time and lessen the bleeding happening at the donor sites. Needless to say, I can’t wait until the last minute to take a bathroom break. All and all the Spanx feel a lot better than the vests. So I’m grateful.

My top complaints today:

1.       Persistent nausea

2.       Abdominal pain

3.       Constant itching (maybe a reaction to my meds?)

4.       The pull of the stitches when moving about

My top blessings today:

1.       An amazing husband who keeps trucking along with me

2.       Bloated boobs and hopefully restored blood flow

3.       A one story house so I can avoid stairs. I can’t even imagine.

4.       Less weeping from the wounds

I think Boob 1 and Boob 2.2 have forgiven me for the torment I have put them through. I am keeping it under wraps that they may see the OR table again in a few months. What they don’t know won’t hurt them.

For now, it’s nap time.  I can’t get rid of this exhausted feeling so I just give in with cat naps throughout the day. And since I can hardly keep my eyes open right now, I am giving in. I will check back in with you tomorrow.  

April 28, 2014- Change in surgery plans. (posted out of order)

Out of surgery. Last minute change in plans. He decided to do both breast instead of one. Didn't expect that at all and it caught me off guard. The right side had progressed since i saw him last. But all is well. Praises! A lot of pain, but working on that too. More formal update later. Thanks for the prayer support. Love to all.

April 28, 2014 - The love of a spouse (posted out of order).

Ron is exhausted. We climbed on the bed to adjust the two pressure vests I'm wearing. After we were done he laid his head down for less than thirty seconds. I asked him to grab the lotion for my dressings and he pops up very loudly says "it looks like salsa". I busted out laughing. He had fallen asleep and started dreaming in that thirty seconds. I asked him what looks like salsa? He said my wounds. Even he laughed. Bless him. He's cared for me without complaint!

April 29, 2014 - Surgery #4 (warning- contains pictures)

Surgery #4. April 29- Post op day #1 for surgery #4. I really thought I would get an update out yesterday, but the day got away from us once we got home and I was a bit too groggy to put my thoughts into cohesive words. You will be happy to know I had no verbal outbreaks while under anesthesia, so the world is all in order and my face can be shown out in public. Now that I have my wits back, I can safely pen some words here for you. Hopefully they will come out in some logical format as I’m definitely not at 100% mentally yet. 

When we arrived for surgery yesterday, we got off to a slower start. We had trouble getting my IV line placed. We’d find a vein, put the line in, but then we would blow the vein and infiltrate the fluids. I’m covered in wonderful dark purple bruises today as a result, but finally we found one in my hand that worked. I have always been a nightmare for a line care nurse. After the line was place, Lead Plastic Surgeon came by to develop a plan (after I charged him the routine $10 a peek- gotta make up some money somehow!) Well after the preliminary groping, what I thought was going to be a little lipo-grafting to Boob 1 (left side) turned into lipo-grafting of both Boob 1 and Boob 2.2. It’s an understatement to say I was a little shocked and boob 2.2 definitely was caught off guard. Here he has been trying to build 1 up with comforting words only to have the rug pulled out from under his feet 10 minutes before heading into the OR. Evidently the right side had started developing the dimpling since my last visit. I had noticed that but did not know how much would be enough to warrant surgery. One good thing in the end is that it removes one more surgery from my upcoming to-do list. So that is a definite silver lining to a dark cloud. The down side is now I have two boobs under maintenance instead of 1. You should have seen my body after he came into the room. (I will insert here I am having a really hard time typing with this grogginess, so my apologies if the words end up all jumbled. Hang in there with me). I was covered in marker drawings- both boobs and all over my stomach. A Van Gough masterpiece to say the least. If I was not so modest I would have taken a picture for you. You will get to see some of it here in the pics I will post, but not everything. After weighing out his options he decided to take the fat from the abdomen. Unfortunately, he didn't take enough for me to notice a change in tummy contour. What a bummer. Seems to me that if you are having liposuction, you might as well make it worth it! Evidently, he didn't share that same thought process. He wanted to only take just enough so I would have less complications in the long run. I should be grateful, but seriously, I had a chance at liposuction! If you had asked me 5 years ago, I would have sworn I would never have plastic surgery on any part of my body but alas….mastectomy changed me a good bit. Now 4 surgeries later, I’m an expert. In the end, he pulled out some volume of fat and injected it in a rainbow pattern across the tops of both breast. You can see the dotted line in the pictures I will post. We could play Connect the Dots a little later if we get bored. Then number them for a Paint by Numbers party if you feel so inclined. Bring your own drink. I will provide the markers and canvas. Might as well have some fun while we are going through this, right? Anyway, it’s done. Both boobs have been sufficiently bloated and we wait and see how well the blood supply restores itself. (See the post from March 31- flip this boob if you need some background information.) I will see the surgeon next week to check the incision sites then 3 months later go back again to see if we need to repeat the procedure. He thinks we will need to have surgery again - most patients do as the fat starts reabsorbing itself. I told him I was probably at low risk for that because I had been working for 20 years now to try and have my fat reabsorb. If you can’t laugh what can you do.

 Last night we had a little scare. We opened up the surgical vests to check the sites and noticed I was weeping a good bit in the abdominal area. We had soak through both pads and out onto the vest. He has told me to expect massive bruising as he knew I bruised when I did something as simple as sneeze, but I wasn't prepared for the leaking/weeping. Quick call to the surgeon and he said it was ok, just to change the pads out as needed. I’m a bit sore in all 3 areas, but it’s tolerable and maybe even better than I was expecting so yet again another silver lining. Just taking everything in stride and being low-key/confined to the sofa for the next few days while it heals. I’m learning mastectomy as well as reconstruction is an ongoing process. I really thought that I would have 1 surgery for mastectomy followed by one more surgery for reconstruction, but I’m finding that this is just an ongoing process and I’m still likely not done. Thankfully though, I have peace about that. All of this is minor in the whole scheme of things. And if all of this allows me to have a cancer free future, it’s worth it. Come what may, we can tackle it all. God is still God and God is still good. That’s my motto moving forward. I’m making this post quick since I’m struggling with my thoughts and typing today- maybe tomorrow will be better as the anesthesia and stuff continues to wear off. Thank you for all of your thoughts and prayers, it means much to both of us. Wish us luck as we start the process today of scraping off betadine stains. I’m sure that is going to be a real treat for us both. Fun all around.

A few pictures below so you can get a general idea for Surgery 101 classes. I tried to keep them tasteful but also to give you an idea of what you can expect if you find yourself in this boat.

1) The chest and abdomen wrap. Velcro up and down the center. Not the most comfortable thing on the planet.
2) the abdominal bruising and two insertion sites. It's not as bloated as it looks. I had to poke it all out to get a pic. If this pic doesn't steer you away from elective liposuction- I don't know what will. But if you have to have it for recon- I promise you you will survive.
3 and 4) Looking down on the top of the chest. You can see the marker dots and the bruising that is starting.



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