Saturday, April 11, 2009

make mine a double

I'm getting really tired of thinking about my breasts. Tired of talking about them, tired of writing about them. Unfortunately, I'm not tired of having them, but that's another story. But I set out to write about this dreadful experience, and though I can gloss over much of it, I have to explain the process behind making the most difficult decision so far. Probably the most difficult decision I've ever made, though I do tend to forget things...

I know that I am lucky to have had a choice at all. Many women don't get to choose whether they will keep a breast or not, whether they have reconstruction at the time of surgery or later, whether they have one sort or another of reconstruction. Just as I am lucky that we caught it early, that I will probably get out of this whole wretched experience with surgery and little else. 

The mastectomy on the left was a definite. The prophylactic mastectomy and the reconstruction were up to me. I would say that I have a fairly alternative view regarding health and medical treatment. I had both my babies at home. I've been seeing an osteopath since I was pregnant with Claire, and while he is an M.D., appointments with him don't bear much resemblance to your standard office visit. I treat my migraines myself and have started acupuncture to help me prepare for surgery and to later recover from it. I don't believe that Western medicine always has the answer, and I do believe that sometimes the Western approach is too drastic and invasive. Funny, then, that I should decide to remove what appears to be a perfectly healthy part of my body. 

Ah, but there it is. It appears to be perfectly healthy. I now know that I can appear perfectly healthy (I do right now), and actually have this monster of a disease hiding inside. I now know that I have an increased risk of cancer in the apparently healthy breast because of the multifocal nature of the cancer on the left. I now know that I am, in fact, willing to take measures both drastic and invasive for the increased chance at a long life without so large a shadow hovering over me. I am electing to have the prophylactic mastectomy. 

And then there is the reconstruction thing. Would it be so bad to be flat-chested? Probably not. But I'm pretty sure that I will be happier with a reasonable facsimile of what I am about to lose. And I'm pretty sure that I'll be happier with all my own skin and fat, albeit relocated a bit. The surgery is going to be long, the recovery is going to be longer, and I have no doubt it will be hard. But six or even eight weeks is a short time in relation to the amount of time I intend to live. You know, another 40 or 50 years or so. 

These decisions wrung me out. I was not myself for a number of days while in the midst of making them. But my friends and family helped me sort through all the facts, to reach the best decision for me. In particular I need to thank a college friend who has just come through a similar experience, and Greg, who even got to watch a dvd about breast reconstruction. Thanks, too, to all who listened to me drone on and on about silicone and flaps and risk and scars. Now that I have made the decision, I feel lighter. I'm ready for the reality. I'm scheduled for surgery May 4. Wish me luck. But I'll probably post again before that. And maybe I won't even write about cancer.  

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