Boob Job: Part 4
Removal
Everything must go.
The flurry of doctors’ appointments, tests and decisions behind me, there were now weeks of waiting for my non-emergency surgery. And those weeks felt like a great leave-taking.
I resigned from boards and committees. My husband and I turned down new work for our architecture practice. I said goodby to the policemen and prison guards I sparred with in Brazilian Jiu-Jitsu, not knowing if I would ever be able to return. I cleaned my attic, basement, closets, kitchen and files. Alone in my room, I photographed my chest, a keepsake for when I could no longer remember how I was before … if I lived that long.
I prepared to die.
I had never had real surgery before. Sure, I had been twilighted to fix my broken nose and to have a colonoscopy. But real surgery, knocked out for hours under the knife? Never. Who could say how I would react to anesthesia? I needed to prepare.
My husband, pregnant step-daughter and I went on a mini-vacation, a long weekend on a remote lake in Maine.
Goodby clouds. Goodby trees. I love you.
I sent my thoughts out to the beauties of the world and wondered if I would live to see the new life that brewed in her belly. I tried not to let on how melancholy I felt.
My sister asked if I would like her to be with me for the surgery. I appreciated the gesture, but I felt I had the support I needed between my husband and step-daughter. I didn’t want to take her away from her three school-age children and husband.
My mother offered to come up as well. I declined. I didn’t think it was necessary to give my reasons. I was the patient, after all. I assumed my wishes would be respected.
I was wrong.
Two days before surgery, I called home and talked to my parents. That’s when I found out that, despite my stated wishes to the contrary, my mother planned on attending my surgery anyway. I was dumbfounded. I was rattled. How could I be so deeply disrespected?
I got off the call as quickly as possible, all the mental calm I had carefully cultivated leading up to surgery shattered.
I should have been resting, charging my immune system for the assault ahead. Instead I lay sleepless in bed, tossing and turning. I envisioned my mother barging in on every aspect of my medical experience, spreading her fears like a contagion, wrestling everyone with her control issues, stressing my already taxed husband with her need for attention, sucking the oxygen out of the room. I pictured myself feebly imploring the nurses from my sickbed to keep her out of my room. I felt like I was trapped in a nightmare.
Finally, unable to take the stress any more, I called my parents at midnight. I thank God sincerely it was my father who answered the phone. I poured out my heart to him. I begged him to stop her. And he did.
I have no idea what kind of conversation they had, but I am grateful to him for listening to and defending me. I am grateful to my mother as well for having the grace to stand down.
This is what cancer taught me: I had to stop caving and handing over what other people wanted from me. I had no more to give. I was at the bottom of the well. I had to take care of myself or I was not going to survive.
The day of surgery finally dawned.
I had prepped my mind with guided imagery and my body with the diet prescribed by my naturopath. It was time to hand over my fate to the surgical team.
Dye was injected into my left areola. The dye would be picked up by my breast’s lymph system and carried to the cluster of lymph nodes in my armpit, where it would mark the sentinel node, the leading filter of my breast’s immune system. If cancer cells had broken free of my tumor, they would appear here first.
The marked node (or nodes) would be removed and sent to pathology while I was still under anesthesia. If no cancer cells were found, we could be fairly certain the cancer had not metastasized.
I was assured that my tumor was small. I had caught it early. It was probably contained.
I was scheduled to have a double mastectomy followed by a first stage of reconstructive surgery. The skin-sparing mastectomy would remove the breast tissue, the nipple, areola and a lozenge of surrounding skin while preserving the majority of the skin. Due to the small size of my natural breasts, there would not be enough skin remaining to cover even the smallest implants. Instead, balloons called expanders would be inserted. These would later to be inflated in stages as my skin slowly stretched.
I was prepped with a paravertebral block to completely numb my chest. The last thing I clearly remember was the anesthesiologist praising my back body for the ease with which he could find his injection landmarks.
I bet he says that to all the girls.
I came to alone in a darkened hospital room. Outside a summer storm raged. Lightning flashed across the nighttime city.
Hello, storm. I’m back.
A fluorescent glowed dimly behind a valance. Hall light slanted in through the half-open door. Perched on the bedside table were a cup of water, packet of crackers and vomit dish. My eyes felt sticky, my mouth dry. My consciousness seemed to drift just outside my skull like a forlorn balloon tied to a mailbox. My chest was thickly bandaged. I needed to pee.
I pressed the call button, and a nurse appeared to guide my unsteady legs to the toilet. She was kind and patient. Helping me back into bed, she advised me to sip and nibble lest I become nauseous. She asked if I wanted the drapes closed against the thunderstorm.
No. Please leave them open.
I spent what remained of the night, drifting in and out of consciousness, sipping from my cup and imagining myself one with power and turbulence of the sky.
Day came and, with it, my plastic surgeon to inspect his work and change the dressings. He told me I could look or not. It was my choice.
I am not a squeamish person, but looking, I was overcome by nausea. What I saw was not myself. It was disorienting. I felt I was spinning.
He must have seen me blanch out of the corner of his eye. “Look away,” he urged. “You don’t have to see this now.”
He finished his inspection, rebandaged me, and zipped me into a dressing-preserving, sports-bra-like contraption. To this he attached the bulb-ended tubes that led into my body, capturing fluids draining from my traumatized tissue.
He pronounced all well. Then he told me the bad news.
The tumor was so close to the underside of my skin that, scrape though they might, they couldn’t get the clear margin they wanted. I would need radiation to kill any cancerous cells that might be clinging to the underside of my skin.
My sentinel nodes, I had two, had shown micrometastases. Ten additional nodes were removed and inspected. These had been clear. There was a good chance the spread of the cancer was confined to the sentinel nodes. But, this meant I would need to speak to my oncologist about chemotherapy.
We said our goodbys, planning to meet again in his office in a few days.
My husband arrived and we hung out for a while. He told me how he had spent the night, what dinner had been like. I was groggy and grateful to see him.
Eventually, a nurse appeared and announced I could leave that morning or, if I felt I wasn’t ready, could stay another night.
“Get me out of here,” I said.
After we promised to stay close by in case of emergency, she gave my husband the opioid prescriptions I would need filled and instructed him to fetch our truck around to the main entrance to pick me up.
Off he went, and she called for an orderly and a wheelchair. They seemed forever coming. The rolling tour that ensued, through miles of corridors, across connecting bridges, down elevators, through atriums, seemed longer still. I imagined, by the time we got to the entrance, my husband would be tapping his foot in annoyance.
But he wasn’t there.
“Could he have gone to another entrance by mistake,” I asked my charioteer?
He assured me, although there were other entrances, my husband would quickly figure out which was the right one.
We waited. Then we waited some more. I began to get nervous, imagining what might have gone wrong. “Could he have been mugged in the parking garage for the oxy prescription?”
“It’s ten in the morning,” he said reassuringly.
Drug fiends sleep in. Good to know.
And we waited. And we waited, parked by the curb. At least it was summer. I could see my orderly was getting agitated thinking of all the other things he could be doing.
Purseless, I asked, “Do you have a cell phone we could use to call my husband?”
“No.”
Finally, over the rise, our truck appeared. Thank God! The orderly and my husband bundled me into the passenger seat. As we drove away I asked what had happened, if he had gotten lost.
“I went out to the parking lot, got in the truck and started driving,” he said. “I got half way across the city. When I passed the art museum, I had the sense that something was wrong, but I couldn’t put my finger on it. Then I realized, ‘Oh my God! Meg’s not in the truck!’”
And there it was. He was that upset. That flustered. He had never let on. He was being brave for me. This was traumatic for him, too.
To be continued …
October 2016 is Breast Cancer Awareness Month.
This October (and perhaps beyond) I will be posting the story of my journey with breast cancer in serial form. My hope is that my story will aid others who are walking this path and the loved ones who want to understand their experience.
To stay abreast of this story, please follow me so the story appears in your feed.
This story is Part 4 in a series. Here are links to other parts of the series:
Part 1: Discovery
Part 2: Research
Part 3: Analysis
Part 5: Treatment
Part 6: Setback
