Boob Job: Part 5
Treatment
I felt like a suicide bomber.
As instructed, prior to surgery I had bought oversized, front-closure shirts at Goodwill, damned if I was going to splurge on clothes that didn’t fit. These were now my uniform. I could wear nothing else.
My voluminous tops hid, in addition to my swaddled chest, a disgusting sight. Tubes emerged from both armpits, weeping bloody yellow liquid into bulbs which looked, for all the world, like three translucent grenades pinned to the zip-front “sports bra” protecting my dressings. No way would I have gotten through airport security.
My constant duty was to inspect the fluid for clarity and measure the flow. Once the fluid cleared and dwindled to a trickle, the drains could be removed. I had heard horror stories involving tubes removed too soon. The serosanguineous fluid, lacking an exit, created a fluid pouch below the skin. No, thank you. No premature drain pulling if I could help it.
The button-front part of the shirt design was because I couldn’t get my arms over my head, or even to shoulder height.
The lower portions of my pectoral muscles had been detached from my chest wall. Circular, pillow-shaped expanders had been inserted under both muscles from below. The protruding lower portion of each cushion was supported by an Alloderm cadaver skin pocket which bridged from pectoral to chest wall. The whole shebang was sutured together, as was the covering breast skin.
A long horizontal gash bisected my left armpit, the aftermath of lymph node removal. The back of the upper arm was numb. A nerve had been severed.
The last thing I wanted to do was tear my sutures. Stillness was my friend. I shuffled around the house, watched TV, read comic novels, avoided lifting anything exceeding ten pounds, and entertained sporadic visitors. Occasionally I fielded questions.
“No, I am not, in fact, dying. Thank you for asking.”
All this I did while assiduously hiding the pendulous globes of bodily fluid jostling at my midriff like Carmen Miranda’s misplaced bananas.
After a couple of days, my husband thought it was safe to leave me alone for a stretch.
It was lunch time. I decided I wanted soup. I knew we had some in the cupboard. Bowls, too. I could reach neither. I couldn’t reach anything above chest level. If it wasn’t in the fridge or dishwasher, I was screwed. I felt as helpless as a seal on dry land.
I completely melted down, my stoic bravery dissolved. All the fear and sadness I had stuffed for months came pouring out in a cascade of self-pity.
My husband came home late in the afternoon to find me sobbing on the sofa. He wanted to know what was wrong.
“I wanted soup and I couldn’t reach it,” I sobbed, cognizant of the pettiness of my drama.
“All you had to do was call,” he said. “I wasn’t very far away. I would have come home.”
“I know,” I choked out. “But it seemed so … stupid. I didn’t want to bother you.”
He assured me that it would have been no bother. But I was unconvinced. I felt I was taking up too much of his time as it was. I hated being dependent, an invalid.
That night I insisted he move everything down to counter level.
The day finally arrived when the drains were pulled and the bandages were removed. I had refused to look at my chest since that first morning’s sickening reveal. Now it was time.
My chest was freakishly flat. Long diagonal incisions chevroned red across my ribs. But, wow. They were the most perfect scars ever, invisible zippers in human flesh. A round of applause for plastic surgery! My doctor was an artist.
I had escaped infection. I hadn’t torn my sutures. I could shower! I didn’t barf! I celebrated small victories.
Now I could begin to regain my strength and range of motion, ever so slowly. And it was time to expand the expanders.
The expanders bore subcutaneous, metallic valves locatable by magnet. Every couple of weeks, I would arrive at my plastic surgeon’s office. He would locate the valve and inject saline solution in the expander, inflating it and stretching the skin until I cried “uncle.” The weeks between appointments allowed my skin time to adjust before the next stretching.
It was an uncomfortable process. The expanders were so firm I felt I had tennis balls sewn under my skin.
Eventually I was stretched to a size suitable for my doctor’s purposes, a size slightly larger than the final product. He needed extra skin for slack in the reconstructive surgery.
The breasts were crooked. He explained initial expander insertion surgery often was. Besides, radiation was going to affect the symmetry through tissue shrinkage. The end result would be symmetrical.
Due to the narrow margin between my tumor and skin, as well as my micrometastatic sentinel lymph nodes, radiation was recommended to kill off any cancer cells surgery might have missed
Final reconstructive surgery would have to wait. No point nuking the permanent implants. Keep those bouncing babies as flexible as possible.
I went to see my radiation oncologist for “mapping” and the tattoos which would insure I was always perfectly positioned while being irradiated.
Expecting the vibrating needle gun from Inked, the dye-filled syringe was a disappointment. It was sad to think that my life’s first tattoos were ratty blue dots. Couldn’t she have done stars? C’est la vie.
My treatment consisted of targeted external beam radiation which raked across my left breast, avoiding my ribs and heart to the extent possible. A second beam shot through my left clavicle, zapping my clavicular lymph nodes, and exiting out my back. The entire appointment took no more than 15 minutes.
Once they positioned me on the table in the center of the the dimly lit, perfectly circular room, the technicians would scurry out to save their skins. I was left alone alone in the quiet whir with dance music, an inexplicable choice for the immobilized, to keep me company.
I would imagine myself at the center of a pagan ritual: a nemeton of ancient oaks, an altar slab, shamans working over my body, the spirit of light descending to cure me, burn away the mutant cells. It felt healing. It kept me sane.
The drive to the radiation treatment center was an hour each way. My course of treatment was five days a week for five weeks. It was a job.
I’d heard stories that radiation led to fatigue. “If the rays don’t get you the drive will,” I thought as I drove myself to and fro. My work output was already in the toilet. No reason to make my husband non-productive as well.
Fatigue hit me on week four. Like a wall. I walked out of my appointment and knew I couldn’t drive home, not safely anyway. I took a nap in in the parking lot, pulled it together eventually, and got myself home.
Time to call in my chits.
Friends had been offering help, but I had been too proud to accept. Not anymore. Illness is humbling. I started making calls. Within no time at all I had lined up drivers for my remaining appointments.
God bless those friends. It was so nice to have a companion for the ride, to sit back and not concentrate. It was nice to talk.
Fatigue hit me at home, too. All the little chores grew into mighty mountains.
One evening, my husband came home and asked, “What’s for dinner?”
I had been sitting like a blob on the sofa watching some black and white movie too esoteric for my tired brain to decipher. “I don’t know,” I replied.
“What do you mean, you don’t know?” he questioned, perhaps a bit too firmly.
I collapsed. I felt like such a failure. I wasn’t holding up my end at work. I wasn’t holding up my end around the house. I was exhausted. I was in pain, the through-and-through radiation burn angry on my clavicle and tennis-ball-stuffed chest. I remember falling to the floor, pounding the carpet with my fist and bawling,
“Why don’t I just die now and get it over with?”
We ordered pizza.
I finished radiation the Friday before Halloween. I hoped it had done its work, destroyed any mutant cells without creating new ones.
Meanwhile, my excised tumor had been having adventures of its own.
Because my tumor was estrogen-positive and relatively small and the metastasizes in my sentinel nodes were microscopic, I was a candidate for the Oncotype DX Test, a genomic analysis. My tumor, after some wrangling with insurance, was sent off to the lab.
Lucky me. I won the genetic lottery. My test score indicated I had a low risk of recurrence, low enough that the benefit of chemotherapy would be unlikely to outweigh the risks.
I was relieved. Chemo was the treatment I had been dreading. Cuts and burns. OK. But poison? This was my fear. Part of me wanted to do everything, and I mean everything, to snuff any chances of a recurrence. But, if a doctor was going to let me off the hook, tell me that the percentages didn’t indicate a benefit … I took the reprieve I was given.
My oncologist gave my body a few weeks to recover from radiation then put me on Tamoxifen, a SERM drug used to block the action of estrogen in estrogen-sensitive breast cancer. If there were any cancer cells roaming my body after surgery and radiation, Tamoxifen would bind to their estrogen receptors, preventing proliferation.
It was now mid-November. I had six months months to recover from radiation before my final reconstructive surgery. The holidays and their joys lay ahead, medicine free.
Or so I thought …
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 5 in a series. Here are links to other parts of the series:
Part 1: Discovery
Part 2: Research
Part 3: Analysis
Part 4: Removal
Part 6: Setback
