Wednesday, March 25, 2009

3/25/2009: Lady's Got Back

Standing in front of Dr. Nahabadian I removed my gown as directed exposing my beautifully reconstructed right breast and my indention with darkened skin on my left side. His eyes immediately moved to my stomach and his lips curled to one side as though he was puzzled. He rolled forward on his stool and proceeded to run his fingertips down my stomach – as though he were performing a tummy tuck. “Nope, that’s not going to work. I’d have to cut you under the belly button from hip to hip to get the amount of skin and tissue I would need,” he traced imaginary lines with his fingers across my stomach. “You are just so tiny.” He instructed me to turn around where he performed the same kneading strokes over my left shoulder blade. “There’s not enough tissue to work with here either,” he said aloud even though we both knew it would be the case since he could barely pinch any tissue. “Go ahead and pull down your pants,” he asked. With my jeans around my ankles Dr. Nahabadian grabbed at the inside of my thigh. “Eh, still not enough,” he said. I looked at him with desperate eyes. I repeated over and over in my head, “Please find something – ANYTHING to make me whole again.” His eyes squinted in deep thought as his lips tightened. “Turn around for me,” he said nodding as though he had figured out the riddle. Lifting my thong strap he squeezed two handfuls at the top of my right butt cheek. “I knew you had it hiding somewhere,” he said as he gave me a little shake. I couldn’t help but laugh.

My surgery is scheduled for May 7. The procedure takes five hours. I will then spend three days in the ICU, have to take two weeks off of work and will need to take it easy for six weeks as I recover. Ugh, another surgery – but at least this one is making me whole again. The surgery is very tricky since I am so petite and my skin has been severely compromised due to the six weeks of radiation I endured. Dr. Nahabadian will have to reconnect each of the blood vessels in order to ensure that the tissue and skin has healthy blood flow. Unfortunately, five percent of these procedures are failures and I have to understand that the new skin and tissue may not take to the damaged area.

Prior to surgery I have to have another PETscan to make sure that I am cancer-free. It is hard to believe that it has already been three months since my last one. If the scan comes back clean, then I will have my mediport removed during my May 7 surgery, which makes me ecstatic. I hate my stupid port. I also need to talk with the Infectious Disease doctors, who saw me both times in the hospital when I had infections, in order to determine which antibiotic I need to go on prior to my surgery – that way we hopefully can avoid an infection.

The purpose of this surgery is to successfully transplant my skin and tissue. I am trying to prepare myself mentally that the new tissue and skin may not initially resemble a breast. In three months I may need a “touch up” surgery in order to tweak Dr. Nahabadian’s work and make sure that I am as symmetrical as possible.

Who would have thought that my butt would make a great breast? So now what are we going to do to reconstruct my butt? Ah, the plot thickens.

To be continued ...

Monday, March 9, 2009

3/9/2009: The Specialist

“I want you to meet with Dr. Nahabedian at Georgetown University Hospital,” said my plastic surgeon, Dr. Wendy Gottlieb. I went to visit Wendy last Friday to have my stitches removed and didn’t realize that I would come out of her office with another big decision looming.

Once my stitches came out and I was bandaged back up, we chit-chatted some about my hospital stay. Wendy said that all the nurses still ask her how I am doing and were so incredibly touched by my story. She said, “You sure do make an impact on everyone you meet.” She then asked me about “this boyfriend” that all the nurses were talking about who would come to my room and curl up on my bed with me every day. “Well, I think you deserve something happy and positive after all that you have been through. Let’s get you reconstructed before the summer … or the wedding gown for that matter,” she said. I shot her a dagger-look that quickly turned to a smile.

My reconstruction is more complicated than other women, because I am very petite. There are a couple of different options: (1) latissimus dorsi myocutaneous back flap procedure which involves taking skin and tissue from my back, cutting the muscle and wrapping it through my armpit to my left breast, (2) TRAM (transverse rectus abdominis musculocutaneous) flap procedure which takes the muscle as well as the skin and fat from the abdomen to sculpt a new breast. However, this can cause complications like abdominal weakness and future back pain because the patient is left with no abdominal muscles, or (3) a procedure that Dr. Nahabedian performs called the DIEP (deep inferior epigastric perferator) flap procedure. The surgeon separates the artery and vein from the muscle in the stomach and then attaches the tissue to the breast site with sutures that are thinner than a hair. Less than one percent of women have this kind of reconstruction, but it ensures that the fresh skin/tissue has a good supply of blood, which has been an issue in my previous reconstruction.

I asked Wendy which surgery she would suggest for me. “I’ve been thinking about this a lot over the last three weeks and going back and forth with the pros and cons for each. I honestly don’t know,” she responded. “I just hate to think about you having a huge scar across your back when you can hide the one on your stomach under most swimsuits.”

So, I am either going to have a large scar across my back or my stomach in order to create a new breast. The idea of having another surgery makes me ill, but to then think about another part of my body being sliced and diced makes me want to just quit all together. I want to be whole again, but this process is exhausting mentally, emotionally and physically.

I meet with Dr. Nahabedian on March 20 to determine if I am a candidate for the DIEP surgery. I have until late April or early May to weigh my options and decide what I want to do with my body. I feel like Humpty Dumpty and that it is taking all of NOVAs plastic surgeons and doctors to put me back together again.

Monday, March 2, 2009

3/2/2009: Prosthetic Shopping

Looking around the lingerie section at Nordstrom’s it didn’t take long to realize that they didn’t have any prosthesis on display. I was approached by a woman in her late thirties with long black hair that ran down her back. She had rosy cheeks and a sweet smile. She asked how she could help me. I looked around and once I realized that no one was in ear shot I responded.

"I had a mastectomy and need a prosthetic," I said in a quiet voice.

Not missing a beat she asked, “Did you have a single or double mastectomy?”

“Well, my story is complicated. I had a double, but I have one implant, so I really just need one. Do I have to buy them as a set.”

“No, not at all. You can purchase just one.“

She escorted me into the dressing room to the largest room in the back. Before going into the room she turned to me and said, “Oh, and my name is Angel.” I smiled and introduced myself. I thought to myself, what are the chances!? She ushered me into a room wallpapered in toile with luxorious seats. It was beautiful. My heart was beating fast and I wasn’t sure what to expect next.

She asked which type of prosthesis I was interested in while she listed off a few options. I shrugged and told her I had no idea since I had never done this before. She gave me a genuine smile and said, “I will bring back a few options for you to try.” Before leaving she asked if I prefered trying on the prosthetic privately, or if I wanted her help.

“At this point everyone has seen my deformed body. If you can stomach it, you are welcome to stay.”

“I understand and please know that I have been doing this for many years and have fitted many woman who have had mastectomies. I will take good care of you.”

She left and I took my clothes off. I ran my fingers along my incision and grew more anxious and nauseous. Looking at myself in the mirror was disgusting. In addition, I had huge bruises on the sides of my waist from the shots I was given while in the hospital.

Angel returned with a box and a bra. I stood infront of her with my single breast exposed and tons of scars and bruises. She never diverted her eyes from mine. She was amazing.

"I am going to guess that you are wearing a 34B … you should be in a 32C.”


“Try this on and you’ll see.”

The bra she had brought me was a full-coverage 32C and it wasn’t an ugly bra either. It had beautiful lace straps and lace across the back. I put it on and it fit like a glove. She handed me the prosthetic and showed me how to position it inside the cup of the bra. Like putting in contacts for the first time, it took a little practice. She left to find a fitted t-shirt so that I could see how it looked underneath clothing. Once I had the shirt on I began looking at myself sideways in the mirror and admiring my perfect, curvy body.

“I don’t mean to offend you, but you look so young to have battled cancer.”

“That’s beacause I am. I found my tumor when I was 25.”

Angel shook her head and said, “It makes me so angry.”

I bought two bras and my left breast prosthetic that evening from a woman named Angel who treated me with the utmost compassion and understanding.

Angel walked me down the hallway to the escalator. Once we got there the tears swelled in my eyes and my heart felt so renewed. Angel put out her hand and I wrapped my arms around her in a full embrace. “Thank you for making me whole again. You will never know what your kindness has meant to me.” I pulled away and a single tear ran down Angel’s face. I will never forget her.