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.

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