Tuesday, May 20, 2008

5/20/2008: Timeline

My friend Bronwyn summed it up best when she said "I guess feeling the worst you have felt emotionally on this journey is to be expected when the end is so close yet in many ways seems so very far." I reached my breaking point yesterday when I had my appointment with my plastic surgeon, Dr. Wendy Gottlieb, and I am finding it so hard to mentally get myself back on track. I feel lost and I hope for my sake it is temporary.
Let me explain. I met with Dr. Wendy Gottlieb (my plastic surgeon) yesterday and I LOVE her. She was incredibly compassionate and optimistic … exactly what I need. She told me that things may change during the process, but whatever happens we will roll with it and she will be able to fix it or make it work. I saw her work and she is truly an artist. I have complete faith and know that I will end up with an amazing end result. What I did not anticipate was that I will have three surgeries over the course of almost a year before I am put back together again. I feel like Humpty Dumpty.

WARNING: If you are sensitive to surgical information, do not read the information below!

Here is my timeline:
(1) Surgery #1: Either June 18 or July 2. Dr. Kenneth Mason (surgeon) will go in through the nipple (the only incision, other than the drains) and remove all the tissue in the breast back to the pectoral muscle. Then Dr. Wendy Gottlieb (plastic surgeon) will then cut the muscle and place the filled expander behind it against the ribs. (The expander looks like an implant, but has a port on it.) She then places the muscle over the expander. On top of that she will line the inside of my skin with donated skin/tissue in order to give the breast a smooth look, instead of the skin looking thin and cottage cheese like. Then they tie me up where my nipple used to be and I head into recovery. I should wake up about the same breast size as I am now. She said she would fill the expander as much as the skin would allow for.
(2) Recovery: I only stay in the hospital 1 to 2 nights. The drains are removed week 1 to 3 depending on my body. I will probably end up with 4 to 5 drains depending on how many lymph nodes they remove.
(3) Once the drains come out (week 2 to 3) they do the first expander fill. Filling the expander consists of a visit to my plastic surgeon's office where they take a long horse-sized needle and stick it through the center of my breast. (At this point I don't feel it since I no longer have nerves in my breast.) It is able to seek out the metal port in the expander and connect. They fill me until I have been "stretched to capacity."
(4) Week 4 to 5 they do the second expander fill (which my plastic surgeon says is usually all it takes to reach the desired size)
(5) Radiation: I cannot start until I have finished my expander fills. Typically radiation lasts 8 weeks, although I won't know how long mine is until they dissect the tissue from my mastectomy and determine how much cancer is left … if any at all.
(6) I then have to wait two months for my body to heal from radiation and the tissue to start rebuilding itself
(7) Surgery #2: Then I get my implants
(8) I wait 2 to 3 months for my breasts to settle into place.
(9) Surgery #3: I have flesh-colored nipples constructed from donated tissue
(10) I have my nipples tattooed to a pink color and am finally finished!

The task before me seems daunting and I am not sure where I will find the strength to continue on this journey. I feel overwhelmed and uneasy about my surgeries. I am not a patient woman and embracing this timeline is difficult for me. I am at a point where I am tired from chemo (on many levels) and am having a hard time mentally and emotionally preparing for an operation that will take almost a year to complete. I understand the mission of this journey is to get healthy, but the 26-year-old woman in me is mourning the loss of her youthful physique.

I opened the gown as I stood topless in front of Dr. Gottlieb. She told me that I was in an excellent starting place with very symmetrical breasts. I stopped her and told her to look at my nipples. I said, "See how little they are? I want them exactly the same." I think she could sense the concern in my voice and see my eyes starting to swell. She stopped measuring my breasts and smiled at me. She said, "We'll make it happen then." Let God be my compass … my journey is so very far from over.

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