“Wow I did a good job,” said Dr. Nahabedian.
“Your work doesn’t even come close to your modesty,” I reboked sarcastically.
Both Dr. Nahabedian and I broke into laughter. He began gently moving his fingers around the edges of my left breast. He was surprised by how quickly the scar was healing from the DIEP procedure and that my skin and tissue had softened considerably from the six weeks of radiation I endured last fall.
“So when are we outfitting you with some nipples?” asked my doctor.
“I need a break. I have had so much done to me and I would really like to just enjoy my summer,” I replied.
He responded with a sympathetic nod and wet eyes as he sensed the exhaustion in my response.
I proceeded to show him what had happened now that the tissue and breast has dropped into place. The new tear drop shape is completely symmetrical with the right side, although it left a bit of a dent across the top where it initially sat. My right side is definitely more round and full on top. I explained that the issue is resolved when I wear a bra and everything is pushed into place, but I want it to look better. He suggested fat grafting, but said we should wait three months to see if I drop anymore. We didn’t speak anymore about it since he could tell I was over the topic of an additional procedure for now.
He finished the appointment by taking photos of his “good job” and telling me that I could resume my normal workouts and exercises. I was ecstatic and pleased that he and I seemed to be on the same page about the break I needed so badly.
Monday, June 1, 2009
Tuesday, May 12, 2009
5/12/2008: DIEP Procedure
“If I am not allowed a Frappuccino I will surely die,” I said dramatically to my surgeon, Dr. Maurice Nahabedian, while I covered my face and let the warm tears of frustration run down my cheeks. “I haven’t been able to eat or drink anything for over 36 hours and I am losing it.”
Dr. Nahabedian smiled, looked at my mother and said, “Go across the street and get this girl Starbuck’s.”
I don’t think I had fully prepared myself for the severity of this surgery, nor had I realized how big of a deal it is in the medical field. My surgery is called the Superior Gluteal Artery Perforator Breast Reconstruction more commonly called the S-GAP. S-GAP reconstruction uses tissue from the top of the buttock, which contains the upper gluteal artery. During this surgery, a rounded section of skin and fat (and occasionally muscle) is removed from the top of the buttock. After being transferred to the breast, the tissue is shaped to create the breast mound and is attached to the remaining breast tissue. Using complex microsurgical techniques, the blood vessels are reconnected to existing vessels in the area. Only two surgeons on the east coast perform this type of operation, and Dr. Nahabedian is one of them. A modest man with a strong handshake and a compassionate tone to his voice – he is one of the best plastic surgeons in the United States and he is right here at Georgetown University Hospital. How lucky am I!? I know, weird thing to say coming from the girl diagnosed with cancer at the age of 27.
I was prepped for surgery by three eager medical residents who looked at me like a medical miracle. They asked me all sorts of questions, each taking notes in their notepads and studying “my case.” I felt like I was on an episode of ‘House.’ They explained that all the medical students were excited about my procedure and said, “A lot of people are going to see you naked today.” Hilarious! My assistant surgeon was named Michael Cohen and was one of the chattiest doctors I have ever met. He genuinely enjoyed talking to me and was quite concerned that I remain calm.
My surgeon met with me prior to surgery and drew out the plans with a black marker along my body. I shook from the sterile nature of the room and cold air. Cohen reassured me that it would all be OK. Dr. Nahabedian finished prepping me by drawing the blue prints along my butt. Cohen asked questions about the artery Dr. Nahabedian would be removing and what would be landmarks internally when he opened me up. I turned my head around and asked, “Will you be able to reach into the right butt cheek and pull some fat over to fluff my left cheek?” Cohen thought very seriously about the question while Dr. Nahabedian laughed knowing that I was breaking the serious tension and explained that the right side would not be touched in case it ever needs to be used in the future.
So, I was rolled into an 8-hour surgery with my surgeon, assistant surgeon, three medical residents, two anesthesiologists, oh, and just the rest of Georgetown University.
I woke up very quickly and realized I was in the ICU. My Mom was crying asking the nurse to please let her stay (which she did the entire duration of my recovery), the residents and Cohen were in my room rubbing a wand across my breast, and the only thing that hurt was the catheter which no one warned me about! There was so much activity and all I wanted was to eat and sleep -- neither happened for a long time. (I didn’t know until several days later, but Cohen slept next door that night on the ICU floor incase I needed him.) The nurses had to use this tiny machine called a Doppler Radar (I though that was only for weather!) and rub it across the new section of my breast every 15 minutes. You could hear the blood pulsing through the blood vessel they had sewn together.
Dr. Nahabedian explained to my parents after my surgery that they removed the skin, tissue, artery and fat from my left butt cheek and it took three tries to finally get the bypass created in my left breast. The arteries and blood vessels were not the same size so it took some magic from “the plastics” (Georgetown University Plastic Surgery) to make it all work. The first 48 hours are the most critical and you can usually tell whether or not the transferred area will take.
Between visits from my dad, brother, Uncle Chuck, co-workers, friends and boyfriend I was in pretty good spirits. They had to keep reminding me that it was only one to two visitors at a time. I even had an old girlfriend from high school come surprise me who works at Georgetown University Hospital as an oncologist RN. I was enveloped in love and compassion that I felt incredibly strong. My nurse Jenna even sat at the end of my bed at 3am and talked to me for hours about becoming a nurse and how she’s never seen a surgery like mine. Eileen was my other nurse who spent too much time in my room chatting about dogs, so she was moved to the other side of the floor the next day to care for another patient. She would still stop by to chat though. I believe that these young nurses truly connected with me and my journey. They saw themselves or their friends and sisters in me and it made the 1 in 8 statistic all more real. And quite frankly, I was the most fun person on the floor! One of the technicians on my floor was huge like a football player with a deep, soulful voice. His station was right outside of my tiny private room and he would sing me love songs anytime my door would open or he would bring in a tray of food. It was like something out of a movie. When I took a lap around the ICU floor (part of my physical therapy) with my friend Laurie, the technician yelled, “if you run by the pool I’ll kick you out” followed by a loud outbursts of laughs from the whole unit. I think they appreciated my spirit and survivor mentality.
Tuesday I was able to have the catheter removed which I HATED, then the physical therapist started working with me on walking and learning how to use my leg again. This was something else I had NOT prepared for in advance. I choked back tears as I reached for her hand and drug my limp leg as I tried desperately to walk again. I felt humiliated and defeated. My physical therapist was patient and my mother was strong while watching me struggle. I know it could not have been easy for her. I gritted my teeth, pulled my dark locks behind my ears, took a deep breath and pushed myself. It is going to take a hell of a lot more to keep me down.
The medical residents came by each morning at 5:30am with their notebooks to do their checkup. When Wednesday came around “the plastics” still wouldn’t let me eat or drink anything in case I had to go back into surgery quickly. I officially lost it -- I started crying. They must have notified Dr. Nahabedian, because he came in and told me that he had heard how great I was doing and that he would let me have coffee and food. Additionally, he said he heard that I was doing really well with physical therapy, even doing stairs without help, and if I chose to go home Wednesday night he would let me. I stayed until Thursday enjoying my coffee and hospital meals (with my boyfriend sneaking in some funnel cake) and made a pillow nest for the bumpy ride home.
It wasn’t until I got home to my parents that I got to really look at my incisions. I was disgusted with myself (as I always am initially) and even got close to fainting while taking my first shower. The pain goes beyond physical and challenges me psychologically. It took seven days for me to finally look at myself in the mirror and make peace with my new body. (Although now I am back to hating my hair and calling myself Keanu Reeves and pretending to dodge bullets like in the ‘Matrix.’) Despite my family and my boyfriend reassuring me that my butt doesn’t look lopsided and that the lines of my new breast incision were done so incredibly well – I needed to believe it myself.
Tomorrow I see Dr. Nahabedian for my post-op appointment where he will remove the drainage tubes from my armpit and hip that are irritating me and we will discuss my “touch-up” surgery planned for 3 months (August). He believes that he can make my breasts more symmetrical, but
I am operating on little victories for now …
Dr. Nahabedian smiled, looked at my mother and said, “Go across the street and get this girl Starbuck’s.”
I don’t think I had fully prepared myself for the severity of this surgery, nor had I realized how big of a deal it is in the medical field. My surgery is called the Superior Gluteal Artery Perforator Breast Reconstruction more commonly called the S-GAP. S-GAP reconstruction uses tissue from the top of the buttock, which contains the upper gluteal artery. During this surgery, a rounded section of skin and fat (and occasionally muscle) is removed from the top of the buttock. After being transferred to the breast, the tissue is shaped to create the breast mound and is attached to the remaining breast tissue. Using complex microsurgical techniques, the blood vessels are reconnected to existing vessels in the area. Only two surgeons on the east coast perform this type of operation, and Dr. Nahabedian is one of them. A modest man with a strong handshake and a compassionate tone to his voice – he is one of the best plastic surgeons in the United States and he is right here at Georgetown University Hospital. How lucky am I!? I know, weird thing to say coming from the girl diagnosed with cancer at the age of 27.
I was prepped for surgery by three eager medical residents who looked at me like a medical miracle. They asked me all sorts of questions, each taking notes in their notepads and studying “my case.” I felt like I was on an episode of ‘House.’ They explained that all the medical students were excited about my procedure and said, “A lot of people are going to see you naked today.” Hilarious! My assistant surgeon was named Michael Cohen and was one of the chattiest doctors I have ever met. He genuinely enjoyed talking to me and was quite concerned that I remain calm.
My surgeon met with me prior to surgery and drew out the plans with a black marker along my body. I shook from the sterile nature of the room and cold air. Cohen reassured me that it would all be OK. Dr. Nahabedian finished prepping me by drawing the blue prints along my butt. Cohen asked questions about the artery Dr. Nahabedian would be removing and what would be landmarks internally when he opened me up. I turned my head around and asked, “Will you be able to reach into the right butt cheek and pull some fat over to fluff my left cheek?” Cohen thought very seriously about the question while Dr. Nahabedian laughed knowing that I was breaking the serious tension and explained that the right side would not be touched in case it ever needs to be used in the future.
So, I was rolled into an 8-hour surgery with my surgeon, assistant surgeon, three medical residents, two anesthesiologists, oh, and just the rest of Georgetown University.
I woke up very quickly and realized I was in the ICU. My Mom was crying asking the nurse to please let her stay (which she did the entire duration of my recovery), the residents and Cohen were in my room rubbing a wand across my breast, and the only thing that hurt was the catheter which no one warned me about! There was so much activity and all I wanted was to eat and sleep -- neither happened for a long time. (I didn’t know until several days later, but Cohen slept next door that night on the ICU floor incase I needed him.) The nurses had to use this tiny machine called a Doppler Radar (I though that was only for weather!) and rub it across the new section of my breast every 15 minutes. You could hear the blood pulsing through the blood vessel they had sewn together.
Dr. Nahabedian explained to my parents after my surgery that they removed the skin, tissue, artery and fat from my left butt cheek and it took three tries to finally get the bypass created in my left breast. The arteries and blood vessels were not the same size so it took some magic from “the plastics” (Georgetown University Plastic Surgery) to make it all work. The first 48 hours are the most critical and you can usually tell whether or not the transferred area will take.
Between visits from my dad, brother, Uncle Chuck, co-workers, friends and boyfriend I was in pretty good spirits. They had to keep reminding me that it was only one to two visitors at a time. I even had an old girlfriend from high school come surprise me who works at Georgetown University Hospital as an oncologist RN. I was enveloped in love and compassion that I felt incredibly strong. My nurse Jenna even sat at the end of my bed at 3am and talked to me for hours about becoming a nurse and how she’s never seen a surgery like mine. Eileen was my other nurse who spent too much time in my room chatting about dogs, so she was moved to the other side of the floor the next day to care for another patient. She would still stop by to chat though. I believe that these young nurses truly connected with me and my journey. They saw themselves or their friends and sisters in me and it made the 1 in 8 statistic all more real. And quite frankly, I was the most fun person on the floor! One of the technicians on my floor was huge like a football player with a deep, soulful voice. His station was right outside of my tiny private room and he would sing me love songs anytime my door would open or he would bring in a tray of food. It was like something out of a movie. When I took a lap around the ICU floor (part of my physical therapy) with my friend Laurie, the technician yelled, “if you run by the pool I’ll kick you out” followed by a loud outbursts of laughs from the whole unit. I think they appreciated my spirit and survivor mentality.
Tuesday I was able to have the catheter removed which I HATED, then the physical therapist started working with me on walking and learning how to use my leg again. This was something else I had NOT prepared for in advance. I choked back tears as I reached for her hand and drug my limp leg as I tried desperately to walk again. I felt humiliated and defeated. My physical therapist was patient and my mother was strong while watching me struggle. I know it could not have been easy for her. I gritted my teeth, pulled my dark locks behind my ears, took a deep breath and pushed myself. It is going to take a hell of a lot more to keep me down.
The medical residents came by each morning at 5:30am with their notebooks to do their checkup. When Wednesday came around “the plastics” still wouldn’t let me eat or drink anything in case I had to go back into surgery quickly. I officially lost it -- I started crying. They must have notified Dr. Nahabedian, because he came in and told me that he had heard how great I was doing and that he would let me have coffee and food. Additionally, he said he heard that I was doing really well with physical therapy, even doing stairs without help, and if I chose to go home Wednesday night he would let me. I stayed until Thursday enjoying my coffee and hospital meals (with my boyfriend sneaking in some funnel cake) and made a pillow nest for the bumpy ride home.
It wasn’t until I got home to my parents that I got to really look at my incisions. I was disgusted with myself (as I always am initially) and even got close to fainting while taking my first shower. The pain goes beyond physical and challenges me psychologically. It took seven days for me to finally look at myself in the mirror and make peace with my new body. (Although now I am back to hating my hair and calling myself Keanu Reeves and pretending to dodge bullets like in the ‘Matrix.’) Despite my family and my boyfriend reassuring me that my butt doesn’t look lopsided and that the lines of my new breast incision were done so incredibly well – I needed to believe it myself.
Tomorrow I see Dr. Nahabedian for my post-op appointment where he will remove the drainage tubes from my armpit and hip that are irritating me and we will discuss my “touch-up” surgery planned for 3 months (August). He believes that he can make my breasts more symmetrical, but
I am operating on little victories for now …
Monday, April 27, 2009
4/27/2009: PETscan Results
"Jennifer, your PETscan looks amazing ..."
Over the past couple of weeks I have fought a nasty case of bronchitis, gone to several concerts and festivals, took a trip to the beach with my friend Heather, and had my pre-surgery PETscan.
My PETscan was on Friday and the following Monday after work I drove to Reston Hospital and picked up the report without telling anyone. Through the medical “mumbo jumbo” I continued to see the word “normal” repeated. The report talked about my mediport, my “collapsed implant” (which is where they removed my breast on the left side), and something about the top of my left lung. I called my Mom waking her from a nap. “Hello,” she said. “My PETscan was normal,” I said calmly. Silence fell over the phone, and then I heard sniffing. This was the first test I had received that was normal. My family was moved to tears – only this time they were joyful.
The following week I went to see my Oncologist, Dr. David Heyer, to review my PETscan results and get my mediport flushed. (Even though I am no longer receiving treatment I still have to have my port accessed and flushed once a month to avoid infection.) Dr. Heyer entered the exam room with a big smile and a sturdy hand shake. He immediately commented about how long my hair is getting and how he likes it dark.
Opening my huge medical folder he looked over my PETscan images. “Jennifer, your PETscan looks amazing,” he said. I choked on the tears and swallowed hard. He brought the images over to me and sat down. He showed me visually the different things that the report was referencing so that I could see what they were referring to on the images. “So does that mean I can get my port removed on May 4 during my reconstruction?” I asked. “It does,” said Dr. Heyer smiling. “And you know what else? I don’t need to see you back for four months.”
Dr. Heyer did point out in my images a section at the top of my left lung that lit up. Apparently, the six weeks of intense radiation has damaged the top section of my left lung. This will never go away, but should heal and eventually scar inside my body. Dr. Heyer told me to be very aware in case I get a cough or any issues breathing. He said that the intensity of the radiation was necessary and that we will just have to keep a watchful eye on the left lung as we continue with my imaging.
Dr. Heyer listened to my chest and my back focusing on my left lung and said that he believed everything sounded good. In four months we will redo the PETscan and see how it has healed.
Leaving the doctors office the nurses and administration all came out to congratulate me with hugs, kisses and huge smiles. I had forgotten that they have been fighting right along side me in this battle and were experiencing emotions similar to mine. I left the doctors office feeling as though I had been given back some of my independence – some of my freedom. I called my boyfriend and my Mom sharing the good news and my sense of renewal. Everyone breathed a sigh of relief and rejoiced in the positive news. Finally!
Over the past couple of weeks I have fought a nasty case of bronchitis, gone to several concerts and festivals, took a trip to the beach with my friend Heather, and had my pre-surgery PETscan.
My PETscan was on Friday and the following Monday after work I drove to Reston Hospital and picked up the report without telling anyone. Through the medical “mumbo jumbo” I continued to see the word “normal” repeated. The report talked about my mediport, my “collapsed implant” (which is where they removed my breast on the left side), and something about the top of my left lung. I called my Mom waking her from a nap. “Hello,” she said. “My PETscan was normal,” I said calmly. Silence fell over the phone, and then I heard sniffing. This was the first test I had received that was normal. My family was moved to tears – only this time they were joyful.
The following week I went to see my Oncologist, Dr. David Heyer, to review my PETscan results and get my mediport flushed. (Even though I am no longer receiving treatment I still have to have my port accessed and flushed once a month to avoid infection.) Dr. Heyer entered the exam room with a big smile and a sturdy hand shake. He immediately commented about how long my hair is getting and how he likes it dark.
Opening my huge medical folder he looked over my PETscan images. “Jennifer, your PETscan looks amazing,” he said. I choked on the tears and swallowed hard. He brought the images over to me and sat down. He showed me visually the different things that the report was referencing so that I could see what they were referring to on the images. “So does that mean I can get my port removed on May 4 during my reconstruction?” I asked. “It does,” said Dr. Heyer smiling. “And you know what else? I don’t need to see you back for four months.”
Dr. Heyer did point out in my images a section at the top of my left lung that lit up. Apparently, the six weeks of intense radiation has damaged the top section of my left lung. This will never go away, but should heal and eventually scar inside my body. Dr. Heyer told me to be very aware in case I get a cough or any issues breathing. He said that the intensity of the radiation was necessary and that we will just have to keep a watchful eye on the left lung as we continue with my imaging.
Dr. Heyer listened to my chest and my back focusing on my left lung and said that he believed everything sounded good. In four months we will redo the PETscan and see how it has healed.
Leaving the doctors office the nurses and administration all came out to congratulate me with hugs, kisses and huge smiles. I had forgotten that they have been fighting right along side me in this battle and were experiencing emotions similar to mine. I left the doctors office feeling as though I had been given back some of my independence – some of my freedom. I called my boyfriend and my Mom sharing the good news and my sense of renewal. Everyone breathed a sigh of relief and rejoiced in the positive news. Finally!
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 ...
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.
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.”
“Really!?”
“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.
"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.”
“Really!?”
“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.
Monday, February 9, 2009
2/9/2009: The Nightmares
Submerged in cool water the sheer white gown clung to my skin. My long black ringlets danced in front of my face. My ears filled with water and buzzed calmly giving silence to everything around me. I looked to the surface of the water where I saw angels and demons circling vigorously above. I released all of the air from my mouth watching the tiny bubbles dance quickly toward the light. I closed my eyes and was peaceful.
Opening my eyes I was engulfed in the darkness of my room. I waited a couple of seconds, and then gasped for air. My dreams were becoming more vivid and I knew this meant that things were about to change significantly. I noticed a severe pain in my left breast. Sitting on my bathroom floor I held my knees to my chest and rocked myself back and forth. I was dizzy and nauseous from anxiety. I knew something was wrong. How could I get sick the day before my biopsy?
Within a couple of hours I was admitted to Reston Hospital and was started on a series of antibiotics through my IV. That evening my plastic surgeon, Dr. Gottlieb came to see me. She reviewed a couple of options for surgery. It only took a couple of minutes and I told Wendy to remove my implant and not replace it. My mother looked at me wide-eyed and reiterated what the surgery meant. I nodded with a knot in my throat and said, "I know -- I will lose my breast." I asked Dr. Gottlieb to also remove the scar tissue and lymph node on my right side while she had me under anesthesia. I figured it made sense to just get it all over with at once.
The infectious disease doctors noticed a murmur in my heart beat and so following surgery I had an echogram done. I cannot even stomach explaining this test even now. It was truly excruciating since they had to rub and push against the crater that was now my left breast. The doctors were worried that the infection had moved to my heart. Luckily they reported back that my heart was "so incredibly strong." My parents burst into tears hearing the news.
My body was not so lucky though when it came to the infection. The tests found that I had a bacteria much like an intestinal infection (urinary track infection) in my breast. I asked my oncologist if this meant that I touched my vagina then my boob. He laughed and said no, but that it was good to see I hadn't lost my sense of humor. I then proceeded to tell everyone who entered my room that my vagina had made me sick. Stupid vagina! Additionally, the tests found that I had a contaminant infection in my mediport. I am now on a series of strong antibiotics for the next couple of weeks to bring my body back to life.
Dr. Gottlieb removed two areas of scar tissue from my right armpit area. I have a teeny incision about an inch long that itches like crazy! My doctors believe that the smaller piece of scar tissue is what was reported as a "questionable lymph node" on my PETscan. Both pieces of scar tissue were dissected and tested. NO CANCER WAS FOUND. I am elated. I will be tested again in a couple of months once my body has bounced back from this surgery and the inflammation has gone down. I will have check-ups every three months to ensure that I remain cancer free.
I was in the hospital four days and despite the cancer-free news, endless love and support of friends and family and the compassion of my nurses and doctors there was a looming sadness for the loss of my left breast. My last day in the hospital, Dr. Gottlieb arrived to my room to check my incisions and remove my drainage tube. She was bandaging me back up and the tears started rolling down my face. She sat on the edge of my bed. I said, "I know I am cancer-free and that I should be so happy, but I am consumed with the loss of my breast." Dr. Gottlieb said, "Jennifer, I am reconstructing one of my patients breasts this month and she is 50 – vanity is real no matter the age. It doesn't matter if you are 27 or 50 – you are a woman and you have lost something that defines you physically in that way. Don't be ashamed for feeling the way you do … you are entitled. And believe me that every woman working on this floor who has been changing your bandages, administering your medicine, or checking your vitals aches seeing what you are going through." It will be two to three months before I will have surgery to reconstruct my left breast. This will entail taking skin, tissue and muscle from my back or stomach to create a new flap for my breast and putting in a new implant. The good news is that the new skin will respond much better than the radiated skin, it will be done by swimsuit season … and I will be able to upgrade.
Leaving the hospital my nurses cried and hugged me. Many of them remember me from my other stays. Like Dr. Gottlieb had described, I saw the pain in their eyes -- they ached for me. Perhaps they were happy it wasn't them or imagined themselves or their daughters in my place. Regardless, I just hope I made an impact. Once I arrived home I unpacked my things.
Dr. Gottlieb had left two pink Victoria Secret bags in my hospital room. One bag contained prosthetic inserts for my bra. They other bag … two sets of beautiful lingerie and Godiva chocolates. As a woman, Dr. Gottlieb also understood the pain and the loss I was experiencing. She is a class act. I was moved to tears by her kindness and compassion.
Despite my pain, I am not ready to stay submerged in the cool waters of my subconscious. As long as my heart is strong, my spirit is vibrant and my vagina is kept clean, I will continue to fight. Keep circling angels and demons above the thin surface that currently separates us ... for my work here is not done.
Opening my eyes I was engulfed in the darkness of my room. I waited a couple of seconds, and then gasped for air. My dreams were becoming more vivid and I knew this meant that things were about to change significantly. I noticed a severe pain in my left breast. Sitting on my bathroom floor I held my knees to my chest and rocked myself back and forth. I was dizzy and nauseous from anxiety. I knew something was wrong. How could I get sick the day before my biopsy?
Within a couple of hours I was admitted to Reston Hospital and was started on a series of antibiotics through my IV. That evening my plastic surgeon, Dr. Gottlieb came to see me. She reviewed a couple of options for surgery. It only took a couple of minutes and I told Wendy to remove my implant and not replace it. My mother looked at me wide-eyed and reiterated what the surgery meant. I nodded with a knot in my throat and said, "I know -- I will lose my breast." I asked Dr. Gottlieb to also remove the scar tissue and lymph node on my right side while she had me under anesthesia. I figured it made sense to just get it all over with at once.
The infectious disease doctors noticed a murmur in my heart beat and so following surgery I had an echogram done. I cannot even stomach explaining this test even now. It was truly excruciating since they had to rub and push against the crater that was now my left breast. The doctors were worried that the infection had moved to my heart. Luckily they reported back that my heart was "so incredibly strong." My parents burst into tears hearing the news.
My body was not so lucky though when it came to the infection. The tests found that I had a bacteria much like an intestinal infection (urinary track infection) in my breast. I asked my oncologist if this meant that I touched my vagina then my boob. He laughed and said no, but that it was good to see I hadn't lost my sense of humor. I then proceeded to tell everyone who entered my room that my vagina had made me sick. Stupid vagina! Additionally, the tests found that I had a contaminant infection in my mediport. I am now on a series of strong antibiotics for the next couple of weeks to bring my body back to life.
Dr. Gottlieb removed two areas of scar tissue from my right armpit area. I have a teeny incision about an inch long that itches like crazy! My doctors believe that the smaller piece of scar tissue is what was reported as a "questionable lymph node" on my PETscan. Both pieces of scar tissue were dissected and tested. NO CANCER WAS FOUND. I am elated. I will be tested again in a couple of months once my body has bounced back from this surgery and the inflammation has gone down. I will have check-ups every three months to ensure that I remain cancer free.
I was in the hospital four days and despite the cancer-free news, endless love and support of friends and family and the compassion of my nurses and doctors there was a looming sadness for the loss of my left breast. My last day in the hospital, Dr. Gottlieb arrived to my room to check my incisions and remove my drainage tube. She was bandaging me back up and the tears started rolling down my face. She sat on the edge of my bed. I said, "I know I am cancer-free and that I should be so happy, but I am consumed with the loss of my breast." Dr. Gottlieb said, "Jennifer, I am reconstructing one of my patients breasts this month and she is 50 – vanity is real no matter the age. It doesn't matter if you are 27 or 50 – you are a woman and you have lost something that defines you physically in that way. Don't be ashamed for feeling the way you do … you are entitled. And believe me that every woman working on this floor who has been changing your bandages, administering your medicine, or checking your vitals aches seeing what you are going through." It will be two to three months before I will have surgery to reconstruct my left breast. This will entail taking skin, tissue and muscle from my back or stomach to create a new flap for my breast and putting in a new implant. The good news is that the new skin will respond much better than the radiated skin, it will be done by swimsuit season … and I will be able to upgrade.
Leaving the hospital my nurses cried and hugged me. Many of them remember me from my other stays. Like Dr. Gottlieb had described, I saw the pain in their eyes -- they ached for me. Perhaps they were happy it wasn't them or imagined themselves or their daughters in my place. Regardless, I just hope I made an impact. Once I arrived home I unpacked my things.
Dr. Gottlieb had left two pink Victoria Secret bags in my hospital room. One bag contained prosthetic inserts for my bra. They other bag … two sets of beautiful lingerie and Godiva chocolates. As a woman, Dr. Gottlieb also understood the pain and the loss I was experiencing. She is a class act. I was moved to tears by her kindness and compassion.
Despite my pain, I am not ready to stay submerged in the cool waters of my subconscious. As long as my heart is strong, my spirit is vibrant and my vagina is kept clean, I will continue to fight. Keep circling angels and demons above the thin surface that currently separates us ... for my work here is not done.
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