N.I.P.P.L.E.

3-21-2021

There are certain words in the English language that have a tendency to make one cringe. Some of these words are: moist, phlegm, crevice, mucous, damp, discharge and smear. Added to my own personal collection of wince worthy words are breast and nipple. I can not tell you why I loathe these words, but for nearly 30 years my husband has heckled me by singing the “nipple song” any time the word nipple has been uttered. If you remember the old “Cheers” episode where Woody sings the K.E.L.L.Y. song, then you know firsthand how the tune goes. I never thought nipple and breast would be two words that would come to dominate my thoughts and conversations, but here we are.

Since my last post, I have met with a plastic surgeon and have my Bilateral Mastectomy with hopes of direct to Reconstruction scheduled for Friday, April 2nd. I am hopeful an operation set for Good Friday is a positive omen.

My meeting with the plastic surgeon was interesting. For over a year I have researched and talked about this surgery, so I feel I had a decent idea of what I wanted going in. The doctor was sufficiently confident and explained things as anticipated. From the beginning of all of this, I was shocked to realize there are so many options when it comes to reconstruction. I feel it might be helpful to someone just starting their journey to review some commonly used terms, so I’m going to do that here. Please keep in mind, this is my own interpretation of each definition and I am clearly not a physician. I’m just a girl sharing my experiences and story with the hope someone finds it useful and a bit encouraging. Here are some of the terms one might encounter when traveling this path….

Mastectomy – The removal of all breast tissue.

Bilateral – Both

Remaining “flat”. – Pretty much self explanatory. The woman chooses not to have reconstruction after her mastectomy. While some ladies choose to wear special bras or prosthetics, an increasing amount of bad ass gals choose to rock the “flat world”. I have known from the start I would not be someone comfortable enough in her own skin to go flat, so reconstruction has been the area I have placed most of my research.

DIEP Flap – In a nutshell, once the breast is removed, the plastic surgeon takes blood vessels; along with the skin and fat that is attached to it from the belly area and transfers it to the chest area to sculpt a new breast mound. This is obviously an intense procedure. It comes with a lot of risk and an extended recovery time. In an ideal world, this would be my first choice. I like the idea of having my own tissue creating my new boobs. However, after much discussion, thought processing and praying, I have decided not to pursue this route. At least, not now. I am thankful for my surgeon’s honesty and feel the risk of permanent/annoying side effects is too great. If the implant route doesn’t turn out the way I’m hoping it will, I will revisit this option in the future.

Implants – since we live in a time that is uber sensitive about looks, I am sure you are all familiar with implants. The two types to choose from remain steady with saline and silicone. Thankfully silicone implants have come a long way in the last twenty years. My physician is confident that changes in silicone are for the better and no longer carry the health scares of the early 2000s. Apparently, the silicone tends to be less heavy and feels more natural. I’m not convinced they are ever going to feel natural, but silicone is my current choice.

Skin Sparing Mastectomy – This procedure leaves the skin, but removes all breast tissue, nipple and areola. The scar you are left with is horizontal across the chest.

Nipple Sparing – This procedure removes the breast tissue, but leaves the skin, nipple and areola intact. The scars tend to be a U shape under the breast and a line from the bottom of the nipple down. There are other approaches, but this was the one my doctor reviewed with me.

Expanders – The ultimate goal is to be able to perform the double mastectomy and go straight to implants, but there is no way to know if this is possible until the tissue is removed and the skin is examined to be sure it is strong enough and elastic enough to hold the implants. If it is not, then expanders will be inserted. Expanders basically act as temporary water balloons. The balloons that are initially placed have a small amount of saline. More saline is added every couple of weeks until the desired size is achieved and then a replacement surgery occurs.

So many decisions to make, right? The kicker is, I will be going into surgery in 12 days time, but really have no idea how I will come out. The ultimate decisions lie in the hands of the surgeons, and there will be two main surgeons performing the surgeries. One will remove the breasts and one will rebuild them. Once they are removed, I imagine they will work together to see if I’m a candidate for implants. If it’s a go, the plastic surgeon will have the final say as to what size is chosen. If you think of the surgery like removing a pillow from the case, you have a decent idea of how it will play out. The breast oncologist will be removing the inside pillow and filling. The plastic surgeon will assess the size of the remaining pillow case and determine if a standard size or queen size pillow fits best. My future pillows are in his hands, but one thing is for certain, king size pillow are not in my future!

As I inch closer to this surgery, I find my emotions are all over the board. I imagine being thrown into menopause in December isn’t helping, but here are a few things that have played on my mind. I have either learned them along the way, or simply want to share, as they have occupied some of my mental space over the last 14 months.

If you know someone who has dealt with a double mastectomy or needs one in the future, please be mindful and know…..this is not a boob job!! What? What? Let me repeat this for those in the back of the plane …this is NOT a boob job!

• The definition of augmentation is – the action or process of becoming greater in size or amount.

• If someone had their leg amputated…you would not say “oh, lucky you…you’re getting a leg job!”

• Breast tissue can go all the way up to the collar bone, down to the ribs and span under the arm pit. Again, not a boob job. Breast augmentation enhances what is already there and your existing tissue acts as a “filler”.

• Most of, if not all of the feeling will leave the breast area. Some sensation MAY return, but it will never ever ever be the same.

• I understand some people don’t know what to say and making light of the situation is their way of trying to lessen the awkwardness, but I can not express nearly enough the fact that this is an extremely hard and emotional decision. I can’t imagine anyone taking the decision lightly, as it will forever alter them in some way, shape or form.

I hate all things Covid related and could not be happier knowing that by getting vaccinated, I will be heading into this surgery a lot less nervous about contracting this stupid wee invisible beastie.

• I hope no lady has to face a pandemic once finding out she has the BRCA mutation.

• If Covid was not happening, all of this would be behind me and I would already be pretty far down the path to recovery.

I have certainly come to realize who is in my circle of support.

• I am blessed beyond measure to have so many people in my circle! They are who will get my love and admiration for the rest of time.

• I hope I never have to live through another pandemic. I love spending time with my family and friend. The time we have spent apart makes the time we get to spend together even more precious.

• If you haven’t been here for me through all of this, I get it, it’s fine. Please understand, you reap what you sew. And although I will probably be there for you in some capacity in the future, it will not be nearly as much as I would have been before all this shit. Oh, well. Such is life in the big city.

I will not miss all these appointments!

• This is a process, which has required a lot of appointments.

• We have been to Pittsburgh more in the last few months than we have in years.

• I am looking forward to the days when overnight stays in the city are for fun adventures and not doctor appointments.

• The day of BIG appointments is tomorrow. I am scheduled for a pre-op clearance, a diagnostic mammogram, a pre-op with the breast oncologist and a breast MRI.

I am sure I could come up with loads more to say, but we are going to take this opportunity to meet friends for dinner and toast the start of the final leg of this part of the journey. If you don’t mind throwing some love and good vibes into the atmosphere, I would appreciate it. The appointments tomorrow will be the last time my boobs will be scrutinized for the presence of cancer. Fingers crossed all scans are clear

Until next time, squeeze the ones you love and never take them for granted. If there is someone you are thinking of, give them a call or send them a text and let them know. You won’t be sorry.

Peace,

G

Today’s song is one that reminds me that as much as I want to be in control, I’m not. There are always external forces at play and sometimes I just have to let those forces guide me through the difficult times.