The cherry on the top

Tuesday at 6 a.m. I go in for reconstruction surgery part 2. This surgery has elicited many jokes from both husband and close friends, although the whole thing is not really that funny. You see, when one has a mastectomy, the whole breast is removed. After the implants are put in place, the boobs are in place as well, but that's it. Smooth, perfect-to-wear-without-a-bra boobs. So now it's time for the lights to be turned on. You can only imagine why this can be funny. :) I am a little anxious before the surgery, but I am not nearly as obsessed with the details as I was with the previous surgeries. And I really don't know why. I figure the surgeon has done this a million times and I can just let him do the best job he can. How does the surgeon form a new nipple? Imagine an incision similar to a three-leaf clover, where the two side leaves fold toward each other to form the cylinder and the top one to cover the top. Then he fills the inside of the cylinder with skin grafts and some other fatty tissue, and sows it all back together. After 6 months or so, when the skin has completely healed, the aureola is tatooed on, and then the job is finished. Or at least until it's time to replace the implants, because, you know, they don't last a lifetime. I figure I should really consider running for Ms. Senior Nevada, given the odds that I will be a perky 80-year old...

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The left. And the right.

It's two days before the surgery. My shoulders hurt more than usual but it could all be work related. Nothing like being on deadline to take your mind off thoughts of cancer and surgeries. Seriously. My therapist last week pointed out that my brain was clearly in overdrive, so much so that she could see it spinning around all the way from across the room. Earlier this year I learned how my left brain tends to take over my body as a mad wedding planner. It's amazing: always thinking, rationalizing, analyzing, thinking strategy, plans of attack, exit strategies.... the whole deal. And apparently the right brain is a bit suffocated. All I want to say is: "Dude, wake up! fight for your turn! I have no time to make special accommodations for you. If you don't speak up, don't blame me. I just live here." • As you can imagine, lately I have been a bit exhausted. It's hard to figure out how to take what's happening to my body and what's coming. As far as I understand, cervical dysplasia is quite common. Several of the women I know have had it and have had the same, or a similar procedure, done. (By the way, I have to note that in my last blog I incorrectly named the procedure. The correct name is LEEP, for loop electrosurgical excision procedure.) On the other hand, the beheading of the ovary is not as common, it seems. I was reading some women get emotional distress after having this done. It's interesting how you get attached to your organs, isn't it? What bugs me the most about a lot of these issues is that the common practice is to just take the parts out. But then you are on your own when it comes to deal with all the consequences for the rest of your life. Particularly with the female reproductive organs. The feel I get from the doctors is: "You are alive. You don't have cancer. Just put up with whatever happens afterwards." Is it just me or there's something wrong with that picture? Why are we always told to just deal with it? And why do we DO that? As I told my other oncologist, the medical community doesn't seem to be extremely helpful to women dealing with after-the-excision type of issues. Most women I know have found help, relief or new ideas on how to best deal with things from other women, not their doctors. It seems like you have to acquire your own internet medical degree in order to take care of yourself. Otherwise you are on your own. It's pretty scary. • So, here I am, trying to figure out the best way to say goodbye to my loyal right ovary. "I really didn't want to do this, but the doctor insists..." "Look at it this way: no more bleeding!" or "Well, it's not like I could afford to get pregnant now!" I am really trying not to think about what will happen and what could happen, but, like I said, the left brain has taken over. God save the right.

Detour ahead

A few days back I was thinking I needed to update my blog, and I remember thinking that I really didn't have much to add keeping in line with the original theme. So, I started thinking possible ways to re-route, if you will, my blog. Well, today I had an appointment with the gynecologist who would be monitoring me in regards of the effects of Tamoxifen in other parts of my body. As it turns out, it seems I have pre-cancerous cells in my cervix. So the theme stands, unfortunately. • The shock of the news was not a new feeling. It seemed all too familiar, yet I still didn't know what to think. It's interesting how your mind works in situations like these. My brain was defiant: "This is not going to get me. Been here, done that. Cancer is not going to get the best out of me." Yet my body was terrified. "Now, what?" The doctor described the procedure (which is at the hospital but out patient) as coring an apple. "Nice thought," I thought. The good news is that if the margins are clear, I am okay. Sounds familiar? I started to think my body was playing a nasty joke on me. But I am just not in the mood for jokes. Now, I feel like I felt several weeks ago: confused and tired. Very tired. I am still exhausted from the last ordeal and I really don't have much energy to face anything like this, but, I have no choice. I will have to. So, detour ahead.

Anticipation

Tomorrow is my birthday. Not a milestone in the number, but definitely one that feels different. It's hard not to think about all those sayings asking you to enjoy the present day because you don't know what you'll have tomorrow. I never thought to be on this road. About four or so years ago a few friends were eating dinner at my house. When the conversation turned about breast cancer, one of them said: "What the statistics say, is that one of us (we were eight) will have breast cancer." I remember wondering who would that be. So, I got the short stick, and here I am. First thing on birthday morning I go to see the surgeon so he can take some sutures off. My breasts are much more comfortable with the implants than they were with the expanders, but the pain hasn't disappeared. I really try not to think about it as much, but it's really tiresome to every day, every hour, every minute, every night, feel the stinking pain. Of course it is not as bad as it was, but it is. At least the rest of my body has decided to move on and pretends the pain isn't there. My head is clear and yesterday I was able to ride my stationary bike for half hour at a strong pace. I am looking forward to PT again next week. Eighty percent of my body is so ready to move on! I am starting to crave perfect nights where I sleep the whole night and I am not sore moving myself around the bed. I don't know when that's going to happen. But I am ready. This birthday is a different one, for sure. But, then again, I am alive, celebrating.

Four days after surgery

A friend of mine who had the second surgery the same week I had my first, told me this one was a piece of cake...compared to the first one. And she was right. The experience at the hospital was different because last time I passed out before they even took me out of the waiting area. And I didn't wake up until I had been in my room for almost four hours! This time I even moved myself to the operating table and centered myself on it ("Grab the edges of the table and center your butt on the table," said the anesthesiologist). That was the last thing I remember until I woke up in the recovery room. These experiences are a bit frightening, and waking up after anesthesia is just weird. But, in the end, surgery went well. And after battling a little with my high blood pressure, they sent me home Friday around 1 pm or so. Now I have to wait two weeks before I can do light exercise with my arms (I hope typing is considered less than light exercise...) and when I see the surgeon this week I'll find out when can I drive again. The other thing that is interesting, is that the pain in my chest doesn't overwhelm me as much as it did the first time. Even though all day long I am in some kind of pain, the rest of my body feels healthy, and my head is clear. I think being familiar with the pain makes it easier to deal with it now. • My mom goes home tomorrow after being with me since April. This has been the longest she has been away from my dad and the grandchildren. It will be sad not having her around but I consider myself blessed to had been able to enjoy her company and care throughout this mess. There are still other surgeries to think about, but not for three more months at least. Right now I just hope the pain stays down so I can gain some sense of normalcy soon.

Claudia 2.0

The time is here. Thursday is the designated day for my next surgery, the one that will bring you Claudia 2.0. The journey to this date has been a little stressful because I didn't realize I had to schedule the surgery way in advance in order to hit the dates I wanted. But, how would I know. It's not like I do this all the time. So, instead of getting new boobs towards the end of August I get them at the beginning of September, just on time for my birthday. The whole scheduling of the surgery wouldn't be a big deal except I had to change my mom's plane ticket twice, and she is really about to have a nervous melt down. She is so ready to go back home. Taking care of a sick person is harder than anyone can imagine. But I venture to say BEING the sick person is even harder than expected. You continue to feel crummy and tired and upset, whereas the rest of the world has moved on. You are old news, dude. The second half of my recovery has been somewhat more difficult than the first part because of this. The medicine makes my body act and feel in strange ways at random times. One day I am full of energy and the next I can barely move my bones ache so much. The weirdness is sometimes amusing, too, like when my chest went through a few days of random spastic shakes. Have you ever had your leg wake you up at night when it shakes out of the blue? Like that, except this is daytime at the office and it is your chest jumping out of your body, like a bolt of electricity hit them. It's both quite annoying and fascinating. Human bodies are such beautiful, complex machines. I remain amazed to the fact that I have two "dead" spots on my sides, where the lateral dorsi muscle was repositioned, that despite the fact I have very little sensation there, they ache and burn and hurt. How can something you don't feel, hurt? • Today I was listening on NPR's Fresh Air an interview with two young women who had cancer. One of them, Kairol Rosenthal, had a blog entry that really resonated with me. She asked if people (cancer people) liked to be called strong. She says: "I’ve surmounted these challenges not because I’m strong, but because the alternative means dying." She also quotes a woman she interviewed for her book, Everything Changes, who said: “The last thing I want is people cheering me on because I had a disease that I didn’t want, was miserable getting through, and wish I never had. That should not be my moment of fame.” In the last four months I've had many thoughts about this. You feel like you do what you have to do, just because it is the ONLY thing you can do. And when you compare your illness with other people you meet, you realize you are a wimp that barely went through anything worth mentioning. It's hard to feel like a superhero. Yet every day, every morning, every night, you battle the aches, the stiffness, the pain, the tiredness of being tired. The fact is your life changed and now you have to shift with it. There are no other options. I look at my breasts, shaped by two half-inflated bags inside me, watching how the skin has expanded to make room for such foreign objects. What was mine is not there anymore, but my skin did what it had to do: it gave me room for yet two other foreign objects that will replace my own. I am not strong, but I will move on.