Approved for Take Off

Saw my doc and everything looks like a GO for my next surgery which is to install a tissue expander. That will happen in a couple of weeks. Over time, saline will be added to the device to stretch the skin and create a pocket large enough to house a breast implant. Last time, the implant was 200 cc. Between now and then, I'll have blood tests and a COVID test and there will be some period of quarantine.

I still haven't paid off all of my bills from the last surgery and have discovered that there is no way to find out much of what I've paid has applied to my deductible. I've also discovered that some of my medical providers have been billed as out-of-network which subjects me to a much larger out-of-pocket exposure.

My healthcare is a tangled mess and as soon as I get through this, I will find a different health insurance plan because the one I have is for shit.

MRI and a waiting game

There's nothing to do but wait - to receive the vaccine, to the end of the pandemic, and for a surgery that may or may not happen in January.

My surgeon and I do not have the best of relationships, in my opinion, but it would be very difficult to find  another one to take over in the middle of this process. I try to be polite, compliant, and as trusting as I can be. My experience, however, is that he could change his mind at any moment as to what he will do so I can only hope things will go as planned.

The plan is to have surgery to place a tissue expander where my right breast used to be for the purpose of preparing a pocket large enough to house a breast implant at some time in the future. Over time, the volume of the expander is increased until it's the size I want to be - ideally, the same size as the left breast.

I don't know what size I am because I haven't worn a bra since March of 2019. After my mastectomy and earlier reconstruction, I never got fitted for a new bra. I've been wearing what is referred to as a soft bra. It is, indeed, soft and comes in sizes such as small, medium, and large. If I had to guess, my cup size would be an A but a Nordstrom employee who was helping me in a dressing room once upon a time in 2019 opine that I was a B. No matter. I'm not going for anything big. (The implant that was removed was a 200 cc if that's any reference at all.)

In the meantime I had an MRI to confirm that whatever scant tissue is still there continues to be cancer free because in no way to I want to proceed with additional surgery only to find out it might need to be undone yet again. I'd forgotten how loud that machine is and wondered if the noises I was hearing were similar to noises produced in torture. I fared well, remaining calm throughout, but I don't know about the angry, aggressive rock "music" that I've heard is also used in torture. At least it wasn't as bad as that.

The MRI revealed that I continue to be cancer free. Now, all that's left is the wait.

My Knockers are Huge

" Knitted Knockers are a light comfortable knitted prosthetic that when placed in a bra has the shape and feel of a real breast, and are more comfortable than silicone prosthetic breasts. "

Someone told me about Knitted Knockers and learned I could get some for free. After I had a breast removed, I quickly became comfortable in my own skin - something I was worried about before my surgery. I was okay with the image presented to me in my mirror but after a relatively brief recovery, I started to worry about how I would present myself to the rest of the world.

As if it should matter.

I was told I could pick up some Knitted Knockers at the cancer center. Indeed, I was given me a bag full of knockers, all of them ridiculously large. I had four pairs of knockers in various sizes and even the smallest were larger than I was previously or ever hoped to be. I pulled some of the stuffing out of one of them and used it to pad my bra. The rest, I returned for someone else to use - someone who had been substantially more endowed.

By doing this, however, I missed an opportunity to play a practical joke on my brother-in-law and his wife. I was going to see them for the first time since my surgery. Thinking of this too late, I could have worn a (greatly reduced) knocker inside my shirt but not where my boob should be - maybe higher and closer to my shoulder - and waited to see how long before they said something (if at all). I could have let it fall, sliding down to my waist, and acted as if I didn't notice that anything was amiss. I could have worn the knockers as they had been presented to me, going from barely noticeable to a double D!

Sadly, none of this occurred to me before I arrived at their house. Cancer isn't funny but there's no reason we can't use humor when coping with it. I didn't get to play my joke on my in-laws but we still had a laugh over it anyway. As for the other knocker - the one I'm not using to stuff my bra, I find great humor in watching my cat bat it about my apartment.

jk - I don't have a cat but the image cracks me up.

How aware of breast cancer do you really want to be?

Do you want to see a woman with only one boob? Maybe you don't want to be that aware. (How about that for spooky?)

Remember when it was daring to go without a bra? What if women with breast prostheses didn't wear them in October? 

How aware do you really want to be?

Sadly, far too many are aware of breast cancer already, one way or another.  Me, I'm living through it a second time. Sort of. My cancer was sooooo 2019. Among the other challenges 2020 has brought, I am facing reconstruction of the same breast for a second time. 

The implant didn't fail, my skin did. A spontaneous wound appeared exposing the implant to contamination which meant the implant had to be removed. I could theorize as to exactly why a wound such as this might occur but the most basic of answers is the skin tissue was too thin, weakened when a hematoma was drained at that location less than a week after last year's mastectomy.

Rare, they say.

Hopefully, awareness will bring change. Actually dollars, one hopes, for research, for a cure. My challenges are relatively small (pun intended). I want to bring awareness in a different way - one that isn't pink and cheerful. I don't really want to be a part of this survivor/warrior/I-kicked-cancer's-ass club. 

Oh, I'm surviving. Better than that, I'm thriving and to be honest, I feel great in my own skin. Far better than I expected I would. For the first time in my life, I feel comfortable not wearing a bra. My husband's regret is that I didn't discover this freedom back when I had two boobs.

I'm discreet in public so don't worry about being too aware of breast cancer in the grocery store, say. But I might be wearing a hoodie that says "Uniboober" on it. Or, "one headlight." Or glasses that read, "My boobs were down there."

Sorry, breast cancer isn't funny. But at some point, one gets tired of crying. If you're facing now, I hope you're hanging in there.

What the actual F?

Good evening and welcome to "What’s Going on with My Boob?" This episode includes a deep dive into what the actual fuck wherein we will look at who said what to whom and when.

First, we have Dr. E who, if you remember was convinced that Dr. M refused to get involved my treatment. Dr. E now recommends that the patient (me) see Dr. M.

Dr. M now has to answer the question, "What the actual fuck?"

Join me as I interview multiple doctors, surgeons, and heads of very important departments as they all evade actual responsibility for my case. (Maybe they should run for office.)

Do I have cancer? No.

Do I have symptoms? No.

Am I overreacting? Probably.

But, then again, who knows? Stay tuned to see what does or does not develop.

Into the tunnel

And, so, the journey to healing begins. In reality, it probably began when I first sought medical attention. It's the first step in finding a way to be free of a disease or, in this case, free of a condition (that of having an open wound exposing me to infection). You could think of surgery as the beginning but it's really somewhere in the middle. Seeking answers is probably the beginning. Even before, being aware of a problem. 

Each step after that is toward some goal or resolution. Each decision is with an image in mind, a vision of the end result. 

There's a certain "been there, done that" (don't think they have a t-shirt for this yet) mentality this time around. This particular journey didn't start with a diagnosis of cancer. Rather, it is a Groundhog Day version of reconstruction, jumping into the middle of a story already in progress and getting stuck in an never-ending loop. (Although, I sincerely hope this is my last time around this particular track.) My point being, I think even my healthcare providers expect I know what to expect.

With the cancer diagnosis I was guided through every step. I had a three-inch binder telling me everything I could expect. This time, I'm asking my surgeon's staff things like, "should I sleep on my back or be propped up on pillows?" They look at me and blink saying, "I don't know. I'll ask the doctor." And, then, they never get back to me. In a perverse way, I'm glad I had cancer last year. At least, I received the tools I need to take care of myself this year.

Hubby is the same. He's been great in the Picking Up The Slack department though I was pretty well organized before the surgery. I got stocked up on groceries and had meals in the freezer. The laundry was done and the sheets had been changed. He hasn't had to do much but I'll give him 5 stars for letting me do nothing.

In the In Sickness or In Health department, I would give him 3 stars. He hasn't been attentive to my schedule regarding when to take my medications (or times when I need to eat so I can take my meds) or when to empty my drains. I've done that mostly on my own. But, when it came to taking off my bandages, he was right there beside me as I saw myself for the first time without one breast. We dealt with my body's new image together and it was fine. We were ready, supportive, and caring.

He gets no points for Pampering. I have had zero coffees in bed. Just before surgery, my office mates ponied up a total of $45 to be added to my Starbucks card for my birthday. (They know me so well.) I was already in quarantine in anticipation of the surgery so I couldn't go out to get one for myself and I didn't want to risk Hubby bringing home something more than coffee by going out to get it for me. I told him that I was looking forward to have a triple grande soy latte in bed the day after surgery - the popsicle to my doctor's visit - but three days later, it has yet to materialize. 

I'm griping now because I actually made him coffee.

Maybe it's more than my body that needs to heal!

I can tell you that regrets and unfulfilled expectations are no salve and won't do anything to help my body heal. Moving forward, trusting, being patient, and accepting my image as it is - that's what I'm learning. And I'm also learning that small kindnesses are important to me and that it makes me feel good when I do those things for others. 

The surgery went well. The pain and bleeding were minimal. It's only the drain that bothers me now. It's in a very awkward place and I keep getting tangled in the tubing and yanking on the stitches. I'll ask if I can get that removed tomorrow. 

Despite the lack of bedside coffee, there is a light at the tunnel. It's bright and joyful and I'm headed straight for it. All will be well enough.

You said it, sister.

Astra understood how I felt but also confirmed that DCIS is referred to as “Stage 0,” a “pre-cancer,” and sometimes, even, a “non-cancer.” It was validating for her to tell me that sometimes a diagnosis of DCIS is even harder than, say, a diagnosis of Stage 1 because it’s not something you can see. It’s not something you can feel. It’s not invasive. Yet, it’s treated exactly like any other breast cancer. The only evidence of it is a few tiny white grains on a grayscale image and a single core needle biopsy. It represents a tiny amount of information upon which very big decisions must be made in a very short period of time.

This is an undated entry in my journal from last year.

A few tiny white grains begot a mastectomy and now second one - only this time, I won't be able to do immediate reconstruction. This, I learned today. It's not what I wanted but it seems it's the only option at this point.

A surgeon will remove my breast on October 8.

All in all, it's not the worst thing that can happen. Shit, a friend of mine just let me know their son died of an accidental overdose. That would be worse. 

On the other hand, I'm not sure pain is relative except as to oneself. So, sucks for me.

I'll get through this. Really, I can do this. It'll be bumpy (bad choice of words) but at the end of the road I will be (theoretically) restored. It'll take time, patience, and trust - and I'm not necessarily good with any of those things.

In the meantime, I'll try to amuse myself by designing snarky breast cancer awareness apparel. For example, a pink hoodie that reads "uniboober."

And, maybe I'll eat more ice cream.

A doctor a day keeps the apple away.

 Oh, wait. That's not how it goes, is it?

October is Breast Cancer Awareness Month

 Can I say I would rather not?

I want to get this off my chest

My Boobs are Trying To Kill Me

I never wanted to tell you that I had cancer

I don’t wear pink

My Eyes are Up Here

Nipple

These are all titles I considered last year as I pondered whether to write about my cancer journey. The first title was something a dear friend said to me. The five year anniversary of her Stage 1 diagnosis is this month. (I love you, V, and I'm hella glad your boobs didn't kill you because I need you to get me though this!)

I told as few people about my cancer as I could get away with. I tole my immediate family, my employers, and the friends I saw nearly every day. Otherwise, I didn't want to make a big deal of it. Whatever I was going through, it wasn't as bad as so many other cancer patients, past and present, had it. Regardless of what I was personally going through, it felt like sympathy was not warranted. 

I have two pink shirts. I wear them rarely. I'm just not a pink girilie-girl. Grew up with boys, had only boy cousins for (30 years), and had boys. I have one grandson. We get along fine. I have no idea what to do with my granddaughter when she asks me to do her hair. Needless to say, I'm not comfortable wearing pink to show my support for breast cancer research and survivorship. Don't get me wrong, I support both of those things. I just don't feel like advertising my own situation.

I've never really had a problem with guys staring at my chest (because my boobs were so small) but it's a common complaint among women and now that all of my focus was on my boobs, I imagined everyone else's was, too. I was still here, though, and I wanted to people to see all of me.

Finally, "nipple" is a word that gets used with alarming frequency in the early stages of breast cancer. It's practically (and, in fact, was) dinner conversation with - well, everyone. It's all about the nipple. Can it be saved? Can it be reconstructed or tattooed. Are there nipple prostheses? The answer is yes to all of them but here's the thing. If you're going to have breast cancer, you and the people you're closest with are going to have to get comfortable with the word "nipple" because it will be used frequently in the first several weeks. A lot.

The title of this post is my attempt at humor. I wanted the cancer off my chest. (Sadly, now, I'm getting my wish.) There was a time I wanted the implant off my chest. I wanted to get all that I was feeling - am feeling - off my chest. 

I just want it to be over as I'm sure so many other cancer patients do. I'm just doing the best I can. I hope you are, too.

What happened?

There's a hole in the bucket, dear Liza, dear Liza ...

Then, fix it!

There's a hole in my boob. I don't know why. It's about as big as the o in boob. Not big but big enough to to introduce bacteria to the implant.

Hello, implant. Meet bacteria.

I can actually see the implant through this hole.

A tiny window into my soul??

I've had an open wound, now, for over a month. Antibiotic medication seems to be keeping any infection from becoming serious. The surrounding tissue looks fine, there's no fever, and no elevated white blood cell count. Can't we just put a bandage on it? 

The answer is, universally, no. If you search for "implant extrusion," you may see the words "rare" and "dangerous." (You may also see some disturbing images so do so at your own risk.) Yet, not one doctor of the five I've seen so far has bothered to offer one.

The chances of it healing, I've been told, is zero. For a variety of reasons, the chances that any patch would hold is nearly zero. I don't want to believe this and yet I have no reason to believe my doctors are not well trained. Even the inter webs agree with science! 

Still, I hope. Even as I plan to move forward with surgery. 

Correction, surgeries.

I'm about to lose my boob for a second time for a cancer I didn't have

While this site was created during a time when I was experiencing extreme back pain, I've more recently been experiencing issues with the flip side. Namely, my breasts. The journey, to date, has been these last 20 months. 

It began with a diagnosis of breast cancer. It was in situ, referred to as Stage 0, meaning there were cancer cells found in milk ducts (of one breast, in my case) that were not yet invasive into the breast tissue (which begins Stage 1). For many reasons, a unilateral mastectomy was recommended. 

Because my diagnosis was Stage 0, it is referred to, by some, as a non-cancer. One oncologist did just that not long after my breast was removed. 

It felt like a slap in the face.

Fast forward to today, it is being recommended that my breast be again removed. This time, it will be an implant rather than breast tissue but I will still need to face the painful task of reconstruction for a second time (in as many years). The process will take months, over three calendar years. Three maximum out-of-pocket deductibles.

This non-cancer will cost me $20,000 before it's over and my insurance company an estimated $150,000.

This new boob had better be pretty spectacular.

In fact, I've already pondered whether we could add a squeaky valve while we're at it. It would be a wildly inappropriate party trick to squeeze my boob and have it squeak. But for a hundred and seventy grand, it really should do something.

[Update: if I include the amount my employer paid to hire a temporary replacement while I was on sick leave, the total cost of my fantastically unfantastic boob is closer to $200,000. If my entire body was valued at the same rate of $200k per .44 lb, I would be worth more than $56 million. Take that, Jaime Sommers.]