Friday, July 4, 2008


My oncologist, Dr. Villa, has always been one who shoots straight from the hip. She was clear on that very first day in her office that I would need a mastectomy. Ultimately she would lobby for a single, calling my urge for a double mastectomy "an emotional response" and medically unnecessary until we knew the results of my genetic testing.

All emotions aside, I knew I wanted a double mastectomy for several reasons. There was an emotional component in that I never wanted to experience that phone call - "It's breast cancer." - again. Removing all of the traitorous breast tissue in my body seemed the most expedient means toward that end. But there were other reasons equally as weighted.

The Girls had always been very large. "Huge tracts of land", is how Daddy-O and his English mates referred to their like. Don't you love how the English turn a phrase? I couldn't imagine spending the rest of my life so unbalanced. I imagined a two-humped camel with one hump missing, traveling through life disfigured with either a hump on it's shoulders only or worse, a flat back and a hump on it's rear-end. Then there were the physical consequences of being so lopsided: back problems.

Yes, I was absolutely, firmly for a double mastectomy. Yet, I had a single. Yes, I buckled. I am a sucker for the rational and practical. Calling my decision an "emotional response" caused a knee-jerk fear of potential regret. So I didn't ring the bell that couldn't be un-rung. Yet. But I did later when the genetic test came back positive for the BRCA2 mutation. With my gut instinct vindicated I had them lop off the rest of the potentially mutinous breast tissue with reconstruction.

Word to the Wise: Trust yourself. Know yourself. If you want a double mastectomy and you are being persuaded otherwise, follow your heart. It is your body. You, and only you, must live in it.

That was another consideration in my decision... reconstruction. Oh how inviting the thought of buying bras in normal sizes and cute colors. The wardrobe potential alone was enough to start me daydreaming... Not to mention the budgetary boon of eliminating chronic chiropractic care. SOLD. The girls and I were downsizing!

Once my reconstruction options were laid out for me, DIEP Flap or nothing (watch this cool 3D version), I had second thoughts. The surgery was anything but simple. The prospect of not lifting my baby for 3 months was daunting. My family and friends were completely against the surgery. The scars are giant, the recovery long and the surgery intense. The surgeon was also out of network for my insurance company so I would have to pay his $10K fee on my own. I was also anxious to return to work and get my life back to normal. No small issues, these.

Daddy-O and I discussed reconstruction at length. He was very supportive but not much help. It didn't matter to him, he said. He'd love me the same either way. Just what I needed to hear but still no help for making the decision. Ultimately I had to examine my own feelings on the matter.

After many, many hours of introspection I came to one simple conclusion. I was only 40 years old. I hoped to have many, many years left in my life. Years in which I intended to feel sexy and sensual. Emotionally I wasn't sure I would feel that way breastless. I certainly didn't in my current state of disproportion. In general, not having reconstruction felt like I would be giving up, acknowledging that cancer would ultimately win. I felt that rebuilding my body was tantamount to rebuilding my life. A physical manifestation of the hope and faith in my ability to survive. In short, planning for the future.

So I did it. And I have never regretted it once. Not during the long weeks of recuperation. Not when I couldn't lift my baby. Not when I saw the giant nasty scars. Not once. Not ever.

I thought maybe I was the only one who felt like that. But according to this article I read this morning, women who have reconstruction experience lasting psychological benefits.

Validation. At last.

This has been cross posted at Mothers With Cancer.

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