Cancer & Cupcakes...well, maybe a little more cancer than cupcakes these days.: I'm Living With Two Attempted Murderers!!

"Girls have got balls. They're just a little higher up, that's all." - Joan Jett

Warning content may not be suitable for all ages, men, and people who simply cannot handle TMI! I cannot be held responsible for those that decide to read further...

It's Monday and a day that I have been looking forward to, but I have also put off. Today, I meet with another plastic surgeon. I had originally met with one in Joliet, but decided that I would get a second opinion. I have mixed emotions about today and I am sure that is why I took so long to make the appointment. My original doctor/surgeon is someone that I completely trust and respect. We had ten good years together and she was the first person that was called when we knew my breast cancer was back. The thing is, I need to find two doctors that I trust and want to move forward with in this journey. The surgeon who spearheads the modified radical bilateral mastectomy and the plastic surgeon who does the reconstruction. And in the ideal situation they will do the surgeries on the same day so that I only have to go under anesthetics once and not have additional surgeries. So, I have to find a matching "set" to remove and replace my not-so-matching set. It is hard enough to locate one doctor that you like and get on the schedule and now I need to find two. While Dr. Marshall works with great plastic surgeons I don't believe that they are the "right" surgeons for me. I gave them both the benefit of the doubt and met with both. One during my first battle and one shortly after I was diagnosed. I can't pin point why I am still shopping for a plastic surgeon, but the reality is that I am. The sad part is that if I decide that I like this plastic surgeon I will be deciding not to go with my trusted surgeon Dr. Marshall. A decision that I don't want to make, but one that I am prepared to make and one that I am confident that she will respect.

My day starts with a shot at Amy's house. Yes, I am on a series of Ground Hog Day experiences. This is the sixth of seven days. She's probably tired of seeing me. The girls are at school and it is just me, Amy, and Andrew. He wouldn't put on pants but he did put on his hat to match mine. He'd be great to wake up to each morning! I'm enjoying seeing them each day. Today I was in and out quickly because I needed to get back to a few hours of work before I leave for Loyola.

After a couple of conference calls I head to Cindi's to pick her up for my appointment. Cindi has been great for appointments that need questions and need an additional set of ears to hear the answers. NEVER go to appointments alone when you know you need to hear all of the details, ask a series of questions, and remember it all after the fact. On the way to Loyola we have time to talk about what will happen today and the questions that I will ask. We discuss that I want to go much smaller in size and that I am mentally prepared for the surgery. I'm just ready for a plan of action, dates, and a doctor to be chosen.

These decisions are not hard for me to make. I have known that I was getting a bilateral mastectomy since the moment I knew that my cancer had returned. The reality is that I could wait until genetic testing and potentially make a different choice, but this is the right decision for me at this point in mt life. This is a decision that I will never second guess. I'm living with two (allegedly) attempted murderers and I know that they must go! Plus, my breast have looked like the belong in National Geographic because of their difference in size...Stephanie's description, not mine but she is right. The mastectomy will remove all of my breast tissue, nipples, an ellipse of skin, and lymph nodes under my left arm. This is the most common type of mastectomy performed today. The surgery leaves women with a more normal looking chest shape and scars that are not as visible in clothing. It also allows for immediate or delayed breast reconstruction. Because I am very well endowed I will have the opportunity to spare some of my skin and have immediate reconstruction after the mastectomy is performed.

We arrive at the main campus of Loyola and head to the check-in area. This is one area that I have not been in yet. I go to the desk and Cindi wipes down my chair with her antibacterial wipes. I laugh, but know that it is need. There are few places with more germs than a hospital. I pay my co-pay and then we started researching questions and start making a list. Cindi calls Jeff for ideas. We have a full page of questions and two pages marked on my iPad. Then I hear "Susan"...that's me. We head back to an office and sit with a Nurse Carol in a room. She asks a few questions to get us started and then hands me a gown and tells me to get "undressed from the waist up with the opening in the front". Directions that I have heard more times than most will hear in their lifetime. Before she left I decided that I need to go to the bathroom again. I blame my last battle with cancer for my weak bladder, but I think it is completely psychological. I just know that I will need to go when I can't go, so I go. I quickly go back to the main waiting area and then return to the room. There are a bunch of doctors waiting in the hallway. I quickly change and then two men enter the room. One is Dr. Erik and one is a student named George. May I simply say that Dr. Erik is adorable. Smart, quirky, a little nerdy, and handsome. Completely my type, but wearing Crocs. He had me at hello, but lost me at the Crocs! :)

I am on the table, Cindi is in a chair, Dr. Erik sits where I would think a doctor would sit and George stays along the wall by the door. He ends up being like a "fly on the wall"...literally. He said nothing. Dr. Erik starts asking many questions and then starts explaining my options. The options are many. I can remove one breast, I can wait for genetic testing to come in then decide, I can get a tummy tuck and then have the fat from my stomach made into breasts, I can remove fat from my back and make it into breast, I can...ok, enough on the options. I stop the conversation and ask "are you going to be my doctor?" You see, Dr. Erik is not who I scheduled my appointment with, but he is the one that is giving me all of the details. Come to find out that he is Dr. VanDevender's Fellow. (A Fellow is a doctor that has completed his residency and has decided to add an additional period of medical training in his chosen specialty. Fellows are capable of acting as attending physician or consultant physician in the generalist field in which they were trained, such as plastic surgery in this case. After completing a fellowship in the relevant sub-specialty, the physician is permitted to practice without direct supervision by other physicians in that sub-specialty.) Once I get that out of my system I am able to move on with the conversation. I think he took offense to my question, but I need to know the answers to things. Plus, I know what I want and tell him that I have already chosen to do a bilateral mastectomy with immediate reconstruction. He respects my decision and goes into greater detail about the procedure, potential complications, and many details. Cindi and I then begin asking questions off my list. Here are some that were asked:

What kind of clean bill of health will I need for surgery? I would simply need to heal from chemo.
Would I qualified for immediate reconstruction? Yes, but it depends on my body and the type of blood vessels that are in my breast tissue and skin.
Will I need tissue expanders? This depends on the surgery results and blood vessels
What will the scarring be like? The scarring is minimal and depends on the surgery
How do you partner with the breast surgeon? They work in partnership on a regular basis. And they only work together on Wednesdays.
Will I have drains? Yes. At least four drains and possibly more...then the conversation got fuzzy

We were doing just fine with the question and answer session. That is until I asked about drains. The answer made me nervous, made the temperature in the room rise, and made me ask if they mind if I take my scarf off. I guess the explanation of the drains caused me to go into the "fog" that I have been in before. Cindi caught it right away. I caught it right away. Thankfully I was able to remove my scarf, cool off, and continue the conversation. I think I made George nervous at this point. The questions continued:

Will I have loss of motion? No
How quickly will I be able to work out again? After 6 weeks of recovery
Does that workout include kickboxing? NOT after only 6 weeks of recovery
May I see pictures? Marilyn will show pictures
May I have a nipple sparing surgery? FORGET IT GIRL! (this is what Cindi wrote on my notes.)
What is the length of the surgery? 4 - 6 hours
What type of implants do you use? Silicone (and he goes into great detail. Apparently the doctor can stand on the implants without breaking them.)
How long do implants last? The manufacturer says 10 years, but they should last the rest of my life.

The questions went on, but there was one on the list that Cindi would not ask. She laughed and said "I'm not asking that question!" So I had to ask it.

Can you do surgery and make sure that I don't have side boob?

We all laughed a little with the question but I'm 100% serious! I want to be perky, a full B cup, and not have side boob for the rest of my life. Something good needs to come out of all this! Then we talked about nipple reconstruction and areola tattooing. This was info that I knew could happen, but Cindi had no idea. She said "Get out! You can tattoo your nipple?" Dr. Erik went into great detail about the nipple reconstruction that can take place after I heal from surgery. It is actually interesting to hear the procedure and we both learn a lot of information. In modern approaches to nipple reconstruction, the nipple mound is created from skin taken as a local flap on the reconstructed breast. He drew a picture of what it would look like. He may be a good doctor, but he needs to take art lessons. Most doctors attempt to draw, but I've never seen anyone that can do a great job at it. The areola can then be tattooed on at a different time and location. The tattoo tends to hide a large portion of the scar on your breast. Some women are comfortable without having a nipple and I will have time to make this decision.

I think Dr. E had enough of us at this point so they left to get Dr. VanDevender. While they were gone Cindi went to find me a drink and came back with orange juice. Just something to keep me going if the conversation turns to drains again.

Dr. V (as he said I could call him), Dr. Erik, George, and Nurse Marilyn come back in the room. It is a full house today! Dr. V introduces himself and has been caught up on the conversation by Dr, Erik. So, we are able to really talk in great detail about things. He wanted to know what size I would like to be and I told him a B cup. I think he was a little shocked because I am currently a DDD and a DD...ok, they do not match. Not even close. Once I had radiation on my right breast in 2001 it did not grow, but the other side did not stop. We continued the conversation about size. Me, Dr. V, and Cindi. The others were just observers at this point. I would look at Cindi for the answer and then tell the doctor. I kept looking at her and then he would look at her and then I realized that we once again had put ourselves into a situation where the people in the room think that Cindi and I are life partners. So I feel the need to make sure that they know we are just friends and she is married. It was just a funny point in the conversation and Dr. V ended up having a great personality. The only reason that I looked to Cindi in the conversation is because I know she understands what it is like to have large breasts. The back strain, the difficulty finding clothes that fit properly, the constant need for a bra, etc. I currently wear a strapless bra with my bathing suits. I am so done with that! Dr. V was still concerned that I was going to go too small and then regret my decision when I came out of surgery. With his concern in mind he asked a simple question:

"If you can only pick ONE would you be an A cup or a D cup?" My answer is quick, simple, and without regret..."A!!!" That's an easy answer. He laughs and says that he likes that he thought of the question and the he trusted that I was ready to go smaller. So he decides to exam my breast and take measurements. There is a curtain that separates me and the doctors from Cindi and George. They pull out tape measure and takes measurements of my breast, the space between them, the space to my collar bone, the band size, etc. I think they are even in shock of the difference in size in my breast. He continues to explain that immediate reconstruction is not a guarantee, but I have plenty of skin that would allow for it in the blood vessels are in my favor. In all, we spent about a couple of hours with the doctors. They are knowledgeable, confident that they can make me look good after surgery, and Dr. V only does breast reconstruction. All the questions that I could think of were answered so we started to say our goodbyes. Then I thought of something. I looked at Dr. Erik and said "Why do you have tape around your shoe?" Here is a doctor that I am going to trust to get my body back to "normal", but he's wearing black Crocs and one has white medical tape wrapped around it to hold it together. Maybe this man cannot be trusted. ;) Apparently it is a medical school thing and a superstition thing. They try to keep their shoes held together until they are completely done. I think it looks like he can't afford to get new shoes and suggest that Dr. K buy him a pair for the holidays. We all laugh. Dr. Erik is still adorable...and even more quirky than I had originally thought.

After the doctors leave Nurse Marilyn comes back with a book of information on the implants and discusses the doctor's calendar and how to arrange for surgery. The conversation leads to the tattooing and I ask if it is painful. It is then that Marilyn tells me that I will not have feeling in my breast after surgery. I'd never really thought about that before. By removing all of my breast tissue I will remove all the nerves and sensations that may occur. It makes it all seem so real, so scary, and so permanent. I have always had very sensitive breasts and they will be no more.

WE sat in the office today and WE met the men that will do my plastic surgery. Doctors that I trust and have a good connection. This also means that I have chosen my surgeon and the hospital where I will have surgery. Dr. Constantine Godellas (who goes by Dean and I just don't get it) will do my breast surgery. Dr. VanDevender & Dr. Erik will do the reconstruction. Surgery will be done in December at Loyola. I will be in the hospital for two nights and recovery will take 6 weeks. FINALLY a plan in place. A plan that I put off, but I am now looking forward to. But also a plan that means I will have to give up a doctor that I respect, trust, and care for. In my heart and mind I know this is the right plan, but I can't help but be a little sad.

Cindi and I leave the hospital and head to dinner. She only agrees to go if I tell her we can get dinner. :) We go to Oakbrook and she does some shopping and the we eat at Wildfire. We talked a lot about the doctors, my decisions, and the process. After the entire day and dinner conversation I am very comfortable with my decision that was made today. Now I just need to get on their schedules. Dr. V has three Wednesdays that he is available in December and now I will need to see what Dr. Godellas has available. Fingers crossed that it all works.

We stopped at my favorite place on earth, Von Maur, on our way home. Cindi shops some more and I help spend her money. I'm a good friend like that. She then hits the reading glasses counter and we strike up a conversation with the girl working there. She thinks we are either sisters or partners. Seriously, we have to start adding Jeff's name into more conversations. It is just a funny end to a long but good day.

So, I am a few months away from getting rid of my enemies for good! Having a bilateral mastectomy does not mean that I have a 100% chance of never getting breast cancer again, but it is a decision that I am 100% confident in making.

Off to bed after a long day. I have chemo this Thursday and I need my rest.

XOXO,