April 1, 2014

Mastectomy Made Simple

Heidi is halfway through a year of treatment for breast cancer, and she's talking some time to reflect on where she's been – including her recent mastectomy.

At the start of my breast cancer experience back in September they said it would be a process that took a year and they were not kidding!  

Here are a few background details about my cancer which are important to share because if I have learned one thing through this process it is that not all cancers are created equal.  In September I was diagnosed with Stage III Invasive Ductal Breast Cancer in my left breast.  My cancer was triple positive which means that naturally occurring hormones were helping my cancer to grow.  The BRCA1/2 genealogy tests came back negative for a hereditary cancer despite the fact that both my paternal aunt and paternal grandmother, the only women on my paternal side, both had breast cancer.  My paternal grandmother died from the disease when she was just 38.  Due to advances in breast cancer treatment and the discovery of Herceptin in the late 1990's my prognosis after all treatment has always been very positive.

The Fall and Winter were spent going through what they call neo-adjuvant chemotherapy.  Neo-adjuvant chemotherapy is chemo that they give you prior to surgery in an attempt to reduce the size of the tumor and also to gauge how you respond to certain drugs in the case of a recurrence in the future.  I have written previously about my chemotherapy experience and you can read my prior reflections about how to help a loved one going through chemotherapy and my reflections on completing chemotherapy in case you might find those helpful.

The benefit to six months of chemotherapy before my single mastectomy was that I had six months to mentally prepare myself for the eventual mastectomy.  By the time I finished the chemotherapy I was able to start preparing myself for the single mastectomy, an option for me due to the type of cancer and also the negative BRCA1/2 results.  

I started preparing myself by accepting the fact that I was going to be losing a breast but gaining a life!  Then I started reading as much as possible.  After consultation with my surgeon, oncologist and plastic surgeon I made the decision to start the reconstruction process at the same time as the mastectomy with an expander and eventual silicone implant further down the road after I complete radiation.  

Once those larger decisions were made I started preparing myself by purchasing a few tricks of the trade in the form of camisoles and bras that could be used immediately after surgery. I used and was very happy with the sizing info provided on the site but there are lots of sites out there.  These camisoles and bras are amazing because they come complete with a little pocket for the drains that take care of the fluid that accumulates after surgery and also a breast prosthesis.  I was comforted by the fact that there is a whole industry out there providing accessories that help you to maintain the look of a breast.  This was important for me but isn't for everyone.

I even went so far as to pack my hospital bag with the after surgery camisole with the breast prosthesis already in place.  I ended up taking it out and not wearing it on the trip home but mentally it helped me to prepare for the after surgery reality.  In the end, with all of the bandages etc. I didn't need to add anything else and was just happy to have made it through the surgery and to be feeling pretty good.  

In the days leading up to and just after the surgery it was important to me to keep our family's schedule as normal as possible so that my three children felt comfortable.  This was made possible by help from my sister, who lives down the road, and my mom, who came to help from California.  I found it was important to be clear about what help I really wanted.  My sister offered to have the kids spend the night at her house but I knew that I would feel better if they could stay in their own house and go about their normal routine.  My sister understood and made that happen for me.  But at first I found it hard to say "no" to her generous offer but knew that if things stayed normal for the kids that it also meant things were staying normal for me and that really helped me to visualize the surgery day and my return home.  

I was scheduled to spend the night in the hospital but had asked beforehand if going home was a possibility if all was going well and was given the okay.  I went into the hospital on the first day of Spring and I used that to my mental advantage as well.  I saw the date as a symbol of renewal and a new start.  By noon my surgery was over, and all had gone according to plan.  

After spending the day and early evening recovering and being monitored my husband and I were able to head home at 9:00pm.  The surgeons, nurses and my family all respected my desire to go home if possible and that really helped me to feel empowered.  I can honestly say that I felt some slight discomfort in the form of tightness but not a strong pain which was a very pleasant surprise.  We headed home and enjoyed a late dinner of Chinese and Thai food that my sister and Mom had picked up for everyone at my request the night before.  

The picture is of my husband and I on our way home from the hospital the same day as my surgery.  I was feeling absolutely elated.  The surgery was over, it had all gone to plan, I was feeling better than I could have ever expected, it was the first day of Spring and I was one step closer to returning to full health.  I felt loved, supported and, most importantly, I still felt like myself.  The mental preparation before hand had really paid off.  

Prior to my surgery we had planned a Spring Break trip to Wilmington and we leave this afternoon.  This was another part of the forward planning that has really helped me to bounce back.  Six months down and six months to go.

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