Monthly Archives: November 2011

Reconstruction Q & A

29 Nov

Reconstruction Q &A

I sat there as the paper shook in her hand and I held that hand and said I will help you through this……
It is these moments that I know I am here for a reason. This is the most meaningful part of me and hope I continue to use it. I always look at what I bring and how it can change people everyday. To guide terrified patients through tests, surgery, chemo or radiation and explain what to expect, hold their hands and sit on a bed and look them in the eye, knowing I have felt their pain , crosses barriers and humbles me.
I explained to a nurse what the patient’s pain felt like so that she could understand what they felt.
My mastectomies for bilateral cancer tumors, needed skin resection with the tumors, making full implant reconstruction with allograft challenging and stretching the skin to it’s max. It felt like nerve pain beyond anything conceivable. My whole chest and armpits felt like weeping blisters of burn. And before it had healed, more surgery as it the left axilla came out too. Some nights, I would lean over my knees in some form of relief despite medication to do something with the nerve pain . But…. 6 week s later, as my cards always say, it settled. Yes, I would do it all again. Done in one go, I was able to move through treatment knowing that the main surgery was behind me.
Seeing patients go through reconstruction in any form – there was a new level of understanding between all of us – knowing that I had been there, inspired that I am back with purpose.
People ask me :
Why do reconstruction?
I understand those who do not feel they need it. I would be quite fine if I was told it was not possible but I remember the day I spoke with the plastic surgeon and she told me that she would make me look great and showed me the new gel substitutes that she would attempt to insert. She cautioned that due to loss of skin tissue, especially on the left side, I may need a tissue expander, and along with all the benefits came surgical risks. The expander is a temporary saline bag that is inflated to gently stretch the pectoral muscle and overlying skin to make room over time for the eventual full implant. It is common to insert this at the time of mastectomy; less common to accommodate a full implant immediately. If there is a certainty of a large amount of radiation, a full implant would be delayed since it can be affected by the radiation.
Reconstruction is commonly done after all treatment too. The plastic surgeon has to assess the condition of the skin if radiation has been done. There is the size of the other breast too to take into consideration.
In the end, I am so proud to wear clothes and be able to play tennis, swim, exercise with no second thought. Finishing the reconstruction with tattoos is an option I explored. It is absolutely remarkable. The quality of artistry is so incredible, that it is hard to tell it is 2D from a short distance. I am suddenly comfortable changing after the gym and feel like I fit in. I am very comfortable with all my scars while enjoying a sense of normality.

Flap vs implant?
There are rotational flaps and free flaps. The Diep free flap is taken from the lower abdomen like a tummy tuck and its blood vessels reconnected with microvascular precision to the chest to provide skin and fat to form a breast shape. It is very effective but you must be a healthy wt and maintain it to keep breast shape. Other rotational flaps like the latissimus and TRAM flaps, sacrifice some muscle and have complicaitons related to this. The other breast is often matched with a lift at the same time. Each person is assessed individually for their suitability to flap vs implant.
So there you have it – reconstruction Q & A
Looking Good does make you feel better and reconstruction can take that to the next step of self confidence too.
Ask me if it is worth it? Absolutely, I hope to help spread comfort and awareness around this topic for lots of women.

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A Christmas Tree Remembers…

27 Nov

A Christmas Tree…

As I get out all the Christmas boxes, I reflect on where I was last year – at the end of treatment with my hysterectomy and BRCA results…

I realized last year, as Christmas cards arrived from far and wide saying “Hope you had a wonderful year!!!” that I had to write one of those letter enclosures to distant friends……except it was – hold on to your seats as I give you the ride of your life – a year of bilateral breast cancer treatment, BRCA mutation and hysterectomy.  It was not the ususal letter where every child in the family is excelling at everything and life is perfect – no , my career was on hold, my husband working hard while emotionally drained and teenage kids having trouble dealing with a life focused on me, not them. For them, a bald, sick mom was not cool – no hugs came for a while – too hard.  University marks were due and focus was really difficult.  They did not want the class to treat them differently or be singled out because of me. They wanted nothing to do with my chemo or hospital visits – it made them too afraid. My daughter said the only part she liked was that I was home instead of at work.

But.. it turned around. Helping them see that good things can happen, that I am still the same person and so determined, helped my daughter strive harder and harder, excelling instead. She lead a Relay for Life Team, voted the person most likely to “find a cure for cancer” in the yearbook and proudly put my bald head picture up in her residence to remind herself of where we have been and how good life is.

Today, we visited my mother in law. Her cancer is palliative and we took over a Christmas tree, set it up with pink lights and ribbons.  It is a beautiful thing… It touches a spirit of remembering where we have been – All those Christmases together, the funny gifts and awkward pictures in matching sweaters. I love the crackers, the traditions, opening presents Christmas morning , especially the little things in the bottom of the stocking. Most of all, it is about being together.

So, I must get back to decorating the tree with Mark. Christmas music is playing and reminding me of my Merry End of Treatment Party last December – a reason to celebrate life…

Tomorrow I am going with her to get a wig because Looking Good really Does make you Feel Better.  I love to live like that. The pride of caring and having people say how good you look means so much to lift your spirit, no matter what life has in store for you.

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Scars of Strength

13 Nov

The most beautiful stones have been tossed by the wind, washed by the waves and polished to brilliance by life’s strongest storms….

This is a watercolour painting of rocks – the exercise was in texture and resists. The image was in my mind and came out on paper to illustrate the beauty that can emerge after so many painful blows and the scars that they leave to make us unique and special. It is these qualities that make us beautiful and shine brighter.

Like the blemishes on the rocks, scars remind us that we were there. Attitude reminds us we got through it. Love reminds us we are never alone. Sharing helps us cope…..

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When you can’t change the outcome, you can change the journey..

7 Nov

Things can blindside you when you least expect it. A family can pull together in struggle and find a path to cling to. My mother-in-law was diagnosed with severe metastatic cancer and we are finding our way through the storm of pain and suffering in the very good hands of excellent doctors. A friend is dealing with a son too young to be in his terminal stages of cancer and the pain that comes with it. It is with this heartfelt distress that I reflect on how to write this blog. You can’t change the outcome of this situation but you can change the journey. This is something I do at work too. Most of the time I can significantly change the outcome in my job and that’s so rewarding, motivating and feeds my soul. Equally rewarding is knowing that I can change the journey – I can make the journey of disease more comfortable and less lonely.

When you can’t change the outcome,
you can change the journey

A spirited person , why must it be you
Those words of more cancer cannot be true
But I realize and see the goodness around
The warmth of family and love that surround
You may not see all the hearts that you touch
To ground us and see what matters so much
It’s those who are there when life is too hard
Do chores, bring the dinner or send a good card
The outcome is there but the journey not clear
More love and hearts help lessen the fear
We’re always there night and day
To give you courage and light your way
Holding hands together when the times are tough
To know we are there can be just enough
Though the outcome is there, let’s smile at today
And cherish the present that can’t go away

(This is my illustration of my feelings in watercolour and pen – taking a painting class is helping me illustrate these thoughts – very therapeutic)

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