My Mastectomy and Me – The Whole Truth

I was diagnosed with breast cancer — invasive lobular carcinoma in my right breast — in late April. The initial shock and flurry of appointments and further testing took me to early May, when it seemed I’d face outpatient lumpectomy surgery and radiation — but that was before the radiologist found that, in fact, my cancer wasn’t a loner, but instead a mother-daughter pair. Their proximate locations made simple lumpectomy unfeasible. So by mid-May the plan had changed to bilateral mastectomy and reconstruction, using a complex and intricate surgery called DIEP (deep inferior epigastric perforators) flap. And the surgery date, because it involves not one but three surgeons, wasn’t scheduled until mid-July, which at the time felt like a hundred years away.

But time does its thing; it’s now early July as I write. My surgery’s clock has ticked down to slightly more than a week from now. In all the time since, I’ve devoted at least a portion of each week to cancer stuff: reading things, buying things (or, more accurately, clicking around the internet shopping for things and viewing before and after photos and video testimonials). It can be confusing to decide which comfort pillow or surgical drain contraption, or front-close bra or postsurgical dress/PJ pants/robe will be to my liking. How can I decide? It’s not like I’ve done this before.

It's the videos that plague me. “I felt whole again,” some of the women in them say, with grateful voices, and I don’t doubt that’s how they feel.

But: “Whole” is a concept I’m having some trouble with. This is a surgery that will, to put it in nonmedical terms, literally remove and rearrange portions of the front of my body.

Remove. And rearrange. I try to let those concepts sink in, but they’re doing so only slowly — a stone dropped in a mud pool as opposed to a clear pond. I suspect it won’t feel real until it’s done, which makes my research-based attempts at preparation feel very similar to how one goes into childbirth for the first time. You can read all you want, you can talk to veterans, you can take a class, but understanding doesn’t dawn fully until you’ve done the thing.

That said, I can’t help but want to try to get my head around it; it’s the reporter in me. So here’s what’ll happen: Skin and fat and nerves and, most crucially, blood vessels (the “perforators” in the P of DIEP), will be excised from my lower abdomen and attached where my old breasts were. It’s plastic surgery but much more, really — linking those blood vessels to ones in my chest, necessary for the flap to stay alive and soft and warm, involves precise, fiddly microsurgery. The plastics part is reshaping the relocated flesh into breasts with — as I’m told is possible in my case — my old nipples. And then there’s the side bonus of an incidental tummy tuck, wherein my abdomen, absent its roll of midlife fat, will be stitched closed and my belly button resurfaced and reshaped above or below (depends on where the best flap is) a hip-to-hip scar.

But I can’t forget that in this removing-and-replacing game of musical body parts, some bits will end up not coming home with me. The tumor(s) will be gone, of course, and good riddance to them; and a couple of lymph nodes, hopefully clean of cancer but sacrificed nonetheless. Another loser in the game is, of course, the rest of my breasts (spare a thought for my lefthand lady, innocent of any cancer — that I know of).

So "whole"? Well, no. This is where the reporter in me steps aside in favor of the editor I am. As I tell my children and the writers I work with, words matter. I won’t be whole. I’ll be different.

How much so, in what ways, I’ll only fully apprehend when I get to the other side, after this midpoint of July that I’ve been both inching and hurtling toward since my diagnosis in late April.

See you there.

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