Asymmetry, Grief and Love

When I look at my naked body in the mirror, I cry.

For days, I’ve been trying to write this post, but I can’t seem to get past that first line. Where do I start? How do I attempt to unravel the layers of emotion that have formed over these past couple of weeks since my second surgery?

Let me start with some facts: The surgery successfully addressed what turned out to be a seroma, not a hematoma. (As far as I understand, the main difference between the two is that a seroma is essentially a collection of clear fluid whereas a hematoma involves blood. Both can apparently lead to Dolly Parton sized breasts.)

Recovery was, as expected, quicker and easier with this surgery than with my mastectomy. I was up and about after the first week. Unfortunately, because of the seroma, I needed a drain. If you’ve never had a drain, trust me, you don’t want one. I forgot to take a picture of my own drain, so I scrolled the internet to give those who’ve never seen one an image of what I walked around with for the last couple of weeks (and for three weeks after my first surgery).

drainMy drain was attached to my bra with a safety pin not this nifty looking eyelet. The long tube that disappears under the bra is inserted into the skin. Then, every day, I (and by “I” I mean Josh, because he usually did it) got to empty and measure the fluid like this (though my fluid was less blood red and more serus):

empty drain

Today was a good day because, after two weeks, I finally got the damn thing out, which means I no longer have to walk around with a plastic tube and container attached to my body, collecting fluid from my wound. Bulky and gross and a great way to feel like a sick person.

As for what else I hoped to accomplish with this unexpected surgery—symmetry and a regained level of comfort in my body—that did not come to fruition. My reconstructed breast (and nipple) is now noticeably smaller than my healthy breast. That, coupled with the physical scars, makes me… well, it makes me cry. I feel ravaged, ugly, older than my years (the post-chemo gray hair isn’t helping); and every time I look in the mirror, I am reminded of what I’ve lost and what I’ve been through and what lurks on the horizon as my new, biggest fear (recurrence, metastasis, telling my children I have a cancer again, missing out on all the things I don’t want to miss in their lives).

But here is the amazing thing: Despite all this— the disappointment, the self-consciousness, the crying, the fear—I generally feel happy.

Growing up, when I was having a hard time about something, my mom would say, “Go somewhere else on the canvas.” Meaning life is like a giant canvas, with, say, one group of friends in one little corner, an aspect of work in another, a particular family member somewhere else, an aching back up top, cancer down below; and that whatever the pieces of our lives might be, there are, for most of us, many of them. When one piece of the canvas bogs us down, it doesn’t mean the entire canvas has to go down with it; we can move our attention elsewhere. For the most part, this is easier said then done for me, but by some miracle, the grief I feel these days in my moments of crying is confined to those moments of crying.

canvas

This morning, I crawled into bed after my follow-up with my surgeon and had another tear-fest. I cried for all the reasons I’ve shared, and because I now need to decide whether I’m going to have yet another surgery, purely elective this time, to achieve some symmetry. There is no rush to this decision, but it weighs on me with the same guilt and shame that weighed on me when I had to decide about reconstruction. I feel ashamed by the thought of choosing a surgery I don’t need to “fix” something I don’t like about my body. Why stop with my reconstructed breast? Why not suck some of the fat out of the saddlebags I’ve always wished away? Why not erase the bags under my eyes? Tighten up my knees, which I’ve always found a bit saggy? Certainly these are choices that many people make, but they are not choices I ever thought I would make. Yet here I am considering what feels like a similar kind of choice, and it weighs on me. I would never, ever begrudge another woman for choosing reconstruction after enduring the traumatic loss of a breast, but I am struggling to find that same compassion and understanding for myself.

Time to go somewhere else on the canvas. I think I’ll linger for awhile in the fact that I am more in love with Josh than ever before, and that to feel that way after 15 years is incredible. Josh, who lies down with me in the middle of the day and tells me, while I cry, that he wants me to feel whatever I’m feeling, but then to remind myself that we will get through this, one foot in front of the next, just like we’ve gotten through everything else. Josh who sings to me, “You are beautiful, in every single way;” and who, after this latest surgery, wouldn’t let me off the couch for days after I felt like I could once again help with the kids and the house; and who is patiently waiting for me to watch Big Love and then read side-by-side in bed like the wonderfully old married couple we are.

heart love

Another Surgery

I need to take on the uncomfortable task of writing publicly about my breasts again. (“Need” isn’t quite the right word. I want to keep people informed, and right now, that requires some explicit boob-talk.)

Dolly Parton during "Steel Magnolias" New York City Benefit Premiere for the American Diabetes Association at Cineplex Odeon in Century City, California, United States. (Photo by Ron Galella/WireImage)Two weeks ago, the night my family and I returned from our glorious, much-needed, post-breast-cancer-treatment and summer vacation, I discovered that my reconstructed breast was suddenly Dolly-Parton big. (Okay, maybe not quite that large, but compared to what I’m used to, it certainly feels that way.) I contacted my plastic surgeon who didn’t seem concerned, and since we already had a follow-up appointment scheduled for two weeks later, he said he would take a look then.

Over the next few weeks, I felt discouraged by how awful I felt—exhausted, light-headed, headachy. “I haven’t felt this bad since chemo,” I kept saying to Josh. “Is this what my nine months of recovery is going to feel like… This bad?!”

On Thursday, I finally met with my plastic surgeon, and he scheduled me for surgery the following Wednesday (two days from now). He thinks that radiation likely caused a hematoma: a broken blood vessel that leads to [Dolly Parton-sized] swelling filled with blood. A hematoma can also cause anemia, which explains how awful I’ve been feeling. (“Imagine you’re having three periods at once,” were his exact words. In other words, significant blood loss and all the resulting symptoms.)

I’ve written about my struggle to decide whether or not I wanted to do reconstruction, and if I did, what kind. After much back and forth, I decided to do implant reconstruction the day of my left mastectomy. I also decided that 4-6 months after radiation (the standard wait time), I would most likely have one more “small”/out-patient surgery to reconstruct my nipple and to put a smaller implant in my healthy breast, so that I feel more even. (You can read about a recent conversation with my 7-year-old daughter to learn more about the current state of my “uneven” breasts.)

My surgeon said that, since he has to operate now to address the hematoma, and since my skin has recovered so well from radiation, he could finish any other reconstruction at the same time and hopefully avoid another surgery. On the one hand, I’m nervous (among other things) about not waiting the recommended 4-6 months—recommended because radiation can continue to affect the tissue for that long with unknown end results. (My surgeon seems pretty darned confident that things will be fine, and I’m choosing to trust him… because I do trust him.) On the other hand, I’m holding onto the idea that this hematoma is a blessing in disguise—that it will give me the opportunity to be done, done, DONE with breast-cancer-related procedures now, versus six months from now.

done

I feel utterly different going into this surgery than I did going into the last. Perhaps it’s because I now have a surgery under my belt. Perhaps it’s because it’s all happening so fast that I don’t have much time to fester and fear. Perhaps it’s because this feels like no big deal compared to the loss of my breast. Perhaps it’s because there’s actually some relief with this surgery—the hope that I’ll feel more comfortable in my body again, both emotionally and physically. (Trust me, a boob filled with blood does not feel good, on any level!) There’s plenty coming up for me, and perhaps I’ll explore some of that in future posts. But mostly, I’m trying not to think too much. Trying to notice, to name, to put one foot in front of the other, to trust that my steps are taking me wherever it is that I need to go.

Some logistics: I have to be at the hospital this Wednesday, September 6 at 6 a.m. Surgery is scheduled for 7:30 a.m. It should take about 2.5 hours and the hope is that I can go home by evening. My surgeon said I should plan to be down-under for about a week, then slowly doing things from home, and hopefully back on my feet after week two. My godmother is coming from the Catskills on Tuesday to be with the kids until they go to school on Wednesday; and then with all of us for a few more days while I recover. Another blessing in disguise: it takes so long for Josh’s PA licensing to come through that he can’t start his new job for at least another month, so he can be 100% at the kids’ and my sides for this next hurdle.