plastic surgeon consult (parental advisory recommended, wink wink)

 Post from May 4th 

Went to the plastic surgeon. I really liked him and his nurse practitioner. They were super chill and not pushy at all. I have a choice to do a lumpectomy or a mastectomy. Dr. Tittensor (breast cancer surgeon) didn't have a recommendation either way. She said I was a good candidate for both.

The plastic surgeon’s nurse practitioner came in first and gave us the rundown of how this kind of surgery goes down. She complimented my chest which I was laughing at because there's nothing there. She said, "You really have very pretty breasts.” I just kept laughing every time she said it. She said, “you know it's not just about size. There's shape, color...." I can't remember what else but I was just laughing. She said, "Trust me I see breasts all day long and you have really pretty breasts." Ryan asked her what she would do if she were in my position. She said she would totally do a double mastectomy with reconstruction. We asked her how many people she’s seen that regret doing the double mastectomy. She said she’s had two people (that she can remember), in ten years that have had the implants taken out. One of them was a PTSD/sexual abuse situation and she couldn’t remember the other one. 

I told the NP that I was leaning toward a lumpectomy because I was done being sick and I just wanted to be done with everything. She said she understood that but she also said, “Just so you know, everyone gets there. Everyone gets to the point where they say, I’m done. I don’t want to do this anymore. You just got there a little faster.” 

When the doctor came in to talk to us, he said, “So I hear you’re thinking about a lumpectomy. Why do you want to do that? Usually people do a lumpectomy because they want to conserve breast tissue but you don’t have any breast tissue there.” I was laughing as I said, “I know I have small boobs. You don’t have to tell me that.” He was like, “oh no! I didn’t mean that!” I was laughing cuz he had said it a couple of times that I had no breast tissue. So I had to tease him a little. 

The doctor was telling us that we need to look long term. Ryan has been saying this to me the whole time. The plastic surgeon was saying, “Of course you don’t want to do this right now. You’re 9 days out from chemo. Don’t make a decision right now when you’re still sick and tired and recovering from chemo. But you also have to understand that you aren’t going to feel this way in a year.  So think about what you want long term. In a year, are you going to wish you had done something different?” My aunt told me she has a friend that did a lumpectomy a year or so ago and she wishes she would’ve done a mastectomy because she’s always worrying- what if? With a mastectomy there’s a .5% chance of it coming back. With a lumpectomy there’s a 5% chance it could come back. 

People (doctors and nurses and nurse practitioners) like to tell me that I'm too young to have cancer. Really? Thanks for telling me. Ya it sucks. . 

Lumpectomy- it's a same day surgery. The recovery is shorter. Once I have the lumpectomy I'm pretty much done with surgery. The rate of occurrence isn't much different than a full mastectomy but I've had multiple people say, "But you're so young, it could come back." And maybe not this same cancer, but some form a cancer. My genetic testing all came back negative so we don't know what caused it but there's obviously something in my body that triggered this at a young age. With a lumpectomy you have to do radiation, no question. But since I had cancer in one lymph node I have to do radiation regardless of the surgery that I choose.

Bilateral Mastectomy- it's a 1-2 night stay in the hospital. It's more of a 3 week recovery and no heavy lifting for six weeks. There is a higher risk of infection with a mastectomy. I have to check my breasts every day and at the first sign of redness I have to call them. (The expanders can get infected and if they do, they have to get them out right away) With the mastectomy they'll put these expanders in, kind of like temporary implants. They have a mesh around them which will absorb into my body. They have a port on them, kind of like my port I get my chemo through. I would go in every week and get saline put in the expanders to stretch my skin. I basically put saline in until I'm the new breast size I want to be and we stop there. They kind of overinflate them a little before radiation because they know that the skin is going to tighten up and shrink. Once you have radiation the skin is kind of frozen and you can't stretch the tissue again. Four months after I’m done with radiation, and my skin has healed, then I go back to the plastic surgeon and we take out the expanders and put in the actual implants. 

Dr. Tittensor has said that most women younger than 60 opt for a bilateral mastectomy because they say they don't want to go through this ever again. I definitely don't want to do this ever again.