Marjorie, Problem Child, Goes to Rehab

So I haven’t written a damn thing in months. I started to write some depressing piece about how down I was feeling a few months ago called “Demons” but the feeling passed and then the moment passed and the few incoherent dribblings I managed to eek out will forever fester in the land of blog post drafts where they belong.

It is now May. The month of my birth. And swiftly approaching is my 44th birthday. 44. A nice round number. It feels like ages ago that my 40th was approaching. We had a party at an Italian restaurant in London. Bill, who suddenly took deathly ill the day of the party — he was literally green and nauseated — managed to drink a Coke, rally and give a heartfelt speech about how great I am. There are pictures of me embracing him following such speech and veering to one side (because I did not want to catch whatever the fuck was ailing him in my delicate condition).

Never in one million years would I have believed you had you told me in advance that I would be as bald as a cue ball for my fortieth. It was such. A weird. Thing.

Moving right along.

When last we met I was going on about how hot I was planning to be super hot this year following Marjorie’s scar revision. (Read my previous post if this is not ringing a bell). Forever the optimist, I kept thinking that “this time around” Marjorie might be okay. That she would come out of it and be better. But the reality is that I am just not sure about Marjorie.

She is not what I would call behaving 100%. You see, radiated skin does what the hell it wants to. It is never the same following the radiation, which affects, among other things, the blood supply, and tends to make things fibrotic (think tight and painful). So when the swelling from surgery subsided and the scar went from looking like Frankenstein’s monster’s forehead to a discolored horizontal line, I noticed the skin around the incision starting to harden up. And telltale signs of the tethering that we were trying to fix in the first place.

The turn of events went something like this: There I was minding my own business abstaining from upper body exercises for what seemed like an eternity and then I had a post-op check-up and got the all clear and then it snowed. Not a little.

So I took it upon myself to go out and shovel the hell out of my considerable driveway, which was the first upper body workout I had done in about 6 weeks. The day after that, I noticed that Marjorie was starting to hint at being up to her old tricks. It was like finding a lighter in your kid’s room after you caught them with cigarettes (or worse) and they swore they would never smoke again.

Shit, I thought. Marjorie is up to her old tricks again. I am assured that shovelling snow did not suddenly cause this behavior, but naturally I began blaming myself for this possible development and wondering why I didn’t just leave the snow and let everyone make fresh tracks in it.

The good news: Marjorie looks better than she did before. She does. I have not dusted off the chick fillets or resulted to spackle and I can wear stuff sans padding and be pretty happy with the result.

The bad news: there is definitely some misbehavior. Marjorie is not, in the esteemed words of Taylor Swift, out of the woods.

Solution: Marjorie goes to rehab.

That’s right, the bitch, in classic attention seeking fashion, is demanding all sorts of special treatment. This includes being massaged with expensive body cream from France and a special scar tweaking rub that I do about twice a day, time permitting, to try to loosen up that area. And we even see a specialist physiotherapist who deals only with problem children such as Marjorie. This is weird because every time you cross paths with someone coming or going from the PT’s office you know this person is a member of the same club and she knows you are too. It isn’t discussed. It is a silent understanding, hanging heavily in the air. All of us ladies and our Marjories.

We are not praying for perfection or even really hoping for normal. Rather we seek improvement; we are just trying to make these casualties of war “as good as they can be.”

This is where a bunch of people will chime in that we ladies are just lucky to be alive and that this is what’s important and we should be thankful for that because it could have been worse.

Here’s a bit of advice. Don’t you ever even THINK of saying that to me or someone like me. It’s dismissive and ridiculous. As if we, of all people, do not understand that having a sightly dented boob and some pain and tethering from scar tissue, or even NO BOOB, is preferable to being six feet under. Ask yourself why you would say such a thing? Is it to make the recipient of the comment feel better, really? Or is it a nice tidy end to an uncomfortable topic that you have decided is no longer worth discussing?

Hell to the NO.

Seeking improvement is a normal human behavior and part of the process of getting on with one’s life. So this should be encouraged (unless of course the person at issue becomes obsessed or unrealistic about what is possible at which point it might become unhealthy behavior).

But just let me try to make her a little better. I can settle for “good enough.”

At the end of the day, the irony is that Marjorie is getting by far more play than her predecessor ever would have on a daily basis, and she cannot even feel it.

What a waste.

2016 Takes Shape

Here we are another year older. And another year wiser. Or not. But I like to think so.

My New Year’s resolution is to try to give less of a shit, generally, which is bound to fail. But I’m really going to give it the college try. Well, selectively. How about this: I will give less of a shit about shit that I deem is less worthy than other shit.

This has been a strange six months for me. I alluded to some of it in Reentry: Part One (no that is NOT a porn) which, sadly, is the last post I wrote and is dated October of last year. I could now go on and on about how I never write anymore, enumerate the various mundane pressures in my life that I feel have kept me from being able to write and have left me feeling inadequate and be all apologetic but as part of my New Year’s resolution, I have decided not to give a shit, right? Besides, I am now writing and that’s what matters.

I remind you that this started as a blog about, among other things, dealing with breast cancer. Incidentally it turned into a blog about whatever, generally, was on my mind and I felt like writing about at the time. It has evolved into a series of posts that are maybe more about the latter and less about dealing with cancer. However, once in a while I feel it is necessary to stir that shit up again. Just in case you thought (hoped?) I had forgotten all about it.

January, they say, is characteristically a difficult month to endure. The pine-scented jingle jangle of the holidays is over, evidenced by discarded carcasses with browning needles here and there. The days are colder and shorter and the bills are higher. It is a time to reflect on what we accomplished and failed to accomplish and we are all suddenly supposed to be better, eat healthier, drink less, exercise more, be more like Tom and Gisele.

For me, it has the added fun-filled benefit of being the anniversary of my cancer diagnosis. January 3, I believe, is the day I received a call (and an e-mail, actually) that “yes there is a cancer… but totally ‘routine’ and ‘treatable.'”

There is “a” cancer. Is this supposed to be better than telling someone, “you have cancer?” It sounds like some politician’s passive announcement after having just ordered fighter jets to drop bombs on the enemy. “[Insert middle eastern location] has been bombed in an airstrike. Civilian casualties were sustained.”

This year marked the fourth anniversary of my diagnosis. You might be thinking: “well, that’s cause for celebration! Another year and you will reach that magical five-year mark.” First of all, I think the five year mark is properly acknowledged on the anniversary of the termination of treatment. And let’s face that it is somewhat arbitrary. Second, forgive me if I am not all excited about the reminder that at age 39, I discovered one night in the shower a lump in my breast, underwent a number of stress-inducing and physically uncomfortable tests, and found out that in fact, yes, against all odds I had a life-threatening illness that would affect the quality of my life for the next who-knows-how-long. Do I sound bitter? Sorry. I’m not. Just keeping it real. It was a sucky, terrifying experience.

One of the hardest things about it, which I endured in waves rather than as a constant, was the feeling that I was damaged goods. The feeling when standing on the street and observing passersby that I was being left behind while everyone went on with their marvelous daily lives, clinking glasses, traveling to exotic locales, being carefree, running up hills in Primrose Hill Park. Of course a lot of that is bullshit since everyone has something they have to deal with — some a lot more serious and unpleasant than my lot. If life were as pretty as everyone pretends it is on Facebook and Instagram the world would be a different place. But if all it takes is a few minutes of looking at social media (come on you know you felt like pretty girl’s fat ugly friend after you looked at your skinny rich friend’s latest [photoshopped?] vacation pics) to make you feel bad about yourself, is it any wonder that, standing outside, pale and bald (albeit clad in a headscarf and slathered with makeup to disguise such things), I felt a little bit like a loser?

There was something about being in that group that made me feel decidedly uncool, like a misfit, a reject, someone with an issue “normal” people politely inquire about but don’t really understand. What’s more, they generally don’t want to be bothered with it because it is uncomfortable, undesirable, “unfun” and just “un.”

As I said, I didn’t always feel that way. And I don’t feel that way any longer. Maybe other people in that situation never felt that way at all. I think it is my nature to want to be included, to join in the party. So that likely predisposed me to experiencing what I did. That and being teased a lot as a kid in grammar school. Fuck you, all of you zeroes who gave me a hard time back in the day. I forgive you. And in any event I don’t give a shit — my NYR, remember?

But anyhow, I will continue with the point of this whole thing, which is really about feeling better about myself.

As my plastic surgeon friend Beth told me years ago on the eve of my treatment, once you are done with all the draconian life-saving nonsense, you are left with your cosmetic appearance. And thanks to the radiation that I was never supposed to need on my right side following my bilateral mastectomy/reconstruction and chemo, my right boob (remember Marjorie?) ended up healing a little less than ideally. I must interject that implants and radiation do NOT mix well and there is about a 50% failure rate (meaning complete failure) so all in all my result was pretty damn good. I don’t want nobody misunderstanding and failing to be impressed by my rockstar surgeon in London. Because he is a badass, though understated because he is so polite and English and wears nice grey flannel suits and shit.

Anyhow, my right “boob” a/k/a Marjorie kind of looked like Rocky Balboa after a few too many rounds, the main offender being a scar that was tethered and caused a significant dent in the middle. For years now I have been covering that bitch up with good, lightly padded Chantelle bras and those stupid lulu lemon oval pads that come in their wouldn’t-fit-anyone-with-normal-tits-that-I could-never-wear-before-anyway exercise tops. Think ultra-thin chicken fillet sitting on top of that dent to smooth it out.

Without the chick fillet, the dent was clearly visible, particularly from a three-quarter angle. Not ideal.

After I moved back to the US I decided to pursue a more permanent remedy and went to see a couple of plastic surgeons. They decided that what I needed was a scar revision, in which they would open the original incision, remove scar tissue, release any tethering to the muscle beneath and sew Marjorie back up with thicker, better skin a couple milimeters on either side of the original scar.

So that is how I decided to start 2016. And on January 5, I went for it.

This morning I just had my follow-up post-op appointment. Marjorie is looking pretty good. Much better, in fact. She is not allowed to carry more than 5 lbs for another two weeks, and she can’t spin or do boot camp class with the other suburban mommies. But if all goes to plan and Marjorie behaves, it will be so worth it.

I told a couple of ladies at my younger daughter’s new school about the procedure and one said, aptly, “that’s good — it won’t be a constant reminder of what happened.” I thought about it and said, “well, I don’t really give a shit about that — there will always be a reminder… I just want to be hot.”

If all goes well, terrific. If it doesn’t, well, then, I will dust off the chicken fillets and try not to give too much of a shit about that either.

Whatever happens, 2016 is taking shape, people. Happy New Year.

Photo on 13-01-2016 at 13.30 #2

It Does Matter

It’s so easy to hear about someone else’s problem and to make an immediate pronouncement about it. How they should feel, what will happen, what matters and what doesn’t (or at least what should matter and what shouldn’t) in the grand scheme of life. The thing is, sometimes you have to bite your tongue.

Let’s face reality. People do not generally like to hear about other people’s problems because most of the time they don’t really give a shit and other people’s problems are boring, annoying, uncomfortable or some combination thereof. I think that we often lob back a not-so-well-thought-out response because we feel that we have to respond to achieve some sort of closure or resolution. Or just to fill the awkward space after someone pulls back the curtain.

But there is something to be said for the American Indian approach to conversation. A long reflective pause can come in handy. It allows one to collect one’s thoughts and assess the new information. Listening is almost always a good thing. Responding without thinking is often not.

What exactly, you might ask, am I getting at? Well, I’ve been noodling about conversations I’ve had and people’s reactions to things I have shared with them. Most of the time I am blissfully upbeat and am able to cope cheerfully and with a good deal of humour. But I, like everyone else on the planet, have my moments of negativity and frustration. And I often feel that whenever I gripe about something I get that rapid-fire response. Shut-down before the conversation really even starts. Sort of like “well you’ve had your cancer and beaten it so really you should not complain about something as trivial as the way you look.”

No one likes a complainer. But people do need to be allowed to express negative feelings sometimes and just because you are on the receiving end of such does not mean you are responsible for “fixing it.” Nor is it your job to dismiss a person’s complaint with a one-liner, although I am 100% certain that I have been guilty of both trying to fix things and dismissing negative observations with an immediate response on numerous occasions. So this is directed at me just as much as anyone else. I should practice what I preach, after all.

I’m looking back, trying to reconstruct (no pun intended) the past eighteen months of my life. How I was then, how I am now. And how my thoughts and feelings have evolved with the passage of time.

I’ve boiled the whole breast cancer ordeal down to two phases. Phase One: kill the enemy. Take no prisoners. This was the honey badger phase. If you don’t know what I am talking about read some of my early blog entries and you will find that the honey badger became my mascot early on in the process, primarily because it’s one naaaaaasty lean, mean killing machine (and secondarily because Randall’s ridiculously effeminate narration on YouTube makes me giggle my ass off).

The goal of Phase One was to eradicate the disease. It felt urgent and critical and it was not difficult for me to be single-minded about the process. The mission was to do whatever necessary to maximise my chances of beating this fucker. So basically I got down to bidness PDQ and that was that.

Throughout treatment I remained hyper-focused on my mission and had only one speed: full steam ahead. I did what I did because I had to do it so I didn’t waste a lot of time being sad about the process. I just pushed through it and tried to amuse myself and others by, among other things, wearing absurd outfits to chemo and walking around London in a pink wig, because I had no choice and I knew it would be over eventually.

At the same time, however, I did spend time considering Phase Two. Phase Two would involve my eventual cosmetic appearance. As my plastic surgeon friend pointed out, once the cancer is a distant memory what you are left with is your reconstruction. It might not seem that important in Phase One but it could later so it needs to be considered carefully from the beginning.

As one relative aptly put it while we were awaiting a diagnosis, “well it’s really going to suck if you have to cut off your boobs, because you have nice boobs.” Yes, I thought. It will suck. And in fact it did and does suck.

Knowing that I had to do it didn’t make it suck less; it merely made wallowing over the suckiness somewhat futile. But still, sometimes I allow myself to wallow just a little bit. Mostly by myself in the privacy of my own home, like while I am curled up on the couch at 11:00pm having just finished another episode of Mad Men courtesy of Apple TV. What? Oh I am only on Season 2 and yes I know I am about the only American left who hasn’t watched every season. Sue me.

Sometimes I do feel that it would be awfully nice to have real breasts again. Something soft that bounces when I run and something with nerves that might notice if I inadvertently walked into a wall. Sometimes I do feel that I am missing something. Something feminine. Something womanly.

In her Op-Ed in the New York Times, Angelina Jolie wrote about her decision to have a prophylactic double mastectomy to reduce her risk of developing breast cancer for which she is a BRCA gene carrier. Ms. Jolie lost her mother to ovarian cancer and very recently, her aunt to  breast cancer.

Ms. Jolie’s doctors estimated that she had an 87% chance of developing breast cancer and a 50% chance of getting ovarian cancer. So she decided to be proactive. She underwent radical surgery so that she would significantly reduce her risk of enduring a Phase One. She went right to Phase Two. It was her choice and in my opinion it was a good choice, a choice I would have made under similar circumstances.

As it turns out, I did not have the “luxury” of foresight with my disease (btw I am not a BRCA gene carrier). So for me Phase Two was not something that I chose but rather something that I had to do. It had no choice but to remove my right breast, although I could have kept the left breast. My thinking was logical. I sort of felt like I might as well just be rid of both if I had to lose the one. That way at least I would be symmetrical, make the plastic surgeon’s job easier and not have to get screening on the left side all the time wondering if disease would develop in that breast.

The decision to remove one or both breasts preventively is controversial. Some believe that doing so is a “psychological” choice rather than a medical one. Meaning that what could arguably be adequately monitored with screening tests and physical exams needn’t be surgically removed simply out of “fear.” That sounds pretty judgmental, don’t you think? Reading such things caused me to revisit my decision. And I can safely say that if faced with the dilemma today I would do the exact same thing I decided to do eighteen months ago.

For me, the decision to remove both breasts was practical. It turns out that my breast surgeon agreed. After telling him that my inclination was to do a “double” I asked him what he would advise his sister to do under the circumstances and he didn’t even hesitate. After all, I was relatively young, at 39. I have a lot of life to live yet. I, like Ms. Jolie, have small children.

Unfortunately for me, unlike Ms. Jolie, I lacked information that would have enabled me to take action before Phase One became necessary. Therefore, Phase One interfered somewhat with Phase Two because I had to (rather unexpectedly) undergo radiation which can cause a host of problems, including affecting the blood supply to the treated area, increasing the risk of infection and of developing a hard scar capsule around the implant. Furthermore, I was not able to keep my right nipple because one of the tumours was too close to the nipple. Again I decided to just take them both off, because they can do pretty groovy nipple reconstructions by cutting a bit of skin from the top of the breast, shaping and suturing it and then eventually adding a tattoo.

Nipple-sparing mastectomies are possible but the nipples do not behave the same way as before and they may lack sensation. And of course there is always that small risk that cancer will develop in the nipple.

So, here we are five months following my implant exchange surgery. My new boobs have softened and settled. But there are a few issues. The incision on the right side (the side that was radiated) is a bit hard and therefore slightly distorts the shape of the implant from a certain angle. Also, the skin over parts of the implant is so thin that I can sometimes feel rippling (sort of like wrinkles) of the implant beneath the surface.

Despite these issues, the overall result is good. Especially considering that I had radiation. Both implants remain soft and in a bra or bathing suit things generally look pretty okay.

But still, sometimes I do feel odd. I look at my reflection and I am confused by the change. The girl with long hair and big boobs has been replaced by a slimmer, smaller- and higher(!)-chested version with short curly hair.

Thanks to an infection in March, which gave me and my plastic surgeon a scare, I have not had my nipple reconstruction yet, so I sort of feel like Barbie (well, maybe a brunette Skipper Barbie because I am nowhere near voluptuous enough to be real Barbie). And I am bothered by the “seam” that the scar on the right has created. We might be able to improve the distortion with some fat grafting (during which some fat would be sucked out of my stomach — bonus — and injected in the small space between skin and silicone implant).

I know that I cannot expect perfection and I do not, particularly with an implant-based reconstruction following radiation, which is known to be problematic. I know that beating the cancer was more important than my cosmetic appearance and I accept that.

Overall I feel pretty good, but I do believe I will feel better once I have my little tweaks. The scars will continue to fade and once I have nipples, provided that goes well, my new twins will more closely approximate the real thing.

But, on occasion I do get pissed off. So let me be pissed off. You do not have to remind me that what’s important is that I don’t have cancer anymore. I know that. And please do not tell me that my cosmetic appearance doesn’t matter. In a world obsessed, and I mean obsessed with breasts and the female form? Please.

It does matter. It matters to me.

The New Normal

Last Friday marked the one-year anniversary of my eighth and final chemotherapy treatment for breast cancer. Following that I did have five weeks of radiation, five days a week, so my end of treatment was technically July 27 (not including another surgery later on). Radiation, however, was a cake walk compared to everything else up to that point so June 7 just carries more significance for me.

When you embark on chemotherapy they warn you that the medicine — in addition to killing cancer cells, which is sort of the point, duh — will affect you, not only immediately, but also for some time in the future. No one can say exactly how and how long you will enjoy the effects of this venomous intravenous cocktail, because how you react and for how long, like so many things medical, are highly individual.

Of course, a number of “individuals” told me what I was in for, either from personal experience or from what they had heard or observed in others undergoing treatment. Solicited, this is helpful advice, provided you don’t take it as scripture since you don’t really know what you, yourself will experience. Unsolicited, it is, well, not. There are things that you know you will probably have to deal with, such as fatigue, loss of muscle, appetite issues, lowered immunity, hair loss, et cetera. And then there are other things that may or may not strike you, such as oral thrush, loss of finger nails or having a constantly runny nose or watery eyes… I could go on but how long have you got?

The thing is, you just don’t know. What you do know is that you will not feel “normal” for some significant period of time. I was prepared for that, as much as one can be. If I’m honest about it I have not really felt like a normal person ever since I suspected that I might have cancer at age 39, because that in and of itself is not normal and made me feel physically weird.

But what is normal? That’s the question I have been asking myself a great deal lately. Normal is somewhat tricky. It’s a little bit shifty. Elusive.

I am sitting here digesting the last year and a half and thinking about how I felt before, during and after treatment. And how I feel right now. At this very moment.

And I have to admit that I do not know if I feel completely normal, one year out from that final chemo. I am not trying to be cute or philosophical here, people. I don’t mean that mentally I will never be the same because I am “forever changed” by this experience. I am talking physically. I’m talking about how my body feels.

See, about two weeks ago I thought that I felt normal. And then something happened and suddenly I noticed that when I woke up in the morning I had so much more energy. And at the gym I had so much more strength and stamina. And I thought, “gee, I guess my body is still ‘recovering’. I guess the way I felt three weeks ago, although I thought it was pretty good, wasn’t as good as it’s going to get.”

And you know what? A few weeks before that (aside from an unfortunate stint with some unexplained infection which dragged on for weeks and seems to have started with a stomach virus) I thought I felt normal, too. But clearly, if I feel the way I do now, then by comparison, the way I felt then was, if I may borrow a line from Ving Rhames in Pulp Fiction, “pretty fucking far from okay.”

I remember chemo. I remember the first time, which I did before I had a port surgically implanted into my chest for treatments two through eight. The nurse pushed the juice into a vein in my left arm. I watched the liquid flow from the huge syringe gripped by her gloved hands through the line and into my arm. I began to feel the effects immediately. My nose tingled, a metallic taste enveloped my tongue, and when I went to the bathroom my piss was pink because the doxorubicin was red in colour. Let me tell you: this was somewhat less festive than rosé champagne and eminently less drinkable. By the time I went home I was rather grey in the face and very tired. And didn’t have much of an appetite. Which for me is not at all normal. I never refuse food unless I have an acute stomach virus. And even then I try to relish the white toast, flat Coke and sliced banana. Oh wait — I lie. There was one time recently when I refused food on a Bangkok Airways flight because the mystery meat was just a little too mysterious even for me. Ew.

I had a dose every two weeks, and by the end of the second week I was always feeling better, more — yup, you got it — normal. And then they would hit me again. Halfway through I was switched to another medicine (part of the original plan) which was easier to take but had other side effects. And then suddenly there I was in my pink wig and feather skirt (see Zero) for my last treatment. And that was it. Dunzo. So when that third week rolled around and they did not hit me again it was fucking magic. I mean I could not believe how much better I started to feel. It was like someone flicked a switch. In fact, you can actually see it on a graph that reflects the data from this exercise circuit I had been doing at the gym. You see a slow decline over the course of my chemo and then the day I worked out in that third week following my final treatment the graph jerks right up into a steep climb.

I remember how I felt that day at the gym. How much easier the exercise was. How much more normal I felt. I thought, “wow, I cannot believe how good I feel.” But now, looking back, I realise how good I didn’t feel. My reconstructive surgeon alluded to something along these lines last year. He said you think you are doing pretty well and only later do you realise you actually felt absolutely crap. I get it now, dude.

And it isn’t always linear. There are ups and downs and setbacks and gains and the whole thing is linked to mood so it’s really very difficult to measure what normal is.

One morning last summer during our visit to the US I waited in a small, sandy parking lot with my husband to meet our dear friends riding the Pan Mass Challenge (a hard core two-day bicycle ride to raise a hellofalotta money for cancer — see http://www.pmc.org). They would do a quick pit stop before making a hard right and continuing on. I remember standing there, chest all beet-red, enraged from radiation, barely any hair on my head, skinny and certainly a little weak. It was so great to see them. But I did not feel normal. I felt like they were riding for me. It was moving, unnerving.

Fast-forward to two weeks ago Saturday when my older daughter (who is eight) and I did a four-mile walk through Regent’s Park to support people fighting cancer at the school by raising money for Macmillan Cancer Support. The walk was fun and easy and although our legs were mildly fatigued by the end it was great. And it hit me that throughout the walk and afterward I felt as though we were doing it to support others. Not for me. It wasn’t for me anymore. Because I am that much closer to normal. There is a whole universe between that day and the day I stood in the sun on Cape Cod waiting to spot my friends.

So what now? Well, after aspiring to normal for so long I’ve decided to scrap that, regroup and come up with a new plan. Normal, whatever that is, is no longer my end game. I want to feel amazing. I want to feel awesome. Sometimes, already, I do. But I want it consistently and I’m going to get it. By the way, I know many of my friends and family are chuckling and thinking that I have never been remotely “normal.” Very funny, people, but you know what I mean.

 

 

D-Day

Well, here I am one week before the last “major” step in my fun-filled journey. That’s right, people. It’s D-day. Time to get my new tits.

I guess C-day would be a more apt description of the event since Ds are not in the cards. Actually I have no idea what cup size they will be because we are sooooo scientific and just above all that pettiness — we go by cc’s, not cup sizes. Where was it that I read or heard or saw in some 80s movie that more than a handful is wasteful, anyway (cough… bullshit)?

So I’ll be all cliché and ask you to please send me positive vibes next Tuesday at 9:00am Greenwich Mean Time (and those of you who started to cry after you read that I will, alas, not be restored to my former bodacious glory can pray for a miracle after you stop blubbering. Just stop it. You know who you are).

Seriously though. It has been nearly a year since I went to the very same hospital where I’ll be going next Tuesday, let a man draw all over my boobies with a Sharpie, waved good-bye to my husband and was wheeled into the OR (or the theatre as they call it here — sounds so dramatic doesn’t it?) for the removal of my breasts. You know, it’s a funny thing. I was not nervous. Not at all. I slept like a baby the night before my double mastectomy. Because I wanted that cancer out of my body and frankly felt as though the day couldn’t come soon enough.

I’ve had a year to think about that now. I’ve been through a lot and have gained some perspective. For one year I have had expanders for boobs. Expanders are like implants but they are not meant to be permanent. They are place-holders, pocket-preparers, envelope-makers. Each expander has a metal port into which a hypodermic needle can be inserted (once it has pierced the skin covering the expander — you cannot see the ports) either to inject or remove saline, thus changing the size of the “boob.” And I’ve tried just about every look under the sun. From “pumped up” to pretty darn flat and everywhere in between. This is for a number of reasons, having to do with slowly inflating to create a good pocket and allow the tissue to stretch and recover around the expander, and having to remove some liquid temporarily to get a good angle during radiation treatments.

The other day I had a strange experience. I attended an exercise boot camp with a couple friends. There I was, struggling on a treadmill at an uncomfortable incline, jogging at an impossible pace (interval training is a bitch, particularly uphill), for me, not having been much of a runner for the past ten years. There was a big ole mirror about two feet from me and I didn’t recognise myself. I looked so slight and sort of weird. And then I realised it was because those jugs of mine weren’t there any more. And what was there wasn’t moving at all (I mean AT ALL). That plus the short hair made me feel kind of boyish. And it dawned on me that my boobs were really part of my identity.

It was just weird. I thought, “gee, my shoulders don’t look as broad as I thought they were.” And “gee, I’m awfully scrawny and lanky…” And I guess it’s because my boobs were sort of my thing, not that they were all-defining or anything but let’s just say they were one of my things. And now they’re not. It’s kind of an odd experience, really.

There are other physical changes too, which no doubt contribute to the sense of otherness. I work out more than I did before this happened. And I am a little older now. So yeah, maybe I am a little more sinewy and lanky. I guess it’s the new me. I’ll tell you something, though. The new me is definitely ready for some new tits. I hope that they move, even a little. These expanders have been better than nothing, for sure, but I’m so over them.

Want to get technical? Here’s the plan: my surgeon is going to go through the same incisions that were made during the first surgery. I’d say my healed incisions are about 3 1/2 inches across the very centre of each breast. He will remove the expanders and pop in — now here’s where it gets creative — my cohesive gel silicone implants. These implants are silicone, yes, but they are “gummy bear” implants, so-named for their cohesive rather than liquid silicone structure. They are still in clinical trial in the US even though they have been around for some twenty years (I don’t know why — ask the FDA). They are particularly appealing for breast reconstruction because they are anatomically shaped (think more tear drop less m&m but they won’t melt in your mouth or your hands) which is supposed to impart a more lifelike look to my breasts. And if I got stabbed in the boob they purportedly wouldn’t leak ooey gooey silicone all inside my insides. Rather, they would stay together, just like a harpooned gummy bear (thus the nickname).

Here’s the bad news: implant reconstruction is tricky in people who have undergone radiation. Radiotherapy damages the blood supply to the tissue that has been subjected to radiation and it also increases the likelihood of capsular contracture — or hard scar tissue — forming around the implant. It also increases the likelihood of other complications none of which I am going to discuss or am particularly concerned about. There’s always something, for Christ’s sake. The gist is that after radiation things can get kind of fucked up and sclerotic and sometimes skin and tissue don’t behave properly. Ah well.

I’m hoping that this doesn’t screw up my results too badly on the side that got zapped. Six months following radiation, that side is already firmer than the non-radiated side, which is nice and soft and ready to behave. The surgeon will try to release some of the scar tissue on that right side in the hope that the new implant will settle and form a better more natural shape. Not so firm and not so high.

I figure if it really gets bad I can just use that boob as a drinks table. Screw it. At least I won’t be setting off any more metal detectors in the airports of the world. Because I really wanted to learn how to say “I’m not packing, I just have breast implants with metal ports” in Thai.

Anyhow that’s about it for tonight’s instalment. Feel free to ask me any questions about any of this. Really you can. I like to be technical. And you might be curious. Or not. Whatever.

Smaller Tits in Sixty Seconds

Remember my favourite catch phrase? Come on, it’s from Boob Retrospective, Armpit Wig and Top Ten Reasons Fighting Breast Cancer Isn’t All Bad. I’ll give you a hint, it’s the No. One Reason. Well today we had the converse, or should I say concave. Which is virtually what’s happened to my newbs.

Just to recap, if you missed my last post (Deflated), I had to get some of the saline taken out of my expanders so they can get the right angle when giving me radiation and thus avoid zapping my left side, which does not need to be treated.

Boy am I psyched the flat look is in. And that I have a relatively small ass so that my latest (unwanted) physical adjustment doesn’t leave me looking too imbalanced.

In the military we call this sort of thing a Temporary Pneumatic Setback or “TPS.” Sort of like SNAFU (situation normal: all fucked up) but shorter. Although SNAFU also applies. FUBAR (fucked up behind all recognition), TARFU (totally and royally fucked up) and BOHICA (bend over here it comes again) also apply. I could write a whole post about military acronym slang and how it is applicable to my current situation. HOOAH.

But I need to get back on point.

Candy Floss (if you don’t know her read Zero), Bill and I went to the appointment with my plastic surgeon this morning. Yes, it was a menage à trois (à quatre if you include the surgeon… and à cinq if you count the nurse). I discussed matters with him for a couple minutes and then it was down to business and he and the nurse stuck those needles in there and sucked out 120 ccs from each “boob.” When they were done I looked down and my girls resembled half full plastic baggies. Not a great look, but really kind of funny. I couldn’t help but be amused.

Undeterred, I whipped a padded bra out of my bag and put it on. Not terrible. And just think of the instant weight loss! I’ve heard you can lose even more in an office visit if you saw off a leg though.

Then CF, Bill and I exited the building and took ourselves to an early lunch. I wore my “rubber” leggings as well to give edge to my ensemble. I figure if I have pink hair and rubber leggings no one in their right mind will be focusing on my tits, or lack thereof. The two of us together on Marylebone High Street must have been a sight. Oh, look, there goes Lady Gaga and her conservatively dressed lawyer friend out for a bite at Le Pain Quotidien.

Speaking of which, do you realise that I have been to that particular LPQ (I’m into acronyms today) with my own hair, with Gabriella (my other lover — oh please — read Armpit Wig if you don’t know her), bald as a cue ball, with a scarf and now with Candy Floss? I wonder if the staff there recognise (it’s plural in England) me or if they think I am five different people. They probably just think I’m a “right nutter” (this means a real weirdo but you could have guessed that couldn’t you?).

And I can live with that because I kind of am. I mean my kids are so used to my weirdness that they let me leave the house bald or with pink hair. And they aren’t even embarrassed by me. Which is kind of great, isn’t it?

I had a great rest of the day. I bought two groovy t-shirts at agnès b (one with an octopus and one with other sea creatures including a lobster). They look good now but there is room for more boob for later as well. Stylish and practical.

Then my friends Susan and Donna and I and Agnieszka took the girls to see The Lion, The Witch and The Wardrobe in Kensington Gardens. It was a terrific show with a great set (tee hee — I said “set”). A circular stage and there were creatures done up à la Lion King, people flying through the air on wires and singing, you name it. We were there with about five hundred British school children because the Brit schools are still in session through some point in July.

Then we hopped on a bus and took the kids to the Hard Rock Cafe. I hadn’t been to an HRC in ages. Check us out. Here I am with my groupies.

When I got home I looked at my flatter self. Not so bad, really. I think I could really kill it with this look for the next month and a half or so.

I just hope it was enough so that they can get their angle. The scan tomorrow will tell all. Send me and CF good vibes. We need ’em. Because if it didn’t work and they have to deflate and delay again I might have to go AWOL.

 

 

 

 

Deflated

There is some required reading prior to delving into this post, people. I know. You feel like you’re back in school. Sorry if that gives you nightmares. But here’s the deal: If you have not read Boob Retrospective or if you read it ages ago and it is not fresh in your mind, you should read it now so that you know what I am talking about.

I had a shitty morning. I was minding my own business, cooking up some scrambled eggs for my five-year-old, when the phone rang. It was my radiation oncologist. I answered and she thought I was my husband. I guess my voice was a bit deep because I hadn’t been up that long. I figured she was about to tell me that all systems were go for my radiation starting on Monday after getting the scan results from last Friday.

But no.

What she told me, rather, was that they were going to have to take some of the saline OUT of my expanders before beginning radiation because otherwise it would cause me to get some radiation to the left breast. (They don’t want to deliver any radiation where it isn’t needed for obvious reasons and if heaven forbid you should ever need any to that area in the future you have problems if it has already been irradiated).

Because I was in front of my children I held it together and finished cooking the breakfast. But then I went into my room and had a good cry. I mean for fuck’s sake. Here I am, finally a sunny day in London, and no more every other Thursday chemo to contend with, and now this Thursday I get to visit the plastic surgeon so he can make my boobs… smaller. By 4 centimetres. Talk about reverse progress.

I can assure you this is not going to look good. I don’t mind so much about the flatness, but it will get all wrinkly, particularly at the top and on the sides where the expanders don’t have much fluid in them. And I get to go through the next six weeks in London and then enjoy my beach vacation like that. Really good for a girl’s self-image. It’s a lucky thing I haven’t gone swimsuit shopping yet. That’s sure to be a barrel of laughs. “Um, yeah, do you have anything that will work with… this?”

The day after the deflation I must have yet another radiation planning scan and then the whole delays my treatment by two days. “But I already bought plane tickets for the US and we were leaving the day after my treatment ended.” I said. My radiation oncologist said that we could double up on two days provided the treatments are at least six hours apart. And that I could get reinflated “right away.” But naturally I won’t be here to get reinflated. I will be in the United States on my bloody vacation, won’t I. Wearing a potato sack.

I really shouldn’t complain, seeing as I have my scalp and mole biopsies to look forward to next Tuesday. That and I found this weird little lumpy thingie on my right arm yesterday and believe you me, once you find a little lump on your body that ends up being a tumour, you do NOT like to find any little lumpy thingies anywhere else. At all.

I am sure (and I am assured via telephone) that this is nothing. However, I don’t like it.

My plastic surgeon was in surgery all day today so I have not been able to speak to him about my impending deflation. I am certain he is no less unhappy than I am about having to undo his slow, steady expansion. Alas. Sucker punched again.

Well, screw all of that. I was meeting my glamorous Parisian friend, Marie, for lunch today at a little place called Cocomaya. So I went for a brisk half hour walk in the neighbourhood, it then being too late for me to get to the gym and back before lunch. Then I put on my lowest cut shirt, showing off my fresh cleavage tattoo. I figure I might as well display what I’ve got before it’s stolen away from me on Thursday morning.

And I went out and had a very nice time with my friend. After lunch I walked through Hyde Park to Harrods to see about the big sale that’s on. I really need to go horseback riding in Hyde Park one day soon. I haven’t been horseback riding in ages.

Of course Harrods was mobbed with (mostly irritating) people. Including one red-faced old bag who yelled at the nice man behind the loose tea counter as he was assisting me “what are you the only one working behind this counter now?” “Yes, madam.” “What the others are all on tea break are they?” “Yes, madam.” “Bloody hell!” I thought she might reach across the counter to strangle him. I suppose this would have been an opportune moment for me to whip off my headscarf and say “is it all right with you, madam, if the nice man finishes helping a cancer patient who is about to have her boobs taken away (again)?” But I am sure she wouldn’t have given a shit (especially since she was probably drunk) so I completely ignored her and just slowed down my order a bit.

I bought strawberry and mango black teas and this lotus situation that comes in an unremarkable little pod but then opens into a gorgeous flower once you pour boiling water over it. I guess I have to see my own situation this way. I am just in my pod phase. Soon I will bloom again (just please don’t pour boiling water on me).

Following that I bought some fresh cod (you may as well pick up something for din din if you find yourself at Harrods in the late afternoon) and some very fine artisanal chocolates. When I got home I gave each child one chocolate and then I gave myself three. This was met with mild outrage by the seven-year-old but I looked her straight in the eye and said “Mommy had a hard day.” And then I popped that third one into my mouth and savoured it. No guilt whatsoever.

I had my eighth and final chemotherapy treatment two weeks ago this coming Thursday. Every Tuesday night before a Thursday chemo I used to think, I have one more day. One more day to feel normal before they hit me again. This week was going to be a day when I didn’t have to think that. But now I am thinking I have one more day. One more day to look (somewhat) normal before they take my newbs away for about eight weeks, just in time for summer. One more day. One more thing to endure. One more festering turd on the road to killing it.

Of course I’ll be a good sport. I will embrace the flat look. Make it work for me. Conceal the wrinkly bits if they show. Get a padded bra or shove a chick fillet in there to plump things up.

And I will still be me. Because they can’t take that away from me.

 

50 Gray

No, this is not a post about Fifty Shades of Grey. My sister-in-law gave me that book for my birthday and I haven’t gotten into it yet. But apparently the whole thing is bondage and sex, which she must feel I could use some of at the moment.

Rather, this is about the planning session I attended this morning for my radiotherapy treatments. One “gray,” which was defined in honour of Louis Harold Gray, is the absorption of one joule of energy, in the form of ionising radiation, per kilogram of matter. It just so happens that my prescribed dose is 50 gray, delivered in 25 sessions. It’s bound to be loads more fun than mummy (that’s mommy if you are in America — I am not making a reference to dead ancient Egyptians) porn, delivered in 500 some odd pages. Not.

So I left my house at about 9:10 am and in it FIVE girls (my kids and my good friend’s three kids, because my friend had a doctor’s appointment at that same time and needed childcare), the housekeeper and the nanny.

For once in my life I left enough time to take the tube. And I even brought a book so I would have something to do on the tube. On the platform after exiting at Warren Street I caught site of the very nice woman and fellow survivor I had met while getting my nails done a few weeks ago (remember her from Why I’m Lucky?) and I even remembered her name. Is that proof enough for you that I don’t have chemo brain? I called out, she turned and we ended up walking all the way to the place together. She’d been there, you see. Been there; done that.

The planning session consisted of meeting with a radiographer (or whatever the appropriate term is) for an initial Q&A, during which I always ask about a billion questions and make things take twice as long. I can’t help it. Inquiring minds want to know.

Prior to that I was greeted by two very pleasant, well-mannered ladies who offered me a cappuccino and even took and rinsed out my thermos, which contained a yucky coffee I had brought from home and wanted to discard because I had inadvertently grabbed the housekeeper’s coffee and it had sugar in it. Blech. Taste bud shock. You would never get this service in the US. Would you? Tell me where if I am wrong; I’d love to know.

Then I went into the scan room where the team positioned me on this table with my arms above my head and then drew all over me and placed wires and whatnots on me and took measurements. Laser beams from the ceiling made marks on me so that they could tell if I was properly aligned. Pretty cool, really. There were three or four ladies with one dude in charge of the proceedings.

Here is a thought. The dude was young and good-looking, and there I was disrobed from the waist up, with my weird “newbs” out, and I didn’t even feel the slightest bit self-conscious. All modesty has gone right out the window with this thing. In fact I was making them all crack up. After my oncologist’s radiographer had put ink and wires all over me, she snapped a couple of photos of the area and I said “this isn’t exactly the nude photo shoot I had been dreaming of… but it will have to do.” She also asked me where I was from and when I indicated I had spent a good deal of time in Manhattan having grown up in Connecticut and been most recently from Boston she wanted to know if we really used the word “smock” in New York. “What?” I said. “Smock,” she repeated. I said I had no idea what she was talking about. Then she said that her husband had bumped someone at the airport and the man had called him “a smock.” Ha ha. “Oh yes,” I replied. “I believe the term you are looking for is ‘Schmuck,’ not ‘smock.'” Now if that doesn’t make you laugh you are truly brain-dead. The English. Good grief.

Anyhow then they took all that crap off me and did the CT scan — it was very quick. Following that, one of the radiographers made three small tattoos on my skin with a blueish ink. One in between my “boobs” and one on either side of my body on the rib cage. That helps them line me up with the lasers and make sure that I am positioned correctly for all radiation sessions. Although I wasn’t deliriously happy about being tattooed and having yet another reminder of all this cancer shit, I figured it made sense to let them do their thing so they get it right. Over time I won’t mind these marks much. They are just little blueish freckles.

After all the fun was over I had another session with a nurse who talked to me about potential side effects, mainly fatigue and skin effect (burning, blistering and breakdown — the three “B’s”). She indicated that the skin reactions are cumulative. Usually the skin doesn’t react right away. It generally happens after about two plus weeks in. I am hoping that this lovely 10% calendula cream called My Girls Cream (tee hee) that was sent to me by a fellow survivor in the US helps me sail through the treatments without too much burning or skin breakdown. Those photons can be mighty hard on a girl (or a guy for that matter).

Then I was done. Feeling pretty good about the whole morning. Not so long; not so bad.

Until I got home and found out that the five little devils had made two holes in my girls’ bedroom walls. The two five-year-olds barricaded themselves in Charlotte’s room and went at this rather soft part of the wall (I don’t know why it is soft but it is) with a pair of scissors and by the time it was discovered had hammered about a four-inch-high narrow gash in the wall out of which dust, dirt and debris (the three “D’s”) was falling out and staining the carpet (thank God for replaceable carpet tiles).

Meanwhile on the other side of the wall, the big girls had exacerbated a small dent that had already been in Isabel’s wall, which now also had the three D’s coming out of it.

All I could think was WTF. Are you kidding me? My girls are lucky I am too weak to give them a good beating. I told Bill about the episode in an email and of course he thought it was mostly funny. Which I suppose it is, in the long run. But seriously, holes in the wall? I told them if they want to fuck up their own house when they are adults they can do so but until then this behaviour is 100% unacceptable.

Here I thought the hardest part of my day was having radiation planning. But it wasn’t. I guess that is something to be thankful for in itself, no? After lunch, at which no one was allowed to get dessert (duh), we went home and things improved. My girls read and did art projects and ended the evening by putting on bathing suits and 3D glasses, getting beach towels and pretending to sun bathe (it was neither warm nor sunny enough for such) in the garden. And I retaliated by whipping up a killer marinara sauce (no recipe) in which I hid an entire zucchini. My kids hate zucchini. I still haven’t told them they ate it right up. Little blighters. Ha ha.

Work it Out Redux

I just got back from the gym. Seeing as it is the Monday after my final chemo (which was just last Thursday), I will own up to the fact that I am a wee bit drag-ass. But not terrible.

I still have to set the cardio on the elliptical and the exercise bike to about 60% of what I was able to do pre-surgery in early February. And I have frankly lost track of how much I downwardly adjusted the weight on the other machines. But, I haven’t had to knock them down again after I adjusted everything a few weeks ago so I am at least holding steady. That’s something. I’ll take it.

Sometimes I peek over surreptitiously at the person next to me on the cardio to try to see how many watts they are doing and just how lame I am. Being a cancer patient doesn’t make me that much less hard on myself. Because if you start going down that road of excuses, where does it end?

There is reasonable, and taking it easy and not pushing too much. And then there is just sorry-ass lame excuse making. I don’t ever want to be in the second camp. Do you?

So anyhow I have formulated a plan. It is a loose plan because I will have to play it by ear and see how I feel during radiation a/k/a radiotherapy (doesn’t that make it sound like a pleasant spa treatment involving music?). The plan goes something like this: Now that chemo is over, it is time to start ratcheting things up at the gym, little by little. So that by the time I am ready for my summer vacation, I am looking and feeling fit and strong for the beach. Even if I have to wear a mumu or a full body tent in order to protect my skin. I want muscles under that tent.

After my cardio/weight circuit this morning I moseyed on into the stretching room to see just how much those pecks have atrophied. I did ten push ups, girl-style, on my knees. Normally this would piss me off. But I know that I am not ready for the full deal. And that is okay. Because I will get there again. But I don’t want to bust anything.  No pun intended.

It is a crappy rainy day here. My husband left his raincoat at work over the weekend. Bad timing. And my older daughter decided not to wear her Wellies to school this morning even though it is the textbook day for such attire. Alas.

Are you wondering what to do on this crappy rainy day here in London, or for that matter wherever you are, be it rainy or sunny or hailing or what have you?

I’ll tell you what to do. Get off your ass and get to the gym. I haven’t reminded you in a long time (see Work It Out) and it’s about time I light another fire under that caboose of yours.

I’ll be right behind you, huffing and puffing away, killing it as much I am able to at 80 watts and climbing.

Summer Buzzies Are Out

For the (wow I’ve already lost track so fill in blank) day, the weather in London has been absolutely, positively supercalifragilisticexpialidocious. I don’t think I saw a single cloud today and that is something else considering how the wind blows things across this island.

We had a mellow day. My big event was walking to Hampstead for a polish change, a medical necessity to help strengthen my nails (sort of hard hit by the chemo drugs). Plus it gives a bald girl a lift. A little colour is always good.

I slathered on SPF 50 and put on the bare minimum of clothing, having worn my parka just last week! (Do you think that warranted an exclamation point, or what is overkill?) A black GAP body tank top, my H&M striped miniskirt, flip-flops and an apple-print headscarf (also H&M). I’d post a pic but I am in my pyjamas now and that train has left the station.

Then I hoofed it up the hill to the Beauty Boutique on Flask Walk. I love this place because it is low-key, friendly, they know who I am and act normal toward me. How nice.

With good weather comes skimpy clothing. People of all shapes and sizes partake, and there were indeed some eye-catching ensembles this afternoon.

The thing I noticed most was how everyone’s tits were out. Lots of tank tops, bustiers, revealing sundresses, you name it. A little sunshine and all hell broke loose. The women of north London were practically serving them up on a plate.

Lots and lots of cleavage. And bouncing scoops of flesh.

As I mentioned in “One to Go,” after chemo on Thursday I saw the radiation oncologist. She warned that there was a good chance the radiation would foul up the reconstruction on my right side. Nothing to be done about that but wait and hope for the best. Expect the worst.

I am not gonna lie. I ain’t thrilled about this. But it wasn’t new information. It just sort of sucked to hear it again when I am about to kick chemo’s ass and embark on the next phase. Got to hand it to the docs, though, they are on the ball. Yesterday I got my entire radiation schedule e-mailed to me, with times and everything. It’s on my iCal, waiting to be crossed off.

I just hope that at the end of the day I won’t have too many complications. Radiation has what my reconstruction surgeon calls “the bystander effect.” For every one bad cell that you are targeting, it destroys or alters about a billion healthy cells. This is too bad. But Das ist so.

Having implant-only based reconstruction surgery following (or prior to) radiation can be problematic. Your skin acts different, the blood supply is affected and you are more prone to bleeding, infections and capsular contracture. Capsular contracture is when scar tissue forms around the implant and sort of squeezes it. It can cause the implant to be hard and/or misshapen. And sometimes further surgery is required, including eventually removing the implant.

I don’t really want to be an Amazon.

I’ll tell you what, though. If that shit happens, if that is my lot, then I’ll take it over the cancer.  I’d rather be an unwitting Amazon than have a great set of reconstructed boobs for two years and then find out I have a recurrence in my chest wall.

If that shit happens, I will become Katniss (from The Hunger Games, people) and take up the bow and arrow (although it is reputed that the Amazons had their left breast removed not their right, so that they could shoot arrows and throw spears more freely, despite being depicted with both breasts in artwork).

I will admit that it is not my first choice, and it would definitely cramp my fashion style. However, sometimes you have to make a sacrifice in order to kill it. And my reconstruction surgeon has more than one trick up his sleeve. So we’ll play it by ear. And meanwhile I will continue to watch the parade of large, jiggly buzzies romping up and down the high street.

An unruly sea to which I not so long ago belonged.