On Losing and Gaining

Yesterday, I lost my breasts. The material that used to be my generous rack is now probably reduced to incinerated ash, along with the perfectly intact reproductive organs I lost a few months ago. It's quite something that none of this anatomy was problematic. I saw a picture of my uterus, Fallopian tubes, and ovaries, laid fully intact on a sheet of surgical material, and they all looked like a textbook diagram. (My bestie used one of her medical school textbooks to show me some female pelvic muscles a few days ago, and it was uncanny how similar my own erstwhile organs looked compared to the textbook images.) That might be one of the more difficult things to wrap my head around. The organs to which I've bid a resolute farewell were fine. The issue was the risk of what they could have become. The term "time bomb" has been helpful, in that it was only a matter of time before those parts would likely make me really sick.

I've already been sick. This blog documented the whole experience. While the whole spinal cord tumor chapter of my life was valuable and ultimately life-saving, it's not something I'd like to relive. I wouldn't wish it on my worst enemy. It's a helluva thing for a medical provider to tell you that there's a thing growing unbidden, uncontrolled inside of you, and that a series of difficult decisions will have to be made to deal with the mysterious It. I don't want to go through that again. If I could help my loved ones avoid that fate, too, I would.

Removing my reproductive system was an internal struggle. The hard parts of that recovery were within me. I think my husband saw me staring into space a few times, trying to identify what messages my body sent, what needs I could meet.

 Removing my breasts is external. Anyone who has seen me in person recently could easily see that my body has a new deficit. For now, I have tubes coming out of me-- drains to collect excess fluid and a 'wound vac' whose mechanics I don't entirely understand but whose little noises are kind of charming, plus a very snug arrangement of bandages and a compression garment. The breasts that used to require visiting a specialty store to find an adequate bra? Gone. I don't yet know what I'm going to do with the wildly expensive bras. Their sizes sound like jokes to anyone who's never existed outside of the 32A-36DD spectrum. My plastic surgeon guessed that my new 'mounds' will have the size of the bras I wore in 7th grade.

So, for breast-owners who opt for prophylactic mastectomies to reduce the risk that comes from the genetic mutation that I have, there are a few options. They can have their breasts removed and call it a day, That approach is called 'going flat' or AFC [aesthetic flat closure]. The folks who take that route are unbelievably cool. Another approach is to fill the voided space with implants or material from other parts of the body [a 'flap' reconstruction, usually from the lower abdomen]. I opted for a middle road called a 'goldilocks' closure or SWIM [skin-sparing Wise-pattern internal mammary perforator]. Basically, the breast tissue was removed entirely to lower or damn-near eliminate my breast cancer risk, and then a plastic surgeon used the resulting skin and subcutaneous fat from the area to create mounds that resemble breasts. Since my body skews juicy, I was a good candidate for this procedure, and now I wait to see if it heals into what I'd prefer.

For now, I'm in an extraordinary amount of pain. I can't sleep in my own bed because I have to remain on an incline; I can't shower because the drain ports can't get wet; I can't lift my arms over my head because it would tug on everything that trying ti heal. I have big feelings about what I've gone through and what the next chapter of my life will look like. I have enormous feelings about the people closest to me to who've dared to share some of this burden, particularly the more grisly parts. (Seriously, partnership hits a new level when one's spouse has to empty drain bulbs into a measuring cup to check how much magic potion my wounds have produced in a given clip of time.) One thing that has become very clear is that these tough moments-- when the meds haven't kicked in, when the meds have kicked in too much, when getting comfortable is just not in the cards-- are really untouchable. I'm fortunate to have people who can hear about the moments, but it's just me in this sore body. It's just me with the horrific daydreams and constant worry that a gnarly infection is just around the corner. It's just me sitting here waiting for my next dose, trying to find some comfort from a blinking cursor. I wouldn't wish this isolation on anyone, but it's difficult to shake the feeling that it's going to be a source of strength in the future. It's difficult to shake the feeling that these tough moments, these tough decisions, are giving me a new lease on life.