Obligatory End of Year, Looking Back, Looking Forward Post

This time last year, I was in New York City, getting ready to ring in a new year, like I had (at rough count, at least three or four other years this decade), at Madison Square Garden, watching, singing, and dancing to a band I loved. Champagne drunk at midnight, I had no idea, as My Morning Jacket launched into Kool & the Gang's "Celebration" (always a personal fave), what I'd face this year. I had no idea my natural breasts were bouncing and jiggling to the beat for the last time, that by the end of the year, they'd be gone.

The year that began in the early morning in Manhattan took me many unexpected places -- to Belize, to Costa Rica, to Cape Cod, and many places in between -- but none so unexpected as the operating room where I traded in my breasts for a chance to ring in many more new years cancer-free. 2009 has been, by any estimation, a year of tumult: first, my husband got a new job, moving from college professor to college administrator, and lengthening his commute from two blocks on foot to 45 minutes by car; then, the crushing news of being BRCA+, the anger, the sadness, the decision; then, our first wedding anniversary, clinking glasses at the bar of the hotel where we'd spent our first night as husband and wife, incredulous that so much could have changed in so short a time; next, our first home, a place we'd live, we hoped, in good health for many years; and then, my double mastectomy. And in the end, we'll remember 2009 as our BRCA year. Four little letters that meant nearly nothing to me a year ago have, in twelve short months, changed my life, my husband's life, my family's lives irrevocably. Everything is different now. Not even my boobs are the same.

Needless to say, I'm anxious to ring in a new year. I have no idea what 2010 has in store for us, but I can only wish it's less eventful than 2009. Please, no surprises, nothing major. Just twelve months free from drama. Tonight we will welcome the new year with friends we didn't know this time last years,friends we've made because of BRCA, friends who've shown me what life looks like as a previvor, friends who have stood by my side through surgery. It's a far cry from the frenzy of a rock concert at MSG, but it's a fitting way to see the year out.

Year-end lists are a popular (and gimmicky) way to sum up what has come before, and in that spirit, I'd like to offer my own: My top 9 blog posts of 2009. I began writing in March, even before I had my genetic test results, and the solace and catharsis that has come from writing here has helped me inestimably. I hope that it has helped other, as well. So, without further delay, my top 9 of '09:

9. Sorry, can't talk. I'm on my way to a cancer appointment
(March) In which I am genetically counseled

8. It was the breast of times, it was the worst of times
(April) In which I come out to friends (and the internet) as a mutant

7. The picture of health
(May) In which I have an MRI

6. The view from the other side
(June) In which I watch a good friend recover from a preventative mastectomy

5. Sky Rockets in Flight, Cape Cod Delight
(July) In which I spend an afternoon with a dear friend recovering from a rare cancer and wonder why I have a chance he never did

4. Previvors vs. Survivors in the World Series of Love
(September) In which I talk about how hard it is to be a previvor

3. The Keynote Speaker Has Left the Building
(October) In which I become a BRCA spokesperson

2. (Don't) Say (Just) Anything
(October) In which I offer the "Top Ten Things Young Previvors (Probably) Don't Want to Hear, and the Top Ten Things We (Probably) Do"

1. A Break Up Letter to My Boobs
(December) In which I say goodbye to boobs

Wishing all of you a very happy and healthy 2010! See you next year!

On Healing

It has been nine days since my surgery, and I am well on my way to recovery. I'm not there yet, and I likely won't be for sometime, but I can see indisputable improvements every day. For example, my new breasts were, at first, terribly bruised, like they had gotten in a fistfight and lost. But now, there is only a slight patchy yellowish discoloration where the deep purple bruises once were. That's a lot of progress in just nine days.

But healing, I've come to realize, is both physical and emotional. And it's the latter I want to write about here.

Not to toot my own horn, but I can confidently say I tried as much as humanly possible to be emotionally healthy before my surgery. In addition to keeping this blog, which has been an indispensable outlet for working out my feelings, I've been in therapy since I received my genetic test results in April, I've been attending support meetings and networking with other BRCA+ women, and I've thought and I've talked and I've philosophized and I've explained and I've listed the pros and cons and I've imagined worst-case scenarios and I've developed a mantra and I've come to peace with the genetic mutation and my choice to have surgery. In short, I was very deliberate and thoughtful in my mental preparation; I went into surgery last Friday confident. I came out of surgery something different.

I'm just going to put it out there: I'm sad. This is really hard. And what makes it even harder is that almost no one in my position talks about feeling down after surgery; they all say, No, I never felt regret, I am 100% happy with my decision. And don't get me wrong, I do feel unburdened from a terrible weight. But am I 100% happy? No. I'd say I'm 80% happy, 20% sad. That's a pretty good ratio, but still, how do I deal with the sad, especially if admitting I'm sad undermines the confidence and bravery and all that heroism shit everyone was complimenting me on?

Here's the thing. Last Friday morning, I was a BRCA+ woman who was going to have a double mastectomy. By Friday afternoon, I was a BRCA+ who'd had a double mastectomy. I went from theoretical to actual in just four brief hours (hours that I was unconscious). And I'm having a really hard time reconciling my new identity. On Wenesday, G and I went to buy a post surgery bra at Nordstrom (I recommend the Natori sport bra, for those in the market for such things). I knew what I was looking for but couldn't find it, so I approached the sales woman at the register of the lingerie department and said, "I just had a double mastectomy and need to buy a bra." And then I sort of froze; that was the first time I'd said it out loud. It sounded so weird, so unbelievable. I just had a what? A double mastectomy? You've got to be kidding! You didn't even have breast cancer! Whaddya crazy?

And it's funny because before my surgery, I was so angry when people would question my choice, probe deeper into why I'd chosen something so radical to prevent a disease I might never get. And now, at least temporarily, I hope, it seems like I'm one of those people. What'd you do that for? You must a lunatic! And that's what's making me sad. I can't quite get my head around the fact that I've done this. It's not that I regret my choice; it's that now I have to learn to live with it.

Sometime last week, which day I cannot recall since they all seem the same, my family and watched a BBC program called "How to Look Good Naked." The woman featured was a young Brit who'd battled breast cancer and had a mastectomy (without reconstruction); she wasn't comfortable in her new body, and the show was designed to rebuild her confidence. She was a sympathetic subject. Poor girl! She'd had breast cancer! And so young! And to lose her breast like that! So tragic! As I watched the show, a lump grew in my throat; she'd had a mastectomy, I'd had a mastectomy. Whoa. If I could have gotten up off the couch without assistance, I would have run to my bedroom and burst into tears. Instead, I sat there and tried to process my feelings. I realized I'd joined a club I never intended to be a part of. From this moment on, I'd never not be a woman who'd had a mastectomy. Even many years from now, when I'm over it and I've healed and I've gotten used to my new bosom, I'll still always be a woman who's had a mastectomy. That's when the permanence of my choice struck me. There was no undo. I'd been changed, and there was no going back.

And maybe that's why some people don't go there. They figure, what's the point of tears? They won't bring my boobs back. So forget that and look on the bright side. And, hey, I'm an optimist, so I totally understand that impulse. It's hard to acknowledge any negatives at all, especially when you feel so persecuted for your choice. It's like doing so gives the doubters fodder. But I think I would derail my recovery if I didn't acknowledge this. I'm not going to put my finger in my ears and say "LALALALALA I can't hear you." I don't think I can heal fully if I avoid the ugly and unexpected emotions of my post-surgery life. That's why I don't want to bury my head in the sand now. I need to get this out: I'm sad.

Now I want to be clear. I'm so glad I had this surgery. I would do it again tomorrow. I could not live my life with the threat of cancer looming over me, never knowing when or if it was going to strike. And I couldn't live a minute longer with the crushing anxiety that had so consumed me in the last few weeks and months. So it's not that I wish I could go back and do it differently. It's that, just as coming to terms with being BRCA+ took a lot of hard work over many months, so too will I have to work hard to come to terms with being a woman who gave up her natural breasts. This entire process has been about adapting to new identities, and I trust that in time I will learn to accept my post-surgery self. But I'd be lying if I said everything is puppy dogs and rainbows on the other side of surgery. Now that the initial elation of simply being alive has ebbed, I'm left with some pretty complicated emotions I've got to work through.

I envy those women that say, Nope, never gave it a second thought, nothing but totally thrilled to have gotten rid of my breasts. But I am not one of those women. And I hope, if nothing else, this blog has proved I'm not afraid to tell it like it is, even if it's ugly, so take this not as a caution to women considering this surgery -- I am not saying don't do it (in fact, I'd still say, do it, sister!) -- but as gentle, completely honest advice: when you are emptying your drains, cleaning your incisions, or applying your gauze, don't forget to stop and attend to your emotional wounds too. They may be deep or there may not be any at all. But don't ignore them for fear of appearing weak or fickle. Acknowledge them and work through them. And in time, they will heal, too.

My physical healing will take months; the psychic healing could take much longer. But I'm confident I will recovery fully in both areas. But no matter what, I'd rather battle a little postpartum blues (or maybe it's PTSD?) than cancer. So as long as I keep that in mind, I know I'll come out of this OK. And you will, too.

Have Yourself a Very Mammary Christmas

'Twas the day before Christmas, and I'm stuck in bed, while pain-killer induced visions dance in my head.

It's been nearly a week since my surgery, but the days have simply melted into one another. I've left the house only once since I got back from the hospital on Sunday (and then only to see my doctor), and I've been sleeping a lot. The first few days back from the hospital were easier, for whatever reason, than the last few: when I last updated this blog, I was imagining going for walks, to the movies, out to dinner; now all of that makes me panic. I've been rather nauseous lately, and I haven't had much of an appetite, so dinners are out. And the painkillers--though a gift from baby Jebus himself--have made me dull-witted (I'm really struggling to compose this, as the words that normally come so easily seem so far out of reach right now), irritable, and unable to concentrate. I need them, of course, because I am in pain: I feel like I have two bowling balls stapled to my chest. But they are making me feel less and less like myself.

Well, in the spirit of Christmas, how about a little gift? The gift of all the gory details about my surgery. Since many of you have asked what exactly I had done, here is a little medical lesson. Think of it as everything you wanted to know about my surgery but were afraid to ask (and maybe even some stuff you didn't want to know). So what exactly did I voluntarily subject myself to last Friday? The technical term is a one-step direct-to-implant skin-sparring nipple-sparing prophylactic bilateral mastectomy. In English, that means that I had both breasts removed as a preventative measure; the doctors scooped out everything inside, but I kept my own nipples (this is an option that many women in my position decide against: the research indicates that keeping nipples--which are, of course, breast tissue--does not significantly increase risk of developing cancer there and improves both aesthetic and psychological outcomes, but many women figure if they are going this far, they might as well go all the way. I chose to keep mine because I knew it would help me greatly to be able to look down at my new breasts and recognize them as still my own. And it has. I don't really feel like I've had my breasts removed at all. It's like I had them replaced; different stuffing, same envelope. And furthermore, if, by some freak occurrence cancer did manifest in my nipples (it is still possible to get breast cancer, even if you have next to no breast tissue), it would be easily detected.). During the mastectomy, the breast surgeon tested the tissue he extracted for any abnormalities; it was possible that I could have had cancerous growths developing in my breasts unbeknownst to me, and, in such a case, I would have awoken without the nipples I had hoped to keep (especially if the tumor was near the nipple). Luckily, the tissue was clear and I got to keep my nipples. (And further tests on the tissue by the pathology lab revealed that indeed, I was completely cancer free. I got the all clear! I dodged the bullet completely. I am a true previvor.)

Once the breast surgeon was through with his portion of the surgery (which, I understand, in my case lasted about an hour), the plastic surgeon began reconstructing my breasts. Easy go, easy come, right? I have to admit that there is no way I would have ever considered this preventative surgery if not for the option of reconstruction. When my grandmother had breast cancer in the 1980s, she had a radical mastectomy, and back then, they took it all: tissue, muscle, skin, nipple. She was left concave, maimed, deformed. And when I first heard that a treatment option for women with the BRCA mutation was a double mastectomy, I recoiled at the idea of looking like my grandmother. Well, and forgive the cliche, but I'm too addled by painkillers to come up with anything more creative: this isn't your grandmother's mastectomy. In fact, when it's all said and done, I'll have more in common with, say, Pamela Anderson than my grandmother. In a society that values overinflated, unnatural bosoms, I'll have exactly what we deem attractive and youthful.

There are, I think, about two dozen different reconstruction options available today, but for ease of discussion, it is useful to think of them falling into two categories: tissue transplants or breast implants. For the former, your own body tissue, from your stomach, back, or ass, is transferred and reconfigured into breasts (this is great if you husband is an ass man, because now he'll have tits made of ass. Budump-ching! I'll be here all week. Don't forget to tip your waiters.). This surgery has both pros (it's permanent, it's you, it looks more natural) and cons (it's extremely painful and the recovery time is significantly longer), but I decided early on it wasn't right for me. The truth is, I'll need to have a revision at some point down the line (implants don't last forever) and I might consider it then; but for now, tissue transfer was just way too scary. So I chose to get implants. It's still strange to type those words since I never in my life thought I'd ever be in the market for breast implants. But this is a little different than cosmetic surgery, and a little more is at stake, so I'm cool with it (though it took me a while to accept). There are two options when it comes to implant surgery, as well: one-step or two-step. The latter is the more traditional approach: after the breast tissue is removed, an inflatable tissue expander is placed beneath the chest muscle; after surgery, a women wakes up with about an A cup. Over the course of weeks and months, that expander is gradually filled with saline, stretching the muscle so as to accommodate a permanent implant. Not to offend the many women who have chosen this method, but it sounds like pure torture to me, not to mention frustratingly slow (the whole reconstruction process takes months), and I was sure there had to be a better way. There was, luckily, and that's what I chose: the one-step procedure allows for immediate implant placement. During surgery, the pectoral muscle is cut and a pocket is created with Alloderm (which I wrote about here); the implant in placed behind the muscle and in the pocket and the reconstruction is complete. Because I chose this type of surgery, I woke up with breasts, misshapen and square though they might be, and I am so glad, from an emotional level, that I decided to go with this reconstruction; it's been a lot easier dealing with all of the emotions and questions and doubts that arise after (yes, after) surgery because I really don't feel all that different. I look pretty much the same as I always have and my breasts still seem like my own, even if, in reality, they are gone.

So, what am I to expect as I recover? As the muscle loosens and my implants settle, my square boobs will become more round. The incisions are under my breasts, so once my new boobs fall into place, you won't even be able to see the scars. So sometime pretty soon, I'll look like nothing really happened at all. And that's exactly what I want. On the downside, I have almost no skin sensation (although I still have more than I expected. I can feel my sternum and around the base of my breasts) and no nipple sensation at all. And this is unlikely to change. The nerves have been cut and damaged, and it's pretty much a dead zone across my chest. But all of that is a small price to pay for the peace of mind I gain, the certainty that I've beat the odds, no matter the extraordinary measures I had to go to do so.

My family is visiting through Sunday (they arrived the night before the surgery) and they keep asking if there is anything else I want for Christmas. But, I tell them, I already got everything I wanted: I made it through surgery and my pathology report came back clean. I couldn't ask for anything more.

Merry Christmas to all!

Greetings from the other side

I’m alive!

And feel fine. Seriously. On Thursday night I said to G that my sincerest wish was that when we were through this surgery, we could both look back and say, “That was no big deal.” And so far, even though it’s only been a few days, I feel I can confidently say, “That was nothing.”

My surgery took place at 7:30 a.m. on Friday. We arrived at the hospital a little after six and checked in. I was given a hospital gown, a hair net, slipper socks, and some funny hose that help prevent blood clots. A nurse came in to take my vitals and several research assistants had me fill out paperwork for studies I’d agreed to be a part of. My mom scratched my back like she used to do when I was a kid, and I cuddled on the little hospital bed with G, wrapping myself around him so tight, embracing and nuzzling and burrowing. And then a “transfer nurse” (so-called because he’d be transferring me into surgery) appeared in the doorway and told me it was time. It is in moments like these that you realize your entire frame of reference for how to act in such situations comes from television and film. I expected an orchestral swell of sentimental music, a cut to slow-mo, a shining tear descending languidly down my husband’s cheek. But no. I hugged everyone goodbye (G got two hugs and a couple extra kisses) and I walked down the hall with my nurse, into the surgical unit, and laid down on a gurney.

I wasn’t particularly nervous yet, mostly because the whole set-up seemed so unreal. The week prior to surgery-—when I thought for sure I’d go on crying jags and descend in to fits of panic—-I was eerily calm, resigned almost to my fate. And that’s how I felt as I stared up at the lights and tried to memorize the pattern on the curtain separating me from the patient across the way who, I overheard, was having some kind of endoscopic procedure. There was no turning back now. This was really going to happen. Might as well just accept it.

Both my doctors stopped by, and Dr. F, my plastic surgeon, drew on me with a cold black pen. He asked if I had any questions, and I said no, because honestly, the only one I had left—-“Am I going to be OK?”—-was the only one he couldn’t answer. Then the anesthesiologist dropped in and gave me something to calm my nerves. Now, this had been described to me as the chemical equivalent of a “cool glass of California white,” which, at 7 in the morning and on an empty stomach, should have given me quite a buzz, but it didn't do too much for me. By the time they pushed me on my gurney into the operating room—-again, lights whizzing by overhead, a view I have seen only in movies-—I wanted to call attention to the fact that I was far too alert and awake to possibly be put under any time soon. An oxygen mask appeared, hovering before my face. I was asked by a disembodied voice to breathe deeply. And that was it.

I woke up in recovery seemingly seconds later. In reality, about four hours had passed, but I was unaware of the forward march of time. I was in and out of consciousness and was bitchslapped by a debilitating wave of nausea—-but I didn’t puke, mostly because my body was still waking up from the anesthetic and I couldn’t wretch properly. And then, more wheeling, more lights overhead. My mom, my husband, my father, waiting in my hospital room. I made it.

I cried. Waves of sobs, tears of joy. I was so happy to be done, to be alive, to be on the other side of surgery. Nothing else mattered--not the fogginess in my brain, the myriad tubes protruding from my body, the disorientation or the lingering wooziness. The thing that I feared the most, that I wouldn’t live to see life on the other side of this fear of surgery, or this fear of disease—-it was gone. I was alive.

The rest of Friday was a blur. My friend A-—she of boob voyage planning fame-—came and sat with Gabe while my parents went back to their hotel to rest. I was in and out of coherence and consciousness, occasionally talking in my sleep (much to my embarrassment). In addition to the oral medication I was on, I was hooked up to a pain pump and had some sort of numbing agent threaded directly into my incision site. I was also catheterized, which was good, because I was so thirsty, I would have had to get up every few minutes to use the bathroom (in fact, I recall somewhere in my haze, a male nurse tech exclaiming he had never seen a more filled catheter tank. That’s me: a good pee-er.). But sometime in the early evening, my skin began to crawl. It was an itch like I had never felt before, a lily-pod hopping frog of an itch that moved somewhere else on my body, from my calf to my forehead and back, the moment I could reach it. I had both G and A clawing at my back, but nothing is more ineffective—-or frustrating—-than trying to describe the location of an itch or the intensity with which you want to be scratched. The nurses seemed baffled—-though it is clear to me I was having some kind of reaction to the pain medication or anesthetic—-and they offered me only doses of Benadryl in ever increasing amounts despite its ineffectiveness. Before bed, I finally got some relief, thanks to some kind of antihistamine whose name escapes me, and was able to sleep relatively well that first night.

I was awoken at quarter to six by my surgeon who appeared, like a holy vision, the light from the hall ensconcing him, at the foot of my bed. G had spent the night with me on my cot, and Dr. F had to maneuver around him in the small room, but he managed a look at my chest and declared everything to be—-bumpy and bruised as it looked from my vantage point—-as it should. Saturday passed inconsistently—-the time seeming to slow and quicken, a strange sort of painkiller-induced elasticity that made the second hand on the old-fashioned wall clock rotate at uneven speeds. G fell sick later that day with a stomach bug, and though he wanted to be there with me, we decided my dad would sit vigil while he got some rest. I read trashy magazines, flipped channels, entertained visitors, and learned to get in and out of bed (goodbye catheter, my old friend).

I was discharged Sunday afternoon and am writing from home, from my bed, surrounded by cats and pillows. I feel fine, incredibly. In fact, when I spoke to my doctor’s nurse this morning, I asked her if something was wrong because I don’t feel as bad as I thought I would. In fact, nothing, thus far, has been as bad as I thought it would. And dare I say it, because to anyone else, they are mutilated, misshapen, multi-colored monstrosities, but my new boobs even look better than I expected.

Today, I’ve felt a few pangs of, not regret, per se, but melancholia perhaps: the letdown after the great climax. I’m done. Now what? What do I do with all that anxiety? Where does it all go? I’m sure I’ll experience some highs and lows in the next weeks (not to mention months and years), and that’s to be expected. But despite all that, I am happy, so very, very happy to be on the other side, alive, recovering, and very lucky to have this second chance at a healthy life.

A Break Up Letter to My Boobs

Dear breasts,

I wish I could start off this letter with something like, “There comes a time in every woman’s life when she has to say goodbye to her boobs…” (and the fact that I feel that way attests to the inevitability of this moment for me), but unfortunately, this is far from routine, and we are both about to enter uncharted territory. The truth is, no woman ever expects to have to do what I’m about to do to you; for most, breasts are sources of pleasure – both physical and emotional – dispensers of nourishment, symbols of femininity. But to me, you’ve become something else, something more sinister. You have the potential to kill me, and because of that, I’m afraid I’m going to have to kill you first.

But first, an apology. I’m sorry I have to do this. I never thought it would end like this. In fact, nothing about our time together has been quite what I expected. But here we are, spending our last few hours in each other’s company: me, woman about to embark on a life free from the specter of breast cancer, and you, two dead boobs dangling. I know this is probably hard to understand, but what I’m doing is what’s best for both of us. And like a love affair that’s lost its passion, we should end things now, when we’re still on speaking terms, before we start throwing plates, when we can still remember the good times, before we learn to hate.

And we sure have shared some good times. Remember the first time I bared you to the bright sun? The tide had gone out at Mont St. Michel in France, and, alone with my friends, two other teenage girls in a deserted expanse of sand and sun, we doffed our bikini tops and tanned like the French do. I was only 15, and K and J, though my peers, seemed so much more like women than I was at the time. You barely filled out an A cup back then. And you had never been propped up by underwires.

But even back then, back before you grew into the womanly, pendulous mounds you are today, you had been touched. And the electricity I felt from so simple a feel! Second base. We’d rounded it. And I began to understand the fascination with you – boys’ eagerness to see and cup, my desire for their touch. But yet, I was painfully shy, almost ashamed of you, incredulous that anyone would find you – my little mosquito bites – worth their affection. Even into my twenties, I often made love with my shirt on, embarrassed to expose you so directly to someone else’s glare. On particularly uninhibited occasions, I’d let you hang free: that time I vacuumed the beach house completely naked, that time I took you drunkenly swimming with some Frenchmen in the Riviera. But for the most part, you were a guarded secret.

Something happened while I was busy protecting you, though. You changed. You swelled into something I could hardly recognize as belonging to me. Suddenly, you required a bra – and not one just for show, so the boys could snap my strap, like they did at summer camp in seventh grade. And as you became more like the breasts I always wanted, I grew more comfortable with you. The more hands that touched you, the more comfortable I felt allowing myself to be felt. And gradually, as my body matured, I grew to love you – you who I once distrusted, for not showing up until so much later than the other girls whose breasts I saw in the locker room after field hockey practice in middle school, for not being big enough to hold a tube of lipstick between like Molly Ringwald in The Breakfast Club, for not being enough handfuls for curious male hands whose disappointment I sensed between sloppy teenage tongue kisses.

You’ve existed in your present form -- ample, worthy of adulation –- for only about ten years or so. And so, in saying goodbye to you now, I can’t help but feel cheated out of time together that was rightfully ours. Just when things were going great, it all had to come crashing down. But at least I’ll always have the memories, the moments in time when I was proud, when I felt beautiful, because of you.

And I will still be beautiful without you. It may take some getting used to, but I spent most of my life getting comfortable with you anyway. And your replacements –- I’m sorry to be so crass, but let’s be honest –- will be, in many ways, far superior (not the least because they won’t try to kill me). But I’d be terribly untruthful if I said I wasn’t going to miss you. Sure, we’ve had a vexed relationship. I can remember so clearly standing in front of my bathroom mirror, a prepubescent girl staring at her bony, naked frame, and wondering where you were, wondering if there was something wrong with me, wondering if I was a boy, or at least destined to be built like one. And just the other night, I stared at you again, thinking you ugly, uneven, udderlike. But at both those moments, separated by decades, you and I, despite our adversarial stance, were one. And after Friday, we’ll be apart, forever.

You haven’t done anything wrong. But I can’t truthfully say, “It’s not you, it’s me.” Because it is you, or at least what you could do to me, that is causing me to make this choice. But it’s also me. I can’t live my life in fear of you a second longer. We have to break up. I just don’t see this as a long term relationship. You just aren’t healthy for me.

So goodbye my old friends. May the joy you’ve brought into my life and others’ live on long after you have gone. I wish it didn’t have to be like this, but you’ve left me no other choice. As we part, however, I know I’m a better, fuller person today than I was all those years ago, so meek, so desperate for affirmation. And I’m confident enough with who I am as a woman that I can live without you. I don’t need you anymore. Thanks for the mammaries.

Ta-ta,
Steph

How to Say Goodbye to Boobs

1) Throw them a party

My boob voyage, or as A, my dear friend and budding party-planner/pop artist who hosted the event for me, called it, The Pointer Sisters Farewell Tour (The Pointer Sisters being the pet name my husband gave my boobs), took place Sunday night. It was a blast; I felt so lucky to have my friends come together to support me. We ate, drank, and played games, including "Pin the pasty on the nip" (pictured above). I received several sets of button down pajamas (fashion be damned) and lots of good wishes. And I got a chance to remind everyone that after all of this, I'm going to be the same person I always was; after all, I'm having my breasts removed, not my sense of humor. The pasty-adorned breast is now hanging in my living room.

2) Photograph them

Last night, I spent a few hours (most of them topless) in the studio with a very talented photographer, whom I met when she shot my wedding. R is a genius behind the lens, and I've never looked better than in the photographs she took of me on my wedding day (though, maybe the professional makeup and designer gown helped). So when I decided to memorialize my mammaries before the old chop chop, I reached out to her, unsure of whether she'd be offended by my request (I can't tell you how many times I wrote and rewrote the email in order to ask, essentially, "So, do you do topless?") or the entire prospect of surgery. But, astonishingly, R not only agreed to do it, she shared with me the story of her grandmother; she developed breast cancer in her 40s nearly fifty years ago and instead of following the recommended course of action -- a lumpectomy -- opted instead to remove her entire breast. R's grandmother will be 90 soon, and she thinks her radical choice saved her life. (That's one brave woman.) So R really got it.

Anyone who knows me well knows that I have a major affection (OK... call it like it is: an obsession) with America's Next Top Model. I routinely have dreams I'm a contestant on the show (which usually involve me expressing some level of incredulity to Tyra about the fact that I'm a) 31 and b) a little too zaftig). But let me tell you, all those hours of mindless entertainment actually came in very handy during my photo shoot. I used all of Tyra's tricks. Smile with my eyes? Just call me Super Smize. Booty tooch? Check. Modeling head to toe? Girl, you know. And after about 30 seconds, it didn't really even register I wasn't wearing a shirt. When R was setting up a shot, she said, "Give me a second, I'm focusing on your eyes." And I said, "Actually, this is the one time where it's OK for you to focusing down here, you know?" Throughout, R was a consummate profession, a skilled director who helped me contort my body into more flattering poses (and positioned lights in order to slim and sculpt), and a reassuring presence who told me over and over again that I was beautiful.

I can't wait to see the pictures. And no, I will NOT be posting them here. These are for me. To remember how I was once. To celebrate the good times. To look forward to the better times ahead.

3) Preserve them in plaster

I ordered a belly-casting kit (you know, the papier-maiche kits that are all the rage at baby showers) but will be using it for a different purpose: I'm going to make a cast of my bust. Not sure what I'll do with it (though perhaps it will go nicely with my pop-art living room boob painting), but I want to cover all my bases (second bases?). I figure this would be a fun/messy activity for G to help me with. After all, he needs to say goodbye to them, too.

4) Write them an ode

Well, this blog has been, in many ways, a love/hate letter to my breasts, but I'm working on one final tribute. Stay tuned for more...

The End is Nigh

Ten days till tits-off. And I feel fine.

Yesterday morning, G and I met with one of my plastic surgeon's nurses, who embodied the adjective chipper, and learned all about life after boobs. It will look like this: I'll have plastic tubes sewn into my arm pippies that will drain me from the inside out, which G will have to occasionally unclog as well as measure my output on a daily puss/blood/strange tissue bits log (Brief pause to recognize G's heroic dedication to the cause. He definitely didn't realize her was in for this when he agreed to those wedding vows last year.). My body may be in pain, but I will be sailing off to Darvocet island and lulled to slumber by the Ambien string quartet. I won't be able to raise my arms, so we'll have to get an old person's stool for the shower so I can sit whilst I bathe. And though I'll probably feel euphoric, energetic, and rarin' to go in just a few days, I'll have the endurance of one of those fainting goats, and will need to be near horizontal surfaces in case of unexpected naps.

And then, supposedly, life will go back to normal. And the only thing different will be that instead of boobs, I'll have silicone spheres sewn into my body in such a way that, to the causal observer, it will appear as though nothing is amiss.

But first, there's these next ten days to get through. And they are shaping up to be busy enough to distract me from thinking too much about this strange end to this bizarre journey I'm on. On Sunday, my dear friend A is hosting a Boob Voyage party. On Monday, I'm working with my wedding photographer (through whose lens I've never looked better) to take some tasteful photos (I'm imagining a lot of draping) of my décolletage. And then my family arrives Thursday and before you know it, I'm walking down the hospital corridor, laying down on the gurney, and going to sleep. Then, I'll wake up, and my life will be different, a little harder for a little while, but ultimately better, because I won't have to think about this any more, count the days, imagine the worst case scenarios, doubt my choices. I'm so glad it's almost over.

Everything Good For You Is Bad for You, Or, Everything Bad For You Is Good For You, Or, FML

Here is the thing about cancer. Many things cause it. And many things prevent it. But there is a surprising overlap in the things that both cause and prevent cancer. Alcohol? Everyone knows that that's bad for you. But, wait. Alcohol can also prevent cancer? You betcha! Becoming a mother late in life causes cancer. But, um, er, it also prevents it. Cell phones definitely cause cancer. Except when they don't. And my personal fave (because I ingest more of it than the average bear), soy causes and does not cause cancer. (In fact, here is a handy guide--called Kill or Cure?--to all the things that allegedly cause or prevent, or sometimes do both simultaneously, cancer, as reported in London's Daily Mail newspaper.)

Now mammograms, those critical diagnostic tests that I so emotionally lobbied for access to, are on the shit list. According to the New York Times, "For young women who have a high risk of breast cancer because of genetic mutations or family history, the radiation from yearly mammograms may make the risk even higher." So, wait. Let me get this straight. You're telling me that the test I would need (were I not undergoing prophylactic surgery) to save my life could actually kill me? Yep. According to the Times, "The report is particularly troubling because it suggests that the very women who are told they need mammograms most may also be the most vulnerable to harm from them." Troubling? Understatement of the year.

All of this serves to illustrate my general point: we're damned if we do, damned if we don't. As a carrier of the breast cancer gene, I have two basic options: closely monitor my breasts or cut them off. The first option presupposes the safety of the very screening techniques that would, theoretically, find any cancer at a curable stage; but what happens when all that screening actually contributes to, and possibly causes, the cancer it's supposed to find? In making my decision to have surgery, I had to weigh the heavy physical toll of altering my body against the heavy emotional toll of uncertainty and anxiety. And I found that, for me at least, I'd rather suffer brief physical pain (followed by emotional peace) than live a life in existential turmoil. Furthermore, I came to realize that the surveillance techniques available to me were not foolproof (and now, apparently, they aren't even safe) and that in order to definitely reduce my risk, I'd have to have surgery.

That surgery is now 15 days away. And the choice that brought me to this point, I'm beginning to realize, is more and more impossible. I was flipping through a book on the checkout counter of Urban Outfitters last night called Would You Rather, featuring absurd questions like "Would you rather fight Mike Tyson or talk like him?" And it's funny because we can think, "Man, it would suck to either fight or talk like Mike Tyson, so how about neither," chuckle, and then close the book. But when you are facing your own version of this--"Would you rather live you life in fear of developing breast cancer, which you have a 90% chance of getting, or cut off your breasts to lower your risk to less than 5%?"--we can't say, "Sucks to be that woman," because we are than woman. But our choice is so comically absurd, our dilemma so strange, when we make a decision, we're fucked either way. Life isn't going to be all rainbows and puppy dogs and champagne after my surgery: I'm not going to have boobs anymore. But if I were to keep my boobs, life wouldn't be rainbow-puppy dog-champagne-filled, either. It would be filled with worry and tests and worry about those tests. The point is, whatever the choice, you get things and you give things up. Either way, your life is irrevocably changed.

Given these latest findings, I'm glad I'm having surgery. But I'm dreading the study that comes out and suggests that PBMs, which we all know should prevent cancer, actually cause it. Hopefully that'll never happen. But given the precedent, it probably will. FML