Wednesday, August 25, 2010

The Elephant in the Room

There is an elephant in the room (or should I say, on this blog) and it's time to acknowledge it. Before I went on hiatus this summer and began posting less frequently (more on why that happened in another post), I "came out" and said something very hard for me to admit (no, nothing about toenails in this post, promise). I wrote about considering a revision surgery and the panoply of emotions (ranging from guilt to self-righteousness) I felt about it.

The news item here is this: for the moment, I'm no longer actively considering revision surgery. Several factors played into this decision. 1) The "imperfections" I perceive are not that big of a deal -- to me or to others. When I stood half naked in the show and tell room at the FORCE conference in June and allowed strange women to stare and poke, a lot of people had very nice things to say about my reconstruction. Someone said, "Yours in the best reconstruction in the room." Another said, "Thank god, these other women were scaring me. Your breasts look amazing." Others asked, "Where are your scars?" (They are hidden under the fold of my breast.) Still others wondered, "How did you get such natural looking nipples?" (They are my natural nipples, that's how.) Needless to say, this was an ENORMOUS confidence boost for me. And, frankly, there were other women in that room in way more dire need for revision than me, and yet they seemed perfectly happy, proud even, of reconstructions I would never dream of showing any one else. I guess beauty truly is in the eye of the beholder. And what I'm beholding seems much more beautiful to me than it did a few months ago. 2) I don't think I have time. Or, put another way, I'm going going to prioritize my time so that I have some to go through a revision surgery and recovery. It's just not at the top of my list. 3) I realized that, all things considered, I was very lucky. My recovery was textbook. I had zero complications. And that's not a guarantee for anyone. My cousin lost one of her expanders to infection and was flat-chested for months while she recovered. Teri, to whom the universe really owes a break, has been suffering complication after complication. And my friends R, for whom I wrote this post in March, has had nothing but heartache and boobache (not to metion four surgeries total, with more on the horizon) since her original PBM went wrong. And yet here I am, complaining because I've got a little dent in the side of my right boob that I HAVE TO POINT OUT TO PEOPLE IT'S SO INSIGNIFICANT. So I've decided not to go stirring the pot. What if I get an infection after my revision (the surgery I've chosen to ameliorate a perceived imperfection) and wind up in worse shape than I started? That's not a question I'd like to answer right now. So I'm not going to ask it.

So that's the news. But there's more to the story than the headline.

As is often the case, BRCA bloggers synchronize in groupthink, and Dee, as well as Teri, extensively, have recently tackled the question of how careful we have be to with our readers, and how much influence we as "public figures" (ie: crazy ladies who decided to overshare on the interwebs) have on their decisions.

Right after I wrote that I was considering of a revision, I got (as I do occasionally) an email from a woman seeking advice. I responded with my usual verve and enthusiasm, but it felt somewhat disingenuous: how could I advocate for someone else something that I had my own mixed feelings about? How can I be a voice of certainty (yes, you can do this and you should do this and there is life on the other side) when my results weren't quite what I'd hoped for? It's a question that I don't have a ready answer for.

But here's what I do know: despite the fact that I'm not 100% thrilled with my cosmetic result (let's say I'm 87% thrilled -- there's a number BRCA mutants might be familiar with), I am IMMENSELY GLAD I CHOSE TO HAVE SURGERY, no matter the outcome. I recently came out the other side of a very stressful period in my life (more on this later, promise), during which my anxiety levels were so high they were interfering with my daily functioning. And it served as a reminder that I am not cut out for uncertainties, for periods of hopeful but tortured waiting. In other words, I was reminded I am not the kind of gal for whom surveillance would have been an option. My quality of life, despite the small dent in my boob, is about a thousand times better than it would be if I kept my old dentless boobs and had to subject them to scanning and poking and waiting and hoping every three months. So, despite the fact that I've opened my mind to the possibility of revision (and, for the moment, have tabled it) I don't regret what I did or dislike my doctors or feel that I chose the wrong reconstruction. I still think surgery is good option (though not a perfect one; Dee articulated this well here) for women who really want to do all they can to reduce their risk of breast cancer. And I still maintain that one of the greatest benefits of surgery is the peace of mind it brings, especially if fear of breast cancer motivates you (as it did me) to have surgery in the first place. And I know that, for me, this was the right choice.

This is major surgery. Things can go right, which, luckily they did for me. Or things can go wrong, as they have for so many others. What your outcome or result will be is impossible to know (dang crystal ball's broken again). But I still want to be a resource for people considering this, and I want to be honest, even if sometimes it means admitting that not everything is puppy dogs and lollipops on the other side of the rainbow. There are sometimes dents in the road (or the boob, in my case). But you can steer around them.


  1. Funny how we seem to be struggling with many of the same issues at the same times. It's like the BRCA experience has a certain lifecycle - initial shock, decision-making, surgery, then a reflection phase along the lines of "what the hell just happened to me over the course of the past year?" I thought I'd stop blogging now that I'm "all done" but I may just be entering my most prolific phase yet as I'm now faced with "coming to terms".

    As for revisions, I happen to notice lots of imperfections in my forgeries but I'm not having any more surgery either. I've come to think that perhaps we're a bit too critical of our man made boobies. My originals were far from perfect too, albeit in different ways, but I didn't spend too much time thinking they had to be surgically tweaked this way and that way until we achieved perfect symetry, centering and an ideal latitude and longitude. Now that I've come to completely accept my counterfeits as part of my body, I've learned to accept their imperfections as though they were "natural".

  2. I read every word of this post riveted (even if I am a few weeks behind). Why do you think it is that we all sort of start thinking the same things around the same time?
    With all of the complications I've encountered, I'm relating to so much of what you said here. I'm only a month out but am so far very unhappy with the way the 2nd surgery went on my right breast - it's 2 sizes smaller than leftie - though I'm told to please be patient, wait for it 'to drop' - etc. I've already decided that they'll be no stage 2 for me. I can't imagine going through this sort of thing simply to get rid of saddle-bags that only me & my ps notice, or to plump out my hip that just got centered out to make a boob... however, if my paranoia ends up being reality, and RR heals in a few months and looks nothing like her sister, instead of a revision, I'm feeling very much like having both of them removed and having no reconstruction at all. I'm just so sick of surgery and recovery. It's hard to encourage other BRCA women, when I'm in this state of mind, and I feel terrible about stepping back from BRCA stuff the way I have.. I'm just sort of confused about reconstruction, especially having gone to some wonderful doctors, and doing everything right, only to have problem after problem... *sigh* This BRCA thing is just so far from easy..

  3. Hi friend! So wonderful to read you blogging again :) I was one of those ladies in the Show and Tell who was so very thankful for your bravery. I was completely overwhelmed there, and you pulled me aside, smiled, and let me look. I'm forever grateful!

    You already know this, and I'm still trying to embrace this -- you are beautiful for all the imperfections, and even for wanting to seek for better. And, you are beautiful for all that you have to go through, all that you have to consider, and for all that most women do not need to endure. You are beautiful for blogging your pain and your victories, your heart and your soul, your courage and your fears.

    love, cheers, and boobs to you, my friend!