Why I'm Having Surgery

On Saturday, members of the Chicago-area FORCE chapter met at Gilda's Club for peer-to-peer support. I had only known my BRCA status for three weeks when I attended my first FORCE event in late April; reflecting on my first impressions (Wow! There are so many other women just like me! And they are so nice and so pretty and not dead! Maybe I'll be OK after all!) and my emotions (bordering on panic attack) during that first meeting makes me realize how far I've come in barely four months. In fact, when I spoke on Saturday to the women I've come to know and love as friends, I commented that time really is elastic; these may have been the most stressful four months of my life, but man, I got shit done.

A brief time line of my emotions/accomplishments

April: Holy shit. Oh my god. I'm going to die. I'm dying. My boobs are going to kill me. My boobs are possibly already killing me. I'm damaged goods. I'm crawling into bed. Mmmm... vegan carrot cake! Must consume more food! And then take a nap. Am I dead yet? Probably soon. Holy shit.

May: I'm not going to die. I'm not going to let my boobs kill me. Wow! Those reconstructed boobs look really great! They are nicer than my real tits. I want those. But surgery is so scary. I'm scared of the anesthesia. Maybe I'll just wait. I'm going to the gym to blow off some steam. My boobs aren't going to kill me. But maybe they will. Holy shit.

June: I'm going to have surgery. Wait. Maybe not. Well, I think I'm going to have surgery. I don't want to have surgery. Why do I have to have surgery? Why me? this isn't fair. Pass the vegan carrot cake. I don't want this. This isn't supposed to happen to me. I'm going to have surgery. Probably. But first a nap.

July: I need to schedule surgery. I'm cool with this. This is part of who I am. Whatever doesn't kill me makes me stronger. I'm not going to let my boobs kill me. They're just boobs. Who cares? I'm picking up the phone. I'm dialing the surgeon. I'm having surgery.

I'm not sure if it's the amount of time that's passed since my initial diagnosis or the fact that I've made my decision (or both), but I feel so much better today than I did in April. Which is not to say I have it all figured out; I still probably spend half of my waking moments thinking about breast cancer, but that's down a good thirty or so percentage points in just four months. And I only check the FORCE message boards, like, three times a day, down from three dozen even in June. I haven't even read a book about boobs in weeks!

Perhaps I'm chill because the "end" is nigh. (The word end belongs in quotation marks because we all know that BRCA mutations are life-long, and there will be more fun--pancreas screenings! ovary removal! implant replacement!--to be had in the future. But for now, at least when it comes to my bosoms, we're nearing the point where I'll say goodbye to them, just as I suspected I would when I registered this blog name way back in March.) Or maybe time has a way of deadening--forgive the macabre image--the initial pang of fear.

This is the thing: I don't know if I'm ever going to get breast cancer. Although my family history is very complete (and oh boy does BRCA cause cancer in my folk!), I don't have a lot to extrapolate from in the immediate branches of my genealogical tree. I got the mutation from my father, who is healthy at 61. His brother, also a mutation carrier, is in his late fifties and disease-free. My grandfather, who bestowed on us all this dark legacy, did not get sick until his seventies. By those standards, I could live a long happy life with all my ladyparts, BRCA be damned. But then, like in so many things in life, men and women are far from equal: BRCA confers a much larger risk to women than it does to men. So I have to look elsewhere for guidance, and these are the numbers that matter: 30 and 87.

Thirty is the age my second cousin was when she was diagnosed with breast cancer. Her circumstances may appear on the surface different than mine (her mother was a breast cancer survivor, which automatically increases her risk); up close, however, we might as well be the same person. She inherited BRCA from her mother who inherited from hers, my grandfather's sister. The only difference is she got it from a woman--a woman who got breast cancer because of it. I got mine from a man who didn't. But, because of my cousin, that risk of getting breast cancer now--like this moment or tomorrow--is very real. So when I think, oh, BRCA doesn't affect my family, I have to remember I'm the oldest women on my branch of the family tree to have tested positive for the mutation. And I don't plan on being the first with breast cancer.

Eighty-seven, in percentage points, is my life-time risk of developing breast cancer. That's a damn near certainty in my book. And it's too stressful a possibility to live with.

From the moment I learned I carried the BRCA mutation--really, even before I tested positive--I knew I would chose preventative surgery. The question always was: when? I now know the answer: December 18, less than two months after my 31st birthday, a little more than eight months since I learned my status. Sure, I could wait a few years. But this is the thing: I walk around every day with a half-ton concert grand piano tethered on a fraying rope above my head. I know there is an 87% chance that puppy will fall on me, but I don't know when. So I've decided I can't walk around with that looming overhead any longer.

That's why I'm having surgery.