Thursday, February 02, 2006

14.4 pounds lost AND I'm a superhero

Today at my Weight Watchers weigh-in I celebrated another 2.6 pound loss (or was it 2.8?)...anyway, I've lost a total of 14.4 pounds. Only 8 pounds until my pre-chemo weight, and then I can start working on the weight that I should have gotten rid of years ago. I am THRILLED with the rate of loss, as I'd promised myself to be happy if I averaged 1 pound a week of loss...but I've lost all 14.4 in four weeks. I can't wait to see what losses February will bring!

Today at radiation my team looked at my chest, and asked me how I was feeling. I told them that I'm working out regularly and walking 3-6 miles several times a week, and that I get tired in the evenings, but that I feel pretty good. They told me that I was a superhero, because usually by the time that people's chests look like mine, they're exhausted. Well, I certainly don't feel like a superhero, but I'll take all the positive reinforcement that I can get.

My chest is now completely red in the radiated area, with one sort of purple-ish area about 2x2 inches. The whole thing is covered with little sores ranging from pinpoint to the size of the head of a pin (all very small, in other words), and it seems that there are more of these each time I look. I keep slathering on the Biafine and hoping for the best. My chest is now officially tender, and I can't snuggle Tessa on that side any more because it hurts (and my lean daughter's too bony...and too wiggly...for a radiated chest hug). I am almost halfway done, having completed 16 of 33 radiation sessions. I have a feeling that, like chemo, the second half is a lot harder than the first, but I'm trying not to focus on that.

Yesterday I scheduled an appointment with Dr. Dawson, the surgeon who performed my first mastectomy, to talk about performing the second mastectomy. Dr. Welk was very convincing that it is advisable to heal from the mastectomy for at least two months before doing reconstruction, and since I want to do reconstruction in October but I don't want to have a mastectomy close to the 3-Day walk, I think I'm looking at doing it SOON. I will discuss with Dr. Dawson having mastectomy number two in March. Of course I dread this - I'm only human, not superhero after all - but I am willing to do what it takes, and having had cancer in one breast I'm not eager to get it in the other, so it will offer peace of mind.

With love,

Tuesday, January 31, 2006

Plastic Surgery: Breast Reconstruction Options

Today, before my usual radiation appointment, I went to meet with a plastic surgeon, Dr. Welk, for a consultation to discuss my reconstruction options. I came away with very different views than when I entered his office, and I have a lot of thinking to do before making any decisions.

It appears that with continued weight loss (which is worth it to me - I think I've dropped another pound or two this week and I'm determined to keep it up) I will not be a candidate for double reconstruction using my own tissue - there simply won't be enough tummy tissue. That means that I will be getting an implant on my right (non-cancer) side. The best kind of implant that I can get would be a procedure that actually uses skin and muscle from my back, referred to as a "lat flap" (I think it's the latimus dorsi muscle - I have to read more about this). This procedure uses some skin from my back, as well as tissue, to wrap the implant, and thus creates a more normal looking breast. The pictures are impressive.

On my left side, where I've already had a mastectomy, I need to do either the lat flap or a TRAM flap. The TRAM flap involves using abdominal skin and tissue, with a muscle to "feed" the flap coming up from the abdomen. Alternately, I could do a lat flap with implant, the same as on the right side, but the doctor thinks that my best results will occur if I do a TRAM on one side and a lat on the other.

I went in all gung-ho about doing the DIEP, which is like a TRAM only doesn't use muscle, but the doctor essentially talked me out of it, and gave me some very compelling reasons why it isn't a superior technique: the results are the same, but the risks are much higher for the DIEP.

The doctor also told me that it is less advisable to do the mastectomy at the time of reconstruction. Damn. He gave statistics about rate of failure that convinced me that it would be best to do the mastectomy, wait two months, and then do the reconstruction on that side. Sigh. All this surgery certainly bums me out.

I will not do any kind of reconstruction until October, as I need to be fit and healthy on the 3-Day walk in August, and then I want to enjoy the beautiful September weather. That's the plan at the moment, anyway.

It's so much to take in. These surgeries are very invasive (though the doctor disagrees with the term "invasive" I say that anything that leaves me covered in scars and moves my muscles around is invasive) - I would end up not only with Frankenbreasts (which certainly would be better than no breasts at all) but also with a foot long (no exaggeration) scar along my belly and another on my back.

Lots to think about.

PS Yesterday's radiation was cancelled because all the computers at Swedish were down, so my new end date is Feb. 28. My skin is getting redder, and there are little dots that look like sores all over the radiated area. They're tiny, but they're a sign of things to come, I think.