Getting ready for surgery

This weekend we had an absolutely lovely time on Orcas with Marisa & Max (her wonderdog). The cabin is heaven on earth, and Marisa and I cooked wonderful (but healthy!) meals, including desserts, and we lounged in the hot-tub, listened to music, drank wine (worth the calories/points!), and soaked up the island ambiance. I didn't even mind that it POURED rain on Saturday (though Ryan went for a bike-ride in the rain anyway).

The last week went well: I felt great, and Ryan had a series of great job interviews for a position at Microsoft (he has one final interview tomorrow, and we won't know anything for a few weeks). Please wish our family well in that regard...

Now, however, I'm home and realizing that my surgery is creeping up on me faster than I'd like.

Today, I feel pretty healthy. I can chase after Tessa (for a while!), and I have the energy to tackle projects around the house or to cook interesting meals or to go to a park etc. My body is leaner than it's been in a decade, and I love wearing clothes that really fit me properly. I'm ready to train for the 3-Day again, and to resume my days in the sun, doing yardwork, taking Tessa to the beach, and accomplishing small tasks here and there.

Tomorrow, I will be in an MRI machine for 45 minutes, being scanned for new cancers in my right (only) breast. My appointment is at 10am tomorrow, with a 9:30am check in time. For some reason, there is already a "just in case" ultrasound scheduled for 2pm tomorrow. If they find anything suspicious in the MRI, I'll have to go back at 2pm. I'm bothered beyond words that "they" have planned for this possibility. My MRI last June was clear, and I've had a lot of chemo....if they find cancer now, I'm going to be very, very, very scared. The MRI is routine before a mastectomy (if there is cancer, the type of mastectomy changes), but it's not routine in MY life, and it brings back horrible memories of lying in that machine and crying for my future last June, right after I was diagnosed. I'm trying not to be negative about it, but I am dreading the event. Please pray that they will find nothing unusual, and that I will be able to maintain some kind of calm while they scan me.

On Tuesday, I hope to do a combination of playing with Tessa in the sunshine -or rain - and being as active as possible with her, combined with taking a little time for myself to get a pedicure and get ready for the surgery. Tuesday night, we'll deliver Tessa to my parents' house, so that she doesn't need to get up with us at 4:30am to get to the hospital on time.

Check-in time is 5:30am on Wednesday, and surgery is scheduled for 7:30am. I will be on the operating table for approximately six hours, and my doctor has said that Ryan will not receive any updates for those six hours. Please pray that Ryan will feel strong and supported as he waits for news. I'm hoping that Ryan will leave the hospital to go for a bike ride during that time, as he feels best when he's on a bike, and sitting there worrying about me will not help me.

The surgery itself is relatively complex. I am having a skin sparing mastectomy, in which they will remove my nipple and the inside of my breast, and also a lat flap reconstruction with a tissue expander. The lat flap procedure involves detatching one side of the latissimus dorsi muscle from my back, and wrapping it under the skin under my arm to the breast area (while part of it is still attached at the back to feed the muscle). Such a procedure creates only a very small A cup, and so I am also having a tissue expander placed between the muscles of the chest wall and the lat flap. The tissue expander is basically an "empty" implant, which will slowly be inflated with tissue to stretch out my skin enough to accomodate the implant. (The stretching is necessary because even though I'm having a skin-sparing mastectomy, some of the breast skin is removed, and the skin will shrink up as result of the shock/trauma of the surgery.) My goal is to return to my natural size, a large B cup or a small C cup. When I come out of surgery, I will be an A cup, but over the space of a few months, I'll be my normal size again.

Information on this procedure is available at:
Pictures of lat flap before and after
Lat Flap Definition
Explanation of lat flap recon with pictures
Brief info on breast reconstruction

I chose to do the lat flap because it tends to give a more natural/realistic breast than a straight implant. I will do the lat flap on the other side, as well, when it's healed from radiation (October if things go well).

I will be in the hospital for five days, most likely to be released on Monday. I will have three drains (I only had one drain for the mastectomy and then another for the node dissection last summer, and I hated them...sigh); two for the front and one for the back, I believe. I will have two five inch incisions; one in the front, one in the back. Because of this, laying down will be difficult, and the recovery is a bit tougher. My parents are going to loan us a recliner chair to put in our guest room, and I'm told that this will be the most comfortable way to sleep.

I hope to use the time in the hospital to rest, to work (an hour here and there) on my BSD curriculum work, to read magazines, and to feel relief that the surgery has gone well. Ryan worries that I overdo it, and in the hospital there will be no chance for that! :-) I hope I don't lose my mind from the boredom, though, and I will welcome visitors (probably Thursday through Sunday, as I don't know how I'll feel on Wednesday and I don't know when I'll be released on Monday).

People have asked how they can help: thank you SO much to those who have reached out. While I'm in the hospital there's not much anybody can do except visit or check on Ryan & Tessa; once I'm home, I think I'll appreciate help with Tessa and/or meals if people are so inclined. I hope to recover quickly, of course, but I can't predict how it will go. I'm told that recovery is a 6 week process, but I heal quickly, so I'm hoping to set a new healing record (wish me luck on that one!).

I will have my cellphone at the hospital once I'm settled (Ryan will bring it to me), but I don't know how much I'll be able to use it due to potential cell phone restrictions. I will be at Swedish on First Hill, and they will have me in their patient directory if you call. On the day of surgery, I will have someone update the blog with info. Ryan will have his cellphone with him on Wednesday, and will certainly appreciate your calls of support, as well.

This is hard. I don't want to do it, any of it. I don't want to think about it, I don't want to plan for it, and I don't want to deal with it. I have to stuff my anger deep inside me that this is my fate, and that I don't have a lot of choices that sound good to me. I hate that my body will have yet more scars, that there are risks with surgery, that my breasts will not be as good as they once were, that I'm always at higher risk for breast cancer than others, that there are no guarantees, that I will endure great pain, that I will not be able to pick up Tessa and hold her the way that every other mother holds her child because I will be healing. I hate that, for several months, my new breast will be rock hard and unnatural looking (until the implant is placed late next fall).

I hate that tomorrow, high tech machines will be used to see if I have cancer again. I am horribly afraid. As I type these words, I can't stop the tears from falling down my face because I'm so afraid. I hate to be afraid. I want to be strong, courageous, and confidant. Instead, I feel fear. What kind of cancer could have survived chemo? What is my fate if they find cancer tomorrow? I know what I've already been through with treatment, and I am certain that it would be worse if some type of cancer is still living in my body. By the time most people read this, the MRI will be over, and hopefully I will have great news and all this worrying will be for nothing. But until then, I'm very, very afraid.

Nearly a year of my life has passed since I found my lump - it's been eleven months. For eleven months, everything has taken a back seat to cancer. I am barely visible at my daughter's preschool (and I vowed to be an involved mother!), my family very nearly fell apart through all of this (though thankfully we're doing well now), the many projects that needed doing still aren't done, and I can barely find the energy to do a quarter of the things I both want and need to do.

I hate that Tessa knows that my nipple will be removed. I hate that she knows what it's like to have her mommy in the hospital. I hate that she keeps asking, "Mommy, will you be able to pick me up?" because she knows I can't and what she most wants is for me to hold her.

I do not have time to mourn because I am in survival mode, but every now and then....like now, as I prepare for the next horror....the anger and fear and mourning leak out. I'm removing my breast to lessen the chance that cancer will recur. I do whatever I can to live a long and happy life, and hope to God that I am doing the right things. I hope that my decision to do reconstruction is the right one: the reconstruction is hard on my body, and it's vanity that's making me do it. There is no use for my breasts, but I want to have two breasts, and I'm fighting hard for that.

I pray that Tessa will not remember the fear that has lived with us for the past year, and that she will somehow learn strength from the whole experience even as she forgets it. Tessa has imaginary tigers that she takes with her when she's frightened or worried, and lately the tigers have been coming everywhere with us. I am grateful that my daughter has chosen such a strong animal for her companion, and hope that the tigers comfort her even as she comforts them, telling them the things that I tell her. It's only for a while, sweetie. Everything will be okay. We can visit in the hospital. This summer, we will have a wonderful time, playing on the beach: we'll have a picnic, then build a sand castle, and then we'll hold hands and run into the water together, laughing because it's so cold. Yes, the tigers can come. We'll keep them safe, and they'll keep us safe.

I send my love - thank you for sending your love back.
Love,
Kristina