My Medical Team is Complete! Warning: Lots of Girl Talk.

My Medical Team is Complete! Warning: Lots of Girl Talk.

Since I last blogged I’ve had two important meetings.  One with the plastic surgeon, and the other with the gynecological oncologist.  They were both home runs.  I feel like Frodo from the Lord of the Rings.  The first part of my journey has been to find those allies who will travel with me to complete the mission of throwing my treacherous orbs into the fire atop Mount Doom. I am now in Rivendell, gathering those who will accompany me. I have the breast surgeon, the oncologist, the oncology nurses, the oncology nurse care manager with my insurance company, and now the last two allies must make our band of sojourners complete.

First, the plastic surgery consult. Okay, so you all know I’ve been obsessing over the whole reconstruction angle of this ordeal. If you need a refresher, check out the blog where I mention Beaches and Otto Titsling. Each woman has to make the best decision for herself when it comes to what to do after mastectomy, and I respect all other decisions: to not have reconstruction at all, to go smaller or larger, etc. It’s a deeply personal choice. I, however, have decided that if I don’t get something to balance out these hips it’ll be a travesty. The most agonizing decision has been how to accomplish this reconstruction.  If you’re squeamish, skip the next paragraph, but I’ll share my thoughts about plastic surgeons first. In my mind, most plastic surgeons are perhaps diminutive with elegant hands and long, nimble fingers, right? When my guy finally appeared, in walked this hulk of a man with boots and five o’clock shadow. I had seen his headshot, but his presence was HUGE.  When we shook hands, I wanted to grab his and just stare at them. I’m amazed that those huge mitts can perform the delicate, intricate surgeries that he’s done. Very cool. And off-putting. He was just as particular and perfectionist as I could have hoped.  I’ll be in very good (large) hands. Now, on to the surgery I wanted.  Another warning if you’re squeamish. Here goes…

I had been researching something called he DIEP reconstruction.  It sounded like a no brainer: they use your stomach fat and the leftover stomach skin to recreate soft, more natural looking breasts.  It’s a one time surgery with very natural looking results (under clothes). I know, right? My first response was where do I sign up?!  Tummy tuck AND new boobs? Heck yeah!!  Well, after talking extensively with the plastic surgeon I am firmly against the DIEP for me. The huge smiling scar from hip to hip I could handle, but the 12 hour surgery, intense wound care, five days in the hospital, six full weeks of recovery, and funny electrical panel looking boobs with no nipples as the end result I just cannot abide.  Really. The stretch marks I have on my belly would be transported to my chest, because they will use that skin to create breasts with scars across the tops. Imagine a topless Stretch Mark Barbie Doll with two Jason in the Hockey Mask looking scars right at the arm pit level. Now imagine that Barbie with much smaller breasts, because apparently I’M NOT FAT ENOUGH to get my size back!!! What? Of course if my dear, loving friends keep feeding me so well (and I thank you) that will be no problem, but I digress. Back to this surgery. The benefit is that after all that front end work, I’d likely not have to have any kind of touch up or maintenance done.  The drawback to me is all that front end work. With four feet of scar tissue(!), you are likely to have some wound issues; I saw pictures of wounds gone bad and it is horrid. I just can’t imagine going through that intense of a surgery after 16 chemo treatments and the mastectomy–not to mention the ovary removal to come. Anyway, this plastic surgeon was excellent, and gave me lots of options as to how this could occur, but then my darling husband asked the question that was the coup de gras: “So, if the tissue comes from Yolanda’s stomach fat and she gains or loses weight, would that affect her new breasts as well?” That’s a perfect example of why I drag him to all these appointments, folks. Outstanding question. The answer is yes.  If I tend to gain weight in my stomach, the breasts do the same. It’s live transferred tissue that behaves just as it did on my stomach. Freaky. If I lost weight, the fat there will act just like my stomach. That means gravity will take it’s toll on those bad girls, and they will fluctuate too much in size. Gone are my dreams of being the only 80 year old in the room with stand up girls.  Sooo we moved on to some other options. I decided on a two stage reconstruction. I’ll have expanders put in immediately after the mastectomies so I’ll wake up with starter breasts. It’ll be my early teens all over again!  I will go to his office to have the breast balloons filled until I either reach the size I’m happy with or get fed up with the weekly expansions, and then we’ll trade the rocks in my chest for silicone pillows. I’ll still use some transferred fat to cushion the upper chest (did you know breast tissue goes all the way up to the clavicle?) since all that tissue will be removed in the mastectomy. After lots of pictures of my breasts and belly (the adult industry can not possibly be glamorous), we bid each other farewell until January. This time, the hand shake felt very comforting and awe inspiring. I still want to grab his hands and stare at them. Maybe in January. I’ve earned it. The man will be drawing all over my topless pictures. It’s only fair.

The next appointment was with the gyn-onc. She was another fabulous ally for the journey. With my BRCA1 gene diagnosis, the standard of care is to remove both breasts and the ovaries due to a much higher risk of ovarian cancer as well as breast cancer. We had a great discussion about whether to leave my ovaries alone since I don’t have my fallopian tubes anymore. Am I oversharing? I feel like if you ever see me in person you’ll be ticking off all the stuff I’m missing, which is a lot. No matter. I pray none of you has to deal with this, but if you do, you will have the benefit of full disclosure. Basically, there are studies out there that suggest that most ovarian cancers start in the fallopian tubes. Stuart is an information gatherer, and sent me many studies to consider. He started this discussion with the doctor as well. This fallopian tube versus ovary genesis matters because perhaps women at risk can keep their ovaries and get the full benefit of the hormones they provide without worrying about ovarian cancer if the cancer doesn’t start in the ovaries. They can give up the fallopian tubes instead. The short answer is that those studies are not mature enough yet to change the standard of care. And since the chemo regiment will probably send me into menopause, there will be little to no benefit to holding on to yet another couple of orbs. I was super reticent because I didn’t want to go through yet another surgery. However, the doc explained that this is a laparoscopic procedure that takes only about an hour with three tiny cuts.  It’s outpatient, and I don’t have to be in a hurry to do it. I can give my body time to recover from the chemo, mastectomy and reconstruction.  Hallelujah.  I’m already sick of heparin flushes. So much dread was lifted off my shoulders. The doctor was kind, lovely, and had such a gentleness about her. I didn’t even give her a dirty look when she made me lay down with my feet in the stirrups. The only stirrups I like help me sit astride a horse. Those stirrups feel empowering and right. Stirrups and tables are not meant to go together. Alas, the doctor won me over. Her confident manner immediately put me at ease, and I feel good about this decision as well. The goal is to live to torture another generation of Weinbergers with geography songs, obscure literary references and bad puns. I think that mission will be accomplished with my complete medical team.

I’ll end this with Frodo’s thoughts on living in a world where evil exists.  He is talking with Gandalf in the Mines of Moria.  The ring, in my mind, is cancer.

“Frodo: I wish the Ring had never come to me. I wish none of this had happened.
Gandalf: So do all who live to see such times, but that is not for them to decide. All we have to decide is what to do with the time that is given to us. There are other forces at work in this world, Frodo, besides the will of evil.”

Gandalf reminds me that in the midst of this journey, God allows me to see the beauty and kindness and gifts that he has given so freely to so many. I am humbled that so many choose to use their gifts to help me along the journey. I realize that were it not for the darkness I’d have no sense of the miraculous power light has to overcome it.

14 Replies to “My Medical Team is Complete! Warning: Lots of Girl Talk.”

  1. You are amazing.! Thank you for your honesty and you humor in the midst of your battle. Praying for complete healing for you!

  2. My eyes water at your journal entry. I celebrate you and your team of experts. I’m so happy you have so much information to help you with your journey. Stay strong and I’m sending you much love .

  3. I had to chuckle reading this. Not that it matters but I would opt for the same reconstruction. The finished product is much nicer. Your clothes will fit better also. Love your spirit!

  4. Wow, Yolanda. Thank you for sharing your heart and the details of your many decisions. Love the Lord of the Rings metaphor. Praying for continued courage and healing.

  5. Thank you for sharing these details. Your humor is a gift to you and to us who care about you! I’m so glad He is providing the team you need and like! Praying for you…xo

  6. Hi Yolanda,
    I think you have absolutely made the right decisions! That was interesting about the weight gain issues with your first option! And what an extra ordeal that would be!
    Then having your ovaries out is a good decision as well. I had a hysterectomy years ago and regretted not having mine out. Ovarian cancer is so hard to detect until it’s too late. I lost a friend last year from it. My aunt passed away from ovarian cancer and they didn’t want to take mine because of the hormone issues, but in retrospect, I wish they had! Good choices. I’m praying!!! Hugs…….

  7. A lot of information. No one I know who has gone through breast cancer surgery ever shared the decisions to be made regarding reconstructive surgery. So glad you found doctors that make you feel confident in their abilities and that you were able to “bond” with them. And praise the Lord for Stuart! He sounds exactly what God intended a husband to be: a loving partner full of wisdom. Keep your sense of humor and faith beautiful lady.

  8. I’m astounded that you can refer to Bette Miller’s hilarious shtick in the midst of all you’re going through. Truly, you are a woman of dignity and honor . Your faith is vibrant, Yolanda. Thank you for sharing this life changing experience with us.

  9. Thanks for sharing all that information. I too love the Lord of the Rings. I look at that movie every chance. My prayers be with you. I know that God cares for you. I plead the blood of Jesus on you knowing that God will heal you. God is your strength. “My flesh and my heart faileth: but God is the strength of my heart, and my portion for ever.” Psalm 73:26 May God bless you Always.

  10. Thanks for sharing the update and for putting it in words that would make me laugh and not shed tears. You are magnificent. Auntie Ollie

  11. Yolanda, I had an incredible woman on the radio show who walked thru a ra rare form of brain cancer and is doing magnificent..Her humor was so beneficial, like yours..she told me that the kind of cancer she had usually attacks Asian men who smoke a lot…duh..but yu and she are so victorious thru this and u encourage all of us…we are praying precious saint of God!

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