The Great Divide

Clinical Update: Had another very informative day. Saw the plastic surgeon and learned more about breast reconstruction than I ever thought I'd need to know. Surgery is now scheduled for August 25. All docs have assured me there's no risk in waiting a couple of weeks ... apparently breast cancer is a very slow growing evil thing. So, I've got a couple of weeks to get through the mountains of paperwork, make my final decisions about the first phase of treatment (one versus two, B-cup or C-cup . . .), and leave my office and clients in some state of organization.

Today I have an MRI to check my other breast and insure there's nothing suspicious on that side. Even if there is it simply means the doctor will take a lymph node from that side. Shouldn't change much else. Also a chest x-ray and EKG ... the final pre-op work-ups that need to be done. Then I can get back to living for a couple of weeks to get things in order. Unfortunatley this was the only MRI time they could fit me in and I had to give up my ticket to Phantom of the Opera with my friend Jen. Ah, priorities ...

I'll be in the hospital for 23 hours ... not 24, that would make me an inpatient and insurance says I have to be an outpatient. Apparently they've come a long way with mastectomy procedures and they can be an in-and-out thing. I will spend the night, and I'm sure will welcome at least one dose of morphine. The good news, though, is because the operation does not involve any bone or muscle, it's a very straightforward procedure. The reconstruction piece is actually far more involved. There are a couple of different ways to approach reconstruction: natural tissue reconstruction where they take skin and fat from somewhere else on your body, and implant reconstruction. I'm not a candidate for the natural tissue kind because I don't have enough tissue anywhere to spare ... I think that's a compliment??? So, implants it is. During the surgery the surgeon will do what's called a "skin saving mastectomy" ... saving as much of my skin as possible while still removing all of the suspect tissue. The plastic surgeon will be there and will insert skin expanders ... little balloons that will go between the chest wall and my skin. These will sit on top of a very expensive material ($11,000, I was told) that will lend support to my future bustline. The balloons will be gradually "inflated" with saline ... once a week ... until they are the size I want. At that point the plastic surgeon will replace the expanders with your basic implant and address the other "cosmetic" things associated ...

I must wax philosophic about the dramatic differences between the environment and patient population at the oncologist's office in Chula Vista, versus the plastic surgeon's office in La Jolla. While every doctor I've ever seen has sterile white exam rooms and hands me a paper gown, the plastic surgeon's exam room is painted a soft green, decorated with artwork and a large mirror, and they handed me a black satin gown. All of the women in the waiting room were very well endowed. The cute young things behind the desk, all of whom must receive free services as part of their benefit package, were clearly not used to dealing with "sick people." I questioned the insurance process and referrals. She said "so you haven't been here before?" I said, "No. On Monday I was diagnosed with breast cancer. This is the fourth doctor I've seen. I just want to be sure all of the referrals are moving ahead as they should." Her response: "Oh."

Word is clearly getting out and I so appreciate all of the phone calls, emails, and positive energy. It's overwhelming to be loved by so many. Please know I love you all too ...