" I implore you, my child; observe heaven and earth, consider all that is in them, and acknowledge that God made them out of nothing (ex nihilo), and that mankind comes into being in the same way..." 2 Maccabees 7:28

Saturday, April 5, 2008

Reconstruction

It's always difficult to know exactly what to say in this blog. I have begun the breast reconstruction process and I think it's interesting; however I often wonder if it's shocking to others that I put so many intimate details posted for the world to see. I also worry if posting all this publicly contributes to the sense of separation from my body that I've been aware of post surgery. On the other hand, there are so many misconceptions about cancer in general and breast cancer specifically, about breast reconstruction... Chances are, all of those reading this blog will at sometime in your life know someone else with the same diagnosis (1 in 8 women will get it) and perhaps you will be in a better place to encourage her knowing the facts. I would like to know that others can benefit from my experience; that was one of the original purposes for writing this blog.

All things considered, I felt the positive outweighed the negative. So the following post will be about the process of breast reconstruction; if that is too much information for you, I certainly understand. Otherwise, read on at your own peril. As it is a bit uncomfortable to write (not because I mind answering question honestly and thoroughly, but rather because I can't see your faces as you read or know how the things I say may be interpreted), I imagine some may find it uncomfortable to read.

I'm not sure what I thought breast reconstruction would be, or even if I ever had a fully formed opinion at all. Since the breast would be entirely removed, I would have guessed they would make an entirely new one out of memory foam or something and just stick it onto my chest with some industrial strength adhesive. It would look just like the real thing, only I would have to wring them out after each shower or swimming laps. Needless to say, this is entirely wrong.

I opted for mastectomy with immediate reconstruction; what this means is that after the actual mastectomy performed by the surgeon, the plastic surgeon then takes over. In a typical breast augmentation an implant is just placed underneath the already existing breast tissue, however following a mastectomy there is no breast tissue left; it has all been removed right down to the chest wall. So before any kind of implant can be put into place, the skin has to be stretched. The plastic surgeon places an expander underneath the muscle and then, after full recovery from the surgery (about 1 month), begins to inflate it by degrees in order to stretch the skin to accept an implant (this is called the expansion process). I had the first expansion on Thursday with the plastic surgeon; he warned me that it may be painful as it does put pressure on your lungs and rib cage. Although I was uncomfortable, it was not painful and it is already feeling better only 2 days later. They can fill it as slowly or as quickly as you are able to tolerate, however the larger you stretch the more painful it will be, regardless of how large you were before the mastectomy. Once the expansion process is completed, they remove the expander and put in it's place a permanent implant (they need to be changed every 10 years or so, so the term permanent is a misnomer, really). All implants can be problematic, however saline is less risky than silicone so I opted for saline, despite the fact that many people feel silicone gives more natural results.

In reading this through, I think that a few years from now I may regret having told the world all these details; as I mentioned before, there is a certain separation from your own body that I think is a pretty typical experience post cancer. At diagnosis, you find out that your body is hosting an invader that is slowly destroying you (though harboring this thought for very long could really drive you nuts- I had to just squelch it every time it would arise. In fact, I think that is one of the areas where all the prayers you sent my way benefited me the most; in the grace to take mastery of my thoughts and not be overwhelmed by fears or obsessions, especially in the early hours of the morning where your intellect is not operative...). In addition to that, following the surgery you have a complete numbness over the entire area of the mastectomy, extending through the armpit and to parts of your back. This area of numbness will grow smaller as the nerves, damaged during the surgery, return to the surface level of the skin, but it will not return completely. It is impossible to predict how much feeling will return, but it will never return in full. All this just contributes to the sense of detachedness (is that a word?) from my physical body at this time. And as the numbness itself is still new, I am very aware of it. Doctors assure me that I will grow accustomed to it in time.

As my risk of recurrence in the second breast is very high, I plan to have the second breast removed at a later date (rather than waiting until something shows up abnormal and having to go through radiation or chemo again). So I am just going to live the asymmetrical life until the second breast can be removed and reconstructed. A year from now I should be done with this whole thing and hopefully begin to feel like my body is my own again, rather than just a prop on a stage that I can exit at any time.

There are lots of things that can cause someone to feel a psychological detachment from their bodies- I hear stories of people who were sexually abused and experience that disconnect later as adults. I don't pretend that my own experience is anything so traumatic as that, but I do imagine a kinship between those souls and myself. It gives me comfort to think that I can offer this up for all those who are suffering the effects of those kinds of traumas. God took on a human body in the person of Jesus, so I know he understands what it is like when we struggle with all the vexations, difficulties and frustrations of our embodiment. And that's nice to know, too.

Thanks for reading my blog.
Love, Faith

5 comments:

Kasia said...

Love you Roomie! Does your chemo start on Monday?

Anonymous said...

You didn't explain why they need to stretch the skin. Or is it the muscle they are stretching, since the implant is under muscle? -Trinka

note_toself said...

Faith - I hope you never regret writing these things. It is all extremely powerful and fascinating in so many ways, and I always feel in awe after reading it.

Lexey said...

It takes a lot of courage to allow others in to your personal experience. I admire your strength. Your words may help someone going through something similar to cope with their own life. And if nothing else, it gives people like myself, who has never met you, the opportunity to send another prayer your way. :)

Mama Manak said...

Faith,

Thanks for writing this! I've always been TERRIFIED of breast cancer, but seeing you write about it makes it not so fearful.

You are in our prayers!

~Christen