My Very Own Final Four - Winning all the Brackets

From excisional biopsy to today has been 10 months.

Four surgeries in ten months and this is the final, making this my very own Final Four amid the March Madness!

As has become customary, I'm putting out my post-operative goals so I can visualize success and feel a sense of accountability to make them all happen.

Reconstruction is Not for Sissies - Fret Happens

I am 5’3”.

I weigh 125 pounds.

And, over the past eight weeks, I have had over 800ccs of saline injected into the tissue expander that is reconstructing my left breast.

If you are fast with math facts and volume amounts, your eyes have probably popped out of your head because the left side of my chest should resemble an enormous cantaloupe.

But it doesn’t. 

Actually my left expander is leaking and we’ve been overfilling the defective device twice a week to try and maintain skin stretch. Instead of another surgery to replace the flawed left expander and then one more months down the line to perform the exchange surgery for both breasts, we are accelerating my final procedure.

Why do I say ‘we’ when my job as a patient is to keep my head on straight, show up to appointments, lie still during fills, follow my doctor’s instructions and well, just be PATIENT.

Because I am not that kind of patient. I am an empowered, if impatient, patient.

And because I truly feel the surgical path we’ve chosen was a team decision between my doctor, my family and myself. It would not have worked for everyone. I suppose the upside of breast cancer at age 40 is my skin is still supple enough to stretch well and I heal quickly.

A complication was not part of my plan and has been, without a doubt, the most difficult part of reconstruction. The literal and figurative ups and downs of going from even to lopsided to over-filled to even is difficult. But I remind myself it isn’t more cancer. It’s just a pain in the arse.

And a pain in the head.

I become self-conscious in a way that has never been me. After a fill, I dress normally and appropriate for our warm Northern California weather. As my expander deflates, I don baggy sweatshirts making my entire shape shapeless. On the really rough days I question the soundness of my decision to reconstruct in the first place. And then I become irritated with myself that, after everything that has happened over the past year, I am the least bit concerned with my own aesthetic. 

The cycle is vicious and while, on an intellectual level, I refute the value of fretting - fret happens.

Finding other women who had walked my path helped me get through some of the early 'dark days' after diagnosis. Conversely, I've seen very little with regard to personal stories on leaky expanders and at times have felt isolated in my frustration. 

And then Dr. H puts in another 100ccs and I’m even.

And I’m happy.

And I’m just counting down the days until March 24^th. (Time to construct another Recovery Plan)

Early on in my diagnosis and treatment, I remember someone saying, “Reconstruction is not for sissies.”

I unabashedly concur.

In fact, I may even need that on a t-shirt!

New Plan: The Good, The Bad & The Ugly

We have a new plan. 

And, as with all plans, there are upsides and downsides.

A weekend without any fill appointments confirmed that my left expander is indeed leaking saline. Although I reached out far and wide, I only connected with a few individuals who have experienced a similar issue and their choices were to replace and continue the process. One woman was close enough to her exchange surgery that she endured a few extra fills prior to exchange.

Still four months out from the minimum window for exchange surgery, feeling somewhat stuck and definitely shrunken, I made an emergency appointment for Tuesday February 25^th. Dr. H confirmed the leak and filled the left side back to status quo.

As we discussed potential next steps, I felt myself gravitating toward the let’s-just-get-this-over-with decision to replace the offending expander. I asked if the procedure could be conducted under a local anesthesia as opposed to my being completely out. The answer was, “Well, it could be but I don’t want to do it that way.”

Even after I promised I wouldn’t sing too loudly in the O.R., Dr. H refused to perform a replacement surgery with me semi-conscious. Before I could make any other commitments I wouldn’t be able to stick too, he offered up an additional solution which stopped my mouth from chattering.

“If I go in to replace the expander and everything looks good, I could just put the implant in.”

I verbally (and probably physically) jumped at the option.

Accelerate the exchange surgery? 

Absolutely. 

Yes, please. 

Sign me up!

THE GOOD:

Contrary to the original plan, I will not be waiting until sometime in the middle of summer for my exchange surgery. I have been right-sized and now will have regular fills on the left side to maintain the skin stretch.

My doctor verified the acceleration of the exchange timeline would not compromise my health or the quality of my results. And then I fact checked with a few studies, so we now have a plan.

Actually, I should rename this section THE FANTASTIC, because THE GOOD barely scratches the surface of my feelings.

THE BAD:

No plan is perfect. In order to make this new plan a reality, we must keep the left side expanded. In order to maintain expansion, I am having continuous fills.

In other words, I have twice a week visits that begin with a deflated left breast and end with an over-expanded left breast.  

As the breast expander loses saline, it wiggles around a little and is less-than-comfortable but certainly not unbearable.

The pain in the arse factor is high and I will have another physical starting over point.

All-in-all, THE GOOD far outweighs THE BAD.

THE UGLY:

I embarked on reconstruction because, despite my best efforts, I was unhappy with the asymmetry of my body. I spent months in a whirlpool of self-reflection and analysis in order to choose a path that was just right for me.

Having a complication, or a hiccup, as I now refer to my leaky expander issue, sometimes leaves me questioning the wisdom of my decision to pursue reconstruction. In a rough emotional moment, I wonder if the universe isn’t somehow saying, “Bad idea, Stace.”

In these moments my husband reminds me that immediately following my January surgery, with only 100cc in both expanders, I was nothing less than ecstatic. For me, the size of my new breasts was completely inconsequential. I had two that matched and I felt whole again.

So THE UGLY is the doubt. 

THE UGLY is the unfounded, yet still very real, fear that I won’t get to ‘reconstructed’. 

THE UGLY is questioning my choice and riding the ups and downs that go along with that second-guessing.

Rather than being able to look beyond scars and discomfort to enjoy my new found symmetry, I find myself on an emotional roller coaster of feeling whole, less than whole and worried about never being whole that directly corresponds to the saline leaking out of my tissue expander and being replaced twice a week.

As I go in for multiple fills on my left side, I work through that accelerated process of happiness, fear and grief.

I go from symmetrical to asymmetrical. And back again.

I go from pain-free to fairly-uncomfortable. And back again.

And I am decidedly not feeling whole.

Yet.

As I type, I know that one day soon, things will be different. Things will be better.

I will feel whole.

That knowledge, forgotten and relearned in a perpetual loop a couple of times a week, helps me see beyond THE GOOD and THE BAD. That knowledge helps me see THE BEAUTY beyond THE UGLY.

THE BEAUTY is, with a little emotional fortitude, a whole lotta reminders and a smidgen of patience I can begin to imagine that wholeness right now.