Dreams

That dream where you show up to school/work/etc. naked?  Boy did breast cancer take that recurring dream to a whole new level.  Oddly, in my dreams, my nakedness always matches the current state of my chest.  For instance, the post-mastectomy (but pre-tissue expanders) chest dream, where I would be running through the streets with my scar laden chest with its folded-in, wrinkly skin.  I would be trying, always unsuccessfully, to find a way to cover up my chest so no one knew how disgusting I looked.  After I got the tissue expanders and then the implants, I would dream of myself at work, at the grocery store, Target, wherever, and I would look down and realize I was topless and everyone could see my scars.  I was mortified.  What’s funny about this to me is that in my dreams I wasn’t worried about being topless in public…my mortification came from realizing that everyone could see what my chest really looked like.  They all thought I had these cute little AA-cup fake titties (my surgeon did a really good job, actually) and I had unknowingly blown my cover and shown everyone how disgusting I really looked.  I had, as my plastic surgeon called them, Breast Mounds, with fat, puffy, nasty scars running the width of them.

I was just starting to get used to my Breast Mounds and was actually starting to like how they looked (in clothing, and only clothing that didn’t show my scars) and was even beginning to think I’d be able to get past how the scars looked, especially with some fancy tattoo work.  And then everything went to hell and I had to have the implants removed.    And now I am back to being breastless with this gross, tight, wrinkly skin, only now I have an open wound on one side!  Sweet!!!!  Now I wake up from that topless dream completely drenched in sweat, near tears, and feeling pretty disturbed for at least a day.  The idea that my friends, family, coworkers, strangers would have any idea how disgusting I look without a shirt…it’s too much to handle.  I am told that, because of my small stature, my breastlessness doesn’t look in any way odd or unusual — I look simply like a woman with a flat chest, they say.  I smile and say thank you, that’s comforting, etc.  If only they knew how disgusting I feel.

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Gratitude (and a little about dignity)

It’s been just over a year since I was diagnosed with breast cancer.  January 2, 2013.  First business day of 2013.  That was how my year started off.  Before the month ended, I’d had a double mastectomy and was awaiting news of whether I’d need chemo and/or radiation.  Luckily, I was determined to be in the low-risk for recurrence category so chemo was not recommended.  I say “luckily” because I was scared shitless of having chemo; now, I wonder if I would have more peace of mind if I’d had chemo.  I am 6 days away from my next 3-month follow-up with the oncologist, and I am already worried about what he’ll say.  Would I be less worried if I’d had chemo?

I did end up having 6 weeks of radiation.  That was a piece of cake.  Er, what I mean to say is that radiation is a deceptively easy treatment.  It was tedious and a little inconvenient (especially the part where I had to figure out alternate treatment options so I could leave town to attend my mother’s funeral in April), but it wasn’t really too bad.  Except that now, 8 months later, I am having such ugly complications because of the radiation.  You see, all the crap they warn you about regarding how radiation kills the tissue and the little blood vessels and capillaries that carry blood to the tissue…that shit really happens!  I’m proof.  I’ve now had 4 surgeries this year — boobs removed (January), tissue expanders put in (June — OUCH!!!!!!), expanders replaced with silicone (October — not too bad, until incision decided not to heal), and finally, silicone implants taken out (also, not too bad until incision decided not to heal).

In some respects, I ended my year much as I started it: having my boobs removed.  This last surgery gave me the opportunity to revisit all the feelings and fears I’d encountered when I first found out I would lose my real breasts almost a year prior.  I think I had a slight advantage, thought, because this time I knew what to expect from breast surgery, I’d already been completely breastless once, and, quite frankly, I was so uncomfortable that I couldn’t wait to get the implants removed.  It did provide some relief initially, until the incision opened up again.  So, for the last 3 weeks, I have been home, “taking it easy”, being waited on, not driving, not working, not cooking or cleaning or doing laundry, not carrying my own purse, not washing my own hair, not even taking real showers.  I’ve had home healthcare nurses visiting every other day to tend to my wounds.  The last I heard (because I still haven’t – and can’t – look at my wounds), I am starting to show some improvement.  The tissue is starting to look a little healthier and the doctor wants me to get in the shower every day now.  No more of those mamsy-pamsy sponge baths.

I have learned a lot about dignity (and the loss of it) this year, and I want to write about that.  But not today.  When I started writing this post, that was my intent, but it is a cloudy, dreary day outside, and I don’t want to darken my heart.  Losing your dignity is dark.  I am fortunate that even at my lowest points, I had something to be grateful for.  When I was apologizing to my husband as he emptied the disgusting drains or held my hair as I puked, he asked me to please stop saying I was sorry and to just say thank you.  To be grateful that he was there to do those things for me.

I am so grateful.  From a practical standpoint, I am grateful for my awesome health insurance.  I don’t even know where to start, except to say that BC (before cancer), I always heard bad things about Health Plan of Nevada.  AD (after diagnosis), I am here to tell you that my insurance company is AMAZING.  I haven’t had one single issue with them.  They have paid all my bills without question.  I have never had to worry about access to doctors, medication, treatment, nurses (seriously, I had a nurse come to my house on CHRISTMAS day.  And New Year’s Day for that matter), you name it.

I am grateful for my friends at work who, on two occasions, rallied and donated so much sick leave to me that I have been able to stay home and rest as I needed to.  They’ve covered my work and made me feel just fine about it.  I am grateful for my amazing daughters who have continually lifted my spirits and given me a bright spot to focus on every single day.  I am also grateful for our new addition, Hank.  He’s the little guy we adopted from the animal shelter — a 1-year old shitzu who has excellent manners and has proven to be the most amazing family dog and awesome recovery companion.

Mostly, I am so grateful for my husband.  I don’t know how I would have gotten through without him.  There was a thing that “went viral” (I feel like a poser using that terminology) about the guy who posed in a pink tutu in honor of his wife who has breast cancer.  Well, my husband hasn’t worn a pink tutu, but I’m sure he would if I asked him to. He has, however, accompanied me to every doctor appointment this year (it’s gotta be pushing 30 appointments), sat through 4 surgeries and nursed me back to health afterwards, emptied drains, changed bandages, wiped my tears, cried with me, let me take my anger out on him, carried my purse, told me I was beautiful when I couldn’t look at myself in the mirror, cooked for me, took care of the kids, cleaned the house, helped me shop for clothes that might make me feel at least somewhat comfortable with my newly disfigured body…and he’s continued to love me with and without breasts. 

Yes, I’m grateful.  And lucky.

Re-Opening

Monday, two days before Christmas, it became evident that I was not healing. By that I mean that my incision has re-opened. I’d known a few days earlier that something just wasn’t right, so I shouldn’t have been surprised when my husband told me on Monday morning that we needed to get me to a doctor that day. Knowing that my surgeon is out of town for two weeks and his office would be closed until after Christmas, I was feeling just a wee bit scared and hopeless. In an act of desperation, I asked my husband to call the surgeon who’d performed my mastectomy (Dr. B) to see if he might be able to see me or have some advice. Dr, B was in surgery, but his nurse got the message to him and by 9:00 a.m., he had called my plastic surgeon, who in turn called his nurse, who in turn called my husband. The recommendation was for me to see a primary care provider that afternoon, which I did, and was set up to have a home health care nurse come to do wound care for me. I had my first visit on Tuesday. The nurse packed my wound (ick) and said they’d have someone come out every other day to change all the dressings. She said that if there was a lot of drainage (i.e., if I drained through the bandage she applied), I should call for a nurse if one wasn’t scheduled. So a nurse came yesterday as well. Yes, a nurse came to my house on Christmas. So many things about this Cancer thing have been so surreal, but I have to say that right now I feel…well…OLD. Christmas caroling over the weekend at an assisted living home with my daughter’s Girl Scout troop, I felt like I could identify with some of the residents. (Incidentally, the whole “caroling with my daughter’s Girl Scout troop” thing is a bit surreal itself. I was there because I somehow agreed to be a co-leader for her troop. Huh? Yeah, that is something I never would have done before Cancer. It still feels a little weird, but my daughter just loves having me be a part of if with her, and for that I am grateful I agreed to do it.) And now I have a nurse coming to my house. Weird. But I am so lucky, and wow do I have awesome insurance.

I had also been starting to worry about missing so much work this year. When I took off to have my mastectomy in January, my coworkers donated a bunch of sick leave to me. This was SUCH a gift. Unfortunately, with this fourth surgery, I have now depleted all of my sick leave and have started dipping into my vacation leave, which will go quickly. This has been nagging at me a little bit – the worry that if anything else goes wrong and I need another week or two off work, I’ll be completely out of leave. This would render me in unpaid status, which could jeopardize my health insurance. So when I realized Monday morning that I was having a situation and probably wouldn’t be able to go to work this week, I kind of freaked out. I expressed my fears to a friend at work and within an hour she and several others had donated more leave to me; she had even talked to the benefits coordinator in HR to ensure that I had enough leave to take the next couple of weeks off. Her instructions to me were that she hopes I will stay home until January 6 and just rest and get better. Meanwhile, I’d sent a text to my boss with this latest drama, and his response was, “I’m praying for you.” I’m not a religious person, but that was really touching. Here I am thinking people are rolling their eyes (“Here we go…Jennifer is out sick again…if it’s not cancer it’s something else…”). Not only are they NOT doing that, they are so concerned that they are willing to donate their leave so that I can stay home and heal. These people really care. They aren’t being nice to me because they like my tits. I really don’t feel worthy of such benevolence so I must assume they are being nice because, well, they are nice and wonderful and kind and generous. And I am so, so fortunate to have so many amazing people in my life.
Sometimes I get bogged down with the dates and details, but it hasn’t escaped me that on this day last year (right about this time of the day as I write this as a matter of fact), I went for my biopsy. I remember submitting my leave slip for that appointment and just writing in “medical procedure”. Little did I know that would be the first of many “procedures”. Little did I know a year later I’d be breastless and on my fifth medical leave. But not just breastless; it’s not just a chest without breasts – it’s a gross, scarred, open-wounded, icky, ugly, disfigured, draining, painful mess. It hurts. I can’t look at it. Despite all that, I can honestly say I feel so grateful and loved. I am home resting, not worrying about money or insurance, and being incredibly well taken care of by a most fabulous husband. I really am fortunate.

Back to Work Again

Tomorrow I return to work again. I recalled writing about returning to work after my surgery in October. That was supposed to have been my last surgery. That was supposed to have been my return to work for good with my little breast mounds all resplendent with scars. Never would I have dreamed that in less than two months, I’d be returning to the OR to have those implants removed. I am still stunned. I was always a good healer, yet my body refuses to heal. When I was newly diagnosed, awaiting my double mastectomy, I was struck with the realization that until cancer, I controlled what happened to me. I was in charge of my health and fitness and appearance. Now I have no say. My body is in charge and it has failed me.
This morning I had my stitches removed and now I am having a good deal of drainage due to seromas. This is alarming to me and certainly inconvenient, but it appears to be common and nothing to worry about. Except that tomorrow I have to go back to work. I am already self-conscious enough about my breastless, concave chest, and now I am worried about incision leakage. I’d already been trying to decide which shirt to wear that would somewhat camouflage my breastlessness. Now I must consider that I’ll also have gauze taped to my chest and that I may leak through the gauze. Should I bring a change of clothes? I’m also worried about injuring myself or my wounds, which aren’t completely closed yet. I’ve decided I may need to suck it up and tell my boss exactly what my limitations are in terms of lifting and reaching…it won’t be an issue, but I just hate having to say it.
I feel sad and anxious about having to go back to work tomorrow. However, I’m sure that If I were to write tomorrow night, I would say that the day went just fine. I would say that I found something perfectly suitable to wear, no one stared at my chest, I didn’t leak through my clothes, I had plenty of help with opening doors and such, and everyone was just lovely. And truly, I would be surprised if it is any different.

Something Went Really Wrong

The other day a commercial came on for some cancer center or another, and my 6-year old looked at me quizzically. I asked her what she was thinking and she said, “You had cancer.” I told her yes. “But you don’t anymore, right?” I told her she was correct, that the doctor cut it all out of me. Last night she was asking more questions about whether I still have to go to the doctor a lot, etc. My 10-year old told her I wouldn’t be having any more surgeries unless something goes “really wrong”.

Well, “really wrong” has happened, apparently. Yesterday the stitches came out. This morning as I was getting ready to get in the shower, I noticed blood on my arm. Blood from my incision, which we will now just call a wound. An open wound. Shower was canceled, hubby bandaged me up, and I decide not to go to work until I talk to the doctor’s office. After dropping the kids off at school, I was able to talk to my surgeon’s nurse, who is just fabulous. She then talked to the surgeon (he’s not in the office today), and it is decided that the implant must come out. So I will be having surgery next Tuesday. My fourth time going under this year.

I am in shock. Honestly, the shock I feel is comparable to that I felt when I was given my cancer diagnosis almost a year ago. My two biggest fears were 1) dying and 2) not having boobs. I beat the cancer and had finally made peace with the nipple-less, scarred breast mounds (at least they make me look feminine with my clothes on). I don’t cry every day anymore, and can actually look at them in the mirror. Now I will be boobless again. And I have to decide whether to have the other side removed or be lopsided until such time as we can try the reconstruction again, if that is even going to be an option and if I will even want to try again. The idea of having one fake boob and wearing a prosthesis on the other side is just very unsettling to me. If I’m going to wear a prosthesis, I wish I’d kept my real boob (the left one was not cancerous). I am just so…devastated. My husband made note of what a beautiful day it is outside today and all I could say was that it feels cloudy to me. I know I should be grateful that the cancer is gone, I am going to be okay, everything else in life is pretty good. Lots of silver linings. Quite frankly, I’m tired of having to find silver linings.

So when my girls get home from school tonight, I will have to let them know that Mommy will be having yet another surgery. I’ll have to find a way to say it so they don’t think something went “really wrong”. I guess that’s where those stupid silver linings will come in handy.