So tomorrow is the surgery.  I’m ready to have it behind me, to start the healing process and to know that I have done everything in my power to combat these BRCA genes for now.  While I am not nervous about the surgeries themselves, I still find myself fixated on the ways in which I will change post surgery.  How being thrust into menopause will effect me, how it will effect the MS.  But I am trying to keep my eye on the prize.

I was speaking to a friend recently who brought up the fact that I had opted for the most aggressive treatment in regards to these genes, and it occurred to me that I was never given an alternative.  All three of my surgeons said this was what I needed to do to ensure my survival, so I’m doing it.  I asked every question imaginable, read up on these genes to the point that I could have an advanced degree in hereditary cancer genes, and I am comfortable and secure in the fact that this was the only way to proceed.  Of course, I keep trying to explain that to my boobs and my ovaries and they just look at me like I’m bat-shit crazy.  Well to hell with them, I won’t see them after tomorrow anyway…

This is the deal, to proceed in hopes of living a long, healthy, fulfilled life.  I figure with how much I am losing over the next 24 hours, I’m making lots of room for new things.  Things like Alaska and Israel with my kid, and seeing him graduate from college and med school (please, please, please).  Things like riding a mechanical bull, and working on 8 plays next season.  Things like a crazy big love which up until now I had only seen as a thing of the past- but what the hell, I mean there’s going to be LOTS of room after all.

Other than that, I haven’t much to say today, except this.  I am incredibly grateful that I have so many people who love me and who have my back.  Along the way, sitting in doctor’s offices, waiting for mammograms, MRIs and blood work I have met a lot of women who have readily shared their stories with me and some of them had no one to take care of them.  I spoke to a woman who opted not to have chemotherapy post mastectomy because she had no one to help her.  No matter how hard things have gotten I have had so many people here to pick me up, dust me off and set me right again that I feel I won’t live long enough to thank them.

And to my family–I know how hard it is to be the person in the waiting room- we have all spent more time in them than should be allotted in one lifetime, so let’s make a pact to take a break from operating rooms and waiting rooms for awhile after this go-around.  BRCA genes be damned.

This will likely be the last entry for at least two weeks, but I’m sure I’ll have plenty to report and pictures for show and tell.  Until then…

For SAGGY!  When a plastic surgeon tells you your breasts are quite pendulous, do not think for a moment that he is speaking of small objects suspended by sinewy strings- he means your boobs need a boost.  Now, in the man’s defense, he speaks the truth.  Gravity dictates that after 40 years, DD breasts, in fact all size breasts, head south for the winter and ultimately, like all old things, just move to Florida and call it a day.  Although I think mine have migrated all the way to South America.  But, out with the old and in with the new I say, and today Dr. Tseng and I decided just what the new will look like.

So today was my final pre-op appointment with the plastic surgeon and as we had moved on from the FLAP procedure (see 2 posts ago if you don’t know what I’m referring to) I had to decide whether to have ‘expanders’ put in as initial reconstruction, or to go straight to the implant which meant picking a size and living with it.  In either case I am most likely going to have to have at least two surgeries to get them right.  With expanders, they essentially put in a pouch filled with saline, that will begin at about 50% capacity.  Then, after three weeks of recovery post surgery, you go in weekly to have more saline injected into the pouch until they are exactly the size you want.  Then they do a follow up surgery where the expanders are replaced with an implant the same size you’ve chosen.  It’s like one of those choose your own adventure stories with boobs!

Now, most of you know that I was not thrilled about having to forgo the FLAP procedure but here’s what is ideal about this scenario for me.  My weight is currently going down because I finally bit the bullet and got off sugar and flour again.  So with that change, I am more apt to lean toward a smaller breast size, but my plastic surgeon is still set on a C.  So, this is a perfect way for us to find a happy medium 10 cc’s at a time.  Yes, I know, I have mastered the art of finding the silver lining.  I told my cousins that at this point I can find a silver lining on a pile of shit.  Who would have thought that facing down something this big would make me more optimistic- or maybe I’m just completely losing it.  Well, as long as I’m not depressed, who cares?

So, I signed my informed consent, I finalized the procedure decision with the surgeon and he walked me through the whole thing once more.  First, the breast surgeon will remove my BRCA breasts as they are unaffectionately referred to, then my plastic surgeon will place in the expanders and do the first step of reconstruction so I will wake up with roughly a B cup.  Then my Gynecologic oncology surgeon will remove my uterus, fallopian tubes and ovaries as well as taking numerous samples to verify that the BRCA gene hasn’t already worked it’s magic in that general area.  They will in fact biopsy breast tissue as well to check for the same thing.  If they find something, as my ex-husband always said, we’ll burn that bridge when we get to it.

So we are now at T minus two weeks.  (can someone please explain to me what T minus means?) I have managed to fill every single day leading up to the surgery- some days with pre op appointments and tests, and some, like last Saturday, with play going and picnicking with my favorite pal.  This weekend we are off to a gorgeous beach house that my sister rented so she’d have something great to do post treatment.  I am a lucky beneficiary of that reward.

One last thing that happened in the waiting room for a scheduled mammogram today.  A very nice woman struck up a conversation with me, mentioned she had had breast cancer and was having a recheck, and asked if mine was routine, etc. because I’m so young.  I explained that I was actually having this test as part of completing the Estriol trial for MS but proceeded to tell her about the BRCA genes and upcoming surgery.  She said to me, “I’m so glad when I meet people like you because it makes it impossible for me to feel sorry for myself.”  Now, of course the subtext there is “thank god I’m not as fucked as you are” but with that, was such a genuine gratitude that I had told her about my situation and it made her load feel lighter.  And for me, it’s no skin off my back to give her this boost, so I’m happy to offer up my story if it helps someone else see their own story with clearer eyes.   Perspective should never be underestimated- and mine is roaring like a lioness ready for battle.  Out with the pendulous and in with the perky!