So the trade out surgery is happening on Thursday and I am grateful and relieved.  After much debate there were a number of issues settled as we approached the trade out of the expanders for the ‘permanent’ implants.  I use quotes on permanent because truly, there’s no such thing, implants have to be traded out every 10-15 years.  But that’s ages away, hopefully by then I’ll be living in a small village in England or Iceland or Alaska, happily putting my son through college or graduate school and not really giving a rat’s ass if my fake boobs are perky or not.  And who am I kidding, they’ll always be perky.

But these were the issues under debate:

1) Silicone or Saline.  Silicone is preferred by my surgeons.  They are more durable in terms of how long they last and they have a more natural look and feel.  But my neurology team had concerns, quite valid ones, as to whether silicone might trigger my MS should a leak occur.  After much consideration, we were at a stalemate.  With no conclusive evidence that one poses any more risk than another, my GP broke the tie and we are going with the silicone.

2) I was not as forceful as I needed to be with my surgeon about my breast size.  I know I joke endlessly about it, but the truth is I have had DD breasts for 20 years and I don’t want large breasts anymore.  My plastic surgeon, with concerns about proportion, was determined to maintain the size but god help me, I really hope I’m not overweight for the rest of my life and then what happens, I lose weight and still have giant breasts.  No, thank you.  So I wrote him a note saying that I have really been turning this over and over in my head and that I want C cups.  So, as of Thursday I will have silicone C’s if all goes as planned.

3) As you may recall, my doctors had made the decree that hormones were off the table in terms of dealing with menopause which came on fast and furious post surgery.  There were a myriad of concerns about hormone replacement, the worst risk being an increase in blood clots that I had developed after my last surgery.  But those concerns paled in comparison to the weeping mess my gynecologic surgeon was faced with last week.  I, who run a notoriously low blood pressure, was running at 191//119 and when the nurse asked me to close my eyes and imagine the ocean, all I could see was me drowning in waves that wouldn’t stop crashing toward me.  I reminded my doctor, I am one who swims, not one who drowns.  So he reversed the hormone decision, said I was in the throes of a seismic hormonal shift, and that clots be damned, he is giving me a low dose hormone replacement therapy as soon as I am finished with the next round of recovery.   It will mean I will have to also stay on a blood thinner for as long as I take the hormone, a trade off with which I can live.

4)  My MS, lest it be completely ignored, has reacted to medication shifts, menopause, metal and plastic body parts and high blood pressure with relative calm, with these few exceptions.  Nerve pain in my arms, fatigue and vertigo that may or may not have contributed to me falling last week, hitting my head on the sidewalk and getting a concussion.  If my health wasn’t already a comedy of errors, this thrust it into that category without any question.  The two best quotes from my doctor.  “Amy, it’s a good thing there’s bad luck or you’d have no luck at all.”  and, “I might just have to make you wear a helmet.”  For the record, at the end of my visit with him, my blood pressure was back to a normal 115/80.  Most likely because I laughed uproariously at my misfortune and thanked the universe for giving me such great doctors.

So hopefully Thursday will bring an end to the hardest parts of this journey.  There will be two small follow up procedures which should be complete by June.  If you think of it, throw a thought into the ether for my old friend Jeff who is having surgery tomorrow, and another for me on Thursday.  Hopefully we will all be at our Thanksgiving tables next week with scads to be thankful for.