Wednesday, November 5, 2014

A Farewell To Breasts

I no longer have breasts.  When I had breasts, I used to imagine doing a stand up routine about them.  Being the anti Phyllis Diller.  I even imagined laughing like she did. "A ha. A ha.  A ha ha ha ha."  Jokes about how my breasts were so large that they entered  a room five minutes before the rest of me did.  How they used to hit me in the face if I wasn't careful when I rolled over in bed.  (That really happened a few times.)

I've had breasts since I was ten. Or so it seems.  I remember being with my mom at Montgomery Ward's to buy a training bra.  I remember thinking how ugly it was.  I have a distinct memory of being three or four and seeing my mom's naked breasts, and her saying, "I hope you never get as big as me." My paternal grandma was also large breasted.  It was inevitable.

I don't remember being flat chested.  I went from nothing to 34D.  I never really could  wear a blouse.  They always gapped somewhere.  Things only got worse when I got married and gained weight.  Two pregnancies later, I weighed slightly over two hundred pounds.  Part of that weight was that I had gone from 34D to 38D to 44I.  When I tell nurses and others post mastectomy that I was once 44I, they are amazed.  I am only 5'2" and small boned.  When I saw my oncologist after the surgery, she pointed out to me that I was still slouching.

When the oncologist starting laying out my treatment plan at the end of May, she did not mince words.  Chemo. Double mastectomy.  End of story.  She has since added radiation.  She also changed it from a double mastectomy to a single mastectomy and reconstructive surgery.

I chose a double mastectomy for the simple reason I didn't want to deal with the awkwardness of prosthetic breasts, especially when it became clear that there would be months between radiation and a second surgery.

Part of me was relieved about it, because I had been so top heavy for so many years.  Part of me was sad. Sad that my left breast had cancer.  Sad that my right breast had to be unfairly taken.  Angry after the fact when the oncologist told me that the tumor had shrunk to 5 mm.   Why did my breasts have to be removed at all?  Of course they had no way to know that until after the fact.

Even though I knew the double mastectomy had to happen, I never said a proper farewell.  Perhaps it should have been some ritual.  Perhaps alone.  Perhaps involving my husband.

I used to imagine conversations between my breasts and me, the right one complaining that it wasn't fair.  I was trying to explain as best as I could why it had to happen.  Not really believing my own explanations.

Perhaps I should have kept my appointment with the plastic surgeon, but ended up in the ER with an anxiety attack instead.  Perhaps she would have discussed the benefit of a single mastectomy versus a double.  Perhaps now I'd be discussing reconstructive surgery and not scar revision instead, but, then again, maybe it would not have made a difference.

I went into the hospital for same day surgery.  I woke up shortly after surgery with four drains dangling down, two on each side.  I hadn't expected that. Was a small detail the surgeon forgot to mention to me.

I knew the purpose of  the double mastectomy was to remove both my breasts and any lymph nodes that were necessary. I had even seen pictures of a woman after a double mastectomy.   I just hadn't seen ME after a double mastectomy.

The following day when my dressing was changed, I was astonished by what my chest looked like.  All those staples.  Skin protruding from below my armpits, where I hadn't expected it.  And no breasts.  Only an indication of where they had once been.  I kept my shock to myself.

Before I left the hospital, the really wonderful male nurse made a binder that fit around my dressing and which allowed us to pin up the drains.  Made it much easier for me to go to the bathroom, as it kept the drains from dangling between my legs.  Made it easier to sleep, too.

I was pleased with myself.  Several trips to the bathroom in the middle of the night.  I was walking fine.  Then a bit before 7 AM, a shift occurred.  I felt pain above the dressing.  I laid back down in bed.  I needed my husband to hold my hand as I walked to the bathroom.

I dreamt that I was asleep in my bed.  I awakened to my husband speaking to me.  Much to my surprise I was lying on the living room floor.  He helped me up and led me to the side of my bed.  I called the surgeon's office.  I  was told that the surgeon wasn't there, but that his colleague was.  We were given a choice.  Come to the office or go to the ER.

I wanted to call an ambulance.  My husband wanted to drive me all the way to either the professional building or the ER.  I saw his point, but I was apprehensive.  He got our housemate.  She helped me get into a chair on the porchlift, while he drove the car onto the sidewalk.  I got safely into the car, and we were on our way to the surgeon's office.

I spent the better part of the day lying on a gurney in an ER examination room.  I either was being wheeled to and from tests or lying there alone.  At least the tests showed that I hadn't had a pulmonary embolism as the ER doctor suspected.  Based upon what the nurse would tell me, the ER doctor and the surgeons were discussing me.  As I suspected,.I  needed a second surgery.  But first I had to be given the first of three transfusions I'd receive over three days, as my hemoglobin was low.

The anesthesiologist, who had been present for the double mastectomy, was yet again standing over me as I lied on a gurney.  He sang "5'2", eyes of blue, has anybody seen my gal?"  I told him that my eyes were brown.  Then I sang along with him.  He knew more of the song than me, so I gave up and listened.  I told the nurses that since he was the one putting me out that I needed to be nice to him.

"I don't want to see you again," the anesthesiologist said, as I woke up in recovery.  I told him the feeling was mutual, except perhaps when I returned for reconstructive surgery.  I think he was amenable to that.

Months from now, after my chest wall has healed from radiation, I will have scar revision surgery.  Given what the plastic surgeon told me about reconstructive surgery, I have decided that it is better to have no breasts than to go through all of that rigmarole.

Even though this is my choice, I wonder if I will ever get used to having no breasts.  Although  my  breasts didn't define me as a woman, they still were a, pardon the pun, large part of me.  My breasts connected me to women who came before me.   And now my daughter have breasts.

I still feel complete, and yet I still feel bereft of what cancer has robbed from me.  I would have preferred breast reduction.  Instead I am left with breast redaction.  Perhaps some day I will be at peace with all of this, but right now I have to adapt to a life without breasts.