Doctor, Doctor, gimme the news…

On Tuesday, I had an appointment to meet with the surgeon about my breast surgery. What I thought was gonna happen was that I would sit down in an office, much like Dr. Wilson’s in House, and that the doctor, my parents, and I would discuss when surgery would happen and what sort of surgery would be needed. You know, about a half hour in the meeting, then on with my day. But no.

What actually happened was that we got to the CBCC and I signed in, at which point they told me that I was scheduled for another ultrasound session. Apparently, more sites lit up on the MRI I had last week, and the surgeon wanted another look before talking to me about surgery. So, I went back, donned the fashionable gown, and waited to be called back for the ultrasound.

My tech this time was Sheila, a lovely woman with corkscrew hair and a light yet professional attitude. The ultrasound took about an hour (or maybe it just seemed that way), and then I was ushered into an exam room while a nurse went to get my mom to be with me for the consult.

First, though, Amber, a nurse with attitude and sense of humor like mine came in and took my history. Again. Never mind that I’ve given my medical history several times since this whole thing started, we must do it again. Then a resident came in and looked over my history and made sure nothing was left out. Then the surgeon came in to give us the news: due to the additional sites found in the MRI, the best option for me is a bilateral mastectomy, with immediate reconstruction. I was given options for how reconstruction would be done, and the surgeon (Dr. Heather Wright–seems good luck to have a surgeon named Dr. Wright) left to call the plastic surgeon to have his look at me. In the meantime, they sent in a genetic counselor to see about me having the BRCA test. I agreed to the test, even though it seems unlikely that a gene is involved. (NO ONE in our family has had breast cancer before–I’m a trailblazer…) The reason I agreed is that the same genes that, when mutated, increase risk of breast cancer, also increase risk of ovarian cancer. If it should come back with a mutation, they will talk to me about having my ovaries removed. I’m pretty well done with them, so that won’t be much of a hardship for me, but I’d like to know one way or another. Also, I have a niece for whom the information might be useful.

After they drew the two vials of blood for the test, the genetic counselor left, and I waited for the plastic surgeon. At this point, we had been in the clinic for close to four hours, and I knew my dad would be getting antsy. I arranged for someone to come pick me up, and sent my parents home (they live about an hour’s drive away). The plastic surgeon, Dr. Rinker I think his name is, is a nice fellow, gentle yet professional. We talked about the options for reconstruction, implants vs. TRAM flap.  (EDIT: I have since confirmed that it will be a free TRAM flap, which is much less scary-looking than the pedicled TRAM flap.)

After hearing the pros and cons of both procedures, I have decided on the TRAM flap. It is a more natural procedure, and more natural result, and I will leave the hospital with fully reconstructed breasts. It does mean a longer hospital stay (a week instead of one night), but there are fewer follow up visits than with the chest expanders and implants. The only question was, would I have enough excess abdominal tissue to create an adequate reconstruction? I undressed enough for the plastic surgeon to have a look at my abdomen. It is oddly reassuring, and a bit surreal, to have a doctor pinch your belly fat and proclaim, “I think you definitely have enough here for a nice pair of C cups…” I knew I was growing that for a reason…

In all, I was there from about 8:30 am until about 3:30 pm. Seven hours. By the time I left I was hungry (thanks, Andee, for stopping at the drive-thru on the way home), I was tired, but I was strangely energized. Now I have answers. I have a plan. Surgery is set for two weeks from now, so now the game plan is to get all my ducks in a row (get my sh*t together, if you prefer). Housework, outstanding artworks with deadlines, all need to be buttoned up NOW.