breast – Karen's Cancer Journey & Beyond

PTCD – Post Traumatic Cancer Disorder

Every fall, it’s time for my annual mammogram and blood tests, so in usual fashion, I procrastinated a couple months and finally made an appointment. This was my third mammogram since my cancer/chemo/ reconstruction/ reduction, so I really didn’t think much of it…at first.

I went in, did all the things (and I only have to do half a mammogram these days, so it’s only half-horrible now!) and went home – no problem. Then the call came. “We need you to come back in because there are some abnormalities we’re seeing and we need to take a second look.” Holy crap.

Now, I typically have to go back every single time I get a mammogram because I’ve had “dense tissue” in my breasts all my life, but this time the announcement rocked me to my core. I didn’t really talk about my fear to anybody because this was a normal thing for me – I was just going in for a second mammogram – same ol’ same ol’. But I had a hard time sleeping, I started crying spontaneously a couple times (this usually happens in the shower) and I had a hard time focusing. Clearly, I’m no longer very spiritually mature in the area of second mammograms!

I did the second mammogram – even tighter and squishier than the first – and went back to the waiting room while the technician (who was so sweet and made the process as easy as possible) spoke with the doctor. She came back a billion hours later to say they needed a couple more shots, so I endured a few more even-more-painful boob squishes and went back to the waiting room a third time with a cold sweat now breaking out, my anxiety on a bender. When she came back, she asked me to come into the room again and sit down (cue the shakes), where she told me…everything looked clear and I was free to go. Whaaaa? I just about melted into my chair.

Relieved, but still experiencing PTSD (or PTCD, as I’m terming it) symptoms – flashbacks, distress, fear, inability to focus, shaking, sweating, numbness – I drove home and collapsed into bed, crying like a baby.

Cancer is a horrible disease that ravages the body, but it’s also an insidious mind-fuck, which took me by surprise this time. So I’m working through my PTCD day by day, year by year. Will my mammograms bring flashbacks every year? I’m thinking maybe so…but I’ll be a little more prepared after this year’s experience.

The definition of vulnerability is uncertainty, risk, and emotional exposure. But vulnerability is not weakness; it’s our most accurate measure of courage. -Brene Brown, Braving the Wilderness

The Journey Continues

My life post-cancer

So to recap the last year, here’s what has happened:

In October 2016, we had the unforgettable experience of taking grandson Loren to Disneyland. We love going as adults, but there’s something magical about going with a child!

November 2016, I turned 50. Tina, against her better judgment, threw me an amazing party (with lots of help!) to celebrate. It was a unique experience for me to see all my worlds come together – I had my family there, my friends from Sacramento, my colleagues from work, my Vistage confidants, my church family (including both Pastors) and my neighbors all together in one house.

In December, we spent a beautiful white Christmas with my family in Lake Tahoe.

In January, I traveled to Ashland for the birth of my second grandbaby. When I got the call that Brie was in active labor, I hopped in my car and sped up I5 as fast as I could…only to wait a week while she went in and out of labor, and I finally went home because I needed to get back to work!

Then in February, Genevieve Oreta Brown made her entrance.

After needing to borrow cars to go to Tahoe and Ashland in the winter weather, I traded in my cute little (impractical) Miata for an all-wheel-drive, automatic transmission (because I would not be able to use my left arm for a while after reconstruction) Audi A4 with enough room in the back seat for 2 car seats.

Breast reconstruction: Diep Flap Procedure (more on this in my previous post):

In April, we visited the grandbabies again for Easter:

Loren helped make Easter cookies!

Genevieve!

I got permission from my surgeon to be able to hold Genevieve if I sat down and someone handed her to me!

In May, we went to Disneyland (our happy place) again:

In June, we got Loren for a whole week!

Then (still in June) I had my right breast reduction (so that they would match).

In July, we went to Sisters, OR to spend time with the family at my brother’s vacation home – it was fabulous!

And I went to the Gray Family Reunion in North Carolina (for the first time)!

In August and September, we helped move my parents and Mama Ladd into new homes – 7 weekends in a row! Thankfully, there was lots of help, including these two:

Then in October, we went to Ashland for Loren’s 6th birthday (and Stace’s 31st).

Which brings us to November 2017. More to come soon!

Why DIEP Flap Procedure?

Before the mastectomy, I just wanted the cancer gone. I was more than willing to sacrifice a breast – a breast that was killing me – to be cancer-free. No, I don’t want to even think about reconstruction right now. I’m nearly 50 years old, and my life is much more important to me than a breast. Just get rid of it!

And truly, after my surgery, there was a huge sense of relief that the cancer had been removed. Recovery and figuring out how to wear a prosthesis consumed my time, energy and emotions.

But then I began to feel lopsided (literally and figuratively). My prosthesis was large, heavy and uncomfortable. It poked out of my bra and showed often if I wore lower cut shirts – embarrassing!

So I came to the decision to have reconstructive surgery.

It is hard for the general public to understand this when you are a “hidden amputee.” I realize there is no comparison to those who have lost limbs. But we frequently look at the visible loss of a limb of an amputee and think to ourselves that it took surgery and physical therapy to regain balance and getting used to the loss of their body part. Only a mastectomy patient would truly understand what I’m speaking of when I talk about the loss of symmetry and what it does to your sense of physical balance.

After researching all my options, I chose the DIEP flap option (“Deep Inferior Epigastric Perforator”) over implants and other procedures for several reasons:

The desire for a natural looking and feeling breast

The new breasts are warm, they are soft and they are truly a part of you. The fact that blood vessels are disconnected from one part of the body and reconnected to the breast area lost to disease again, is a feeling that only the patient can truly appreciate the benefit of. You feel “huggable” again. You don’t have any foreign objects in your body.

No need for additional surgery down the road

Implants will typically need to be replaced after about 10 years or so. The possibility of a rupture or leak scared me. And having to deal with this again in my 60s, 70s and beyond had no appeal to me! Natural tissue reconstruction is permanent.

Tummy tuck bonus

Take my 49-year-old muffin top and make it into a great breast? SOLD!

I still have enough “fluff” on the rest of my body to make my tummy tuck pretty camouflaged, but my pants DO fit better!

The main criteria for being eligible for DIEP Flap? Plenty of abdominal “tissue” – check!

The procedure was actually much more involved than the mastectomy. I had an amazing plastic surgeon – Dr. Karly Kaplan at Kaiser – who I give all the credit for an amazing procedure that resulted in a beautiful C/D breast!

I was in surgery for nearly 8 hours while Dr. Kaplan meticulously performed microscopic surgery to remove and reattach the flap to the recipient vessels on my chest wall. An incision was made along my bikini line, then skin, soft tissue, and tiny feeding blood vessels were removed. The blood vessels were matched to supplying vessels at the mastectomy site and reattached under a microscope. Tissue is then transformed into a new breast mound. Oh, and my belly button was moved up by about 3 inches. Pretty incredible!

I spent one night in ICU following the surgery and 4 more days in the hospital before going home. The sunshine and fresh air were divine after being in a hospital bed for five days. Drains at both incision sites, compression girdle, walking around like a comma to protect my abdominal incision, sleeping in a sitting position, and dry shampoo for days…ugh.

I continue to be numb at the abdominal scar site where they take the tummy tissue to form the new breast. This is a very large scar, hip bone to hip bone, and many layers of fascia, both deep and superficial, have been cut through to reach the deep inferior epigastric perforator. You can still see all the scars on my breasts and abdomen, but they have faded dramatically.

Lingering issues?

My left (reconstructed) breast is actually larger and perkier than my right side (I had a reduction on my right side to match the reconstructed left, and while it’s pretty close, there’s a definite difference – especially noticeable in a bathing suit).
I opted for nipple reconstruction on my fake right breast, but still need to finish the tattooing process so it looks natural.

If any of my readers have also had the DIEP Flap procedure, I’d love to hear from you!