Are you an oncologist yet? How ’bout now?

Diagnosed August 30th. Tentative surgery date is the first week of October. Four weeks is forever if the decision you have to make is what to have for breakfast but four weeks to take on, digest and decide on what to do with this cancer is a blink! I am both grateful for and exhausted by the sheer number of specialists I have been assigned. (Surgery, medical oncology, radiation oncology, reconstructive surgery, fertility…) Grateful in that I feel confident all of these folks have my very best interests at heart. Exhausted because each one of them offers a myriad options I must choose. None of them have told me what I must do. My rebel nature would resist that anyway. What they do is they lay out all of the options with all of their stats and I must then ask the right questions, inform myself and choose. (Do not forget dear reader that these stats are things like probability of recurrence and worse) The choose-your-own-adventure-ness of my life has never been so obvious. Is 2-3% too much? 85% enough? Never lose sight of what the wrong choice could mean. Oof!

The first decision: The surgery.
I have chosen to have bilateral (double) mastectomy surgery. There are two main reasons for this decision. The first is the more shallow reason. Symmetry. I have never exactly had symmetrical boobs and from what I gather most women don’t. I have always loved my little oddballs but it’s in the back of my mind. If I was to just have the single mastectomy I am afraid the asymmetry would persist.  A lumpectomy is out of the question for me. Removing all of the breast tissue takes radiation out of the equation because there will be no tissue to irradiate. With chemo looming I’d prefer to take the route of as little chemical warfare as necessary. Nice lead in to the second and WAY more important reason. Lobular carcinoma is not a boob jumper meaning that these cancer cells are not prone to moving from one breast to the other but it does have a habit of showing up in the other breast at a later date. I chose the bilateral mastectomy because I am young (30 years too young for this one to be exact) and I don’t want to fear the tissue that I have left. I sure as shit never want to go through this again. After polling my various specialists this seems to be what they would recommend for me as well. I feel very confident in this decision.
There is one major drawback though. I will lose sensitivity. I will not be able to feel my new nipples. FUCK!! I guess it’s a small price to pay against the cancer coming back and I’ll pay it but I don’t like it. If 90% of sex is mental I should be able to just re-wire in such a way that tells my erotic brain that when I see the new jigglies being touched with intent that this is HOT. There won’t be that familiar jolt to my loins that has previously sparked this nipple-slave but I was due for a change up anyway. grrrr…..

The next decision: The new boobs.
OK so bilateral mastectomy it is. Well now what? There are three options. The first being no reconstructive surgery. Like I have said before, I love the boobies. I love them. This is not for me. Easy. The second option is to use my own fat to reconstruct breasts. While this sounds pretty great in that I wouldn’t have foreign bodies in me and I would get a tummy tuck out of the deal there are some pretty serious drawbacks. It is an INTENSE surgery that involves bringing not only fat from other areas of the body around and sculpting it into boobs but also bring muscle tissue from somewhere to give them blood supply. One option for the blood supply muscle is from my back. They would also bring skin with that muscle tissue. Sorry but I am quite tattooed back there and they just wouldn’t look the same around front. (Also, and the real reason not to use back muscles is that I need those for stuff like pulling weeds and paddling my boat.) The other place they could pull muscle from is my abdomen. They could pull up my middle two abs and use those but again I am NOT ok with this making me a physically weaker person. This surgery, called the tram-flap or free flap surgery, also takes 7 or so hours on the operating table, 3 days in the ICU and another 5 still in the hospital before I can go home. Too much. No thanks. So that leaves us option three. The plastic fantastic! At the time of the mastectomy surgery the plastic surgeon of my choosing will insert what are called spacers. These are like starter boobs that they will gradually fill over the following couple of weeks to allow my skin and tissues to stretch out. After I have determined they have reached maximum glory there will be another out-patient surgery to put in the silicone. The silicone technology has come a long way in that, even if it were to rupture, the silicone doesn’t travel anymore. These look and feel more realistic than the saline option. I have seen the saline option and they are sloshy. I believe (but should double check) that at the same time as the implants go in I will have nipples reconstructed and aureolas tattooed on.

Another one: The plastic surgeon.
This is the fun part. Guess who wins when you get plastic surgeons competing for who can sculpt a better breast? That’s right, me! All I did was mention the name of another surgeon I was considering talking to and it was enough to get this guys hackles up. “I would pit my breasts up against any that that guy can do!” That was a real quote. Alright dude, show me what you got.

There are oh so many more decision that must be made but I can sense, dear readers, that you are getting overwhelmed. Believe me, I know the feeling. I’ll leave you with a list of demands for my new teetees.
1. No longer will you hide in my armpits. Greet the day ahead of you.
2. Your aureolas must be no larger than a half dollar coin. no smaller than a quarter.
3. You will not grow hairs. That is rude and will not be tolerated.
4. Your nipples will be large, like pencil erasers and always at attention.
5. You will be perfect in a t-shirt even unholstered.
These are the rules.