Making the Breast Decision: Mastectomy & Reconstruction?

Originally Published by RebelleSociety.com
July 23rd, 2013

 

{via Tumblr}

 

It’s been 4 months since a core biopsy revealed I have invasive breast cancer. Since then, my days have been chock-full of research and reflection, so I’ve had plenty of time to think about the upcoming July 24th surgery that will theoretically save my life.

In the past 4 months I’ve had 14 infusions of chemotherapy and 16 weeks toweigh the options: single mastectomy, double mastectomy, reconstruction, no reconstruction, nipple tattoo, artistic tattoo, no tattoo. I’ve grappled with whether the path of least resistance would be to peel myself back to the bone, bravely staying flat chested forever, or to move gracefully forward with the replication of what I am about to loose.

Each option has its pros and cons. Of course they are all preferable to have no options at all.

With all the decisions that needed to be made, I’ve researched all my available choices (there are many) and prepared myself for the various possible outcomes of resection (there are a few). I’ve asked everyone I knew who’s gone before me all the relevant (and delicate) questions: Are you happy with your choices? Would you do things differently? Do you like the way you look?

Some of my fellow breast cancer warriors elected to remove only the breast affected by cancer, and haven’t sought to reconstruct. Some of these women use an external prosthetic in their bras and bathing suits, some don’t.

Many women I’ve spoken to have removed both the diseased breast and the healthy one prophylactically, and have reconstructed both. Some of these women were candidates for nipple-sparing mastectomies, which left their original areola and nipples intact; some were not and could not.

For those for whom saving the nipple and surrounding skin isn’t an option artistic tattooing can be healing. These women are empowered by reclaiming this part of their body with stunning tattoos where nipples or whole breasts used to be. Each woman’s options are affected by her case, diagnosis and genetic background.

The possibilities are many. The choices can feel overwhelming…

{Via BreastFree.org}

I’ve taken a winding, sometimes bumpy road to arrive at my own decision.

In the beginning I researched various autologous reconstruction procedures, all of which create new breasts using some fat, muscle, skin and blood vessels harvested from another area of one’s own body. But I came to the conclusion that this option could leave me physically weakened in the donor area of my body, and might seriously interfere with my yoga practice.

Then I asked myself if I’d be okay using cadaver or bovine (yes, cow) tissue to hold a silicon or saline implant in place. As an aspiring vegan, this presented me with a bit of an ethical dilemma, and I wasn’t sure if I could introduce any kind of foreign body into my own; whether it came from a four-legged friend or a chemical manufacturer.

Down to the bone.

In May, I came to the momentary conclusion that I would choose mastectomy without reconstruction. I started compulsively feeling my ribcage, imagining a smooth hillside slope from my collarbones down to my bellybutton. I’d press my fingers into the divots between my ribs and try to picture myself with a full set of 12 impressions instead of the breast tissue that presently occludes the spaces between my fifth, sixth and seventh intercostal muscles.

For hours and hours I Googled images of women without reconstruction to see how I would feel when trying on a more Balanchine ballet dancer version of femininity: flat chested and boy-like. What I found were hundreds, maybe thousands of brave women who have documented their journey through breast cancer and proudly displayed photographed themselves or posed for others.

Coffee table books and websites, like The Scar Project, celebrate these women and beautifully illustrate the process of survival and recovery. The photographs I unearthed revealed incredible courage and strength, and touched places deep inside my feminine soul.

 

{David Jay Photography via TheScarProject.org}

 

{David Jay Photography via TheScarProject.org}

 

But after sitting with this decision for several weeks, I realized that something was off. My decision no longer felt personal. It felt political, forced and academic. I realized that the pressure of what I thought I was supposed to choose was strangling what I wanted to choose. 

Through meditation and self-inquiry, I realized how reactionary my initial decision had been. I had judged myself harshly in April for wanting “fake breasts,” and I had labeled myself vain. I needed to get out of my head and listen to my heart.

When I finally did, I realized that choosing not to reconstruct out of fear of being judged for having implants is no more authentic than choosing reconstruction for fear of being flat chested. Either path is honorable and navigating breast cancer is brave, period. Other people’s opinions are none of our business.

CM

 

Beauty takes many forms.

I have unending admiration for the women who have lost their breasts to cancer and have chosen not to reconstruct. I think they are just as beautiful as women who’ve never gone through cancer, or prophylactically opted for surgery. But after much debate with myself, I have chosen another path.

Tomorrow, June 24th, I am having a bilateral mastectomy. I have chosen to remove both my breast that has cancer and the one that does not. If single stage reconstruction is possible, it will happen shortly after my breast tissue and cancer is removed.

If my cancer is still too extensive to save the majority of my skin and nipple, my plastic surgeon will put in tissue expanders that will stretch my skin until it is able to hold a pair of implants. Either way, I am excited to have a new pair.

This decision has brought with it great freedom. I feel released now; released from the pressure I was putting on myself to practice the asceticism I had applauded as part of renouncing reconstruction.

With my mind settled on rebuilding what cancer has taken from me, I’ve been able to return my focus to my heart. Spending time in quiet meditation and holding myself with greater tenderness, I’ve been mourning the imminent loss of the breasts I used to feed my son, and pleasure my partner.

In honoring our time together I’ve been directing thoughts of loving kindness towards my breasts and letting go of any negative feelings I’ve had about them in the past. I’ve come to realize that for me saying good-bye to my breasts has also been about letting go of any shame, blame or animosity I’ve felt about them in the past.

I’ve forgiven their colossal and quite early development in my pre-teens, the shrinking they did when I lost weight in my 20s, the tear-jerking mastitis I had during the first few months of breast feeding, and their abrupt deflation after I weaned my son. I’ve reached back into my relationship memories and forgiven the right one for being smaller than the left (a physically perceptible fact that mortified and embarrassed me in my 20s) and I’ve reframed any disappointments I’ve had in my sense of self as they’ve related to my beautiful mammary glands. On the brink of momentous change, I think I’ve finally made peace and let go of all the old gripes and insecurities.

I’ve put my hands over my chest and thanked my breasts for all the amazing things they’ve brought into my world: a strapping, well-nourished toddler, a satisfied and engaged partner, and a deeply loving maternal sensibility within myself.

I’m ready now; ready to make space in my heart to welcome myself home again: perhaps a little modified, but healthy, cancer-free and just as much a woman as before.

{Photo: Larisa Forman / Caitlin Marcoux}

“Think of all the beauty still left around you and be happy.” ~ Anne Frank

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Read more about my journey with cancer:

>> 10 Practical Tips for the first 10 Days of Cancer. 

>> How to Talk to Someone with Cancer.

>> Cancer and Equanimity: Can you see the forest through the trees?

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Looking for more 411 on Breast Cancer?

Check out these resources and personal stories:

Breastcancer.org

BreastFree.org

StupidCancer.org

Susan G. Komen

American Cancer Society

Breast Cancer Resource Center

Living Beyond the Breast

National Cancer Institute

Caring4Cancer

Crazy Sexy Cancer

Breast Cancer Blogs:

Generation Why

Chemo Babe

Boo Cancer Your Suck

Stupid Dumb Breast Cancer

Pretty: It’s All in Your Head

I’m going bald.

Many of us have had that classic anxiety dream, you know, the one where your teeth fall out? According to Dr. Oz it’s one of the 5 most common dreams. Your teeth falling out of your mouth is likened to your emotions falling out of control and is said to represent the worries and anxieties that surround us in life.

If you dream of losing your teeth, it has to do with ‘loss’ in general such as loss of youth and all things associated with our anxiety of getting older.

~ Dictionary of Dreams

Today is April 25th. It’s been one month now since I was diagnosed with stage 2 invasive ductal carcinoma. It’s a big day, there’s a lot going on and a lot to be grateful for, so when I sat up in bed to enjoy my 6 am cup of coffee, I was feeling pretty excited.  I opened up my digital datebook to check the schedule of todays appointments, and reached up to scratch and itch. Then it happened – a snowfall of hair and flaky skin, and it rained down, all over the glowing screen of my iPad. A faint gasp and then a sob… grief.

Hey, I knew this was coming. I’ve been preparing for weeks. I’ve taken steps all along the way that I thought would help me to feel empowered and in control.

Back on April 1st, I threw myself a hair cutting party. I celebrated cutting off all my thick locks, and had my dear friend Darya free me from the long hair I had identified myself by for the last 19 years. Then on the 10th my friend Anne cut it even shorter. I still felt in control, and I was managing my anxiety about going bald just fine. Thank you very much.

Ice Pack Head: April 14th, 2013

Ice Pack Head: April 14th, 2013

But last week my scalp started to itch something awful. The skin on my head began to feel hot – so hot in fact that I started wearing Granny-style ice packs on my head at home, and I started having the dream, except it was my hair falling out, not my teeth. In my car on Sunday afternoon I noticed a disproportionate amount of platinum blonde hair on my steering wheel and car seat. It was enough to make me pause.

So really, it should come as no surprise that on my one month Cancerversary I am facing the anxiety that accompanies hair loss. Scheduled, no less, to confront it tonight while I teach class, up on a stage, in front of 80 yogis and yoginis at the Dreamland Film & Performing Arts Center. I lived in Chicago for 5 years, where they have a saying, “Go big or go home”. This has never felt more apropos.

Yogis have a practice called Satya.  It is one of the five restraints, or moral codes of conduct, and is basically the belief that we must always tell the truth.

As much as I would like you to think I’m above and beyond feeling upset at the loss of my hair, the truth is I’m not. I can get on board with being bald, but  I am not beyond grieving the loss of my hair. I am not beyond feeling naked and raw. I am not beyond the pain and humility of this exposure. One month and 4 chemotherapy infusions in, my face is broken out, my chest and back are covered in red splotches and eruptions of localized break-outs, the tops of my hands are scaly and bumpy and itchy as hell. I am struggling to feel attractive, feminine, and sexual.

Blast from the past

Back in junior high school there were a couple of boys who’d taunt me and call me Pimple Face. I spent many nights in tears, struggling with a tube of Clearasil and my raging adolescent hormones. Those experiences left deep emotional scars and I worked hard in college to overcome the self-hatred that accompanied my teen years. Now that my skin and hair are being challenged by chemotherapy I am reminded how fragile and vulnerable my relationship to my body can be. And how diligently I have to work to keep loving myself.

The truth is that since surviving adolescence, I have enjoyed the privilege of being pretty and I’ve taken it for granted. Like many women I have wasted countless hours of my life comparing myself to others and have felt disdain for the the body I have been gifted with. I have worried and wondered if the men I have been involved with would find me attractive enough to continuously love me.

I have betrayed the beauty that I have been blessed with by longing for someone else’s. But I have never been traumatically scared, or chemically burned. I haven’t suffered an amputated limb or genital mutilation. I am fortunate enough to have a symmetrical face, and a strong physique. And now, on the brink of finally appreciating that, I have to stand idly by and watch my body morph into something I recognize even less. It is ironic. It is humbling. It is painful. But, it is also a gift.

It is an opportunity for growth.

Yesterday my friend and teacher, Elena posted on FaceBook that “Vulnerability is the best medicine”. If she’s right, I am getting one really big hit of medicine right now. Hopefully I can learn from this vulnerability and use to heal myself; not only from cancer but from the dark, ugly truth that I have not been appreciative of my body.

It’s time to embrace adage that bald is beautiful. In fact, both the men I’ve married in my life have been bald. Never mind that the first one died of cancer. He’s probably having a good laugh at me (or with me) right about now.

I don’t know if I continue to let my hair fall out naturally, or if when I go to Darya’s this morning for my pre-benefit pedicure I’ll ask her to shave it all off. There’s probably still enough hair on my head to spend one more night amongst the Hairy, but I’ll make that call in a few hours.

To all the women who have faced the loss of their hair, I bow to you. To all the cancer survivors who have showed their vulnerability and bravery, I bow to you. To all the BEAUTIFUL baldies out there – let me get down on my knees and bow. Thank you for showing me the way.