We took a walk down memory lane last night with our long-term friend from France and coordinators who will host groups of students in a couple of months. Our French host being the exception, I believe I was the oldest at the table. Someone mentioned the new telephone earpiece which just came out. It is fashioned to look like a “vintage” telephone, a handheld device which most of us remember from just a few years ago, squiggly cord included. Aside, I asked if anyone remembered when we had party lines and I was mostly alone in that category. (No, Baby Busters, it is not the same as conference calling.)
Remember when our choices were simple? Phone or mail? White or wheat? Paper or plastic? Things are much more complicated now. We have twelve types of bread for our sub sandwich and multiple bag options for our groceries. Technology has brought us email, Skype, Twitter, Facebook, blogs, and snail mail is slowly (pun intended) becoming a virtue of the past. Fortunately for patients with “my kind of cancer,” technology has also provided more opportunities in the form of “plastic” surgery.
Have you ever wondered why they call it plastic? I found this in a few different forums: “The word derives from the Greek πλαστικός (plastikos) meaning fit for molding, and πλαστός (plastos) meaning molded. The first reported plastic surgery was performed in India in 600 B.C. The first use of the term ‘plastic surgery’ was used by the French in 1798. The first textbook published was in Germany in 1838. The American Board of Plastic Surgery was then formed in 1937.”
I’ll take it. Plastic sounds better than paper.
That was a long way around to provide you with an update. Just when I think I have seen all the doctors, I am introduced to yet another. Today we met my plastic surgeon Dr. Gordley. He looks remarkably similar to Jeff Probst, which I thought was appropriate since he is helping me to become a survivor. While reconstruction is one of his possible roles (it is an elective procedure after all), he is potentially going to be involved during my mastectomy on July 8th as a first course of action. In the event my surgeon has trouble closing me up, he described several possible ways he could help her, the most extensive involving transferring muscle and tissue from my back and using it as a patch. The latter would also mean an extra night in the hospital and a few more drain tubes, with the plastic surgeon following me up instead of the surgeon.
Imagine you cut a hole in the shape of a circle out of your jeans, and then you try to fix it by connecting the sides together. If the jeans have enough stretch, you may be able to tug and pull and sew it back together. But if they are too tight, you may need a patch to fill the hole. This is the best way I can describe what Dr. Gordley might do if he is called on during my surgery. He’s there to help with the stretch, and if not, he will help patch me up. I’m praying my skin will stretch and they will not need to use any additional tissue. Now you know how to pray as well.
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The plastic surgeon could potentially be involved in as many as four surgical procedures, the first being on July 8th when I have my mastectomy. It just gets longer and more drawn out every time I see someone. I admit when this thing started I knew it would be a lengthy process. After all, a year is a long time! But I was hoping by the end of the year I would be “done.” I’m learning there is more. We were on a fact-finding mission today, but the final decision on reconstruction won’t happen until well into the new year.
My doctors keep using the phrase, “your type of cancer.” Apparently plastic surgeons are fairly common who do implants, but I cannot get implants because of the radiation I will endure. Dr. Gordley is the only surgeon in the area who does this particular procedure. He completed more than 50 in the past year, and had success with all 50. No one dies on the table. Each one “took” as in the blood flowed and the tissue formed into a breast attached and stayed. We are blessed to even have this option to consider. Not too long ago, as late as the 1970s, women with this type of breast cancer had a mastectomy and never considered reconstruction as an option. Now it is a federal law that insurance companies pay for all the procedures involved.
In the 1980s women had the option of a TRANS flap, which involved losing the abdominal muscle as the stomach tissue was folded, slid under the abdomen and repositioned to form a breast while maintaining the connection to the blood flow. Now plastic surgeons use microsurgery and an evolution of the TRANS flap in a procedure called a DIEP flap. They remove the stomach tissue as they do with a tummy tuck, but rather than discarding the tissue as they would with a tummy tuck, they form it into the shape of a breast and repurpose it. Using microscopic instruments they connect veins and arteries from the stomach tissue to the ones in the chest cavity in order to keep the blood flowing to the tissue. Similar to cutting and pasting, the six-pack remains in place. The whole process is incredibly amazing and mind boggling at the same time.
A free tummy tuck is one of the side benefits, but recovery is extensive. If I choose to do the surgery, I will spend a week in the hospital with part of that time in ICU, followed by 6-8 weeks of limited work and absolutely no lifting. The first few weeks of recovery is the worse, I am told, and friends have indicated recovery is harder than they lead you to believe.
Reconstruction comes first, then they let the tissue settle. The second step is to form the nipple and areola. I could walk away with my first tattoo (the areola), again yet to be determined. The last procedure is when they even out the two breasts, again many months later. All in all, it could be the end of 2014 before we are really “done.”
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All of this could change if Dr. Gordley has to patch me up after the mastectomy. He wouldn’t say exactly, but indicated we would cross that bridge when we come to it. Quality of life in women who have had reconstruction significantly outweighs the quality of life in women who elected not to have the procedure (in a regimented study). So there are many reasons to do it. But like I said, we have a while to make that decision so for now I’m putting this information in a blog and sitting the post on the back burner to simmer.
If you have had a DIEP Flap reconstructive procedure, I have a question for you. If you had it to do all over, would you do it again? Why or why not? Feel free to comment here or send me a private message.