Breast Reconstruction 101

I walk into a plastic surgeon’s office.  I look around at the tall windows, plush white armchairs, and stacks of before-and-after, breast-photo books lining the walls. I feel completely out of place. I associate plastic surgery with wealthy, vain people who don’t want to look old (hope I am not offending anyone here).  I am just a young cancer patient, wearing a scarf, black t-shirt and jeans, trying to figure out how I am going to feel and look like myself again.

The doctor shakes my hand and sits across from me on the other side of a wide, glass desk.  Immediately she looks down at my stack of paperwork and reads aloud the bullet points: “okay, breast cancer, BRCA positive, double mastectomy.”  I am already in a fog of fatigue, but the more she speaks, the more overwhelmed and withdrawn I become.  I try not to cry as she talks about “tissue expanders” and “flaps.”

After a brief discussion about some of my breast reconstruction options (Before or after radiation?  Implants or flaps? The latter involves a transfer of tissue from my abdomen to my breast), she takes me into an exam room and tells me to put on a gown.  Then she says, “I’m sorry, our shade does not cover the whole window.  The construction workers can see in here.” She leaves.

Is this a joke? I look out the window, down at three men who, sure enough, could easily look up and see me topless.  I look around for a candid camera.  She comes back in. After she examines me, which basically involves her grabbing my belly to see if I have enough fat to make some new breasts (which I do, in case you are curious), she abruptly opens the door and exits again before I have time to put the gown back on.  I quickly grab the gown and cover myself so nobody in the hallway sees me.  Have you ever had a doctor not wait for you to put a gown back on before walking out the door?  This was a first for me.

When I go back into her office Ian and his mom are there for some moral support.  The doctor proceeds to put on a ten-minute promotional DVD outlining the different types of reconstruction.  She continues to sit at her desk, typing up notes from our meeting. I almost lose it—laughing, not crying this time—one minute in to the computer-image breasts flashing to some crappy synthesizer beat.  I usually feel completely comfortable having my close friends and family with me at all these appointments, but I just felt embarrassed for Ian and my mother-in-law to have to watch this high school science PowerPoint video.  (Ian said it seemed like an in-flight, pre-takeoff video; he kept waiting for the part about silicone boobs falling from the ceiling with the oxygen masks).

Following the boob movie she asked if we had any questions. Ian and his mom asked a few things, but I had one eye on the door, sweating. 

I have been warned that often surgeons lack bedside manner. Perhaps I should not be surprised that this plastic surgeon made no effort to connect, to understand me.  After the appointment, I thought to myself: had she just been able to ask me one question, it would have meant a lot. Maybe “How are you feeling about all this?” or “What do you hope to come from reconstructive surgery?”—an invitation to understand my particular point of view, my desires as a patient, would have made all the difference.

I’m more than halfway through chemotherapy at this point.  The end is in sight, which should feel like a relief, a blessing, but truthfully, I’m actually dreading it.  First of all, while chemo is a tough experience physically and psychologically on many levels, there is comfort in knowing that as long as I am taking the drugs, they are working.  I worry about microscopic cancer cells unleashing their power again post chemo.  The other reason I fear the end of chemo is because the next step will be to have my breasts and ovaries removed, a bilateral mastectomy and oophorectomy.  The closer the surgery gets, the more real the loss feels.  The surgery is a symbolic ending – to my childbearing and breastfeeding years, but also the body I’ve come to know and love.

I got used to the no hair thing pretty quickly.  Ian too, except the other night when I woke him up and he said, “I thought we had a bald intruder.”  I actually like my shiny head and pretty scarves. I also know the hair will grow back.  I think about people who lost parts of their bodies in sudden, tragic ways, like the Boston marathon bombing victims.  I realize that my surgery is part of my planned treatment, a choice, significantly increasingly my chances of being cured – forever.

Recently, Yael asked me to take off my scarf.  I didn’t want her to think I was embarrassed or ashamed so I took it off with a confident smile.  She said, “Mommy, you look pretty.”  I told Ian to take a picture of us and then, feeling brave in the moment, posted the photo on Facebook.  I love my mother’s comment: “think of what Yael saw in your face that made her say that…..Your papa Nat’s favorite line was: “a woman is beautiful when she is loved.” I feel like it was all a rehearsal for this moment.”

May this be a rehearsal for moments to come, when one day my scars reflect not what I have lost, but what I have gained.  During all those future moments when I make sure my daughters feel beautiful, not for any particular part of their body, but because they are so completely and fearlessly loved.

  

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10 Responses to Breast Reconstruction 101

  1. Emily says:

    Adina,

    You are amazing. Ian is amazing. Your kids are amazing. Never stop being who you are. And please write a book so I can read more of your writing! Love and miss you so much!! ❤ – xoxo Emily Schwartz

  2. Gail says:

    After reading all of this, my one (selfish) thought… It’s too bad we have such a physical distance between us…. You are the kind of person one can be proud to call “friend”. And I am so very happy that Ian found such a wonderful woman to share his life (and that, you shall).
    My prayers are with you and Ian.
    Also, isn’t Kathy wonderful? From the moment I met her, I adored her.
    From my heart… love, Gail

  3. Barbara Schecter says:

    Oh Adina–It is just such an intense and vulnerable time. Every tiny moment of human connection makes (would have made) such a difference.
    But out of all this you have continued to forge strength and love and send it out into the world…for yourself and your daughters and all the rest of us. That makes all the difference.
    All my love, mom

  4. Rose Batzdorff says:

    Hi Adina. This is Rose, Michelle’s aunt. I want to share something from a book I just read (The Storyteller by Jodi Picoult). A little girl is looking at her naked grandmother who has just had a mastectomy and says, “Grandma, something is missing.” The grandmother says, “Yes, but looks what’s left.” Clearly, you have (and will have) a lot left. Thinking about you.
    Rose Batzdorff

  5. Emma says:

    Thank you for your wonderful writing.

  6. Janet & Buddy Promisel says:

    Think of what Rose said above. We always try to think of the glass as half full not half empty. You clearly have so much, a wonderful husband, two beautiful kids and you are still and will always be the beautiful person you are. We love you, Aunt Janet & Uncle Buddy

  7. Kelly Kean says:

    Adina,
    As a health care provider, I apologize for the way that you were treated. Being a surgeon is not an excuse to treat people as anything less than human beings who are trusting a complete stranger with not only their bodies, but their hopes and dreams as well, at one of their most vulnerable moments in their lives. There are surgeons (and other health care providers) who will make an effort to understand, connect, reassure, and help you. Keep in mind that you live in an option rich environment, and all of the people on your care team are people who work for you. You have hired them. You can also fire them.

    All that said, there are times when it is hard to see the scars that our bodies carry around. When I struggle with my scars (both inside and out) I like to think of birch trees. Birch trees are some of my most favorite trees. They have soft, quiet leaves that are such a lovely shade of spring green and they whisper in the wind. In the autumn their leaves literally glow. In the winter, they look silent as they blend in with the snow. But the thing that I love most about birch trees is their bark. The white bark, that peels back and reveals more colors than you’d ever expect from a tree; pinks, golds, greens, blues. All of these colors are scars, that show only when the tree grows. Our scars are signs of our growth; often in unexpected and unwanted ways, but growth all the same. Like birch trees though, after the growth, there will be beauty.

    Love,
    Kelly

    • adinaleora says:

      Kelly, thank you so much for this beautiful, thoughtful comment. I love, love, seriously love the image of the birch tree. I will without a doubt keep this at the forefront of my mind in after surgery.

  8. Kari says:

    Adina, you are amazing and your words are so poignant. After reading three consecutive posts, I have to stop now because I can’t focus on the screen anymore through my tears. I look forward to seeing you next weekend!
    Love,
    Kari

    • adinaleora says:

      Oh Kari! I should have warned you. It is all really so emotional and most people don’t read them all at once. Thank you for so many nice comments. I won’t be offended if you need a break for awhile! Even I need one sometimes…

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