Angelina’s Diary of a Surgery

I just read Angelina Jolie Pitt’s op-ed in The New York Times about her second preventative surgery: to remove her fallopian tubes and ovaries. Just as she did with her prophylactic bilateral mastectomy two years ago, Jolie Pitt writes articulately and openly about her laparoscopic bilateral salpingo-oophorectomy, using imagery and opinions that those of us who have walked in her shoes immediately understand.

She writes, “The beautiful thing about such moments in life is that there is so much clarity. You know what you live for and what matters. It is polarizing, and it is peaceful.”

So much clarity. Amidst untold chaos and unimaginable confusion, there is clarity.

She recounts her consultation with the GYN surgeon, who had also treated her mother: “I last saw her [the surgeon] the day my mother passed away, and she teared up when she saw me: ‘You look just like her.’ I broke down. But we smiled at each other and agreed we were there to deal with any problem, so ‘let’s get on with it.’”

I had a similar encounter with someone who cared for my own sweet mama during her cancer treatment. The woman who was my mom’s radiation tech is now a nurse in my orthopedist’s office. I knew as soon as I saw her face that she was the kind practitioner who blasted pointed radiation into my mom’s beleaguered body five days a week for weeks on end. When I encountered her in the orthopedist’s office, I was thrown for a moment because she was out of context. But before long we realized who each other was, and she said the same thing to me that Jolie Pitt’s mom’s surgeon said to her: “You look just like her.”

Stupid fucking cancer.

When Jolie Pitt wrote about her mastectomy in May 2013 she cast the spotlight on the issue of femininity being defined by body parts. After her mastectomy she wrote: “I do not feel any less of a woman. I feel empowered that I made a strong choice that in no way diminishes my femininity.” With her latest surgery, Jolie Pitt casts the spotlight on another jarring and difficult result: forced menopause.

Becoming menopausal decades before its natural occurrence is unpleasant, to say the least. The physical and emotional ramifications of forced menopause suck. Really suck. There is no easing into the myriad effects, which can include hot flashes, night sweats, increased sweating, sleep disturbances, mood swings, urinary tract infections, sexual disfunction, memory loss, difficulty concentrating, back pain, joint stiffness, and fatigue. As if that’s not enough, throw in the accelerated aging: loss of elasticity in skin, lack of collagen, hair loss, brittle nails, diminished muscle tone, slower metabolism, and weight gain. Suck. At a time when many women are claiming the best version of themselves (“40 is the new 20!” “I’ve finally come into my own!” et al), early menopause creates instant grannies. Suck. If anyone can shed light on the ugly truths of forced menopause, my money is on Angelina. Yes, she has unlimited financial means and resources unavailable to the average cancerchick, but she also has a platform for educating the masses and she’s gonna use it. Hooray!

At the time of this publishing, there were 321 comments on her story; by the end of the day that number will have climbed. The handful of comments that I scanned were positive, but there are some who chastise her for her choices. I’m always amazed at how ugly people can be with the anonymity that our online world provides. How nice it would be if those cowardly, overly opinionated haters could really digest Jolie Pitt’s reasoning and respect her choice. How nice it would be if they would re-read the last sentence in this segment of her latest essay:

“I did not do this solely because I carry the BRCA1 gene mutation, and I want other women to hear this. A positive BRCA test does not mean a leap to surgery. I have spoken to many doctors, surgeons and naturopaths. There are other options. There is more than one way to deal with any health issue. The most important thing is to learn about the options and choose what is right for you personally.”

Choose what is right for you personally.

What works for you may not be the same thing that works for me, or for your neighbor or your cousin or the woman who works at your favorite Hallmark store. Cancer, like any disease, is an immensely personal issue, and any and all decisions resulting from a diagnosis should be personal.

 

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Maleficent blurs the lines

Here’s my take on the latest Disney film, but first a disclaimer: I hate Disney films.

Now, before you boo me and flame me and hate me, let me clarify. I hate that Disney films have traditionally relied on the death of the main character’s mother to build the character arc that defines the movie.

Dealing with the death of someone significant (in my case, my sweet mama) sucks. It really sucks. Going to the movies or employing other forms of escapism should distance one from that suckiness, not magnify it, and I’ve been smacked in the face by Disney’s tired mechanism again and again. However, my favorite girl wanted to see Maleficent and she wanted me to go with her, so I girded my heart against Disney’s mean mechanism and took my girl to the movies.

Sufficiently girded, I was crazy-curious about those cheekbones the makeup artists gave the titular character.

googleimages.com

googleimages.com

Yowza. That bone structure is sharp. And somewhat distracting.

And those lips.

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glamour.com

That lipstick.

maccosmetics.com

maccosmetics.com

Those wings.

gooleimages.com

gooleimages.com

I am enough intrigued by Maleficent’s messages to look past Disney’s transgressions upon my heart. Most intriguing in this case is the idea that the bad guy (or in this case, the bad girl) isn’t always bad. Or perhaps has good reason to be bad. The line between good and evil is blurred. And while that may be troubling, it’s realistic.

It’s not just realistic, it’s also updated and reflective of modern life, not “once upon a time.” The fairy tale transcends a bedtime story to be indicative of real life. Aren’t we in essence creatures who endeavor to be “good” and do the “right thing” even though forces beyond us sometimes conspire against us? Or is it just me? My instinct when someone cuts in front of me in line is to tap them on the back and tell them to get the hell behind me, to take their turn. Instead, I smile sweetly and gently point out that I believe I was there first. Why, just yesterday while waiting for new tires I saw not one but two different people look at the sign on the door to the work area — the one in big, red letters that says DO NOT ENTER WORK AREA. FOR COSTCO TIRE CENTER EMPLOYEES ONLY — and open the door. They stopped to read the sign, then tried to enter the work area anyway. My first thought was to ask them if (a) they truly do not understand the sign; or (b) if they truly think the sign and its message do not apply to them; or (c) if they truly are so important and pressed for time that they cannot wait for the tire-center employee to leave the perilous work area and come to the safety of the lobby area to serve them. However, I chose none of those options; I minded my own business and let the tire-center employee deal with it. I want to be polite and nonviolent, yet the idiots around me present a challenge. I want to be “good” but have lots of reasons to be bad. I want to be nice, but life gets in the way.

Maleficent knows what I mean. She feels my pain. She’s a sweet, orphaned fairy (gorgeously portrayed as a young fairy by Isobel Molloy) who has yet to grow into those cheekbones (but early on masters the art of choosing the right shade of red for her lips) and who smiles a hugely charming smile as she frolics with her woodland-creature friends.

googleimages.com

googleimages.com

Our sweet orphaned fairy goes about her business in the Moors and meets a boy who becomes her friend but later betrays her. He drugs her and takes something precious from her (and no, you did not imagine the hints of rufies and date rape here). His betrayal creates the proverbial woman scorned. As the movie’s narrator points out, the antagonist and the protagonist are one and the same. That blurred line between good and evil reappears.

While Maleficent appears to be a bitter, resentful she-beast hell bent on extracting revenge from the man who wronged her, we could also ask, what about that man? What is his role in her transformation? Is his lust for power and his drive for the throne a cautionary tale about the repercussions of overwhelming greed and hunger for power?

I think so. But I digress.

Whether the woman scorned was born or made into the role of the villain is irrelevant in the face of the idea that maybe, just maybe, we all have a touch of both good and bad in us.

And maybe, just maybe, it’s ok to root for a female bad-guy as we’ve longed rooted for the male versions. They may be bad, but we sympathize with them. We kinda identify with them. Who among us has not been wronged or hurt by someone we love? That’s not to say I want to hang out with Hannibal Lecter or that I condone his predilections, but there are aspects of him that are intriguing, interesting. He’s smart and funny and pretty damn dignified for a man in a scary-looking metal mask. He’s also quite kind to Clarice. I despise him but am intrigued by him. Blurred lines.

Many messages are at work here: that things aren’t always as they seem. People (and fairies) are complicated. Unchecked power and greed lead to ruin. And perhaps more importantly, that the dichotomy between good and evil is not so black and white. Blurred lines.

 

 


No easy choice

I have a friend I met through this little blog. Like I, she lives in a suburb of this vast, sprawling city, although we are on completely opposite ends of the city — an hour’s drive apart. In this city of more than 2 million people, we both had the same surgeon for our reconstruction. She found this little blog while researching our shared doc. Small world, huh?

M and I have gotten to know each other in short order, as is the case when strangers are bound by the worst-case scenario. Instead of discovering that we both like to hike or collect Troll dolls or any number of commonalities that bring people together to forge a friendship, we’ve bonded over things like post-surgery infections, failed surgeries, broken promises and shattered dreams. We’ve traded war stories, vented frustrations and showed each other our scars — the ones on the outside, that is; the ones that can be seen by others.

Our most recent conversation was about how our reconstructive surgeries didn’t exactly turn out the way we expected. We’ve covered this topic before, and will likely cover it again. This most recent conversation coincided with this article in The New York Times following Angelina Jolie’s announcement that she had a prophylactic mastectomy. While Jolie has received a lot of praise, the article says that some breast surgeons worry that the general public will think that reconstruction following a mastectomy is “a quick and easy procedure” and that most people don’t fully understand what’s really involved. I certainly didn’t. I do now. Man, oh man, I do now.

The Times article elaborates: “For most patients, breast reconstruction requires an extended series of operations and follow-up visits that can yield variable results. Some women experience so many complications that they just have the implants removed.” While not all reconstruction involves implants, as in the case with M and me, that’s the most common version, and as long as one doesn’t suffer complications like M and I did, it’s a straightforward process.

It is not, however, a boob job. Roseann Valletti was interviewed for The Times article, and reports that “she is uncomfortable. All the time. ‘It feels like I’m wrapped up in duct tape,’ said Mrs. Valletti, 54, of the persistent tightness in her chest that many women describe after breast reconstruction. They look terrific, to the eye, but it’s never going to feel like it’s not pulling or it’s not tight. It took me a while to accept that. This is the new normal.”

Ah, yes…the “new normal.” M and I have discussed this “new normal.” A lot. And we’ve both come to the conclusion that we don’t like it. Not one bit. We’re so over the “look on the bright side” mentality that is forced upon us cancer patients, especially those of us “lucky” enough to have “the good kind” of cancer. Newsflash, people: there is no good kind. There are degrees of shittiness, but none of them is good.

M and I have learned the hard way that reconstruction after a mastectomy is not a simple thing, as some people may have inferred from Jolie’s experience. As stated in The Times: “Even with the best plastic surgeon, breast reconstruction carries the risks of infection, bleeding, anesthesia complications, scarring and persistent pain in the back and shoulder. Implants can rupture or leak, and may need to be replaced. If tissue is transplanted to the breast from other parts of the body, there will be additional incisions that need to heal. If muscle is removed, long-term weakness may result. A syndrome called upper quarter dysfunction — its symptoms include pain, restricted immobility and impaired sensation and strength — has been reported in over half of breast cancer survivors and may be more frequent in those who undergo breast reconstruction, according to a 2012 study in the journal Cancer.”

Running through that check list, I can say yes to bleeding, infection (not just risk of, but full-blown), scarring, persistent pain, and additional incisions. No anesthesia complications, no implants (ruptured, leaky or otherwise), or upper quarter dysfunction, although I certainly do have all of the symptoms listed, so perhaps I do have it and just don’t know it. Add to that list less-than-satisfactory aesthetic results, intermittent lymphedema, frustratingly painful scar tissue, divots in both armpits from lymph-node removal, unholy difficulty finding a bra that fits, PTSD, a near-uncontrollable aversion to antibiotics, and discomfort when reaching or stretching my arms.

Dr Deanna Attai, a mainstay in the online breast cancer community, was interviewed for The Times article and said, “We do not yet have the ability to wave a wand over you and take out breast tissue and put in an implant — we’re not at “Star Trek” medicine.”

Rats. I like the idea of just waving a magic wand and getting “Star Trek” medicine. Although, if there were such a magic wand to be waved, I’d wish not for “Star Trek” medicine, but for never having had breast cancer in the first place.

doobybrain.com

doobybrain.com


I hope AJ has unplugged

The backlash surrounding Angelina Jolie’s announcement that she has a prophylactic bilateral mastectomy is a lot of things: stunning (not in the good way), discouraging, upsetting, disgusting, rage-inducing, sad…the list is long.shut-your-face

I keep telling myself to just stop reading the negative headlines and judgmental comments, but I can’t. I’m drawn to them like a thirsty girl to a sparkling glass of bubbly.

The comments range from stupid to mean to crazy. This crackpot goes way out on a limb with a conspiracy theory (thanks to my friend Katie for alerting all of us to this blood-pressure raiser). A couple of gems from Mike Adams, who calls himself the Health Ranger, but whom I’m calling Senor Crazy-Pants:

“The cancer industry wants to funnel women like cattle into their slash-poison-burn system of quack treatments. And Angelina Jolie is their new cheerleader. Scarred and no doubt experiencing the chest and armpit numbness that almost always accompanies mastectomy surgery, she now seeks to ‘inspire’ other women to exercise their own sick ‘choice’ and have their breasts removed, too!

“It is the sickest invocation of women’s power that I’ve ever witnessed. This is not empowering women, it’s marching them into self-mutilation. And the ‘risk’ is a complete fraud. In truth, Angelina Jolie had a higher risk of dying on the operating table than dying from breast cancer if she simply followed an anti-cancer lifestyle.”

According to Senor Crazy-Pants, we could avoid cancer with a healthy diet and lifestyle. So it’s my fault that I got cancer, even though I don’t eat meat, choose organic, strive for a plant-based diet, and avoid processed foods and environmental chemicals.

Unbelievable.

Other comments:

“She wanted a boob job so this is a convenient way of getting one PLUS accolades from everyone.” Yes, because a woman whose net worth is estimated to be $120 million can’t afford breast augmentation.

“This is no less than a media stunt to gain more market share to stay up high on the A list.” Right. As if her every move isn’t chronicled by papparazzi. Going to the grocery store is People-worthy news for her.

 “It’s not ‘brave’, it’s stupid. When one has a genetical risk of developing cancer, the procedure is to have them checked at least once a year, up to every six months. Removing healthy organs just for the hell of it is insane and the surgeon who accepted to do this is highly unprofessional.” It’s not enough to criticize and judge her so let’s drop her surgeon in the grease, too. And by the way, it’s “genetic risk” not “genetical risk.” Sheesh.
“How brave is she, if she did that [preventative mastectomy] out of fear?” I’ll give you something to fear, you dumbass commenter.
“Is she really trying to save herself from possible breast cancer or is she following orders from her Council on Foreign Relations bosses to have a ‘unisex’ look?” Sorry, but she already had reconstruction, so the unisex look theory died before it hit the mainstream media.
“Angie DID IT AGAIN…..she stole Poor Bitter Barren Spinster Jennifer Aniston’s marriage thunder RIGHT FROM UNDER HER…..” Ahhh, so that’s why she underwent 3 months of medical hell — to deflect publicity from her arch-nemesis. I’m just spit-balling here, but I’d say that her nearly 10-year relationship with Brad Pitt and their 6 children satisfies her need for vengeance.
“If anyone believes she did this as a way to prevent cancer you’re naive. She’s had 3 kids and she’s getting older. She needed a way to justify getting breast implants (since she’s against plastic surgery) and this is a way for her to do so. Nothing she ever does is for anything but selfish, self-promoting, and self-absorbed reasons.” Duh, she has 6 kids…get your celeb gossip facts straight. And how selfish, self-promoting and self-absorbed is it to be involved in 29 different charities and to donate millions of dollars to those causes.
I don’t care what doctors think are your ‘chances’ for getting cancer. She could’ve kept her tits and monitored the situation closely. The dumb bitch chose to mutilate herself. This woman needs a fucking lobotomy … and to all of you morons who will coo about how “brave” she is, you need lobotomies too. She’s not brave. She’s a stupid, attention-junkie whore.” Wow. Way to work in extreme judgement, disparaging ideals, quackery, and cuss words. I’m glad this commenter “doesn’t care what doctors think” because if he/she is chosen for the cancer lottery, he/she will already have all the answers.
“I can’t get past the thought that this is a level of self-mutilation that would appeal to her.” Self-mutilation and prophylactic bilateral mastectomy. Not exactly the same thing, but thanks for playing.
“Is this drastic action really the only option? This seems like a combo of Ange’s crazy, extreme self destructiveness. and love of attention. More great
publicity for the Jolie Pitts! Again, going to the grocery store provides tabloid fodder for days. She’s probably the last person soliciting publicity.

“RIP Angie’s boobs. You had options, dummy!” And what options would those be? Living in fear? Wondering if this year’s well-woman exam would turn up a lump? Hide under the bed and hope it all blows over? Who’s the dummy here?

“Angie cuts off her boobs, Brad’s gonna be f****** the nanny!” Yes, because nice boobs are the only reason a man would want to be intimate with a woman.

“What a waste of a bangin’ set of boobies.” The waste here is that this commenter is alive and breathing air while Angelina’s mother is dead from ovarian cancer.

“Angelina Jolie’s boobs have been removed…I’ll never smile again.” I’ll give this tweeter partial credit for being creative, but that’s it.

“Because you can never be too careful these days, with the cancer industry scaring women half to death at every opportunity. ‘My breasts might murder me!’ seems to be the slogan of many women these days, all of whom are victims of outrageous cancer industry propaganda and fear mongering.” Damn that cancer industry and its propaganda and fear mongering!

“Being an empowered woman doesn’t mean cutting off your breasts and aborting live babies — even though both of these things are often celebrated by delusional women’s groups. Being an empowered woman means protecting your health, your body and your womanhood by honoring and respecting your body, not maiming it.” Damn those delusional women’s groups. And I guess I missed the news story that Jolie had a late-term abortion as well as a mastectomy. Were they at the same time?? Did the “highly unprofessional” surgeon referred to in a previous comment perform the abortion, too?? Is that covered by insurance??

Good grief.i_love_the_sound_you_make_when_you_shut_up_biker_shirt

One of my fellow bloggers had a much more useful comment. When I read it, I copied it and pasted it, but forgot to attribute it, and now I can’t remember who wrote it. Apologies, ladies. If this is yours, please tell me so in the comments section so I can thank you properly. “There are no ‘good’ choices in such cases: only bad and worse ones. Making them in Jolie’s situation, when your own mom has died of cancer, is even harder.”

Truer words are seldom spoken (or typed). While I’m a proponent of freedom of speech in general, I wish there were a rule that prevented idiots and mean-spirited fools from spouting off on something with as much gravitas as Jolie’s decision. dont-be-so-quick-to-judge-you-just-never-know-when-you-might-find-yourself-walking-in-that-persons-shoesI wish there were a policy stating “If you haven’t had cancer, your voice will not be heard.” imgI wish there were an amendment upholding the right of those of us who’ve lost a beloved member of our tribe to speak about the pain and grief and unfillable hole left by that person’s death.bob-marley I wish there were a mute button to be used when people spew garbage about a situation in which they know nothing.shut-up-fool-001

I really wish that everyone who takes the time to render their judgement and register their opinion on a total stranger’s wrenching choice would read Jackie’s post on this heated topic:

“I have a message for people of the judgmental persuasion. Until you know what it’s like to hear the words ‘You have cancer,’ or to lose your mother or sister or daughter to it, you don’t get a vote. (Even then, you don’t get a vote; but you’re far less likely to want one.) Check the beam in your own eye, if you tend toward the Biblical. If you don’t, let me put it in language you’ll understand. Shut. The. Fuck. Up.”

stephanpastis.com

stephanpastis.com

 

thank you, google images, for providing such lovely graphics.

sorry about the formatting; not sure what’s up with that.


Our newest spokesperson: Angelina Jolie

Thanks to my friend Marie at Journeying Beyond Breast Cancer for the heads-up on a noteworthy event in the breast cancer world: Angelina Jolie’s preventative bilateral mastectomy.

Yes, you read that right: Angelina Jolie had a preventative bilateral mastectomy. She spoke out on her choice in this New York Times piece. I’ve read it twice and know that I will return to it again and again. Not because she’s a celebrity (frankly, I don’t get our societal obsession with celebs; if anyone can find anything remotely interesting about Kim Kardashian besides her unfortunate maternity wardrobe, please drop me a line. I just don’t get it.).

But I digress.

I will likely return to Jolie’s article because she’s articulate and well-informed about this nasty beast called cancer. She’s proactive, which ladies and gentlemen is what makes or breaks your fight against this damned disease. She advocates for a person’s right to choose the medical care that’s right for them. True, she has money and resources unknown to most people, but her message still stands.

Normally when a celeb comes out with a revelation about cancer — particularly breast cancer — the world takes notice because it’s happening to a celebrity. We get all atwitter about the person rather than the disease and the many ways in which it affects them. It becomes about the celebrity instead of about the cancer. In the case of a celeb with breast cancer, I cringe along with my pink-ribbon sisters when that celeb boasts of having “caught it early” and even worse, waxes poetic about how exciting it is to get “new boobs.” (Exhibit A: Giuliana Rancic. I threw up in my mouth more than once while reading her account of her cancer experience and wonder if she really believes the crapola she shoveled.) Newsflash: “new” does not correlate to “better.”

Jolie writes of losing her mother to cancer at age 56, and how the disease stole from her own kids “the chance to know her and experience how loving and gracious she was.” I get that. My favorite girl was 3 when my mom died, and she has few real memories of her YaYa. There are plenty of stories that have been recounted to form memories, but nothing tangible. mom's funeral

That, my friends, is a tragedy.

Jolie says she tried to explain to her children the disease that took “mommy’s mommy” and that they wondered if the same thing could happen to her. The scariest thing about my own diagnosis was explaining to my kids that YaYa’s cancer — which they watched her die from — was very different from my cancer.

But is it really?

Yes, the particulars are different — ovarian vs breast, stage II vs metastatic — but to a child, what’s the real difference here? It’s an amorphous, scary monster that snatches away the people they love.

Jolie says that “cancer is still a word that strikes fear into people’s hearts, producing a deep sense of powerlessness.” The best way to combat that powerless feeling is to do something about it. Jolie underwent the BRCA analysis, which tells us if we carry a gene that makes us more likely to develop breast or ovarian cancer.  Her results: an 87 percent chance of developing breast cancer, and a 50 percent chance of developing ovarian cancer.

She goes on to say, “On a personal note, I do not feel any less of a woman. I feel empowered that I made a strong choice that in no way diminishes my femininity.”

For someone in her business, and as someone who is celebrated for her body as much–if not more–than for her charity work, that’s big.

So is the empowerment Jolie speaks of: “For any woman reading this, I hope it helps you to know you have options. I want to encourage every woman, especially if you have a family history of breast or ovarian cancer, to seek out the information and medical experts who can help you through this aspect of your life, and to make your own informed choices.”

Make your own informed choices.

The majority of breast cancers occur in women with no family history of the disease. That’s one of the many ways this stealthy beast sneaks up on us and takes over our lives. People like Angelina Jolie are helping to change this. She says, “I choose not to keep my story private because there are many women who do not know that they might be living under the shadow of cancer. It is my hope that they, too, will be able to get gene tested, and that if they have a high risk they, too, will know that they have strong options.”

Living under the shadow of cancer.

Those words will stay with me as I read and re-read her piece.

I expect Jolie to bring her considerable influence to addressing the fact that the cost of the BRCA test (upwards of $3,000) precludes many women from undergoing the test. The test is not always covered under insurance, and the insurance companies will squawk about it being unnecessary if there’s no family history of the diseases. But as Jolie says, that should not stop us from trying. Often it’s as simple as having the prescribing doctor contact the insurance company to assert the need for the test.

Jolie ends her article with this: “Life comes with many challenges. The ones that should not scare us are the ones we can take on and take control of.”