Amy’s take


It’s Amy H this time.  Guest Blogger, yet again.

Now before you get all worried that something has struck Nancy down or she’s in a morphine haze, puking or both as is the usual case when I blog for her, let me tell you that she is doing just fine…thankyouverymuch!

I have the distinct and unique pleasure of accompanying Nancy on her visits to the famous (or infamous?) Dr. S.  Just very recently, one of “our” visits happened.  Nancy & I connected the day before just to handle logistics.  Here’s the texts so you know how we figure stuff out:

Me on the day before:  “S at 2right?  Lunch?”

Her: “Yes!!  What works for you?”

Me: “Amy p wants to do lunch. you want to pick me up at 1245 and go get that good salad at the brew house?”

Her: “Perfect. Amy P meeting us there?”

Me: “I’ll tell her to”

That’s the extent of our conversation until she rolled in at 12:45 to pick me up… the Fiat…just sayin’….but with no top down….I should have picked up on the mood….

Hey, how are you??

“HORRIBLE!!!!” and then Nancy launches into a tirade that you won’t believe about her morning.  I won’t go into details, but let’s just say that things didn’t work out the way they played out in Nancy’s head for that morning, and not because she had unrealistic expectations. THEN she gets a text meant to alert her to some bad business. It was a nudge of sorts, to ask “have you checked this out?”…. again, not going into details except to say that there was a certain “liberty” taken which shouldn’t have been taken….and it affected Nancy….  Let me add that it’s just one of those “times” for Nancy.  And I don’t mean “time of the month,” just one of those times where there seems to be no one who understands the “journey” that Nancy has been on.  She feels alone.  So, the little, everyday, bad times are just the tip of the iceberg.  And then her frustrations with the cancer “journey” make themselves known through the everyday occurrences of her life.  She does such a great job holding things together and then some everyday, seemingly miniscule inconvenience is like the prick of a pin on a balloon.  Just so you know, it’s not an overreaction, mind you, because each of these events is definitely cause for frustration, it’s just that these frustrations allow her the liberty to vent when she typically holds it together.  Does that make sense?

So, we meet Amy P. at lunch.  Anything to drink?

Nancy, “I’ll have a beer.”

Well, alrighty then, twist my arm, I wouldn’t want you to drink a beer all by your lonesome at lunch time.

Hey, we’re sort of in a hurry so we are going to order, too.

Nancy says, “I’m not hungry, I’m just going to go with my beer.”

Amy & I echo, “What? We could have cancelled lunch if you  had already eaten….”

Nancy emphatically replies, “NO!! I need this but I’m just not hungry!”  We had a great girls’ lunch — talking about things, some everyday, some not so everyday.  Most people would look at our easy banter from afar and not realize that at times we were discussing surgery, doctors, treatments at other times carpool, dinner prep AND Nancy’s horrible morning.

We say adios to Amy P. then we head over to see good ole Dr. S!  We are greeted, as usual by Marcy & Brenda, Dr. S’s employees who have become our friends over the past year or so.  Brenda is ready for us to come back to the exam room and calls “Mrs. Hicks?” with a casual smile and ushers us out of the waiting area.  Brenda only uses formalities when other patients are in the waiting room.

Nancy always scoffs at this address when Brenda does that saying, “Puh lease, Brenda, really? It’s Nancy!”

I point out, “Nancy, you know she only does that when there are other patients waiting. Brenda needs to keep up the professional appearances!” (As an aside to the Dr. S. camp blog readers, Brenda is always professional, as is Marcy.  It’s just nice knowing that there’s a familiarity that allows them to give Nancy the comfort of addressing her by her first name.)

Brenda hands Nancy the not-so-customary white paper gown.  What happened to the fancy blue paper gowns?  Things are slightly amiss.  Brenda turns to leave with a chuckle and a twinkle in her eye, knowing Nancy well and her need for the familiar in this still unfamiliar medical world.

Marcy walks in, really to say, “Hi” but with Nancy’s thick file in her arms as the excuse to peek in. “Hey, how are you?” We all exchange pleasantries that seem simple on appearance but truly are fraught with more meaning.  We’ve shared more than the burden of Nancy’s “cancer journey,” and the four of us relish these stolen moments to catch up on each other’s lives outside of Dr. S’s presence and all under pretext of the “patient’s visit.”  I write this so you know how most of the office visits to Nancy’s caregivers go.  They become her friends.  They are the fabric of her life now, too.  Not just mere staff.  She’s concerned about them, bakes cookies for them, inquires about their families, knows their birthdays.

In strides the good Dr. S.  “Hi, Nancy!  How are you?” he asks with a big smile. This is the 4th visit in a row that it is apparent he is in a VERY good mood!  Nancy has barely had time to let us get her into the paper gown–opening to the front.  Marcy quick steps back to the front desk and Brenda steps out of the way in the exam room. Good, he’s on time and we won’t be late for carpool.  He knows how much she hates to wait, and I certainly am glad we didn’t have to resort to slipping a note under the other exam-room door to tell him to hurry up, as we have been known to do.

Nancy replies to his greeting, “I am having a TERRIBLE, HORRIBLE, NO GOOD, VERY BAD DAY.”  (She really didn’t say that but he got the point.)

“Why, Naancee?  Why are you having a bad day?” (sorry, not sure how to put his accent in there.)

I intercept this one, “Well, such and such happened and then something else.”  I actually used the actual incidences.

Then Nancy interjected, “About that something else……” as she discussed in more detail the latest angst of the day.  It was a bad day, mind you.

Dr. S slipped into exam mode, eyeing Nancy’s reconstructed body with a critical gaze.  I am amazed at how Nancy’s body continues to heal.  It’s been 2 weeks since I’ve last seen her in all her glory and the “17 inch scar–and I’ve measured it!” looks like the crease that your underwear would make on your tummy if it was too tight.  Really amazing.

Dr. S. steps back, looks at this, palpates that, getting a figure on how he’s going to finish the masterpiece.  He mumbles to himself and has me hold a hand mirror so Nancy can peer at his intended adjustments. She didn’t even want to look, but we made her.

As an aside, he mentions that he has had “two messages from us.  One from you.” Indicating me. “And one from her.”Indicating Nancy.

“When did I message you?”

“You know, you were going to meet me in Denver!”

“Huh?”  Come to find out our good doctor has misinterpreted his messages.  Nancy and I are planning to attend one of his local conferences on the fat transfer process and he thought I was meeting him at his recent Denver conference.  Yeah, right.  I’m a stay at home mom.  I don’t have the time or the budget to be hopping around attending the fat transfer conferences of fancy schmancy plastic surgeons outside of the Houston area!  And besides, I’d only texted him that one time when he was in New Orleans and I had a restaurant recommendation for him–which he took my advice on, I might add….

He quickly changes gears, “So, Nancy, you know…about this bad day….”  He then goes in, and with the gentleness of a long-time friend, conveys to Nancy what I’ve long known are his feelings. “You know, I could not have done the work I’ve done, if you were the type of patient who didn’t do her work.  I have been able to stand by you KNOWING that you were going to do your homework and do what I asked you to when it comes down to what matters.  You have allowed me to do my best. You know, Nancy, this day is just a bad spot, and that situation is just a situation.  If you allow it to control you then you have ultimately lost control and that’s not the Nancy I know.”  He went on to wax philosophical about a situation with a former patient and also his insight on the infection that Nancy had.  But ultimately it was the highest compliment that he could have ever paid her.  I was struck by his gentleness, sincerity, kindness and, dare I say it? Love.

In the midst of this conversation he had been commenting on her skin and I agreed with his assessment.  Dr. S doesn’t think he’s going to have to cut  and stitch an area on her revision because Nancy’s skin is so resilient.  He will just make some adjustments internally and that’s it, no cuts necessary.  Her skin will adapt.  Nancy will adapt.

I look back and Nancy’s eyes give her feelings away.  All the talk about how good the newly constructed chest looks was too much. It was the tipping point in this already-terrible day. ‘YOUJUSTDONTUNDERSTAND!!!!’ these eyes are shouting, and nearly overflowing with the tears that are threatening. “That’s easy for you to say with you both sitting over there without all of THIS going on!”  indicating her body. She actually verbalizes this. It’s a statement and a challenge. She adds that if the shoe were on the other foot, and she was looking at Dr S’s masterpiece-quality work on someone else’s body — anybody’s body but hers — she too would say it looks great. But it’s her body, not someone else’s. And no matter how good the masterpiece is, it’s never going to be the same. She has had ENOUGH of this day!  I know enough to steer Dr. S’s attention from her so she can blink her tears away without him seeing her angst.

He finishes the conversation with another compliment about her resilience and strength and then tops it off with a decision on a final revision date.  Oh Happy Day!  A FINAL revision date!  Did he say final??

We wrap up the visit with some yada yada yada and signatures over surgery paperwork, scheduling our next visit—Marcy kindly penciling us in so we can make it out again next time for carpool.  Marcy confiding to us in a whisper after we inquired about her. Nancy making some smarty pants remark about how she’ll cry in front of Dr. S over her dead body.  I called her on that one, “Oh yeah?  You nearly did it today!”

“Could you tell?” she quickly inquired with concern.

“I could….but not him.”

On the way home I could not even convey to Nancy how she is so right.  We aren’t in her place.  We truly DON’T understand–even those of you on your own “cancer journey” can’t really understand her unique “journey.” I hate that she feels so alone at times, probably most of the time. But we are here.  Trevor, her kids, you, me, all of us.  Even Dr. S.  And we all love her.

Good fat

Another thing to add to the long list of things to love about me: I have “good fat.”

So sayeth Dr Spiegel, who recognized the high quality of my fat at first glance. So skilled in assessing fat is she that a physical exam wasn’t necessary. No need to grab the fat; she could tell the caliber of my chunky-monkey-ness just by looking.

That’s good, because I need that fat for my upcoming revision. While the Drs S did an outstanding, better-than-expected job at reconstructing my sunken, mastectomied chest, there are a few little tweaks needed before I am “done.”

One big lesson about breast cancer and reconstruction: you’re never really done, and it’s never really over.

Much like the plight of an at-home mom in a house full of busy, messy kids, there’s always something else that needs to be done. In this case, rather than errands, laundry, and getting people to & from activities, what needs to be done is correcting asymmetry, changing shape from oblong to rounded, and filling out a few collapsed areas. The best way to do this? Suck out some of that good fat from my hips and inject it up top. 

Remember the “dog ears” left on my hips after closing my 17-inch belly incision during reconstruction? Those pesky globs of fat have tormented me the last 4 months, since surgery. They’ve gotten a bit smaller as I’ve counted calories and gotten back into the gym and onto the tennis court, but they’re still there. At last they will serve their purpose.

I wanted to get Dr Spiegel’s opinion on the best way to go about this before I went under the knife with Dr S. Since the 2 Drs S worked so well together on The Big Dig, I coveted her advice on the revision. I also knew I’d get very clear answers to my questions, as she is very good at communicating and explaining options.

She had the same ideas as Dr S for how to handle this revision. That’s all the confirmation I need. While I’m not looking forward to it (more anesthesia, pain, and downtime), it’s one more step closer to being done. Or as done as a cancer patient ever gets.

Here’s the plan: I go on vacation to Salisbury Beach for 2 weeks, to forget all about the trials & tribulations of the last year. I soak up every second of my favorite beach in an effort to make up for missing it last year. I say yes to every adult beverage offered me, regardless of time of day, food consumed, or number of beverages preceding. I revel in the balmy weather, listen to the sound of the ocean, and relish my friends’ company. I eat lobster in some form each day. I savor the traditions this trip provides my family. I thank my lucky stars that I’m present for this tradition.

Then I come home–tanned, relaxed, refreshed & slightly worried about the state of my liver–and have 2 days before my revision procedure.

I know, I know — having fat sucked out of an area you don’t want it and relocated into an area you do want it sounds like a dream come true. In theory, anyway. I would find it a lot more dreamy if it didn’t involve tools that look like this

and this

and this

Thank you, Google images, for helping me visualize the method of extraction. I’ve been looking forward to bidding adieu to the dog ears since they became a part of my body and to finally having some symmetry to my newly constructed chest, but like everything in this “cancer journey,” it comes at a cost.