Turf wars

Posted: February 26, 2011 | Author: | Filed under: breast cancer | Tags: , , , , , , , , , , , , | 9 Comments

I wish I knew how to make this blog play music. I bet it can, since I’m pretty sure it’s smarter than I am, but I haven’t figured it out yet. I need a jazzy yet foreboding score to set the scene. Think Star Wars theme song combined with Indiana Jones theme Song with a little West Side Story mixed in.

I knew this was going to happen. I was partly dreading it, but a little curious too to see how it would play out. It played out, all right, and yesterday by 10:30 a.m. I was exhausted by it. Thanks to a beautiful bottle of Vueve Cliquot that Trevor presented at dinner last night, now I’m over it.

But it’s such a great story, I must share.

Those of you who’ve been along for the ride since this summer, when I was updating my trials & tribulations via Caring Bridge, know that I have an especially close relationship with my plastic surgeon. I’ve written a lot about the many ways I have tweaked him, and I hope to continue to do so here. In fact, I plan to. I will invent new ways to tweak him if they don’t present themselves organically, because I love him and really enjoy tweaking him. He likes it, too.  Trevor and I used to joke while endlessly waiting for Dr S during my multiple hospitalizations last summer that I would write a screenplay when this was all over entitled “Waiting for Dr S.” The title will be “The Tweaking of Dr S.” He always showed up, and he always brought his A-game to my bedside. I love that man.

I had great and ambitious ideas about transferring all my Caring Bridge posts over to this new, improved blogsite but it hasn’t happened. Yet. So for now, if you’re interested in reading (or re-reading) about the tweaking of Dr S, I’ve copied & pasted one of my faves at the end of this post.

As I’ve said before, surgeons and bedside manner don’t always go together. No peas & carrots there.

Because I don’t have enough on my plate or on my mind in the last few days before the big surgery, I had to go see Dr. S one last time. Personally, I though we had covered everything, and whatever we missed I certainly had covered with Dr Spiegel. But Dr S insisted I come back, one last time, to be extra sure everything is covered. I asked a simple question. I just wanted to know how he and Dr Spiegel are dividing up the work involved in this long, complicated surgery. Seems simple, right?

A little background: once we decided on the type of reconstruction surgery, Dr S referred me to Dr Spiegel. (Correction: once the post-mastectomy infection ruled out the easier option of tissue expanders to implants as my reconstruction, the option with which I was left was DIEP. Nitpicky? Perhaps, but I like full disclosure.) I did not want to go see Dr Spiegel. Nothing personal, I had just had it up to here with doctor’s visits, and I didn’t want to add another doc into my personal rotation. I’m 100 percent satisfied with the care I get from Dr S, and don’t feel the need for another doc. I was still under the mistaken idea that I could pretend to be a normal person in the interregnum between healing from the infection and reconstruction. Wrong! There is no “normal” anymore, so no interregnum.

I didn’t want to do it, but I did, and I have to admit, I’m glad I did, and Dr S was right. Yes, I said it: Dr S was right.

When Dr Spiegel told me that she and her assistant usually do the DIEP procedure themselves, but that Dr S was welcome to be involved, I got nervous. He doesn’t like to “be involved,” he likes to be in control; that’s why he’s so incredibly good at what he does.

It sounded so simple coming out of her mouth: She and Jenn usually handle the procedure but if another plastic surgeon refers a patient and wants to “be involved,” he is welcome.

I guess I envisioned two teams working together toward a common goal. Teamwork! Division of labor! Cooperation!

No, instead it might  be a little more animalistic than that. They are the dogs, and I am the soccer ball. Great.

Back to the simple question: Dr S didn’t quite answer me yesterday when I asked him exactly which part of the surgery he’ll be doing on Wednesday. See, Dr Spiegel may be a bit more experienced with microsurgery (the part of the DIEP procedure that involves harvesting blood vessels from my belly and reattaching them in my chest). This is presumably why he referred me to her. He is exceptionally good at the “artistic” side of plastic surgery, and I know beyond a shadow of a doubt that he will do a phenomenal job.

To me, finding out which surgeon is doing which part of the surgery is a perfectly normal thing. If I hired two laborers to do work in my home, I would ask which one would be doing which part of the job.

Dr S understandably didn’t want to disclose too much, but my guess is that Dr Spiegel do the blood vessel part, and he would do the transferring of skin and sculpting that skin into a nice rack. He also said that any revision surgery and all my follow-up visits would be with him. Ok by me.

 

Office supplies

Posted: January 18, 2011 | Author: | Filed under: Uncategorized | Tags: , , , , , , , , , , , , , | 5 Comments

I’ve been trying to figure out how to print out all my old Caring Bridge journal entries without actually having to use my own ink cartridge. The one thing I really miss about having an office job is the access to free supplies. I’m no cheapskate (just ask poor Trevor how good I am at spending money), but there are certain things on which I just don’t like to spend money. Ink cartridges for sure. It used to be pajamas, too. Hated to spend money on those, but since I had to spend so much time in them in the recent past, I’m over it.

When I worked for a living, as opposed to working for my family and for society in general (via raising two upstanding citizens who will hopefully become productive members of said society), there were some perks. The bi-monthly paycheck was one. Since I was in the publishing industry, every time we came out with a new book that I had worked on, my name was listed in the “credits.” Not as exciting as seeing one’s name on the silver screen, but worth something nonetheless.

I also liked the wide variety of ink pens.

I’m a bit of a stationery connoisseur, and love the feel of good heavy cardstock, the look of watermarked paper, and the ease of a good ink pen. When I was editing by hand (I’m assuming it’s all done on computer these days, and boy howdy are my tired old eyes and I glad I’m not staring at a screen all day trying to fix somebody’s dangling participle), I used a red ink pen made by Flair. Haven’t seen one like it in a lot of years, not even at Office Max. Maybe they determined the red dye in the ink was a carcinogen. Maybe I have a lawsuit in the works.

More likely, the Flair pen went out of fashion, replaced by some fancy-pants quick-clicking pen filled with recycled organic range-free food dye. I still miss it. And like my favorite lip balm (Blistex Herbal Answer in the light green, .15 oz tube, comes in the yellow box with daisies on the front and contains aloe, avocado, chamomile, shea butter & jojoba, SPF 15), if I ever see it, I buy in bulk. All those people who go on Survivor and get to take one personal item (or at least they used to: I haven’t seen the show in years) may take a family photo or their Bible. I would take my Blistex.

But back to the lack of free office supplies. I’m too cheap to spend my husband’s hard-earned money on ink cartridges, so I’m not going to print my Caring Bridge journal for posterity. Maybe this blog will go viral one day and I’ll be sponsored by HP and get free ink for life. Or maybe I’ll just keep blabbing away into the ether, regardless of who’s reading.

Oh no, not again!

Posted: October 19, 2010 | Author: | Filed under: breast cancer, cancer fatigue, infection, tennis | Tags: , , , , , , , , , , , , , | 2 Comments

So I have this little spot on the area formerly known as my right breast, which is now known as the right chest wall and was, over the summer, the site of a whole lot of activity. Things have been really calm lately, so I guess it was time for something to happen. This little spot popped up a week or so ago, about the time I started playing tennis again. Because I so enjoyed being back out on the court, and because I really needed to believe that I was finally out of the woods, I tried to ignore it. It wasn’t very big, it wasn’t all that red, and it only stuck out a little.

Well, if I’ve learned one thing from this whole mess, it’s that ignoring a spot in the hot zone doesn’t work. Never. No matter how hard you try. So once this little spot got a little bigger, a little redder, and stuck out a little more, I knew it was time to make the call.

I’ve gotten to know Dr S’s office manager, Marcie, and his nurse, Brenda, really well. Maybe too well. So when Marcie answered and I told her what was going on and I asked her if she wanted to ask him if he needed to see me, she said she wasn’t going to ask because we both know the answer. And yes, she does just lay it out there like that. Personally, I find it refreshing.

My  next check-up with the good doctor isn’t for another 3 weeks, and Marcie said there’s no way he’s going to wait that long to see you, so get yourself on in here. I tend to do what Marcie says. Dr S, not so much, but Marcie for sure.

When Brenda saw the little spot, she made that face. That “I skipped the poker face” lesson in nursing school. That face that makes me want to run screaming out of that building and never come back. So not only did she make the face, but she said he’s probably going to want to biopsy that. Commence running and screaming.

He wasn’t in that exam room five seconds before he hollered at Brenda to get him a syringe and a needle. I said, Wait — a syringe and a needle? Why both? What are you going to do? He looked me right in the eye and said, I don’t know, but I need a needle! A this point, it was too late to run screaming from the building, but I wanted to.

He poked the spot with the needle– more than once — and then used the syringe to try and collect something but nothing came out. The spot appears to be nice and harmless. Perfectly innocent. It’s probably scar tissue, so we’re just going to watch it. Keep an eye on it. See what happens.

Works for me. I’m thinking I’ll be out of there in time to get the cheap rate on the parking. Just wanted to ask him one question though, real quick as he’s out the door.

All I wanted to know was the name of the doctor in Miami who pioneered the technique that he’s thinking of using for my reconstruction. I’ve done a little research, but not much, and wanted to make sure I was headed in the right direction.

I have a lot of questions about this procedure, and it’s a big decision to make now that it’s not as simple as tissue expanders to implants. But I wasn’t going to ask the questions right then, because that’s a conversation for another time. I just wanted to know if I was on the right track in my fact-finding.

If you missed my post on Caring Bridge a while back about the “examine the fat” game I played with Dr S not once but twice, for two times the humiliation, you’re in luck because I’ll be dadgummed if he didn’t want to play it again. And as we all know, whatever Dr S wants, Dr S gets.

(If you want to read the original post, go to http://www.caringbridge.org/visit/nancyhicks/journal/2. I haven’t figured out how to add a link to this blog so if that doesn’t work, go to the old Caring Bridge blog and look at the journal entry for October 6th).

Why that man insists of tormenting me, I will never know. But I think he really enjoys it. Just as I’m wrapping my head around yet another change in the game plan, from TRAM-flap reconstruction to this new Brava technique of building new boobs out of fat that’s been relocated, he throws me another curve ball. Now he’s thinking that maybe the Brava technique isn’t the right option for me after all. Maybe we need to re-visit the TRAM-flap, which means he needs to pinch an inch and see how much building material I have.

I said uh-uh, no way, not again. We have done this twice and I’m still recovering from the humiliation. I’m not doing it again. He didn’t go so far as to say he doesn’t remember, but that’s my suspicion. I guess I should be flattered that my fat is so unremarkable as to render him striken with amnesia not once but twice, but I’m too wrapped up in being humiliated, again.

That man doesn’t take “no” for an answer. I said it repeatedly, and y’all know I’m no weenie when it comes to making myself heard. I told him politely then with some choice words that I wasn’t going to show him again. His response: Come on, it’s not like I’m a stranger.

THAT’S THE PROBLEM! Once you lose the “stranger” status with your doctor,  you move from clinical to personal, in a hurry. I know this man too well and have quite frankly been through enough already and really shouldn’t have to suffer yet another indignity.

However, knowing him as well as I do and having been through as much as I have with him, I know the fastest way to get through the unpleasantness is to just, well, get through the unpleasantness. And that’s how I found myself once again playing the “examine the fat” with Dr S.

And guess what? The result was exactly the same: He scrutinized my belly and said there’s probably enough to make a B-cup. But only on one side. I said, I know you think I’m really demanding, but I insist on having a matched set. We had previously discussed the idea of doing the TRAM-flap for one side, and using an implant on the other side, but I said then and said again that I don’t want to do that. Just seems like asking to be lopsided at some point down the road. He actually agreed with me, which scared me just a little.

So he seems to be leaning toward the TRAM-flap again, and away from the Brava technique. He gave me the website to research, I said, ok fine, we’ll talk about it later. And I thought I was out of there.

As I was checking out with Marcie, though, he called me into his office. It’s not quite like it was being called to the principal’s office as a kid, but a little disconcerting still. He’d pulled up the website and wanted to go over it right then & there. I didn’t even want to think about how many patients were waiting for him.

So we looked at a bunch of photos and I was quite underwhelmed with the results. Maybe it’s because I was perfectly satisfied with the set-up I had, pre-mastectomy. I’ve explained that to Dr S before: that while he does amazing work, and the majority of reconstruction patients whose photos I’ve seen look way better after than they did before, I was just fine where I was. So the “new boobs” as a prize for going through breast cancer, mastectomy and reconstruction isn’t a big draw for me. Excuse me for being underwhelmed.

As if I’m not confused enough at this point, he introduces yet another option: taking the muscle from my back, under the shoulder blades, and using that to build the new pair of goods. We looked at some photos of that, too, but I had one question: how would that affect my serve? Seems to me that slicing the muscle away from an area that is used to torque the body and generate force while serving the ball means bad things for one’s game.  I’m not going through life with a permanently wimpy serve. I’ve suffered enough.

Howdy!

Posted: October 8, 2010 | Author: | Filed under: breast cancer | Tags: , , , , , , , | 4 Comments

Welcome to the Pink Underbelly. It’s a step up from my Caring Bridge blog, which many of you have faithfully followed since I was diagnosed in April (thank you!).

A lot has happened in the past 5 months — some good, some bad, some downright scary. I’ve blogged about this wild ride for therapy, and if I’ve entertained and educated along the way, it’s a bonus.