Joanna Montgomery gets it. She really gets it. It’s a common misconception, yet something that those of us who’ve faced it head-on know. We know because we learn the hard way. Despite the Pollyanna snow job by pink-ribbon celebs like Giuliana Rancic and Amy Robach, having a mastectomy does not mean you get new boobs. Not even close. In this article, Montgomery explains it, succinctly and completely.
“There’s a huge misconception among the general populous about what it means to have one’s breasts removed and replaced with artificial ones (if they are replaced at all). When speaking about my upcoming surgery, I had many well-meaning people say things like, ‘Well at least you get new boobs!’ and, ‘Your husband must be so excited… has he picked ’em out yet?’ Yeah, well, it’s not quite like that. Not at all, in fact.”
Yeah, it’s not at all like that.
Here’s how it really is, as Montgomery so eloquently explains: “It seems that those not in the know tend to equate post-mastectomy reconstructed breasts with augmented breasts or ‘boob jobs.’ Nothing could be further from the truth. You see, augmented breasts are actually real live breasts with nipples and healthy breast tissue behind which silicone or saline implants have been placed, either under or above the muscle, thereby pushing them up and out. If augmented breasts didn’t look damn good, breast augmentation surgeries would not be so, ahem, popular. So even though augmented boobs are often called ‘fake boobs,’ they’re really not. I, on the other hand, do have fake boobs (or ‘foobs,’ as I have become prone to calling them).”
I have foobs, too. Not implants, but foobs made from my own flesh and tissue carved from my belly via a 17-inch-long incision.
Like Montgomery, I am thankful to have had skilled surgeons at the helm of my reconstruction, and I’m thankful to have good health insurance (although the out-of-pocket expenses are still hefty). Sometimes honesty about our foobs is interpreted as being ungrateful. Montgomery says, “those of us who either opted to have mastectomies as a preventative measure, or had mastectomies as a life-saving measure, aren’t excited about our ‘new boobs.’ In truth, we’ll never be the same. We see ourselves differently now when we look in the mirror, because we are different, inside as well as outside.”
As if one case of breast cancer isn’t enough, how about two cases?
Identical twin sisters Kelly McCarthy and Kristen Maurer from Indiana share a lot of things — including breast cancer. The 34-year-old sisters saw first-hand how devastating cancer is when their mother died from colon cancer last year. Like so many struck by breast cancer, the sisters had no family history of the disease.
Apparently it’s not all that unusual, though, for identical twins to develop the same cancer, because they have the exact same genetic makeup. In addition, twins also have a mirror effect, with one twin getting cancer in one breast, and the other twin getting it in the other breast. McCarthy and Maurer were no different in this regard.
Their treatment was similarly influenced by each other: McCarthy was diagnosed first, with triple-negative breast cancer in her right breast, while 9 months pregnant. A week later, her baby was born, and shortly thereafter she started chemo & radiation, then had a mastectomy. Because of her sister’s diagnosis, Maurer got tested and found early-stage cancer in her left breast and had a bilateral mastectomy with tissue expanders and then implants.
McCarthy’s reconstruction was a bit different: instead of going the more common route of tissue expanders to implant, she decided on a second mastectomy on the “unaffected” breast and flap reconstruction of both breasts. The problem was, she didn’t have enough fat & tissue to create two new breasts. I had a similar experience, sorta. Well, minus the identical twin sister, but sorta. I had extra fat before my DIEP reconstruction, aka The Big Dig, just not enough in my belly, the main harvesting site for DIEP surgery. Instead of having a twin sister donate her excess fat, I had to gain weight so that there would be enough excess in my belly. I went on the All-Butter-Lots-of-Cheese-Bottomless-Beer-Mug diet and packed on 12 pounds. Sadly, not all of it went to my belly (the rest I happen to be sitting upon as I type).
The worst part of the forced weight gain? No, it’s not the leftover junk in my trunk or the persistent craving for beer. It was the “Grab the Fat” game I had to play, more than once, with my plastic surgeons to determine whether my fat was fatty enough. Egads, I’d almost forgotten about the “Grab the Fat” game. I wrote about in this post,
“I thought I’d plumbed the depths of humiliation with the ‘grab the fat’ game we played more than once in preparation for reconstruction. In this game, the doc asked me to drop my drawers so he could grab my belly fat and determine if it was plump enough and plentiful enough to construct a new set of knockers. In a modified game of Twister, he had me sit, stand, and lean over to see just how much fat I had around my middle. Not once, but twice.
Humiliating doesn’t quite cover it.
But today, it was total humiliation, all humiliation all the time. I was basically splayed out like a deboned chicken on the exam table while he searched and plotted. Ladies and gents, just imagine your least favorite body parts being put under the microscope so to speak. Just consider for a moment being asked to stand up, sit down, and contort your body in the absolute least-flattering ways so that the softest, flabbiest, most-despised parts of your body are on full display. And then have those parts analyzed and calculated to determine just how fatty they are. We go to such lengths to de-emphasize these body parts, yet mine were being trotted out like the prize-winning hog at the state fair.”
McCarthy was fortunate enough to skip the “Grab the Fat” portion of the DIEP journey, but her sister probably endured it, because she donated her belly fat & tissue so that her twin could get reconstruction via DIEP surgery. Maurer underwent abdominal surgery — not a tummy tuck, people, because there’s no free lunch in breast cancer — to harvest the goods for her sister’s other breast.
How awesome is that??
Like most twins, McCarthy and Maurer share a close bond. But now, McCarthy said, “I feel closer. Her tissue is over my heart.”
As I predicted yesterday, my favorite doctor and all-around funny guy Dr S did indeed shake his head at me when I reported that I was fever-free until evening time. He shook his head, just as I expected, and said if you had a fever — even one that didn’t come until evening time — you were not fever-free. I said yeah, yeah, yeah, I’m claiming it. It counts. Even if I’m the only one who thinks so, for the record I was fever-free. So there.
He probably would have argued with me if I were still feeling like something scraped off the bottom of someone’s shoe and if the redness/soreness/streakiness/swelling hadn’t tapered off considerably. I still look like I’ve been beaten mercilessly by a very large stick after last week’s surgery, but I feel a lot better. Yesterday followed the same pattern as the day before, with me being fever-free until the end of the day. Last night the fever came on even later than the day before, and I expect this means it’s pulling off a long, protracted, and overly dramatic good-bye. That’s my official medical opinion; don’t try to talk me out of this idea or change my mind. I’m operating under the assumption that my body is working it all out, and that a slight fever at the tail-end of the day is emblematic of the trauma my body endured last week and not indicative of anything infection-related.
My visit to Dr S was quite pleasant, and as usual, we scuffled a bit over a few points. The main scuffle is an ongoing one in which the good doctor claims that before The Big Dig, i.e., my DIEP surgery for reconstruction, I did not have a waist. This has always struck me as seriously funny because one thing I’ve always had, maybe even from birth, is a waist. I was curvy before it was cool. Way before J-Lo, Beyonce, and Kim Kardashian, I had a waist and a round butt, and I’ve never had skinny legs. Not that I’m a tub-o, but I’ve always had meat on my bones and muscle. I learned long ago that certain fashion trends were not for me, and I’ve lived 42 years without ever wearing a pair of skinny jeans, quite happily I might add.
So it’s always struck me as funny that my favorite surgeon said that in the course of restructuring my body during The Big Dig that he “gave me” a waist. Of course I wasted no time in correcting him, and we’ve gone round and round about this issue ever since.
I reminded him that unlike a lot of his patients, I was pretty happy with my body before cancer invaded and necessitated surgeries that would change so many aspects of my physical self. I’ve always been physically active, and can truly say I’m one of those weirdos who likes to work out. Every time we watch the Biggest Loser, I get a little envious about the contestants being able to spend hours in the gym every day. I know, weird, huh?
As much as I enjoy working out, I love, love, love to play tennis. Back in the day, pre-cancer, my favorite day was Monday because I would have a tennis lesson, then work out, then go to a tennis drill. I’d stop for a snack in between the lesson and the gym, and change clothes then have lunch before drill, then happily collapse in a heap. Super weird, right? Some of my happiest days ever were spent at Newk’s tennis camp, where we played tennis for 16 hours over the course of a too-short weekend. If you’re a tennis player but have never heard of Newk’s, get online now and make a reservation. It will be one of the best weekends of your life.
Carianne, Rebecca, Sharon, Staci, Melanie and I played hard and had a blast. We fully embraced the camp philosophy of “Eat, sleep, and breathe tennis,” and we found it true that while at Newk’s, you have “No worries, mate!”
Kim, Staci, Sharon and I were so thrilled to meet John Newcombe himself. What a kick to be at camp with him, visit with him, and watch him in action — yes, he still plays like a pro. He’s a stand-up guy who entertained us with his tennis tales and inspired us to become “rock solid.” They say his moustache is insured for $13 million, and I believe it! My favorite thing he said about his longevity in the tennis world: “I’m basically living the same, I just curtailed the stupidity.” I’d say anyone who chooses to build a first-rate tennis academy in the Texas Hill Country has indeed curtailed the stupidity. The scenery surrounding Newk’s place is gorgeous, the pros are fun and knowledgeable, and the weekend camps are the best!
Directors Chris & Sal and the other pros earned their money the weekends we visited. We played hard, sassed them, and tried to drink them under the table. They’ve got youth on their side, though, and all-day tennis while hungover would bother me more than it would them. Team Mexico and Team Australia entertained us royally, and we will be back for another hard-core weekend soon. Planning to return to Newk’s has kept me going during this long, drawn-out, and unpleasant recovery from the dreaded disease and the even-worse infection.
That’s part of why this idea of me not having a waist has been so funny. I have indeed always had one, and to settle the issue once and for all, I went to my appointment yesterday loaded with physical evidence.
Then there’s the wedding dress. Again, the photo is old — coming up on 19 years — but even in all-white, the least-flattering color for full-body shots, I see a waist. I also see a very sweet look on my mama’s face, and remembering her in that sparkly pink dress brings a bittersweet smile to my face.
This green dress was my favorite piece of my work wardrobe. I still have it, and might just try to squeeze into it for my next appointment with Dr S. Part of what I loved about it was that it wrapped around the front and buttoned at the waist. Yes, at the waist!
My final piece of evidence was this photo of Yvonne and me at our Cooking Club Christmas party before I was diagnosed in April. Our Cooking Club goes all-out for the Christmas party, and since it’s the only time all year we invite the men, sometimes it gets pretty wild. Thankfully this photo was taken before the wild rumpus began, and again, I see…a waist!
After scrutinizing my photo evidence with his highly trained eye, Dr S had a few things to say. First, the cheerleader photo was from too far back in history. Second, that I looked very young in my wedding photo (compared to the ravaged old hag I am now, I guess), and when I told him I’ve been married 18 years he asked, “To the same person?” I know, I know, Trevor deserves a medal. Third, he said Yvonne is so pretty. On that point, the good doctor and I agree (xo, my friend!).
So the long story short, after examining my evidence, Dr S concluded that he never said I didn’t have a waist, but that he “enhanced it.” Like a lot of skirmishes, one must choose whether it’s a battle worth fighting. I unloaded my ammo in this skirmish, proved to my favorite surgeon that my waist pre-dated him, and smiled in satisfaction. I will admit that I enjoy these little scuffles with Dr S. He’s a worthy opponent in the stubbornness department, but I think he bests me in the “dogged determination to prove you’re right arena.” I’ve got him in the “who can hold a grudge longer” contest, though. We’ve gone toe-to-toe more than once, and I suspect that trend will continue.
My latest scuffle with the good doctor reminds me of my favorite quote by Kim Clijsters, one of my tennis role models. The reigning champ of the US Open and the Australian Open was the first mom to win a major title since Evonne Goolagong did it in 1980. (If you thought Evonne won a title for strangest last name in tennis, you would be wrong.)
Kim is a scrappy, smart player who gives it all on the court. Her “split shots” wow me every time.
She talks of how losing motivates her more than winning does. She seems to like the battle as much as the result, and believes that “it’s the imperfect matches that make you great.” I think so too. But that’s not my favorite quote of hers; it’s this:
“It’s nice to win 6-1, 6-0 but there’s nothing better than when it’s 5-all in the third set and nobody knows who will prevail.”
I’ve been slowly but surely freaking out about this surgery. I was all ready for it this time last week, but it was not to be. Having to wait a week because of pokey construction at the surgical center didn’t make me happy; I don’t like to wait in general, and on something this big and this important, even less. If there’s more than one person in line ahead of me at the grocery store, I consider that a long wait, so imagine what waiting a week has been like.
The wait is over and the day is here. I’m ready.
I prepared in numerous ways, including waking up multiple times each night; making myself half crazy with worry; imagining every possible way the dreaded infection could sneak back into my life; going overboard on stocking the house with groceries; meeting myself coming and going with laundry and errands; and cooking meals that my children won’t eat.
No wonder I can’t sleep at night.
Why do I do this to myself? I know full good and well that watching that stuff is going to creep me out. Picturing my beloved doc doing those things while I’m sawing logs really creeps me out. I trust him with my life but hate to think of what he’ll be doing to me this morning. I’m gonna be one sore chica.
I scrubbed myself with Hibiclens this morning, to kill off any friendly or hostile bacteria living on my skin. You know your life has changed — and not for the better — when you have a bottle of the Hib in your shower (insert sad face here).
Here’s the game plan: I’ll show up at the surgery center at 8 a.m. without having had my daily cup of coffee or one bite of food since bedtime (I’m not very pleasant when I’m hungry; I’ll be the first to say it. And BTW, packing my kids’ lunches without being able to have one bite of food myself is cruel. There’s not much in their lunches I would eat anyway, but still). I’ll put on the hospital gown and shower cap, and possibly the compression hose. I’ll get marked up by my doc, which involves standing naked in a small room while he peers at and examines up-close the fattiest parts of my body; he’ll use a Sharpie to annotate the choice cuts that he’ll be removing, and I’ll try to slink into the OR with my dignity intact. I’ll endure the inevitable digging by the anesthesiologist and/or nurse anesthetist in a fruitless attempt to find a vein that doesn’t roll over and play dead; this usually involves multiple pokes and results in a giant bruise. I’ll watch the clock and wonder how much longer until they give me the shot that makes none of this hardship matter as I drift off into a heavy-limbed, blissful sleep. I’ll endure who-knows-what kind of horror show as my doc and his team manipulate and position my sleeping carcass to extract maximum fattiness. Some he will keep, and some he will throw away. The fattiness he keeps will be spun in a centrifuge to extract all the liquid. Then the liquid-free, pure fattiness will be injected into my sunken chest. I’ll wake up in the recovery room several hours later, trying not to barf and thinking how good it will feel to get home and leave the hospital stink behind. I’ll hope that I get home before my kids’ school day ends, and will hopefully, fingers crossed, please, please, please be one step closer to reaching the finish line and being done with the aftermath of breast cancer.
Yesterday was pretty crazy. We were stranded Sunday night in Boston because of weather and heavy air traffic in the New York area, and had to spend the night in a hotel. We made the best of it, but being a day behind schedule bugs me and my type-A ways, especially when my to-do list is long and my time for completion is short.
I’ve traded the beach views for the view of the lake across the street, and while the vacation was fabulous, there’s no place like home. I love the beach and never tire of the sound of the crashing waves, but there is something to be said for the comfort of sleeping in my own bed.
Monday was supposed to be my day to “get ‘er done” and take care of all the pre-op chores. I did indeed get it done, but was half a day behind because instead of hitting the ground running, I was traveling from Boston to Houston. Don’t be jealous when I tell you I spend yesterday unpacking, going through a big stack of mail, sorting the recycling, doing laundry, getting groceries, organizing school supplies, returning phone calls, and giving thanks & treats to our pet sitters.
Today would have been a similarly busy day, but instead of wrapping up last-minute things before the surgery, I was fielding a call from my doc’s office tell me that the surgery had to be postponed. The surgical center that he uses for the type of procedure I’m having is under construction and behind schedule. Did I mention that I don’t like a change of plans?
My brain has been racing with details of the to-do list, and unwelcome thoughts of the surgery keep bulling their way in. I’ve been strangely nervous about this procedure. I expected to be joyful and excited but instead I’m uneasy. This should be a piece of cake compared to the many previous procedures; it’s out-patient for once. It also should signal my approaching the home stretch. I’m not there yet, but with this surgery behind me I would be one step closer.
So why the nerves? As REM would say, “What’s the frequency, Kenneth?” I have no idea, but perhaps it was my instinct telling me it’s not time, it’s not going to happen. Perhaps it’s the proximity to the start of school and the end of summer. I’m not good with transitions and definitely don’t like change (part of the Type-A package, perhaps?); even though the shift from summer to starting school is usually quite welcome (for me, but not my kids), I’m struggling this time around. I’m all ready, but still feel like there’s not enough time. This procedure has been in my mind a harbinger of the end of summer and the beginning of the elusive pursuit of getting back to “normal.” When I endured The Big Dig in March, I knew that as gee-gantic as that surgery was, it wasn’t the end of reconstruction and that a couple of revisions would be required. Once everything settled, so to speak, after The Big Dig, I was left with a decidedly less-sunken chest and absence of post-mastectomy-infection scar tissue. Things were much improved in the chest region. However, as with most masterpieces, the first draft wasn’t the final draft.
The second draft was scheduled to commence at 6:30 a.m. tomorrow in a hopefully-germ-free surgical center instead of the mega hospitals I’ve been in for the previous gigs. The goal is to reallocate some fat from the ends of the 17-inch belly incision to fill in the not-quite symmetrical boobage. I’m requesting that my doc fine-tunes my belly-button scar, which is kinda grody, and he will also work his magic on the spots of scar tissue along my belly incision. There are several pea-sized spots that are quite the menace: pain, throbbing, and impaired mobility top the list. I hope that there will also be some cleaning up of the “whale tail” ends of the belly incision. As the moniker suggests, the ends of that big-ass incision look like a whale’s tail, and while I marvel at the giant sea creatures, I don’t want a facsimile on my bod. Thank you, googleimages, for the visual. Imagine that lovely tail upended vertically instead of horizontal and you’ve got a good idea of what the ends of my giant incision look like.
But alas, none of this will happen tomorrow, and I have to wait. In addition to not liking a change of plans, I’m not a big fan of waiting either.
The reason for the delay is legit, yet my cries of “find me another surgery center so we can stay on schedule” went unheeded. It seems that the surgery center I was scheduled for has the right equipment for the fat transfer procedure, and while we certainly could find another gig, there’s no reason to rush it and every reason to wait until all the conditions are right. Not every surgery center/hospital has the stuff my doc needs to suck out my fat, and the one that does have the right stuff isn’t accommodating patients just now.
Three things about my visit to the doc today that were unpleasant, besides the news of the delay. First, he introduced a possibility that I had not considered: infection.
Oh yes, infection.
The very thing that dominated my life for most of the past year is now conveniently shelved in the way-back recesses of my brain. I hadn’t even thought about the possibility of re-introducing or re-acquiring an infection. Yet as my doc lovingly pointed out, with me you just never know.
So he’s thinking of sucking the fat out of the dog ears and throwing it away. Sounds great, right? Get rid of the little bulges at either end of the big-ass incision. I’m all for that. But then what do we use to smooth out the not-so-round part of my newly constructed chest?
And that brings us to the second thing that was muy unpleasant during my appointment today: the search for other sources of fat.
I thought I’d plumbed the depths of humiliation with the “grab the fat” game we played more than once in preparation for reconstruction. In this game, the doc asked me to drop my drawers so he could grab my belly fat and determine if it was plump enough and plentiful enough to construct a new set of knockers. In a modified game of Twister, he had me sit, stand, and lean over to see just how much fat I had around my middle. Not once, but twice.
Humiliating doesn’t quite cover it.
But today, it was total humiliation, all humiliation all the time. I was basically splayed out like a deboned chicken on the exam table while he searched and plotted. Ladies and gents, just imagine your least favorite body parts being put under the microscope so to speak. Just consider for a moment being asked to stand up, sit down, and contort your body in the absolute least-flattering ways so that the softest, flabbiest, most-despised parts of your body are on full display. And then have those parts analyzed and calculated to determine just how fatty they are. We go to such lengths to de-emphasize these body parts, yet mine were being trotted out like the prize-winning hog at the state fair.
And in closing, we’ll cover the third and final unpleasant thing about my dr’s appointment today: prophylactic antibiotics.
Yes, that’s right: I used the “A” word. Antibiotics. Again.
I’m going back on my old friends Bactrim and Minocycline as a preventative. Just in case any wily bacterium were thinking of re-establishing a house party on my dime. I’m nauseated just thinking about it. I spent how many days taking the dynamic duo? 267. Yep, 267 straight days of swallowing 2 pills every 12 hours.
Is there no end to this madness?
Texas is a baseball powerhouse in general, and our neck of the woods is no different. We’re right down the highway from Pearland, whose Boys of Summer blazed a trail from Texas to Williamsport, Pennsylvania, last summer to go nearly all the way in the prestigious Little League World Series.
This truckload of Pearland boys could be from any Little League in Texas; hopefully in a couple of years it will be my kid’s First Colony team. We watched every game last summer, cheering for those boys in blue and hoping they would prevail. We laughed at the way the media zeroed in on the Pearland moms and their blinged-out team shirts. I guess not everyone “does” baseball that way, but around here, it’s de rigueur for baseball moms to have glitzy shirts, often with their kid’s number emblazoned in rhinestones. Writer Ken Hoffman said the Pearland team “tore through Texas tournaments and blew into Williamsport with tape-measure home runs, speeding- ticket-worthy fastballs and bedazzling mothers that the Little League World Series won’t forget.”
All Stars is an exciting time. Grueling, too, with practice 7 days a week until the games start. We plan our vacations around the All Stars schedule, and schedule our daily activities around practice. The first tournament begins Tuesday, and I sure hope the Big Red Machine blows through District and Sectionals the way they did last summer, blazing a trail straight for the State Championship in Tyler, TX.
Since I missed pretty much all of it last summer, I didn’t realize that our district, Texas East Little League, “stretches from the Sabine River in the East to I-20 in the North to I-35 on the West to San Antonio and from there to the Gulf of Mexico and back to the Sabine River,” according to the Texas East website.
We’re that little strip of green in the middle, District 16. Texas is a big state, the second-biggest in the country in both population and area, and baseball is serious business around here. I don’t know how many Little Leagues there are in Texas, but considering that this great state is 773 miles wide and 790 miles long and populated by some 25 million people (thank you, Wikipedia), I’d say there are a bunch.
I’ve written a lot about having missed so many of Payton’s games last summer. Don’t worry, I’m not going to re-hash it today. Suffice to say that if it had just been the bilateral mastectomy in mid-May, I would have been in fine shape for the All Star summer schedule. But no, the post-mastectomy infection had to surface, and the resulting hospital stays and surgeries meant there would be no trip to Tyler for me. From the moment that infection reared its ugly head, my life became one complication after another, and I began to live the famous Winston Churchill quote of “If you’re going through hell, keep going.” Just do it without being able to watch your kid play the best baseball of his life. From mastectomy to infection, to nearly 30 days in the hospital, to multiple tissue excisions, to saying good-bye to the tissue expanders, to a shaky recovery involving all manner of antibiotics and home health, to slowly very slowly getting a semblance of a normal life back to finally getting around to reconstruction, to the long recovery process after The Big Dig. Quite a circuitous route I took, with very little baseball.
So this summer, I’m going to soak it all up. Every scorching minute of it. Since Texas is in a major, seemingly unending drought, we probably won’t have to worry about getting rained out, like we did a few times last summer. I’ll be in my blinged-out shirt, cheering hard for the boys in red, and reflecting back on how much I missed last summer at the ballpark.