Official diagnosis
Posted: February 1, 2011 Filed under: breast cancer | Tags: breast cancer, cancer battle, cancer diagnosis, DIEP, hospital, new boobs, plastic surgery, post-mastectomy, surgery 4 CommentsWhile looking through my paperwork from Dr Spiegel and mapping out the next month of pre-op stuff I have to do, I found something that made me laugh out loud.
I hope you find it funny, too.
If you don’t, there’s something really wrong with you.
This is the orders for the EKG and labwork I have to get done before my reconstruction. 
The handwriting is kinda hard to read, and the picture is pretty fuzzy, but if you look closely you’ll see that for Diagnosis, it says “absence of breasts.”
Other than laughing hysterically, I don’t know how to respond to that.
Introducing the New Dr S
Posted: January 20, 2011 Filed under: breast cancer | Tags: Baylor College of Medicine, DIEP, flap, Johns Hopkins, lymphedema, microsurgery, new boobs, panties, plastic surgery, reconstruction, recovery, SIEA 8 CommentsThere’s a new Dr S in my life. I’m happy to introduce Dr Aldona Spiegel. 
She’s purty.
And smart.
She’s younger than me and has 3 kids, ages 6, 2 and an infant. She’s tall, slender and blonde. And she’s a renowned surgeon. If I didn’t like her so much, I might hate her a little.
But she’s gonna build my new boobs, so I love her.
We had a fantastic consultation today. Every aspect of her office, from the atmosphere to the staff, is first-rate. Beautiful waiting area, pleasant receptionist, warm & friendly nurses, a big Mac (computer, not burger) in the exam rooms, a fantastic physician’s assistant, a comprehensive bound photo book of before & after pictures of her patients, and of course the lovely doctor herself.
According to her website, “Her goal is to provide not only the most advanced breast restoration procedures, but also a caring and supportive environment—allowing each woman to complete a successful rehabilitation from her breast cancer battle.”
I like that. I’m especially intrigued by the idea of rehab from my battle. Sounds good.
How about this: “Dr. Spiegel is committed to providing superior, patient-focused care and preparing the next generation of surgeons to meet the highest standards of excellence. This vision combines a dedication to advanced research, exceptional education, and the development of new, less invasive treatments and procedures.”
Great!
She trained in general surgery at Johns Hopkins Hospital and did her fellowship in reconstructive microsurgery and specialization in plastic surgery at Baylor College of Medicine where she was served as Assistant Professor of Plastic Surgery. Dr. Spiegel has trained with leading reconstructive surgeons around the world, developing and improving upon techniques to help minimize the aftereffects of breast cancer on a woman’s body.
This just keeps getting better and better!
Here’s where we get into the medical mumbo-jumbo: “Dr. Spiegel’s clinical expertise is in advanced breast reconstruction techniques and microsurgery, particularly in the area of surgical reconstruction with reinnervated autologous muscle-preserving perforator flaps, including the DIEP Flap, SIEA Flap, SGAP Flap, TUG Flap, and the TAP flap. Dr. Spiegel also specializes in Lymphedema Procedures, advanced Implant and Latissmus reconstruction, and has pioneered Sensory Innervation procedures which have the ability to reestablish sensation to the breast resulting in the most complete form of breast restoration. In addition, she is interested in all aspects of aesthetic surgery and is committed to women’s health issues in plastic surgery.”
Sweet. She is the total package.
The only complaint I have is with the panties. 
They were made of paper. And small. Really small. I spent a few seconds staring at them before thinking, one size does not fit all.
Egads. Cue the humiliation. Again.
Luckily, I’ve been humiliated in a doctor’s office before, so I’m ready for it and ok with it. I slipped on my pretty blue paper panties and the matching blue paper gown and prepared to meet my new savior, Dr Spiegel. I’m so glad I’m past caring about meeting a beautiful and successful doctor while wearing the most unflattering paper garments ever.
She answered all my questions, most importantly the one about weight gain. I’m good, I’m fat enough and don’t need to gain any more.
Whew, that’s a relief. I was getting pretty tired of drinking beer & eating chips. Now that I’ve bulked up, I am free to return to my normal, healthy eating. She said she would prefer to have a bit more building material, but she can work with what I’ve got, so I don’t have to worry about applying for a new zip code for all the junk in my trunk.
Now that’s a relief.
She’s planning my reconstruction, and it’s going to be pretty great. I’m actually starting to envision an end to this long, bumpy road. As much as I detest the idea of another hospital stay and recovery, I’m looking forward to closing the book on this chapter of my life. It’s such a cliche, but it’s true. Reconstruction is a big, scary step. I totally understand why some women never do it. And if not for the infection and the mess it left behind, I wouldn’t be in any hurry to do it myself.
But the infection did leave a nasty mess, and it continues to wreak havoc, and the best way to end that madness is to excise the tissue (again), and replace it with new tissue and a new blood supply.
It means a long surgery, a night in the ICU, and several additional nights in a regular room. Ugh, yuck, and ick. But, it will all be worth it when it’s done and I can say I’m truly on the other side of this wretched business.
Stay tuned.
A weighty issue
Posted: January 9, 2011 Filed under: breast cancer, food | Tags: beer. pizza, blueberries, breast cancer, brunch, champagne, DIEP, gym, healthy eating, new boobs, reconstruction, recovery, super foods, surgery, tennis, weight gain 10 CommentsI received a serious assignment from my doc. Now don’t laugh when I tell you this, because it’s not funny, and don’t say “lucky you” because I’m not so lucky. It’s serious.
He wants me to gain weight. A lot of it. So he can build my new boobs. 
We’ve had this conversation a couple of times and I’ve stuck my fingers in my ears and said “la la la, I can’t hear you” because I didn’t want to do this. I’ve spent most of my life beyond the age of about 15 trying not to gain weight. When you’re five-foot-nothing, there aren’t a lot of places to hide the extra pounds, and I personally don’t like the way my body feels with a lot of extra weight on my frame. I’ve never been a skinny chick and don’t aspire to be, but don’t want to be mistaken for a contestant on The Biggest Loser, either.
I worked hard to prep my body before and after my mastectomy, to gain as much muscle strength and cardio conditioning while fueling myself with a good diet. I also played as much tennis as humanly possible in the weeks leading up to surgery. It all paid off, too, with a shorter surgery, no need for Alloderm (cadaver tissue used to connect and close mastectomied chests), and a pretty easy recovery. Because I was in good shape, I was up and out of the hospital bed the day after surgery, trolling the halls. When I got home, I had a decent amount of independence because I didn’t need much physical assistance. That was, and is, important to me. So the idea of turning into a big blobby girl, even temporarily, scares me.
The first few times Dr S brought it up, he warned me that I didn’t have enough belly fat to build the new girls. At that point, reconstruction seemed so far away that I didn’t pay much attention. But the last 2 times I’ve seen him, he’s been more stern about it. I hate it when he gets stern with me.
When I saw him a couple of weeks before Christmas, I told him I’d been drinking a few beers for the first time in 15 years, and I wasn’t playing much tennis because of a recurring foot injury. That was about as much as I was willing to commit to his “living large” plan. I did the usual indulging over the holidays, but I also went to the gym.
So when I saw him the other day, instead of shrinking from his “examine the fat” game as I have in the past, I told him I’d been working on a big project — a BIG project — and showed him my newly rounded belly. I was sitting on the exam table so my belly even hung over a little bit. I thought it was quite impressive, as it’s the biggest it’s ever been without a fetus inside of it.
He was not impressed. Not even a little bit.
He told me to pull my jeans down a little and gave me the pinch test, then had me bend over to see how far it hangs. So much fun. I live for that game.
Then he made a very stern face and said it’s not enough. It’s still not enough. It’s enough for one side, but not both. And maybe not even enough for one. Since I have impossibly high standards and insist on a matched set, that’s a problem.
Dr Sternface says I’m not really even a candidate for the DIEP flap procedure, but since I have no other options, we have to try and make it work. I was thinking about this later and wondered, if I’m not a candidate but don’t have any other choices (i.e., tissue expanders to implants), what’s a girl to do?
Eat, girl, eat. And then eat some more. Then have a beer. Followed by a milkshake.
People make fun of me for being a healthy eater. I genuinely like oatmeal with blueberries. I love salad. Not being a carnivore eliminates a lot of the unhealthier options for me, and I like it that way. I’m not super picky but I don’t like drive-through food in general, and I don’t get the “all you can eat” places at all. I’m not a big junk-food junkie, and usually whatever I cook is way better than that stuff anyway. Not being conceited, just stating a fact.
I’m not doing a very good job with my assignment. Yesterday I had half a bagel with a piece of melted provolone and a handful of blueberries. It felt pretty indulgent to me. Lunch was two pieces of leftover pizza, with an orange. Cheese & crackers for a snack before we played tennis, then dinner after with the tennis gang at a BBQ place. I had pinto beans with pickles, coleslaw, green beans, some mac & cheese and a few fries. Oh, and a roll. Wish I’d thought to put butter on it. Melanie told me that I wasn’t going to get the job done eating all those vegetables and suggested I get a milkshake. Every day.
Today we played 3 sets of tennis and I was hungry. We splurged on brunch at the club, which for me meant mixed fruit, cheese & crackers, salad with lots of blue cheese dressing, and some tuna. Mimosas, of course. Then some pasta with artichoke hearts, mushrooms & sundried tomatoes. Then a few bites of seafood ettouffee. And a sliver of key lime pie and a chocolate-dipped strawberry.
I feel kinda sick.
My doc keeps saying he just hates the idea of me going through this giant surgery and hard recovery and not being satisfied with the results. I keep telling him that any change over the status quo will be an improvement, and I’m ok being average. At least in this one category. He doesn’t seem to believe me, even though we’ve had the same conversation repeatedly.
He wants me to go see the other surgeon who will help him with my case. I’ll have to see what she thinks about the bulk-up plan. Meanwhile, I need to think of a new t-shirt slogan. Something like the “baby” with an arrow pointing at the pregnant belly t-shirt, only a different kind of “under construction.” Any ideas?
Hunan Plastic Surgery
Posted: December 28, 2010 Filed under: breast cancer | Tags: Brazil, breast cancer, breast implants, China, crazy, economic reform, facelift, flat chest, Hunan, liposuction, new boobs, plastic surgery, surgeon, surgery Leave a commentI read an article about plastic surgery in China (you may have, too, and if so, were you as freaked out as I was?). It told the story of Wang Baobao, age 28, who has had some 180 plastic surgeries. She started with her first operation at age 16, and has 6 or 7 procedures each time she goes under.
She’s had something done to “nearly every part” of her body: she’s had her eyes widened (and more Western-looking), her nose & jaw narrowed, and her chin reshaped. She’s had fat sucked out from her hips, thighs, stomach, and rear end. She even had heel implants, to make her taller (didn’t work). She’s had her breasts done, of course, and she says, “I had to keep having operations to repair them.” Yeah, me too.
China is third in the world of most plastic surgeries performed, behind Brazil and the U.S. No data, though, on how many procedures in any of those countries are for non-cosmetic problems.
The “official” estimate is that 3 million plastic surgeries were performed in China last year. The Deputy Secretary of the Chinese Association of Plastics & Aesthetics says his hospital sees 100,000 plastic surgery patients a year, and that all of Shanghai could see 300,000 a year. Try getting a hospital room there.
However, the Deputy Secretary points out that “most people don’t have surgeries at officially regulated hospitals. Many patients go to beauty salons and other unregulated facilities.” A beauty salon??? Egads. That’s a major infection waiting to happen. Trust me, I know.
Before the economic reforms of the 1980s, people in China were only allowed to have plastic surgery to correct a physical deformity, mostly hairlip patients. Cosmetic procedures were considered a bourgeois way of life. What’s so bad about the bourgeois? Doesn’t everyone deserve a perfect physique? (says the girl with the flattest and most scarred chest in the Western Hemisphere.) I’m all for economic reforms, and think in general prosperity is a good thing for society, but when the rising tide of affluence is outpaced by the pursuit of physical beauty, we may be headed for trouble. Xi Shirong, the senior plastic surgeon at Beijing Hospital, says he sees at least 20 patients a day, mostly women in their 20s. That’s right, in their 20s.
24-year-old Wang Bei, a singer in China, died in the OR during a facelift. Can someone explain to me why a 24-year-old would need a facelift?
Back to Wang Baobao. She says the technology wasn’t good enough and the surgeons not skilled enough. One might think she’d be able to find a better surgeon, though, considering how many times she went under the knife. Isn’t that the definition of insanity: doing the same thing over & over but expecting different results? She says she kept “needing repair operations.” Again, me too. Sigh. She’s spent some $600,000 on her surgeries and says “the effects are not that good. And all over my body, there are too many scars.” Ya think?
Good ol’ Dr S
Posted: November 14, 2010 Filed under: Uncategorized | Tags: breast cancer, cancer battle, cancer diagnosis, check-up, Daylight Savings, infection, mastectomy, new boobs, plastic surgeon, plastic surgery, recovery, survivor 6 CommentsIt’s been too long since I’ve posted a good story about Dr S, my most-favorite and much-abused plastic surgeon who saw me through the worst of the infection(s) this past summer and with whom I have an ongoing love-hate relationship. I love to needle him, and he hates to see my name on his clinic schedule!
I saw him Friday for a check-up (I love the way “check-up” sounds so simple & innocent, and misleadingly free of scary stuff like tumors and fat necrosis and scar tissue and reconstruction). He’s usually pretty prompt, and out of the many, many office visits I’ve had with him, I really haven’t had to wait too long for him. The few times it has happened, though, it has made me mad and I let him know it. I understand that delays happen, and the doctor isn’t always in control of the schedule, but I’m just an impatient person and it annoys me. My bad.
Friday was no exception. After waiting nearly an hour in the waiting area (so aptly named, that place), I waited some more in the exam room. I’ve explained before that although I am “just” an at-home mom, my time is still valuable, and I prefer him to keep some other patient waiting and get to me first. Not that I want some other patient to have to wait longer than me, but really once you’ve been diagnosed and gone through a nasty surgery and then the whole infection scene and multiple hospitalizations, well, ok maybe I do want someone else to have to wait longer. Surely all of that mess garners some sort of street cred or extra credit or something that allows me to go to the front of the line. But no. Like so many things related to cancer and subsequent recovery, there’s no easy way, no priority boarding, no free ride.
So after an hour of waiting on Friday, Amy and I were joking, as we’ve done before, about the many ways we could get his attention. We can usually hear his voice through the exam room walls and can gauge if he’s wrapping things up with the previous patient (although sadly, we can’t make out all the words and so can’t really get a sense of what they’re discussing, and y’all know how nosey I am; being able to properly eavesdrop would pass the time quite nicely). We’ve considered texting him from the waiting area and the exam room (yes, I do have his cell number), or knocking on the walls and hollering, Hurry it up in there, we’ve got to get back to Sugar Land for carpool!
Well on Friday we hatched a new plan and decided to write him a note and slip it under the door. We ripped the paper covering from the exam table and scribbled, You’ve got 5 minutes. Then we stuck it under the door.
Ballsy? Perhaps. Rude? A little. Effective? Most definitely. He burst through the exam room door post haste, note in hand and grinning wildly. He needed a little shake-up to his day. He muttered something about how he’s never in all his years had a patient give him so much grief. I replied that I’ve never in all my years liked waiting, something I’ve been imminently clear about from day one with him. Y’all may recall from my previous blog on Caring Bridge that I told Dr S at our first consultation, shortly after my diagnosis, that I know full well and good that he has other patients; I’m not his only patient, but I expect to be his number-one priority. I was kidding then, but oh how eerily prescient that little wisecrack turned out to be. Six months later–and today is exactly six months since my mastectomy–that man is still not rid of me.
Here’s the really funny part, though — he actually tried to blame his lack of punctuality on Daylight Savings. He said his schedule has been messed up since the time change, and I guess what we’re supposed to infer from that is that it’s not his fault. Time change, huh? It must have been pretty clear by the look on my face that I wasn’t buying that, because he asked me why I was looking at him as if he were FOC. I wasn’t familiar with that acronym so he said what about FOS? That one I know, and told him that I did indeed think he was FOS. Totally FOS. Since we “fall back” with the time change, he should have been an hour early!










