Back from Cambridge and still waiting to see the plastic surgeon

(Note lots of random discussion of reconstruction - so if flesh talk makes you squeamish be forewarned.)

Just thought I would check in, though no real news to report. Cambridge was fun and it was great seeing old friends (friends that I've had for 20+ years - none of us are old despite that math, we were apparently toddlers in college) over the weekend and then some newer friends at the conference Sunday-Tuesday. The Harvard undergrads turned out to be safe and the most reckless thing I did was buy 4 pairs of shoes and assorted other clothing with Pam and Taleen. A little retail therapy did me good as did the re-introduction of alcohol back into my life. I'm sticking to one maybe 2 drinks and trying to make them weak. (Yes I had three mojitos yesterday but they were largely mixed with extra sprite and ice and I did have the bartender add more vodka to my orange juice Monday night in Cambridge.) I'm guessing the drinking multiple nights in a row is also not a habit I will keep up but seemed to work this past week. (I didn't drink Wednesday or Thursday.)

Cambridge was beautiful, the conference was interesting though I apparently can handle going to about 3/4's of a day long conference. This was true this past week and at the NTA meetings the week before.

Tracy was a champ at presenting our synthesis non-paper and I basically asked and answered questions. It was interesting being with other people who care about what's happening to locl governments. I may have to apologize to some folks who during the cocktail hours and breaks may have thought they would be coming and having lovely conversations about local finances and what people were working on and ended up finding themselves faced with boob talk. A number of folks at the conference are people I know pretty well and have been following my progress throughout the year. In general, public finance/tax folks are very nice and have been super supportive. But it has in the end meant I've ended up talking about my breasts with way more men than I'd ever have thought. Of course they maybe should just be relieved that I'm not stripping down and showing them my scars, something I've mainly done with women.


Coming back to DC was fine though it has been rainy and dreary. I'm doing okay and while the weekend break was welcome I'm a little sad i passed up the Monday morning meeting with the plastic surgeon - as I am still waiting to see him on Friday.

In the meantime I've started reading about reconstruction. I think I'm leaning towards the free flap surgery - which entails moving flesh, fat and skin but not muscle from the stomach or butt to form a new breast and then reattaching to the blood supply. Upside, it is my own body, doesn't require moving my muscle (tram flaps and other earlier surgeries include moving and using ab or back muscles), and looks more natural(then implants) and if everything goes right, I have a minor second surgery to create a nipple and then I'm done. Down side long (possibly 11 hours) surgery, month-long recovery time (longer than implant recovery) due to 2 incision sites and higher potential for the surgery not to be successful and the flesh could die.

Implant surgery requires putting in a chest expander (unlike cosmetic surgery it goes behind the chest muscle as the skin needs a source of nourishment and the breast flesh is gone) which is partly filled with saline and you need to come in a couple of times for more expansion and then have the final surgery. Downside of implants - will look much more different than other side (implants stay round and perky) , feel less natural and likely will need to be replaced at some point and might require doing something on the other side for symmetry. Upside surgery is quicker, and more surgeons can do this.

Tram flap (the other surgery type using your own body) requires using muscle can take as much time as free flap but it is less tricky since not detaching and reattaching veins and arteries but does involve moving a muscle. Given my back issues I'm not sure I'm ready to use lower ab or back muscles.

I think assuming the plastic surgeon says i am a good candidate I would go for the free flap if we can do it pretty soon. If they don't think this could be done I might go with the implant and potential surgery on the other breast to even things out. The idea of using my muscles kind of freak me out.

I'm having random dreams about not being to have the surgery right away and the cancer remaining in my body is freaking me out. I want this to be over and I'd also hate to have to start recovery all over. My arm and breast are still hurting now - if I'm totally recovered and need to start over I'll be somewhat bummed.

I have names of women who have gone through this decision making process and will begin having discussions. Most of the people I know have had double mastectomy reconstruction - I'm not sure if the considerations are all the same given the symmetry issues don't come into play for them.

Otherwise, things are okay. I'm hoping that things will be somewhat resolved on Friday. I might see about scheduling an appointment with another plastic surgeon for this week to try and have more options.

In other minor news -my hair is coming back (i have even started shaving my legs) and have lost one of my big toe nails - the other one is bound to come off soon as well. They've both been pretty dead since taxol times and have been the other body part I've been somewhat obsessing about. (Of course if we tally it up, most of my body is getting a certain amount of attention - checking on hair, wanting my arm to be less sore and start working, my breast needs to stop aching and the toe-nails. I also need new glasses/contacts but figure that can wait for next flex-period.)

Hope you are all having a good day and best wishes for those participating in the random race for the cure races throughout the country.

Kim