Tissue Transfers & Implants & Tattooed Nipples... Oh My!

  My friend Greg said to me a few weeks ago "I've never seen someone Blog an event so quickly"... referring to my posting about my biopsy, propped up in a comfy chair, doped up on percocet, just after we got home from the hospital.  Seems things have changed a little over the past few weeks and my rush to share my news has slowed to a crawl.  It's difficult to share something when you're really not sure what it is... or what to do with it... or who wants to hear it?! 

  There's no real 'bad news' ... well, not other than the fact that I have to deal with this at all and there's even some 'good news'.  Good news is that my genetic testing came back as 'normal' (I've always thought of 'normal' as a dryer setting!).  This means that my ovaries aren't of any concern to me now, which is a very welcome load off of my mind/plate.  Even more importantly,  this takes some pressure off of my siblings and their children.  It doesn't mean that they don't have the gene mutations... but my tests being normal takes off the glaring spotlight that it would have thrown on them had the results been different.  The whole concept of 'Genetic Testing' is just a quagmire of 'what if's and what fors'... I get that it does have a positive impact in some situations to have this information but for the most part, to me it just looks like it leads to more confusion.  

  Our first meeting with Dr. Wandra Miles (one of the Plastic Surgeons recommended by Dr. Lee, my Breast Surgeon) went well.  I'm very glad I've been doing lots of reading and educating myself on various types of reconstructive surgery, it certainly makes these conversations much easier to navigate and has us coming away feeling more confident and informed rather than overwhelmed and confused.  Before seeing her, I had decided (if possible) that I would opt for DIEP FLAP surgery, in hopes of using my own tissue and taking a more organic approach as well as eliminating the future necessity of surgeries to replace implants.  According to Dr. Miles I don't have the amount of excess tissue that would be needed to create new breasts so it looks like I will be getting implants.  There are lots of pros/cons on both sides  and if tissue transfer isn't in the stars for me... I'll have to make the most of what is.  

  The surgery itself will be skin sparing which means that they conserve all of the natural skin aside from the areola/nipple and original biopsy incision area.  (don't even ask about the areola/nipple conundrum... that seems down the road and far away to me right now... but if you're interested... Nipple & Areola Reconstruction .  And even more strange, many women opt for tattooing !  If I was going to get tattoos on my breasts... I think I'd get Daisies :)  but like I said... that's waaaaay down the road and my head is already full!  It's kind of interesting though.  When you think logically about how insignificant breast nipples are (unless you're planning to breast feed... it seems ridiculous that you'd go through surgery or tattooing to replace them?!  Here's an explanation of immediate reconstruction with tissue expanders (which is what I'm planning on doing) along with some photos that might make you think differently about 'breasts without nipples/areolas'?!

  One of the 'pros' of going with implants is that I won't have to deal with losing the loss of muscle in another area of my body.  When tissue/muscle are transferred from your abdomen, there is a risk of hernia as well as loss of core stability... I'd like to become a 'real runner' (or at least stick to a decent running regimen someday) so having my core muscles in tact is very important to me.  I got a very good 'vibe' from Dr. Miles as her primary concern (after ridding my body of Cancer) was to make sure that I understood the options to allow me to continue to enjoy activities that are important to me.... after I've had my surgery.  

  My next appointment is back with my breast surgeon, Dr. Lee on Monday/22nd.  This will be to let her know I've made my decisions on the type of procedure and reconstruction.  Since both surgeons work with patients on the same day, with the plastic surgeon coming in right after the mastectomy has been completed, everybody will have to be available on the same day.  They do this stuff everyday so I'm sure scheduling won't be an issue.  If it can happen... I'm looking at having the surgery in the first two weeks of January.  Talk about a way to start the New Year!  

  The insurance issues continue to daunt me.  Thankfully Susan (who looks after the insurance stuff for David's company) has been and continues to be very patient and helpful to me.  I think in the grand scheme of things this won't get to a point where it financially ruins us.  The onus will just remain on me to track all charges and make sure they are being processed properly.  If the information I've been getting is correct... after we satisfy the individual deductible of $2500.00 and pay the out of pocket cap of $3000.00... the insurance 'should' pay 100% of all 'eligible' expenses as long as the provider is 'in the network'.   That's great news for us... now if we can only make sure it actully works out that way!!

  And how am I? ... good question... calm & frantic... I think I spend so much time worrying about how I'm going to get back on track of being a productive part of society, that I spend little time worrying about possible complications with my surgeries.  Maybe this will be one of those things where I gain 'super-human strength' from going through all this crap and take life by the horns after this is done.   Sounds like a good scenario... you know... grey clouds and silver linings and all that jazz?!  :)

PS...  I'm considering David as an applicant for SaintHood!  We always knew we worked best as a couple under pressure.... but he's shown me a love and understanding that I had no idea was even possible.  David... ty :)