Bits & Bites

We will be traveling for holiday joy with family. Well, at least one side of the family (mine) is joyful during this season. A side trip to Sanibel Island for a few days won’t make up for the missed vacation in Hawaii but should provide enough beach time for the family excitement ahead.

The critters and house always get tremendous care from our wonderful pet-sitting company, Nunn Better. Seneca does an amazing job with her staff, and our “Pack” usually has their favorite gal, Aubrey, to spoil them rotten when we travel. Of course we would rather they romp on the beach with us and visit their puppy cousins. I do worry about them. Ha! They are too busy enjoying respite from us and happy to avoid kennel-care.

Betsy & Scruffy

PeeTee & Lucy

After a reaaallllly long weight-loss plateau, I have dropped a few pounds. I continue to be fascinated how my body shape changes even without losing much weight. Don’t say I am toning up because my physical activity still is not up to pre-mastectomy level, but at least I’m moving again without discomfort. Although my goal seems to be only 14-pounds away, I think maintenance for me will hit when I can fit into the pair of really tight size 10 pants hanging. Who knows? Who cares. I’m pretty much eating what I plan to eat for life except there will be no hesitancy for treats in the future. This time of year. with my seasonal affective disorder flaring and the associated carb urge, it is a bit dangerous to venture away from my mantra: no grains, starch, added sugar.

My favorite/only plastic surgeon insisted on a huge hug rather than a handshake at the start of our visit this week. “What, after all we’ve been through you just want to shake my hand?” So, I pressed my artificial boobs into his chest and then flash him. “Are you satisfied with this?” I ask. He tells me I look great for just a little over 2 months since my tissue expanders were replaced with silicone. Scars are healing well. Skin flab might be removed after weight loss is done, depends on if I want more scars. We discuss how one foob hangs lower. Most women’s breasts are not even. I just never noticed because mine were hanging at my waist. He did not use any tissue matrix (we agreed) to reinforce the lower poles of the “pockets” holding my implants. So, I do have to watch and see if that one foob drops any lower. My symmastia (uniboob) has not recurred but I’m still at high risk for up to 2 years. In other words, I am like many women who undergo breast reconstruction after breast cancer – over 25% will require additional surgery after “permanent” implants are placed. I ain’t planning on it, but I am aware. The next step is to get nipple tattoos. (Just in case you were dying to know.) No nipple reconstruction. I don’t want “headlights” all the time, and the Barbie look is kinda weird. We are planning a trip to Baltimore in the spring to have mine done by a tattoo artist who works with academic reconstruction centers across the country. Always wanted a tattoo. Just thought it might be a green sea turtle…

Leaving you with a link to a fun read from the New York Times: Holiday Gifts From Your Kitchen Even non-chefs like make me can make healthy, lemon olive oil and dress it up in a pretty container.

Be reading you on the interwebs!

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My First Pink October…

…after having breast cancer and reconstruction. What a change in perspective. All the pink makes me want to puke. Not P!nk the artist, whom I adore, but the color pink that has been co-opted as a fund-raising tool. There is nothing wrong with fund-raising for a cancer that will impact 1 in every 8 American women. (Remember that lung cancer still is the number one cancer killer of women, and most cases are preventable.) The problem is where do those $$ go? For what purpose? Read the not-so-fine print and you will see that proceeds go to “breast cancer awareness month” without designated organizations or what amount of your donation actually goes to the cause.

Also, you should consider that if you want to “give to breast cancer” – what aspect of breast cancer? Prevention, screening, treatment, research? Prevention of any type of cancer is a tough issue to deal with. There is rarely one factor that causes cancer. Even women with strong genetic susceptibility to breast cancer will not all develop the disease. Women who lead the most healthy lifestyles can get cancer. (Fat, post-menopausal women are at higher risk, sigh.) Women who lead more unhealthy lifestyles might never get cancer. Screening – many women have no access to mammograms, which have their own problems with false negatives and false positives. Treatment – women with metastatic disease clamor for more effective drugs and rightfully so.  My little ol’ Stage 0 cancer is now 20% of new breast cancers yet we still don’t know which ones will progress and which could sit forever in the ducts never causing any problems. This is after more than 20 years of well-designed randomized controlled trials. So, we all get the same recommendation and many of us opt for aggressive treatment, and some of us (OK, me) who have lost 140 pounds know that the standard of care would leave devastating cosmetic results, so we opt to lop off our breasts. Research – certainly more is needed but how much more profit do pharmaceutical companies need, and who is to say what amount of profit is too much?

Many others have written much more eloquently about these issues. I will just leave you with a few images that I shot at the grocery store yesterday. But first, be sure to purchase your favorite firearm in pink this month. Leave ’em laughing at the range.

Pink handgun

Walther P-22

yogurt

"Give hope with every cup" WTH?

Think pink when you pee

Think pink when you poo

Pink paper products everywhere!

Don't forget the babies

Or the pets!

My favorite stethoscope brand sells out

At the check out counter when the clerk asked if I wanted to donate, it was all I could do to stop myself from saying, “I already gave my breasts to cancer.”

Botox, Boobs, & Caffeine Addiction

During my pre-op visit 2 days ago as I’m going through the list of questions generated for my plastic surgeon (and he is trying not to roll his eyes or fall asleep or, even worse, laugh), his ears perk up when I mention the repeated pectoral muscle spasms that I have had since the bilateral mastectomy for cancer and tissue expander placement 4 months ago. Dr. N mentions that some women have very reactive pecs – must be all my work outs – and he has long thought that the Botox maker should do a study injecting Botox into pecs at the time of implant replacement. The academic physician in me said, “Go for it and let’s write a report for a journal.” He laughed saying he is so past that stage of his career, and I forget that I am past that stage, too. Any way, I am letting him do this (paying out of pocket but just the actual cost of the drug) because I won’t be allowed to do pushups forever. Plus, anything to prevent continued muscle spasm (short of not being able to function with my arms). OK, so I am bit leery of paralyzing my pecs, but I am more concerned with continued spams preventing proper positioning of the silicone boobs foobs.

Now for the latest on the pet front. You are aware that we have a pack consisting of 2 humans, 2 dogs, 2 cats, right? Our chihuahua-terrible mix, Mr. PeeTee, is quite the coffee fiend who somehow knows exactly when I am down to 1/4 cup of my French press coffee. That is when patience evaporates from the 3 neurons in his brain (eat, sleep, & pee) and the whining and clawing begin. Without further introduction, here is the little monster finishing a cup along with his favorite brand. (Yes, he is wearing a diaper because the sucker refuses to be potty trained. Probably why he was on the chopping block at a nearby county “shelter”.)

PeeTee with coffeePeeTee and more coffee

Exercise & Surgery Plan Update

Status

The recumbent bike stayed in the Arizona room, which now has temporary pleated shades (the cats eat any shade with strings) covering the six windows and a darker film on the door. A 20″ floor fan keeps me cool, and I open the room to the rest of the house before starting my 30 minutes on the bike. After 5 minutes of grumbling about aching knees, I lose myself in whatever I’m reading or watching on the iPad or giggle (yes, I am capable of giggling) at the dogs as they run wild in what usually is restricted cat territory. The 30 minutes pass quickly, and I’m ready for the next day. Walking has not been as consistent, but I’m working on it. My chest swells in the heat – nothing but a thin layer of skin between my foobs and the rest of me so the saline inside feels as if it is boiling in the direct sun!

Speaking of foobs, I moved up the surgery date to September 28. That means we give up our trip to Hawaii – heavy sigh. It was Sue who suggested spending our vacation time for surgery. I probably wouldn’t be able to enjoy Hawaii very much with the tissue expanders causing so much discomfort, and I refuse to wear a swim suit with the extra skin that I can hide so easily under camisoles and shirts. (Hey, no bra needed with these rocks.) This next surgery is supposed to be a “breeze” compared to the mastectomy. How much of a breeze can a 2½ surgery be when the plastic surgeon has to replace the expanders with nice, soft silicone implants, remove excess skin, make needed repairs (incisions and secure the division between breasts)? The recovery should be much quicker although — you know I just don’t want to think about that aspect until it gets closer.

I have a goal to lose 10 pounds in the next 6½ weeks, so I’m off to bike, walk, and plan the rest of today’s food. Here’s to anticipating my new chest and getting rid of pain discomfort!

Foobs, Boobs, & Haboobs

The past week has been full of non-blogging because, well, just because. I’m stuck in a non-exercise, non-physical activity phase until the incisions are more fully healed, and my chest wall is less irritated by the tissue expanders. The breast surgeon (as opposed to the plastic surgeon whom I see regularly) said the irritation at the bottom part of the tissue expanders – now referred to as my “melons” – is probably local lymphedema. Mastectomy is an amazingly disruptive surgery where the breast tissue is scraped scooped away from the chest wall, ripping away severing local blood supply, small nerves, and lymph channels. So while I don’t have the dreaded lymphedema in my right arm from removing a few nodes to check for early cancer spread, there is this local process going on that is not very pretty. It looks and feels like a sunburn, but I am tolerating the discomfort better.

When last I blogged, groaning about a collection of fluid in my right breast that needed to be drained, it has been aspirated twice. No biggie, no pain (no sensation), no infection. The tissue expanders are now a tremendous 705 cc each – that is almost 1.5 liters of saline sitting on my chest. They really do look like melons or really large softballs, including seams! After repeated advice to keep my arms still to prevent fluid accumulation, my surgeon admonished me (in his sardonic manner) to stretch my pecs to minimize spasms. No wonder patients get so confused – don’t move, move, move this way but not that way… Any hoo, my hunky brother taught me two easy pec stretches and BAM! mucho relief. Next visit I plan to teach them to the doc’s patient educator.

So maybe now you’re wondering if my chest will look like Pam Anderson’s after all of this? No way. I am already expanded past the size silicone implants that will be placed. This over-expansion process allows a more natural looking droop. I mean perky is nice, but who wants breasts at their collar bones?! If all continues to go well, I should have final surgery for my new foobs in October, maybe November. That is getting dangerously near the return of the in-laws. Double ouch. Surgery and in-laws. I need to be in my best physical and mental shape to handle their annual visit.

Eating continues to be weird in that I have minimal appetite but have only lost 5 pounds the past 6 weeks. Yes, I finally stepped on the scale. Part my perceived slow loss is due to the expanders now weighing more than my natural fatty breasts (water weighs more than fat). I have, however, dropped another size and am fitting into some size 10 clothes. My hips do love to hang on to fat!

My outlook is more positive, except when I take Valium for severe muscle spasms – then I get a little brain cloud. All I have to do to keep in perspective about my (former) breast cancer is to read the breast cancer forums at BCO and thank God that I am NOT having to go through chemo and radiation at the same time as reconstruction. Those women are amazingly strong. I am amazingly fortunate and blessed with good health, a wonderful family, and…

It’s officially monsoon season! Yippee, rain, glorious rain in Tucson. It was one of Tucson’s thunderstorms that generated the haboob over Phoenix this week. I’m certain every teen-age boy is going around saying, “Nice haboobs you got there!”

Brother

My "baby" bro

 

Bro and Wife (He made me add this!)

All About Perspective

She scrunched over her omelet at the opposite end of the counter, reading the local newspaper, sipping coffee, splashing salsa on the eggs. We were the only ones eating at the L-shaped counter – no waiting for those seats if one chooses to display one’s solitude at the famously busy breakfast diner. As she stirred to leave, I noticed 2 white, plastic bracelets on her left arm, similar to the yellow one that I wore for cancer a month ago. My curiosity overcame introversion as I quietly asked if she would mind telling me what the white stood for. One of them was for Gabby Giffords, our U.S. Representative who had been shot in the left side of the head last January. The other was for aphasia (difficulty or inability to speak). I pried more, “Do you have a family member with aphasia?” “No, I have it”, she replied very clearly.  I noticed then her right arm was severely contracted. I commented that she probably related strongly to Rep. Giffords’ injury, at which point she glared at me and said, “What are you, OK?” “Um, a physician.”  Now I was regretting the intrusion. She suddenly brightened and told me that June is National Aphasia Month. No idea there was such a thing I told her. She then described her stroke more than 20-years ago. This woman probably my was age. I commented that her language skills were remarkable and learned more – she couldn’t speak for 2 years and still is in various forms of therapy. I would have never known she had aphasia except she punctuated her speech with “OK” as some people do with “uh” when searching for a word. She raised 3 kids during and after the stroke, went through a divorce, and functioned as well as anyone else in that diner that I could tell, including me. Amazing. I had been perseverating in my head just after having stitches removed about the possibility of fluid collecting under my mastectomy. I hurt. I was worried. And this woman not only survived a massive stroke but continued to work on her functional ability and wanted me to tell everyone about National Aphasia Month because so many of the 2 million people with aphasia cannot speak for themselves.

Later that day, after too many hours of running around doing errands because I had been house bound for a week, I headed to the pharmacy checkout and saw “Ruby”, a 30-ish year old technician who frequently hands me my meds. Oh fuck – she was wearing a head scarf, clearly bald, pale, facial skin showing the effects of chemo. After I checked that no one else was around, I put my arm across my flattened chest and discreetly said, “I have breast cancer. How are you doing?” “Colon cancer. I’m really doing OK.” OK? OK!? She looked like shit. “I’m almost done with chemo and most of the metastases are gone.” (Mets! Stage 4!) “My blood counts are doing good, and I’m handling work fine.” Somehow I managed to overcome my shock, stay out of doctor mode, and express my empathy and encouragement. She seemed genuinely grateful. I stumbled to Safeway next door and was sobbing by the time I hit the coffee aisle.

These 2 women have had/have life-threatening illnesses and are more than surviving. If I were Ruby, I would be on a beach in Hawaii smoking ganja soaking up all the sun and sea in my last days. Screw me for being such a weenie, so weak, so vain for having chose reconstruction when I could have just had a flat chest and moved on with my life (and weight loss and fitness).

Or I could draw strength from their stories and buck up. Right now I’ll just sit here and cry a bit because I have developed a seroma on my right side. Such a small thing.

Hey, did I mention it’s National Aphasia Awareness Month?

Collecting Cartoons – Body Image At Work

You might this offensive, but I find humor in big boob cartoons. Having been a former humongous big breasted, and now no breasted, woman, I have started collecting humorous cartoons (NOT PORN) that depict big bazookas without being demeaning. I laughed at such images when my breasts hung to my waist; I’m really laughing at them now as part of the mourning process for my breasts.

For someone who chose not to have obesity surgery because of refusing to deform her body (don’t yell, I know bariatric surgery works – this is my sh!t), opting to cut off both my breasts for Stage 0 breast cancer might seem incongruous. It isn’t. That aspect, however, does help explain grieving my breasts – not because I feel a loss of femininity or sexual identity. Shock is the best word I can find to describe that first glance at my chest. For days I couldn’t help with the dressing changes because I could not bear the lack of sensation and the lack of breasts. Sue would gently turn me away from the mirrors while she did nursing duty. This week I have been on my own for dressing changes and am fully experiencing my incisions, skin sensations, scars, excess skin waiting to be adjusted at the final surgery. While I do have some “boobage” now from saline in the tissue expanders, I know that I will never have real breasts. What I have chosen to do is purely cosmetic and at times regret the choice (usually in the middle of the night when I can’t sleep because of discomfort and when I start obsessing over the possibility of more complications). I also know that had I elected not to undergo reconstruction, I would have regretted that choice even more. My body image, while unstable throughout my life, would not have tolerated a scarred, flat chest and having to wear a device to accommodate the new sizes I am shrinking into.

So, without further inner psychoanalysis I present my first (OK, second, check here) boob image that caused my sister and I to giggle in the aisles at Walgreens while looking for a birthday card. Feel free to submit your images to sskarmar2010@hotmail.com.

“A cheerful heart is good medicine, but a crushed spirit dries up the bones.” Proverbs 17:22

Booby trap cartoon

Scanned from the front of a greeting card: Tomato Cards, DCIStudios.com