2 Weeks Out

June 10th marked two weeks until my bilateral (double) mastectomy. When I had that realization things started to feel real. I’ve been talking about it for months, it felt so far away. But it’s not far away anymore. I don’t know what emotions are presenting themselves at any given moment. I think it’s a bit of a tornado of all of them all at once:

• I feel confident about my health (outside of the cancer) and ability to recover. 
• I feel scared of the unknowns and how much pain I’ll be in afterwards. 
• I feel confident in my medical team and facilities.  
• I feel scared something unexpected will happen that is out of anyone’s control. 
• I feel supported by my health insurance company for what they can cover. 
• I feel scared my health insurance won’t cover everything. 
• I feel supported by my incredible husband, family and friends. 
• I feel scared about being away from work for up to a month. 

I’m able to push through the waves of emotion by leaning on my natural default in turbulent situations: “business-mode.” Another part of my being takes over and I love her very much. She absorbs information, rationalizes and accepts the reality of it, educates herself, asks the right questions, and processes the answers to make sound decisions. She’s served me well so far. But no matter how much research, or leg work, or preparation she can muster, at the end of the day, after all the decisions have been made, every remaining detail is out of her control. Out of my control.  

I’ve done my best to remind myself to “give in” to the fact that I won’t have control over much in the coming weeks. Working what’s to come isn’t going to be of benefit to me. Letting thoughts and feelings flow in and out has been the best approach. When I’m mad, I allow it. When I feel like crying, I allow it. When I’m afraid, I allow it. The same applies to the positive parts of all this, which has been more present than bad – the sweetest surprise. When I’m loved on, I allow it. When help is offered, I allow it. When support is expressed, I allow it. No holding on to any one thought or feelings, just clouds floating by. 

As I mentioned, I feel confident about who is caring for me, which is the most important part at this point in the journey. University of Iowa Health Care has been a fitting medical home for me. I’m constantly impressed by their efficiency and follow up. They also really care. I have left every appointment feeling better than they found me. 

The past few weeks have included pre-surgical visits with my surgical oncologist, plastic surgeon, and oncology psychiatrist. I have a CT scan next week along with another visit with behavioral oncology and first visit with the oncology dietician. There is a wide range of support services available, and I’ve been asking to be referred to as many as I have time for.  

At this moment, my care plan is to have a bilateral (double) mastectomy with “expanders” inserted. Expanders help preserve the shape of the breast as I heal, give my immune system a break from fighting cancer, and prepare for reconstruction. Later in the year (if my blood vessels qualify – fingers and toes crossed) I’ll have DIEP (Deep Inferior Epigastric Perforator) flap breast reconstruction. It uses tummy tissue to rebuild the breasts. I chose this route because it is a “forever” procedure. Implants require monitoring and replacement in 10-15 years. The whole reason for choosing to have a bilateral mastectomy vs. a unilateral mastectomy was to have no ongoing maintenance – monitoring, biopsies, hopefully no cancer treatment, etc. So, although there will be a bit more to the DIEP surgery, in the long run, it’s the best choice for me. A big investment up front for, best case scenario, a long-term solution to remain breast cancer-free for the rest of my days! 

I look forward to sharing more leading up to and after my surgery. Thanks to those of you who are following along, your care, concern, and support means so much! 

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Things I’ve Learned and Recommend… 
I believe being your own advocate is the best thing you can do for yourself when faced with a medical challenge. For me, being an advocate for myself took the shape of research, building out a narrowed list of what type of care or treatment I thought was best for me, and visualizing myself receiving the care or treatment to ensure it felt right and would fit my lifestyle. I took the medical knowledge, a list of pros and cons of treatment options, and open questions to each doctor. I ran through everything with them to ensure I was basing my decisions on sound facts and outcomes, asking if they had any specific recommendations based on what they knew about me, and then took both what I gathered and their professional feedback home with me for consideration.  

There is no rush (unless, of course, the surgery or treatment is urgent) to make a call on the spot, especially if you are a “processer” like me. You must live with the decisions you make, not your health care team. Walking into appointments with a baseline understanding of what would be happening, questions, and preliminary ideas of what treatment plan I wanted to follow was extremely empowering. It allowed me to be fully present and listen to my doctors without being overwhelmed with a bunch of new information and being unprepared when asked what I’d like to do. Appointments were efficient and effective because we were able to get right into creating a plan unique to me. 

I make this sound like it was easy, but many times I had to coerce myself into looking what was coming straight in the eye. Opening the comprehensive breast cancer guide was hard, but every time I got into it, I closed the book feeling better off for being brave enough to face the facts and reassured that whatever choice I made was OK as long as it sat right with me.