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Wednesday, September 26, 2012

Plastic Surgeon 2

And so the saga continues...

Harry turns 19 today and, as the first week of my second year after diagnosis progresses, I wake up rather late.  Last night I had an allergy attack and took a Phenergan.   It must have knocked me out as I feel like I've been run over by a railway train.

Harry is camping on Moreton Island with Robyn and I have already given him his (very practical) loot - a sports bag, some teeshirts and undies, a voucher to get himself some decent shoes.

It's 10.30 am by the time I drag my sorry butt out of bed, in time to hear Anne at the door.  She is here to drop off the money for a fundraising cruise I'm helping to organise.  I barely think twice as I greet her in the kitchen in my mismatched Elmo pyjamas and one boob untidily outlined under the skimpy garment.  My eyes are red and shadowed underneath as usual.  My hair has tightened into the curls I loathe.

It's only afterwards as I head to the shower that I catch sight of my reflection in the mirror.   All in all, I look pretty goddamn awful  and I realise that I should have covered up to greet Anne who was as usual immaculate in her professional attire.  (Later I will call her to apologise for this insult to her eyeballs.)

The fact is that general attractiveness or lack thereof is somewhat top of mind today.

Today I have an appointment with Dr Chin at the Wesley.

Today I hope to be given an alternative to the rather gruesome Lattisimus Dorsi operation previously discussed with Dr Lily.

Here's the story.

Not long after my visit to Dr Lily, my mum saw a story on "A Current Affair" about a new breast reconstruction procedure involving the use of stem cells.  It's only about 18-months old and it's offered by just one practitioner in Australia, Dr Chin who happens to operate in Brisbane.

My mum and both my sisters, Nicky and Fiona, are dead set against the Lattisimum operation, a major procedure that involves rearranging a muscle and could possibly lead to long-term issues with mobility.

Nicky suggests that I should embrace my scars much as anyone does after a bad accident.

Fiona is horrified at the scale of the operation involved.

Mum says that in Japan (where she lived for three years in her youth), all the women are flat-chested and get by in padded bras.  She knows I'm not vain. "I've never given you bad advice," says my Mum, who is never shy of self-congratulation.

But Mum seemed to think Dr Chin's option could be worth considering.

Al just wants me to do what makes me happy and he says we will find the money somehow to cover whatever I need.  (You can see why I love that man!).

I drive to the Wesley, ruefully glancing at my hideous reflection in the mirror.  As is usual after an allergy attack, my nose has taken on Aboriginal proportions.   A pimple is sprouting above my lip.  I am less Miranda Kerr than JOHN Kerr.  :(

At the hospital I grab a coffee as I still feel drugged and sluggish.

Making my way to Dr Chin's medical suite, I sit in a waiting room where I ponder human incompetence.  (One of the receptionists seems quite old and seems quite disorganised.  She even stuffed up my appointment.  I toy with making a complaint but decide she's really quite lovely and besides, she's wearing a nice jacket).

I play a game of Chicktionary on my Iphone.   (I bet you didn't know that "Filbert" is a word - it's the name of a type of nut tree).

Then I follow Dr Chin into his waiting room.  He is a handsome shortish fellow who initially sits ona  stool right next to me to question me.  It's a bit disconcerting.  I notice he has a smooth untarnished face.

Dr Lambley has already sent ahead a referral and Dr Chin first clarifies that I intend to have the other breast removed.

It's true.  I hate being unsymmetrical and that is one decision I've made.  Paris is done for.  I am sick of my prophylactic and especially, the ugly, cumbersome bras that are needed to carry it around.

Dr Chin asks me to go into a changing room where I am to strip down to my bra and knickers.  He tells me that he needs to see if I have enough body fat as FAT is the key to this procedure.

Undressed, I sit quite uncomfortably in a chair staring at a closed door.  I notice a cardboard box in which are contained the models of long bones.  For the man who has everything, I suppose.

When Dr Chin comes back in, he doesn't feel me up like Lily did but just looks at me.  At once he shakes his head.  "Not enough fat!"  he observes.  Then he says:  "Would you be able to put on 10 kilos for me?"

"10 Kilos!" I exclaim (note the subtle use of the exclamation mark).  "I've never been 10 kilos overweight before."

Then he says he will make do with 5 or 6 minimum.  This is what is needed for some smallish mounds.

Once I am dressed again and sitting at his desk, Dr Chin explains that he needs me to have my mastectomy first as he needs two even scars to work with.

He explains what this procedure involves and runs me quickly through a few slides on a power point.  Here's what I discover:

This procedure is called Stem cell-enriched fat therapy which regenerates the required tissue from autologous (Self) 'stem cells'.

This natural augmentation procedure uses fat obtained from another part of the body using liposuction.  Extracted stem cells are used to regenerate the required tissue to reconstruct the breasts (10 grams of stem cells can help manufacture 700 grams of potential fat).

The procedure basically includes an implant around which the fat is placed.

Only one operation is needed and the most uncomfortable part is the liposuction.  (I will need to wear compression bandages for six weeks afterwards).

Instead of manufacturing nipples out of skin flaps, there are now stick on varieties available which can last up to 6 weeks including bathing.

In between, I discover that Dr Chin grew up and was educated in Dublin.  He doesn't have an Irish accent unless he's drunk.  In my view, he could also work on his bedside manner.  He is quite brusque and really, I find he could do with lightening up a little.

As it is, I manage to ask only a few questions, and then he hustles me out to see the nurse who I must say is a lot more informative.

Here are the pros of this procedure compared to the Lattisimus Dorsi operation:

1.  It's less invasive.  No parts of my body will need to be moved, removed or restitched.
2.  It's quicker.  Only one operation is needed.
3.  I'll be fully mobile in a relatively shorter space of time.
4.  I will end up with a flatter stomach and maybe even skinnier thighs!  (Bonus!)
5.  Fat can be 'cultivated' so a thin person can be briefly fat in order to generate the raw material required.
6.  For the first time in my life, I can eat crap with impunity.  (I am already salivating over that McDonalds Hot Choc Sundae: the one I've avoided for 19 years... I used to pig out on them when I was pregnant with Harry).

Here are the cons:

1.  It's much more expensive.  The cost is $10-$12000 compared to $3000 under Dr Lily.
2.  I have to put on 10 Kilos!
3.  I must spend 6 weeks in compression bandages.
4.  I might get used to eating (even more) crap.
5.  Unfortunately, I still won't look like Miranda Kerr.

My dilemma is compounded by the fact that, by November, I should be back to my optimal weight thanks to the hard work I've been doing to satisfy Dr Cam's research.

There's also that huge psychological barrier for me where weight gain is concerned: FAT is considered to be the one, universally acknowledged factor contributing to the risk of cancer recurrence.

It will all come down to how badly I want two lumps to fill out a dress.  Keep in mind that these lumps will be insensate, anyway.

Really, what difference will some smaller lumps on my chest make to the overall quality of my life?  I mean, check out Miranda Kerr (ugly cow):


For that matter, check out Keira Knightly.


Or Cameron Diaz:

Or Sienna Miller:

Or Kate Moss:

Or Milla Jovovich:

Or for that matter Jack Nicholson!

Boobs!  Who really needs them?

This is the 10AA question I need to consider in the coming weeks.

In the meantime, I do hope you'll forgive me if you find me leering at your cleavage.

Just put my lechery down to research.















Sunday, September 23, 2012

One Year Anniversary

El Nino and almost unrelenting fine weather and on this rather warm Sunday I find myself "celebrating" the first year anniversary of D-Day.  Diagnosis Day.

It seems that September 23 is doomed to hold significance in my life and I suppose, it's quite an important day in other ways:

In 1642:  Harvard graduated its first students (I bet you didn't know that!)
In 1846:  Astronomer Johann Galle discovered the planet Neptune.
In 1932:  The Kingdom of Hejaz and Nejd was renamed the Kingdom of Saudi Arabia
In 1962:  The Jetsons aired for the first time.
In 1980:  Bob Marley gave his last concert
In 2004:  Hurricane Jeanne reportedly killed 1070 in Haiti.

I wish I could tell you this last year has zoomed by.  It hasn't.

I seem to have lived every last living inch of the past 365 days and to an extent, I thank you, my blog readers for this.

Much as I have rued ever starting this bloody epistle - on those days when I have really been in a bad mental space - the process of sharing this long-winded episode of my life with you has, I guess, kept me in an almost constant state of hyper-awareness.

In fact, there isn't one thing that has happened through this disease where I haven't regularly weighed up whether it might be useful to you, informative or enlightening.  Everything has been assessed for what it might have added to 'My breast cancer story'.

Ultimately, I believe there's a reason to pay homage to this disease because of the amazing things it has delivered to me so far:  revelations, insights, friendships and above all, love.

Thanks to cancer I have learned how to give and receive love.  I have hugged more warm bodies this year than I have in my entire lifetime

Thanks to cancer, I have made several new friends amongst the breast cancer community, great, wonderful, brave women who are always willing to speak honestly and candidly to me about their experiences and are generous with their advice.

Thanks to cancer, I have made an effort to get to know my own friends even better and, as I mused in an earlier blog, one of it's great side effects is that it has brought several of my old friends back to me.

In short, cancer has, above all, taught me the value of people.

September 23 will always be important to me.

Four days after my birthday, and three days before Harry's, it is the day in 2011 when I was changed forever.

How have I marked it?

Last night, Karen, me and the Williams Will team went out for dinner at a fantastic restaurant called 'Cinco'.  (Three of the team of 7 have birthdays within 5 days of each other would you believe).

This morning I went for a 10 km walk with Spunky in the heat.  It was so hot, I stopped by the golf club for a drink of water.

I spent the afternoon preparing a YouTube film and  have attached the link below.  You had better watch it before the copyright people descend. :))

This evening, I, Al and the boys are off to see The Soiree which is supposed to be a fantastic show at the Brisbane Festival.  (It's sold out!).  We'll have some dinner and celebrate Harry's birthday early as it's unlikely we will see him on Wednesday, the 26th, his birthday.

Tomorrow, I'm off to Adelaide to see a client.

On Wednesday, I am seeing a new plastic surgeon about another reconstruction option.

Life goes on.

Isn't it great?

Now please enjoy my video.

http://youtu.be/Hd5hursfge0

Friday, September 7, 2012

No Guarantees

It's a beautiful, breezy Friday morning, the kind of day when it's just bloody brilliant to be alive.

The good residents of Brisbane have enjoyed the driest August on record and, as we move into September and Spring, it's easy to feel blessed that I live in such a fantastic place.

50 weeks since diagnosis and physically I am feeling pretty good right now. My cold has dissipated and along with it the trail of tissues I've been leaving behind. I've simply been rejoicing in the simple pleasure of breathing unencumbered. (Olive Leaf Extract I love you!)

I've also been sleeping better. It's only since I've been sick that I have truly realised the marvellous medicinal properties of a good kip.

In other exciting news, my eyebrows have thickened and, in the absence of the 'meno' which has been well and truly 'paused', I am even getting a little colour to my lips.

As well, my armpit hairs haven't grown back apart from the teensiest tiniest tips of follicles. That's got to be a good thing!

What's not exciting is that my hair is so curly I've been told there is something 'reggae' about me. Certainly, I seem to have a strange desire to limbo under low furniture and I can't get the 'Banana Boat Song' out of my head. (Somebody pass me the bongos).

Meanwhile, my sessions with Dr Cam at the Wesley also ended this week. I've lost 2 kilos of fat and gained 1 kg of muscle in 7 weeks since undertaking his program and am continuing to be (mostly) virtuous about nutrition and exercise. Well, it's virtuous by MY usual standards, at least. If you don't count the odd Freddo Frog. Or scone with cream and jam.

Physically it's all been pretty good. I can run 10 kilometres again (albeit slowly) even though my bones and joints ache all the way.

I am improving at tennis with my Tuesday night fixture providing a pleasant social outlet.

In odd weeks I manage 9 holes of golf: it's always good for the soul, wandering over pristine green meadows, breathing the fresh air and testing out a choice expletive or two when you can't find your fucking ball.

But mentally, it's been a different story altogether and, I have to report that, over the last three weeks I've been visiting a counsellor at the Cancer Council. (The phrase 'Cancer Council Counsellor' surely leaving 'She sells seashells' for dead in the tongue-twister department).

I did so on the recommendation of my fellow breast cancer friend, Kerrie.

We in Australia are lucky to receive up to 5 free counselling sessions through this wonderful charity and so, with my mood sometimes wavering toward the slightly dismal side, I figured that there was no harm in talking to someone impartial about my thoughts.

As a result of the process so far,the one thing I've determined is that my moods are very closely geared to my level of physical or mental activity.

I need a sense of purpose in order to feel worthwhile and unfortunately, watching repeats of 'The Bold and the Beautiful' just doesn't cut it.

It also doesn't help that I've wallowed at home 'in between projects'. The recent turn of events - the election ending, work drying up, Harry leaving home - certainly doesn't help the cancer fighter's doldrums.

No wonder I have had days when I've felt as if I've been floundering in a vacuum - a joyless, airless (and partially hairless) place that has been devoid of motivation, of need and desire. Aah, those 'moments'.

The worst of these episodes seems to strike in the face of what I perceive to be a disappointment: when things don't turn out the way I had expected.

For example, a few weeks ago I applied for a job at the local Council - foolishly believing that all the work I've done for Karen (you know, the MAYOR) may actually have assisted my position. Besides which, my newly minted CV was assessed by my good friend, Nic, who is also a Doctor of Marketing. (You'd think she knows something: last night she dined with the Director of Marketing at Disney Corp; she speaks 4 languages; she's brilliant in fact).

How stupid was I? The coveted job went to some second rate bureaucrat ousted from the State Government department she'd been gathering dust in for the past 20 something years. A career bureaucrat.

Yes, I am not even as good as The Fish that John West Rejected.

So off I went. On a spin. Off to my 'moment'. And, thankfully, off to the counsellor.

As a result, over the last three weeks, I've really gained a much closer understanding of the mental game you need to survive cancer.

When we talk about the 'cancer battle' it's not about the chemotherapy or the radiation. The battle isn't about the nasty ongoing side effects. It's not about hot flashes or insomnia or aching.

That's not the real battle. We humans have equipped ourselves fantastically to deal with physical problems. Pain? Try pain killers. Can't Sleep? Sleeping pills. Crippled? Go the wheelchair.

But where the mental or emotional game is concerned, it's a whole different story.

There, inside your head, is where the real battle is fought and it begins in earnest post treatment. (There's something I could not have predicted).

Post cancer treatment you feel more alone than ever.

Post cancer treatment it seems some of the support network peels away as your friends move onto other projects.

Post cancer treatment all the surface cues point to recovery. A collective sigh of relief is released. And everyone moves on.

Or so it seems.

The reality, as I've discovered, is that many cancer survivors tend to put on the mask that says: "I'm moving on. I'm coping fantastically. It is all fucking awesome, man."

But things are not as they seem.

At last, Chris has come clean about her own dark feelings.

I can see through Mary's persistent attempts at perkiness.

I know Sharon still seems side swiped by it all, waking up to find her lithe and limber 40-something body replaced by someone older, even crankier.

When Cathy made a speech at her 50th birthday celebration, she burst into tears.

It is that sleight of hand I alluded to in one of my earliest blogs, as I dealt with my preconceived ideas of chemotherapy. You might recall I described it as passing through a sliding door, into an alternative reality.

I do believe it is exactly the way I imagined it.

Over the past couple of months I have come to more intimately know many cancer survivors. In fact, during Daffodil Day last month, I bought a bunch of daffodils that, eerily, comprised 13 blooms, one each for every person touched by breast cancer that I had come to know so far this year. (Since then, sadly, I will need at least two extra blooms).

There is something that all of these women have in common and I sense it with my writer's eye: the way that, whatever stage they are in, they have the look of that person spat out onto the beach by one of those huge dumping waves.

You know how you emerge swimming costume askew, possibly one large boob dislodged from the pathetic confines of the skimpy lycra, hair a-tangle, and disoriented?

Yes, that's the look. Right there. The "Holy Shit! How did I get here!" look.

I also sense that, just like me, they bring to this new life, upended on that strange beach, a new awareness.

No, not some lesson in how to be "Amazing" or "Inspirational" (gag). Not of a higher purpose, some fantastic revelation that is somehow life-changing (puke). Not of someone who knows the "Things That Are Really Important." Like that doozy: "Living in the Moment". Oh Puh-lease!

We have a new awareness, yes. And it is of this.

That palpating at the peripheries of our vision is the Ghost of Chemos Past. It is the ghost that tells us that Nothing is Forever. Not cancer. Not its side effects. And especially, not this thing called Living.

It is the ghost that tells us to keep walking, steadily but warily.

Because no one knows what's around the corner.

No matter who you are, or how well you live, or how noble may be your way of life, your intentions or how great your Sense of Purpose, we are none of safe from the Hand of Fate. Not even Miranda Kerr.

There is the Universe, that Great Pitcher, gathering that hard, round ball in his hand, feeling the seam of it, and sizing up the path along which he will send it curving toward you, so perfectly bowled that you will never see it coming as it knocks you to the ground. That Foul Ball.

We who fight the cancer fight, are more than ever aware at how much our destinies are beyond our control.

They really are.

There are simply no guarantees. So why do we live that way?

Why, as I write, are so many of you dreaming about your retirement? How you'll spend your superannuation?

Why are so many of you sitting there telling yourself that "One Day, I'll..." (insert Bucket List Item Number 1578000).

So here is an exercise I want you to complete. Write down one thing you might have been planning to do 'One Day' and work out a plan for how you might make it happen sooner.

Please don't leave things until it's too late. Call that friend. Sign up for that course. Visit that relative. Take up golf. Join that club.

But, in the meantime, keep walking. Keep moving.

Seize the Day but make sure you stop from time to have a good look around.

It's a beautiful, breezy Friday morning, the kind of day when it's just bloody brilliant to be alive.

But I suppose you've noticed.