More results, deconstruction, reconstruction

So Wednesday, I got the results from the breast MRI. Basically, it revealed nothing new. Which is good and bad. The good part is that it didn't show any signs of cancer in my right breast. The bad part is that it confirmed everything in my left breast but gave more detail: The tumor is the size that Dr. Brian thought it was (4 cm x 3.8 cm x 3 cm), and there are other details on the report, but I don't know what they mean. We have an appointment with Dr. Brian on Monday at 3:30, during which I'm going to ask her to explain all the med-speak.

My reaction kind of surprised me. I took it almost as hard as when I first learned I had cancer. I was really upset. I guess that completely unbeknownst to my conscious mind, in some small, dark corner of my head, I was still holding out hope that the mammograms were wrong, the biopsy was wrong, Dr. Brian was wrong. So this breast MRI is kind of like the death sentence for my left breast. I'm very sad about that. And I don't want to hear a single person say, "Oh, but at least your right breast is clear." That's like telling a mother who has lost a child, "Well, at least you still have your other child."

So we went to talk to the plastic surgeon yesterday afternoon about reconstructive surgery. It's much more complicated than I first understood. The type of reconstruction that Dr. Heistein (pronounced HIGH-steen) is recommending is called immediate two-stage reconstruction; you can read about it here. But I'll summarize: immediately after the mastectomy, Dr. Heistein would come in and make a pocket between my rib cage and the muscles of my chest wall. This is where the tissue expander would be placed. He would slowly fill it once a week for 8 weeks until it gets to the approximate size I want; with each time it gets filled, it would be painful, as would the initial placement of it because it is stretching very strong chest muscles. The filling of the expander could not take place while I'm on chemo, if I have to have it. So then around 4 to 6 months after the mastectomy, I'd have to have another surgery, with an incision just as large (he said he'd just cut through the mastectomy scar, in fact), to remove the expander (which is very rigid) and put in the actual implant. I'd probably need a week at home to recover from this surgery. Then way on down the road, I'd have to have the implant replaced in 10-15 years.

Oh, and he's saying that to make the right one match the left, I'd need to have at least a lift on the right, if not an implant. I saw pictures of some of his patients. He's correct; the ones who look the most balanced and natural are the ones who've had both breasts worked on. Though as long as I'm wearing a bra, they would probably look fine. It's just without that, they won't sit at the same level on my chest.

::sigh::

Having almost no experience with surgery in my life, I'm finding all this very difficult to comprehend or try to figure out. I've been under general anesthesia a few times but have never had to have an incision in my skin or my muscle for a surgical procedure, so I'm just at a complete loss as to how much this is going to hurt or how difficult the recuperation will be. I know I can talk to other people about it, but each person is so unique with her own level of strength and ability to bounce back, I really wonder how much it would reveal that would be helpful to me. Even though I've been assured by both surgeons that pain management will not be a problem, that's what I was told when I broke my wrist and was given Vicodin, which made me vomit for two days after I stopped taking it (I can't take codeine).

What it boils down to is that I know I have to have the mastectomy. I have no choice in that. So I will look abnormal after that if I don't have the reconstruction. But the reconstruction is my choice, and I think I will regret it if I don't do it. But it's scaring me. Bad. As I told a friend, I'm stuck between an awful place and an awfuller place. Kyle asked me which was which, and I'm thinking that the awful place is the reconstructive surgery, and the awfuller place is feeling that I will look abnormal/deformed.