Where’s My Damn DNA?
My oncologist visit on Monday was scheduled to discuss the results of my genetic testing. We thought we gave them plenty of time to swish it around, stain it colors, scan it with lasers, play it music, whatever it is they do to it to make it talk. But apparently we did not. Faced with the choice of either going ahead with our plan with the knowledge that there is a chance that the genetic test results might derail them or waiting longer for all the tests to come through, we decided to go full steam ahead with our plan of mastectomy of the right breast and simultaneous reconstruction using autologous (tummy) tissue. I am aware that if my genes reveal one of several mutations, that best practices (and thus our plan) would instead require a double mastectomy and the reconstruction could not be attempted as planned due to a lack of enough tummy fat with which to fashion two new boobs. I am banking on the relatively few incidences of breast cancer in my family, which make me think that the likelihood of genetic doom is small. Like my tummy fat.
After synchronizing our plans, we spent the rest of the visit asking and answering questions. (In case you were unclear, I was asking, she was answering.) Questions like:
Q: Is Dr. Cruise really that way?
A: Oh for sure, but he’s really that good.
Q: I’ve seen a lot of post-mastectomy equipment and special jammies advertised online. Which of those things do I need?
A: None except a recliner, which you will need because with a crescent-moon shape of skin, fat and muscle cut from hip to hip, you will be unable to stand up or lie down straight for a while. You will have drains in your chest and belly, but you can pin them to a lanyard or shoelace. (Confession: I bought a pretty pink drain-holding apron anyway.)
Q: Why do the MRI results use the word “enhancement” to mean “cancer”? Seems odd.
A: Because on the MRI, the cancer cells light up like Christmas tree lights. They are “enhanced” by the contrast fluid given via IV during the procedure. She brought up my MRI scan and there were the Christmas lights. A big white glob of them.
She says she will call as soon as she hears from the genetics lab. I’m writing this on Thursday and so far, no word.
Dr. Cruise puts on a show
So far during this journey, I have resisted allowing Drew to accompany me into doctor’s offices because (a) it’s my body and it’s a rather intimate part of it, and (b) I don’t want to have to feel the need to “act brave” or act in any other way than what is natural for me while I process the news that comes from each one of these visits. And what if I have to ask a particularly embarrassing question? Ugh. I’ve explained all this to Drew and although he would rather not only (a) be there beside me every single moment, but (b) if he could, crawl inside me and take it all on in my place, he has understood and accepted this limitation cheerfully. However, now we have a male doctor (part of the patriarchy!) and he wants to make sure the marital unit is all on the same page, so I invited Drew in to this appointment.
If you have ever wondered whether the autism spectrum is a positive rather than a negative human adaptation, may I present our Dr. Cruise. He is a walking talking poster boy of surgical success despite or perhaps because of a complete lack of human connection. He explained the specific procedure with visual aids, letting us know that the microsurgery he will be performing involves stitching blood vessels that at most are two millimeters in diameter with surgical threads one half the width of a human hair using microscopes only 10 times the power of normal sight. He reiterated the risks of failure of the procedure (failure meaning the failure of the implanted tissue to regain blood flow and thus its eventual death and removal). He likes to explain that although the failure rate is between 1 and 5%, if you are one of that 1 to 5% then it is a 100% failure rate. He answered every question by beginning the explanation in layman’s terms and finishing in medical terminology. It was as if he was trying to communicate in a foreign language but could not complete the sentence without reverting to his native tongue.
When he had to leave the room momentarily, Drew and I would give each other “see what I mean?!” faces. He was just as I described, or maybe more.
As he continued his medical soliloquy, he mentioned in passing that the surgery was scheduled for March 6.
News to me, but welcome news, I guess. If it has to happen, let’s get this thing behind us. The next two weeks, I will try to wrap things up that I can do ahead of time, and trust Drew with the rest. Drew will be taking time off to nurse me back to health.
It’s quite an involved operation with two operative sites. My oncology surgeon will be performing the mastectomy while Dr. Cruise performs the harvesting of my belly fat, small amount of muscle, and important blood supply from my belly. Once my oncologist completes the mastectomy and removal of a few leading lymph nodes for biopsy, Dr. Cruise will complete the breast reconstruction. The entire procedure will take up to eight hours. After the operation, I will spend the night in the post-op intensive care ward where nurses will monitor the blood flow in my FrankenBreast every hour to make sure it stays alive. The next day I will be transferred to a regular post-up room and remain for up to four more days. In these days of cycling people out of hospitals as fast as possible, that’s a heck of a long time, so you can imagine the shape that I will be in those first few days.
After that I will be remanded to the care of Nurse Drew, who is taking his job very seriously. He is planning to take off work for a full month following my operation and will stay by my side as long as I need him. What a guy.
I didn’t sleep much last night, but soon this will be my new normal. Time to be brave.