A Breast Reconstruction Patient's Journey

Pamela’s Story: Part 3

The following is the third chapter in a 5-part series by Pamela K. She shares her experience with breast cancer diagnosis and breast reconstruction surgery with Dr. Christopher Hess in Fairfax, Virginia. Click here to see all chapters from Pamela’s story.

Countdown to Surgery

“A woman is like a teabag. You can’t tell how strong she is until you put her in hot water.” – Eleanor Roosevelt

I had surgery to remove the tissue of my left breast and begin its reconstruction on April 25, the Monday after Easter.

I wish I’d had time to throw that breast one heck of a going away party. Y’know, gather all the girlfriends, whip up a batch of strong cocktails, serve appropriately decorated cupcakes – I’m talking a real, whiz-bang of a sendoff. Trouble is, with the Easter holiday, and preparing for a leave from work, and planning ahead to minimize the upset my surgery and recovery would cause to our home life, I just couldn’t fit in the time to pull the party together. But I loved the idea of it. In fact, such a great idea was my good-bye party that it was recently part of the storyline of a new sitcom on NBC called Love Bites. A woman on the show was having a mastectomy, and threw a blow out of a party for her breast, complete with a live band, the cupcakes I’d envisioned, AND a huge breast cake. Hey, when one of “the girls” is leaving town, she ought to get her props. So, if you’re facing this kind of surgery, this is something you might want to build into your timeline. There’s nothing like a little moxie and a lot of humor to get you through the tough times.

Sadly, since I didn’t get to throw “my girl” the going away party of my dreams, I’m thinking I may instead have a “welcome home” soiree when my new and improved breasts are all done.

Of course, behind this good-bye party was a need for some kind of closure around this loss. In fact, I was filled with trepidation about this surgery. This wasn’t my first big surgery. I’d had spinal fusion surgery 15 months before, and I’d actually been looking forward to that one. It took away near crippling nerve pain I’d been having in my legs for months. Aah, and that’s the thing I finally realized. I couldn’t seem to relax about this breast surgery in part because it wasn’t fixing anything that hurt. I had no pain. I didn’t feel sick. For all intents and purposes, my breast was in fine working order. Except that I had cancer.

As the days counted down to surgery, I felt a growing sense of panic. I wanted the cancer out of me, for sure, but was I ready to lose my breast? While my emotions were roiling, my mind had plenty of new information to process.

My husband and I had informative, helpful pre-op meetings with both Dr. Hess and my breast surgeon, Dr. Chiantella, in the week before surgery, so we logically understood what would be happening. The two doctors would be in the O.R. together. Dr. Chiantella would do her work first, removing the breast tissue and the sentinel lymph node to see if the cancer had spread (it hadn’t), while Dr. Hess used this time to do a lift on my healthy breast. Then, he would flip me on my side to harvest the muscle in my back that he would use as part of the reconstruction. Then, I would be on my back again while Dr. Hess did the first part of the reconstruction work, inserting an “expander,” a saline sack that would live in me for many months to help my body make ready for the silicone implant that would eventually replace the saline sack. I was lucky in that the doctors were able to do a nipple sparing surgery.

Dr. Hess said I would wake up sore, especially in my back, and all bandaged up, with two drains in the front and two in the back. He explained that I would be in the hospital about five days – longer than I expected – and that the drains could be in for as long as a month – much longer than I expected. As I visibly chafed at these timelines, Dr. Hess shot my husband a look and said, “I can see she has the patience of a hummingbird, so this should be fun!” He’s a funny guy, Dr. Hess, and he certainly had me pegged. My husband thought so, too. He and Dr. Hess bonded with all kind of “husband” humor that day. “Hello…remember me…half naked in the robe over here?! This is MY appointment, right?” My husband, by the way, still uses the hummingbird line on me at home.

Oscar and I walked out of the pre-op visits with each of my surgeons feeling like we had the logistics down, and we were intellectually comfortable with everything they explained to us. What I still couldn’t wrap my head around, though, was how I would feel waking up with my breast “gone.” And how would my husband feel about having a wife who was missing a part he’d always been quite fond of? I wasn’t sorry I had chosen this more aggressive procedure; that still felt right to me. I just didn’t know how I’d feel about it once it was done, and there was clearly no “do over” possible if I had any regrets.

One night, a few days before the surgery, my husband and I were lying in bed, my head on his chest, and I crumbled. I was exhausted from trying to keep the emotional panic at bay; I just couldn’t do it anymore. I cried very hard, and I told him how scared I was about how I’d feel when I woke up, and of how he’d feel about me afterward. I told him how much I hated that we had to go through this, and how sorry I was that I’d gotten sick like this.

For context, you need to know that my husband isn’t one for idle chatter. He just doesn’t talk all that much. But when he does, at important moments and in situations that really matter, he often has perfect pitch – and that was certainly the case on this night. He told me that I had nothing to be sorry for, that I didn’t wish or cause any of this. He said he loved me very, very much, and that his love had nothing whatsoever to do with my breasts – and having been together for nearly 20 years, I believed him. He said he loved me for who I am, and listed all the qualities he admires and respects about me, and there wasn’t a breast or any other body part that was on the list. He said exactly what I needed to hear, exactly when I needed to hear it, and it slayed my panic and helped me ground myself again. I will forever be grateful to him for this, and many other special moments when he’s been there for me on this journey. He is an outstanding cancer husband.

So, aside from leaning on my husband, how else did I prepare for my surgery? Well, I am a big believer that, in life, what we think about we bring about; so I worked on replacing my panic with more positive thoughts. Over and over again in the weeks and days leading up to the surgery, I saw myself going into the surgery calm, relaxed, and confident in my surgeons. I visualized myself at the hospital, going through the preparatory procedures, with a mind that was quiet, emotions that were calm, and a body that was relaxed – and coming out of it the same way. And this helped me tremendously.

I also continued to exercise right up until the day I went to the hospital, to help manage my stress, and I got plenty of rest leading up to the surgery. I found it difficult to sleep in the early months of my diagnosis, including in the time ahead of the surgery, so I often took an over-the-counter sleeping pill, which helped me get the rest I needed. Doctors will also readily prescribe sleeping pills or anti-anxiety pills for cancer patients who need them, recognizing what a stressful time this can be in a person’s life.

On Easter Sunday, the day before my surgery, I found myself feeling calm, relaxed, and, finally, ready for the surgical part of this journey. That day in church, it was almost as if I heard God telling I’d done all I could to prepare myself, and now it was time for me to relax, lie back in his hands, and leave it to him. I am a person of faith, so giving it all up to God worked wonders for me in the last 24 hours before my surgery. We even managed to have a lovely Easter Sunday dinner with friends and family at our house.

The morning of the surgery, on the way to the hospital, my husband and I listened to a comedy CD that a co-worker had given me. It was very funny stuff, and it helped us relax. I focused on remembering some of the jokes to tell the nurses and doctors. And, in fact, I had them all laughing (OK, at least smiling) as they got me ready for the O.R. My surgery was at Reston Hospital Center, and I can’t say enough about the wonderful people who work there, from the nurse who is the breast cancer navigator and met us as soon as we arrived, to the radiologist who injected some radioactive material into my breast ahead of the surgery so the sentinel node could be identified, to the nurses who put in my IV, to the anesthesia doc who met with us.

Dr. Hess arrived right on schedule, and after some pleasantries, (I believe I told him a few jokes) he pulled out a purple magic marker and asked me to sit up straight. He proceeded to draw all kinds of dots and lines on my upper chest and breasts that he said would guide him while he was doing his work. I told him purple was one of my favorite colors, so this must be a good sign! Not long after that, I got the happy juice, and hardly had time to enjoy it. I was asleep before they even wheeled me into the operating room.

Part 4 – Pamela K: After Surgery: The First Five Days


www.cancer.org : The American Cancer Society Web Site has some wonderful resources, particularly under its Find Support & Treatment section, which also includes resources for caregivers.

Breast Cancer Husband: How to Help Your Wife (And Yourself) Through Diagnosis, Treatment, and Beyond, by Marc Silver. My husband is reading this book and finds it very helpful.

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