Non Nervous Nellie

The plan WAS to go for a quick walk after services, go home, shower and dress for the appointment with the plastic surgeon.  For starters, I was going to see him alone for (I think) the first time.  No Elyssa, no Rod, no Evelyn, nobody but me.  I had left a lot of time to get from services, to the walk, to the cleanup, to leave early for my appointment, to give myself time to calm down for the argument over aureola tattoos I was sure we'd have.  He is historically behind; it's just how things are at Dr. D'Amico's office and that's what you plan for.

Having been back home now for a couple of hours, I would say that I am inordinately pleased with how my day turned out, though not how I envisioned.

Services went as planned (not that I was in charge.)  Lovely small (but big enough) group who put their "whole selves in," as Joel Mosbacher likes to say, with prayer and song.  We chanted the Torah and Haftarah blessings together, we cried together about our losses, and we finished with kiddush and a sweet snack of chocolate toffee matzah (I didn't make this particular batch, but I have the recipe!)

And then commenced the socializing.  As it happens, long-time friends Leslie, Jane, and Lisa were there today, and we all sat together during services.  Afterward we did some catching up, and since my doctor visit was by then generating a decent amount of anxiety, it became the topic of conversation.  "You'll be fine."  "Don't forget to ask questions." "I'm sure he's very good; you look great already."  (This last bit is always nice to hear, considering how far I've come to get to this point.)  Long story short (or short story long, as it were,) I was there enough time kibbutzing that I did not have time to change into my jeans and sneakers and go for my walk.

So I hightailed it home, grabbed a quick shower, changed into the thinnest white tank I own (more about that later) and flung myself into the car.  It was then almost 1:20, and I had planned to allow 45 minutes to make what is under ideal conditions, a 30 minute drive to a 1:45 appointment.  I called the doctor's office and confirmed that he was already behind in time, and the information seemed to "free" me somehow.  I relaxed, but instead of taking a leisurely right-hand lane Sunday drive kind of path, I drove my trusty minivan more like a race car.  All of a sudden I paid careful attention to all the lanes of (hated) highway; I signaled, and moved back and forth to maintain the highest (legal, sort of) speed possible.  I was no longer nervous about my appointment, and when I finally glided in to the parking lot EARLY my anxieties were gone.

Of course, arriving early does not guarantee being seen early.  So I sat in the waiting room for over a 1/2 hour (sometimes we've waited over 2 hours) filling out some new paperwork.  He now takes my insurance.  Is this good news?  Time will tell (and so will I, when I find out!)

A review of the basic "he said, she said" history - Dr. D'Amico feels that a reconstruction without aureola tattooing and nipple reconstruction is like a car without headlights, among other interesting metaphors.  I feel that one of the benefits of the mastectomy (other than the obvious, that of cutting out cancer cell-hosting tissue) was that I could FINALLY wear thin, close-fitting shirts.  And for the past four years I've been fairly adamant about this.   I wore the special white top to show him what I meant.  He reluctantly agreed he could see my scars through the shirt, and conceded on the nipple reconstruction...

He's been fairly adamant about his opinion on the tattoos though, and in conversations with other women who have faced this dilemma I have no clear "winner" one way or the other.  Even other doctors I've spoken to have come down on both sides of the discussion.  Bottom line is, I should do what feels right for me.

And I just DON'T KNOW.  If I get them, will I fell more like these parts of me are now "real?"  If I get them, will I now have the unwanted visibility through the shirt issue I had before?  If I get them light enough to NOT show through, will that be so light that it just doesn't look natural compared to what I was born with?  It's pretty damned permanent, and so hard to decide.  Shouldn't I be healthy enough psychologically by now and grateful enough to be alive that this should not be such a big issue for me?

Today he started with "Let me ask you, are all the pictures on your walls unframed?"  I responded, "yes, I know, car without headlights, unfinished painting...."  

I was completely honest.  I told him I've wavering a little, but I wanted to know if this SHAPE (right kind of round with a flat front, left kind of more realistically shaped) is what is going to be now and forever.  One remaining concern is that even if you put a tattoo on something that (from my looking-downward) viewpoint isn't shaped ideally, that won't make it any more realistic-looking.  The silk purse-sow's ear story comes to mind every single time.

I told him if I could afford it, I'd go through the latissimus surgery on the right side to become more symmetrical up front.  (Please understand, I look okay in clothes, and in profile things look fairly even, and from the medical measuring point of view, the "projection" is actually the same. But it's not going to fool anyone, and bras are shaped to fit how my lefthand side is now shaped, so there's always a pucker on the right.)  But he said right away (as my wallet breathed a sigh of relief) that he would never put me through that again unless it was medically necessary.

Fun fact: the lovely dream that once you have reconstructed breasts you don't ever wear a bra again, is pretty much a fantasy, at least as I have experienced it.  If you go without a bra for many days in a row and do any kind of strenuous moving, things start to get sore and you realize that you need support once in a while.  So you still have to buy bras, and they still have to fit.

But wait, there's more.  He started to say something and I interrupted him, hardly believing what was coming out of my mouth:  "I heard there are new implants that are shaped more realistically and can be customized, kind of like a pyramid-ical shape?"  He is used to Rod and I asking more unusual questions than the average bear, since we study hard about what's going on with me.  So he really didn't skip a beat and said that indeed, there are.

They have been in use in Europe for many years and would have been available to me in 2010 if not for the good ole' FDA and their numerous regulations to keep us safe.  (I feel neither here nor there about the FDA, but this is how he felt, clearly.)  Up until now all the implants are round (as you might notice when you see famous actresses bare-breasted and can tell "who has" and "who hasn't," and the new ones have "an anatomically shaped silhouette," to quote from the Natrelle website.  I do, in fact, have wrinkling on my skin on the right side where the contents of the round implant head mostly south (thank you, gravity); it's not only a little weird, but it's also just another daily reminder of June 28, 2010.  Between taking the medication every night and getting dressed every morning, there's still a lot of "just" in my adjusting.

At any rate, all decisions are put off while magical Marie in his office asks what the fine folks at United HealthCare think about this idea.  If we go ahead, I've promised a tattoo decision in time, and he's promised to remove (for free) a large mole dead center in my chest that I've had all my life, escaped the knife every time so far, and is (joking here) the only reason I never wear those slinky cut down to the navel dresses.  Hah!

As I said, today did not turn out how I planned, but it was good.  I think I'd better schedule the bone density scan and colonoscopy while I've still got the courage.