Saturday, February 16, 2013

Surgical Decisions Confirmed

We have been praying that God would give us peace and make clear the direction we should take for the next steps in my cancer journey.  I can happily say that we are now at peace with the direction we have chosen to take for the next steps.

On 2/27/13, I will hopefully be having a bilateral mastectomy with expanders.   The expanders give me some options for reconstruction down the road.  Without them, I probably would not be a candidate for reconstruction.  My radiation oncologist, plastic surgeon and surgeon are all on board.  After seeking a second breast surgeon opinion, we feel comfortable staying with our current surgeon.  After all, we really liked her for our first two visits to her office.  Perhaps it was the confusion with the surgical direction we should take for next steps, along with the change in surgery dates that muddled things up.  In addition, I guess I am sort of a unique patient (with my stage, size, need for extensive radiation, etc.) and it provides some uncertainty with decision making.  I plan on contacting my breast surgeon's office on Monday to confirm everything.  We have the surgery date set already, but it was originally for a single (left modified radical) mastectomy at another hospital.  So, I am hoping that my surgeon has enough time available for the double mastectomy with expanders.  I also hope that she is ok doing it at the hospital where my plastic surgeon needs to perform the procedure.  He told me he already discussed it with her and confirmed it, but I want to do so also, based on the scheduling issues I have had in the past with the office.  

My recovery is going to be a little more difficult than if I just had the single mastectomy with no expanders.  But, this way I can reduce the number of surgical procedures I have in total.  Given I have a lot of radiation and then recovery from that ahead of me, I don't feel comfortable waiting that long to have the right breast removed.  My radiation oncologist is on board with me having the expanders placed, but I can only expand them to what is equivalent to an "A" cup.  As I mentioned in a previous post, this is due to the need to have my internal mammary lymph node radiated.  This is completely fine with me, and it means that I won't have to stretch my pectoral muscles as much prior to radiation.  Hopefully this will result in faster healing, so I can get started on radiation sooner and without complications.   The purpose of the expanders is really to expand the space behind the pectoralis muscle to fill the skin envelope that my breast surgeon leaves behind, not expand the skin envelope.  This will preserve the space for future reconstruction, since radiation would otherwise damage the skin and not allow it to stretch or create any space for implants if I choose that direction later.

So, I am feeling comfortable and I am so glad God has given us a peace about these future steps.  He has been there all along with way directing us.  This time, He required a little more patience of us than the past decisions.  But he continues to grow us throughout this process, and for that I am thankful.  

Looking back, I don't think my body would have been ready for the original 2/11/13 or even the 2/13/13 surgery date.  I went in for labwork at my oncologist's office yesterday afternoon and found out my white blood count is still a tad low.  I was really surprised by that, but also know that God is in control.  God knows the perfect timing for my surgery.  I can rest assured when "scheduling issues" or other "problems" arise, it is just a way for Him to use circumstances to orchestrate His design (in this case for my healing).  I am so glad He is in control.    

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