Category Archives: Surgery

Angelina Jolie

Over the past couple of weeks, a lot of people have been asking me my opinion on the op-ed that Angelina Jolie wrote about her preventative double mastectomy. First of all, it’s awesome that any of you care about my opinion, so thank you! Second, I think she’s a God damn rockstar and the op-ed ruled.

Let me start by pointing out what I think is its single flaw: She really glossed over the whole mastectomy part of it. I don’t want to scare those of you who may one day need this procedure – it’s saved millions of lives and obviously I am doing fine these days (and looking pretty damn good if I do say so myself, tried on a bikini the other day and my new boobs are rockin’) – but seriously, she covered the whole thing in one sentence, like it was a cavity filling. Maybe my experience was more extreme than others, but I literally couldn’t sit up for nearly a week after my mastectomy. I didn’t shower for like nine days because I couldn’t stand up long enough, and I wasn’t allowed to take a bath. I wore the same pair of pajamas for a fortnight.

And don’t even get me started on the drains. THE DRAINS. They’re like a medieval torture device designed to be as painful and inconvenient as possible, all while also being unbearably disgusting. While I had my drains in, I was on Skype with my friend Danielle and her roommate Megan, and I lifted up my pajama top to show them where the drain went into my skin, and MEGAN FAINTED AND HAD TO GO TO THE EMERGENCY ROOM. True story. That’s how disgusting these drains are.

I hope Angie had an easier time with her procedure than I did, but assuming she had an experience even remotely similar to mine which included a lot of pain, vomiting and Law & Order, I think she’d do us all a favor by just admitting that it really sucked balls there for a few weeks. It’s all fine now and I don’t regret my choice even for one second, but I don’t want to lie to you all. It was miserable for a little while. But 100% worth it.

I also want to take this opportunity to clear up a little confusion about what a mastectomy is these days. When people hear the word – and certainly when I first did – they imagine a scarred, pitted crater where a breast used to be. But Angie and I actually had the same procedure (twinsies! BFFs!), which is a skin-sparing and nipple-sparing mastectomy with immediate implant-based reconstruction. With this option, my new breasts look natural. And awesome. The only thing indicating that they’ve been tampered with is a thin, light scar that runs from the outer side of my nipple to just before my armpit. So when you picture Angie and I as mastectomy survivors, think less sad cancer coffee table book portrait and more Pamela Anderson.

My favorite thing about Angelina Jolie’s op-ed, though, was this line:

I do not feel any less of a woman. I feel empowered that I made a strong choice that in no way diminishes my femininity.

It’s hard to struggle with a cancer that messes with your sexuality, especially when you’re in your sexual prime (me) or the sexiest woman in the world (also me. Just kidding. Obviously that’s Angelina). And it’s weird to think about my future as a woman when I’m missing one of the defining parts of being a woman, even if no one knows I’m missing it but me. I think Angelina Jolie very eloquently captured the idea that those of us who make this choice do so because we are strong, empowered and determined – qualities that are far more important than breasts when it comes to defining fierce, beautiful, inspiring women.

By the way, my second favorite thing about the op-ed is when she just casually mentions that Brad Pitt is her partner, like we didn’t know. DUH BRANGELINA WE KNOW YOU GUYS ARE ADORABLE.

A toast to vein champagne

After the Great Vein Explosion of 2013, from which I still have a weird bruise/rash on my hand where the IV was inserted, I finally opted to have a PortaCath…inserted? Placed? I prefer installed, since it’s a titanium implant with a self-sealing rubber lumen and a long tube that goes into the jugular vein, and all of those words make me feel like the Terminator. I am now half girl, half robot, all lean, mean chemo machine.

The procedure is performed under something called “conscious sedation,” which is a bizarre oxymoron to me. I mean, when somebody is inserting tubing into a vein in my neck as thick as my pinky finger, I don’t want to be any kind of conscious at all. Fortunately, what they should really call it is “extremely happy adult naptime,” because I was far, far more sedated than I was conscious. Heavy on the sedation, light on the consciousness, just how I like it when I’m getting cut open with a scalpel.

I wasn’t allowed to eat or drink anything past midnight on the night before the operation, which of course means that at exactly 12:01am my mouth became the Sahara Desert and I was struck with an absolutely insatiable craving for potato chips. I tossed and turned in bed for a long time, trying not to focus on thirst and hunger and therefore focusing on absolutely nothing but thirst and hunger for at least two hours. I eventually drifted off to sleep, and woke up to the completely unfamiliar sound of the alarm I never, ever set anymore because I had to get to USC by 7:30am for my pre-procedure blood tests and other prep.

Somehow, when I sleep until 11am, I never wake up hungry. But when my alarm starts blaring at 6:45 in the morning, I wake up absolutely dying, dying for a sausage, egg and cheese biscuit from McDonald’s. I KNOW IT’S BAD FOR ME. But have you ever eaten one? It’s like the perfect lovechild of all the world’s best breakfast foods in one greasy, fatty disgusting sandwich. It’s also something that I associate with treating myself, since I only ever let myself have one when something horrible is happening, like I have a killer hangover or I have to go the airport at the crack of dawn. Whatever, I don’t have to explain myself to you, internet! If you don’t like the sausage, egg and cheese biscuit from McDonald’s, you’re un-American and the terrorists win.

As I was getting my blood drawn and my vitals checked in the prep room, having neither eaten nor hydrated since 7pm the night before, the nurse asked me if I was currently experiencing any pain.

“Does hunger count?” I asked. “I’m ravenous.”

Also, am I going to be out of here in time to get McDonald’s breakfast? I added in my head.

As I was lusting after my disgusting fantasy biscuit, the nurse set up my IV and it dawned on me that this the last IV I’ll be getting for quite some time. This new device does everything – it can be used to draw blood, administer chemotherapy, inject contrast for CT scans, MRIs and MUGAs and just about anything else you can think of. It can remain implanted for as long as I need it, requires no maintenance except for a monthly saline and heparin flush and means I’ll never have to deal with a blown out vein again. And best of all, no more tourniquets. I hate the way it feels as my arm goes numb and the nurse starts slapping me to try to find a vein. Never again!

Once everything was good to go, the doctor came in, obtained my consent for the procedure and let me play with the different Portacaths they had available. I actually ended up with a model known as a PowerPort, which is a deep, beautiful purple and shaped like a heart. Sadly, it is hidden underneath my skin, so no one will know that it totally matches this J. Crew sweater that I love.

I shifted myself over to a shockingly comfortable surgical table, and then the nurse asked me – I swear I’m not making this up – “Are you ready to take a magic carpet ride?” I answered with a whole-hearted affirmative and she pumped me full of my favorite drug in the world, Versed. In fact, I learned today that Versed is often referred to as “vein champagne,” a nickname I find to be unbelievably apt because it does make me feel like it’s New Year’s Eve and I’m looking fantastic in my glittery dress and the handsomest guy in the room is about to kiss me at midnight for good luck. Modern medicine is amazing.

Thanks to the drugs, the rest of the procedure plays back in my memory like a time lapse.

The first frame is the injection of the local anesthetic. I remember it stinging a bit, but I didn’t care. I was far away in another world, high out of my mind on happy juice.

Next frame. The nurse is asking me how I’m doing. It takes a massive amount of effort to bring her face into focus. “I’m dreaming about the Lion King,” I slur. I really was.

Next frame. My dream shifts. I’m in a forest somewhere. Wait, maybe a cave. There’s some tugging and pressure near my neck. I hear the doctor’s voices but I feel like they’re on a TV someone left on in the background.

Next frame. The doctor is sewing me up. I’m not sure how I know, but I know. She says, “We’re just about done!” I literally do not believe her, because it feels like I’ve been in the room for thirty seconds, tops. In reality, it took about half an hour.

Next frame. I’m being wheeled into the recovery room. The drugs are starting to wear off, but I’m sleepy. The nurse turns the lights off and lets me nap.

When I wake up for good, I discover my new hardware is pretty subtle. Take a look:

PowerPort

The top incision, near my neck, is where the catheter is inserted. The longer incision is where the pocket was created for the PowerPort, which is the roundish button below it. There’s a thin tube connecting the two and arching down into my jugular vein, where it stops just inside the entrance to my heart. The little red prick in the center of the port is where the nurse accessed it with a special needle to ensure that it was placed correctly, which it was.

All in all, the procedure was a piece of cake. Truthfully, the worst part about it was that we didn’t finish it in time for me to get that sausage, egg and cheese biscuit before McDonald’s stopped serving breakfast. Dammit.

Look for my new reality show, “15 Eggs and Counting,” on TLC

Just in case you’ve been on pins and needles wondering, let me say this first: I’m happy to report that yesterday’s egg retrieval procedure was a breeze, and I’m home resting comfortably now! I have a little bit of cramping and discomfort and my abdomen is swollen like I’m 3 months pregnant, but all of that should go away within the week.

You’d think that having undergone an 8-hour marathon surgery that removed some of my body parts, required that I be catheterized and ventilated with a breathing tube, and kept me in the hospital for three days, I’d be pretty relaxed about a 20-minute aspiration procedure performed under light sedation, but the mind has an amazing capacity to make absolutely no sense at all out of circumstances.

I was fairly relaxed in the waiting room, and even held it together as I was changing into the gown and hospital socks, but I was shaking and trembling by the time I was asked to lie on the surgical table. Part of my anxiety was due to the fact that there was a woman in the recovery room when I walked into the procedure area, who seemed upset and rated her pain an “8” on the universal hospital pain scale from “don’t know why I’m here” to “imminent death.” She also seemed like she was having a difficult time talking, which scared me pretty badly.

One amazing thing about the medical profession is that it considers even totally reasonable anxiety about a needle going into your ladybits to be more anxiety than you need to experience, so I was given sedation almost immediately. The anesthesiologist was a talkative, funny young guy who walked me through everything he was doing, and even gave me a little bit of numbing medication before he inserted my IV. I was blown away by this little courtesy because this was about my 5,000th IV in the last two months, and most of the time they just ram it in there, sometimes taking several minutes to get it done right.

Once the IV was in, the anesthesiologist picked up a little vial of clear medication and asked, “How often do you drink?”

“Like, alcohol?” I clarified. “I dunno, maybe a glass of wine a week these days. I mean, this isn’t college anymore.”

He laughed, hooked the vial to my IV and said, “You’re about to get hammered like it’s freshman year.”

Within 30 seconds, I was absolutely drunk. The anesthesiologist told me that it’s a drug called Versed, a potent type of hypnotic agent that’s often used to help patients relax before more powerful surgical anesthetics are used. At that point, I felt like I didn’t even need the second anesthetic. I was basically in a dream, feeling like I was falling asleep while getting the best backrub ever in a hot tub full of rosewater and love.

“They should sell this on the street,” I said, because I had absolutely no sense of decorum or appropriateness or any kind of mental filter once this drug was in my system.

Versed also causes amnesia, so I don’t remember much after that little quip. The fertility doctor came in and asked me to put my legs into the stirrups. I remember greeting him with the stupidest smile on my face. The anesthesiologist hooked me up to another syringe, this one full of a milky liquid called propofol.

“Bye-bye,” I said, like a giant idiot, because I was high as hell.

The next thing I knew, I was waking up in the recovery room. It was like waking up from a particularly deep nap – I felt groggy and a little sick, but I emerged from the mental fog quickly. It was nothing like my mastectomy, where I spent the five or six hours following the procedure drifting in and out of consciousness, waking up only to eat a little bit jello and then retch it back up 15 minutes later. With half an hour, I felt completely fine except for a little bit of crampiness, like a bad period.

The doctor came in while I was in recovery to let me know that they had gotten 15 healthy eggs, which means that even if I wind up totally infertile at the end of this whole ordeal, I can still get all Duggar family up in this bitch (“this bitch” being my womb) if I so choose.

The nurse came by, gave me some water and disconnected my IV, then told me I was cleared to go home. As I was changing back into my clothes (I’m really fashionable, so to this appointment I wore fuzzy Ugg boots, a fraternity t-shirt of dubious origin and a pair of pajama pants with lambs on them that say “It’s sheepy time”), I noticed that the woman who had been in the recovery room when I arrived was still there. I also realized that the “difficulty talking” that had frightened me earlier was actually because she was Russian and had an accent, and I felt like a moron.

“Good luck,” she said. “I hope you have a successful pregnancy!”

I had actually forgotten that most of the other people in the clinic were they because they were actively trying to conceive, not because they needed to freeze some eggs in order to keep them from getting poisoned to death by drugs with nicknames like “The Red Devil.” I didn’t want to correct her, so I just smiled and said, “You too.” After all, I hope I have a successful pregnancy, too – one day, a long time from now.

Artificial puberty, round two

At age 25 with plenty of planned years of awesome boobage ahead of me, I never really considered not having reconstruction after my mastectomy. Although the reconstruction procedure added 4 hours to my surgery and meant considerably more pain and discomfort, there was and is something important to me about maintaining these bastions of my femininity – and I think it goes deeper than just wanting to look good in a tank top, although that’s certainly a consideration.

I found this beautiful quote in the book Reconstructing Aphrodite, a series of essays from women who decided to rebuild their bodies after the devastation of a mastectomy. It really spoke to me, and I hope it will speak to you too.

From the moment I was diagnosed with breast cancer and faced a possible mastectomy, I knew I wanted reconstruction. This response was out of my own sense of art, symmetry, and aesthetic. It was the same response I would have to a tooth extraction or the loss of any body part. It speaks of how I approach an environment that to me is visually out-of-balance.

How could I be concerned about something so superficial while facing cancer? Perhaps because I did not believe that I had the worst disease in the world. Princess Diana said, “The worst disease in the world is the lack of love.” Mother Teresa said, “The worst disease in the world is to be nothing to nobody.”

I live in the abundant love of God amid friends and family who express God’s loving kindness. We are surrounded by survivors of all life’s troubles and grief, surrounded by hope, peace, and joy. I saw the choice for reconstruction as only one of the endless ways to create beauty in my world. It was my surgeon’s sense of art and beauty and her respect for the female form that gave me the confidence to pursue this path.

Yesterday I had my second expander fill. I popped another Ativan beforehand, so that I could remain calm in the face of the MegaNeedle. Alas, I do not possess quite the same level of mental zen as the author of the above quote, although I have been doing a variety of yoga poses to ease my tense back. Child pose is THE BEST.

I was too calm about the fill, perhaps, because the MegaNeedle got the best of me this time. I felt everything as my right breast was punctured. I shouted out in alarm more than pain, because I was so surprised to have any sensation. The plastic surgeon apologized, but said it was good news, because it could herald the return of feeling in my breasts. Sweet! Maybe I won’t have to go the rest of my life unsure whether or not I’m having a nip-slip.

It’s quite weird to be numb across such a wide swath of my body. For example, I noticed that the DermaBond skin glue the surgeons used to close up my wounds – which, as I previously mentioned, looked like the Joker’s face – had started to crack, peel and fall off. I’m sure that if I had sensation, that would be unbearably itchy, but I can’t feel a thing. Side note: Can you believe that after surgery they still patch you up using things that can be found at OfficeMax? Staples, thread, glue? What year is this?

Anyway, the plastic surgeon noticed it, and accelerated the process by peeling off the remainder of the DermaBond with sterile tweezers. Again, I’m willing to bet this would be uncomfortable if I could feel it. When she was done, I was absolutely stunned. The dark, bumpy, scarlike appearance of my wound was approximately 95% due to the DermaBond itself. The actual scar is probably less than an 1/8 of an inch thick and is currently sort of a medium-pink, likely to fade to skin color within a couple of years. Although scar tissue is basically the least of my worries, considering that my life is literally on the line here, I can’t lie: I’m happy that I’ll be able to bare sideboob with abandon by 2015.

Every time I leave USC, I pass a promise on the wall:

USC's Promise

I never fail to marvel at the hundreds of thousands of scientists who work every day to heal people like me. After my diagnosis, I read the book The Emperor of All Maladies, a biological history of cancer written by an oncologist. It was like picking at a scab – painful at times, but equally addicting – and it gave me an enormous appreciation for all that we’ve been able to achieve in the long history of cancer. Gordie read it too, and is considering getting a tattoo of a crab in my honor. You guys, I SWOON.

Real talk

Dear ABC Programming Executives,

I would like to propose a unique addition to your spring lineup of primetime television shows. It will be called The Oncologist, and, like The Bachelorette, it will follow a young woman – who also happens to be a cancer patient – as she interviews 5,000 different oncologists to choose the one who is right for her. They’ll go on hot dates in the chemo ward, and all those dreamy helicopter scenes will take place in MedEvac choppers. Not only will there be boob shots, there will also be an enormous amount of boob fondling, boob pressing, boob gazing and even boob needle sticking. At the end of each episode she’ll hand the best oncologists a single plastic tube from a bouquet of surgical drains. “Dr. Jones, will you accept this Jackson-Pruitt bulb?” 

If you like that, just wait for my other proposals: Dancing with the Surgeons and Keeping Up with the Kancer Ward.

Warm regards,

Michelle

Today I had yet another meeting with yet another oncologist, but this time it had a different tone. Now that my pathology report is in from the surgery, we can stop talking in hypotheticals and start talking about what’s actually going to happen to me. We’re shooting for a chemo start date of Monday, February 25. I chose Monday because Mondays suck anyway, so what’s little poisonous vein detergent here and there? The oncologists are recommending six cycles of TCH, a standard chemotherapy regimen for my type of cancer, follow by an additional 12-14 cycles of Herceptin (the H in TCH) on its own. The infusions take around three to four hours each, during which they give you a happy cocktail of anti-anxiety, anti-nausea, anti-allergy meds that make you sleepy and silly, so most people just nap in the chair. Additionally, every single one of those treatments will be preceded by a blood draw and followed by a shot of Neulasta, a drug designed to boost white blood cell counts. Neulasta can cause debilitating pain, so I’ll be getting yet another painkiller to deal with that pleasant little side effect. Otherwise, the main things I can expect to experience are fatigue and baldness. Fortunately, they’ve developed great drugs for combating nausea and vomiting, which I can expect to more or less skip over. Too bad no one’s come up with a hair conservation technique yet. I’d take a night bowing to the porcelain gods to keep my flowing locks, but oh well. Chrome dome is the price you pay for admission to the Chemo Club.

Since I just outlined a treatment plan that involves being poked by needles about a million and one times, I’ve decided to get a PortaCath. The “port,” as the cool kids call it, like basically an implanted IV that’s threaded through the jugular vein and into the main valve above the heart, then connected to the outside of your body with a round resealing rubber access point that protrudes about 1/4-inch from the chest, below the clavicle. It’ll make me a lean, mean chemo machine. I also like to imagine it’ll make me part robot. And I won’t have to go through any airport TSA scanners for a year, since between it and the tissue expanders I’ll be like 50% metal.

The PortaCath means one more surgery, but at this point, who’s counting? (I am. That’ll make four. Four surgeries scheduled since diagnosis: mastectomy, port placement, egg harvesting and, eventually, the glorious implant exchange.)

One more quick thing – another beautiful bouquet came today, this time from the pledge class below mine back in my sorority days. Going Greek was one of the best things I ever did, and to this day my pledge sisters are among my best and closest friends. I was so moved to receive such a gorgeous gift from my sisters. Normally I like to thank my thoughtful friends with personal texts and emails (I’m still not into the phone since my phone cancer diagnosis gave me phone PTSD), but I don’t know which one of these beautiful and wonderful ladies to reach out to, so I’d like to thank them all here! You are such wonderful people and I’m so proud you’re my sisters! LITB and AXOXO. Thank you PC ’08! Don’t think I didn’t notice the carnations. 🙂

“Jackson-Pratt drains are pure evil”

The above title is the exact search query I entered in Google this morning, because I had to know that I’m not the only person who is ready to rip these things out of my sides with sheer force and throw them into the garbage disposal for revenge. I am so tired of these awful extra appendages I’ve been given. It’s like walking around with heavy, leaking tentacles hanging off my chest. I feel like a six-armed monster ready to terrorize local children at the park, if I had the strength to walk/shuffle the three blocks to said park.

In my Googling, I stumbled upon plenty of other breast cancer and BRCA 1 & 2 blogs written by women who’ve had the unique displeasure of undergoing a double mastectomy. A lot of these women wrote about pinning their drains to the inside of their blouses to go back to work or wearing a cute belt around their favorite sundress to keep the drains supported so they wouldn’t tug or pull at their skin. WHAT. THE. F–K. You guys, I’m not kidding when I say that I haven’t changed out of the same pair of leopard print pajamas in six days. I’ve taken one shower, and that’s a generous term for what happened, because actually I sat in an iron piece of patio furniture that my dad had brought upstairs while my mom blasted me with the removable showerhead. Basically, I only get up out of my chaise lounge to pee, and I swear that if I could get away with just wetting myself right here I’d do it. How in the world are these women doing anything that resembles normal life? I put on jeans today for my doctor’s appointment and the only thing I could think the entire time I was wearing them was how not worth the effort it was.

Reading these other blogs, I started to think that perhaps I was exaggerating the hospital scene I’d set up in the living room to manage my discomfort. After all, I’ve dropped down to half doses of Percocet (yay for weaning off of dangerously habit-forming opiates!), and my appetite is beginning to return to normal. The only thing that I have to keep in check, sadly, is my sense of humor. Laughter is not the best medicine if you have just undergone massive chest surgery. It’s the single most painful thing on Earth.

There’s another reason I’ve got to turn down the dial on the self-pity, and that’s because two of my awful JP drains came out today! Their output had decreased significantly over the last couple of days, and I knew that today was the day they’d probably be removed. I was nervous and nauseated all morning, because it’s really hard to be excited about the idea of someone pulling a bunch of medical tubing out of the wasteland that used to be your cleavage, even if you know it’ll make you more comfortable in the long run. Luckily, the whole ordeal lasted literally less than a minute. The plastic surgeon cut the stitch on my skin, which was a relief in and of itself, not unlike removing a heavy earring or an itchy piece of clothing. Then she braced herself against my ribs and just ripped those suckers right out.

I’ve been thinking about it all day, and I still can’t come up with a way to describe the feeling. It’s certainly not pleasant, but it’s not painful, either. I guess the only way to communicate it is to say that it feels like someone pulling a foot and a half of plastic tubing through your chest and out of a hole in your side. Because that’s exactly what it is.

The relief was instant! I immediately felt like I could breathe easier, and some of the weird lumps and bumps in my chest disappeared. Some of the tightness is gone, and the pain has decreased immensely. I even felt healthy enough today to relax outside by the pool with a trashy magazine, which had me forgetting for an hour or two that I’m a cancer patient. And when you’re really ill, that’s pretty much the most you can ask for.

The other two are coming out on Wednesday. I’m just counting the days.

Also, I have a little piece of business to take care of. These incredible, beautiful, one-of-a-kind, AMAZING sequined Glamoury Mammary shoes came in the mail today!

Glamoury Mammary Shoes

They’re exactly the right size and I’m already SO obsessed with them. The only problem is that they didn’t come with a note or a return address, so I have no idea who they are from! If you sent them, please text me so that I can thank you. Whoever you are, you are a wonderful person. I can guarantee that these special sneakers will be on my feet at every single scan, test, appointment and chemo session in my future. I know they’ll bring me luck.

Home sweet home

R.I.P. Michelle’s Boobs, 2002ish-January 11, 2013.

Short version: Surgery is over, and everything went great! No complications, pain is now under control and I’m on the road to recovery.

Longer, funnier version: Before I went to the hospital for my surgery, I made the massive mistake of Google-ing “How bad is recovering from a double mastectomy?” The first result was an article from E! personality Guiliana Rancic, and the title of it was: “It was hell.”

I guess that was a little bit of a stretch, but not much. Yes, the pain was bad and the nausea was intense. I spent the entire first day in a drug-induced haze, unable to move or even talk with clarity. I tried to send Gordie a text to let him know I was alright, but my fingers couldn’t hit any of the right buttons. I was so off, even autocorrect couldn’t help me.

But far and away the worst moment of the whole experience was when I first realized I had to pee. A nurse helped me to a little toilet in the middle of the room. It was a big effort because I had been catheterized while in surgery, and the strain of standing and shuffling made me throw up. So there I was, in the middle of a hospital recovery room surrounded by other patients and my parents, mostly naked and struggling to pee while simultaneously vomiting into a pink basin. Welcome to USC Keck Medical Center, please leave your dignity at the door. I am convinced that if there is a hell, it would just be me reliving that 15-minute stretch over and over and over again.

Then, a little bit later as I was becoming more alert, the surgeon came in to talk to me. She gave me the best news I have ever heard in my entire life. I swear that there are no sweeter words in the English language than these:

“Your lymph nodes were clear.”

I was so happy to hear that news that I instantly starting crying. The crying was strenuous, so that made me throw up again. But WHATEVER. A few rounds of chemotherapy and one more surgery to get permanent implants placed, and this nightmare will be behind me – hopefully forever.

Cosmetically, I’m pleased with the way things are looking so far. The scars are hidden on the sides of my chest, so they’re not too noticeable. They’re also a good deal smaller than I expected! The plastic surgeon said my breast volume was only 100cc to begin with, and she already filled my expanders to 80cc, so there’s actually not a massively noticeable difference in size. But there will be when she fills me up to the full 300cc volume of the expander, because that’ll put me between a B and a C cup. Ah, silver linings. I finally get to go through puberty!

Now, I’m home and resting more or less comfortably. I have about nine separate painkillers in my system, which is no doubt assisting with the comfort thing. I have disgusting surgical drains, but I’m getting used to how unsightly and awkward they are. I finally solved the problem of maintaining them, as well as my local ropivacaine drip, by stuffing them into a fanny pack.

So before I slip into another narcotics-induced nap, I leave you with the following mental image of me: I am currently sprawled out on a chaise lounge, wearing leopard print pajamas with a massive black fanny pack around my waist, drinking a glass of prune juice. If you’ve ever had narcotic pain medicine before, you’ll know that the prune juice is actually the most important part of that whole equation. Ick.

My very unorthodox boob job

I just returned from the hospital, where I was given my radioactive injection. Remember when I thought that was going to be so cool? It totally wasn’t cool at all. It was just four needle stabs right in the nipple, accompanied by some nice burning and stinging sensations as the isotopes made their way through my lymph system. It was pretty much a nonevent. I didn’t Hulk out or anything, so that’s good, but we’ll have to wait a few days to see if I get accepted to Xavier’s School for Gifted Youngsters.

After the injections, some big, clunky machines were used to map the radioactivity as it traveled through my system. My surgeon gave me a little tattoo over the sentinel node, which turned out to be the original chunky node that was spotted on the first ultrasound. That’s good news, because it means that if that little chubby guy is cancerous, he’s the only suspicious-looking node in there. I’ve nicknamed him Season 7 Fat Mac from It’s Always Sunny in Philadelphia. It’s kind of a mouthful but he’s worth it. Anyway, there could be more nodes affected by the Big C, but my surgeon reassured me that if I were at a very late stage with lots of lymphatic invasion, that would be noticeable by now. He says it’s sort of a toss-up whether or not the cancer’s made it to my nodes, but if it has, chances are good that only a few are affected. No matter the outcome, he said, the situation will be treatable and, hopefully, curable.

The funniest part about the whole ordeal was when the nurse offered me some privacy so I could change into the gown. I literally laughed out loud because, at this point, who hasn’t seen my boobs? I feel like I should be getting Mardi Gras beads every time I have to go in for a test, which is every 10 minutes. I pretty much just start stripping as soon as I get into any exam room. I’m like a compulsive flasher any time I’m within 100 feet of a hospital.

USC is a teaching hospital, and my surgeon thinks that I am just the coolest (probably because of my winning personality, but it doesn’t hurt that my case is really unusual), so he had a whole team of fellows and medical students come to meet me today once the procedure was finished. I felt like Miss Cancer America. The strangest thing was meeting the medical student who will be observing my surgery from the operating theatre. Since my roommates back in Richmond are two med students and a nurse, I know that plenty of people my age are working in the medical field, but it was weird to look one of them in the eyes and share a silent acknowledgement about just how unfair it is that we’re on opposite sides of this divide right now.

I find that it helps not to focus on the mastectomy I’ll be having tomorrow, but instead to focus on the reconstruction I’ll be having in the weeks to follow. With that in mind, I’ve chosen to think of this as my very unorthodox boob job. But real talk: I’m really, really scared. I’m scared of so many things, like whether or not there’s going to be cancer everywhere, exploding out of every orifice and in every organ in my body, which seems unlikely but I feel like anything is possible because hey, I’m 25 and I have breast cancer! I’m also irrationally scared that I will wake up in the middle of the surgery and the team won’t realize it and they’ll operate on me for hours and hours and I’ll feel everything. I actually brought that one up with the surgeon who laughed and assured me that would not happen. He said machines will be monitoring pretty much everything in my body, and if anything looks off, they’ll adjust the anesthesia accordingly.

Tonight, I have to sanitize basically everything in my life. I need to wash jammies, bedsheets and blankets. I need to use a nasal antibiotic to kill of potential Staph or MRSA germs. I need to wipe down my whole body with these weird germ-killing towelettes. I have to take off my nail polish, wash my hair and I’m not allowed to shave anything, so I hope my docs enjoy operating on my hairy armpits.

Me: “Will you still love me tomorrow?”

Boyfriend: “Yes. Why wouldn’t I?”

Me: “I’m not going to have boobs.”

Boyfriend: “And cancer. You’re not going to have cancer.”

Helps to have someone to put things in perspective. Plus, having talked to my surgeon today, I truly feel that I am in the best possible hands. But it wouldn’t hurt to have a few extra prayers on my side.

Say ta-ta to my tatas, ’cause this is the final entry I’ll write with them. See, boobs? When you mess with me, you get the death penalty and get carted out of an OR in a biohazard bag. Take note, other organs who may be considering mutiny. I will literally cut you.

GUYS. I get to have big(ish) boobs one day!

I originally started this blog as a way to cope and organize my thoughts, not really expecting anyone to read it or care, but it seems like a lot of people are really enjoying my posts! I was trying to tell people individually and at my own pace, but Facebook spilled the beans about my battle with the Big C after I posted the news to a group I’m a part of, so thanks a lot for that, Mark Zuckerberg. Anyway, it really makes me happy to hear that people are reading along. I hope that if you or somebody you love has to go through this nightmare someday, this blog can help you and show you that this disease doesn’t have to be all about crying and pity parties. I did plenty of that, but at the end of the day, feeling sorry for yourself doesn’t cure cancer. Might as well laugh about it.

It’s been a busy morning on the cancer front. Since I have decided on a total mastectomy (F–K YOU, CANCER! I SHOW NO MERCY!), I had an 8am meeting with the plastic surgeon to discuss my options for reconstruction. Luckily, I’m a great candidate for an immediate reconstruction using tissue expanders and eventually implants. There’s another option, where they reconstruct your breasts using fat from other places on your body, but the surgeon took one look at me and told me I just didn’t have enough chub for that. Don’t worry though, I’m working on it. Eating caramel corn as I type.

So, immediate reconstruction means that when the oncological surgeon goes in and hacks off my real, evil boobies, the plastic surgeon will be right behind him, creating a little pocket for an implant and preparing me for my brand new hooters. I’ll actually only have to go about two or three weeks with a totally flat chest (well, slightly flatter than normal), which is kind of nice, since for some reason I was imagining living years as The Boobless Wonder.

As a size 30A, I’ve imagined plenty of times what it might be like if one day I got implants. I thought about how fun it would be to customize my breast size and finally wind up with a womanly, sexy shape instead of looking like a prepubescent boy on his way to gym class, where he’s gonna get beat up by the jocks and probably shoved in his locker and/or given a swirlie. (Did I take that too far? Whatever. Cancer card.) Fortunately, although the experience was dampened by that whole “you have cancer and we’re gonna cut off your breasts and rip out your lymph nodes” thing, it was still just as exciting as I pictured when the surgeon told me I could go as big as I want. Full B, here I come! Fun fact, they actually don’t even make implants as small as my real boobs.

I’ve done plenty of complaining about being so petite, but truth be told, my 30As might have saved my life. It’s unusual to catch a breast lump by self-examination when it’s less than 2 centimeters (mine’s 1.4cm), but because I have so little breast tissue and body fat, mine was easy to spot. Plus, my mastectomy will be a lot less traumatic than some women’s, for a number of reasons. First, I just don’t have to lose that much tissue. Second, my sexuality and sense of femininity has never been very wrapped up in my breasts, so emotionally, I’m not too distressed about saying bye-bye to them. The thing that makes the saddest is that I’ll never be able to breastfeed my future children. Although that gets me down, it’s more important that I get out of this alive and cancer-free before I start thinking about kiddos. Gotta look out for number one.

Even with cancer, it can’t all be bad news

The “infusion room.” That’s what they call the area where they administer the chemotherapy drugs. At Cedars-Sinai, where I was this afternoon, it’s a surprisingly welcoming space with deep geometric aquariums full of colorful fish, big palm trees stretching towards a ceiling dotted with bright, open skylights and comfy recliners equipped with their own televisions and workstations. If it weren’t all the poles and bags labeled “BIOHAZARD – FATAL IF ADMINISTERED INCORRECTLY” full of blood-red doxorubicin, you might think it’d be a pretty nice place to have a Super Bowl party.

Fortunately, I wasn’t at the Cedars-Sinai Infusion Center to actually receive an infusion today. Instead, I was meeting with the first of three surgeons who will help determine the course of treatment for my cancer. He was frank, but what he had to say was mostly positive. And perhaps most importantly for my peace of mind, he helped us fill in some more pieces of the puzzle so we can figure out how to get this monster out of my body forever.

So, we learned a few new things, mostly good things:

First, my cancer is estrogen-receptor positive. This means that it feeds on estrogen to grow, and unfortunately for me, being all young and fertile, my body makes an awful lot of estrogen. But being ER+ is actually good news, because there is a special drug that I can take starve my cancer cells to death, drastically reducing my odds of a recurrence. The drug, called Tamoxifen, will put me into premature menopause – hot flashes, osteoporosis and all – for five years. But it’ll kill the f–k out of cancer cells, and that’s the name of the game here.

Second, preliminary tests indicate that my cancer is very slow-growing – slower, even, than many other breast cancers, with only 5 percent of its cell population actively dividing at any time. This is great news because it means that there is a very good chance my cancer has not spread. The surgeon estimated that there was an 80 percent chance I am still in stage 1 – which sends my odds of disease-free five-year survival well above 90 percent. Nothing is for certain, however, and we will have no way of knowing until my lymph nodes are surgically biopsied. Even if the lymph nodes are cancerous, it doesn’t automatically make me terminal. The surgeon was extremely optimistic that I was at an early stage and my treatment, while unpleasant, will be straightforward and effective.

Finally, there’s the matter of the surgery itself. I have two options – a lumpectomy plus radiation, or a bilateral mastectomy. Since I’m still enjoying the sexiest years of my life, I’m not especially keen to surgically amputate both of my breasts. (I’m a good candidate for reconstruction, however – and what better way to tell breast cancer to shove it than by getting massive fake DDs just for fun? IN YO FACE, KILLER BOOBIES.) On the other hand, the lumpectomy isn’t a perfect option either. Since my tumor is directly above my heart, there is a (very remote) chance that some errant x-rays could damage my cardiac muscles. And while it’s only a few percentage points, a lumpectomy does increase my odds of a local recurrence compared to a radical mastectomy that’ll just rip all of that booby biz right off.

Decisions, decisions. Considering that up until this whole cancer shenanigan, the hardest decision I found myself making on a regular basis was whether or not I wanted Jimmy John’s to deliver when I could easily walk the two blocks to pick it up myself, it’s kind of hard to believe that anybody is putting me in charge of these things. To keep my breasts or not to keep my breasts? That, I suppose, is the question.