Deconstructing the Reconstructing

I've never considered myself to be a vain person.

Yes, I care about the way I look, and I understand the power of appearance in our society. But my parents raised me to value intellect and character. Be confident in your appearance, and then, hit 'em with your smarts.

So if you had told me just a year ago that I would be sitting in a plastic surgeon's office discussing breast implants, I would have said you were crazy. To me, plastic surgery - boob jobs, tummy tucks, facelifts - were for the very rich, very self-obsessed Real Housewives in our society. The portrayal of plastic surgery in popular media borders on the grotesque. I didn't understand people who would go through the risks of an operation for a strictly aesthetic result. It seemed the ultimate in vanity. No, this was not something for me.

Of course, I have never been unhappy with my appearance - until now. Believe me when I tell you that looking at my reflection in the mirror days after undergoing a double mastectomy to treat breast cancer was one of the toughest moments in my life. I now know what it feels like to look at myself and think I'm ugly. I now know the impact that can have on one's life.

I was lucky in that moment to know that the way my body looked was temporary. My plastic surgeon placed tissue expanders in my chest during the surgery, beginning the process of reconstruction.

For the past six months, those expanders have been gradually filled to create a capsule for the silicone implants that will be placed there next week. The process has involved some discomfort, a little pain, and a lot of self-questioning. More than once, I have left the doctor's office wondering why I'm doing this. I'm 55 years old - why do I need to have breasts, especially ones that have no function? Why am I putting myself through the risks of another surgery for a strictly aesthetic result? I can't entirely answer those questions except to say this breast reconstruction is helping me to heal on a deep psychological level.

Despite the questioning, I feel like I have made a good decision, one that is right for me. I spent a lot of time with a doctor I trust going over my options. I understand why some women choose not to have reconstruction. A colleague at work, who had a unilateral mastectomy 10 years ago, chose not to have her breast rebuilt. She met with a surgeon, but decided it wasn't for her. She told me she thinks of her altered body like a Picasso painting. It is a strikingly beautiful image.

I have also since learned more about plastic surgery. Much of what I thought of as plastic surgery is a small subset - cosmetic surgery. The field encompasses much more. This type of surgery restores form and function to a body that is either formed improperly or damaged by disease or trauma. It includes craniofacial surgery, microsurgery, hand surgery, reconstructive surgery, and the treatment of burns. It is much bigger than I thought.

And those people who choose to have cosmetic surgery to feel better about themselves - I get it now. This has been another lesson learned on this complicated journey. Any time I get to learn to be less judgmental of others is a good thing.

Spring Forward

"It's been a long hard year, 

But now the good times are coming

And we should be feeling fine.

But it only reminds us, as our fortunes are turning,

Of the passing of the time."

- Wendy Waldman "Prayer for You"

The clocks have changed, the sun shines higher in the sky, but the temperatures still dip to uncomfortable levels. The first purple flowers of spring have popped in the front garden, but are surrounded by the detritus of winter. The back deck beckons, but a pile of snow still stands with fortitude in the middle of it.

The purple harbingers of spring

Spring in the Northeast United States has been hard coming this year - after a long winter, it's been a laborious spring.

The stubborn snow on the deck

I, too, feel mentally frozen, stuck in the snows of coping with cancer surgery. I feel stuck on October 20, a sunny day with autumn foliage turned up full blast. That was the day I had a double mastectomy to remove the malignant cells that had invaded. The next six weeks, I was in the weeds, mostly housebound, mostly in bed, determined everyday to do a little bit more. The season changed to winter without my even noticing. I've felt cold ever since.

My scarred chest has remained undercover in long sleeve shirts and sweaters. It is hard for someone to notice any difference. But taking off my shirt at the end of the day is still a jarring experience. Tissue expanders have created breasts of sorts, but they are hard and unwieldy. I have visited the plastic surgeon's office every other week for the last four months to fill the expanders. It is a painful process, but designed to create a capsule for the permanent implants to come. For now, my breasts are sort of an odd, lumpy shape, with a certain Barbie-doll quality to them.

I have dreaded putting on the spring clothing I last wore when I had breasts.But last week I pulled out a sleeveless, scoop-neck turquoise dress that had never failed to make me feel good. While the smaller bust size made it a little lower cut than it used to be, I looked - pretty! And my husband certainly enjoyed the low-cut part.

Our front garden in full bloom, May 2014

I had the last fill of the tissue expanders last week. The surgery for the implants is scheduled for later this month, with nipple reconstruction to follow. I'm nearing the end of this part of the journey.

I saw my first robin yesterday. The thaw has begun.

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Please enjoy this song from one of my favorite singer/songwriters, Wendy Waldman. It's from her 1976 album, The Main Refrain. I had it on vinyl and enjoy it today as much as I did when I was a teenager..

Six Months Gone

It was six months ago today that I got the phone call.

I had spent most of the month of July telling myself everything was all right. I went into my annual mammogram in early July with a vague, uneasy feeling. There was no explanation for it. Then I was told to come back in for more imaging. Then an ultrasound. I was still telling myself everything was all right, even when the radiologist said there was an area that needed to be biopsied. In mid-July, I spent a week of mornings having fun with children at our church's vacation Bible school, and the afternoons having more tests. All the while I kept telling myself everything would be all right.

On August 7, my ob-gyn called to tell me things were not all right. I had breast cancer. Additional tests revealed a second area in my right breast. I made the very difficult decision to have a bi-lateral mastectomy. It turned out to be a good one - pre-cancerous cells were picked up in my left "unaffected" breast.

The surgery went very well, but recovery was extremely challenging. Just lifting a coffee cup to my lips was difficult. Brushing my hair seemed an insurmountable task. There was pain and pain medication. There was nausea. There was looking at incisions and scars where there were once beautiful breasts. Shoulders, arms, chest, and back were all affected, but physical therapy has given me back full range of motion.

An Oncotype DX test revealed that chemotherapy and radiation were not recommended for me. The risks far outweighed the benefits. I'm on a five-year course of tamoxifen to increase my chances of long-term survival. I am currently undergoing reconstruction of both my breasts. While it's not the same, I am very pleased so far.

Here are a few things I have learned.

• Life got simpler. Previously I often felt pulled in many directions in life, as a mother, wife, daughter, teacher, friend, colleague. I am now moving in one direction - toward health and life. Everything else will fall into place.
• I look better. I thought it was my imagination, and I have no explanation for it, but my skin is glowing, my hair looks smoother, I have lost some weight. I have a lot of energy. I look at pictures from just a year ago, and I see puffy, chalky skin and dry hair. Maybe my body had been sick for a while. Maybe the lifting of the burden of worrying about my health has paid off.
• I only worry about what's in front of me now. When I first received my diagnosis, I began to worry about chemotherapy. I worried about the pain, I worried about the sickness, and I worried about being unavailable to life. Guess what? No chemotherapy. All that worry for nothing. Lesson learned.
• I can't live in fear. I know my odds for getting cancer again. They might be better than yours. I can't worry about it. I can only do what I can to maintain my health. I get up at 4:30 most weekday mornings to exercise. I don't eat meat, and I try to consume lots of healthy fruits and vegetables. I manage stress.

I don't want to be defined by my experience with breast cancer, but I don't want to forget either. I lost a lot, but gained just as much.

 And everything is all right.

Resolving the Resolutions

"When you die, it does not mean you lose to cancer. You beat cancer by how you live, why you live and in the manner you live." - Stuart Scott

Stuart Scott died early on January 4, but he beat cancer. Scott continued to live his life as a partner, father, and ESPN anchor, despite his struggles with the disease. His words resonated even before I was diagnosed with breast cancer last August.

When you have a life-threatening condition. Scott told us, you don't want to leave everything behind and travel. You want normal. You want your day-to-day life. He fought for seven years to live his normal life. Making long-term goals doesn't always make sense because none of us is guaranteed a long term. 

We are now in the season for long-term goal-setting, the New Year's resolution. I have resolved to look at them in a different way. 

On New Year's Eve 2013, I had big plans for 2014. I had struggled with diverticulitis that year that eventually resulted in surgery on my colon. I was feeling better than I had in a long time. I was going to focus on my work and on my health.

Instead, I found my job in jeopardy and I was battling breast cancer. I was a different woman on New Year's Eve 2014, one whose priorities are definitely different. It doesn't make sense to make plans for the next 12 months, when undoubtedly I'll be different again.

I may rip a page from the 12-Step Program - One day at a time. I could concentrate on how I keep myself healthy just today, how to make a difference for my family, my colleagues, and my students just today. Those goals might mean different things a week from now, a month from now, or a year from now.

Trainer and motivational speaker Chalene Johnson (chalenejohnson.com) advocates re-writing 10 life goals every week. The ones that recur are surely important to you. She also says there will be one or two that, once achieved, will allow the others to fall into place. Being healthy and cancer-free winds up at the top of my list every week, and it will allow me to achieve my other goals.

These kinds of resolutions will allow me to beat cancer in the way I live and how I view the world. When the ball drops on 2015, I will be different. Two things will be certain: Don't mess with me and I am capable of everything. 

Rest in peace, Stuart Scott. My prayers are with your family, your friends and colleagues, and your fans.

Beautiful Angels

There are angels among us. I have often felt their presence, but never more profoundly than during and after my cancer surgery in October 2014.

They wield scalpels and stethoscopes. They bring food for your family. They send cards, flowers, messages. They bring you your breakfast when you can't get out of bed. They curl up in your lap and purr. They pray for you.

You don't see their wings, but you often recognize their faces. But sometimes they are strangers.

The day after the surgery to remove both my breasts, I was hurting physically and emotionally. My friend, Peter called me. "I have something I think will cheer you up," he said.

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Indeed. Peter had secured a poster promoting a concert by singer-songwriter James Maddock. James had signed it to me, wishing me well. It really lifted my spirits to have a personalized message from an artist that I admire so much. It was a simple gesture that had a big impact.

The poster James gave me

I first discovered James when he played a concert nearby. I had never heard of him. By the end of his opening song, I was hooked. He is British, but his music seems uniquely American, rooted in the folk-rock traditions of the United States. He is a fixture in the fertile music scene in downtown New York. He has a distinctive raspy voice, an amiable stage persona, and a quirky social media presence. He's released three studio albums, and his newest, The Green,  is now out and available here at Amazon,. His lyrics seem deeply personal, but listeners can interpret them for themselves.

Like me, James is 50-something, and his songs tend to reflect the themes that inhabit those in our stage of life:

• A longing for more time to explore the roads not taken ("Another Life")
• Messy relationships ("Mister Universe," "What Have I Done?")
• The vagaries of love ("Stoned On You," "Love is a Flower")

One of his loveliest tunes is entitled "Beautiful Now." The lyrics tell of a man looking at an old photograph of his beloved, taken long before he knew her. As he gazes at the picture, he notes her youthful splendor and radiance. Then he hits us with this chorus.

"You were beautiful then/ But you're way more beautiful now."

Those lyrics have taken on a new meaning for me. I don't have the body of my youth, but it had been replaced by one that was stronger, curvier, more confident. The surgery abruptly changed it, and I have been struggling with the "new normal."

At first, I thought the scars and incisions that snake their way across my chest were ugly. They hurt and I hated them. James' lyrics prompted me to re-think them. Now I see the gentle curves and delicate folds as the beauty of health and the brilliance of life. They are beautiful now.

So thank you, James, for taking the time to cheer up a stranger when she needed it. Thank you for your music. Thank you Tracy Plass and Peter Swarr for making it happen.

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Please enjoy this live version of James singing "Beautiful Now."

R-E-S-P-E-C-T

As I continue to recover from breast cancer surgery, I realized that my relationship with cancer will be an ongoing one. I have further treatment to come and continued monitoring for many years. But how to describe this complicated relationship? I have been searching for the right word. A few that I've considered:

• Fear - My tendency with fear is to hide under the bed and wait for whatever is scaring me to go away. This is not a good strategy for maintaining health. We all know people who avoid doctors and tests because they are afraid of what they might find. So fear is not the right word.
• Hate - It's easy to be angry and hateful about cancer. I've seen it ravage the bodies of people I love. Some of them didn't survive. But hate is a heavy burden to carry. To me it also implies malice and intent. Those little cells were once a normal part of my body. For a variety of reasons, they broke bad. I don't think they were out to get me. If I did hate them, I forgive them now. They are gone.

In talking to my husband about this, we came up with a new word: Respect. I respect cancer. I respect its power. It is an adversary worthy of my due diligence.

I respect cancer enough to have routine regular screenings, one of which resulted in my diagnosis. I respect cancer enough to find out as much as I can about it and its treatment. I respect cancer enough to seek out the best medical professionals to help me fight it. I respect cancer enough to carefully follow post-operative care instructions and recommendations for ongoing treatment. I respect cancer enough to research diet and lifestyle changes that can help me keep it at bay. I respect cancer enough that I will do whatever I can with my life to help those who are coping with it and to see it eradicated.

So, I have a new mantra I repeat in my head. They are the words of the incomparable Otis Redding that have been immortalized by the Queen of Soul herself, Aretha Franklin.

"R-E-S-P-E-C-T

Take care, TCB"

Baring the Scars and Bearing the Scars

Nothing prepares you for the first time you look at your mastectomy incisions.

Nothing.

No amount of preparation and looking at photos of other surgeries. No amount of love and support from your spouse and family. No amount of emotional strength (you think) you have.

When I took my first shower after surgery last week, I finally had the courage to look in the mirror. I saw myself as torn apart. Ripped. Ruined. And I cried. I gave myself permission to mourn the way my body used to look. But in the midst of the tears came another image.

The new smoothness of my chest reminded me of the days when I wore undershirts and camis. I remembered the cute little sundresses my mom dressed me in. There were no worries of bra straps slipping or too much cleavage showing. I could almost feel the golden California sunshine of my 1960s childhood.

It's not that I want my body to look like a little girl's - I'm having reconstruction done. But that fleeting image reminded me of two important things:  1) that beauty comes in many different forms and 2) my body has been constantly changing since the day I was born.

I recall when I was pregnant with my son. My body dazzled me almost daily with the changes it made to grow a little human boy. I am no less astounded by my body's ability to be up and walking mere hours after major surgery and that my use of my arms is coming back so swiftly. It is now working hard to scar over the incisions and heal. Amazing! Among the strongest parts of our bodies are the scars.

I am fortunate that the surgery went well. The sentinel nodes were clear and the margins were clean.

I have since spent more time with those incisions. They are healing well. I don't feel as troubled by them, and I know the scars will continue to fade. I have begun the process of reconstruction with a wonderful plastic surgeon. He told me from the start that I won't be the same. All I want is a little piece of "me" back. I don't think I want to fill out a D cup again. A little extra perkiness would be nice.

So, cheers to change. As my husband and I gazed at the new topography of my body he said,. "This is what healthy looks like."