Memorial Day weekend 2005 found me heading away from the Jersey Shore to Manhattan, where my surgeons waited to perform double mastectomies and my coveted DIEP flap reconstruction.
Now, the thing about the DIEP that is really challenging is that it’s a long surgery. There can be complications, and success is not guaranteed. Not a bit of that impacted my determination to get it done. I really believed it was going to be fine and, if the new girls were too indeed small to fit my frame, I figured I could always get implants later, though it seemed unlikely I’d ever want a foreign thing inside me.
I was concerned, however, about perhaps falling into an irreversible coma during the procedure. The Terry Schiavo case was all over the news back then, and the phrase ‘persistent vegetative state’ was on everyone’s lips. I made sure my insurance, my last will and testament, power of attorney and all that was in order before I left home. I had intense anxiety about my little boy, fearing that if I never woke up he wouldn’t understand how deeply I cherished him, how his birth had been the greatest gift of my life and how in his smile I saw the complete and total sum of my heart.
And though it tore at me to imagine him being, as Clapton sang, a motherless child, I never considered not going through with the surgery. I never gave a moment’s thought to its failing.
In the end, however, that’s exactly what happened.
The moment I awoke from surgery, I knew things had not gone well. I was too alert for coming up from almost a day under anesthesia. Looking around, I croaked until someone came up to me. My memory of who spoke is foggy, but the first question I asked was ‘did the DIEP work?’ and the answer that came back was ‘No.”
It took a small eternity for me to process this word.
It hadn’t worked. The DIEP had failed, which meant there were expanders in me. Instead of living, swinging breasts, I had empty, plastic balloons. Talk about a letdown. I fell into a state of disbelief.
After all I’d gone through, how diligent a patient I’d been, how resourceful I was to stick to my guns and never let those insurance representatives bully me out of my preferred procedure – it failed. How could that be?
A chasm opened up, dark and wailing and so deeply, crushingly sad I found myself unable to accept what was an absolutely undeniable, irrefutable truth –
My boobs, my living, breathing, naturally hanging boobs, were gone. In their place were the dreaded expanders, and the vision I’d been holding onto of being as good as new in just a couple of weeks faded away.
I wasn’t going to get girls that were better than the real thing because they were made of fat and not cancer-growing ingredients. I wasn’t going to hit the beach this summer with super short post chemo hair and a pair of tiny titties bouncing around just like the real thing. No, I was going to be fake. I was going to have two round melons sticking off my body, and just to get them would have to endure months of doctors visits and more surgeries and anesthesia and skin grafts and no, oh no, oh God, no, it can’t be, it can’t have failed. My boobs – my boobs, why? Why didn’t you work, why didn’t you come to me, how could you have failed me, where are you my boobs?
I didn’t cry much during my cancer experience, but I cried then, thick salty tears that fell in a puddle below my ears, leaving a cool stream of misery on my cheeks.
My boobs – Oh God, it was awful, understanding that what I wanted was never going to be. The pain burned down to my soul, fueling my tears. I had tried so hard to be a good sport, and not complain through all the months of treatment. I tried to keep a sense of humor about going bald and gaining weight and having yellow skin and no eyelashes and being sick and weak and pimply and unable to taste anything but metal.
I really tried to not let the cancer get to me, seeking the bright side and all that light at the end of the tunnel stuff everyone claims is half the battle when it comes to beating the big C. I reverted to my Catholic School Girl mentality, doing well and expecting to be rewarded for my hard work and really, what was so unattainable about what I was asking for? All I wanted was something small to replace what was no longer safe to keep, but it seemed that wasn’t going to happen and the finality of this sliced through me, cramping my surgically tightened guts, making me feel like I could vomit for the next ten years and never fully expel the disappointment saturating my psyche.
Devastated, I was also developing a searing fury towards my doctor. All night, in post surgical pain and sharing a room with a mentally challenged woman who spent the entirety of our co-habitation screaming at the top of her lungs ‘oh Lord, help me, my legs!” I thought of his assurances that my new boobs would be small, but fine. I thought of the repulsive plastic things inside of me, and all I was going to have to deal with now before this nightmare known as breast cancer would be over. In the dark, shutting my eyes and ears from the noise of my roommate and the nurses who came to the door every fifteen minutes imploring her to shut up, I silently cursed my plastic surgeon with language that I think might have made a drug dealer blush.
I suppose at some point I slept. The long hours passed, the sun came up through the eastern facing windows, and Bruce arrived. He knew how freaked out I was. I think maybe he even warned the doctor, because when arrived he had just the right amount of empathy and regret to mollify my rage. He took my hand, smoothed my shiny bald head and said he was sorry. He knew I was upset. He also heard what a rough night we’d had in my room and had already made arrangements to move me away from the screamer. It was going to be all right, he assured me. He would make sure I ended up happy.
What could I say? It wasn’t my nature to beat up someone who had already apologized for his errors. Tearing up again, I asked him what had gone wrong.
“You had no fat,” he said. “Or actually, the fat you had was no good. After your C-section, the scarring in your abdominal cavity was significant. The fat pedicle was atrophied. There was nothing live to work with.” He smiled. “You made yourself so fit after having your baby you left us with nothing to use.”
In the grand tradition of saving the best for last, I suppose that was the greatest of all my cancer ironies. I’d spent my entire adult life eating healthy, vegetarian-like foods, shunning red meat, avoiding alcohol, exercising fanatically, doing yoga and staying out of the sun, yet I ended up with a set of very aggressive malignancies and now a body too lean for a DIEP.
It was kind of funny, if you really thought about it. Lying there between my husband and my plastic surgeon, I felt the knot in my stomach begin to loosen. While other women could smoke cigarettes, swill cosmopolitans and pull from endless stores of fat in their thighs and bellies and butts, my Spartan mentality and tightly muscled body offered up no protection from cancer or the resources from which to harvest enough slimy white stuff to make a pair of boobs.
Considering the cause of the atrophied fat, my spirit lightened even more. I’d had fibroids on the outside of my uterus, which my obstetrician had warned early in my pregnancy would likely drop into my vaginal canal during labor, blocking natural delivery. Being 40, over the moon happy about this one and only chance to be a biological mom, (our older boy was Bruce’s child from his first marriage), and not about to let anything stand in the way of my baby arriving healthy, happy and without incident, I immediately booked a C-section.
Other women told me to wait, to ‘try’, to see if perhaps a vaginal birth would be possible but I never second-guessed my decision. I wanted my baby more than anything, and wasn’t going to take even the slimmest chance something might go wrong. My son was born at 38 weeks a whopping eight and a half pounds, with all his fingers and toes and a head full of hair. He was gloriously perfect and beautiful and such a joy and blessing nothing surrounding his existence could ever be less than a miracle to me. If atrophied abdominal fat was a by-product of his birth, so be it. I didn’t care, as long as I got to be his mom.
And just like that, within seconds of hearing why my boobs had bailed, all the anger and pain and sadness vanished. I started to laugh, a rueful little chuckle at the insanity of this whole journey. Implants, expanders, atrophied abdominal fat –who cared? I had Bruce, we had our family, my life, and whatever my new boobs ended up looking like, as long as I still turned my husband on, as long as I could continue living and loving and being here on this earth, what difference did any of it make?
“Oh Jesus, God, my legs! Help me Lord!” my roommate screamed.
The three of us burst out laughing. A nurse came and wheeled me down the hall to a room with a spectacular view of the East River, and for five days I convalesced before being released to begin the last phase of this long journey to normalcy.