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My Walk Down Cancer Lane

by Nancy S.

At 47, I received “the letter”…the one that says, “…you are requested to attend a repeat mammogram…” 

Ok, I never minded the process of having to turn my breasts into pancakes since it was pretty quick.  

A few days later, I was asked to return to the imaging center, as they wanted to do a stereotactic biopsy.  My husband went with and waited while I went on my new adventure.  I don’t recall much pain at all but I did end up with a memento – a large hematoma.  The bright light was that I didn’t do a post mammogram afterwards.

Following the biopsy results, I had a meeting with the nurse.  My darling patient husband went with me to hear about the news - “DCIS” – the earliest form of breast cancer”.  I thought, “Ok, that’s fine.  I don’t mind hospitals or needles so this will be a snap”.  On the other side of me, I felt a huge surge of tension and I realized my husband was terrified.

We continued listening to the nurse about the treatment choices and how they would line up surgeons/doctors.  The drive home was pretty quiet but I was already thinking of all my appointments.  I went into planning mode and my husband went into catatonic mode.

With the choices made (lumpectomy, no lymph node testing), I was all set for the surgery.  Off we went to the imaging center where I had my first dose of lightheadedness.  About the time the thin wire (wire localization) was placed into my breast, they proceeded to mammogram it.  Nothing like standing alone, looking down at a wire poking out of my breast while the machine did it’s squeezing routine.  A chair was brought in so I wouldn’t fall and hang by my breast.

Driving to the hospital and trying to keep my head upright so as not to poke my eye out, we arrived in plenty of time to sit and wait.  When they finally called me into pre-op, we went through the regular routine of surgery.  Undress, put on new socks and cap, sit in bed, get hooked up to the IV, talk to the nurse, talk to another nurse, see sweet husband’s concerned face, talk to anesthesiologist, wonder when it will start….

Surgery was quick and pain free.  I immediately requested that my husband take me to Starbucks.  Off we went.  Had a wonderful latte and came home to rest.  No biggie.

Had my post-op appointment with the surgeon.  “We didn’t get it all – none of the margins were clear”.  Oh joy.  Planning mode was engaged again.  Dear husband was scared.

Next surgery was a month later.  Same hospital routine.  Same post surgery routine with – yet another – wonderful latte.

Post-op appointment was better.  “Only one margin wasn’t clear but it’s very close to the skin”.  Nifty.  More planning was done for radiation appointments.  Began my paper collection of surgical reports and pathology reports.  Maybe I could have a bonfire when all this was over with!

Enter Del Amo Diagnostic Center.  Had the initial scans and whatnots.  All fun.  No pain. Same time every day, same dear faces of others that had more serious conditions, same short burst of radiation and then the crème de la crème – a stop at Coffee Bean and Tea Leaf.  Dear husband and I would treat ourselves to a bear claw and a cup of post-radiation joe.  Home again to test efixes thanks to working at a wonderful company that allows this.

Radiation completion date nearing, we wondered what was next.  I gave myself time to get used to the “twice sliced” right breast.  Didn’t sit right even hidden in bras and it certainly looked alien upon exiting the shower and seeing it in the mirror.  Could I live with it?  One ptosis breast and one partially surgically removed breast. 

After 8 months of contemplation, I decided I wanted to fix my image.  Off I went to get consultations.  My thought was to find two doctors that agreed on the same course of action.  First doctor: take part of my back to create the right breast again and lift the left breast.  Second doctor: plug in implants in both breasts under the tissue.  Third doctor:  Implants under the muscle.  Oh dear.  Different opinions.  Number one’s recommendation sounded complicated.  Number two and three talked about implants.  Easy?  Yes.  Speedy return to normal?  Yes.  I had heard that placing the implant behind the muscle not only keeps it in place, but it makes it easier to view the tissue during the mammogram procedure.  Ok, choice made.  Doc number two.

First procedure was October 31, 2005.  The right breast looked like an elongated egg and the implant hung somewhere just under my collarbone.  Lovely.  A tight, rigid goose egg. 

Second surgery was done on March 1st 2006.  Doc forced that implant down into the pocket and stitched sutures above it to keep it from rising like dough.  Did a ‘crescent’ lift on the tube sock side.  Why did I feel like having a croissant after that?

During all the breast fun, my body decided it wanted more.  I snuck a D&C in there since I had bleeding that started on April 30th and didn’t stop for a few weeks.  The fun never ends.

Before my third surgery on July 7th, I decided to get a second opinion.  It seemed like things were not improving much and I wanted to know if this was the usual or not.  The doctor at UCLA said that implants were NOT a good thing to do after radiation.  He went on to say that there’s always a chance that the implant will continue to want to rise up.  I went home feeling down about everything but felt I was already on a course of action and would proceed with the next surgery.  Doc was going to do a complete lift on the continually slinky left breast.

Post-surgery, right breast still very tight and uncomfortable – getting back cramps but no other cramps which may signify the rite of passage to menopause?

Fourth surgery was conducted on October 26th to move the oddly placed nipple on the right breast and raise the left inframmamory fold on the left breast.  First disaster struck.  Original lumpectomy incision opened up.  Doc stitched it closed in the office.  Thank goodness – I didn’t want to see a cracked egg shaped breast looking back at me.  On the other side, my slinky breast did not take to being raised up.

Stitches reopened in March of 2007 and – yet another – surgery was scheduled on April 13th, 2007 to close the wound.  In addition, scar tissue was removed and a capsulectomy was performed. 

Open, Open Open:  Fast-forward a few weeks and the incision reopened again.  Doc tried doing another wound closure in his office but it reopened and another wound appeared at the bottom of the right breast.  My skin was literally falling apart!  My family doc sent a culture off to see if there was an infection.  Lo and behold, pseudomonas aeruginosa!  He started me on Cipro and sent me off to the Infectious Disease Center.

The ID doc took one look and said the implant must come out as well as the alloderm.  She said to stay the course with Cipro.  Off we went to get the implant removed.  The extraction didn’t hurt except that more wounds had opened up at the bottom.  Each time the skin began to open, it was like having a bee sting me continually.

Weekly visits at ID Med from May through September.  During that time, they determined that Cipro was not taking care of the infection so they had me begin daily IV infusions of a new antibiotic.  It began on my birthday - July 23rd!  I did not want the PICC line so I chose to have them remove the IV port every few days.  The last infusion was on September 7th 2007.  YAY!  Since the ID doc and the Wound Specialist said there was nothing further they could do to close the wound, I called my oncologist to find out who I could see for the mess I’d gotten myself into.

Fast forward to my angel.  On September 10, 2007, Dr. Mark Kobayashi at UCI came into my life with encouragement, joy, tenderness and concern.  He looked at the photos I’d brought along and said he could help me.  My next appointment was on the 24th and he took one look at the wounds (still oozing), and said, “it’s time for surgery”.

On October 5th 2007, my wounds were miraculously closed up.  My oncologist called this a true mastectomy.  I had drains coming out but no more oozing.  My dear husband didn’t have to bandage me daily anymore.  Since he kept me in the hospital for 3 days on antibiotics, we were sure the infection was long gone.  Dr. Kobayashi watched me like a hawk to make sure things were progressing normally.  With his warm and happy demeanor, my husband and I looked forward to each and every visit.

Since my right side was now a bit concave and somewhat stuck to the chest wall, Dr. Kobayashi wanted to wait until we saw some “movement”.  It took about a year but we finally saw the skin relax a little on the right side. skin.  During that time, he began the arduous process of making my left “slinky” change into a normal breast.   The day he said it was time to do a lattisimus dorsi flap procedure on the right side, I was excited to finally to get part of me back (so to speak).  My back muscle was tunneled through to the front and an implant was placed behind it.  It was a very long surgery but when you have an angel of a doctor who is a perfectionist, it takes time to make things “just so”.

I woke up and couldn’t believe I had a breast on the right side!  There was a skin patch the shape of South America but it sure looked great! 

Fast forward to several surgeries where Dr. Kobayashi did a tremendous job of removing most of the skin patch…all due to my skin stretching even after radiation!  He also kept up the heavy weightlifting job of keeping my left breast up by tacking it to the ribs.

After a total of 16 surgeries since my DCIS diagnosis, I actually look better that before it all started.  The scar on my back is my badge of honor and I feel blessed to have gone through the process like so many others.

Most of all, I have met the most incredible man that has the joy of a child, the compassion of an angel and humility that is so rare these days.  He is truly my angel and my husband and I love him deeply.  

Looking back, this journey was easy at times, even (dare I say) fun, but there were times of deep depression and hopelessness as well.  I’ve learned that everyone reacts differently when they are told they have ‘cancer’ but when we reach out to others, it becomes easier and we learn so much about courage, support and compassion.