Today I had occupational therapy in the morning (doing great, they are not worried about my strength, they want to continue working on my flexibility) and a meeting with my surgeon in the afternoon.
The highlights of the surgeon meeting were: discussing a flat closure, talking about timing, and learning about what to expect as far as what I'll be able to do physically after the surgery.
I have mentioned this before, but I will not be doing any kind of reconstructive surgery. As soon as medical professionals check and double check this a couple of times, they then go into a very "that makes it so much easier for everyone in a host of ways" (Examples: it will be less painful for me because I won't have expanders, radiation will be easier because it's not trying to work around plastic, scheduling will be easier because it's just one surgeon instead of two surgeons, etc etc). I am so curious about how this information is presented to people who do decide to get reconstructive surgery, but I guess I'll never know.
Because I will not be getting reconstructive surgery, I would like a flat closure. This is a very important thing to discuss with your surgeon ahead of surgery, and it's a very important thing to feel like your surgeon understands and is on board with before surgery! A flat closure just means they remove more skin, and you end up with a flat chest. The alternative, and what is done if you're planning to do reconstruction, is they save as much skin as possible because that will be important when they're rebuilding the breast. If you get this kind of closure and you don't get reconstructive surgery, you end up with a lot of loose skin on your chest. I had a friend who had a double mastectomy tell me, "Ask about aesthetic closure. Ask about a flat closure. I didn't and I wish I had." I don't know how often it happens now, but I have read a number of accounts of people who wanted a flat closure, but whose surgeons didn't do it (either because they forgot maybe? Or they assumed the person wanted reconstructive surgery later?). The American medical establishment's historial preciousness around breasts is weird. See also: the breast cancer awareness shirts that go all in on "save the boobies" and things like this. No, I would like to save myself. And I don't want to have any more surgery than I have to. I want to recover as quickly as possible. My sense of who I am is not tied to any particular part of me, and while I know it'll take some getting used to when I look different, I also know I will get used to it, and it'll be great. I am lucky, because I'm fairly small (frame, etc), and it's not going to look that different for me to go from what I have right now to nothing.
Anyway my surgeon was totally on board with that, and explained the difference (which is why I was able to explain it to you in the paragraph above!).
As far as timing, they usually schedule surgery for 4-6 weeks after your last chemo session. This will put my surgery in late November, assuming that I continue to handle chemo well, and we don't have to reschedule any sessions due to bloodwork results. Fingers crossed for that.
Post-surgery, I wanted to know about my physical limitations, because I've had friends who have had slightly different surgeries who had a lot of tips on how to get the house ready, what I would or would not be able to do, etc, but I wanted to actually talk to the doctor. My main questions were "will I be able to get out of bed on my own, will I be able to get out of a recliner." The answers to both were yes, with the caveat that one arm is probably going to be a little more limited in movement initially (because I'll be losing some axillary lymph nodes) but he thought I probably wouldn't have that much trouble with these specific movements.
There's still a lot of chemo go to, and after surgery, I've still got a month of radiation, but it's nice to feel like I'm getting ready for the next step. I'm feeling relatively good, I continue to really like all my doctors and nurses, and I feel very lucky to have the insurance I have, and be at the hospital I'm at.
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