*This is *my* experience, not everyone’s. Also, this is authenticity. That’s what you get with me. I want to model that which I value. Also, also, I continue to document my cancer story to bring awareness to the REALITY of a word that tends to remain vague for those not *in* it. This isn’t so much a ‘life coaching post’ but rather an opportunity to learn about the inside of cancer. Please, allow my story to invite an encounter with empathy. 🫶🏼 I appreciate your time reading.

I get ‘the phone call’ – “You have cancer.”

4 days later I’m in a consult for surgery – bilateral mastectomy. Amputation. My only option because of how aggressive my cancer seems to be, because of my age, because of how high my chance for recurrence is. 

General Surgeon consult. Everyone is telling me that because I’m so young, I’ll want/need reconstruction. No one in my medical care team is spending equal time on ALL of the options. Instead it was mostly focused on, “if you want to have all of your *recon* options available to you once treatment is over, you’ll want to meet with, pick and schedule a plastic surgeon to join me, (general surgeon) in the OR.”

“Uh, ok. I guess…” I don’t even have the bandwidth to think of anything else. I’m spinning on ‘you have cancer’ and ‘it’s looking pretty advanced’ and ‘hopefully it’s not in your bones, liver, brain or lungs yet…’

Not to mention the fact that at this time in my cancer timeline, the ONE person I know that has ‘gone before me,’ gave me this advice: “just show up when they tell you to so that you focus only on the battle to live.” Sage advice for someone looking at life and death.

So, “ok. Where am I going today? Oh, the plastic surgeon’s office for a consult?! Ok. Wait. A plastic surgeon?!”

‘Just show up. Just show up. Just show up.’

---

Plastic surgeon says, “let’s talk recon. We can do skin-sparing but can’t do nipple-sparing. Those gotta go cuz they are really sick. But, here are 50+ pictures of women that I’ve operated on. I’m top 5 in the country and can build you amazing breasts after your BMX and any treatment you have to have. Yes, you have the option to go flat but I’ve never had a patient under 70 choose that, so there’s that. Every patient I’ve seen under 70 has been reconstructed and my patients are very happy with their results. I can even make you new nipples that look really real! Then you can have professional tattoos done to make them the right color and look 3-dimensional! Here are some pictures of those, too.”

“Uh, ok.” I’m only 37. Skin…nipples…3D tattoos….I’m not even close to 70…book….cancer….close it…top 5 in country….

“Of course, I also have to tell you that the stars will have to align to get me, an OR and your general surgeon all lined up schedule wise, so you should probably decide soon.

“Uh. Ok.” 

(Mind you, for me, it was surgery first, treatment after. So, I have literally minutes to make this decision. Everyone around me is urgent and pressing urgency. My cancer was not to be effed around with. And the surgeon had another patient waiting in the room next door. My best chance for stars aligning was to say yes. Instantaneously.)

So, “Um, sure. You can be my surgeon.” I guess we’ll go with this guy. He’s a cocky plastic surgeon…and don’t you want a cocky plastic surgeon?! He wasn’t rude or disrespectful, knows his stuff, has pictures to prove it all, and was nice enough. I guess let’s try to see if the stars align. We don’t have time to waste on other consults.

The stars aligned. On my way home from that very appointment, I got the phone call from his nurse navigator, “the galactic star-gods favor you. 8 days from now there is an opening in all three calendars. This was NEVER expected, would NEVER happen again, and I’d lose out on ‘once in a lifetime’ luck if I didn’t say yes.” 

So, “yes” it was. Sure. I’ll have a literal amputation 8 days from now. 13 days after my phone call where I was thrown into cancer.

“Good. I thought you might say yes. You’ll need to be prepared for 3 pre-op appointments prior to surgery next week, stay tuned. I’ll call you with dates and times, ok.”

“Ok.” 

Just like my friend said: Just say ‘ok’ and just show up.

I did in fact have an appointment every day leading up to that surgery day (not including Labor Day of course. A day of rest. Ha-freakin-ha).

Pre-surg bloodwork. Physical therapy consult. Pre-surg consult. Pre-surg marking appt. And no context to go with any of those.

‘Just show up. Just show up. Just show up.’

---

Surgery day. Radioactive contrast pushed through my veins to illuminate cancer in my lymph nodes. Amputation. Expanders. Drains. Overnight stay in hospital. Round-the-clock touching.

Waking up and looking down to see what my body looked like without body parts. Having my drains stripped by nurses. Them teaching my husband how to strip my drains. Having t-rex arms. Needing help to shower. Having pig skin and cadaver tissue sewn inside of me holding in ‘expanders’ which I was now gonna have to go get filled up once a week for 6 weeks with a needle and saline. Expanders that were placed under my pectoralis muscles. Expanders that were painful. But, that is what breast cancer patients do. Especially cancer patients under 70. Especially cancer patients under 70 because they will want to “look and feel normal after all this is said and done” so they can “move on and close the book on all this cancer stuff.” 

Expander fill-ups. Extreme pain. Physical therapy. Worse than extreme pain. Post ops a-plenty. 

‘Just show up. Just show up. Just show up.’

---

“You’ll have to pause all reconstruction options until after treatment because your pathology came back. It’s advanced and in fact aggressive. You’ll need chemo and radiation. Your PS won’t even discuss recon until 3 months after radiation. It won’t be until sometime next year that you even start talking about it. Now it’s time to pick an oncologist.”

“Oh, ok. So these expanders (hard as rocks, painfully stretching out skin and muscle, forming ‘pockets’) have to stay in until next year?” Chemo? oh god. Bald. Chemo. C h e m o. Radiation. Recon next year. Oncologist. 

Port placed.

Chemo.
Chemo was soul-sucking. E.v.e.r.y.r.o.u.n.d.

Radiation.
Have one expander emptied for radiation to work. Lopsided. Stuffing my bra like an insecure 5^th grader.
Radiation was soul-sucking. E.v.e.r.y.d.a.y. 
Expander refilled all at once (extreme pain). 

‘Just show up. Just show up. Just show up.’

---

Then it was sometime next year. . . . . . .

Skin checks with PS 3 times over 3 months.

Consult time. “Okay, let’s talk recon options. We’ve come this far, flat just doesn’t make sense at this point. You’ve suffered this much with expanders, why give up now? So, there are three different flap procedures you’re eligible for. You can’t have implants bc of radiation, they will likely be rejected and will be too much for your radiated skin and tissues to handle. So, flaps: we can take your back muscles and flip them forward and up to make breasts. We can take your ab muscles and flip them up to make breasts or we can take this really nice belly fat (aka mom pooch) you have here and make breasts and give you a tummy tuck while we’re at it. That’s always a nice little perk.”

“Um. I really don’t want to move muscles around so let’s go with the mom fat. Shrug. Anything to get these expanders out.” 

“Okay, sounds great.” Surgery is scheduled in 2 months.

Phone rings – “Hi, your surgery can be in 3 weeks cuz we had a cancellation. Want it?”

“Uh, sure. I guess the sooner we do this the sooner I can start my recovery to ‘all better’ and close that book you all are talking about.”

‘Just show up. Just show up. Just show up.’

---

DIEP surgery. Hip to hip incision. Can’t stand up straight for weeks. Drains. 3 days in the hospital. Hands touching me and pushing down on me and feeling for heat. ‘Successful surgery’ in that the ‘transplanted fat lived on both sides and the redesigned blood vessels took’ even after radiation. We’re lucky.

Day 3. Take off bandaging. Look down. It’s ugly. The scars are horrific. Boobs horrendously lopsided (so is my replaced belly button). I look ridiculous in clothes. Radiation is to blame. But, I showed up like I was told. Surgeon kept me alive. Did a great job with an incredibly intricate surgery. I have hope that it will all be worth it. It has to be.

Post op. Surgeon isn’t pleased with how the fat on the left side is doing. Damn radiation. It sometimes happens. It’s unfortunate. Let’s do a revision. “I can harvest fat from other places on your body and inject it into your left side so that we can achieve better symmetry. Of course, they will never be perfect and they are sisters not twins, but I can get them close. You have some great fat on your legs and back and butt to use. Keep eating ice cream.”

‘Just show up. Just show up. Just show up.’ And keep being fat, I guess.

---

Revision 1. Day 3. Devastation. Radiation to blame. Pancake on left. Plump on right.

Post op. “Okay, well, let’s try again. You have such great fat. We can put the fat here, here and here this time to create the shape of round instead of pancake. I’ll not put fat in the other side as much this time. It seems to like it over there on the right. The left, not so much because of radiation.”

Revision 2. Day 3. Devastation. Radiation to blame. I look ridiculous. 

Post op. Left side too high. Right side too low. “But, we’ve worked so hard. Why give up now. I have another technique I can try. I can remove skin from right. Tighten up right so that it lays higher like left. I’ll put fat in a different place on left. It’ll work.”

Revision 3. Day 3. Devastation. Radiation to blame. We’re all doing our best but I still look ridiculous. 

Post op. “Oh man. Radiation has done a number on you. I am seeing, though, that all of this fat grafting is really helping your radiation burns, both internal and external, heal. You’ve got great looking skin and tissue now. All of this is worth it.” 

“But, symmetry of any acceptable sort is not happening. I can’t go anywhere without stuffing my bra to look even from the outside. This isn’t supposed to be. This isn’t what I was ‘sold.’ Can I do implants under the DIEP to help? I really don’t want any more surgeries.”

“Yes, actually. Because your tissues are so much healthier, your implants should thrive.” 

‘Just show up. Just show up. Just show up.”

---

Revision 4. Implants placed. Day 3. Devastation. Huge and awfully uneven. Radiation to blame. I look ridiculous.

Post op. “Well, okay, we’ll have to do more fat grafting. Your body took the implants differently because this isn’t just an augmentation since you’ve had a mastectomy. I’m still battling against radiation, so let’s keep trying.”

Revision 5. Day 3. Devastation. Radiation to blame. It’s not working. “But let’s keep trying. We’ve come this far. You still have great fat.” I’m so glad my fat is so good. At least I’m doing that right. And you’re right, it’s dumb to give up now.

Revision 6. Day 3. Devastation. Radiation to blame. It’s not working. “But let’s keep trying. We’ve come this far. You still have great fat. Let’s do an implant exchange and I’ll use two different sizes and shapes of implants. That should do it.”

‘Just show up. Just show up. Just show up.’

---

Revision 7. Implant exchange. Day 3. Actually looks amazing. Success! We did it.

[A significant caveat – at no point during this recon journey am I allowed to exercise to be at a healthy weight. Not only did I need to keep making fat by ‘eating all the ice cream’ to be able to transfer and graft it, also, where do women lose weight first – boobs. So, why would I exercise and undo everything that I’m doing by exercising!? Why waste this pain and suffering? Why make it even harder to not look ridiculous? And this isn’t even a ‘vanity’ thing, it’s simply me, grasping at straws, to be human, in the most unideal circumstances, with no luck of any kind working in my favor. I mean, other than waking up from anesthesia each time.]

I went a whole year without a surgery. It was glorious. (Of course, I still wasn’t able to exercise cuz I can’t mess up what we finally got right……..)

But it was also a whole year of feeling like trash. And wondering why. 

Consult with PS. “Um, I think the implants are making me sick.”

“You’ll need to rule everything else out before I consider removing them. We finally have success. It’s only for your good that I won’t remove them until it’s our last option.”

“Ok.” 

So, multiple doctors. Attempt to rule everything out. Asking ‘Why do I feel sick and in pain and exhausted ALL.OF.THE.TIME?!?’ It wasn’t tamoxifen. I stopped taking that…risking recurrence for quality of life. It wasn’t anything my bloodwork could diagnose. It didn’t appear to be autoimmune even though it felt like it. 

So?? Could it be the implants? It might be the implants. It might, in fact, be the very thing that has ‘worked.’ My.dumb.luck.

‘Just show up. Just show up. Just show up.’

---

While ruling everything out that year, I also spent that year living in a body that constantly attacked me. Physically, emotionally, psychologically. My fake boobs were suffocating. They were too big. They were too heavy for my brutalized body. They were incredibly painful. I couldn’t sleep at all because of the pain, therefore, chronically sleep deprived. Bad. All bad.

It was time to get the implants OUT. Because either it was the implants or I was “one of the few” stuck with chronic illness the rest of my life because of cancer treatment, but I did what I was told…. I ruled everything out….. I made this my last option….. It simply HAD to be the implants….. Please let it be the implants…..

But, I also realized something else: That not only was I desperate to get the implants removed, I was desperate to get all of it off. I hated living with an elephant’s ass on my face every second of every day. And it wasn’t until I had time away from ‘just trying to fix it all’ and ‘make it all worth his while and my pain and suffering’ and ‘doing what everyone else told me to do’ that I realized I should have just gone flat to begin with. Hindsight, turns out, is always right. 

So, instead of just taking out the implants, let’s take it all. I know it seems wild after everything, but here’s the kicker —–
—–IF I take out my implants, I’m back to my own fat. Which, by experience, didn’t do so well on its own. Option 1: I’m only ever going to be never exercising so that I don’t lose whatever symmetry we can create; Option 2: I keep having revisions; Option 3: I settle for looking ridiculous. Those options all suck.
So, if I don’t want them anyways because of how they make me feel, just TAKE THEM OFF. LEAVE ME FLAT. GIVE ME ACTUAL OPTIONS: 1. If I’m flat, then I can be flat if I want. Or 2. I can use prosthetics to create LITERAL PERFECT symmetry without any.more.emotional.upheavels and slices into my body.

JUST.MAKE.ME.FLAT.ONCE.AND.FOR.ALL.

Consult with PS. “Please, just take it all when you take out the implants. Why? Here’s alllll the reasons why.”

“Um, I can’t do that. We’ve come too far. I can take out your implants, fine, but I can’t get behind undoing it all. I’ve never undone a DIEP this far in.” 

“But. But. *THIS* is what *I* want.” (No one gets it, but *I* do. Finally).

“If after the implants come out and you take some time with that and you still want to undo it all, then I guess we can talk about it then.”

“Well, I really need these implants out, like yesterday, because I feel like shit. So, ok. Please schedule the surgery.”

‘Just show up. Just show up. Just show up.’

---

Surgery. Explant. Day 3. Day 10. Day 90. Looks fine. I still hate them. I still don’t want them at all because of how they make me feel. I’m still feeling like shit. I’m still in pain. I still can’t sleep. I still can’t exercise and lose all our work. I still want them off. I still want my options that come with being flat. I still want what I finally chose for myself. Hindsight is still a bitch. 

I wait the obligatory 3 months. Consult with PS. “Yes, I still want to be flat. I mean I don’t want to be flat but in MY circumstances, I do want to be flat. But no, no one *actually* wants *this.*” 

“Fine. I still don’t get it at all. I still struggle with this decision. But you have to live with it. I’ll do my best.”

‘Just show up. Just show up. Just show up.’

---

Surgery. Deconstruction. Day 3. Devastation. Not even remotely flat. Weird fat lumps. Scar ridges. All obvious from a mile away. ‘Craters.’ ‘Deflated balloons.’ However you want to visualize it. Uglier than I’ve ever been. Can’t wear clothes right. SO much to process.

But also, sleeping better. And not regretting the physical removal of the sheer weight of transplanted fat. (I think thigh and butt fat is heavier in mass than normal boob fat.)

Anyways, the grief hits hard. 
This isn’t anything I’ve wanted even though I’ve been doing all the deciding by ‘just showing up’ like I was told to do.
I guess I am responsible. 
I guess I am to blame. 
I am misunderstood. 
I am lonely.
I am spinning.
My surgeon is downtrodden. 
My surgeon can’t understand.
My husband can’t understand.
My story a failure.
How did we get here?

‘Just show up. Just show up. Just show up.’

---

Post op consult with PS. “Oh. Oh. This is not what I was expecting. That is not how it looked when I closed you up.” 

“I wanted as close to an AFC (aesthetic flat closure) as possible. This isn’t it.”

“I know. Though it looked a lot like it when we were done in the OR. Also, that’s only possible when it’s done at the time of the mastectomy, not after undoing full reconstruction. That ship sailed. Sorry.”

“Oh. But I was just showing up like everyone was telling me to. No one told me I had that option for real. The ship sailed, you’re right, without me fully on it, with no way of knowing anything. In any case, what are my options now?”

“I can try again. I can cut out skin. I can lipo the fat. But you’ll never be flat. You’ll always have contour. But I can get you closer than what this is. I’m willing if you are. Can you live with that?”

‘I don’t know.’

---

Life is long. No one told me that, either. They just told me life was short. Urgent.
But cancer teaches me both are true. 
So does grief. 

None of this has been ‘chosen’ because I thought it was fun. I didn’t ask for cancer. I didn’t ask for any of this. It just…..transpires….happens….occurs….’the ship, just, sails’……. 

I have only ‘just shown up,’ just like I’ve been told to do, and every time, I do my best with what minimal information I have. Yes, I’ve made decisions along the way. But without the benefit of hindsight. Without the benefit of a crystal ball. Without the benefit of someone else who is NOT me–the patient just showing up to survive–pushing the PAUSE button in the chaos of urgency, to say, “STOP. It’s okay to STOP for a long moment and consider ALL of your options.” Or even, “It’s okay to get off this ship at any point.”

Maybe I can keep sleeping better.
Maybe I can start feeling lighter in all the ways, not just physically.
Maybe I can start exercising and push through the joint pain that ended up having nothing to do with implants.
Maybe I can accept nothing because nothing is better than something in this case.
Maybe I can get to a point where I don’t want to throw my body away.
Maybe I can learn to exist in a body that attacks me chronically and ruthlessly no matter what I have tried to the extreme degrees I’ve tried.
Maybe I can learn to live with deflated balloons/craters.
Maybe I’ll try one last time.

Maybe. But I don’t know. 

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