My daunting question I had to finally come to grips with was, ‘do I have a double mastectomy when one breast is probably healthy?’ The office was bright, airy and friendly, just like Dr Shane Barker, but being at a plastic surgeon felt like going to the tailor. Except at the tailor you don’t have someone sizing your breasts up in the same way. It was a strange experience. I am glad that Derek came with me as it would also be helpful to him to understand. For those of you who don’t know what to expect; which is probably most of you, it is all very professionally and unemotionally executed; in the end there is also the possible execution of the breast(s). If I could have enjoyed the experience I should have felt like the ‘queen of the show’ but I was there for self-preservation and my only feeling was that I would do anything to obtain that. So my resolve was also my dignity. Having a man discuss my breast shape, size and nipple colour as if it was a suit I was wearing was a very unusual experience. It somehow made it easier. He took photographs of them from all angles. I was eager to know about the procedure of the implants as it would help me make up my mind about the mastectomy of the ‘healthy breast.’
Shane said, ‘I will work with Aaron (Dr Ndhluni) and start the process of reconstruction on the side that he would have just done the mastectomy; so the initial saline bag for the breast implant is inserted simultaneously with the mastectomy’.
At some point I was presented with a whole array of silicone breasts; and this felt much like viewing a new car in a show room. It didn’t feel like we were talking about me and my body personally. It probably only dawned on me at this point that we women have different shaped breasts that stand in different angles. He continued, ‘I will use your skin in the process of reconstruction. It’s great that you have big breasts as the extra skin will be used in securing the prosthesis under your muscle.’ I had never thought about it. I had pictured it put in under the skin but it made sense to secure it under the muscle.
We went home with all the information. Just from a totally esthetic angle it would be nice to have two breasts the same size; instead of one small one and one big one. Dr Barker had felt that smaller is better. Some one said, ‘well at least you will have perky breasts till you die,’ ‘that could be fun, no more bras,’ I retorted. Deep inside I was fully aware that this was an inseparable part of my womanhood and femininity. It was also an important part of our sexual relationship. We couldn’t deny that. There would be no tactile feeling afterwards, ever! I would feel pressure but no touch. How would that impact us? Yet for me it was more important to be healthy and stress-free, which, if I kept one of my breasts I would have to go for 6 monthly check-ups; and as one professional pointed out, ‘it is so difficult to detect, you might have cancer in your right breast as well or miss it in the future.’ Financially we were covered for bi-lateral mastectomy and reconstruction as Derek had earlier that year taken out Gap Cover. What a stroke of inspiration it was that he had done that. I will always be grateful. Finally we came to a decision.
Journal entry August 2012
We pretty much made up an ‘agreed’ mind about the bilateral mastectomy. Derek is more accepting of it. It is sad loosing what is mine, been mine since I was 12 years old. They are part of my identity. My femininity. It is a loss. I will have to grieve.
The next time I saw Shane Barker was the day before my bilateral mastectomy. This felt even more surreal as I stood there with him drawing on my body with a black marker pen. As I looked in the mirror I thought it looked like he had drawn a dress maker’s pattern or plate of armour on me. I have got photos but it is not the sort of thing I would show you. These were the lines which mapped out where the surgery incisions were to be made by Dr Ndhluni and how it would preserve the skin for the reconstruction. I realized that it was truly going to be a team effort: the two surgeons working together. It was all so professionally done that I really did feel like I was in competent hands.
Final journal entry before surgery
I am afraid of the surgery, of the anaesthetics as I am asthmatic, of the pain, the drains, of infection; but I trust the process, trust God, and trust the medical team. But … Maybe I will die.
I was scared for the next day. It was going to be a big day. My body was going to change forever as I surrendered to the knife and the process of procuring life. I was scared but also letting go of control, as I knew I truly had no control. I went to bed with my patterned breasts knowing I was saying good bye to them forever.
Take care and make the most of your life!
Till next time, Morag.
If you want to read the sequence of events from the beginning you can find them here:
Third The question was: One or two breasts.
Fifth I am on fire: breast surgery recover
Sixth Why me, cancer, why me?
Seventh Breast reconstruction