My account of life both on and off of two wheels...... "At least I'm enjoying the ride"

Wednesday, December 12, 2012

Do what will heal you.

I have not shared with many or posted about the details of my upcoming surgery.  I have been trying to avoid being overly influenced by others or their opinions.  I have discussed my options with medical professionals, other women that have had to make these choices and some of my closest friends and family.  Of course G and I have discussed this more than we both would like.  G is my biggest fan and I am very grateful for that.  

The decision process has been more than difficult.  The rescheduling of the surgery was a blessing as I have used this extra time to try and sort out my options and find peace with my choice.
When I made the decision to have a bilateral mastectomy back in May of 2010, I had the option to reconstruct my breasts or wait and delay reconstruction.
“You are young and most women your age choose reconstruction”

 I heard that from many and while I still considered no reconstruction at all, I knew that if I was going to do it, I should start the process right away.  I wanted to get it over with as soon as possible or I may not go back. 

It all seemed so straight forward at the time. 

I was so overwhelmed with all the decisions that I had to make back then.  I had the whole “you have cancer” noise running through my head and on top of it, I had to make reconstruction decisions.  I chose the “easiest” and most common option for reconstruction with the least invasive surgery. 

After finding out that I needed radiation, it was too late.  We had started the process already.   I knew that the results could fail and I could be right where I am today.    I just tried not to think that way.  I still had to get through chemo and radiation so there was no time to think of the “what if” regarding reconstruction.

We pressed on because for some women, the results work even post radiation. I was hopeful that I would be one of those.  
The bottom line is I no longer can just have an implant on my radiated side.  The tissue and skin is so damaged from radiation that it is too unhealthy to hold an implant comfortably or safely.
If I want to continue the reconstruction process, I need healthy tissue to replace what is damaged.

That has been one of the biggest dilemmas for me.  Continue or give up what I started.

If you have been paying attention at all, I am not quick to give up but I do know when enough is enough.   These choices are not as straight forward as one may think.  So much more is involved at this point and all the procedures are ones that I declined from the start and thought I would 'never' do that.  

The only reconstruction options that I have at this point involve having major surgery and taking tissue and muscle from other parts of my body to form a new breast.
The only surgeries that I am a good candidate for is the LAT Flap or a GAP, TUG or PAP flap.  All of these involve a huge recovery and possibly or most certainly weakness from the donor site.  I already have some upper body weakness from the implants and don’t forget my cording issues in my left arm.  Oh and there is also the chance that they too could fail! 

The GAP, TUG and PAP all involve taking tissue from my butt or legs.  As much as I like the idea of making my butt a little small, no thank you!  My legs are my engine on the bike.  These also have a higher risk of failure especially on radiated tissue.

The strongest option for me and what was suggested by two different surgeons is the Latissimus  Dorsi Flap or better known as the LAT Flap.  It utilizes the whole Lat muscle, tissue and skin from your back.  The muscle remains connected and is pulled under the arm and around to the chest to create the new breast mound and replace as much of the damaged skin as possible.  There is hope that the new skin will be able to regenerate healthier skin.  It still requires an implant to match the other side since I do not have a ton of extra tissue to donate and the Lat muscle, while very large is actually pretty thin.   This surgery could help my cording issue or exacerbate it.  It most likely will be a much harder rehab for me and I could end up weakening the integrity of my back. 

I have been on the schedule for the Lat Flap surgery but the idea of this surgery has not settled well with me.  I am extremely concerned of losing strength in my back for obvious reasons.  I am an avid mountain biker that wishes to be competitive again and I am finishing my Pilates training certification.  While the Lat may solve some problems, it could cause more and there is no reversing this.  The muscle cannot be put back where it belongs.   I have had night terrors of waking up on the operating table with my back cut open and muscle hanging out only to be left on the operating table while everyone leaves.
Yes, this has been a tough 5 weeks.   

I have done lots of research and deep soul searching regarding what is the most important to me.  

I was given some really sound advice from a new friend.  “Do what will heal you”
I have come to the conclusion that today, my body; my muscles and a strong recovery from treatments are way more important to me than breasts.  I have already put my body through more than I have every thought I would or could go through.   It is time to give my body a break and give it time to really heal.   Enough is enough.

To deconstruct is still a big surgery but we are anticipating a much easier and quicker recovery.   It sort of feels like I am going through the mastectomy all over again but this time, I know more.  I do not have the same fear of cancer that I had the first time.  Of course there are still no guarantees of how this will look and how I will heal both physically and mentally.  The skin and muscle in my chest has already been stretched.  The extra skin can be cut out but the muscle, while still functioning may not ever lay flat.
I do anticipate having a few moments of grieving and "what the fuck did I do” moments.  Of course I expect many wardrobe malfunctions so I may need to find a good seamstress to alter some of my favorite dresses or just go shopping. But  I will take it all one day at a time.
The most important thing is I choose what feels right and to honor my body for taking me this far in life. 

While sitting in my car at the trailhead with my bike in tow, I spoke to my plastic surgeon yesterday.  I most certainly got the feeling she is not thrilled with my decision but she respects my choice and will help me achieve this goal of getting my body back to a stronger and healthier state that I so desire.   She also reminded me that we can revisit reconstruction at a time that is better for me down the road.

I hung up the phone, unloaded my bike and took a moment.  I felt a bit of weight coming off my shoulders and as I took a deep breath, I looked up.  There he was.  “My” hawk that I have spoken about before.  He was circling the parking lot.  I smiled, soaked in the peace and thanked him for his message as I pedaled into the woods. 

While I am mentally and in turn physically exhausted, I still had moments while pedaling that I could feel my body and how strong it really was.  How hard I have worked to get here.  The implants have only impaired my strength and have never truly been comfortable.  

I actually saw the hawk two more times over the course of my ride.  I do believe he was following me and I like to believe that he was watching over me. Reminding me to look at the big picture- my health and doing the things that make me happy.  

I do understand that I am in the minority with my choice but this seems to be the best way for me to heal myself. 

Finding clarity in the woods. 



  1. Rebecca, whether you're in a minority or not, who cares? This is right for you. You're so much than a girl with breasts. I so admire you for rebuilding your strength, knowing what you love and doing it. Good luck with the surgery. You're moving on, that's a good thing. xoxo

    1. Stacey, thank you for your supportive and kind words. I was thinking of you yesterday and specifically your post about being finished with reconstruction. I guess in a way, I will be also. It will just look a little different ;) Hope you are well xo Rebecca

  2. I had a DIEP flap, which was the right decision for me, and your decision is the right one for you. I love these lines: "The most important thing is I choose what feels right and to honor my body for taking me this far in life." Simply beautiful. You have to do what will best heal you physically, emotionally, and spiritually.

    1. Beth, you are right. Each decision is so personal. I wish all of us did not have to make them. Thank you for reading and for taking the time to comment.

  3. Rebecca,
    Thank you so much for writing so candidly and so eloquently about something so highly personal. These decisions to do or not do reconstruction are so difficult and so personal and, of course, are often made when our minds are on over-load with cancer stuff. With or without breasts, we are who we are. You are who you are. As you said, you are making the best choice to heal yourself. That's truly inspiring. My best to you and thanks again for writing.

    1. Nancy, Thank you so much for reading and taking the time to comment. I promised myself to always write honestly so that others might understand what it is we go through but mostly for other women who get hit with these tougher than tough decisions. It is just nice to have so much support.

  4. You've been through much and have had to revisit something you thought you'd made a choice about earlier. Your decision to do what feels right to you is the answer. Not what you feel your surgeon or "public" thinks is right. That "minority" may be larger than you think ; )
    Wishing you peace and health. Best on the restore surgery.

    1. Hey SpeedyChix- thank you for the comment of support and thank you for the x-mas card :) I do hope you find your lungs and legs and maybe we can even catch a ride together this summer?

  5. Your surgeon supports whatever decision you make. Only YOU know what is right for you. You are a beautiful person, inside and out. I am really amazed by your journey.

    1. Hi Dr.DP! You most certainly have supported me no matter what and I am so grateful for that and many other things you have done for me over this process. I have not been the easiest of patients...

  6. Chills--the hawk!

    I remember hanging up the phone with you and weeping for all that cancer has taken away. And then I got out of my car and took a walk through the trees and felt the sunshine on my cheeks and couldn't help but smile for the deep connection I felt to another human being that I have never met.

    I'm ok with representing the minority choice--especially now that I have you!


  7. Hey Becky - I'm sorry I haven't kept up with your blog lately. Mom filled me in on a little of what is going on, but I haven't checked in for a while. I just wanted to say that while reading this post, I felt a sense of you really settling into your ownership of this journey. I have watched other people go through not exactly the same journey, but the same struggle - making decisions that you never ever wanted to make, having the weight of the world on your shoulders, and relying on the advice of experts and taking the lead from what the "majority" of people do. Then eventually realizing - those experts are the experts in their field, but YOU are the expert on YOU. Only you can decide what is right for you, and which path will lead you to the best result for YOU. Joe and I are still on that journey with Sasha - trying to learn how to listen to our guts, not just follow the lead of the doctors and the majority. I'm holding back tears, really just happy for you that you've found some peace with your decision. And OF COURSE there are the oh-fuck-what-did-I-do moments, but what decision doesn't come with those. Lots of love to you.