On 22 Nov I had a discussion with a family member who could unpick my ramblings about mastectomies and reconstructions and he suggested I write to my consultant surgeon to outline exactly what functionality I would want after any operation, and set my unusually isolated domestic scene for post surgical care. This might help the consultant get a clear picture without me forgetting key bits and help him suggest what would work best in terms of reconstruction now, or later, what type of reconstruction if undertaken at this stage, and what would minimise risks of spread and usual surgery problems.
Brilliantly, I had also received a message from a good friend who had also recently been jollying through the whole tit lump escapade and her invaluable observations about numbness and lack of sensation after node removal, coupled with observations from some others about muscle weakness after some kinds of reconstruction, helped me create a picture of what to say that I wanted to avoid, if possible.
I managed to speak to the surgical secretary for the hospital and she forwarded on my note to the consultant surgeon.
Come the appointment with my consultant on 24 Nov, he had read my note and had taken it on board enough to mean we whipped through the meeting. He examined me with the nurse specialist in attendance to see how a DIEP flap would work and he was pretty positive. Handily, I have spent the last two years developing a spare tyre for just such an eventuality, so using a chunk of my tummy fat to reconstruct the breast after mastectomy might work well and, more importantly, be compatible with radiotherapy where other reconstructions are not. I would get a free tummy tuck in the process, no damage to back muscles, and no implants. The downsides were more short-term: far longer initial recovery, being temporarily incapacitated by three different wounds that would need to heal (node, breast and tummy), which would stop me from using my arm and sitting with any ease for a few weeks, and stop me being back to full independence for a couple of months. On top, there were the risks of being on an operating table for eight hours and recovering from the anaesthetic. I've always know since childhood, as the daughter of a research medic, that the anaesthetic is the iffy bit.
The problem is that all this opping will happen in a different hospital, St John's Livingston, but one where my consultant has worked before, undertaking the same double operation and with the colleagues that would be undertaking the operation on me this time. He offered to arrange to undertake the mastectomy part of the operation with his colleague plastic surgeon undertaking the reconstruction part. Whether that will work administratively is another thing but I appreciated the offer. I would stay with my current hospital for all other ongoing treatment, like drugs and scans and check ups and the rest.
Off I went after the ten minute discussion to celebrate 'having a way forward' with kedgeree and chocolate ganache (cholesterol-free, of course...ahem)
