I was sure of what I wanted when I went into the appointment with the surgeon today. A bilateral mastectomy with implants please. I didn’t have the whole low down on implants, but barring major disaster, that seemed the perfect option.

Then disaster.

The implant in my bad boob has a 40% chance of failure because of the radiotherapy done last time. The surgeon strongly recommended I not do that option.

So I’m there in yet another appointment having gone in expecting one outcome and suddenly being thrown into chaos. My hopes of avoiding an extra wound site have been dashed on the rocks of radiotherapy. In this reeling state, the surgeon laid out the only other options.

Option one: Single mastectomy and reconstruction from tummy tissue and breast reduction on the good boob to match. D cup sized boobs.

Option two: Double mastectomy and reconstruction using tummy tissue. B cup sized boobs.

The plastic surgeon was arguing for the first option as all my doctors have all through this process. Just as I was being swayed, in walked the mastectomy surgeon. The knee patter.

He smiled warmly and greeted me as old friends. I smiled back politely and then we went back to the well trodden road of back and forth. Me expressing a worry, him dismissing it. To the point where he said that my understanding of my cancer was based on Daily Mail articles.

Yes my friends, he said that.

He mistook my stunned silence for acquiescence and went in for the closer. He leaned in and said I must make a decision quickly. The clock was ticking and I had to get a move on. Just before he had entered this space, the plastic surgeon had said I could take a couple of days to make the right decision. My surgery is booked in for the 3rd of October, three whole weeks away.

At this point I could feel the tears of frustration coming. I was not going to cry in front of this man. Again. So I stood up, told them I needed a break and went to cry in the corridor. Not so much a huffy walk out as an empowered decision to remove myself from the situation.

My family and my nurse followed after and we occupied a different office far away from him. We invited the plastic surgeon back into what we claimed as our space and the whole dynamic changed. He agreed to whatever surgery I wanted to do and checked out my tummy fat again. Apparently it’s a ‘good belly’. Think he was trying to be nice.

We didn’t invite the mastectomy surgeon back in. But he came anyway. He hovered at the door, full of apologies and big statements about just wanting to do the best for me. I tried to tell him again that I only want to be listened to, to be heard. And he came in close for a hug I didn’t want and asked me to tell him we were friends again. His apology was as problematic as his errors. I couldn’t wait for him to go and he did quickly.

When the plastic surgeon left, he shook my hand and suggested that I could see the clinical psychologist. He didn’t offer this is a ‘you must be crazy if you’re not listening to me’. He offered it in the realisation that if I’m happy about the decision going into surgery, there’s more chance of me being happy coming out. And he at least counts my happiness as a measure of his success. I trust him completely.

We stayed a lot longer chatting with my breast care nurse. She shared her thoughts, much along the lines of the other lovely nurse. This is my life, they are men and don’t really get it, this is my decision. This is my decision.

So I made a pros and cons list. My only hesitation at going with my original choice of a double mastectomy is that now I have to have the third wound site on the tummy. It’s a bigger op using microsurgery to reattach blood vessels from the tummy tissue to the chest wall. So I’m exposing myself to a bit more surgery, a bit more recovery, a bit more risk. It gives me pause.

And small boobs.

But on the plus side is no more anxiety, no more mammograms, no more surgery.




7 thoughts on “Choices

  1. sokari

    What! I dont really have any other way of articulating my feelings on reading this except to swear profusely over and over. The choices are tight, I am so sorry. Thinking of you and sending love.

  2. Heidi

    Sokari, swearing is an entirely appropriate response! Lilah has been berating us for the amount of times she’s heard the F word lately. Urgh, urgh and double urgh.

  3. Karen

    I totally agree with Sokari – there are no appropriate words – but I just have to say I have total admiration for how you navigate these unbelievably complex situations. Again and again you turn around a disempowering situation and come out in all your dignity and power. You are doing a brilliant job of the most important challenge of your life. What a totally gobsmacking Daily Mail comment from the surgeon, and his ongoing behaviour is so inappropriate. HOWEVER, one thing we found when G was having his lung removed, was that the surgeon can have absolutely no social skills whatsoever – in fact can be downright rude – but he can still be amazing at the most fundamental part of his job – the surgery. It’s a real shame he’s like this and it must be really horrible for you, but the most important thing for your future is that he’s good at the surgery bit of the job. You don’t need him for anything else. Luckily you are surrounded by medical professionals who are much better at the more human aspects of the job. Be strong, lovely one, and keep the faith. You are really phenomenal xxxxxxx

  4. Caroline Phillips

    You shine. Always. You know what you want. And what feels right with you will be right for the rest of your life.

    I completely agree with what Karen and Sokari have already brilliantly articulated.

    I also wonder if surgeons are currently feeling raw about the ‘rogue surgeon’, Ian Paterson who’s recently been convicted of traumatising his patients by carrying out ‘needless breast operations’ [Telegraph] – and deliberately harming them. The story’s currency might be affecting how they approach their patients. Who knows.

    But you know what you want, darling. Well done for pressing that pause button when you needed to. We can so often forget it’s there when other people are bamboozling us for answers that suit their schedule!!

    Love and strength to you always, C xxxx

  5. Heidi

    Yes Karen I agree, I think his surgical skills are probably good. Shame they don’t get training on social ones. Although I think the newer ones are getting better at that. And they’re all influenced by their speciality. So my choice to have a bilateral MX makes no sense to an oncologist or surgeon and so they really can’t compute. The plastic surgeon deals a bit more in human happiness so he’s calculating that in to his success.

    Caroline, thanks for lovely words. I did feel good about reclaiming time and space. Sometimes all we can do is remove ourselves from a situation. Gave myself a time out!

  6. Heidi

    Oh yes Caroline maybe some sensitivities around that rogue surgeon. But I think the trend has been away from radical surgery for a very long time as surgical techniques have become more precise. This study I saw sees a shift in that from early 2000s towards young women especially asking for preventative mastectomies. Maybe why the rogue surgeon got away with it so long because he was riding the trend.

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