Super easy

"Oh, I thought it would be super easy!", he says, his eyebrows dropping back down over his eyelids. "Nope, it’s not really that simple," I reply, smiling apologetically.

He looks like a kid who has just discovered that moms push babies out of their vaginas. He looks incredulous and a little appalled. I have just told him that I still don’t have a date for my breast reconstruction surgery because there are more than four methods to choose from, each with its pros and cons. And that in the best-case scenario, my stomach will be slashed open from hip to hip, a chunk of skin and fat removed and sewn onto my chest. And that I had needed to undergo a scan to find out if they can do this because I’ve previously had surgery on my stomach and it’s not certain that enough harvestable veins are left. And that I will need at least three surgeries to complete the reconstruction. And that radiation damaged the tiny blood vessels in my flesh and implants are therefore not recommended. And that I have a 2.5 higher chance of experiencing post-operative complications that most women. And that I still haven’t picked a surgeon because I want to be sure I pick the right one.

I leave the conversation feeling like I want to cry. Not, like, BAWL my eyes out, just shed a disappointed tear or two. Bless his heart; he thought it would be super easy. I tell myself not to get worked up about it. This is not a person who was trying to be a jerk. He’s a friend. He’s on my side. But it still stings. It stings that most people have no idea what I am going through.

September will mark one year since my mastectomy. In November, it will have been one year since I finished radiation, and I will be able to, with a pristine conscience, start the process of reconstructing my right breast. Easy.

In my experience, most people tend to think that breast reconstruction consists of popping in an implant on the side of the mastectomy. Well, um, no. For women like me, who do not have tiny tits and who went through radiation, reconstruction looks a little more like this.

First, you remove autologous tissue from another part of your body (stomach, inner thigh, upper butt cheek or back) and attach it to the site of the mastectomy, forming a new breast. The surgery lasts anywhere between 6 to 8 hours, after which you can’t move for about two days, and have more than half a dozen tubes poke out of our body, including a urinary catheter. You are tucked underneath a heated blanket that helps dilate your newly connected veins so that they start pumping blood and irrigating the transferred tissue. If all goes perfectly well and the new tissue does not turn black and die, you are out of the hospital after a week and back in business in 4-6 weeks. Then, you wait 3-4 months before embarking on a lift/reduction of your remaining breast, which involves making a circular incision around the areola and down the middle to scoop up and cut off the excess, followed by 4 weeks of recovery. Then, about 3 months later, and if you don’t require further corrective surgery on your new boob, you can construct a brand new nipple, and, once it heals, tattoo it to add to the illusion that it’s real. In case they use your inner thigh, instead of your stomach, you need liposuction on your other leg to avoid looking like a disfigured sack of potatoes. If they use your back, they also take the muscle, so you risk damage to your shoulder in the long run.

Yeah, super fucking easy.

People’s, especially men’s, ignorance of even the most basic truths of medicine and human anatomy, and the unfailing belief in the seemingly unlimited elasticity of the female body never ceases to amaze me. Skin expands, and forty-centimeter incisions somehow miraculously disappear without leaving a scar. How could reconstructing a missing body part ever be easy? Even if it is “just” a prosthetic implant reconstruction, what’s so easy about it? As if you could just stick that thing in during an afternoon appointment.

I had an angiogram last week, to see if there are enough usable veins in my stomach for a DIEP reconstruction (i.e., using my stomach). I schlepped to the American Hospital in Paris for an 8 AM appointment. It was my second visit this month since my post-treatment check-ups had to be done in July.

An angiogram is like an x-ray for your veins, they inject you with radioactive iodine and plop you into a scanner that takes the pictures. The nurse fumbles with the tired veins of my left arm until he hits the right spot. I howl "fuck" and start to cry silently, saying sorry. I used to never be scared of needles. As a doctors' child, I was proud of coolly going in for an appointment and helping the nurses find my "difficult" veins, hidden under a comfortable layer of fat no matter my weight. But now, I cry almost every time. When I was on chemo, I had to do blood tests every Monday. Each week, I would change sides from left to right, so that one side could get some rest. No more. My right arm is now off-limits because most of the lymph nodes were removed during the mastectomy and constricting blood flow could cause serious swelling. So the veins in the crook of my left arm are now the only ones in service. The constant prodding has made them even harder to find and penetrate.

I am hooked up and the nurse has left. The machine sucks me up and the scanner begins to whizz. First, the iodine hits my mouth. It's hot and tastes disgusting - like straight up iodine. An intense heat grips my throat and I feel like I can't breathe. I feel dizzy. I know that it's just all my head, no one and nothing is choking me, but I can't help it. It travels down to my stomach and spreads over my lap like warm piss. I feel high. It's uncomfortable but not that bad. There's nothing massively wrong. Yet, I choke back tears.

This month I have (1) had a PET scan, (2) had a mammogram, (3) had an ultrasound, (4) done four hours of physical therapy, (5) had the veins in my left arm pierced four times, twice for blood work and twice for an IV for the scans, and (6) seen my gynecologist to check out a weird blip that the PET scan showed on one of my ovaries.

Is any one of those things that hard individually? No, they’re pretty easy. But once you add them all together, once you add up all the time, all the fucking worry, all the dreading, all the not knowing –

You know what, I too am surprised that it's not “super easy". I wish, every fucking hour of every fucking day, that it were.