Doctor trifecta

                

                It’s the first week of September. Not only back to school, but back to the medical world after a summer break. This week, it was like the Triple Witching day, only with doctors instead of economists.  I got to see my plastic surgeon, my oncologist, and the woman who is administering the drug study I am in. As a bonus, I also got referrals to a geneticist and a gastroenterologist! I hit the jackpot. Still waiting for blood test results, but nobody seemed to find anything freaky.

                But, I have to go see a geneticist. Every month, they are learning more about the genetic basis of some cancers. This month, I learned that if you have the gene for cystic fibrosis, your chance of developing certain kinds of cancer goes up. Something like 1 in 23 white Americans have the gene. Guess who does?  It’s me!  We learned this when I had Matthew. Fortunately, to develop the actual illness, cystic fibrosis, you need to get two copies of that gene, one from Mom and one from Dad, and John doesn’t have it, so the kids are okay. But you only need copy one to increase your risk of cancer, so to the geneticist I will go, to see what we can do about it anyway. It sounds like the first step may be a colonoscopy, hence the gastroenterologist. Yippee.

                I will also need to go back to the OBGYN to have her check out every last female part that’s still in there. I am sorely tempted to have them all yanked out by the roots, while she’s at it. They aren’t doing anybody any good right now, anyway. All they seem to be doing is giving me hot flashes and threatening to kill me. Who needs that? It is clearer to me every day that the female body is cleverly designed to self-destruct like a Mission Impossible cassette tape the minute you stop having children. Why did that need to be the case? Major design flaw, I would say. I should watch my mouth or I will be answering to the whirlwind just now.

                I also met with my plastic surgeon about my first big reconstruction surgery, which is coming up on the 19^th. I decided last year that I am too young to go sailing into the future boobless, or with grossly mismatched boobs. So, although I have always sort of thought plastic surgery was usually silly, here I go. In about two weeks, I am going to have my temporary implant in the robo-boob replaced with a more permanent one, and the other boob, I hope, resized and relocated to match. There will be another surgery a few months after that, and if I live long enough, more surgeries down the road to replace the implant every so many years.

                Decisions, decisions.   I got to decide what sort of implant I want. Specifically, do I want one filled with saline, or one filled with silicone goo?  I instinctively wanted to avoid the silicone goo, remembering recalls of the 1980s where women got sick after silicone-filled implants leaked. But my surgeon recommended the silicone one over the saline one. The silicone one is lighter, she said.  And nowadays, they are not filled with liquid silicone, which used to leak out sometimes, but with a gel that more or less stays put. You get a hole in a saline implant, she said, and it just goes flat.  But you get a hole in a silicone-gel one, and the gel stays where it belongs. I imagined a boobload of Fix-a-Flat, but that was probably inappropriate.

                In addition, my doctor said, the silicone ones look and feel more boobular. There’s less of that waterbed-like wave action. And both types of implants are made out of silicone, so it’s not like you are avoiding sticking a bunch of silicone in your chest if you go for the saline-filled version, anyway. So, I decided, hell, she’s the doctor, and I signed up for the silicone-goo one.  Because, you know, if I am going to mess around with all this reconstruction, I am holding out for total awesomeness. A new saline-filled boob might look okay, and be perky and all that, but if it sloshes around, that’s not good enough.

                What a strange conversation it turned out to be. She asks me if, while she’s digging around in there, she can do a little bit of liposuction “here” and “here,” and she points out where. She thinks it would look nice if she does. Duh! Easy question! Suck all the lipo you want, I told her. I am already going to be unconscious. Go for it. Knock yourself out.

                The surgeon is still trying to figure out whether, on the “good,” boob, we are doing a reduction or just a “lift.” Apparently this will be a game-day decision, depending on my weight at that particular moment. Either way, there will be a scar. This sucks.  But, I had already decided that for me, it would be better to have two boobs with faded scars on them that look like they are part of the same person, than one scarred-but-perky one looming six inches above a scar-free old-lady one, sad as a lonely little wrinkled balloon. Right now, my “good” (i.e., cancer-free) boob is, like, down in the tropics, while the robo-boob is up there in the taiga somewhere.  When I’m done, they are both going to be up there together somewhere in the temperate zone.

                So, I had to sign mondo release forms.  The lawyers are certainly on the case. There was no shortage of release forms. They sure don’t intend to be sued by the likes of me.

                There was a many-pages-long release form about the dangers of surgery in general.  Then, there is a risk of a phenomenon that can happen where your body builds all kinds of scar tissue around the implant and it gets hard as a rock. Or, the other extreme, the implant can shift, or sag, or disappoint in very many interesting ways. Did you know an implant can wrinkle? I can do that by myself, thank you. Did you know that they can erupt like Old Faithful? Actually that’s a lie. I totally made that up.

                But I did have to initial the paragraph where they spelled out, Hon, your breastfeeding days are over. (I can live with this.) I had to initial the place where they gave me fair warning, this might be pretty painful, and for a pretty long time. (I could have guessed this from the prescriptions they gave me for recreational-quality pain pills and Valium.) Oh, and I initialed the place where they say, if it doesn’t work out, you might need a do-over.  You might even need a do-over using spare parts cut off other parts of your own body.

                There was a whole separate waiver form for the silicone-filled implant itself. I read in great detail all the many things that can go wrong, and initialed paragraph after paragraph with gay abandon. Yeah, the silicone could leak. What if it does? I could get cancer or something. Honey Badger finds it difficult to worry a lot more than she already does.

                There was good news, too. The new implant, unlike the temporary one that’s in there now, will not have a big metal valve in it. So I won’t have to explain to the TSA every time I go on an airplane why my chest is setting off the metal detector. And I’ll be able to get an MRI!  Right now, they are strictly forbidden, because they could suck the implant right out of me in an uncontrolled way. Ouch!

                That’s good, because they want me to get an MRI next month.  As part of our plan to be vigilant about any potential recurrence of cancer, I am supposed to get a breast MRI every so often, starting ASAP. My oncologist, who saw me today, actually urged me to expedite that one. I told him I was on it as soon as they remove the metal parts from my chest so I don’t explode. That seemed reasonable to him.

                I am looking forward to that MRI. Every time I have an itch or a twinge in that “good” boob, I start fearing the worst. I imagine lumps where there aren’t any. I understand this is normal. Still, it would be great to have an “all clear,” even a temporary one.