January is the second year anniversary of my bilateral mastectomy surgery. I chose not to have immediate reconstruction because of the two lumpectomies preceding the mastectomies and I was looking down the barrel of eight chemo treatments. Reconstruction is not a "slam dunk." It requires that spacer bags be placed behind the pectoral muscles and be injected with fluid at intervals to stretch the tissues to create a space for the implant. The process is very uncomfortable and my oncologist mentioned one day that a chemo patient called in "sick" for a treatment because her injections the day before hurt so badly. Also, I was not convinced that reconstructed breasts were all they were cracked-up to be. More surgery would be required down the road to replace the spacers with the silicone implants. Many women also develop scar tissue that can encapsulate the implants or have leaks that require surgery. I have hugged a friend with implants that felt like I was being pressed up against two grapefruits. Another friends is going to physical therapy and has to deal with massaging the implants back under the pectoral muscle. A breast cancer survivor and single mastectomy coworker told me she has had eight surgeries to deal with her one reconstructed breast and that she is "DONE!" I have heard women complain about one breast implant sagging out of alignment with its mate. I have heard how implants feel like a constant 10 lbs of pressure on your chest. I have seen salvaged nipples that looked beautiful and some that looked ghostly anemic.
If I could know with some certainty that the reconstructed product would actually be "sexy" to my husband, it would have been a "no-brainer." Looking at photos of reconstructed breasts at the consultation with my plastic surgeon gave me reason for pause. Of course I queried my husband about his opinion. I asked him straight out whether he felt he needed breasts at all for future sexual pleasure. I begged him to honestly tell me if he thought reconstructed breasts could be attractive to him. You can guess his reply. I know he was as honest as he could have been at the time. I have compassion for him and the muddled place he was in. How could he really answer these questions? I was putting him in a worse place than between a rock and a hard spot. If I had believed that reconstruction would truly have met his needs, I would have reconstructed right away, even if I had not necessarily thought I needed it.
Whether
I needed to have breasts was something I did not know yet. To be sure, I felt a lot of pressure to reconstruct. It seemed that anyone who knew what I was going through, assumed I would be reconstructing. People were really surprised that I did not automatically sign up for that. I found it was often difficult to articulate why I was not going to reconstruct at the time of mastectomy. Culturally, it seems like an expectation that mastectomy patients will automatically reconstruct in the size of their choosing and get on with life. After all, "everyone" is getting implants, even if they don't have cancer. What's the big deal? It's no different than getting a new set of really good all weather tires, right? I could not put my finger on it exactly, but I did not want to make the wrong decision for the wrong reasons. I wanted to explore what life would be like without breasts first to determine if I REALLY wanted to commit to the reconstruction process.
So, now I have been exploring life without breasts for two years. It has not been a stagnate process. I have seen progressive changes in my conscious thoughts and in my dreams. Last night I had a dream. It was extremely petty compared to the dream of Rev. Martin Luther King, who happens to be celebrated on this date. My dream life has always been a pretty classic potluck casserole of my current issues in life. Some times my dreams are fast-paced action adventures, sometimes strange and goofy combinations of people and events that are laughable and fortunately, sometimes romantic and erotic. The fact that I can rely upon my dreams to reflect my present status and state of mind actually gives me a peek into my authentic self....I think, I am, after all, no psychiatrist. The dream I awoke from this morning involved a very large family and friends gathering at a home. It was very crowded and buzzing with conversation and happiness. I can relate this part of the dream to the fact that I was writing thank you cards and sending out little photo books of our family Christmas party last night. Then, I dreamt that my nephew, Tim, came to the party about halfway through. This was a wonderful thing because in real life, he has not socialized with the family in a decade and it has been a source of sadness and concern for me. He is often on my heart and I try to pray for him every day. This eeked into my dream because as I was addressing those thank you cards, I had to call his sister, my niece, to get her address. I asked her if she also had an address for her sister whom we also don't get to see much, but for other reasons. She mentioned that she could find it for me, but that she, herself, had not had the opportunity to talk to her sister over the holidays. Without warning, I found myself overwhelmed with emotion thinking about the prodigal niece and nephew. My voice quavered as I confessed that I was suddenly emotional, that it was just because I love these kids so much and want them to know they are loved, missed and cared for. I would give anything to communicate that the family arms are always open, accepting, understanding, forgiving...always...just give us the chance. Please give us the chance to show that we have grown and changed too. Across the board, I can say we have grown and changed into better versions of what you remember. Anyway, that is why Tim wandered into my dream, spot on. Then my dream shifted to the intimate company of one person at the party. As physical closeness and snuggling increased, I put my hand on my chest and heard myself admit before being discovered, "I don't have any. I, uhhh, have a pink ribbon." Then, I woke up. Damn.
What is interesting to me is that early on, after the mastectomies, I would have dreams of still having breasts. I would look down toward my chest in my dreams and I could see them or at least see cleavage. Then I began having dreams that dealt with the missing breasts. Now, it seems that my subconscious has linked the fact that they are not simply gone, but gone due to cancer. What I like best about all of these dreams is that I still have naughty dreams even when my subconscious knows I don't have boobs anymore, which frankly, were a big part of the naughty dreams before cancer. I don't think it is a coincidence that my dream life is reflecting my own little epiphany about being boobless. In the last month or two, I have realized that I have arrived some where important. It seems clear to me that I have arrived at a destination I would be sorry I missed if I had rushed into reconstruction. It is like I have been slogging up a mountain trail in dense fog. I have been on the unfamiliar, shrouded trail so long that I wasn't expecting any view points. All of a sudden, the sun burns through the fog and I realize I am up about five thousand feet, overlooking the western Columbia River Gorge. A broad smile covers my face and I drink in the view. I believe that my "ah ha" moment is all about stripping away the superficial and finding the core of my sexuality. I have realized that I still look at my husband with the same loving and lusty desires. The internal drives and feelings have not changed. In fact, because of who he is to me and how he has treated me through this cancer journey, my loving and lusty feelings for him have intensified. I have found myself feeling very aroused and ready to get after it without having any insecurity about not bringing boobs to the table...or bed, especially if there is red wine involved. What an amazing place to be. What a paradox that my sex life could be richer after mastectomies than before.
I remember a particularly intense conversation with Roger a few days before my mastectomies. I was actively grieving the impending losses as Rog and I were lying in bed talking. It was dark and I was expressing my fears about being less attractive to him sexually and wondering if I was making the right decision not to reconstruct. He said something that night that I will never forget. It was so profound and so reassuring that I leaped out of bed and ran to the kitchen to write it down. I have said it to myself many times since. If there were ever a book about our marriage, his comment would be the title. As I was wading around my pool of doubt and insecurity, he declared, "Don't worry, Babe, we will still be us." That was it. That is what it has been since. That is what it is now and that is what it will be. What comfort. What confidence. What an expression of real love in it's true form. What a relief. What a great focal point. What a gift. Thank you Rog, for teaching me to be confident in the fact, that no matter what comes our way, "We will still be us."
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