BRCA: The Great Nipple Debate

In the past two days, I've seen my OB, the Breast Specialist, and the Plastic Surgeon. Oh my!

Hysterectomy: 

Yesterday morning, I saw my OB for my final check-up (8 weeks after surgery). Woohoo! All of my internal stitches are gone and I was released to normal activity. Sort of. I was told to be "conservative" on my lifting, and to "take it easy." I could return to Boot camp, soccer, and running, but I'm not suppose to overdo it. My doctor said that I will get tired easily so I need to listen to my body. All that being said, I went to Boot camp this morning (at 5:30am) and I'm pooped. I'm not sure if it's because I got up early, I haven't worked out in 8 weeks, I'm getting over a sinus & ear infection, or the fact that I had body parts removed. So, I'll play it safe and go with all of the above. I guess that's what the doctor means by "don't overdo it." Lesson learned.

Double Mastectomy: 

Yesterday afternoon, my husband and I met with the Breast Specialist for my Pre-op appointment. There was only one question that I really wanted an answer to. The Great Nipple Debate. Keep them or don't keep them?

About two months ago, we met with the Plastic Surgeon for the first time and he said to remove the nipples to eliminate all chances of developing breast cancer. It made sense. Then shortly after that appointment, we met with the Breast Specialist for the first time and she said that I could keep them because the cancer risk would be very small. So, we settled on keeping them. Until, a few weeks ago when the Plastic Surgeon's office called to schedule my Pre-op appointment and they questioned my decision to keep the nipples. And so the Great Nipple Debate began.

Thankfully, yesterday afternoon, the Breast Specialist settled the debate. I told myself prior to this appointment that I wanted a clear direction to go, without any doubts. I decided that if my remaining chances to get cancer in the nipple area was 10% or more then I would remove them, but anything less was an answered prayer that they were safe to keep. Her answer ... a less than 1% chance of developing cancer if I keep the nipples. The Debate is over. They're staying! 

The ONLY thing that would change this is if the removed breast tissue near the nipple area comes back with pre-cancerous or cancerous cells that were not detected with the Mammogram, Ultrasound, or MRI. As far as I'm concerned, this will not be the case. 

If you're wondering why I'm being so open about the nipple issue, I'll tell you. 

#1) I decided from day 1 to be very open about this journey. 

#2) My girls will read this someday and I don't want to forget the decisions that I had to make that they may also face in the future.

#3) Inquiring minds want to know. Trust me, my girlfriends are just as curious about all this as I am. 

#4) I want to encourage others who are facing the same decisions or will be facing the same decisions. It's always nice to relate to someone when you're going through a hard time.

#5) The word nipple lost all modesty the day I nursed my first child, which was quickly followed my nursing two more children.

Breast Reconstruction:

Today, we met with the Plastic Surgeon for my Pre-op appointment. Here's what we know.

• He didn't disagree with my decision to keep the nipples, but he did share with me his concerns. The biggest risk was that as my expanders are filled, the nipples may not align properly. I'm willing to take that risk to look somewhat normal when all of this is over. So, if you feel so led, please pray that everything lines up correctly over the next few months. Seriously, do it!
• John 16:23-24 - "...Very truly I tell you, my Father will give you whatever you ask in my name...Ask and you will receive, and your joy will be complete."
• Once I get in the operating room, I will have to sit or stand as lines are drawn on my chest to guide the doctors during surgery. He assured me that they will give me an IV and something to calm my nerves as soon as I enter the room in case I get the sudden urge to run (those were my words not the doctors - ha). The prep and drawing process will take around 45 minutes, and then anesthesia will come in. The entire surgery will take around 3 hours.
• Once the breast tissue is removed by the Breast Specialist, the Plastic Surgeon will insert the expander and something else (we can't remember the name of it) that will set at the base of the expander to keep it in place. The port on the expander will be at the top, and this is the place that will be accessed to fill them with saline.
• I will stay overnight at the hospital.
• I may have little to no pain, lots of pain, or pain on one side and not the other. The last option would be weird.
• I will have at least two drains on each side that will stay for 10-14 days. These drains will be sown into my skin so they don't move, which totally grosses me out. Never mind the fact that my breasts are being removed.
• We will go back 3 days after surgery to have the dressing removed and we'll be taught how to care for the drains, stitches, etc. 
• My doctor isn't concerned about the surgery, he's concerned about me resting during recovery. Because I'm young, in shape, and have young kids, he can't stress enough that I'm not to do anything for 4-6 weeks to allow myself to heal properly. I think I can be still ... as long as they put me in a straight jacket. 
• After the 4-6 weeks, I will start the expansion process. I can go once a week, once every two weeks, whatever I choose. I guess it will depend on the discomfort level that I feel after each fill. The purpose of the expanders is to slowly stretch my skin and pec muscles to support the implants later on.
• We'll decide the breast size once the fills are going in. Depending on any left over breast tissue, pec muscle size (the right could be bigger since I'm right handed), etc. the expanders and later implants could end up being different sizes. 
• Once the final size is determined, they will fill the expanders 10-15% larger and that will sit for 6 weeks before the final surgery to remove the expanders and insert the implants. 
• I should be able to return to "somewhat" normal activity as the expanders are being filled even though they're not as sturdy as the implants will be. I will have to be cautious at workouts and soccer if I choose to return to those before the entire process is complete.
• This will take 3-6 months to complete, and we start in two weeks. Let's do this!

If your head is spinning after reading all of that, then welcome to my world. It's been a lot to take in since we first found out that I was BRCA2 positive in January. I've learned a lot about myself and my character, and I fully trust that God will never give me more than I can handle. I can't thank my family and friends enough for the love and support that they have shown me. This journey, my journey, it has become our journey. We will prevail.

Proverbs 19:21 - "Many are the plans in a person's heart, but it is the Lord's plans that prevail."

Proverbs 24:5 - "The wise prevail through great power, and those who have knowledge muster their strength."

You can read my entire BRCA journey here by starting with the bottom post.