The Surgeon

It has been almost 34 years since the first time I walked into the surgeon's office. I didn't know him. I had chosen his name from a list. I thought I could hide the fear behind a bravado spirit. I was young and in those days, didn't have a clue what to ask and I didn't know enough to be afraid.

Were there such things as chemo in those days? I really don't know. I don't remember ever having that conversation. While my outside was calm, my insides were in a turmoil.

I remember after the surgeon examined me, he took a look at the radiology report that said the lump was a cyst. His comment was, "That is no cyst. That is a lump and if it is cancer, I do a radical."

Radical? I knew a little bit about that. The church pianist at my father's church had undergone a radical. In those days, no one talked about breasts. Breasts were a secret topic. Did society think the disease would go away if no one talked about it? or that women would be less afraid if they knew nothing?

By the time I checked in for surgery, I had already heard the comment from the GP about lumpectomies and had that to chew around a couple of weeks. I didn't ask anything else.

I went into surgery, believing the doctor knew what was best for me. He had a calming voice. He knew the path I was facing. I was at a fork in the road in my life.

The surgery lasted over four hours. The initial lab work identified the lump as malignant. I lost a lot of blood during surgery and the surgeon fought to keep me from going into shock. The result was a radical.

Later when I woke up, I saw the blood dripping into my veins. I saw the IV and felt the heavy bandage on my chest. The drainage tubes were tight under the skin, pulling and hurting. Around me, nurses were talking quietly as they tended my needs. I was aware, but not awake enough to tell them I could understand their conversation.

A friend who worked in the lab at the hospital came in to check on me. I had not been awake enough when the surgeon came in to discuss the surgery. But, from the nurses' conversation, I knew something frightening had happened during surgery. I looked at my friend and said, "When did you know what had happened to me?" Believing I knew, she said she knew as soon as she got to work at 9 that I had lost a lot of blood and they were fighting to save my life.

My friend went to the employee lounge and overheard the GP asking my surgeon if I knew about the mastectomy. That was when my friend learned that the surgeon had not been able to talk to me and I had trapped her into telling me the truth.

After my friend left my room, I dozed off. The next time I awoke, my surgeon was sitting on the side of the bed, patting my face, calling my name. I opened my eyes. I saw the tears slipping down his cheeks as he said, "I am sorry. I am so sorry. I had to take it all." For 34 years, I have not forgotten his tears. He cared. The surgery he performed that day was not done out of some wish to butcher a young woman. He performed the mastectomy to give me the best chance at life possible.

From the list of five surgeons, I am so grateful, God led me to this surgeon. From the jungles of two tours of duty in Vietnam, to the halls of Walter Reed and now to civilian life, the toughness he showed with his decisions were softened by the heart of God.

The following months and years were difficult. Yet, through it all, my surgeon was there to make me mad enough to fight for myself. Fight to want to live. He never let me forget I had value. I was important.

There was a reason God allowed me to face breast cancer and a radical mastectomy 34 years ago. He knew the journey I faced. He placed me on this journey to share with other women and their families.

Today, what is my choice? Today my choice is life. I would rather be flat chested and live than keep the breast, have my immune system destroyed by chemo, burned by radiation and have my life shortened.

I am so grateful. Thank you doc, for healing me.

Harsh Words/Or Were They?

Before I went in for my possible mastectomy, I had a physical by a GP who was a member of the clinic where I was to undergo my surgery. Although my surgeon had told me he would do a radical, I really never expected it. No one in my family had ever had breast cancer at that time. I was the first.

Just a few weeks before, Phil Donahue had a guest surgeon from PA on his show. The discussion was about lumpectomies followed by radiation. This was a new procedure with no studies on success rates but his manner was so convincing. Listening to the surgeon, it sounded like a good idea to me. I was young. No history of BC in my family. Why not?

So, I asked the good doctor about other choices for surgery, especially the lumpectomy. (I had heard nightmare stories about radiation treatments at the big hospital in Wichita.) He said, "Well, we could sew you up and let you die." That statement shut me up. I didn't ask any more questions.

For years I thought that statement was harsh and even cruel. But, you know, sometimes you have to be cruel to be kind. Sort of like Simon on American Idol. Gotta say it like it is.

If I knew where that doctor was, I would thank him. It WAS a harsh statement, but women facing surgery for BC should have someone get their attention without sugar coating everything. Get the facts. Choose life.

I'll get into the "HOLY GRAIL" of breast reconstruction another time. Those are promoted by surgeons with dollar signs in their eyes, women who have never had one done but want to be sure BC women have a "choice" or by BC women who are still in the honeymoon stages after the reconstruction. None of them address the real damage those surgeries from hell cause patients.

My surgeon chose a radical mastectomy FOR me all those years ago. Knowing what I know now, after reading many obits of women who chose lesser surgeries with treatments that ended up shortening their lives, I am glad he made that choice for me.

Women are only making partially informed decisions. Surgeons don't have the guts to give them the whole story about survival rates. If women knew a radical could give them 30-40 more years of life, don't you think more of them would choose to be flat chested and alive than dead in five. I like that. "Flat chested and alive, rather than dead in five."

Saddened

My heart grows sad when I read the obits of young women who have lost their brave battle against breast cancer. I wonder how they made the decision for the journey they traveled.

Three times this month I have read obituaries of young women (under 55, one was 39) who died within a few years of diagnosis of breast cancer. Each had "breast saving" surgery, followed by chemo and/or radiation.

How much time was cut out of their lives because of these choices. Yes, I know. It WAS their choice. Our society is all about freedom of choice.

Why don't we call it like it is. Freedom to die sooner than reaching for life by taking a more radical approach to fighting breast cancer. This freedom of choice based on incomplete information is killing women. My opinion.

Why is the information given women incomplete? The medical professionals aren't tracking the radical mastectomies. We don't exist on their radar. We aren't acknowledged because our survival rates would screw up their stats.

My radical mastectomy was over 30 years ago. I was young, so yes, I know what the emotional trauma of being diagnosed with breast cancer is like at the ripe old age of 27. The two Reach to Recovery volunteers who came to visit me in the hospital had undergone their radicals over 20 years previously. As far as I know, both lived another 20 years.

Before women are seduced into these lesser surgeries, give them the "whole truth, and nothing but the truth" about their chances.

Folks, I am flat chested. Somedays I totally forget I have no breasts. My prostheses are stored away and only taken out for special occassions.

And when I die, I don't want the obits to say I have fought the battle against breast cancer for over 30 years. I have survived.

Vanity

Ladies, we all have been led to believe that the number ONE killer of women is heart disease, followed by breast cancer.

Not so!

You heard it here.

THE Number One killer of women is vanity.

Yep. You read it right. Vanity.

What else would cause thousands of women diagnosed with breast cancer each year to choose breast saving surgery, followed up with chemo and/or radiation?

What else would make women choose to shorten their lives, choose to die?

Vanity, thy name is vanity.

Wouldn't you rather live longer, a bit scarred maybe, but live to see your children grow into adults, rock those grandbabies, go to graduations and weddings?

The choice is yours, choose life.

A Hunting I Went

OK, it has been a few days since the last post. I thought I would give medical science one more chance to post studies on long-term mastectomies. One more chance. Finding one is like finding a hair on a duck's back.

Medical science, IMHO, doesn't want those studies to be found, IF they exist. Why? There is money in tissue saving breast surgeries and treatments. There is NO big money in radical or modified mastectomies.

Ladies, look in the mirror. Do you love yourself? Does your husband or significant other love you? Is it a real love or a conditional love where you are loved only as long as you have two perfectly formed breasts.

Take a look ladies. Choose to live.

Thanks Doc

I look back on my days in the hospital following my mastectomy as a vacation in comparison to today’s approach to women’s surgeries. I stayed in the hospital for nine days. I didn’t go home until my surgeon, a veteran surgeon to our troops in Vietnam (two tours of duty in a MASH unit) said I should go home.

This blog won’t end today so I’ll eventually get to my unvarnished opinion of what I believe is the best chance for women who are diagnosed with breast cancer. But, I’ll give you a hint. The radical mastectomy saved my life. My surgeon, with his choice of a radical, gave me another 34 years of life. That is more than the majority of my R to R patients have had with their more simplified surgeries and treatments.

Thanks, Doc, for all these years.

In the good old days!

I underwent a radical mastectomy. That was the surgery of choice in the good old days. Choice meaning, the doctor’s choice and a woman’s only option. In the good old days, women checked into a hospital the night before surgery, underwent blood and other lab tests, signed an almost blank medical release form (we trusted our doctors then) and left herself to the tender mercy of her surgeon. We were allowed to remain in the hospital until our surgeon was ready to release us. A Reach to Recovery (R to R) volunteer would come in and offer instructions on arm exercises, bra fittings, prostheses options and give emotional support.

Today is a different story. Women get to the hospital shortly before surgery. All lab work and x-rays have been done before arrival. Women are placed on the hospital’s conveyor belt, slid into surgery, out to recovery and the floor, just in time to be released before the staff has to change the sheets again. No time for an R to R volunteer. The new breed of doctors may not even be aware there are volunteers to help the patient. The new breed of doctor is valiantly hanging on to what little bit of authority the big insurance companies have left him or her.

In the good old days, an R to R volunteer was called the day after surgery and knew she had 2-4 days to get there. By the time I had my last R to R patient in 1983, I got the call during surgery and the patient was dismissed the next day. The well-informed ward clerk who called me said the patient had surgery the previous day and was due to go home the next. I quickly rushed to the hospital, only to find a patient who was barely awake enough from surgery to know I had arrived. But, yes, she went home the next day.

What was the difference between my own surgery and time in the hospital? None of the patients I served during my five years as an R to R volunteer had undergone a radical mastectomy. Most had simple mastectomies with a few modified radicals. By not removing muscle, there was no longer any need to keep women in the hospital for longer recovery.

What about their emotional status? Who cared? Insurance companies had now taken control over patient stays and doctors no longer could keep a patient in-house when the little snip at the insurance company call center said the patient had to go home. It didn’t matter if one more day would have allowed the patient to be more focused and aware of her surroundings. The extra time would have allowed family members and friends to plan ahead for meals, child care, errands, and other events the patient would have to face. Insurance companies just plain don’t care. The snip on the phone is supervised by a superior who gets a bonus for all those extra dollars not spent on patient care.