There better be a next time …

and there is!

I had my nipples checked out by my plastic surgeon again, and he (again) told me to wait and see how they turn up (clear throat) after the infection disappears, but that they’ll likely need to be done again. It looks like (crossed fingers) he could do the same minimal procedure under local anaesthetic. Oh heaven on earth let this be the case, otherwise, I’m stuck with some ‘wee nipples of the rouge variety. Worse things.

From ruffles to pimples

My nipples haven’t stuck in place. Instead of nipple ruffles I have nipple pimples. The water proof dressing wasn’t so water proof. Unfortunately when I changed the dressing they’d already become infected. I figured the water trailed in along my mastectomy scar, because the second water proof (to the power 10) dressing let the old H of 2O in also.

The initial nipple tack done under local anaesthetic went really well. The bugger with having an infection is that the stitched wound spreads apart and in effect undoes/unzips the stitches and neat job performed by the surgeon. The result of all this is that my previously pert nipples are now flattened; the left will hopefully go the distance, but the right is a goner. The plastic surgeon told me to allow the wound to dry out. On seeing the infection he quickly announced, “We’ll get them looking good don’t worry”. Then he proceeded to discuss skin grafts, preferably taken near an existing scar to mask the graft site. I blanked out the entire option let alone conversation about skin grafting. I just don’t want that much more hassle for something that’s between Brett and I only. If we can live with the current results then ‘stuff it’ they’re staying as is. However, the final results aren’t in yet as the infected right side hasn’t healed and both sides have crusty scabs. No decisive news on this front (so to speak).

‘Delivery for Ms Dietrich – one pair of nipples – just sign here please … ‘

My nipples are on. I walked into my plastic surgeon’s office last Wednesday (28th July) with no nipples and an hour and a half later I walked out with some. They’re not giving any peek-a-boo action through my shirt yet. If I peer down my top I see two twenty centimetre blood stains under water proof dressings. The dressings stay on for a week and then my plastic surgeon removes or changes them.

I opted to have the nipple ruffles performed under local anaesthetic to avoid a general anesthetic and hospital stay. It was painless, and took the length of a good lunch with friends. I didn’t have to enter the hospital system and more importantly have my brain (and body) shut down for a minor surgical procedure. No nausea and no pea-souper.

On the operating (procedures) table my plastic surgeon, his nurse and I talked about Charlie Teo – a renowned (some say notorious) Australian neurosurgeon. I’d just read an excellent book called Life In His Hands: The True Story of a Neurosurgeon and a Pianist (2008) about Dr Teo’s treatment of a young pianist with a hemangiopericytoma brain tumour. These tumours originate in membrane covering the brain tissue and are classed as malignant because the recurrence rate is high and they grow fast[i]. They mostly occur in young men.

My plastic surgeon and Dr Teo met as registrars in Queensland. Dr Teo sat in a coffee room in full bike leathers with a thumping 1000cc motorbike parked outside after riding up from Sydney. My plastic surgeon liked his openness and thought him a genuinely nice guy.

According to some neurosurgeons Charlie Teo operates on patients others class as inoperable. Some of his surgeries result in quicker deaths and unpleasant final days before the brain tumour takes its toll. What our discussion led to was interesting – that of hope. Dr Teo provides hope when others don’t, even if the surgery is so risky the person’s life might end on the operating theatre.

If you have a medico willing to risk a procedure that might give you longer on the earth and you’re fully briefed on the consequences if the operation fails then having the choice to hope (beyond medical doubts) is worthy in my eyes.

The hematologist-oncologist Dr Jerome Groopman in The Anatomy of Hope: how people find strength in the face of illness (2004) put it like this:

My place is to provide choice and understanding. To hope under the most extreme circumstances is an act of defiance … that permits a person to live his life on his own terms. It is part of the human spirit to endure and give a miracle a chance to happen (p.81).

Dr Groopman goes on to say that with new therapies in cancer what once seemed a miraculous turn around from likely death in patients with advanced, aggressive cancers surviving becomes more commonplace with advancements in chemotherapy treatments and drug regimens[ii].

The reason I was lighter and happier when I woke up without my breasts after a double mastectomy was that hope had flooded back into my room. I finally dared to think ‘I might get over this’.

Several months before my mother died the palliative chemotherapy she received had shrunk the metastatic tumour in her liver. The reason my mother gave palliative chemotherapy a try was to sustain her life long enough to tie-up loose ends like a failing marriage as well as to have as long as possible with me. When I entered her home to become her full time carer, in her words, she’d been sent home to die. There was no further treatment offered or arranged for my mother and no arrangements made like hospice services or support service information in her area. Mum lived in Northern Rivers NSW and had to drive to the Gold Coast or Brisbane for appointments with medical specialists[1]. There was no hope of a recovery and she’d been given roughly a year to live.

One time Mum sat up in bed and in a chirpy voice told me that you never knew a miracle might occur and she could still be cured of cancer. I didn’t want her to fixate on a false hope that her cancer was no longer terminal and gently reminded her of the fact. In hindsight I would’ve had more fun with it – made the conversation lighter – instead of quashing her levity.

[1] Patient Assistance Travel Scheme (PATS) is a travel allowance for people who travelling 70-100 kilometres for treatment. My mother did this all the time, but never knew about this allowance. I didn’t either.

[i] Wyndham, Susan (2008). Life In His Hands: The True Story of a Neurosurgeon and a Pianist, p.21. Picador: Sydney.

[ii] Groopman, Dr Jerome (2004). The Anatomy of Hope: how people find strength in the face of illness. Simon & Schuster: London.