Resilience helps after a quadruple mastectomy (yup – 4 of ’em)

Oops, I did it again. As in two original breasts, four total mastectomies. Think of that when ordering a double double coffee at Tim’s. After the shock of the first two mastectomies, undergoing another two was – well – a shock. I mean, who has four mastectomies?

Paul comic

“Decker,” I negotiated with my partner, “since you have two nipples to my none, how about a nipple donation? Then you’ll have either a left or right, your choice, and I can have one transplanted to the middle.” He declined.

At least this double mastectomy, on 18 September, was preventative, not because cancer returned. Whew.

remaining breast tissue crop

The July chest ultrasound revealed the bulges were remaining breast tissue and not pooled lymph fluid as we’d believed. Quick consensus followed. Yes, mastectomies may not improve survival. Still, it seemed unwise to leave a potential home for an aggressive cancer while my risk of recurrence is so high. I figured the worst that could happen if I repeated the double mastectomy was that my wardrobe would need adjusting. The worst that could happen if I didn’t have it repeated was too awful to accept as reasonable risk.

Dr. Kanashiro masterfully retraced the incisions she’d made the first time, flattening me further. ‘No’ is still my final answer to reconstruction.

The third and fourth mastectomies were just as miserable an experience as the first and second. Compared to the chemo blowing out my brain, when I fell deep into a non-functional state of profound sadness, repeat mastectomies were only inconvenient. 

Seriously? Have body parts amputated sequentially, endure life alterations in what I’ve dubbed Post Change Syndrome (PCS), and just bounce back? Well, yes. Although ‘bounce’ might be defined as dragging myself up a ragged mountain wall, but that’s where resilience comes in.

In 21 August’s post, I mused about the four qualities that supported my recovery after chemo beat me up:

Resilience, Mindset, Optimism and Discipline.

Once again I relied on these four qualities to recover from drastic change.

The Resilience Project defines resilience well: “In the context of exposure to significant adversity, resilience is both the capacity of individuals to navigate their way to the psychological, social, cultural, and physical resources that sustain their well-being, and their capacity individually and collectively to negotiate for these resources to be provided in culturally meaningful ways.”

I use conflict competence skills to navigate through adversity and negotiate for resources to make my body inhospitable to cancer. But which came first in my case – resilience or conflict competence? I had to trawl my memory for this because, as a professor once said: “scratch a theory, you’ll find a biography.”

Scratch my theory that conflict management is a great skill and you’ll find my biography included battling parents, a home with hostility expressed in screaming insults, leaving me insecure and prone to outbursts. I sought conflict management training to deal with my biography and wound up with a rewarding career and the skills to get through PCS. In my storyline, through negotiation training I gained conflict competence and became resilient.

Grandparents Etta and Meyer Switzer

Grandparents Etta and Meyer Switzer

But I my path to resilience was easier because of one stable person in my childhood – my grandfather.

My new theory: the influence of one stable person plus conflict competence help in adversity. I’m grateful for so many things, including my family and Resilience.

 

My medical choice is different than Angelina Jolie’s

For anyone who missed Angelina Jolie’s May 14, 2013, NY Times Op-Ed My Medical Choice, she announced her prophylactic (preventative) mastectomies. Now that people have stopped talking about it, I have an answer to the questions I’d dodged about her letter. Oh, to be as quick with a quip as say, Oscar Wilde. Nope, I needed weeks for a comeback line. And here it is: all breast cancers, like all breasts and all risks, are not the same. So the choices are different.

Pretty lame huh? Yeah, pathetic that in two months I couldn’t come up with anything wittier. Except, it’s my truth. Here’s a few ways her experience and mine are different, and then an answer to the big so what?

Angelina had a risk of breast cancer. This was not like facing Triple Negative Breast Cancer. Angelina has small scars, nothing that would make her children “uncomfortable”. That’s different than scars from armpit to sternum on both sides of my chest. Angelina feels she had “a strong choice that in no way diminishes [her] femininity.” I took less than two seconds to choose not being dead over being feminine. Angelina had reconstructive surgery for new breasts that are “beautiful.” I choose to live with a chest as flat as the prairie whose photograph I picked for this blog. Angelina traded her perfect breasts in for other perfect breasts. I donated my perfect breasts to the tumor bank for research without regret or request for visiting privileges.

That’s the ‘what’. And the ‘so what’ is: We have in common we’re both women who weren’t born with breasts, won’t die with our own breasts and didn’t want to die because of our breasts.

Angelina wrote: “Everything else is just Mommy, the same as I always was.”

photo credit: hollywoodlife.com FameFlynet

photo credit: hollywoodlife.com FameFlynet

What else could we be but ourselves, whatever gets amputated, mutilated, rearranged or droopy? But, really, she’s the same as always? We come through trials transformed, like characters in a good novel (or even in the novel I’ve written).

But I understand, I think, what Angelina might have meant. To those who love us and who we love, we’re still here, still strong, still attentive to them. We’ll shove aside our fears and doubts and nightmares and the quivering parts of our guts that worry we’re not out of danger yet, to answer “Here I am” when our loved ones cry out their fears and doubts.

Finally, here’s the ‘what next’. I’ll hug Decker, and Beth, and Marcus, and Andria, and friends and family, and even Trail the Westie Terrier to my flat chest and assume it’s just as comforting and comfortable as Angelina’s perfect implants. Because our loved ones will hear our hearts beat for them, breasts or no breasts.

Flat is Beautiful

The local newspaper, The Calgary Herald, today printed the last installment of a weeklong feature series on the trouble women have getting reconstructive breast surgery. Wow. Who knew the private matter of a woman who had, lost and now wants breasts again was up for public debate? The journalist’s thesis was ‘having cancer is bad enough, being disfigured is a constant reminder and psychologically painful. Your sense of identity is lost. It’s hard to function or feel normal when you’re self-conscious, demoralized and despairing. Mastectomies are a medical condition deserving of breast reconstruction.’ The journalist referred to it as Battle Scars.

Those interviewed for the counterargument said: ‘reconstruction, like cosmetic surgery and breast augmentation, is elective, costly and low priority. Breast reconstruction should get operating room time after surgical needs for physical trauma and pain. The medical system saved your life from killer breast cancer. Be grateful and be quiet.’ (One husband in the article was quoted calling anyone expressing this sentiment “insensitive” and worth being punched out.)

Is it really a public policy issue how I look or feel after my double mastectomy left me flat chested to the bone with a cover of skin? Cancer can change a person, visibly and invisibly.  People now guess I’m 10 years older than I looked two years ago. My two-and-a-half years older sister Andria was, on more than one occasion mistaken for my mother. My daughter was taken to be older or at least the same age as me before treatment. Not any more.

What’s invisible is the change in my attitude about how I look. I enjoyed my breasts, and my figure got attention. If I’m noticed now, say – in the locker room after a workout when I walk around with a towel at my waist like a man – it’s an opportunity to talk about breast health, the need for a positive lifestyle, and taking care of ourselves. My reality is to defy the beauty industry and what we’re sold as the feminine standard. I have scars from sternum to armpit from mastectomies, not from battles. This is my new shape. I don’t see myself, as one plastic surgeon in the article called women with mastectomies, as a “poor women going through this difficult time” but my heart goes out to the women who relate to that sentiment.

I wonder if our attitudes about our bodies before surgery are a reflection of our attitudes towards them after surgery? If so, then perhaps we should be looking (and this isn’t a stunning new insight) at how to support women gain confidence in their worth no matter what breasts they have or don’t have.  For example, do you remember Twiggy, the first skinny supermodel? She made flat girls trendy. Dressed in mod paisley polyester (aw crap, what was I thinking?) my breast buds and hipless shape were, to my immature brain, so cool that I was hot. Now I know I was delusional, but it was fun at the time. Being breastless now isn’t much different than it was then. Batty odd woman alert – I’m goin’ back to my Twiggy persona. MR900349135

I find the question: ‘How can we support women/people to accept the changes as well as those who grieve and mourn their loss?’ a more relevant and useful and interesting exploration than: ‘Why can’t women have reconstruction whenever they want it.’

Some women aren’t resilient, but research suggests most anyone can be. It’s another lesson from the conflict competence toolkit. Resilience is a teachable learnable skill and it’s never too late to learn it. Besides, resilience looks good on a girl without or with breasts, whether reconstructed or real.