I’ve been talking for a little while about trying to decide between the 1 and 2 step mastectomies. Obvi, one surgery is better than two. Also, the expanders apparently feel super hard like the Mean Girls mom and they can be really uncomfortable like you have cement basketballs inside you for months. After doing tons of research and talking to people who had both 1 and 2 step, I was ready to meet with my reconstructive surgeon today and discuss both options in depth. In the end, I am still going with the 2-step tissue expander option for surgery, despite is being a longer process and adding an additional surgery to the mix. The reasons for this are:

1. My skin and nipples have a better chance of a good outcome with the two step process

2. My chest wall is wide, so I need a larger implant to fill it in once all my tissue is ripped out removed, and it would be too traumatic on the skin to do in one stage

3. A lot of one steps result in a second surgery anyway because of how they heal, and my wide chest wall signals that could be the case

4. The implant I want isn’t possible with one-step. I like this brand (Mentor) because they are made in the U.S. and every person I’ve seen that has the results I like the most has them.

So, the moral of the story is – do your research, be prepared with questions, and have an open mind.

I went to my second meditation class today. It was super relaxing and a lot easier this week since I knew what to expect. I fell asleep again and a friend came with me today, which was nice. Tomorrow, Adam and I meet with my reconstructive surgeon to discuss the direct to implant surgery. After talking to more and more people who have had the direct to implant surgery, I would way rather do that than the 2 step. The 2 step works great for a lot of people, but I keep hearing how uncomfortable the tissue expanders are. For me, having cement basketballs in my chest for months doesn’t work well, since I’ll be doing clinical rotations during that time. I’ll keep everyone posted about the outcome of my appointment tomorrow, but cross your fingers for me!

Yesterday marked 1 month until my nipple delay, so I’m really going to start eating clean and working out more. I’m also going to cut out caffeine but I’ll realistically probably start that the week before since I have 12-hour shifts and school going on. So this weekend is kind of a food bonanza since I’ll start clean eating on Monday. This morning, Adam and I went to an awesome waffle joint and I had gluten free fried chicken and waffles. It was so good! I balanced that out with a rebounder class.

A rebounder is basically like a mini-trampoline that is an awesome workout. NASA says that 10 minutes on a rebounder = 30 minutes of running. Plus, it helps drain your lymphatic system, which will be really good before my surgery. I’m even thinking of buying one for the house to use it daily before my mastectomy. Hopefully I won’t look like this.

Before I start, let me just say how happy I am to have a post titled after a Ciara song :). Anyhoo, I’ve been joining more online forums for people with BRCA mutations. It has opened up a way for me to speak to tons of people around the world online to ask questions and do research, which is pretty cool.

When I went to the FORCE conference, I met some women who had reconstruction with the direct to implant (1-step) option as well as the tissue expander (2-step) option. 1-step is when an implant is placed in at the time of the mastectomy. 2-step is when tissue expanders are placed in during the mastectomy and they are slowly filled with saline each week, and then swapped out for implants in a second surgery around 3 months later.

Part of the reason I chose the 2 step option is because of how often I’ve heard of 1-step actually resulting in multiple surgeries. Also, there can be issues with blood flow when the 1-step is performed. I’ve also heard about how uncomfortable the expanders can be (check out my post on that here).  Both my breast and reconstructive surgeons said I was a candidate for 1-step, but I didn’t go into too much detail about it with them because of the blood flow issues.

Now that I’ve met more women who have had the 1-step direct to implant surgery, I am interested in talking to my surgeon about it in more depth. Not only have I met these women, but many of them showed me their results at the FORCE conference “show-and-tell” session. A lot of the 1-step breasts I saw and felt appeared natural and had great results with only one surgery. I also posted about this choice on one of the online forums and had many women respond with great feedback and photo results from the 1-step. I called my reconstructive surgeon and her amazing assistant talked to me about both options and scheduled an appointment for me to speak to my surgeon about both options again in more depth. I’m thankful to have such a great medical team behind me.

I’ll keep everyone posted on how that consult goes (on July 21), but it does help me feel less stressed knowing I have fully researched all of my options.

As the date approaches for my mastectomy (Aug 26th), time is becoming my best friend and worst enemy. The more time I have, the more research I’m able to do. For me, this is awesome because I am connecting with more and more previvors.  I’m able to ask lots of questions and everyone has been so open and helpful with answers. People have even sent me photos of their results.  It’s great to have this type of community.

Time is also my enemy because I am getting more eager each day to have the surgery behind me. I’m definitely thinking about the surgery a lot and trying to put all my positive energy into visualizing a quick recovery, successful surgery, and clean pathology.  Good thing I have two 12 hour shifts two days in a row this quarter, which helps the weeks go by more quickly and helps me focus on helping my patients.

For some reason, the recovery after my mastectomy is what I worry about/think about the most. I’ve talked to people with a wide variety of experiences of what the recovery from their prophylactic mastectomy was like – ranging from “I had a lot of discomfort but never bad pain” to “I felt like I was run over by a big rig.” As a nursing student, I see firsthand how individualized the post-surgical process is. The bed rest and arm restriction protocols are honestly what worry me even more than the pain. Pain medicine can help when I hurt, but what can help me when I am stuck in bed for weeks? The answer is bad TV. Okay – maybe that’s not the only answer, mindfulness exercises are important too – but I will be calling the cable company soon to see about getting cable in our bedroom for 6 weeks.

For now, I am just focusing on putting out the energy that my recovery is going to go really well and surgery will go smoothly. But, as powerful as energy is, it will only get you so far. So, I’m stepping up my fitness and nutrition game along with making sure I feel as prepared as possible. I know if I have all the supplies I need and support system in place, I’ll feel more in-control when I walk into the hospital at the a$$ crack of dawn on August 26th. I’m also going to focus on the light at the end of the tunnel, which is knowing my breast cancer risk is dropping from a lifetime risk of 87% higher than the general population to around 1%. That is the thing that helps me sleep soundly at night.

One of my favorite bloggers, The Bloggess, recently wrote a great piece on simple euphoric moments after surgery.  Check it out here.

Today marks the two month countdown until my mastectomy (otherwise known as ticking time bomb breasts removal). I find myself thinking about the surgery more often and definitely thinking about the recovery. In the next two months – my main goals are to be more fit and eat better, to organize all of the logistics before surgery, and to have some fun over the next few months.  Thanks everyone for your ongoing support!