Saturday, November 28, 2009
Time to Become Two Titted again....nov 29
Since none of what I have done is reversible, I must carry on in quest to restore myself to two-titted person so it’s back to Dr Rex, the young and very amiable one in Beverly Hills (very Dr McDreamy) for a second visit to see if I like him as much as I thought I did. One visit is not enough I’ve realized when sharp knives are involved. I’m shown reconstruction photos but these are not reassuring. Gruesome shots of grafts from the upper inner thigh, the stomach, the buttocks and the back with fresh livid scars leaping out at me. I immediately assume these photos mean the doc thinks I will need such surgery but he starts off by denying it, saying that he thinks my breast skin will SOMEHOW un-wrinkle and un-shrivel back to life. Maybe.
But what he REALLY recommends, to minimize the risk of re-infection is something different. He is suggesting taking both triangle-shaped latissimus muscles from my back – the ones you use for pull-ups or a mighty golf swing– and putting them into my breasts to support the implants. And because it’s my own living tissue, there’s very little chance of re infection and it will look better BUT---to make it look symmetrical he wants to do BOTH breasts-so that means two incisions under my arms – another two further down for the camera to enter my body and two more incisions where the muscles are slipped in. A four hour operation and 4 drains for a couple of weeks. FOUR BLOODY DRAINS hanging around yours truly. Two was charming. Four really sounds like fun.
He’s cute but not that cute. Jeez. And that ol dead people’s skin, Alloderm (which would support the implants –instead of the aforementioned latissimus muscles which I now realize I’m very fond of just where they are) is sounding good right about now.
Let’s leave back muscles where they naturally reside and pop some new nice clean Alloderm and an expander into my left and see if we can’t get back to where we were…and then wait two or three months till, God willing, I might be ready for the permanent implants and life again as I once knew it. That’s Dr Bob’s plan and it’s sounding good—especially when I discover that Dr Rex, contrary to what the girl answering the phone told me, is not contracted with Blue Cross and thus it would cost me a good deal of cash.
Two days Later
Dr Bob starts to seem like an even MORE APPEALING OPTION WHEN I go to see YET ANOTHER surgeon Dr John…a very well-known one at UCLA who does a heap of breast work and who many smart and well-heeled Beverly hills ladies all love and praise to the skies…I had seen him in my initial quest for MR RIGHT but passed him over when I realized I was basically penniless and HAD to go with the best of the lot who were contracted with Anthem Blue Cross but as a former journalist I am curious to educate self and get the lie of the land so to speak. At our first meeting he had concurred about expanders and finally implants as the way to go and now I am curious, IN THE LIGHT OF THE TEN WEEK STAPH INFECTION, to see if he suggests staying on the expander/implant path or might he be on the same page as Dr Rex and recommend the latissimus muscle removal- or perhaps even some other whacking great surgery.
By the way, just negotiating getting to UCLA is enough to put you off…Could it be any duller? Going to Westwood is massively dull and then getting a spot in the colossal car park and finding your way into the right building is not for the faint of heart. And though it should be comforting that the correct building, number 200, is actually named THE PETER MORTON Building, it’s not. Hard to say why as he’s one of my oldest friends since the London days and the Hard Rock on Knightsbridge (that really dates me!) but here’s my thought for the day. Once old pals become billionaires, things just somehow aren’t the same. And anyway, the last time I tried to get out of the PETER MORTON BUILDING, after seeing a wonderful oncologist recommended to me by the stunningly effective and clever movie producer Laura Ziskin (who raised $100 million in one night last year on TV in her STAND UP FOR CANCER marathon on all the networks) it was like trying to escape Fort Knox. It was about two hours after Michael Jackson’s body had been taken there and it was bedlam. The gorgeous male friend who actually accompanied me to see this marvelous man Dr John Glaspy (giving me an upsetting glimpse into how divinely comforting it would be to have a husband to go to doctors with, though, what if…. what if he disagreed with me and had ideas of his own and insisted I hook up with a doctor I didn’t LIKE---hmmm, maybe not so groovy) ….sorry, I digress…anyway my friend had been called by a music industry lawyer friend as we sat waiting for the doctor. This friend said he’d heard Michael Jackson had overdosed and died. It was hard to take in—as I feverishly studied my questions for Dr Glaspy who I was using as a final sounding board for my double mastectomy decision. I thought he was a good guy to go to for the TRUTH. When I went to see him a month or so earlier, at Laura Ziskin’s suggestion, I was blown away at first sight. This was a man with the kindest, wisest, loveliest eyes I’d ever seen – and a very charismatic, magical smile. I adored him on the spot. Husky, but definitely marriage material. Smart as a whip. A researching, groundbreaking oncologist. A winner…Okay, okay I’m getting carried away. I admit it.
Best of all, he was BRUTALLY FRANK. One of the reasons I had even wanted a second opinion was because although I liked the oncologist I had been seeing, she had basically fudged the truth. Or put a spin on it that is truly scary and horrifying when you are first diagnosed with ‘fast-growing invasive breast cancer. She had told me that chemotherapy would boost my chances of survival by about 30 %...and as my daughter and I sat in her office a few days after my lumpectomy she pretty much made sure of our business by adding that if the cancer was not ‘contained in the breast’ it was not going to be pretty. “If it spreads, there is nothing more we can do for you.”
No further discussion was offered or asked for. I could think of everything –but nothing to say and I looked over to see my darling daughter in floods of tears. So, although it seems moronically naïve and just plain moronic in retrospect, I asked not a single follow-up question. I was rendered speechless by such a definitive statement – and my own ignorance. Fearing she might lay something even scarier on us – such as, tests indicated I had six months to live, we fled. And about ten days later I embarked on my three months of vile chemotherapy. But as the weeks wore on and I lost hair and sense of self, I did start trying to catch up with the whirlwind and find out more information. I read books, I searched the internet and I bought the $350 Moss Report. He’s not a doctor but a very well-respected journalist/researcher who has written huge 500 page reports on virtually every type of cancer known to man.
But I must boast that by the time I started to wade through this very lengthy tome, I knew enough to to be able to email the assistant to Ralph Moss, pointing out that some of their facts about available breast cancer tests were out of date. She politely agreed, apologized and sent an immediate refund. But what is NOT in dispute is that most oncologists do present statistics in a way that promotes the use of chemotherapy whereas the true statistics are that CHEMO IMPROVES YOUR CHANCES OF SURVIVAL ONLY BY ABOUT 1-2%. YES, JUST ONE TO TWO PER CENT.!!!
So when I walked in to see John Glaspy and told him about my cancer he immediately responded with “Well if you’d come to see me sooner and told me you did NOT want chemo, YOU WOULDN’T HAVE GOT AN ARGUMENT FROM ME !!
Excuse me?? What kind of heretical talk was this?? I practically hugged him on the spot—simultaneously devastated that I had already finished the fucking chemo. And so I asked him if he agreed with the statistic that chemo only improves your survival rates by THIS ALARMING 1-2 % and he said YES. “But you never know’ he added, trying, I suspect, to simply comfort me,
‘Perhaps you’d have been in that 1-2% and it’s saved your life’. He smiled his ridiculously lovely smile and I found myself choking back tears- suddenly weepy, weary and touched by his kind manner as a flash of leaving one’s kids behind seized my brain.
Okay—well that was a flashback to our first meeting where he even discussed the advantages of complementary treatments like Vitamin C therapies and acupuncture etc. The guy was a veritable Renaissance Man. My kind of oncologist. And so I had revisited him to discuss the concept of the double mastectomy INSTEAD OF RADIATION and he agreed with me that the side effects of radiation were very much played down and that by using the new skin and nipple-sparing techniques for mastectomies, it was definitely a good option ESPECIALLY SINCE THE LYING PRICK OF A RADIOLOGIST – one of the top guys in Beverly Hills had lied to my face and said that he almost NEVER saw any side effects to radiation nor did he ever see problems with the skin of women who already had implants. Women like me. To my face he lied with an Aussie pal as witness who knows a lot about cancer and the whole ball of wax. She too was stunned given that it’s VERY WELL DOCUMENTED that the breast skin is fairly likely to ripple and get lumpy after radiation. Which is when I stormed off with my fellow Aussie and thought “Well bugger that for a joke” and embarked on my mastectomy research. Not that it’s actually turned out all that well of course….but still, getting an infection only happens to a small minority.
And SO it was now, after being reassured by Dr Glaspy that my chances of recurrence were down to 1-2% after a double mastectomy and that he would recommend it, that my dear friend Richard and I tried to leave UCLA. We immediately felt the buzz and panic in the air and at every turn came across hoards of crazed people running in all directions. We were assured by two nurses in the elevator that they had just been with Michael Jackson and he was NOT dead. But moments later, caught up in the drama of it, all we headed outside to see helicopters and paparazzi galore and well, the rumors now were that he had definitely died. It was ghastly and confusing and just so deeply troubling and upsetting. We had a coffee in the café and then---well, we sat in our respective cars for almost THREE hours trying just to get OUT OF THE BASTARD CAR PARK.
SO, WHERE WAS I?
Back at UCLA –about 3 months after my last visit with Dr Glaspy---to see a reconstructive surgeon, Dr John who I had seen once before. I had liked him but as I said, I chose Dr Bob as I both liked the look of his work and he took my insurance.
Well, this time round, the good surgeon takes one look at my breast area and visibly winces. He seems bad-tempered and I instantly blurt out “Please don’t hate me –I went elsewhere for the surgery because I couldn’t afford you”, but it doesn’t seem to appease Dr John. In fact I suspect he thinks the talk of money rather vulgar. He basically acts like a war general, telling me to man up and to jolly well ‘live with it’ (meaning the lopsided unibreasted phase) for about six months to “completely minimize the risk of reinfection” and stop worrying about the way I look – as if I’m some half-witted shallow vain fuckwit who is making a mountain out of a molehill. (Well I’ll be frank -I’m as vain as any middle-aged fool who still harbors just the faintest glimmer of hope that I’ll still meet my dream man and provide my heavenly adopted son with a father figure)
He then demands—with not an iota of the charm he showed the first time around, that I sit and bend slightly forward from the waist so he can grab the subsequent roll of fat and then concludes that in 6 months or more a ‘flap’ would be the way to go. He could take skin and muscle from my lower stomach, making an incision’ from hipbone to hipbone’ and use it to make a breast from scratch, nipple and all. Somewhat stunned, I ask if he doesn’t agree that I could just try having an expander put in again. No, there’s too much risk of re-infection he insists like some know-it-all-celebrated surgeon and besides, he bitches,” that’s all they know how to do at St John’s - you need to come to UCLA where we know how to do flaps.”
Only one tiny problem…I don’t want a fucking flap. (And by the way, I do not use the term ‘know it all’ lightly…fact is they have done NO studies or compiled NO statistics on any of this because I’ve asked all eight surgeons I’ve seen and it’s educated guesses ALL the way with half saying “Go ahead and fill ‘er up in 6-8 weeks---and the other half saying “Wait 6 months before putting back the expander.” So, let’s be very VERY frank - it’s a crapshoot all the way. And grudges against other hospitals are not MY BUSINESS Doc.
And by the way, this ‘flap’ thing they love mentioning …I totally understand that some women who had very large tumors were simply not able to have the skin-sparing mastectomy I was ‘lucky’ enough to have and this flap or skin graft – (taken from back, stomach. upper thigh etc) was an unfortunate necessity but I would prefer to go the simplest route for now…and once his very sweet assistant shows me horrifying photos of the huge long scars – about 14 INCHES LONG – on the stomachs of poor women who needed – or were talked into goddamn flaps, I really know I won’t heading back to UCLA for a little while.
But I do spend a fun evening at the Hollywood School House and help put up decorations for the Halloween Haunted House which is an 8th grade fundraiser and since the darling boy is in 8th grade and they are raising money to go on a fabulous trip to Washington DC I feel compelled to hit Vine American Party Store and buy lots of witty scary things—limbs and heads and bloody swords and cobwebs and you name it. All stuff I ALREADY have in a couple of boxes somewhere in the depths of my garage OR in storage but I have never boasted that I know where anything I possess actually is after so many moves so little things have to be bought over and OVER again..verrry frustrating. The kids have a ball and Nick flirts with the girls and even though they won’t kiss you in the car when you drop them off at school of a morning, Nick is clearly thrilled to see me and gives me lots of very adorable hugs and has a ball helping hang things and placing the coffin he’ll pop out of, in a prime spot. Some parent helpers get a kick out of me at the top of a very high ladder in very high bright red patent leather Mary Jane Manolo’s. What can I say? I’m chic. For an hour.