It's a creekmore world

Week # 19: Goldilocks and the Titty Docs: A tough reconstruction decision.

.

.
The kids are off to school, officially signaling the end of summer.  Trish walks with us to their schools, a little less than mile away.  It’s a hilly walk – down, up, down and back  up again.  Trish is stopped in her tracks, short of breath, halfway back.

Her red blood counts are getting lower.  We’re told it’s still safe, but she doesn’t have the stamina to exercise.  On the first four chemo treatments she was dancing by the first Monday after, but after the 5th treatment she couldn’t do it.  And tonight doesn’t look likely either.  When she gets home she sleeps.  It’s 9:30am Monday September 1st, and we are 19 weeks into Trish’s second bout with cancer.

If some is good, more is better, right?

Sheyla Hershey
All week we have visits to plastic surgeons to figure out Trish’s reconstruction options.   Reconstruction is a subject we’ve joked about a lot.  Early on in the summer we made a facebook fan page for people to vote for Trish’s new boob size called ‘Go big or go home!

I kidded with one of the Doctors, who showed me an implant and said it was the largest size available in the United States.  “Oh really? ‘ I asked ‘Do you have imported ones that are bigger in the back somewhere?  Can we see those?”  She nervously scanned our faces to see if we were joking.

And then there was the Brazilian ‘model’, Sheyla Hershey, who had the largest implants ever recorded taken out because her skin couldn’t hold them.  She tried to wear size 51-KKK, but the skin ruptured and she developed staph infections.  We joke about getting them donated to Trish for recycling.  Save some silicon!  Recycle foobs!

And there have been lots of humor about getting 3 or 4 boobs. The picture on the right, from the wall of one plastic surgeon, seems to imply they do this sort of thing.

Our assumption in all this joking, totally naieve, was that plastic surgery can do anything we wanted.  So we could afford to joke.  But upon consultation, we are hit with the reality that plastic surgery has it’s limits. And Trish is faced with a diffucult choice regarding reconstruction.

Goldilocks and the three Titty Docs

We have three appointments with doctors, all reccomended by Trish’s primary cancer surgeon. We’re confident they can all get the job done. And they all give us the same basic diagnosis.  The difference is style.

Too 'Lady Gaga'
And in style, the three Doctors are amazingly different. The first was a little too slick, the second was a little too geeky, and our final choice, Dr. Kathy Huang, was just right. In choosing a surgeon, we want information and options from the Doctor, but not too much.

Dr. Slick:  The slick one was very nice, but really didn’t go over the challenges or complications enough. In restrospect, he didn’t say anything false, but we get the feeling that he was too optimistic.  Neither of the other docs were as casual about the reconstruction.

And the office was bustling with people that had too much plastic surgery – young secretarys with puffy lips and boob jobs.  The robes were thick, plush terrycloth and everything was spotless.

Too, um,  'Park Slope'
Dr. Geek:  Her office is bleak.  It’s an older part of Suburban Hospital and looks a little run down.  Dr. Geek invites us into her office, which is filled with tools, liquids and an old patient chair in the middle.  Her scrubs are disheveled and she carries a laptop and a few 3-ring binders.

The next hour is spent going over her pictures, power point slides and her presentation about breast cancer surgery.  Oddly, she spends a lot of time telling us about procedures that Trish can’t have.  And then there is a point where she shows us pictures of procedures that didn’t work.  They are not pretty.

I suppose her point was to educate us.  And she did that, although it was much more than we wanted. She was the least flexible about treatment, telling us there was only one option.  (And it is eventually the option we chose, so she was right.)

This one is just right!
Dr. Just Right: Our final visit is with Kathy Huang.  She seemed confident but really outlined the challenges she faced with reconstructing the cancer breast after a mastectomy.   But she was incisive, getting to the exact issues quickly.  It was the right balance for us.  We took a few days to decide, but we both knew in her office that she was the right one.

Bubble-boobs

The consultations more-or-less say the same basic thing, which is that replacing the breast on the cancer side is very complicated.  In a normal procedure, an inflatable temporary implant is slid underneath the top muscle in the chest.  The skin and muscle are stretched over a few months to the size desired.   And then a ‘permanent’ implant is put in.  (Implants need to be changed every 8-15 years usually.)

Soccer Ball Boobs
You can do it without putting it under the pectoral muscle, but it often doesn’t look as good, and the skin envelope of the implant struggles to get enough blood supply.  It’s a faster recovery and the surgical scars can be in a number of places including the armpit or navel.

This is why a lot of actresses and porn stars have bubble boobs – they go for the quick procedure instead of the slower one.  That look also comes from a lack of body fat, (suck it skinny chicks!)

Trish will be a Cyborg-Zombie

On Trish’s healthy boob side, she will do a normal procedure and get the inflatable implant.  But on the cancer side, there are two huge problems.

Cyborg-Zombie!
One, the cancer surgeon will take a lot of the skin, leaving little or no ‘envelope’ in which to hold the implant. It’s very difficult to replace all that skin without taking it from other places.

Cool, but creepy fact: they can use the skin of dead people to augment Trish’s skin, which with the metal rods from her broken back, will make Trish a cyborg-zombie.

Franken-Tits

The second problem is that Trish had radiation with the lump-ectomy last time. After a mastectomy, normal skin might be able to stretch enough to get a small implant underneath, but radiated skin is damaged and can’t do that.  It won’t regrow enough.

So Doctors look for other places to get skin.  But you can’t just graft skin onto an implant, there has to be a structure, and it needs blood.  That means taking some thin muscle too.  But you can’t just take any muscle, because it has to stay connected to a blood supply.

So the two choices are stomach and back.  In both cases the muscle remains attached at one end to it’s original blood supply.   They detach most of the muscle and flip it on to the breast.  The skin stays connected to a blood supply and the muscle gives the surgeon some tissue to shape the new breast.

Her stomach (DIEP) is not an option because she had so many surgeries there already.  The back (TRAM) is possible, but in addition to having a gorgeous tattoo, it’s critical to her because she is so active in dance and trapeze.  And she has already broken her back once, so back pain is a chronic issue for her.  The back in not an attractive option either.

I love Lily's scarf
By the end of the week, there are a lot of tears.  It’s a choice that brings furrowed brows all week.

4 thoughts on “Week # 19: Goldilocks and the Titty Docs: A tough reconstruction decision.

  1. Aviva

    Such a beautiful photo of Trish from the back. A real treasure for your children to have for years to come. Kudos to you guys for seeing the beauty and the humor in this otherwise bleak situation. I can’t imagine anyone going through this ordeal with as much care and flair and fun. Much love to both of you. Viv

  2. Kelly Kubsch

    I have come to the conclusion that the Creekmores are the most amazing family I’ve seen. Staying as optimistic as possible through life changing events such as these is truly great to see. You guys are winning this battle in a way I’m sure many wish they could. Keep it up! :)

  3. Clare

    After reading this entry I feel like such a “boob” for casually posting an inquiry on Trish’s wall about her eventual choice of a cup size.

    All I can say is that you guys are amazing and inspiring, and Trish is in my thoughts every day.

Leave a Reply