Over the past 2 months, I have been contemplating surgery options ~ a lumpectomy, mastectomy, or double mastectomy ~ and a decision has finally arrived. I would love to tell you that all I had to do was sit quietly in meditation and watch this clear beautiful neon-sign-of-an-answer show up before my eyes.
This was so NOT the case for me.
The “peace with the unknown” I initially experienced about surgery options turned out to have a pretty quick expiration date. In fact, the whole “decision-making” process has been the most challenging, gut-wrenching, emotional part of this entire journey so far. Chemo was a freaking breeze compared to the turmoil my mind has gone through. There were times I wished I didn’t have a choice. There was even a moment I wished the cancer would show up somewhere else in my breast so I could know what to do. Why? Because I was believing the thought…
“I will make the wrong decision.”
Under the influence of this thought, I am paralyzed with fear. My mind can only see the worse case scenario of each option. It’s all shit and I’m forced to choose the lesser of two evil shits. For the 1st time, I truly feel like a victim and I am furious that I’m in this situation. I want someone/something to give me a clear answer. I worry what people will think of me if I choose this or that. I tell myself I’m a failure at being “peaceful.” I’m overcome with emotions and I tighten my body which leads to exhaustion, achier muscles, and headaches. In summary, when I believe this thought, I feel like complete, total, utter crap.
Without the thought – and it took some time get my mind here – I feel so much lighter. The pressure is lifted (literally) off my shoulders and I again, see the blessings in each option. I feel more motivated and open to learning more if needed, talking to others, sitting with myself, & enjoying my life. I feel empowered, open, free, and trusting of my own intuition and the universe.
Turn it around to: “I will make the right decision.”
Suddenly, I am reminded that each option has major bonuses. A lumpectomy is an easier surgery plus I found a plastic surgeon who can do another procedure so my boobs look similar. I get to keep my natural breasts and they’ll be smaller which is nice for my shoulders. A mastectomy gives me peace of mind that the cancer is 100% gone and there’s way less of a chance of reoccurrence. I don’t need to worry about monitoring my lumpy breasts with diagnostic tests & biopsies. My breasts will look more like they did before I began treatment and they’ll stay perky for life which is also nice for my shoulders! And looking back at my history, have I ever really made a “wrong” decision? Even the times I thought something bad was happening…it turned out to be even better than I imagined. I broke my ankle and then met my husband when he offered me a stool to sit on…we were kicked out of our apartment and ended up moving to a retreat property and creating a new business…I failed my first yoga training and then started my own private practice. The only thing that could go “wrong” is the label my mind puts on it. Also, I will make the right decision – something will feel really right at some point.
Hmmmm….feeling much better.
Here are some other stressful thoughts I have taken to inquiry:
People will judge me.
If I choose a lumpectomy, the cancer will come back.
If I choose a double, I will not like my breasts.
I should be more peaceful in this process.
I want the universe to give me a clear decision.
I am not “evolved” if I choose a double mastectomy.
I need to be at peace with my decision.
Doing The Work really helped to bring me back to the present moment and clear my mind of some major bullshit. And I noticed I still go back and forth to attaching to some of these thoughts. Here are a few other techniques that have supported me.
Clarifying My Intention
Sitting with the questions, “Why am I choosing surgery? What is its purpose? What do I want from this experience in the longterm?” helped me to clarify a clear vision to hold as I walk through different options. For me, it boils down to:
- Cure this body of cancer cells
- Prevent cancer cells from returning
- Feel longterm mental peace
- Look/feel good about my body
I dove into learning as much info as I could about each option. This included asking more questions to my breast & plastic surgeon, getting a 2nd opinion for surgery and reconstruction, and talking with other women who have had each type of surgery. Some new info I learned was:
- A much less invasive lumpectomy is an option with my 2nd opinion breast surgeon. Of course, clear margins are needed which could lead to more surgeries.
- There is a higher risk of reoccurrence with a lumpectomy; a double mastectomy drops the reoccurrence rate from 12% to 1%. The survival rate is the same.
- For a lumpectomy, “you get what you get” in terms how the breast looks is not true – there are plastic surgery techniques to help the breasts look even. In a separate surgery, the other breast can be reduced and lifted (which involves cutting out the nipple and moving it up). After a lumpectomy is complete, there is more monitoring of the breast tissue with frequent mammograms and ultrasounds.
- For a single mastectomy, the plastic surgeon can make the other side match. However, over time – aging will make the real breast sag while the other remains the same.
- For a single or double mastectomy, there are at least 2 surgeries. The 1st is when the breast tissue is removed and expanders are put in place to help stretch the skin and prepare the breasts for implants. The implants are done months after radiation and extra fat is injected between the implants and the skin for a natural look & feel. My 2nd opinion plastic surgeon offers a less invasive technique for reconstruction that includes the use of implants + liposuction. He would use fat grafting (liposuction) in more forgiving areas like “love handles” which leaves very little scarring and is an easy recovery. The 1st surgeon wanted to do implants + belly fat which involves a 3rd pretty intense surgery that cuts the stomach from hip to hip to gather belly fat to help build the breasts. After these surgeries, there are no more mammograms or ultrasounds – just the occasional chest X-ray.
- Radiation will be recommended regardless of which surgery I choose because cancer was found in my lymph nodes.
Two things began to become clear: (1) I prefer my 2nd opinion medical team: Dr. Laidley (breast surgeon) and Dr. Antonetti (plastic surgeon) at Medical City and (2) doing a single mastectomy was not an option for me. It’s either a lumpectomy or a double.
I also have REALLY loved connecting with women who have been through this. There is an instant bond that exists with cancer patients and survivors ~ an immediate sense of connection and compassion. I also received a helpful reminder from each woman that it’s completely normal to feel everything I am feeling. Fear, worry, anxiety, doubt….these are all natural human emotions in life and in this process. I am not alone. Ever. For some of the women who chose a lumpectomy, the cancer came back and they ended up getting a mastectomy or a double. The ones who were very happy with their lumpectomy and are still cancer-free had a much smaller tumor initially with no involvement of the lymph nodes. For the double mastectomy women, most of them said the procedure was hard but not as tough as they thought it would be, and not one person regretted their decision.
Everyone I talked to reminded me that this is a personal decision; I need to do what feels right for me.
After many weeks of this information gathering phase, I started to get completely overwhelmed…I had thought that during one of the meetings, something would just click and my decision would be made. But I still felt torn. I knew it was bad when one day, my husband asked me if I wanted a salad for dinner. If so, he would go to the store and buy lettuce. I completely freaked out on him, ran into the room sobbing, “YOU make the decision! I can’t handle it!”
I had to take a break and step away from it all for a few days. Then Type A Bethany took over with…
The Good Ol’ PRO/CON List
Yep, I’m a dork and created an entire spreadsheet titled “The Future of My Boobs” which listed out the pro’s and con’s with each surgery option, along with the procedure recommended by each doctor, and additional questions/things to consider. I then scheduled a FOMB meeting with my mom and husband and we walked through everything together. At this time I was a week away from my last chemo session so chemo brain was in full effect. This process helped to better organize my thoughts and make sure I had a clear understanding of each option. Here it is in case it’s helpful for you too.
Trying it on & Feeling it out
I decided to “try on” my two different decisions as if I were trying on a new dress. Ok, I’m doing a lumpectomy. How does it feel? Do I notice any physical sensations? How do I feel as I imagine the next 60 years? Then I tried on the double.
This is what shocked me the most. When I try on a lumpectomy…I lose my breath and constrict my body. I feel anxious.
When I try on a double, I feel relief.
This is not what I expected to feel. I mean, after all – I ended up getting what I thought I wanted with a less invasive lumpectomy. But the truth is, it still didn’t feel right. I have what doctors call “Fibrocystic Breast Disease” which is a fancy term for “super lump boobs.” So for me, a lumpectomy feels easier this year, but harder in the long run with the constant monitoring of my breast tissue. A double feels harder now but so much better as I imagine the rest of my life.
I also noticed that when I would talk to people about it, I was looking for them to tell me it was ok to choose a double mastectomy. I mean shit, there was also that moment of hoping for more cancer to show up so I could make this decision. Instead of looking outward for that permission, I decided to give it to myself instead.
So yes, I have chosen to do a double mastectomy.
If you are surprised by my decision, so am I. If you are relieved by my decision, so am I.
Still I don’t know
I had felt so incredibly solid in my decision for weeks and then I found out the reconstruction process may take longer than I had originally thought – it could be NEXT spring or summer. This threw me over the edge and I began to second guess EVERYTHING. Am I making a mistake? Will I regret it? Are these just pre-surgery jitters or is my heart talking? Back to the ping-pong match of going back and forth between options. I’m not going to lie – the past few weeks have kind of sucked ass.
All I wanted was that feeling of clarity to come back and stay forever.
I discovered that I really, really, really needed to spend time with my emotions – give them the FULL expression. I’ve gone from feeling perfectly fine to sobbing within seconds. I had a hard time sleeping and would wake up in the middle of the night in tears. I felt like movement helped – longer walks, jumping on the trampoline, yoga, epson salt baths. One day, in a fit of anger, I tore up a cardboard box…I attended an incredible Somatic Movement + Sound Healing Workshop ~ I cried before, a little during, and a ton afterwards. My husband held me on many occasions and facilitated me on additional stressful thoughts. It was so clear that suffering started in my mind and then the body followed. But this awareness angered me even more – I was watching it happen and couldn’t just press the “off” button.
I also feel like I’ve been experiencing a natural mourning/grieving process for my breasts. They will never be the same as they once were. Well, actually – they are already not the same! But how do I know they won’t be better? The worse that can happen is my stressful story about them. I’ve spent some time drawing pictures of my old boobs too which was healing.
One day, I was journaling in nature working the thought, “I want the universe to give me a clear decision” and I was listening to Pandora. When I was in the turnarounds, I heard these lyrics:
Settle down, it will all be clear.
If you get lost, you can always be found.
Know you’re not alone.
I’m going to make this place your home.
Thank you, universe. Right now, what’s true for me is a double feels like the best decision. And I’m open to my mind changing. This Thursday, I am scheduled for a pre-op visit with the surgeons to go through the details of the operation & how to prepare for it. The surgery is scheduled for April 18th. I’ve decided to just spend my time doing things I love, be present with anything else that comes up, and see what happens.
And maybe…just maybe…Future New Boob Bethany will go from this to this!