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Well apparently losing two sisters, mother, several aunts and first cousins combined with testing positive for the genetic pre-disposition for cancer is not compelling enough reason for a bilateral prophylactic Mastectomy.  I was also told that my fear and anxiety related to developing breast cancer was "over the top" and that hyper vigilance should be "good enough"

It's not "good enough" before I left Sunnybrook I called the Plastic Surgeon who started this fiasco last September and made an appointment for today.  In the interim I spoke to the clinical oncologist I work with who reassured me that I was not unduly anxious about the situation and offered to do the referrals himself.  I asked if I could take a rain cheque pending the appointment I had today.. he agreed.

I saw the plastic surgeon today, armed with my arguments pro-mastectomy, turned out to be a soft sell. . in fact he offered the referral before I asked, he also suggested I see another "newly minted" plastic surgeon to ensure that immediate reconstruction is truly "off the table".

Life is like a Merry-GO-Round one day up another day down, every thing going round and round.  Start again from the beginning

Last night I met with a group of friends who joined together to celebrate a mutual friend's 25th Wedding Anniversary.

The couple are very active in the Greater Toronto WLS Surgery Community, interestingly enough the group of friends were mostly from the WLS Community at various stages of their journey.  It's a little strange to be amongst a group of 30 people that I would not have known three years ago, and that I only know now because I made a decision to do something for ME!!

I have been feeling 'frumpy" lately, strange how we can still look in the mirror and not see how far we have come, yet its there. . .this group of friends many of whom I have not seen for months pointed out how good I was looking, and made me see I am not the one I used to be. . .I so thank them for that.  I pray I return in like the kindness they shared with me.

Tomorrow I head for Sunnybrook, and hopefully get the news that will help me move on from this period of self loath yet again.  I hope I get the date for my repeat prophylactic mastectomy tomorrow. . .maybe knowing when this will happen will give me some sense of closure and a chance to once again move along on my journey.

So I met up with a group of fellow WLS ladies today, It was nice to be considered a "vet" as I still feel very much a "newbie" but I guess being over two years out, at goal and maintaining equals a WLS vet.  I was feeling pretty good about myself.  I know I am no super model but I am < 200 pounds and if it wasn't for all the loose skin. . .well you know without me sayin.

I met a fresh post-op today who asked "so are you considering the surgery"

Excuse me??  This really hurt??  My self confidence was rocked!!  I felt like that little fat kid in High School that no one bothered with and everyone laughed at!  The flood of emotion was overwhelming.  I made light of it and laughed it off and the logical me thought, poor thing, likely dealing with her newly acquired "carb starved" dopiness, or maybe has some unrealistic view of how her journey was going to unfold.  The emotional me however, the words stung, self doubt rolled in like a tidal wave and I again wondered if I was suffering from dyslexic anorexia. . .looking in the mirror and thinking I look OK when really I should be considering revision surgery. . .

Its going to be a tough couple of days but I know the logical me will reel in the emotional me and I will once again get my head on straight and move on.

Well I spent the day at Sunnybrook dealing with the speed bump I encountered. . .I qualify for a "redo" of my mastectomy except that this time, since I have no active disease it will be a prophylactic one. . .waiting list.  Pre-existing conditions and previous surgeries mean that reconstruction using an abdominal flap is a no go.  Immediate reconstruction is also not an option.  My options are these.  Bilateral Prophylactic Mastectomy with possible 2 staged reconstruction once healing has occurred, with the understanding that I could possibly never have reconstruction or continue with hyper vigilance. . .I have 3 months to decide.

In April I had my first Plastics appointment I went with the guy who did my original mastectomy/reconstruction in 2004.  The bilateral Mastectomy was done to treat a thickening in the right breast which tested positive for cancer and prophylactic on the left breast as I tested positive for the breast cancer gene.  I had immediate reconstruction using my own adipose tissues, and was OK with my results. 

Long story short after my first consult I was less than impressed with his plan of action.  I made an appointment with another plastic surgeon but life got busy and I had to cancel.  Over the summer I reached goal weight and received the name of yet a third plastics guy.  I made an appointment and saw this third guy in late September.  Imagine my feelings when I learned from this third guy that the breast mound I have is mammary tissue that was supposed to have been removed in 2004!  I was sent immediately for a mammogram, luckily it was negative, then referred to a third plastic surgeon for a repeat radical mastectomy and flap reconstruction using my panni. . .

I saw the forth guy Tuesday, and again was less than impressed, he told me he doesn't work on hospital staff (we both are out of Humber) then laughed that off as a joke.  He then said that flap reconstruction is off the tabled as my BMI is/was too high, then decided that he would refer me to a fifth surgeon at Sunnybrook, where I had my radiation therapy.  It may be a year before I have my surgery but I shouldn't worry as they will do monthly mammograms to ensure active disease does not develop. . .so here I sit. . .waiting. . .fighting back tears. . .I thought the breast cancer thing was behind me, I celebrated 6 years cancer free last November 4Th. . .don't feel much like celebrating this year. . .the dark cloud is hanging overhead again

Wow. . .at 182 pounds I am getting way more attention. . .and I am really not sure how I should react. 

Men flirting and telling me how attractive I am.

Me preening in front of a mirror. . .

This is so unlike me.

I used to throw on whatever was clean and fit, not much thought behind it aside from, have I worn this this week.

I have actually started wearing make-up!

Who is this person in the mirror?  I am not sure but I tink I like her

18 and a half months post VSG and I am where my surgeon expected me to be. . .hovering around 200, ONDERLAND.  In my heart I know I am not done, I am 20 pounds from normal.  I am not exactly sure I can or want to be normal, I do know that just inside the gate of onderland is not exactly my goal either.

Tuesday, April 12, 2011 is my first appointment with the plastic surgeon, Dr. Sean Rice, he did my mastectomy and reconstruction 7 years ago. . .I am anxious to see what he thinks he can do, and at what price.

I know I want my "BAT-WINGS" gone. . .I want my "Fajita skirt" gone, and anything else will be gravy.

I am just at the very beginning of this plastic surgery thing and am not even considering a date before the end of this year.  The thought of binders and compression garments in the heat of summer just does not appeal to me!

In other news. . .I am finally done with my ankle recovery.  I have permission to start running on it, first with a brace gradually working toward brace free.  I want to run in the Terry Fox Marathon this coming fall.

I went to see my GI guy in Hamilton 2 weeks ago (did I mention how much I love this guy)

I have been having a great deal of issues regarding nocturnal regurge and aspiration pneumonia. . .there is a med he can give me but wanted to do a scope first.  So two weeks ago my "friend" and I booked it to Hamilton for the scope.  The nurse filled out the precursory paper work and asked me how much I weighed.  She wrote it down, and took me into the room. 

The anesthetic resident asked me if the nurse had weighed me, I sheepishly said no. . .he spoke rhetorically saying "the nurse's need to understand that the dosage is weight based, we have to go weigh you!"

Like a scolded puppy dog I followed him down the hall to be "weighed".

In my head I was fuming. . .he thinks I weigh more than I said. . .I still look like a fat slob. . .I will always be a fat ugly slob. . .

Onto the scale I stepped, imagine my surprise when he started at 180 and started moving up. . .

". . .I would never have believed you weigh 204, I thought 180 was a heavy guestimate for you. . .where are you hiding 204 pounds"

Uhm. . .have you seen my a$$?

I am 14 months and one day, but who's counting right, post-op and went for a follow-up appointment with the fine
Dr. Hagen.  As usual a smile broke across his face as I responded to his calling my name.  "I barely recognize you!"  He said.  "People must really be noticing how wonderful you look by now."

While I hate to admit it he was right about my GERD, it has decreased significantly with my weight loss, and like me he is worried regarding my nocturnal re-gurge, and the fact that I am now suffering through my firth  aspiration pneumonia in a year.  Unfortunately he has no magic pill to stop this and so this continues.

I have developed a painful hardened lump on my right buttocks, he is unsure if it is a cyst, a calcification etc, but agrees that given my history it should come out.  That is booked for January 26, 2011.

All in All a good visit, free from his office now until February.

Effective today my endocrinologist has declared me "cured" re Uncontrolled Type II Insulin Resistant Diabetes.  I was hoping to go to annual follow-ups with him, instead he said that he no longer needed to see me!!   WOOHOO.  I went from self-injecting insulin a minimum of 5 times a day(under consideration for an insulin pump) to normal range fasting blood sugar and normal HGB A1C in less than a year. 

He wrote on my chart in big red letters.

Patient discharged, uncontrolled Type II Insulin Resistant Diabetes RESOLVED (not in remision RESOLVED) by WLS/VSG 17-SEP-10

I am a happy girl!