Holey Moley: Part Two

Cripes a'mighty! So my theory about the hole was fairly accurate except the bit about how the circular piece of skin got from back to front to make an areola. I literally imagined it as a skin patch being cut from the back and plonked on top of the new breast as a final touch. Instead, an ellipse-shaped piece of skin is still attached to the back muscle as it's swung around under the armpit. The reason it's a fairly large ellipse is to give access to the muscle.

Once around the front as it were, the surgeon shaves the excess skin from the ends of the ellipse to make a circle, replaces the orange peel-like flaps of breast skin over the top of the muscle so that it meets the new areola, and stitches it all together at that point. (See my previous post on the melon spoon myth for more food/breast analogies.) I have to say I'm in awe but also slightly perplexed at the notion that someone could actually enjoy slicing another human being like an orange, but there you go. Mr A loves what he does. Surgeons eh?

Source: flickr.com

Why the gory details matter

I thought I might risk turning people off by posting a picture of my back wound on my blog, but then my friend Becky told me to watch Embarrassing Bodies. Blimey! I love Channel 4's disclaimer: "This video contains explicit medical imagery". Somehow that is more arresting than their parallel warning, "nudity in a medical context". It makes me feel better about being explicit about my surgery - it's important to me to share that experience openly and honestly. This is why:

• It helps me come to terms with the facts. 
• I like saying the things people want to ask me about, but are too polite to; conversely, I like saying the things people don't want to hear as well.
• It's payback for all those times when I had to listen to other people's boring work stories/birth stories/poo stories/funny things that happened and you should have been there stories/etc.

I'm going to use the Embarrassing Bodies series to prepare myself for my next task: watching a sentinel node biopsy, mastectomy and LD reconstruction, the surgeries I had, live in theatre. My friends think I'm bonkers, but I'm absolutely fascinated, and I really want to stand and watch my surgeon, Mr A, at work. (Although sitting may be better. In truth, I shall probably be feeling quite sick.) He's going to video an operation for me to watch at home so I can decide to opt out of watching the real thing if I want to. Before that happens, I'm also going to prepare myself by editing an earlier post, in which I wrote "etc." instead of "nipple" because it felt rude.

Holey Moley: Part One

At long last, I think the hole in my back is starting to heal properly. People have been asking me why, if I've had a mastectomy, I have a hole in my back, so I shall explain. Avert your eyes if you're squeamish about these things, because I'm going to include a photograph of it. Mmmwwahahahaha! (I can't deny it gives me pleasure to share the gory details. We shall investigate why another time.)

Although I had a skin-sparing mastectomy, I was unable to keep the areola etc.* because they contained the ends of the milk ducts (in which the cancer cells were sitting). However, because of the very fact that the cancer cells were contained in the milk ducts, I was able to have reconstruction at the same time as the mastectomy. I didn't want to have implants - they have to be replaced every ten years or so. I wanted something permanent and more natural (i.e. something that will realistically droop!), so the new breast took shape using muscle from my back. When the muscle was in place, they patched up the areola with a circular piece of skin taken from the back as well. It's my theory that the skin graft is to blame for the hole.

Now skin is really stretchy (the lycra of the body, if you will) and I am sure Mr A sewed it up using his best blanket stitch. (Ok, I made that up, but it reminds me to ask him how they do it.) But because of all the stress and tension on that area as I began to use my muscles again - carrying children, awkwardly trying to shoehorn them in and out of car seats, weeding the garden, and so on - the hole opened up and started oozing. And it hasn't stopped. Mr A tried to sew it back together. It opened up again. Over three months later, it is still oozing, and now, joy of joys, it is infected. I'm on antibiotics now though, and the lovely tissue viability consultant and Mr A are due to take another look tomorrow. Thankfully, I think the wound is drying up. I'm on the home stretch. What a relief.

There's a hole in my back, dear Liza, a hole.

*Nipple. See post above for context.