Sunday, April 1, 2012

Two Days and Counting

March 12, 2012:

I have to start by saying that I have the greatest breast surgeon that anyone could ever hope for! She actually called me over the weekend to let me know she had been thinking more about my surgery and wanted to talk to me about the option of a nipple sparing mastectomy (NSM). Initially she wasn't sure I was a candidate, but after thinking about it more and talking to my plastic surgeon they both agree that I am. She wanted to talk to me in person about it but because of my pre-op appointment I didn't have time to get to her office in St. Paul and then back to Woodbury in time. She was operating in Maplewood so she offered to stop by MY office after she was done and we basically had my "appointment" there!

The NSM would involve a different incision and removal of most of the tissue below the nipple, but not the nipple itself. The tissue would be sent to the lab during surgery and if there were any cancerous or atypical cells present then I would no longer be a candidate and the nipple and areola would have to be removed. If the final pathology report (that comes back 3 days after surgery) showed any abnormal cells then I could end up having the nipple removed anyway, just several days after the initial surgery. There is also a small risk of necrosis, meaning that the nipple tissue would start to die after surgery and require removal.

Dr. Schmidt gave me some articles to review and told me to think about it. Initially I was excited about the idea, but after reading the articles I am concerned about a slightly higher risk of recurrence reported in the literature (about 3%). At this point the main benefit would be cosmetic, and my highest levels of anxiety stem from the fear of recurrence, so I have decided not to have that procedure. I will just be sticking with the typical mastectomy with some options for nipple reconstruction at a later date.

My pre-op appointment went fine. It was with a family practice nurse practitioner, whose office is just down the hall from my plastic surgeon. My vital signs all looked great, my hemoglobin level is excellent, and I'm not pregnant! She cleared me for surgery without any problems, so almost everything is in place now.

I have one more appointment with the plastic surgeon tomorrow morning. He will be doing all of the markings he will need for surgery. I should be getting a phone call from the hospital tomorrow letting me know what time I need to be there. My parents, younger brother and his fiance, mother-in-law and sister-in-law will all be there the day of surgery so I hope they have a big waiting room! Dr. Schmidt anticipates me going home on Friday, which is what I am hoping for as well. Derek will be posting an update Wednesday once I am out of surgery, but I will try my best to be updating myself on Thursday!

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