Decisions
Warning: this one’s a bit morose and philosophical. But it’s helping me work through a few things.
Today was the first hard day. Don’t get too excited, I haven’t actually started any treatment yet. It’s all been tests and appointments and referrals and a lot of research. It was just hard. The first day that it all felt a bit too much to deal with. A big part of that is the number of decisions I need to make.
Essentially there are two options:
- Chemotherapy first to try to shrink the tumor so I can have a breast-conserving surgery in a few months time to try to keep part or most of my breast. This would need to start asap and, because of timing, would probably rule out any chance to freeze any eggs and likely rule out having children in the future.
- Mastectomy to remove the whole breast asap followed by about six weeks of recovery. This would give me time to get some eggs removed and frozen before chemo starts.
The mastectomy itself has some options too:
2A. If I want a reconstruction the mastectomy could be done in a skin-sparing and nipple-sparing way with an expander already put in to maximise my chances at a good reconstruction.
2B. I can choose to go flat to start and see how I feel about it. I can still opt for a reconstruction later, but the result wouldn’t be as good as if I made the decision now.
I think I’m actually finding all the options a bit too overwhelming. If I had no choice at all and it was certain that I would lose the breast and not be able to have a reconstruction and not be able to have children, then I think I could actually handle that easier. But instead there are all these decisions that I have to make that mostly hinge on things I don’t really care a whole lot about right now. Certainly compared to increasing my chances of survival it all seems kind of trivial.
I’m also trying to make decisions based not on how I feel right now, but on how I might feel years into the future. And not just any years. These are likely to be life-changing and perspective changing years. Who knows what I’ll want or what I’ll consider “worth it” in five years time.
Right now, I have limited experience with hospitals and surgery and find it all a bit daunting. Right now I’d like to limit the number of procedures I have to go through and just go for the simplest option. Right now I kind of like the idea of being a lean single-breasted childless amazon.
But.
The reality is that over the last year or two my feelings about having children have changed substantially. Not enough to decide I definitely want to start a family, but enough to be entertaining the possibility, albeit in a fairly abstract way. If I were to have that quantum of change again over the next few years I could very easily find myself desiring a child. Equally, I could go back the other way and decide I’d rather focus on other pursuits.
And while I like the idea of being a lean single-breasted amazon warrior princess, I’m not sure it will really suit the rest of my body shape. I’ve seen some really cool pictures of women with one breast that I think look awesome. But they’re all rather a bit smaller busted than I am. B-cups at most. Most of the pictures I’ve seen of women with my bust size with one breast look more disfigured than just asymmetrical in a cool way. Historically I’ve felt good about my body by working with what I have rather than pining for a different shape. While it would be very sad not to have that cool amazon body, maybe I’ll be happier by making the most of what I have. Not to mention the very real privilege I know I get by being conventionally attractive and “normal” looking. I’m not sure I should give that up lightly.
It also feels like such a betrayal of my past self and values to choose the egg freezing or the reconstruction. Who is this person who is suddenly contemplating things I’d have never even considered in the past? And who will she be when she’s had a year of fighting cancer?
