Surgery and Then Some

The taste of whipped cream reminds me of my eldest sister. There is no mystery as to why this is so. It is simply because she makes the best hot chocolate on the planet. It is the best not because it comes from a fancy Ghirardelli gourmet tin; she uses plain old Hershey's cocoa. Yet, when she hands me a mug topped with a generous amount of whipped cream, it is an elixir, an ambrosia that comforts my soul and warms my toes and heart. Not to mention that my sister believes in the notion of second helpings of whipped cream. This is something I had never thought of before. You make the cocoa, you put the whipped cream on top, you let it get a little melty and then you scoop it all up until it is gone. What is left is a cup of lonely, whipped-creamless hot chocolate...unless you are my sister, in which case more whipped cream goes in. It reminds me of "second breakfast" from the first Lord of the Rings movie. I feel strangely liberated from the odd constraint I had apparently placed on myself all these years - that one can have only a single cloud of whipped cream on one's cocoa or, indeed, only one breakfast.
     I am actually the youngest of three and have two older sisters. We grew up in New England, about 20 miles north of Boston. For us, hot chocolate was what you had on cold snowy mornings when school was canceled, or after you went sledding, or went skating on the stream back in the woods behind the house, or you'd just been outside building snow forts or snowmen or both. We would come in wet, cold, red-cheeked, with runny noses, but happy grins. At that time, it was my mom that made the cocoa - in the same old-fashioned way. And it was just as delicious. I have never understood why some people don't like cocoa.
     It was my eldest sister who came to stay with us to help out just before and for some time after surgery. The surgery was scheduled two weeks after my visit with the oncological surgeon. We met with  the plastic surgeon (who looked exceptionally young) at the end of the same week that we first met the former. After listening to his advice and asking lots of questions, I decided not to have reconstruction right away. To do so would prolong my recovery and delay chemo, if chemo was necessary (it was and is). There was also no guarantee of success for the kind of reconstruction I wanted. I learned that my situation (two prior cancers with radiation) calls for a more extensive type of reconstruction, the success of which is higher if you wait. When I learned that this type of surgery would take 10-12 hours in the operating room, I began to think I could do without. I loathe surgery, particularly the waking up part. I would spare myself that even if it means I will be forever flat-chested.
       The weeks before the surgery passed rather hectically as I was busy arranging my classes in such a way that others could take over. I tried to cross every 't' and dot every 'i' in the hopes that things would go smoothly for my generous and caring colleagues (faculty, students, and staff). Because I am so fortunate to work with people who are incredibly wonderful and supportive, I was able to let go of any worry that my students would be left confused and unhappy. The day I told my classes I had to leave for medical reasons was rather stressful. I truly enjoy my teaching and was having a fabulous time. I did not want to leave. I also did not want them to worry, yet wasn't really sure whether such an announcement would upset anyone at all. It is often hard to tell whether the rapport you think you have with your students is all in your head or the genuine article. On my last day with my two larger classes, I received an orchid, a candle, a stuffed lamb (they all knew how much I love sheep), and a card from each class signed by many. It was so incredibly touching and unexpected that I was overwhelmed. One of my students also brought energy bars that she had made herself. She told me she looked up all the things that are good for my particular illness and packed them with all sorts of delicious and healing ingredients. They were, in fact, delicious. I read a book recently in which one of the characters "counted his sums" every night before he went to bed. What he counted were his blessings, and I think I could reach quite a high number just from this paragraph alone.
       The night before my surgery I was scared to death and trying not to show it. Mike and my sister gamely tried to keep my mind off of it (we played cards, watched a movie, and my sister made comfort food; I wanted mashed potatoes), but all I could think about was that by that time the next night, several pieces of me would no longer be there. It is all well and good to remind yourself that your body is not you, but another thing altogether to make yourself believe it. I tried to shuffle words like "amputation" away and concentrate instead on what the removal of my breasts would do for my body. It was a tough sell. Before going to bed, my sister asked if she could "smudge" me. We went out on the porch and in the glow of the lights strung along the beams, she lit a sage stick and moved around and about me. I am not sure what she said, but it is a moment I will always remember.
       The morning of surgery I was even more scared. I simply do not like being put under. I utterly despise it. It was a minor relief that the surgical staff were so nice. They didn't mind at all that Mike and I played Uno while we waited for my turn in the OR (I kept losing, of course). The anesthesiologist in particular was incredibly caring. We told him that I am hard to intubate, which had caused problems in previous surgeries. He very methodically considered how they should go about it this time. I just got more and more nervous by his Plan As and Plan Bs, despite the fact that he was clearly brilliant. But then he said, "We treat everyone here like family; if you were my daughter, this is how I would do it.". I felt somewhat better then.
       They wheeled me to the "kissing corner" where I said good-bye to Mike and my sister. I remember being in the OR, the chatter of the surgical team, and hearing the anesthesiologist say, "OK, we can go ahead and get started". I said, "Um, am I still supposed to be awake?". They laughed and said all was well. They'd been "pre-oxygenating" me but at that point they told me to go to my happy place. They said that the anesthesiologist was from Hawaii and when I was well, I could visit him there; he offered to make me pulled pork for dinner and the others maintained that no other pulled pork could hold a candle to his. Not unexpectedly, and to the utter hilarity of Mike and my sister, "pulled pork" was the first thing I said to them when I woke up. They maintain that I was mumbling "pulled pork" over and over. Despite my explaining how perfectly reasonable this was, they still think it incredibly funny.
       I won't dwell overmuch on post-surgical details. I'll just say that it was really quite hard, especially mentally. My sister had offered to stay the night with me in my hospital room and when we saw how small it was, it looked like it might not be possible. I had initially told her it wasn't necessary but in that moment, after having been placed from one bed to the other, groggy, in pain, and still terrified, I realized just how much I did not want to be alone that night. She stayed and it was so soul-warmingly comforting, I can't even describe it. Mike stayed until quite late and then came along again the next morning. I was discharged that afternoon. All of the nurses and staff were awfully good to me and after one brief meltdown when bandages were being checked, one nurse held my hand and said, "You are so much stronger than you think. Last night you told me you couldn't imagine getting out of bed, but when I came on duty this morning, you were walking around the ward. Not everyone could have done that. You will get through this." When I left I had four tubes hanging off of me, which made dressing a challenge. Two for drainage and two for pain. We realized after about a week that one of the pain pumps had  been disabled and never worked. I described the sensation of suddenly having no breasts like this: Imagine you have a big wide rubber band around your chest that is way too tight, and now light it on fire. Not to mention you suddenly have six arms which cannot simply dangle but must be supported. The pain pumps had straps to put over my shoulders, but the drainage tubes had to be pinned to whatever I was wearing. I had the pumps for two weeks and the drains for three. Once home, bandages had to be changed, but I squeezed my eyes tightly shut for that and for my first several showers. I did not want to look, not even the tiniest peek. Mike covered the mirrors for me, changed the dressings, and emptied the tubes. My sister attended to the tubes and dressings, too. I was well looked after. Sometimes I cried, though. I couldn't help it.
      The surgery was on April 5th, so a lot of time has passed since then. I have had physical therapy in order to get back the range of motion in my arms and for the lymphedema that I've had since Cancer #1 and that reared its ugly head after Cancer #3. I have started chemo, which no one, including my doctor,  expected to hit me as hard as it has so soon.
       On the morning that my hair started to fall out in clumps all over my pillow and after I watched it go down the drain in the shower, I made myself a cup of cocoa with two helpings of whipped cream.