Losing My Mother, Previving For My Children

Thank you to Grey Genetics and Patient Stories for having me on to discuss my journey with BRCA and surgery, but more importantly, for allowing me to discuss my children, who were/are a big part of all the decisions I made along the way.

Please click the image below to hear this podcast.

Show notes from Grey Genetics

At just 13, Heather lost her mother to breast cancer. Fifteen years later, a mother herself, Heather had genetic testing done and learned that she carried a mutation in a BRCA gene. Heather shares her experience as a previvor–from genetic counseling to finding the right doctors to her continued involvement in the BRCA community and the many changes she’s witnessed since she was tested in 2005.

Interview Reference Points: 

Heather learns that she carries a BRCA1 mutation @ 1:20

Making major medical decisions and finding the right doctors @ 7:54

Heather’s children’s books @ 19:59

Heather remembers her mother @ 22:19

Heather’s surveillance today and memories of scanxiety @ 27:24

The Breast Advocate app @ 29:14

Life after an oophorectomy @ 31:30 

Heather’s children’s and their BRCA risks @ 36:07

BRCA resources: then and now and the shift toward shared decision making @ 41:00

Heather’s advice to individuals considering genetic testing @ 43:35

Heather’s advice to individuals looking for the right doctors @ 45:08

My BRCA Story (Heather’s blog)

Heather on Twitter: @expattravelmom

Heather on Facebook

Beyond The Pink Moon Facebook Group

The Breast Advocate app

Breast Reconstruction Resources:

Terri Coutee on Twitter: @6state

The Diep C Foundation

The Diep C Journey Facebook Group

Heather’s books on Amazon:

Why is Mommy Having Surgery? She Looks OK to Me: For families with BRCA risk and undergoing prophylactic surgery and implant reconstruction

This Much I Know

Fat Grafting or No...One of the Most Asked Questions of Me

I had an amazing experience with my surgery, from beginning to end.  I'm one of the ones who truly had a one and done experience.  I chose a phenomenal team at PRMA in San Antonio, using Dr. Chrysopoulo as my surgeon.  Dr. C, as we all affectionately call him, is a microsurgeon and even more importantly, a board certified plastic surgeon skilled in breast reconstruction.  I cannot emphasize enough how important it is to do your research before you settle on a surgeon or surgical team.  You have a choice. You have the right.  You need to choose someone who knows what he/she is doing.  Someone who can connect you to previous patients, someone who can show before and after photos, and most importantly, someone who will listen to YOU.

That being said, I often get asked whether or not I had any fat grafting done after my "one and done" surgery.  The answer is, no.  For me, I feel like my results really couldn't be any better.  Could I be fuller?  Maybe.  Is there animation I wish would be covered?  Slightly.  But is the process worth it?  I don't feel it is, for ME.  Firstly, let me explain what fat grafting is.

File:Breasts.svg - Wikimedia Commons

Fat grafting basically involves taking fat from one part of the body and putting it in another.  In this case, it is most often taken from the stomach or thighs and placed into the breasts via liposuction.  Again, DO YOUR RESEARCH.  You need to make sure the place you're going to does this often, has correct procedures and know how to handle the fat cells properly.  But that's it.  In and out.

So why don't I want to do it?  I don't want to go through any more procedures, I really don't.  But that, on top of the fact that there's no guarantee that the first procedure will stick, added to me thinking it just wasn't worth it.  There's actually a chance that 30-50% of the fat in the first transfer will be reabsorbed by the body.  30-50%!  That's too high for me to think it's worth it.  I'm reading Facebook posts talking about this very thing, weekly.  Women going in for fat grafting, loving the immediate results, but then having reabsorption and having to choose whether to go through another procedure or just leave it alone and be happy with what they have.

So, for those of you who write in and ask if I ever did fat grafting, or why I didn't, there you go.  It was a personal decision and I'm happy with it.  For me, my journey was always about removing my ticking time bombs, not about perfection.  But, I'm pretty damn close, and I'm happy with that.

For answers to questions you might have, check out The Breast Advocate App.

PRMA Testimonial

I've given a lot of information about PRMA and Dr. Chrysopoulo via this blog throughout my journey.  Please read and view my complete testimonials, here in one place.  If you have any questions, please don't hesitate to contact myself or Courtney, the PRMA Patient Liaison.  Long distance travel should not be a factor in preventing you from going to the best.

PRMA One-Step Implants with Alloderm

Testimony 

Read my story about coming to terms with BRCA and deciding on prophylactic mastectomy at PRMA.

Traveling 9000 Miles for Breast Reconstruction

 Read this blog post by PRMA patient liaison Courtney Floyd and watch my video testimony.

Contact us via Twitter too! 

Courtney Floyd @diepflapbreast
Dr. Chrysopoulo @mchrysopoulo
Heather @expattravelmom

Capsular Contracture and Implant Exercises

There I was, sitting on my bed minding my own business.   I thought, hey, now is a good time to do my implant exercises.  So, I grabbed my breasts and pushed them up and in and held them in position.  It was just at that moment that my daughter walked in and asked, "what in the heck are you doing?"  I couldn't help but laugh and say, "Exercises!  Why?  Something strange?"

I'm four weeks post op and I'm well on my way with my regular stretching exercises, but there's another exercise I do that many don't know about.  It's for the implants.  While having a final follow up Skype chat with Dr. Chrysopoulo, we discussed the healing process, what to look forward to during further recovery, easing back into exercise programs and something called capsular contracture.  Capsular contracture is when the sub muscular pocket that is formed around the implant tightens due to scar tissue, contracting the implant, thus making it feel, and look, firm. This is not comfortable nor is it attractive.  This can happen to anyone, perfect surgery or not.  It has been noted to happen in some cases where blood has collected around the implant or when a low grade infection infection has occurred.  Serious cases need surgery to remove the scar tissue and set the implant free.

Dr. C told me I needed to start doing an exercise of sorts, daily, which would hopefully prevent this capsular contracture from happening.  He described the process as pushing the implants up towards the collar bone and holding in place for about 20 seconds.  I'm essentially sliding them up within the pocket that was created during surgery.  It was the visual in my head that made me respond with, "so you want me to make awesome cleavage like a Victoria's Secret model?"  To which he replied, "yes, exactly."  See, now you have the visual too!  Doing this exercise is supposed to help keep the capsule larger than the implant itself, therefore letting the implant settle more naturally and remain free from restraint.

http://www.enhancementscosmeticsurgery.com/wp-content/uploads/2014/11/capular-contracture.png

In doing some research, I learned a little additional information regarding implants, exercise and capsular contracture.  Apparently this is only done with smooth, non-textured and non-teardrop shaped implants.  Reason being is the other types of implants are not meant to be moved, they are meant to adhere to the tissue around them, staying in one position and therefore creating a natural look.  Otherwise, you might flip that teardrop and then what happens!  Some doctors even say that having Alloderm, the piece of cadaver tissue that acts like a hammock supporting the implants, may help in avoiding the capsular contracture.  Here's why.  In order to have a full capsular contracture, the scar tissue has to form a complete "circle" around the implant, meeting all the way around.  This layer of Alloderm prevents the scar tissue from building, like a force field.  So, I'm two for two right now...smooth round implants and Alloderm.  

I started this exercise about a week ago, it doesn't hurt at all, and I'll continue doing it for up to a year during the healing process.  Its easy to do, doesn't take much time and in the long run, will hopefully help my implants look more and more natural over time.  

One Month Post Op

Yes, I'm going to be like a new mom again, one who posts updates of her babies daily for the first week, then weekly up to "four weeks old", then does the monthly photos and updates until "24 months old" (not 2 years), then yearly.  Why?  Because when I search the internet, these are the things I look for.  How was someone doing each week immediately following surgery?  What is it like and what changes happen as the months go by?  If I want to know, surely someone out there wants to know too.  Think of me as your What to Expect When You're Expecting Healing mama. So here you go, here's what life is like for me one month post op.

Sleeping

I put this one first because its my biggest pet peeve right now.  I mean its 3:30 am and here I am, wide awake and writing.  I WANT TO SLEEP NORMALLY AGAIN.  There, its out there into the universe.  Lets hope the universe responds kindly.  Seriously though, here we are, four weeks out, and I'm still having to sleep on my back.  I'm not a back sleeper, at all.  I find myself tossing and turning all night because I just can't get comfortable.  Even with pillows...they just make me hot.  I've been given permission to slightly lean to the side, propping my breast with a soft pillow so that nothing firm will press on the Alloderm and in turn weaken it, but that's not doing it for me either.  In the beginning I was sleeping just fine due to the medications.  But now, medicine free, I sleep for maybe five hours and then I'm wide awake.  Luckily, there's a whole other side of the world awake on Twitter.

By Andr.V.S. (Own work) [CC BY-SA 4.0 (http://creativecommons.org/licenses/by-sa/4.0)],
via Wikimedia Commons

Breasts

You would think this would have been number one on my list, but seriously, if you knew how much I loved sleep, you'd understand. At one month post op, everyone pretty much assumes I'm back to normal activity, living life as before and beyond the pain.  Clearing all that up for you now, I'm not.  Am I happy?  Yes!  Am I healing?  Yes!  Am I grateful?  Yes!  But reality is, there's still a lot I'm going through with my new breasts.  Yes, they are pretty flawless, they are damaged breast tissue free and they look darn good in my summer dresses, but we are still having a love-hate relationship.

• Nipples- They feel like the painful nipples of a newly breast feeding mother.  If anything or anyone touches them...  Even my bra gliding against them the wrong way sends hair raising sensations down my spine.  Yes, yes, I'm told by my nurse and surgeon that this is a good thing, as it means sensation is coming back, but WOW!

• Implants- At this stage, they are so much softer than they were the first couple weeks.  I can grab them and gently squeeze them...molding them to my grip.  I say that because I imagined having these stiff mounds on my chest that wouldn't move.  However, there are two scenarios that are strange to feel and I'm still getting used to.  1) putting my arms at my sides.  While my breasts are by no means huge, it feels strange to feel the edges of my breasts when I put my arms at my sides...and they don't move out of the way.  2) when I've been lying down for a while and then get up, the weight of everything shifts with gravity which causes me to grab my breasts and hold them for a minute...letting everything settle.  The good news is that my surgeon told me they'll never "pop out" of place if I bend over or reach for something quickly.  He knows me well...me and my irrational thoughts.

• Muscles- I'm not what you would call a fitness buff.  I don't really like working out.  I go in cycles, getting really into some exercise routine and then...nothing.  Let's just say the 'nothing' phase has lasted longer than it should.  That being said, my muscles at the top and sides of my breasts feel like someone just made me do 50 push-ups and then told me not to stretch.  Feel it?  They are pretty sore and tight.  Because they are tight, my range of motion is not great, so when I suddenly reach for something or try to go back to my normal daily routines, OUCH!  You can still forget those repetitive motions at this point, which, by the way, includes shaving my legs.  That causes pain for me.  

• Cording- Ok, so this is new to me.  I'm not sure if I have it yet, but in speaking with my nurse, we're keeping an eye on the possibility.  Cording is, in the lovely words of nurse Denise, "scar tissue or bands that form after a mastectomy. You are usually able to see and feel the rope-like band starting from the axillary area or right near it. It can extend to the elbow along the inner arm and cause pain or discomfort when trying to stretch the arm. Typically physical therapy is required to “break” the bands up. You might look into a physical therapist that specializes in or is familiar with post-mastectomy patients."  Let's hope this is not what I'm experiencing, and I'll bypass it, but I think its important for others to know its a possibility.  Here's a video demonstrating what cording looks like.

• Scars- There is a light at the end of this tunnel.  My surgical tape finally came off today in the shower.   My incisions look amazing, thanks to the precision of my microsurgeon Dr. Chrysopoulo!  They are clean, they are light pink and they are doing beautifully.  I also got permission to start applying InviCible cream to them to start the scar healing process.  I'm supposed to be massaging the scar so that it will hopefully soften up as well as lay nicely in the skin, not protrude out.  There is zero pain where my scars are, but I think that's due to being mostly numb on the underside of my breasts.

• Sensation- at this point, not a lot has changed from when I described them in How Do They Feel? 

By J.C. Stadler and Piercy Roberts After Adam Buck (Scanned by H. Churchyard)
[Public domain], via Wikimedia Commons

Exercises

About two to three weeks post mastectomy, depending on your surgery and healing, you'll be asked to do exercises to stretch your muscles and prevent the stiffening and scar tissue build up.  These are standard stretching exercises recommended to women post mastectomy, and are relatively easy to do.  That being said, my surgeon was not kidding when he said to approach every exercise as if its my first time.  Don't think you're going to hop back into yoga, pilates or even these simple to do stretches.  Your range of motion is different, your muscles are healing and you will need to take your time.  Be kind to yourself.

Medicine

One month out, I'm still on some Advil during the day, but cautious of not irritating my stomach by taking too much, and I still occasionally take 1/2  a muscle relaxer at night as my muscles are tight by the end of the day, and quite achy.  Other than that, the anxiety meds and pain killers are shelved.  

Emotions (updated 12 hrs after original post)

I thought I was past the highs and lows of recovery.  I'm a month out, I've been off the meds and I was getting back to life just fine.  But today, for whatever reason why, the emotions came flooding back.  My breasts are sore, I woke up at 3:30am to write this blog post and haven't slept since and at 7:30pm tonight, bam!  The tears started flowing.  I had been experiencing a lot of muscle pain throughout the day and was getting frustrated.  I put high expectations on myself, no secret, and I think I feel that I should be doing better than I am.  As I was getting ready for bed tonight and rubbing my scars with treatment cream, I began to cry.  I hated feeling the thickness of the scar under the skin...how it rippled under my fingers.  I'm not good with blood, surgical photos and creepy sensations in my body.  This was one of them.  It was all just too much and I broke down.  At this point, I don't know if its considered normal to be so emotional.  Just this morning I was so thrilled to get dressed with confidence and assurance, that I turned to my husband and told him I didn't have to hate my breasts anymore, that I could love them.  My fears were taken away.  And then an emotional swing the other way tonight...tears.  All I can say is let is all out when it happens, talk to someone and acknowledge it.

So, there you have it.  This is what its like one month post op.  Not terrible, but by no means back to normal.  It really is a process.  I wish writing this put me back into a state of sleeping bliss.  Lets go see who's on Twitter.  Night!

The Other Man

I write this post mainly for the male supporters in our lives.  The ones who would do anything for us.  The ones who we love more than anything.  The ones we've dedicated the rest of our lives to.  The ones who are standing by your side through your diagnosis, your treatment and your recovery.  The ones who kiss us good morning and kiss us goodnight.  The ones who may not understand this new relationship with the "other man" in our lives right now, but who will hopefully sympathize with what we're going through, and later understand what it was all about. My husband falls into this category.  We might talk endlessly about this other man, sing his praises and confer with other women about him, and I want to help you know why we do it.

Women, by nature, have basic needs that need to be met.  We need to feel safe and secure, we want to know we are loved, we want to nurture, we want to be appreciated, we want to feel like we can count on someone and we want our feelings to be understood (even if you don't really understand).  We form relationships and bonds with others when these needs are met.  Women hold relationships near and dear to their hearts.  We protect our relationships.  Its natural.  Its why you are number one in her life right now.  You met her needs.  So what's going on with this other man she's talking about so much?  She's made a new friend, that's all. 

                                                 

When a woman goes through something life-threatening or life-changing, the people immediately involved in that experience become forever bonded at the heart.  For example, her doctor.  He becomes a hero in her life.  This can be any doctor in her life.  Her therapist, her OBGYN, her surgeon...you name it.  They see her through some of the hardest times in her life such as dealing with trauma, welcoming new life into the world or helping her go through the struggles of conceiving, or even performing life-saving surgeries.  This is a person who listens, sympathizes and shows concern for what she's going through, just like you do.  We, as women, tend to open up and talk to these people in our lives.  We love to talk.  And part of a doctor's job is to listen.  We like that too; we value that.  So its completely natural that her doctor becomes an important person in her life with whom she connects and holds dear.

I recently read an article that I can't get out of my mind called, "It is OK for the doctor to cry."  I was so touched by the story as it was so refreshing to hear the other side of the doctor-patient relationship, from a doctor's perspective.  It's not often you hear this, nor find it.  It's actually quite rare in my experience.  Early on the author recounts a moment with one of her patients:

She begins to weep into her husband’s chest but somehow manages to thank me for taking care of her for the past week and being “one of her nicest doctors.”  She even stands up to hug me.  I leave the room really quickly with tears forming and sneak into the bathroom as I begin to cry.

This doctor is humanized.  The doctor met the emotional needs of her patient, and a bond was formed.  The articles goes on to describe the compassion a doctor forms for her patient, and how she sees her patient as something more than a medical file number.  Her patients are mothers, fathers, sisters, brothers and more.  This is how I felt.  The author ends by saying:

Yes, we should distance ourselves emotionally if it affects our medical decision-making but when it boils down to patient care, feeling for a patient and his or her family makes medicine humanistic and real.

My journey was all about forming relationships.  I "read" people quite quickly, and I make decisions based on connections and my heart.  I know when I don't feel good about a person, or when we're not a good fit.  I made judgements based on comments doctors made in social media, on reviews left by other patients, by how the front office handled my calls requesting information and by how I connected with the doctor (IF I was allowed to actually talk to the doctor).  I needed what the article said, "make medicine humanistic and real."  If my needs weren't met, you weren't going to touch me with a knife.  My husband knew I had made my choice in surgeons a long time before we actually Skyped with my surgeon, as I had a good gut feeling from the PRMA patient liaison, Courtney, with whom I had been working. I couldn't stop talking about PRMA and Courtney.  Everything was, "Courtney said...", or "Courtney's so nice" or "Courtney is probably so sick of me...".  

 My needs, however, were eventually met with my chosen surgeon, Dr. Chrysopoulo.  He was real.  He IS real.  He provided assurance early on that built my trust. Throughout the process, he made comments that personalized the experience like, "if it was my wife...," or "you're the love of his [my husband] life and mother of his kids. Doesn't matter how positive you are...all bets are off [referring to my husband's biggest fear being that they'd find cancer when operating, but hiding it from me till all was said and done]."  My doctor cared about us as a family.  He took the time to ask my husband how he was really doing, husband to husband, after the surgery.  I kept telling my surgeon that I trusted him because he had taken the time to build the trust.  During my in-person consultation, he'd ask me if I wanted A or B, and I'd reply telling him I trusted his opinion and left him with the ultimate decision.  He had been welcomed into the 'circle of trust.'  He humanized the experience, just as the doctor said in the article.  In return, my husband listened to a lot of, "but Dr. C said.." or "according to Dr. C...".  I get it.  I talked a lot about my doctor, still do.  And Denise...oh Denise.  She's my nurse, and she's wonderful.  Up until my last day in the USA, I kept referring to Denise like she was my BFF and my husband would laugh.  She captured my heart too.

                                               

In a recent article, I spoke about the power of social media.  My doctor is wonderfully involved in it.  It's fun to see him interacting with people, patients, strangers and other doctors.  It's more fun to see how many other women are out there speaking highly of him, you're proud that you chose someone so revered.  I've become friends with some of his patients, like Terri, who also formed a relationship with him.  She spreads the word about how wonderful he is as well, like a personal cheerleader.  We love what he's done for us, plain and simple.  He's a doctor, he's brilliant at what he does and he cares for his patients.  We've gone through a very emotional time together, so of course we're all connected by that 'something common' between us.  I was talking to a friend from home this morning about my experience and how I was going to write this blog post.  She replied with, "it is such a unique relationship and situation." She totally understood and felt that I should write this to help other men understand what is happening.

My husband gets it now.  He said today, "I totally get (and support) the bond that you have. He essentially saved your life, and those words went through my mind weeks ago."  I know it must be hard to have your significant other speak so highly of someone else so often.  I don't think I'd like my husband coming home from his appointments speaking about his amazing female doctor and how supported he feels by her!  Not fair of me, I know.  But in the end, we're all friends now.  We can all chat like we've known each other forever, and we're all connected via Twitter and Facebook as well.  In the end, just consider your significant other's doctor, with whom you've all shared a major life experience with, as another friend to add to your circle.  At least that's my hope.  I hope you have a doctor who humanizes your experience.  However, I don't think my husband and I will ever be able to call him by his first name...he'll always be Dr. C to us.

First Intimate Experiences After Mastectomy

There are a few topics of interest among those who have had, or are considering a mastectomy with reconstruction, like myself.  I've always been open with my journey, some think too open, but I'm going to continue because people want to know.  I recently said on Beyond the Pink Moon:

I started my blog for my family and friends on FB, all 200 of them, many whom are acquaintances. Never did I think I'd have a voice beyond that. 

To which my friend Nicki Durlester replied:

You do indeed have a voice "beyond that." The powerful voice of a #BRCA #advocate!! You will touch more lives than you will ever know and perhaps save some too. The ripple effect... Doesn't get any better than that in my humble opinion. 

I don't say this from an ego standpoint, I say this as a woman who has made an incredibly difficult choice and who hopes that I do help just one person go through this journey.  Intimate or not, its life, and its affecting more women than you might know.  So, here's three recently "new" experiences for me after having had a mastectomy with reconstruction.  These below situations will differ for everyone, depending on your own type of surgery and recovery timeline.  

Bra Shopping

One of the milestones I was able to celebrate at three weeks was changing from the surgical bra to a regular bra.  You never realize how much you loved your bras and took them for granted until you've been in a big, bulky and hot surgical compression bra.  What I didn't know was that finding a bra that fit right would be a challenge.  Remember, I had a one-step, nipple-sparing, reconstruction with direct to implant.  I have no rippling, and so far, no need for further follow up surgeries.  I can only speak to my experience, not for anyone else.

Your first step, get fitted. You have changed shape, and whether you wanted to or not, size, in some way or another.  I went from a mother of three nursed kids to a perky mom of three kids.  I'm no longer able to do the "lift and place" method of getting my breast into the cup of the bra.  The bra needs to fit ME.  That means shape and size changed.  I needed to figure out what my new measurements were.  

Next, ask your doctor what type of bra he wants you in.  Mine suggests non-underwire bras, which is fine by me.  I really disliked my underwire bras to begin with, so going for something more comfortable was an easy change to make.  My nurse also suggested getting bras that had good support and some light padding.  I was able to find many different styles of non-underwire bras in various stores, but I was surprised that they didn't all fit the same.  Some were great and some just didn't want to conform to my new breasts.  There were gaps where I wasn't used to having them, and they just didn't lay right over the breast nor underneath.  It will take time to find the right bras for your new shape.

I grabbed some bras for the short interim in various stores.  Some work wonderfully and still make me feel feminine, some don't work so well and remind me of the awkward situation.  That being said, there are a few online companies known for helping women after reconstruction too.  I have orders placed and I look forward to seeing how they fit.  These are Genie Bra, The Coobie Store and new to the scene, Ana Ono Intimates which were created specifically for breast surgery clients.  Once I get these and test them out, I can let you know.

UPDATE: Genie bras are great!  I bought each style and I'm loving the full coverage and support of them.

By Steifer with help of Gytha (Own work) [CC BY-SA 3.0
(http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons

Massage

At three weeks out, I asked my doctor if I could get a massage.  Happily, thanks to things progressing well, he approved.  When I made the appointment with the spa at La Torretta, I was very upfront, as letting them know was key to my amazing experience.  I knew I couldn't lie on my chest, yet I wanted a full massage, so being open and honest was in everyone's best interest.  It wasn't an easy thing to do, as its slightly uncomfortable letting a stranger know about your situation, but I think I saved everyone any last minute surprises in the massage room.  Thankfully, they were more than accommodating, but needed a doctor release just to be sure.

Doctor release in hand, I was able to have a normal, full-body massage.  After sleeping slightly inclined for three weeks, my back, neck and shoulders were beginning to feel the pain.  My therapist was lovely.  She was originally going to have be in a Satori chair and just do reflexology, but once we spoke in person, she decided to treat me more like a pregnancy massage, and I got the full experience, lying down on my back in a massage room.  She was able to complete a full massage while avoiding my chest.  She asked me questions, made sure I was OK and provided a comfortable environment.  I wore a good, supportive bandeau style bra which allowed me to be covered, comfortable and supported, and allowed the therapist access to my shoulders without straps being in the way.  I wasn't ready to not wear anything as I still need some support.

Intimacy

This is probably the most difficult subject to discuss and yet one of the most important ones...for women and men.  I don't know if my husband will write a post on this from his point of view, but I think I can speak for both of us on some accounts.  Without divulging too much, I'd like to touch on this topic as best I can.

I'm extremely blessed to be with someone who is very open with me and with whom I feel completely comfortable.  He's seen me go from a young and fit 20-something, to a woman who gained 50 lbs with each pregnancy (you can't come back from those stretch marks!) and now, to a woman who has reconstructed her breasts...the only ones he's ever known on me.    Through each stage, he has told me how beautiful I am.  After my surgery, he told me how pleased he was with the results, that I looked perfect.  Here's the kicker, I believe him.

I say I believe him because I'm not one who takes compliments graciously.  I have a hard time.  I find flaws.  I'm not nice to myself quite often when it comes to body image.  I struggled with eating issues growing up and struggle to this day to be kind to myself.  However, in this case, I believe him because I do look good.  I can't criticize my new shape.  My results are better than I expected, and for me to say that and mean it, means a lot.  

My husband and I dove into intimate situations right after surgery when it came to showering.  I've never had to have someone help me shower, yet here I was, dependent on my husband.  The first shower with the nurse was one thing...I didn't care and I was pretty doped up.  But then we were home, three days out from the surgery, and I needed help doing something that seemed so easy.  Because of the medicine, the sleeping and sitting, my body was weak.  It was hard for me to have enough strength on my own to stand up the length of a shower, let alone wash my hair and body.  I needed him and I needed to be OK with him helping me.  It wasn't just that, it was the fact that he was seeing my breasts, drains hanging out and stitches underneath, fresh from surgery.  Ideally, in a perfect world, he wouldn't see them until everything was healed and the scars were gone.  But that didn't  happen.

As time went on, and I became more and more comfortable with my new breasts, I was more open to my husband commenting on my breasts in a more intimate, non-surgical way, and most importantly, for him to ask questions and eventually, touch them.  We were making the bridge from something medical to something intimate.  He took cues from me...he's curious, which is natural.  He only talked about them as much as I was comfortable with doing.  At three weeks, I'm less sore, my breasts are settling in more and I'm feeling really good about myself.  My husband has been patient, supportive and nothing but open.  I can't give the magic timeline for this to happen for everyone.  I can't say that everyone will feel as comfortable or as open.  What I hope is that every woman feels supported, and that her support follows her lead.  It's not easy, its not comfortable and it may take a long time before she wants her breasts to be discussed, looked at or touched.  Just...listen.