Just when you think you have a plan...

...it all goes to shit.

I thought that we had this surgery thing worked out. I thought the plastic surgeon and I had a plan.

Today, I found out that, no indeed, there is no plan. Seems like the plastic surgeon and the breast surgeon have been having communication difficulties. Seems like no one has really taken time to explain to me the whole process for radiation. Seems like nothing can be fully decided until I meet with the radiation oncologists next Friday. Then, depending on what he says, I can re-meet with the plastic surgeon, and then the surgeon will be happy to do whatever I want her to do.

Need I mention each of these appointments costs me $35, which isn't much until you add up all the $35 appointments I've had in the last few months. About $525 worth. That's like the annual soccer fees for 1.5 children or something.

So, here are my surgery options:

Option A (what I had thought was the plan):
* bilateral mastectomy, immediate reconstruction with spacers, followed by radiation and then implants at a later date. The downside to this I thought, was that there is always a chance the radiation will damage the one spacer and it would have to be removed, thereby ruining my chance to have an implant on that side. There is also a chance that the radiation would cause the skin to contract and I'd have to have that side "fleshed out" with my own tissues, which involves micro surgery and a longer healing time, either soon or sometime in the future. If I "lose" the spacer, my only option for reconstruction is via my own tissue, and that would involve both abdominal surgery and removal of tissue from my back, then more surgeries to repair the mutilation of those areas as well as a week long hospital stay and 6-8, maybe 10 or more, weeks of recovery at home. Big time, serious, painful, significant crap, not to mention potential for abdominal problems down the line and other crap I don't want to deal with.

Option B (what the surgeon thinks the radiation Onco will advocate and what she advocates):
*complete mastectomy of the affected side, no spacer, immediate radiation, 6 weeks after radiation is finished prophylactic mastectomy of the other side with immediate reconstruction via my own tissue (see above for issues with that) on affected side and implant in my other side. In clothing I'd look balanced, but in reality, I'd have one breast that is "natural" and one that defies nature. One that would age and sag and one that wouldn't. That totally doesn't appeal to me. I have a thing about symmetry.

Option C (which no one is talking about but me and Amy):
* no reconstruction on either side and just going breastfree. I don't think I'd wear a prosthetic. I've never heard a single good thing about them.

Of course, option C is always lurking there because there is a pretty high chance that the reconstruction with my own tissue won't work and the tissue will die or part of it will die and I'll be left mutilated worse than before.

None of these options except for the first, initial plan, appeals to me. Two major surgeries isn't appealing, two different types of boobs isn't appealing, I thought I'd decided against the autologous tissue procedure. I've not read one single good thing about it. Nothing appealing there at all as far as I'm concerned. This whole thing could eat up months and months of my life and cause me lots and lots of pain, scarring, and more surgery in the future to fix the issues arising from the whole procedure....

At the same time, mutilation for the sake of boobies seems to go against some of the deepest held philosophies I have.

I haven't felt this overwhelmed since my initial diagnosis.