Choices

Life is full of choices. We make an infinite number of choices in our lifetimes, and each one, large or small directly effects our future in one way or another. Sometimes life throws curve balls our way and things happen that we had no way of avoiding. But Even things beyond our control are effected by the way we chose to deal with them. How do you know when the choice you make is the right one? What happens when you have to make a decision and can see both sides and you are left unsure on how to proceed? What do you do? How do you deal with uncertainty? How do you know what path to walk down and which choice is the best one??

This morning we met with my plastic surgeon for my pre op appointment. I walked into the office feeling confident and excited for Zach to meet her. I had a clear vision as to how my next weeks would be and what my surgery would entail. I had come to terms with everything and have been doing wonderfully given the circumstances. That is until I sat there in the room speaking with my plastics dr. Now I feel overwhelmed, confused and completely torn.

When I had met with my breast surgeon four weeks ago, we discussed my history, my options and both came to the conclusion that a complete bilateral mastectomy would give me the best chance of ridding myself from this nightmare of repeat hamartomas, pain and more surgeries. In doing so my 85% breast cancer risk would be removed along with them. Keeping my nipples means keeping a tiny layer of breast tissue, keeping breast tissue allows room for the development for more hamartomas, after all they are formed when normal cells grow in a disorganized way. The chances of developing Hamartomas withing that thin layer is unknown but there is potential of another one forming if any breast tissue is left behind. My incidence rate has been 4 within a 10 month span, one of which was just above my right nipple. When I told my plastic surgeon this morning that we had opted against nipple sparing, I immediately felt persecuted for the choice my breast surgeon and I had made. I was continually reminded that I don't have cancer, and that even a large number of breast cancer patients are opting for nipple sparing mastectomies now more than ever. She told me that being so aggressive was like "throwing the baby out with the bath water" and wasn't necessary, and that there would only be about a 5% risk should I decide to keep my nipples. While 5% may seem like nothing to some, I reminded myself that I am one that makes up the 5.7% of women with breast hamartomas. My Plastics dr went on and on advocating for my nipples, asking me to consider fighting for them and keeping them. I told her about my history and the reasons my surgeon and I had arrived and the decision we had. I felt that because I don't have cancer, that being aggressive against a disease beyond my control, that little is known about seemed completely irrational. I am ready to have this chapter of my life end so that I can move on and work on rebuilding. I was reminded that nipples are a part of who we are, and that removing them can and will negatively effect my mental well being for some time and mental recovery is longer for patients that have their nipples removed than for those that keep them. I was told that by sparing them I would be able to connect with my "foobs" on a different level and feel that they are more a part of me than they would otherwise. So here I am torn, and with a choice to make. A choice that I am struggling to make. I don't know where to go from here and I only have 2 weeks left to decide.

My Plastic Surgeon has my mental well being and my appearance at the top of her priority list. She has seen women on both sides of the spectrum. Then I have my Breast surgeon, the dr that saw me last june for my very first hamartoma, the surgeon that has cared for me and for the past year, she is the one that did my first, second, and third lumpectomy, and diagnosed me with my 4th hamartoma and came to conclusion of my needing the mastectomy in the first place. Who do I listen to? Ultimately it is my choice..but what choice is the right one?

I currently feel as though I have ticking time bombs strapped to my chest. It is ideally only a matter of time before another hamartoma develops, and with each new one there is a risk of it either containing malignant cells, or turning malignant over time. To me, sparing my nipples feels comparable to having a bomb that you have only cut one wire from..it may never go off now, but there is no way of knowing for sure and the chance for detonation is still there. Is that a chance one should take if there is an option for complete bomb removal eliminating the risk of detonation all together?

I don't personally see myself as losing my nipples anymore, but rather giving them, in exchange for a long healthy life free of uncertainty, risks thus eliminating the potential for having to have them removed years down the road. I rather be proactive, then end up having to be reactive over time because of something that serves no purpose beyond cosmetic values. But there is a chance of keeping my nipples and never having another issue and I could go on through life just fine...but is that a risk I should take? This isn't a fair choice to have to make, nor is feeling guilty and being told that your nipples deserve a chance. For the first time in weeks I am feeling lost and numb again and I don't know where to go from here, what choice is the right one?

I know when I wake up and look in the mirror for the first time it won't be easy. My husband is fearful of me losing my nipples because of my long history surrounding my body image. But this is far from fighting eating disorders and compulsive thoughts, and I am not the same person I was years ago. I have come a long way and worked hard to embrace myself for all that I am and to love myself even for my flaws. I will have to adjust and adapt and grow to love my new body that is true, but will having or not having nipples change that? While it will be a long road of mental healing, I will also know that I will no longer have to look at my chest and feel disconnected and full of fear and wonder. Would I still struggle to connect with my new chest if my nipples are left intact? And if I decide to have my nipples taken and I have hard days and crumble will it be blamed on my choice to have my nipples removed causing others to think "I told you so"? I have never been on the other side of the fence but I was ready to be there..I was nervously excited to be there and finally feel free and now I am left completely unsure. If you were in my shoes, what would you do?? Do you leave something such as your nipples for cosmetic reasons because you were told it would help you feel better about yourself when looking into a mirror, they would give you the chance of feeling full, thus leaving a tiny window of risk that could potentially lead to more surgeries? Or do you make a clean break, remove the risks and learn how to rebuild and feel whole again without them?

Life is all about choices..and I am unsure on which choice is the right one to make. I do know, that no matter what, my life is about to change forever.