Reconstruction, Rebirth

When I need an energy infusion here in Minnesota, I listen to a certain NOLA band cranked up loud on my stereo. Months ago, enjoying the annual Halloween pilgrimage my husband and I make to New Orleans, my energy was high -- even before we strolled into Vaso Club on Frenchmen Street. But for only a $5 cover, and with an icy Abita Purple Haze in hand, the music lifted me to new heights. The notes tight, complex, everywhere at once. Throbbing with life -- my life -- the one I plan to ride for many years, now that cancer is gone from my body more than half a decade. The jazz screamed joy. Two trumpets, sax, tuba, trombone, snare and bass drum. The t-shirted guy’s t-bone hung loose at his side, his front tooth glinting diamond in the red stage lights that painted the brick wall behind him hot, as he sang, “I feel like funkin’ it up! Feel like funkin’ it up!”

Beating breast cancer can inject your life with a new level of passion, purpose, and energy. Part of it, I hate to admit, may be related to that spectral little wisp of a dark cloud that never totally dissipates, no matter how rosy your prognosis or how many years pass since the sun reappeared on your horizon. I’d rather credit my feelings to other things, but sometimes the shadows, by their contrast, do help highlight the heady largesse a healthy life offers. Part of that happy life, for me, is having all my body parts back. I highly endorse keeping as many as you possibly can. And if you can’t, then I recommend replacement. The studies back me up, too.


A few years ago, Dr. Andrea Pusic of Sloan-Kettering and some of her colleagues interviewed several thousand women to learn about the most important issues following breast surgery. From this they developed and refined the BREAST-Q questionnaire, which measures patient satisfaction and quality of life after breast reconstruction. They found that successful outcomes are not only based on what reconstructed breasts look like, but also involve physical, social, and sexual well-being, as well as process of care. This included the woman's satisfaction with the information and expectations provided, and her interactions with her medical team and surgeon. This assessment tool is now the worldwide gold standard for quantifying breast reconstruction satisfaction, which has greatly aided research looking at type, technique, and timing of surgery.

So what have we learned from some of this research? Well, judging from my quick and dirty Internet perusal of the literature, I found that women report higher satisfaction from autologous (using your own tissue) reconstruction rather than implant reconstruction -- over the short-term (three weeks) as well as eight years out. Among women who chose implant reconstruction, they were more satisfied with silicone than saline. But regardless of type or timing of breast reconstruction, it is a well-established finding that women who choose some form of breast reconstruction over none report better body image, greater self-esteem and sexual functioning, improved mental health, better emotional well-being, and higher energy levels.

One of the studies I read, which struck a personal chord, compared patients who had delayed versus immediate reconstruction. I should preface the results by saying it’s generally accepted that, other things being equal, immediate reconstruction provides a better aesthetic outcome than delayed. But eighteen months out from surgery, seventy-six percent of women who had delayed reconstruction were satisfied with their outcomes, as opposed to fifty-nine percent with immediate recon. Half of the delayed reported feeling sexually attractive versus one-third of the immediate.

In the discussion of the results, the researchers surmised that satisfaction with breast reconstruction outcome is often not so much a function of the quality of the work, as it is about what the woman is using for comparison. With immediate reconstruction, she is comparing her new breast to her original and seeing what she has lost. With delayed reconstruction, she is comparing her new breast to a scarred, empty chest and seeing what she has gained. I can personally attest to the experience of the latter. I call it magic. Even a resurrection. Definitely a rebirth.

And back on Frenchmen Street, who dat band? Rebirth! Rebirth Brass Band!



http://www.youtube.com/watch?v=CbtAoOp6_UM