An article from CNN.com written by Allison Gilbert

My preventive mastectomy: Alive for my kids


I'm not a helicopter parent and my children would tell you I don't bake cupcakes for their birthday parties. But I'd readily cut off my breasts for them -- and recently, I did.

Removing breast tissue uncompromised by cancer is relatively easy. It took the breast surgeon about two hours to slice through my chest and complete the double mastectomy seven weeks ago.

The time-consuming part was left to the plastic surgeon who created new breasts out of my own belly fat so I could avoid getting implants. Total operating time: 11.5 hours. And I don't regret a second.

The decision to have surgery without having cancer wasn't easy, but it seemed logical to me. My mother, aunt and grandmother have all died from breast or ovarian cancer, and I tested positive for the breast cancer gene.

Being BRCA positive means a woman's chance of developing breast and ovarian cancer is substantially elevated.

"Patients with BRCA1 or BRCA2 mutations have 50%-85% lifetime risk of developing breast cancer and up to approximately 60% lifetime risk of ovarian cancer," according to Karen Brown, director of the Cancer Genetic Counseling Program at the Mount Sinai School of Medicine in New York.

By comparison, the lifetime risk of breast cancer for the general population is 13% and 1.7% for ovarian cancer.

CNN iReport: Tested for the breast cancer gene?

At my gynecologist's urging, I tackled the threat of ovarian cancer first. Because the disease is hard to detect and so often fatal, my ovaries were removed in 2007, a few years after my husband and I decided we were done having kids.

The most difficult part of the operation came in the months that followed: I was thrust into menopause at 37. Despite age-inappropriate night sweats and hot flashes, I was relieved to have the surgery behind me and wrote about it in my book, "Parentless Parents: How the Loss of Our Mothers and Fathers Impacts the Way We Raise Our Children."

The emotional release was short-lived. Less than a year later, my mother's sister was diagnosed with breast cancer and died within four months.

Aunt Ronnie's death set me on a preventive mastectomy warpath. I had already been under high-risk surveillance for more than a decade -- being examined annually by a leading breast specialist and alternating between mammograms, breast MRIs and sonograms every three months -- but suddenly being on watch didn't seem enough, and I began researching surgical options.

Regardless of my family history and BRCA status, I still went back and forth on having a mastectomy. I vacillated between feeling smug and insane.

Over the years, I'd read too many stories like the one in the Wall Street Journal last week, on doctors who make fatal mistakes (up to 98,000 people die every year in the United States because of medical errors, according to the Institute of Medicine). I was anxious about choosing a bad surgeon and a bad hospital.

The stakes felt even higher after I decided to go an unconventional route to reconstruction. Implants generally offer a quicker surgery and recovery, but they're also known to leak, shift out of place, and feel hard to the touch and uncomfortable.

I would also likely have to replace them every 10 years -- not an unimportant consideration, since I'm 42.

Ultimately, on August 7, I underwent double mastectomy with DIEP (Deep Inferior Epigastric Perforator) flap reconstruction. The benefits would be that my new breasts would be permanent, made from my own skin and flesh, and I'd be getting rid of my childbearing belly fat in the process.

I had multiple consultations with surgeons who explained every reason not to have the procedure. They warned me that I'd be under anesthesia unnecessarily long and I'd be opening myself up to needless complications.

While every concern was valid, it wasn't until I was six doctors into my investigation that I realized the likely reason why I was getting such push-back. The plastic surgeons I was consulting, despite their shining pedigrees and swanky offices, couldn't perform a DIEP. The procedure requires highly skilled microsurgery and not every plastic surgeon, I learned, is a microsurgeon.

It also requires a great deal of stamina. The doctors I interviewed who perform DIEP flaps were generally younger and fitter than those who didn't. On average, a double mastectomy with DIEP reconstruction takes 10-12 hours, while reconstruction using implants can take as little as three.

In total, I met with 10 surgeons before choosing my team, and while I am now thrilled with the outcome, all the years of research and worry took a toll on me.

The worst moment came one night when my husband and I were in bed. I began to cry uncontrollably and wished I could talk with my mother and aunt about which procedure to have, which doctor I should choose, and whether I should even have the surgery.

Then a moment of bittersweet grace clarified what I needed to do. It struck me that the reason I couldn't speak to my mother and aunt is exactly the reason I had to have the surgery.

Undergoing a prophylactic double mastectomy was a great decision for me. It's clearly not a choice every woman would make, but I'm convinced without it I would have been one of the estimated 226,000 women the American Cancer Society says is diagnosed with invasive breast cancer every year.

I could have tried to eat my way to a cancer-free life, but even Dr. T. Colin Campbell, author of the popular vegetables-are-key-to-health book "The China Study" admits diet may not be enough to protect BRCA patients from cancer.

"We need more research," Campbell told me. "Conservatively, I'd say go ahead and have the surgery, and eat a plant-based diet after."

I also could have waited for a vaccine, a pill or some other medical advance to come my way that would have made such a radical decision avoidable.

Perhaps MD Anderson Cancer Center's newly announced war on cancer will produce positive results for patients who are susceptible to triple negative breast cancer, the type of aggressive disease likely to afflict BRCA1 patients and the kind my aunt most likely died from.

But every surgery substitute seemed locked in hope, not statistics. And as I've told my husband and children, I wasn't willing to wait. I love them more than my chest.

One Year Anniversary

My surgery was one year ago on September 12.  I just didn't feel like writing.  The last few months have been stressful and disappointing.  I thought when the doctor said, "you need one year..."  I thought, OK, here's my year...boom, I'm all better.  And I'm not.  Writing every night in my journal and reading where I was and what I was feeling every day leading up to September 12 was difficult.  For me, it's as if it just happened.  There is still quite a lot a do not remember, but I don't think I will ever forget the unbelievable pain.  Pain on every level.  I've shed many, many tears this year.  

Last year at this time everyday was filled with IV's, machines, hospital staff, doctors, pain pumps, drainage tubes, a doppler, compression boots, breathing tubes, monitors, etc....and family.  We all prayed that my transplanted tissue and blood vessels stayed alive.  Otherwise I was headed back to surgery.  Those days are foggy but not the pain.  ICU, hospital, recovery home...all in a mere 10 days.

September 12, this year was spent getting a mani/pedi, then meeting family for dinner at Bistango's.  A lovely restaurant with a piano bar.  We figured Jack would like this.  And he did!  After having a great dinner I DANCED with my son.  Jack loved the music, the singing and of course I had tears in my eyes.  There was no rhythm as he says "shake your sillies out."  But that's OK.  I can hold my son.  I can dance with my son.  That's all I needed.  But once again Mom had different plans......

This navy blue Audi Q7 was waiting outside for me.  

Still trying to figure out every bell and whistle and there are many.  It's like an a airplane cockpit inside.  Jack says, "I'll show you what all these buttons do."  He probably will have it figured out before I do for sure.  

2011-2012 A year I will NEVER forget.  

XO, Janeen

"Faith is the bridge between where I am at and where God is taking me." - God Posts

One Year Later

Tomorrow September 12, 2012 marks one year since Janeen's surgery.  It doesn't seem possible to me that one year has already gone by.  I'm sure to Janeen it feels like an eternity but it has only been 12 months.

After Janeen's last entry you all must have thought what the hell has happened?  She had just had one of those days and she vented on the blog.  I truly don't blame her but it made me sad to read all she wrote and I felt so helpless.  No matter what I say, or how I say it or when I say it, if Janeen's down she doesn't want to hear anything.  She was beating herself up because she has to wear a safety belt in the pool so she won't drown.  She was in 7' of water and without stomach muscles you sink.  It's easy for me to sit here and say, " so what, you had to put on a safety belt, at least your in the water doing your exercises".  See, I'm so proud of her for getting up every morning and getting in the pool that I don't think how difficult it is for her to do what the other swimmers are able to do, and so she becomes frustrated beyond words.  Then in her exercise class she  feels she needs to go to the back of the room because she ia unable to do the sit ups and other exercises everyone else can do, so again she is extremely frustrated. Again, I am so proud of her that she gets to the gym and does the class period.  I can't feel what is going on inside of her and she knows it frustrates me to always talk about what she cannot do. 

Janeen can nurture and love Jack.  She can keep house and  by that I mean do everything as she has no housekeeper.  She does all her own errands, lifts groceries, cases of water, cases of dog food and can lift and carry her 50 lb son.  I think that's pretty good for one year out. She walks her dogs, her loveable puggies, plays with Jack outside and runs up and down the street when he is riding his bike or driving his car.  Pretty good for one year out.  She still works for me doing my errands and helping me around my house, pretty good for one year out.  I think you all must be getting my point by now.
What Janeen is capable of doing is nothing short of miraculous.  The doctor's said, " you will need to give yourself one year".  Janeen heard, " you will be good as new in one year".  Big difference!

I don't have a crystal ball to know when Janeen will feel like her old self.  Maybe she never will.  That's a possibility, but I know for sure she cannot keep living September 12, 2011 over and over in her mind and be healthy. She cannot continue to feel sorry for me for the 18 1/2 hr. wait I endured.  I did it and it is done.  She was cut up really bad but she survived, she is beautiful and she is my hero.
My daughter is the strongest lady I know and she is way to hard on herself.  So, no more living in 2011, this is 2012.  The past is the past and if she/we stay in the past we miss the little joys of every day living and there are so many.  The constant worry about the future, same thing, you aren't living in the now and once the now is gone, it is gone.

So folks please continue to pray for Janeen.  We will celebrate tomorrow night with a family dinner and be so very thankful for all my family who have supported us and have shown their love for us this past year. September 12th will be a Happy Day or as Jack and I say, " it's a PARTY".

Love to all,
Barb