Before the Scars

*Adult content: This post contains a picture of my chest before surgery*

After being diagnosed with breast cancer, I had elected to have a double mastectomy performed, which is recommended for people who are BRCA2 positive. I would have both breasts removed, along with my nipples and almost all of my breast tissue, to minimize my chances of the breast cancer returning. Some BRCA2 positive women have the surgery performed before they get cancer. I would have done the same, had I not been diagnosed so young. My general surgeon also planned to take at least one or two lymph nodes, to send to a histopathologist to make sure the cancer hadn't spread. If it did, I would need chemotherapy. Cancer and surgery was one thing, chemo was a whole different ball game that I didn't want to play.

Gifts from one of my coworkers.

I had already met with a plastic surgeon to plan my reconstruction, which means putting in expanders to stretch the skin,  which then eventually get replaced with implants. I was not ready to go my entire life without at least some form of breasts,  so I wanted to have expanders put in during the same surgery as my mastectomy. My general surgeon would perform the mastectomy. Then, when she finished one breast, the plastic surgeon would start the reconstruction as she worked on the other breast to cut down on surgery time.

My surgery was scheduled for a Monday morning. I had to make an appointment with my plastic surgeon on the Friday before the surgery. He wanted to make sure the general surgeon made the incisions in the best spots for the reconstruction. He wouldn't be in the surgery room for the first incisions, so he drew the incision lines on me. He made two large elliptical incision lines, one around each nipple. He also made large u-shaped lines on the underside of my breasts. I was given a marker to redraw the lines over the weekend if they started to fade when I showered.

As a veterinarian, I have performed surgeries before. So when I looked at myself in the mirror, my head was filled with images of what my skin would look like during surgery as they peeled it from my subcutaneous tissues. I had nightmares about it. I cried every time I took a shower and saw myself in the mirror. I was about to have my breasts amputated. A part of me gone forever. I knew I would never feel natural again. I would never have nipples again. I took a picture of my chest, knowing I would regret not having a picture. Someday, I wouldn't be able to remember what I had looked like. The body I was finally becoming confident in would be gone. Forever.

A picture of my breasts with the incision lines. 

Another errand before surgery was picking up a special soap to use. The soap is called chlorhexidine, I use it a lot as part of my job. Chlorhexidine is an antiseptic, which means it helps keep bacteria from growing, which then decreases the risk of infection after surgery. I was told to stop by the front desk of the nearby hospital and pick it up, no charge. When I walked in, the woman at the desk was talking to someone. When she turned and asked what I needed, I told her I needed the pre-surgery chlorhexidine. She asked me what surgery I was having. For some reason, I didn't expect her to ask this and I became immediately flustered, I couldn't think of the word mastectomy! I can keep my cool when being bit by one of my animal patients, but this small question threw me. I said "I...am getting my breasts... uh... removed." Way to sound smooth and confident, Nikki. The woman was so sweet, and apologized that she had to ask, but there were different packages depending on the type of surgery. She wished me luck and an easy recovery, sincerely, without a hint of pity. I almost started crying as a result of my overwhelming appreciation and embarrassment.

Chlorhexidine is a liquid soap, and it came in a plastic bottle with a sheet of instructions. My plastic surgeon had also given me directions. The night before the surgery, I was to use some of the bottle to wash my breasts and underarms for two minutes, in a circular motion, starting on the nipples and working outward. Then, the morning of surgery, I had to take another shower. This time, doing the same with my chest but then also washing my entire body as well, except for my face, hair, and genital region.

I set my alarm for 4:00am on surgery day. I washed as directed. As I washed my breasts I started to sob. I couldn't stop. After the shower, I looked at myself in the mirror for the last time before surgery, trying to see through my tears. Those emotions are so raw, I still feel them, and they can take me down without a moment's notice. Emotions don't care how much you've prepared. All I could think about was how much I hated what I was about to do. I wasn't being strong or brave, I just didn't have a choice. I took several deep breaths, just keep going, just keep going. My husband helped me redraw the incision lines as I tried to stop crying. I wanted to look calm when I got to the hospital, not like this, even though all I could think was: I don't want to do this. I don't want to do this. I don't want to do this.