The Decision Tree

Family, we love them, we hate them, we grow with them, and sometimes we don’t. The genetic test are back – the news is “good” news – I don’t have BRCA which would mean my lifetime risk of cancers would be extremely high. Bad news, we can’t deny this is genetic – my mother, my grandmother, and now me – all the same type of cancer. My lifetime chance is still fairly high to get cancer in the other breast – so now ... CHOICES.

I will be honest - I have spent more time staring at my breasts in the mirror than I ever have before in my life the last few weeks. I like my breasts, they are part of me, and they are pretty nice. Making the choice to remove them because I might have to go through this again? Well, that’s no easy mental exercise.

I make decisions for a living – so I am doing my best to gather the information I need to make my decisions – following my standard process - I am being present, deliberate, intentional about each step of this strange journey. No one can really help you understand how making huge life altering decisions at speed makes you feel – but the best way to describe it is a combination of numb, overwhelmed, horrified, and sometimes you just feel overcome with a whole lotta “fuck it”. There is so much information out there – your care team will tell you to “not overthink it” but until you have to make a choice to keep or remove your breasts – or walked a day inside of my insane head - you really shouldn’t tell me this.

This week as I listened to my surgeon describe my breasts as saggy – then share that with some reconstruction options I would have to go bigger (from my already DD breasts?!) – I almost broke out laughing out loud as I pictured myself coming back to work after my cancer treatment with huge Dolly Parton breasts – my co-workers all being quite confused as to how my cancer treatment - where I disappeared during one of the more crazy times in operational history at our company – somehow resulted in huge knockers. Sometimes we gotta laugh so we don’t cry… I paused and asked her “Wait… so how big are we talking?” – she has yet to answer this question. LOL

Vanity – it is part of this process because it ties directly to long term mental health. As I talk to my girlfriend’s about this experience it’s interesting to hear people’s thoughts – of course some are in the camp of – use cancer to get perkier boobies! – and on the other side we have the more risk adverse who want me to focus only on health. My friends who have had children are extremely perplexed by my surgeon’s description of my breasts as “saggy” – to them it makes no sense – as they text to say… wait what? YOUR boobs are considered saggy? I am sure they text me this while looking at their own breasts which have been used to nourish their little humans and are tired and worn out like the superheroes they are – unlike mine who have been living the good life all these years… sure gravity at 38 is very different than 28… but come on – comparatively? I think mine are doing pretty well! So, as I look at them… I do often think, why do I have to ruin such a good thing… but you know… health, meets vanity, meets risk… which brings us back to CHOICES.

This is a numbers game – a messed up version of Russian roulette - and sometimes I feel like I need a statistician as part of my care team. I mean, maybe I do have one since my genetics counselor is basically a statistician – but still – sometimes my ears feel crossed as I listen to all the information that contributes to my choices.

Life circumstances also play a role in all of this. I am 38, single, childless, slightly vain, and insecure… so the idea of making decisions that could impact my dating, sex life, and fertility come with some added layers of complexity.

On the flip side – we have my mother – who was ready to cut off her breasts at my age when her mother was diagnosed with cancer… who eventually had a double mastectomy after her diagnosis at 55, skipped reconstruction, and has bravely danced topless at her dance retreats with her girlfriends in the desert. She is a badass free spirit and some days I wish I had a little more of her in me, confidence to not worry about societies expectations of my female body and how it should look… she understands I am different but is worried about the reconstruction options – concerned about multiple surgeries, - lifetime replacement requirements – side effects – nerve impacts... and while I am equally worried – each of these things all go into my massively growing decision tree... whose branches each day seems to reach further and further with if this, then this scenarios….

Don’t over think it they say… trust your gut they say…. HA!