E-Memoirs

E-MEMOIRS

Dr. McLaughlin’s Personal Blog

Recovery

So much comes to mind with this word. My absence from this blog has a lot to do with recovery. In many ways, I am recovered. In many others, I am recovering.

In the most literal translation, recovery brings to mind ‘getting over it’. The actual definition describes recovery as a return to a normal state of health, mind, or strength. I don’t know about you, but I don’t know who determines what ‘normal’ is so perhaps recovery in the literal sense is unattainable. That’s a little too deep for my purposes here so I’ll let that go. Let’s explore the different situations that recovery can be applied in our lives:

Maybe one is recovering or recovered from surgery. As a surgeon, I see this every day in my work life. As anyone that knows me is aware, I have recovered from 2 surgeries in the past 4 months and am doing very well from that standpoint. Post mastectomy life is business as usual with the exception of the absence of sensation from your neck to your navel. Many have heard me say I cannot go to bars with dart boards as one errant dart could shut me down and I’d never know it. On the up side, bras are SOooo last season for me because these perky little twins are right where they belong. It’s easy for me to kid about it since I’m cured. I’m stage 0 with no plans for any further surgery on the horizon…that sounds like recovered to me. In retrospect, that recovery was a piece of cake. It’s all that cake (and the champagne and tater tots, of course) that transitions me to the next interpretation of the word…

I have approached fitness sporadically my entire life. I will embark on a fitness plan, diet and exercise, and hit it 400%. After about 2 days of that, I generally cannot walk without a limp. You must hydrate after a workout but the when the terror of sitting down to tinkle because it means you have to stand back up eventually precludes you from doing so….not good. All or none has been my mantra my entire life and this is evidenced in situations like this. Recovery means Aleve, water and time in this case. Once recovered, I return to it in one form or another. I am trying to teach myself moderation. After 47 years, it is a slow process but at least I am trying.

Recovery is very often from a mental or emotional situation. I do not know anyone that has not endured grief, strife, despair in their lives. I am somehow soothed by the reality that without sadness there can be no happiness. If you did not know despair, how could you truly embrace joy? The thing about recovery in a situation like this is that I do not believe it is ever a complete transition. You can recover from trauma and find the capacity to move through the world naturally once again, even be truly happy, but scars remain. That’s OK; scars are part of life, both real and figurative.

Perhaps recovery means from addiction of some kind. This is so prevalent in our world; it would be unusual for someone to not have someone in their lives touched by some type of addiction. Drugs, alcohol, gambling, smoking….regretfully, I am addicted to Amazon Prime. There is not a 12 step program to help me here but I am trying to keep it in perspective. When recovery is applied to situations like this, it is one step at a time, one foot in front of the other, but can absolutely be attained.

My world has been rather crazy for the past several years but more so the past 4 months. The greatest despair, grief in my life was the loss of my beloved mother almost 8 years ago. I acknowledge that loss is part of life but sometimes, when you’re not yet ready for reality…in losing my mother I was NEVER going to be ready for reality…it completely knocks the life out of you. I believe that I have recovered on many levels from her loss in the sense that I can laugh when telling stories about her, look for hours at pictures of her, hold her belongings peacefully and think of her.

We all have stories in our past that color our present. My way has always been duck and run. I am not proud of that. I am often a little delusional that the world can be butterflies, unicorns and rainbows and can’t we all just get along? That is not reality. It has taken a series of events in my life to realize that my inability to process anything that I find ‘unsavory’ is not effective. What I have been missing for longer than I can even remember, indeed perhaps never even had in the first place, is faith.

That is hard to acknowledge but very true. I long for faith. When I was losing my mother, I relied on many around me that I knew had a strong faith to help me endure. Pray with me, pray for her, I would beg. And they did…never any question when you ask for someone to pray that they do. I always marveled at the inner peace and calm that those individuals maintained without ever faltering. Prayer with them always made me feel calmer soothed. What is interesting in retrospect with some realizations I have recently made was why was I looking to others for their faith? Why couldn’t I pray for calm and peace for myself, my beloved mother, my family, my friends on my own?

In my practice, it is not at all uncommon for patients and their families to wish to pray together before surgery. I have always wondered who in the world would deny someone that? Yes, for heaven’s sake, please let’s pray. I don’t know how many times every single day you read a request on Facebook to pray for someone and their family. What do you do? You share the post and pray. I will ‘like’ a post as if to acknowledge I am doing what you ask but admit here that I may or may not have actually said a prayer. That’s cheating and that’s not OK and that is no more.

So if I have indeed been longing for faith, what was I waiting for? My little light bulb had to go off for me to realize that you can say you’re a good person all day long, you can believe you are doing good things in this world, you can make people laugh and do whatever it takes to disguise the angst that might be your reality within but until you calm those waters through building and strengthening of your own faith, you are never going to win the battle. My interpretation of faith is that it’s all going to be OK because it is, in fact, all going to be OK. Perhaps the means of getting to a specific endpoint is not what I might have imagined and every moment in time might not be completely delightful but I realize that pretending that every moment in time is going to be completely delightful is completely out of touch with reality. The peace and calm of resting in the knowledge that God will protect me and those that I love has given me a sense of calm that I have never previously known.

I am a work in progress. Faith has to be learned, practiced and strengthened. I am actively trying, learning. You might say I am in recovery mode. It feels really, really good. Please pray for me to continue to grow and learn. I welcome that more than I could articulate.

I have already said my prayers this morning for God to protect my family, my friends, my decisions, my patients…and also my patience. I might also be praying that I can stay away from Amazon Prime today. No promises but I’ll try…

Here’s up to it!

Fanculo al cancro

I have breast cancer. Better stated, I HAD breast cancer.

I am 47 years old and healthy. Very healthy...the old idiom 'healthy as a horse' just makes me feel like I need to ramp up the workouts but can't do that right now with my drains in so let's just go with 'I am REALLY healthy'.

I hate to go to the doctor. Doctors are the worst patients in the world. There was simply nothing wrong with me or no concerns physically when I called my Gyn to inquire why I hadn’t had a well woman exam in over a year and seemed like a good idea. I wanted to get the idea of it out of the way so I could just worry about it again next year. After my tubal ligation in December 2014 I was doing great. I ordered a mammogram on myself in April of 2015 simply because I thought I fell a lump and scared myself. That exam was normal, exhale, nothing to worry about. I have no family history whatsoever of breast cancer. I had not felt a lump and I do check, even though when you drink as much coffee as I do, it is cyst city and hard to tell. Yes, I was due for my routine checkup and it was scheduled. I passed the Pap smear with flying colors (know you’re glad you know that…nothing like a good oversharing) and was not remotely concerned with the mammogram.

On June 2nd when I got the call that those pesky little calcifications on my mammogram were not benign, I questioned my health, my reserve, my future. That crap lasted about 30 seconds because I got the call in the middle of a mommy makeover. That requires some explanation: surgeons do not always have the luxury of fielding news at their convenience. That is not to say that my office, my friends and family haven’t gone to lengths in my life to protect me from something I may not want to know about when I am in surgery. In this case, we were braced for the results of the biopsy done 2 days earlier but did not know that the phone call was coming when it did.

Funny true story: on the day of the biopsy result, I was in the operating room, doing my thing, with my bestie Toni at the head of the table doing the anesthesia thing. Despite the knowledge some results were coming our way, we were having a great case, doing what I love to do most: operating. About 2 hours into the 6-hour case, my cell phone rings and Toni answers it for me, on speaker so I can participate. It’s a local phone number as evidenced by the area code but an unknown number. After the obligatory pleasantries, the man on the other end states ‘”…this is Ed from Coleman…” All I heard was ‘Komen’ as in Susan B. Komen, as in breast cancer. “The hot tub cover you ordered is in.” No one has ever been more relieved to have a new hot tub cover than me. We laughed about the irony and kept operating.

30 minutes later, reality hit. The radiologist called himself and gave me a quick pep talk, I recall he might have even said, ‘are you ready for this?’ or something like that. Remind you, I am on speaker phone with Toni holding the phone to my ear. He goes on to tell me it was indeed DCIS on the left side, high grade. Nothing invasive, very small area. Got it, thank you, have a tummy tuck to do.

The next phone call I asked Toni to make for me was to Danielle LeBlanc, a very close personal friend and fellow plastic surgeon whose practice happens to be centered on breast reconstruction. She is a PHENOMENAL surgeon…I have admired her results for years and always told her that if, God forbid I ever needed breast reconstruction, she’s my girl. She knew about the mammogram and pending results so when I got her on the phone to tell her, her reply was simply ‘dammit’. I asked her to please contact Anita Chow, the bad ass breast surgeon I selected to do my mastectomies, and find out between them if I was a candidate for bilateral nipple sparing mastectomies with straight to implant reconstruction. Love you, mean it, gotta go finish this tummy tuck…

The patient that was the recipient of that mommy makeover is aware of all the events that transpired that day while she was taking her anesthesia nap and is a friend of mine. Here’s the deal with processing unfortunate news when you’re in the middle of a surgical commitment: laser focus. It was actually a relief to have anything to think about that was not my left breast. Her case came together great, she has since recovered right on schedule and we are forever bound by the reality that my life changed at the same time hers changed. Am I overstating the power of a mommy makeover? Nope…it’s pretty great and she is rocking the fitted dress right now while I have a surgical bra and drains. But I’m getting ahead of myself…

A little education about breast cancer. It is either noninvasive or invasive which basically means noninvasive stays put and doesn’t show up anywhere else. If you have to have cancer, it is what you want. Breast cancer is either ductal or lobular which is a description of the cells it derives from. If someone has LCIS, that means lobular carcinoma in situ (noninvasive)…that is considered a pre-pre cancer and really not a big deal: that is what the radiologist that found the calcifications originally believed I had. DCIS is the same thing but ductal, a little more serious than LCIS…but still better than the nasty invasive cancers. One option to treat this tiny focus of mean cells in my left breast would have been to pluck it out (a lumpectomy) and radiate everything around it remaining and leave righty alone. The alternative to that is remove all breast tissue both sides and never have another concern that breast cancer is going to hurt me again. I have deemed this the surgical apocalypse because it is a lot for a little: but the answer I needed to live with this diagnosis because I cannot live in fear of when it will come to the right and will it recur in the left and might it be invasive. Aaarrgh!  

Toni told me only after she, myself and Jeff had our consult with Dr. Chow that she originally thought I’d lost my mind after that phone call in the operating room when I requested consideration of this surgical approach. Dr. Chow confirmed that for someone my age…young (smiling)…with this diagnosis in the location is was (close to the muscle, away from the nipple), this surgical approach is absolutely reasonable and is a surgical cure for me. No anticipation for chemotherapy or radiation. My breasts will match as closely as possible because they will be reconstructed at the same time with the same technique. Yippee! But wait a minute…double mastectomies? Damn.

After my consult with Danielle, again accompanied by my constant companions and care takers Toni and Jeff, the plan was set, the implant size selected and nothing to do but wait for surgery. 5 days before surgery I had a preoperative appointment at the hospital. Per usual, Jeff insisted on accompanying me. All the financial pleasantries taken care of…side note-if you happen to have a credit card with miles or points or anything the you benefit from while spending money, use it for your out of pocket expenses before your insurance kicks in because in some small, stupid way you get a sense of  ‘I’m earning miles through American Express toward our next flight to Italy or somewhere exotic.’…they pull me to the back to do blood work, EKG. I asked if Jeff could come with me; after all, he accompanied me to support me so extracting me from him counter intuitive, right? Her first answer was that he could wait in the waiting room but then she relented. This was one of my first moments of, ‘Really?’ I have not played the surgeon card through this experience. I did not tell her I know the system and there is no reason he cannot be with me during this. Boy, I’ve learned SO much about our medical care systems in the short time I have lived this. Things are going to change, people, but once again, I’m getting ahead of myself…

I operated, saw patients, tried to tuck everything in before my surgery because in my almost 13 years in practice, I have NEVER been away from my office as long as this stretch. The days before my surgery were busy with all of that as well as getting ready personally: mani/pedi, bikini wax, grey roots covered, a facial. Dramatic and unnecessary you say? Nope. Essential. If I’m going to be poked, prodded, cut, drained I am going to do it as the most well-groomed client the hospital has ever seen. ‘Client’, you say? Yes, try that approach next time you, regretfully, are going through something you didn’t look forward to or plan. I refused to ever be considered a ‘patient’ because that, to me, sets up a state of mind that isn’t positive. A client is someone you have negotiated services with. Not unlike contracting with a financial planner, a designer. Whatever. Call yourself a client and see how your surroundings respond…I think it’s a good thing.

We arrived at the hospital at 5am for surgery. Actually, since I hate being late, we arrived at 4:45am…always the overachievers. Around 5:15 I was taken to my room where I was asked to change into my purple paper gown and hospital issue slippers. I chose to sit in the chair next to the stretcher because that is what a client would do: remain as non-vulnerable for as long as possible. When there is so much going on you cannot control, do whatever you can to control something. Bossy? Perhaps. The process of getting a surgeon ready to have surgery is complicated.

At 6:15 I was loaded into a wheelchair for transport to radiology to have a needle placed into the tiny area of calcium. It is important during surgery to remove a margin of normal tissue surrounding the evil calcium and even the most elegant surgeon with the best dexterity could not have found the DCIS without the assistance of a small wire right in it. That process, the needle localization, was very well tolerated technically. Very little pain in the left breast but a lot of brain pain as, per protocol, I was alone in a dark waiting room, waiting for the transporter to come back and get me. Alone with my thoughts: scared. Dislike. Back to my people and support system. By this time, one of my dearest girlfriends had made the pilgrimage from Dallas to Fort Worth with custom T shirt emblazoned with my battle cry through this process: Fanculo al Cancro. The girlfriend is Christy Milkereit and the translation is ‘Fuck Cancer’ in Italian. My mother, my heritage, is Italian…hence the adoration for the language…and I think we can all agree that sporting a shirt with ‘Fanculo’ is more socially acceptable than ‘Fuck’.

My next field trip was to Nuclear Medicine to have a radiographic tracer injected into my left breast so Dr. Chow could find the sentinel lymph node to biopsy and prove that, for sure, no concern for this little cancer making a move. I asked if Jeff could come with me on this one. Yes, he was allowed to push my wheelchair and that made me smile. Good thing since the injection did not. There is a lovely program at the hospital here I believe most hospitals offer: Breast Nurse Navigator. A RN named Kim had called me before that preop appointment on Friday to introduce herself. She explained she and her partner had a list of all breast surgery patients and followed them through the process. She mentioned her partner was out and she was spread a little thin; my reply was that I happen to know the process as a surgeon myself that is actually on staff at this hospital and I have a great support system intact…please focus your attention on the other patients that may not have such great support. She agreed but showed up at the injection to hold my hand. I was told it was like a bee sting, a mosquito bite...worst case scenario, a wasp sting. Dr. Chow does her injections herself and she is a friend of mine who I admire and respect tremendously. When getting ready to do the injection she asked the nurse, ‘may I have some alcohol’ to prep the skin. My reply: “I have been asking the same question all morning…” but I clearly meant a strong cocktail instead. At least I got a giggle out of her. The injection does not feel like a bee sting at all. It feels like a hot poker right into your nipple. If I ever come across a bee or a wasp that might sting like that, I am going to shoot the little ‘fanculo’. Ouch.

Next step: operating room. I remember very little here. The nurses are my friends and know me here. They absolutely recognize that a surgeon on the other side of the game is not natural. Side note: I have had surgery many, many times before. I have been under anesthesia multiple times for unnecessary, fun, elective cosmetic surgery. I have never been coy about what procedures I’ve had done: rhinoplasties (yes, two), mastopexy, liposuction. I have had an appendectomy and a tonsillectomy. I had a tubal ligation. None of these procedures were scary, not even those that were not elective. I have never feared general anesthesia. I have also never had breast cancer facing bilateral mastectomies before. I was scared. Really scared. The anesthesiologist asked me if I wanted Versed once my IV was started. Who in the hell would say no to that, I asked. The nurse asked me if I wanted local anesthesia where she was going to start my IV. Who in the hell would say no to that, I asked. IV in, Versed in, off to surgery. I awoke about 8 hours later in recovery. I remember very little here. It was late enough that all other patients were out of the recovery room and they let my people come in. All good news: the sentinel lymph node was negative as anticipated, the flaps were healthy and Dr. LeBlanc was able to put in implants instead of expanders and save my nipples.

Let the recovery begin. I was in the hospital overnight and was paroled for good behavior the next day. It has come to my attention that I have had only sporadic good behavior since. Oops. Back to that doctors are the worst patients. I am compliant with my restrictions, whether or not those that know me best believe me. I am embracing my good fortune and the blessing that I no longer have cancer. I am frustrated with the drains and my shoulders are stiff. I cannot sleep on my side or stomach as I love to do. I have ‘breasts’ and ‘nipples’ but it is not normal and real. I am trying to make light of it, I am using humor and sarcasm to cope which works for me.

Yesterday I had a complete come apart. I asked my beloved Jeff to check things out for me…make sure that where I was hurting that there was nothing he could see of concern. Secretly in my mind I wanted him to say, ‘Damn, Boo…you’re so hot’. I stood there in front of him, topless, with drains clipped to a lariat around my neck. He inspected as I requested. He didn’t scowl, he didn’t look away in despair, he didn’t vomit. But I perceived my reality in front of him and burst into tears. ‘Don’t look at me, I’m hideous’ was my reality. I’m sorry I made you look. I’m sorry I don’t have real breasts anymore I’m sorry there are areas on my nipples that are not going to survive and they are discolored. The tears wouldn’t stop. He held me, laughing, and kissed my eyes. “Sweet girl, we’re healthy”, he said. His focus and reality is that the disease is behind us, the healing is all around us and the future is wide open. I need to come to terms with that, too.

Having breast cancer was one of the best things that ever happened to me for so many reasons. I know with certainty that I have only ever been as scared in my entire life as I was during the 3 weeks from diagnosis to surgery one time: when my mother was in the ICU, critically ill. For 5 weeks it went on…she would legitimately get better on Sunday after I arrived on Friday, such that I believed she would actually be OK and I would go back to work. That was until the end of the week when she got worse again. I lived in fear of every phone call, every message. I lost her and that will forever be the darkest time of my life. I desperately wished she was here to hold my hand and take care of me through this process but it occurred to me that she would have been so concerned for me, so sad. I could not have tolerated making her sad. Having her sitting on my shoulder as my Guardian Angel is what has helped me through this. That and the army of friends and family that have supported me, loved me, fed me, dried my tears, emptied my drains, changed my dressings.

I am a better surgeon and a better person for having lived this. I got off easy: no chemotherapy, no radiation. Yes, I have incisions and drains and implants. I will need more surgeries down the road because that is part of it. I struggle with guilt for that phases of breast cancer survival that I circumvented. Would I change my reality just to experience those things? Hell no. My heart breaks for those that I know and love that are walking that walk. I did not want to ever be a breast cancer survivor but I sure as hell would never want to be a breast cancer non-survivor. I am in a position to make changes for all patients….clients…following behind me from what I have experienced. I am lucky to know many people that support me that are in a position to really help me make a difference. I am researching how to make it happen now, I will need support and input and will keep those interested in touch.

Until then, I am laying low, waiting for my drains to come out. I laugh every day, sometimes through tears. When I say raise a glass it can be a glass of whatever you want it to be. I choose champagne, but only in moderation because I am in recovery mode right now. Saying thank you could never begin to express my gratitude to so many for so much. Let my actions tell my story and let’s make big changes: attention to early detection, support for those walking the walk without adequate support, to recovery. There are so many needs out there, so many different cancers. I want to help them all. Shooting for the stars, but doing it right now without raising my arms above my shoulders.

Love those around you, embrace the day. Smell the roses, ignore the weeds. More to come, have to go enjoy brunch with my beloveds now. Until the next time…

Here’s up to it!

#fanculoalcancro #raiseaglasstokickcancersass

 

 

 

But I Don't Want to Look Plastic

plas·tic sur·ger·y

[ˈplastik ˈsərj(ə)rē]

NOUN

The process of reconstructing or repairing parts of the body, especially by the transfer of tissue, either in the treatment of injury or for cosmetic reasons.

It has nothing to do with actual plastics. Silicone sometimes…yes, but not actual plastics. I think most people do realize this. I am occasionally asked by patients why it is called plastic surgery and share this definition. The reason this is on the forefront of my mind today is because of something that a new consult said to someone in my office yesterday, ‘But I don’t want to look plastic.’

No one does. OK, maybe some people do. I am not interested in aligning myself with that clientele. I believe that those people moving through the world with a completely unnatural, surgical appearance are the victim of a surgeon or physician that didn’t know when to say when. This lady’s concern was looking too ‘done’. She had been to another physician for injections, nothing surgical. Good thing since he wasn’t a surgeon….although that is not always a deterrent for some physicians. I have had patients present to me to discuss mole removal and in discussing their history relate they had liposuction by a Dermatologist. And you’re coming to a Plastic Surgeon for a mole? This is a topic for another blog. Let me stay on point…

I loved the reply that Patty came up with when the patient stated her concerns about looking ‘plastic’.

Do I look plastic to you?

No.

She went on to tell the lady what she had previously had injected. Those injections were done by me because I would beat her mercilessly if she came in here with evidence of someone else working on her. Not really beat her but it would break my heart. She knows that…my office is amazing and loyal and great. Doubt they would cheat on me. But I’m watching, ladies…

Two points are very relevant to me regarding this exchange. The first is my drive to use the proper tool for the job and the second is when to know that certain tools are not the right one for the job. In this lady’s case, and in the case of many other patients I see, the injections she had done were not the right fix for the job. That is my opinion and I think most know what you can say about opinions. Everybody has one, just like something else. And I believe most of you know what that other thing is that everybody has.

You could present yourself to 100 plastic surgeons and likely come up with 100 different plans. One of the many, many things I love about Plastic Surgery is the variety. There are more fillers on the market than I even realize. There are multiple ways to do every procedure that anyone could come up with. I love that Plastic Surgery allows you to address literally every area of the body. Last Thursday my surgical schedule was a lower blepharoplasty (eyelids) then augmentation mastopexy (implants and a breast lift) then a brachioplasty (arm lift) then liposuction then a laser with fat grafting. 5 different patients, 5 different things: one of the best surgical days ever. Plastic Surgery is the love child of art and science. Figure out what needs to be corrected to make someone happy then figure how to execute the correction. Sometimes it is surgical, sometimes it is not.

Some patients desire an aggressive approach. I am all about instant gratification. I could only ever have been a surgeon because the alternative-life as a medical doctor-would have driven me batty. Let’s change this medication and check back with me in 6 weeks. Aaargh! Dislike. Here’s an idea: let’s cut it out and see immediate results. Excellent!

Some patients are not interested in jumping in with both feet. I have mad respect for that. The beauty of fillers and injectables is that there is little if any down time. Many people have little bruising or swelling and are moving through the world the next day...no big deal. I wish that had been my recent reality: I injected fillers into my face 2 weeks ago to correct some things I didn’t like. I am still swollen beneath my eyes and on my cheek. Oh well, goes with the reality of being a female plastic surgeon and practicing what you preach.

What does not make a lot of sense to me is someone that desires an aggressive result but is not interested in taking the plunge. With risk comes reward is a mantra that I often repeat. Perhaps more relevant to this conversation is ‘with lack of aggression comes disappointment’, at least in some cases. It’s not that the physician that did the injections knew he couldn’t deliver the results she wanted. I seriously doubt that is the case. I believe that too many physicians don’t know how to shut up and listen. Let the patient really explain what they want. After talking to this patient, it was clear to me that the plan to inject fillers was not going to deliver what she wanted to see corrected. After I discussed with her the options that would result in the difference she wanted, she expressed that the recovery from those procedures was more than she could take on right now. Totally acceptable, but not a reason to default to another technique that will not get the job done.

So back to her comment about looking plastic…I know what she means. A lot of people pursue so much ‘correction’ that they lose their natural appearance. I believe that this can result from the propensity to apply the wrong fix for the job. Clearly I’ve circled back to my opinion. If someone, for example, has significant volume loss in their face that sometimes comes with age and with this volume loss comes skin laxity and wrinkles, it is my opinion that trying to correct that conservatively with fillers is an exercise in ‘looking plastic’. Either accept that a face lift is the answer or accept that an incomplete, but believable and more natural, correction can be achieved with a different approach.

Do not be afraid of what it takes to maintain your youth, or at least the appearance of youth. Age is but a number. My beloved husband always says that he will continue to get older but he will never grow up. I LOVE that…I don’t want to grow up either. But I also don’t want to necessarily look like I am getting older if I can help it. Many that know me know that I abide by less is always more. You can always put more in or pull it tighter but you can rarely back it up. I love that the ladies in my world embrace this philosophy as well.  

I leave you with this quote from one of Plastic Surgery’s greatest advocates:

‘I’ve had so much plastic surgery, when I die they will donate my body to Tupperware.’ –Joan Rivers

Don’t be a Tupperware donor. I, for sure, will help talk you down if you find yourself headed in that direction. But also do not be afraid to maintain, correct, enhance. Remember, less is more. I look forward to the opportunity to help you find your way through the magnificent world of Plastic Surgery. You can find your own Tupperware.

Here’s up to it!

E

Where Have You Been?

I admit it has surprised and delighted me that some have asked why I haven’t written a blog in so long. So as I sit down this morning to write, imagining in my mind that the last one was a couple of weeks ago, I am startled to see that it was December 1. What?!? There are three drafts that I started that were never finished…the third entitled ‘Champagne’, the second one ‘Love, Loss and Champagne’ and the first just ‘L’. It would appear I was very distracted…and had champagne on the brain. December was an extraordinary month, and not in an entirely positive and holiday festive way. I feel compelled to explain my absence by explaining what reality put on my doorstep these past few months.

The first unexpected loss was December 10, the last was January 20. There were 4 total. After each loss someone would comment, ‘and especially at this time of year.’ There is never a good time for loss but I do agree that it is extraordinarily hard at the holidays.

What did I learn, gain or gather from the losses I endured? There has to be a silver lining to everything that happens. If you can’t find a message, something positive in every event I find it impossible to process what has happened. I still find it impossible to process some of what happened but I am trying.

Our friend Rod was killed in a motorcycle accident on December 10. He epitomized ‘life of the party’. The man never met a stranger, never had a cross word. He lived hard and fast: to paraphrase from Top Gun ‘Mach-2 with his hair on fire’ was his way, if only he’d had hair. He would have embraced the irony in that. The message of Rod’s loss is live like today is your last day. No regrets, no excuses. Sometimes this is not realistic or responsible. But as we gathered to raise glasses to our friend, the general sentiment was that he didn’t miss much and squeezed a TON of life into his years. Would we all have preferred another 20 or more years with him? Absolutely. Cheers to you, Rod. You are missed.

The next friend I lost was a long time patient of mine that had evolved into a dear friend over the years. I had not had the privilege of seeing her for many years but when our paths crossed it made me smile. She was elegant, funny, fun. What did I learn from her loss? Don’t waste time if you feel you need to be in someone’s company that you haven’t seen in a while. Maybe you saw them yesterday but they are on your mind: reach out, let them know. Many have the same policy that Jeff and I do: do not part company with discord or without ‘I love you’. God forbid you didn’t have the chance to let someone know.

The loss that affected me most deeply was Tim. He died on December 30.  Tim was my assistant in the operating room but more than anything Tim was my friend. He was a very, very dear friend…one of my closest friends. We had a bond many didn’t understand but was so effortless to us. His girlfriend, who I love, told me after we lost him that I was like the other woman and she was OK with that. That may not sound like a compliment but it meant so much to me. Tim is survived by his three children that I love. I love his mother. I love his girlfriend. I am really struggling to find the message here. He was Buddhist and I have learned a lot about Buddhism since his passing. Much of what I have learned is soothing in a time of loss. His loss has brought me closer to those that also loved him; I have spent more time with his mother and children than I had while I had him here. I confess I am struggling to learn the message regarding Tim’s loss. I confess there are many days that I reject reality and believe I will talk to him tomorrow. I am searching.

The fourth loss was Grady. Have you ever met someone later in life that you instantly like so much that you are excited about learning more about them in the future…someone so talented, interesting that their dress, style mesmerizes you. Grady was an artist, a musician. He was truly one of the coolest dudes I have ever met and there is just no other way to sum it up. He had been a high school friend of Jeff’s and I had just had the privilege of meeting him and his wife in November. Jeff has a shirt that Grady admired…his wife Lisa had reached out to me to learn where we bought it and Grady had found one. Lisa said it was his favorite shirt. The message from his loss is to cultivate your funky, your fun…your art. Make a presence that will endure when you are no longer here to create. I will never forget Grady and I just had the smallest glimpse into his greatness. Cheers to you, Grady…thank you for the honor of your company and the privilege of being able to say I knew you.

This is not an uplifting blog. Many have probably stopped reading already and opted to clip their toenails or take out the garbage because that is more exciting. My office has mentioned to me many times that I need to write. They have suggested many topics that are relevant to my practice that might be helpful or interesting. But I feel I must explain my absence before I move on to levity and education and beauty and all things pretty. Loss is part of life and I know that. How can you appreciate happy if you have never known sad? It would be impossible.

I am still trying to process my world without these four in it. As is reality, some of the losses are much harder to endure on a day to day basis than others. I will take this from each of them:

Live large and embrace every opportunity you are granted, as there is no guarantee of tomorrow.

Do not let the sun set on absence or regret or apology…if it crosses your mind, do it: because you may not get another chance.

Cultivate your art, your story…make your world a place that others thrive in and want to visit.

Regarding my Timmy…I am still searching, my friend. I was so blessed to have the friendship that we shared. The lessons with your loss are complicated and painful. I choose just to love you and believe that the meaning in your reality will come to me in time. I will never again operate without you over my shoulder and in my heart and mind.

How did champagne sneak into the story? Because I started this writing during the holidays and that’s champagne’s time to shine. If you know me you know I love champagne…any time is the right time. It is festive and happy. Over the course of this past December, many glasses were raised. I celebrate you, friends and loved ones, and raise my glass to you. Cheers! Now for heaven’s sake send me an idea to write about that will generate giggles and smiles and hopefully hordes of people running to the office to book surgery. Which brings us to my beloved mother’s favorite toast…

Here’s up to it!

E

Thanksgiving

So it is now 5 days after Thanksgiving Day. Back to work yesterday and the catch up game continues but that is OK with me because I had a great little break and much time to ponder the innumerable things I am thankful for.

I am thankful that people actually read this blog and many have asked when the next post was coming. If you’re telling me this to flatter and charm me, please continue because it is working. I know I am not a great humanitarian or changing people’s lives here, but if this is entertaining or educational or just a distraction from something you might be doing you need a break from, I’m here for you.

I am thankful for my laptop computer because I am sitting at my dining room table, Christmas tree to the right, the Today show on to the left. I often have to bring homework to my annex office here as the paperwork and computer drudgery is just too overwhelming to complete before I ‘clock out’ at the end of the day. That sounds more dramatic than the reality: I prefer to work here although my office is amazing. Dorothy was right: there’s no place like home.

I am thankful for my beloved dog, Lucy. This sweet, almost 15 year old beauty follows me everywhere I go in this house and plops down next to me. Such a simple gesture but arguably one of the most precious things ever. I read a hideous post the other day about a man who took his dog to a shelter and when asked why he was relinquishing the dog he stated, ‘she is always by my side.’ Yea, that’s awful….dog has to go. There’s a special place in hell for people like you, mister.

I am thankful that I am wearing size 6 jeans right now (especially on the heels of that long holiday…whew!), that I can actually sit and stand in them, that I can feel my feet as the blood flow is not strangulated. I am thankful that denim manufacturers have started adding enough elastic to denim that sizes previously unattainable to me are now an option. For girls like me that were once associated with Butterball and not only when buying a turkey, things like this matter.

I am thankful that the sun is going to shine today after many days of cold, wet rain. I am thankful for the cold, wet rain because that means a chance to bring out the cozy rain boots and sweaters.

OK. Enough of that frivolity. All of those things matter. It is a great thing to sit in your world alone and look around and feel happy, satisfied. Thankful. But those things I listed aren’t really what it’s about and I know that. Giving thanks for the tangible things is important. You should appreciate things. But it’s the intangibles that really matter. Let me continue to embrace what I am thankful for:

My health. I am so thankful that Jeff and I have good health. I am thankful that my family and friends, for the most part, are in good health. There are some very dear to me that are struggling with their health right now. Breast cancer is an exceptionally evil monster in the world of many that I love right now. I am recovering from a stupid calf injury and a cut thumb. If that’s the worst thing going on with me, it’s all good.

My work. I am heading into my 12th year in practice and cannot believe the beautiful world that surrounds me. The amazing women…and Tim…that make it all happen. The gorgeous patients that trust me with their concerns. The gift of a surgical suite in the office that is dedicated to the memory of my amazing mother. I am thankful that I have personal relationships with my patients and consider so many friends after the work is done.

My home. I think I might take for granted having a place to call home. Some days I don’t even process where I am headed when I go there. But then I get there and a smile consistently comes over my face. It’s not much, our small little bungalow. But it’s ours, mine and Jeff’s. And Lucy and Tucker’s, I suppose, but they rarely invite friends over or have mail delivered so I tend to exclude them. So sad. Many know we renovated our house a year or so ago and it is all that we imagined. I always laugh when I tell people what David Lewis, our friend and builder, first came over after we had really moved in and decorated. ‘It’s a visual orgasm’, he said. ‘A lot going on here.’ I like that. A visual orgasm. Who wouldn’t be thankful for that?

My family. My real and extended family. I will never recover from the loss of my mother now almost 7 years ago. That forever changed the landscape of my family. We are geographically scattered about the nation and do not get to spend holidays together. I love my family and I miss what our unity once was. My Texas family is a blessing that I can hardly comprehend. The love of so many and the time to spend together is priceless. My friends are so precious to me and I am grateful for every one of them, near and far. There are some that I haven’t had the privilege of face time with in quite some time but feel certain that when the time comes, it will be like just yesterday.

I am so thankful for so many blessings in my life. My world is not perfect but it’s pretty damn close as far as I am concerned. I am hopeful for the future, grateful for the present, nostalgic for the past. I wish for everyone grace, gratitude, peace and joy as we embark on this holiday season. Our world is a frightening place right now but I choose to focus on that which I can control here in my little world. I focus on thanks. If you’re reading this, I am thankful for you.

Here’s up to it!

E

Perspective...or, imagine how you'd feel if you really had a problem

I am in a foul mood. I have had a run of dumb luck so epic I cannot even believe it: a series of freak injuries that I have not experienced ever before in my life.

As a surgeon, I pride myself on good hand-eye coordination and technical skills. I do not consider myself clumsy and I am sufficiently proficient around the house that I once installed a new garage door opener, built an above ground garden, and once installed a light fixture in my kitchen…all by myself.

In the past 3 weeks, I have sustained more traumas to myself than I call ever recall. Three weeks ago I was getting ready to do an office procedure when I cut myself with a surgical knife…held in my right hand and into my left thumb. It was deep enough and in just the wrong spot to require 3 sutures. Thank God I know how to get to someone to sew me up. I was asked why I didn’t just sew myself up…putting the sutures in wouldn’t have been a problem but tying the knots with one hand would have been an exercise in frustration and futility.

Two days after the assault on myself, I was between cases in the operating room and had just pulled up some local anesthesia for the next case. Let me clarify something here: the sutures on my left thumb were covered with surgical glue so I could safely and effectively scrub for my cases that day and there was never any concern for loss of function of my thumb so not a big deal. The syringe of anesthesia that I was carrying still had the rather bulky needle on it that I had used to pull up the medicine…for those of us in the business, it was an 18G needle. Anyway, I somehow dropped the syringe during which time the cap came off the needle and it landed in my right second toe: right through my shoe, like a lawn dart. I still wish I had the wherewithal to have taken a picture because it was just too fantastic to believe. Yes, that needle and syringe were discarded and the patient received fresh anesthesia. I didn’t think much of the injury at the time as it bled just a little but the next day my little piggy was purple.

I had an uneventful week after that until 3 days ago. I was at our house hanging a clock in the kitchen. I have always been very competent to handle matters around the house. The clock was not heavy, not even bulky. I measured where I wanted it, made a special trip to the store to purchase appropriate hardware to accommodate it. Once I got it on the wall I had a sense that it was a little squirrely. I imagined if and when it fell it would bang up the wall, the cabinet and the floor. Yes, all of those things happened when it fell. I had just turned around to clean up my tools when it fell…I spun around and lunged to grab it (unsuccessfully) and in the process sustained a partial tear in a muscle in my calf. Yes, profanity ensued. Now I am wobbling around trying to conceal my limp as the reality of the injury is so uncool. I am on crutches for any distance as it is just not fair to society to watch me hobble and it would take me hours to get to where I am trying to go. I had a case at the big hospital here yesterday which necessitated my crutch walking, with a bag holding the patient’s chart strapped around my neck…and my recently lacerated left thumb banging into the crutch handle and my bag with every step. Good times.

I had agreed to participate in a marathon relay a month from now and had started running again after many years. It felt good to run and I was ready to start increasing my mileage after surviving 3 miles last week. I had gotten into Zyn22, a local sexy spin class, pretty regularly and had stepped away only to try to focus on running. I was ready to go back and ramp it up…get cute and fit for the holiday.

Nope. Not going to happen right now. Have to let my bum leg heal while I watch the world go by.

I have been tripping over my lower lip pouting. I have complained to anyone that will listen how irritated I am that I cannot do whatever I want to do without dragging my sore leg around. Today I was complaining that the sun was too bright when I was trying to do injections on a friend in the office. I complained that the chair she was sitting in wouldn’t anchor in one place. I complained about the service at lunch so slow after my sweet Jeff surprised me midday to take me to lunch after a dramatic text to him stating that I was having a mini nervous breakdown and that I needed him. (I am not having a nervous breakdown…it was a cry for attention. Fear not.)

Do I need a vacation? Perhaps a financial windfall so I can sit at home and eat bon bons while I pay the bills out of my money market account would ease my angst. Do I need a personal assistant or better disability insurance?

Nope. What I need is a big fat dose of perspective.

My leg will heal. My thumb is fine. There will always be road to run on and there is a race every weekend on the calendar if I feel the need to compete. The clock in the kitchen is where we wanted it and the painters will fix the wall and the cabinet. My little purple piggy is long since recovered.

I have a dear friend that is facing surgery next Friday….double mastectomy for advanced breast cancer. She is enduring chemotherapy, radiation, pain all over her body. She is widowed after losing her husband ridiculously prematurely over a year ago. I have another friend that just announced she was diagnosed with breast cancer last week…she has a beautiful young baby girl. I am not a county music fan but have followed the story of Joey Feek, fighting terminal cervical cancer now on hospice care. Heart breaking.

I have an office full of amazing women that are tripping over each other to help me navigate the halls here without injuring myself further. I have patients that ask me about my injury (because of the damn limp…so embarrassing) before I can even ask them how they are. I have family and friends that field my complaints and concerns and pep talk me through it. I have a beautiful home to return to every night. I have food in the pantry, wine in the bar. I have a car to drive to get me to my beautiful office and to the hospital to do surgery when I need to and to get back to the hospital to check on my patients.

I have the most amazing husband I could dream up that runs around the house to get me what I need and save me the steps right now and surprises me at my office when he thinks the Blue Funk Demons are really getting me down. I’ve got it so good. Sometimes you really do need a little hiccup in your world to allow you to truly grasp what crisis is…or isn’t.

‘Sometimes a change of perspective is all it takes to see the light.’ –Dan Brown

My light bulb is shining pretty brightly right now. That’s a good thing because I probably shouldn’t get up on a ladder until this leg heals…

Here’s up to it!

E