The Patchwork Princess

Warning: If you have no desire to look at pictures of a first-stage surgical reconstruction, the time to bail out is now. (No blood! I promise!)

I can still remember the first time I saw a picture of a reconstructed breast. It looked to my horrified eyes like a carelessly-assembled piece of patchwork, or a hastily-mended rag doll- some sort of amateur needlework project where too little attention had been paid to the finer details of symmetry, line, colour-matching.

Cruel? Me? No, just honest. It was seriously off-putting. I didn't even want to think about whether I'd ever need that done.

Now that I've been through that human assembly line myself, I understand that what I was looking at back then was something of a botch-up. It was still a relatively new surgery and I guess not every surgeon who did it had it 100% nailed. Around that time, some disappointed women in my support group started referring to their reconstruction results as Frankenboobs, though perhaps Munster Mammaries would have been more apt. You could almost see the stitches. I had trouble imagining that these transplanted hunks of flesh, revealed in the bedroom, would ever look sexy- though of course they represented a significant improvement on lugging around a pair of hot, sticky, heavy prostheses all summer once one was inspired to put one's clothes back on.

Some two years later, I realise how damned lucky I am to have a far better result than the one I looked at with such shock back then. Certainly, if you look closely enough, there's an element of patchwork about my new 'breasts' still. Four weeks out from surgery, there are still puckers, faint stitch marks, slightly raised joins here and there where my old scars were opened up and the pieces of my stomach flesh added in. But in other places, significantly across the top where it's most obvious, the scar is starting to recede; I can imagine, with enough massage and liberal anointment of BioOil, that eventually I might just have a thin white line across each new breast, only a little more obvious than my first mastectomy scar (which had almost disappeared into the shadows of my poor exposed ribs).

It doesn't hurt up there, or at least not unless I sneeze (which event can only be described as 'fucking agony'). There's no sensation in the flap that was moved up from my tummy; all the blood vessels, right down to those the diameter of hairs, were painstakingly joined up to keep the flesh alive- but the nerves were destroyed in the process.

Oddly, though, there's significant referred feeling onto my chest wall- much more than I expected. I may not have nipples any more, but at least I'll notice if someone's groping me on the bus.

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Are you ready for a photo? I'm not shy. See, you're actually looking at my stomach, and whatever your knee-jerk reactions might tell you, this is nothing you wouldn't see on the beach if I happened to be the sort of girl who wore a bikini (which admittedly I'm not). I've seen more shocking things in the food hall at Tuggerah Westfield.

It's not a real pair of breasts. And I'm putting it here not out of some weird desire to be an exhibitionist, but because maybe there's someone out there who's at the beginning of this revolting journey through hell, who'll look at this and feel far less horrified than I did when I saw my first reconstruction. And will be more hopeful, and less frightened.

There's still tape over the joins. I have to replace that every day after my shower and the BioOil massage; Dr Yes says it helps keep the scar line from spreading out. We won't talk too much about the interesting task of getting paper non-allergenic tape to stick to skin that's just been massaged with oil. Suffice to say that 'hog-tying a muddy pig with a plastic skipping rope' comes to mind.

They do look a little like Barbie boobs... but without the plastic.
How incredibly eco-sensitive of me.

I took this shot about ten days ago. It's all much cleaner now, and even those tiny bits of bruising are nearly gone. This is, apparently, a pretty amazing result, as absolutely everybody who's seen it and ought to know has been quick to point out. Certainly I'm amazed, and not only because Dr Mattel had told me that such a reconstruction was impossible, or at least not worth the trouble.  I went from 'not even an A cup' to a genuine C cup, just by getting a better surgeon.

Respect for your medical staff is a nice default position to aspire to, but second opinions can be priceless.

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The stomach has been more of an issue, unsurprisingly. The nerves haven't been decimated to as great an extent, which of course means more discomfort (though compared to chemo, the pain of this operation has been a stroll in the park on a sunny day, with fragrant roses and gushing fountains in the middle distance). There's more bruising, which is still somewhat in evidence. And unfortunately, in my usual gung-ho style I made a tactical error soon after coming home which was almost my undoing.

It was, of course, all down to my desire to keep up the exercise and satisfy the same need in the new puppies (no innuendo intended). The hunting dogs were delighted to have me home again, and I went back to walking them in the mornings straight away- the first day somewhat less far than usual, and the second day back to our usual tramp of about two kilometres. I might add that this was all completely fine. I felt really good.

(Well, I am very fit. And I did recover from surgery stupidly quickly, and they do give us some very nice drugs in our party bags.)

About a week into this, I got halfway across the yard and realised I'd forgotten my girdle. Yes, folks, the totally unsexy reality is that 'support garments' are required for six weeks after surgery. Given that I'd been split open along what is delicately called 'the Caesarian line', one doesn't really want to rely on dissolving stitches and hope.

A sensible person would have gone back and got it. But no, the Patchwork Princess was above all that and decided to keep strolling after Velcrodog and the pups, who in typical exuberant fashion were about a hundred metres ahead of me and already playing their favourite game of trying to kill each other by jumping on each other's heads. 

This failure to stop and go get it, gentle reader, was A Bad Idea. Doing what the surgeon tells you is A Good Idea. You heard it here first.

It was after this walk that I started to feel a distinctly uncomfortable sloshing sensation in my abdomen. Who knows? It may have been coincidence. It may have been going to happen anyway. But from the moment of that bad decision (and I'm telling you, by the end of that walk I wasn't feeling too special) I had a seroma developing along the right side of my abdomen.

A what, I hear you say? 

A seroma. Don't worry, it's not fatal. Just bloody uncomfortable in the wrong place, which this definitely was. It's a pocket of fluid- the same fluid which my six drains were getting rid of after the operation.

A seroma which requires drainage is enough of a pain in the arse when you're in the same city as your doctor, but when you're not even in the same state it becomes a bit of an issue. It took me another two weeks to sort out getting someone here to stick a needle in my guts, after locating the seroma by ultrasound. That's where I spent my morning today- looking at a long, black leech-shaped pocket of fluid on the screen and watching it gradually disappear as the doctor sucked it dry with a syringe.

I was left feeling much better at once, but wondering how a twenty-minute procedure could possibly cost nearly five hundred bucks. Yeah, yeah, I'll get all but two hundred of that back on Medicare, but what the hell do the poor people do?

I guess they walk around flat-chested for the rest of their life. Patchwork Princess indeed. It doesn't hurt to remember how privileged I am to be in a position to choose that surgeon, to have that operation at all, and to pay for the fallout when something goes wrong because I took a stupid short cut. 

Mind you, that's more good luck than good management. I'm not quite sure whether my long-deceased mother grabbed that blocksplitter again (see Episode Two of this blog) and chose her moment to top one of our more annoying relatives, who'd happened to bequeath me a handy sum in her will. It arrived at the crucial moment during chemo when things were getting desperate in financial terms, and it paid for (amongst other even more crucial things) my new foobs.

Amusingly, it was that very same relative who'd devoted considerable energy to battering my ego when I was a highly sensitive adolescent, by telling me at every opportunity how desperately I needed a breast reduction. Karma's a bitch, and arrives in a multitude of unexpected ways.

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And it's true: I do feel like a princess. Honestly, I've never had a body this 'culturally acceptable'. It blows my mind to think that I'm going to be able to wear clothes I could only dream about before.

Like this.

It's an odd feeling. I've had moments of complete transcendent happiness, and moments of what I can only describe as 'survivor guilt'. It seems crazy that everything's ended up going so well for me, while for other people who are just as deserving of wondrous things, the excrement hits the rotating cooling device over and over again.

And then I think about my Bear, and what he's been through, and what we still go through every single bloody day because of his obvious and severe PTSD, and I remember that about 95% of the time while I was so ill I didn't dare to even think about things going badly for me, because it would have destroyed him completely. I've always been a princess to him. He deserves to have a princess in his life, after everything that's happened to him.

It was the same with this operation. He was so scared, and I was so determined that nothing would go wrong, because it just wouldn't bloody dare. There's a limit to how much unfairness one human can take, and he's had his share three times over.

"How do you feel?" he said to me, when we'd got home from the airport and he'd carried my bag from the car for me, because princesses with brand new patchwork foobs aren't meant to carry stuff, you know?

"I feel like a girl again," I said.

And he hugged me, and cried his eyes out with joy.

Lipstick, laughter and learning to be new

I'm getting pretty good at this hospital gig.

I know now to pack my iPod, my phone, my laptop, my DVD drive, some movies, an extension cord, a double adaptor. I know how to buy an extra data pack and turn my phone into a WiFi hub. I know I need to stay connected to stay sane while I heal. Everything's a learning experience if you let it be.

I know what clothes I'll need, what toiletries. I put in some snacks in case the food's inedible.

And now, I pack my lipstick.

***********************

I never used to do this lipstick gig. As a teenager I was self-conscious about my big lips, my rather yellowed teeth from the hideous amounts of antibiotics I consumed as a child. Did I mention that I was a sickly child? I was always in bed with tonsillitis or the flu, or, once, a case of rheumatic fever that scared the wits out of my mother. She decided I was to be wrapped in cotton wool after that. I was a compliant child; went along with it like a lamb, or at least until I got to my late teens and decided to lash out a bit. I still remember the colour draining from my mother's face when I showed her the holiday snaps of me riding a horse along the edge of the mind-numbingly steep Arrow Gorge in New Zealand.

It took me years to discover that I have the constitution of an ox, and little fear. My heart doesn't have a murmur after all. My body heals quickly.

And it's taken me years to discover the liberation of lipstick. Everything's a learning experience if you let it be- even cancer.

***********************

I now have these wonderful new friends, you see, and I learn stuff from them all the time. The Freeloader gave me these people. I would never have met them without him. Here are just some of them.

It was all Angie's fault, really. The lipstick thing, I mean. She's nagged us all into slapping on a bright mouth to help us feel beautiful again. We've all got our issues- whether it's a flat chest and a lost career, or a permanent loss of hair, or knees that just don't work any more, or PTSD, or a metastasis waiting to grab us by the throat one day.

It's not a competition. We know all our issues are crushing for each of us, in their own way.

But we're not letting them crush us. Power in numbers, in being there for each other at any hour of the day or night. Power in sharing truths, and in finding many of them darkly hilarious. And power in bright, laughing mouths.

****************

And so my lipstick went into my bag when I lined up for this - well, I hesitate to call it the final hurdle, because that's kind of tempting fate - but there's no doubt I've thought of this as some sort of end point. As Dr Yes put it, a restoration of sorts. A reparation, perhaps.

Not that I'll ever be the same. I have to learn to be new. The girl with the amazing cleavage is gone forever. My new foobs (false boobs, for the uninitiated) are many sizes down on what I was used to.

She didn't go alone, mind you. Fortunately it seems that the girl with eyes bigger than her stomach has also gone forever.  Looking at the wonderful menu in this five-star hospital, I choose the All Bran for breakfast, because I've learned that painkillers have their, um, down side and eating chook food is better than trying to force concrete through fresh scar tissue (did I mention the tummy tuck that comes with the foobs?). But I choose the fruit Danish too, because I've also learned that denying yourself everything you like is no way to stay healthy.

And then I look at lunch and dinner, and I take the casserole and the pasta but reject the cheesecake, reject the pudding and custard, because I know I'll just feel bloated afterwards with that delightful chemo-hangover metallic over-sweet taste lingering in my mouth.

And I know, now, that I don't need three two-course meals a day.

This is okay. I don't feel like I'm depriving myself. I feel like I'm listening to myself. I didn't know how to do that before.

******************

The day of the operation started with a small glitch, as my enthusiastic cousin Pam dropped me off at the wrong hospital and drove away.

I just laughed and rang her to come back. Honestly, I swear after you've sat in the BP toilets at Maclean having a panic attack because your bone scan results are coming back tomorrow and you don't know yet if you're terminal, NOTHING is ever as bad again. There are many hospitals with the same name in this city, and two of them are only blocks apart. An easy mistake to make.

Here is something you learn when you get a cancer diagnosis: don't sweat the small stuff. Honestly. Just don't. You'll find a way around it, and that's a lot easier if you're not conflating the situation with panic.

And you'll find you have zero patience with people who make a drama out of every little thing. Watch all the cancer patients drop the drama queens off their Facebook friends list like there's an Ebola outbreak onstage. Yeah, even if they're family. Just stop it, you old hams out there. Stop making mountains out of molehills (unless, of course, it's a malignant molehill, in which case throw everything you've got at that fucker).

Anyway, once we'd arrived in the correct location things moved rapidly. A double DIEP reconstruction is an eight to ten hour procedure, so I was the first and last on Dr Yes' list. Yet again, I struck it lucky with outstanding medical staff; they moved me rapidly and cheerfully through the usual steps, from paperwork and consents and billing and privacy statements to the fashion-statement stockings, Prada surgical gown and temporary removal of my eyesight. (Yes, folks, since chemo everything's a bit blurry without the glasses. Take what you want and pay for it. Dear nurse, please fill in my menu for me, because I can't see a damn thing on that sheet of paper and I could be ordering dry muesli with Vegemite sauce for all I know.)

I admit I'd had a few butterflies leading up to the day. The Bear was having a shocking time of it, worrying that I was pushing my luck by lining up for yet another surgery. I protested angrily, while secretly wondering the same thing. Should I be content just to be alive, and flat? Was I cruising for a bruising? How much could this poor battered body take, after two years of abuse in the name of a cure?

Was this all just vanity?

But wait. Lipstick. It's just like our little gang colouring in our lips to take on the world, regardless of the issues that torment us in the dark. It's not vanity. It's grabbing back our power. It's the ultimate fuck you, cancer.

You took my breasts. Now I'm getting new ones, and what's more, they won't knock me out when this new me goes out running. Shove that where the sun don't shine, Freeloader.

*********************

And so before I knew it, I was asleep, and seemingly moments later I was awake again, with Dr Yes enthusing about how well everything had gone. My blood vessels had been very cooperative. The operation had taken just over seven hours (a total win- the less time under anaesthetic, the better).

All and sundry proceeded to comment on what a good result it was, what a great surgeon Dr Yes was. "They're so even." "They're so tidy." "Wow, they look great."

Or maybe I was just high on morphine.

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A day later I was sitting up in the chair with my laptop going ten to the dozen and standing unaided, surprising the nurses. Business as usual here. (Though, admittedly, falling asleep every few hours- the nurses have to check the blood flow in the newly transplanted foobs every half hour all the first night, so my sleep was a bit non-existent.)

Whatever! Onward and upward!

Two days later I'm walking round the ward unaided, though somewhat stooped; the tummy tuck is very tight to start with. I've graduated from morphine to less noxious substances, which is kind of a bummer but much better for the concrete mixer, if you get my drift and pardon my pun. And the foob checks have graduated to every two hours, which is a slightly more decent amount of sleep at a stretch.

I'm well enough to put my lipstick on. Huzzah! The nurses look surprised. (Let them.)

I'll be in here a few days yet, walking around or not. I'm taking no chances. They do a sort of ultrasoundy Doppler thing on the foobs every few hours; you can hear the rush and throb as the blood pulses through them. It's kind of like being pregnant with twins. These babies are going to be assured of complete health before I take them home.

Look out, world. New me coming through.

How to eat an elephant

I write this from the bedroom, where I sit propped up in bed with aching head and pouring nose. The throes of a spring cold are upon me, and for all the cheerfulness I can muster it might as well be man-flu. I'm not particularly ill, but I'd like nothing better than to lie in bed moaning while my poor, long-suffering better half brings me worshipful offerings and does all the housework.

Sorry for myself? Not really. Just lacking in any tolerance whatsoever for being ill. Two years of fighting the Freeloader has left me minus any capacity for patience when my body mucks up yet again.

It's hot outside. I should be back in the lagoon, pulling out more bloody salvinia. But my body won't co-operate. I've realised that the lagoon project is a monster of fearful proportions. The idea of clearing it in one season is just ridiculous, as I found out by the end of last summer as I slipped and slid around on the increasingly treacherous mud slick beneath my feet. I finally decided that my good intentions were going to end up manifesting as a broken leg if I wasn't careful. I left it to the gods and another season, praying that the hideous stuff wouldn't grow back to such an extent that all my work was undone.

One woman working by hand just isn't going to do a job that size in one go. I need to stick at it for years, not days or months. It's an elephant waiting to be eaten- an elephant with a knowing smirk on its face, laughing internally at my pathetic little daily nibbles. And how do you eat a whole elephant?

One bite at a time, my friends. One bite at a time.

********************

Not an elephant. I don't have a picture of
an elephant. But close- my puppy's dad.

This philosophy was taught to me by one of my support group friends, a woman who lives day to day with a Stage 4 diagnosis leering at her. She surprised all of us when the metastasis news came along by turning immediately from fearful little mouse to steely lion.  And now she's nipping off one little piece of the future at a time, and purposefully avoiding looking at the size of the beast on her shoulder.

This year, as the weather's turned warm enough for me to test the lagoon waters again, I've started to understand how very relevant that approach is to so many situations. Take my fitness, for example. Many a time I've whined to you all about how weak I was since chemo, how quickly my arm started to ache when I did any work, how easily I tire since radiotherapy.

And yet this year, as I drag armful after armful of heavy water weed to the bank, I realise that it's easier than last year. I'm clearing more in a session now than I did then, and I'm less pooped afterwards. It takes time to work the destruction of treatment out of your system. It's not going to happen in days or months. It takes years.

Don't expect too much too soon. One bite at a time. And stick at it.

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Mind you, sometimes I'm a slow learner. One of the simple joys of life that's come along with the second mastectomy is being able to run freely for the first time since I was a child. Naturally, once I discovered that I could run I tried to swallow the full pachyderm at a single gulp. I took to walking / running for my high intensity interval training three times a week.

Sadly, though my ability to run may have returned to the days of being 12 years old, my knees have not. Soon I was in fucking agony. I had to give away the HIIT altogether for a few weeks while my joints recovered.

You're 58, idiot, and you're taking little lumps of concentrated bone degenerant every night for five years. Get a grip.

How did I turn myself from this elephantine creature
on the right to the silhouette in the next photo?

'One bite at a time' in this context has turned out to mean walking / gentle jogging, and saying 'no' to my perfectionism on the days when I realise I'm getting twinges of pain. It probably helps that I'm theoretically not meant to be losing any more weight before my reconstruction surgery next month; torn between keeping my circulatory system in top condition and maintaining a bit of stomach fat so I don't end up undergoing major plastic surgery for the sake of two mosquito bites on my chest, I'd probably been erring on the side of keeping the blood pumping. So I do have some sort of rationale for doing less.

Point one of a kilo at a time.

Hard on myself, aren't I? It was ever thus.

I have to remind myself that it's the duration of the exercise per week that makes a difference to my survival, not the intensity. Half an hour walking the dogs every morning would be enough on its own. I don't have to run.

But gee it's nice to stretch out without knocking myself out with a pair of flying tits. Or even just one.

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Speaking of flying, it was the second flight to Melbourne to see my plastic surgeon that brought on the lurgy. Apparently when smoking was banned on aircraft, they stopped circulating fresh air through the body of the plane and instead started recycling it to save fuel. I guess if the same germ flies past you three hundred times in two hours you're probably going to catch something sooner or later.

But I digress (cough, hack). Seeing Dr Yes was a complete pleasure. It was the CT scan he ordered afterwards that gave me the roaring heebie jeebies. Yes, sure, sure, it was just to check on the size of my abdominal blood vessels, but there's always that gremlin whispering in my ear they're going to find something else.

Fuck off, gremlin. And when you get there, fuck off some more. At this stage I've had no urgent phone calls telling me to come in immediately, so I'm guessing no Christmas lights showed up.

But back to Dr Yes. What a man.

We sat across from each other, each armed with a MacBook Air. I shot questions at him. He shot information back, complete with illustrations, and I speed-typed his answers into my document. Huzzah for the age of technology!

Yes, I'll be confined to walking only for six weeks, but he'll try to get me up out of bed the day after the operation (huzzah again- I am Not Good at lying still). No swimming in the dam till I'm fully healed (damn indeed- why did I choose to have this done in summer?). No driving for at least three weeks (see Candy go stir crazy). But I can probably fly home after I've had my one-week check up (and that's three huzzahs for the win).

And so on. I'm nothing if not thorough, and neither is he.

He pulled out a circulatory CT scan, so I could see how clearly the size of the blood vessels to each side of the abdomen show up.

"If you don't have a major vessel on each side, we'll have to do a TRAM instead of a DIEP on the side without," he explained. "It's not like we can wake you up to ask if that's okay, so we try to get as much information as we can beforehand."

Not keen on having my rectus abdominus spliced and resected on my chest, or on having my internal organs on that side restrained with mesh, I'm now praying for two whacking great arteries showing up so he can just use the fat to make my nearly-C-cups instead of messing with the muscle. There's even a chance (though a small one) that I won't have a major vessel on either side, in which case the operation becomes a double TRAM.

Looking at my (apparently minimal) stomach fat, he assessed the situation and then chose two implants of approximately the same volume. Opened a zippered kit, handed me an appropriately-sized bra and a flesh-coloured stretchy top.

"This will give you an approximation of the result, so you can judge whether you're likely to be happy with it or whether you want me to put implants in as well."

The result was surprising. I'd been fretting about having such a small chest after living with double-Ds or greater all my adult life. But I have to say, it looked good. It looked fine.

Not like mosquito bites.

No implants for me.

**********************

And so that's another bite of the reconstruction elephant taken care of. It's going to be a long journey; after the initial operation there's the six-week checkup, fat injections using liposuction if I'm suddenly unhappy with the size or shape, nipple construction surgery after three to six months, tattooing of the nipples...

...it's a fully-grown pachyderm on my plate.

One bite at a time, Candy... just as soon as I get over this damn cold and get my appetite back.

It's a bit like how I got myself through treatment, really. Just diagnosed in this one.

Halfway through chemo and feeling like unholy crap in this one. Yeah, I look fine.
That because I'd spent two hours at 'Look Good, Feel Better'.

And, finally, on the other side... my birthday this year, two years to the day after the first photo.
I did make it through. One. Bite. At. A. Time.

Shiva, Vishnu and the virtue of acting on impulse

I have often been called impulsive, usually in a somewhat derogatory tone. It kind of ticks me off; often the actions that others label impulsive are the ones that are most completely authentic. My impulses are often a response to that native third eye instinct that somehow didn't quite get taught out of me by my white, lower-middle-class upbringing. They're the sign that I am, for once, actually listening to myself.

And so it was on an impulse that I pulled up outside Dr Rosie's clinic last week and, despite knowing full well that she was booked to the gills for weeks in advance, tried my luck at a walk-in. It certainly wasn't on my list of tasks for the day. But it suddenly seemed important.

And walk in I did, because her next patient was running late. Impulsive me: 10. Judgemental wankers: 0.

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See, the black cloud hanging over me hadn't gone away. Despite my best efforts to exercise, eat well, sleep plenty, think positive thoughts and seek support from others in the same circumstances, my depression was hanging round and worsening.







It didn't help that Shiva, Goddess of Destruction, had turned up last Saturday in the form of a vicious hailstorm centred on our property. One moment we had glorious sunshine, and the next we had Narnia.

I'd tagged my friend Angie in this photo on Facebook, nostalgic for relaxed mornings sitting on her veranda with good coffee and great chats. A few hours later, I sat in the same place on my great grandmother's rocking chair wondering what the fuck just happened.

It was mind-bending. After ten minutes of sheer mayhem as ice pelted from the sky, often whipped sideways by a treacherous wind, the Bear and I wandered around in amazement, transported to an unfamiliar landscape which we may never see again.

The animals were just as bewildered....

....So that's why we have all this fleece?

But, of course, once the sense of wonder wore off we headed miserably for our vegie garden, where we'd spent a good many days at the end of August getting the jump on spring. 

Anyone for coleslaw?

We couldn't even see some of the plants under a good inch-thick layer of ice. There was, really, nothing left.

To say I felt picked on was an understatement. I'd really had to make an effort, weighed down as I was by misery, to put my mind and body into buying the makings of our spring garden and encouraging the Bear to get the beds ready. I knew that the sooner we had our own produce, the more likely I was to be able to eat a healthy summer diet. It all translates into that bottom line, surviving the Freeloader. 

I want to live. But Nature, who has so often helped me stay rational, had turned on me.

In my fragile state of mind, it was all too much.

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And so, impulsively, to Dr Rosie, who in typical left-of-centre fashion started in on the Hindu gods.

"Do you have spiritual beliefs?" she asked, after I'd rattled off the list of strategies that had failed to lift my gloom. "Do you believe in anything bigger than yourself?"

"Well, sort of, but I don't label it as a god. I believe we don't know everything, and anyone who pretends to is a fraud. And I believe in nature," I replied, "but even that isn't on my side at the moment." 

I recounted the story of our own private hailstorm hell as she listened in wonder; even two properties away from us there had been only a few random hailstones, and in town they'd just had a little rain.

"Well, you know," she countered, "the Hindus believe that Shiva destroys to make way for Vishnu to create. You have to find a way to build from this."

And wrote me a script for Pristiq, because that's the sort of all-rounder she is. Always looking at the big picture, using conventional medicine as one of her many tools. I've never once walked out of her office with just a script, no matter how busy she is. There's always something to think about as well.

********************************

And so to Vishnu.

If, like Dr Rosie, I look at the big picture, then Shiva has been active in the guise of the Freeloader too. I see that some vital links have been destroyed between my Bear and me. All those months where I simply couldn't take part in farm life have led us to living very separate lives each day. He's become accustomed to doing all the heavy, dirty farm work by himself. I've become accustomed to doing my exercise, then falling in an exhausted heap and either entertaining myself with indoor tasks or resorting to my internet addiction. I can spend hours achieving absolutely nothing more than cooking the evening meal and making coffee, while he slaves away outside barely keeping pace with what has to be done.

Hardly a wonder that he's exhausted too.

Hardly a wonder that we don't always connect. Misunderstandings happen. Sparks fly. 

How can I build something better?

The Pristiq, for all its side effects, does seem to be working. Despite the twitchy legs, the reduced appetite, the sudden-onset tiredness, I do feel lighter less than a week into the first script. Some people get exactly the opposite effect from that intended and get plunged into a suicidal state; luckily I don't seem to be one of them. The first night was pretty ghastly, complete with insomnia, nausea and such badly restless legs that I felt like I was back in the throes of menopause, but things have settled down quite quickly since then.

And so now I must be active to undo Shiva's work. I try to spend less time at the computer, though its siren song is always at the back of my mind; the numbness of my puzzle games is a great escape for a restless mind, which is all too quick to start ruminating on my lack of employment and my lack of breasts. I dragged the Bear unwillingly to town, where we visited the little seedling nursery together to buy some replacement stock for the garden. Poor Bear. If I was shattered by the hail, he had his hard-working heart broken. He loves his garden.

But the nursery was a hit. He immediately fell into a delightful conversation with the owner, and came home much cheered. And instead of leaving him to do the work of re-digging the beds and replanting, I made the effort to get out there and help. We've all but forgotten how to do things together. It's time to build that back up.

"Good to be in the garden with you," he says to me about every half hour.

"It is," I reply.

And the twinkle in his eye reminds me of another crazy impulse, over ten years ago now, when I was standing next to a man I barely knew at a New Year's Eve bonfire. He'd recently taken up a tenancy in the cottage on the property I owned with my then-partner; we'd barely exchanged a word up till now.

"I'm going back to the valley tomorrow to see some old friends," the man said to me. "I might stay there."

I have no idea what happened next. There is no explanation for what came out of my mouth, and a less impulsive person would have crushed those words into oblivion rather than speaking them out loud.

"Don't go," I said. "I want you to stay."

That man became my Bear.

Counting the cards

My father taught my brother and me to play cards when we were very young. Many hours were spent sitting around the dining table at my grandparents' house in the country, playing hand after hand of '500' late into the night.

My grandmother clearly couldn't concentrate
for long enough to smile for the camera.

The game was frequently enlivened by the fact that our pack of cards had no joker; my grandmother, struggling to communicate with us in Franglais and subject to spasmodic lapses of concentration, regularly forgot that we'd substituted the two of spades. This threw my father's card-counting pedantry into total chaos. Often she played it as a discard, causing him to become incandescent with frustration. Once she threw it out in kitty, a fact only discovered after the playing of the last trick; I can still remember the sound of my father's chair being pushed back in disgust as my brother and I fell about laughing.

The levity was always welcome to me, as for some reason I've never been lucky at cards. Usually I'd be dealt hand after hand of complete crap; I'd spend the hours tossing out fives and sevens with mounting gloom. Thus was I introduced, painfully, to the origin of the expression 'I can't take a trick'.

And I've got to say, lately that saying seems particularly apt.

********************

I mean, take this blog post- really, the least of my worries. I was planning on calling it 'The gift that keeps on giving', a reference to the Freeloader's habit of tossing some new and delightful consequence of our illness in our path the moment we stagger to our feet after the last trip-up.

But right now I can't even take a simple little trick like that. Writing while depressed is a bastard of a thing, but I'm trying to keep everyone up to date, aren't I? I had to try. So I sat down, and started, and stalled, and stopped. Weary of trying to squeeze the words out, short of confidence, fearing my post was just a series of pathetic whinges strung together on a twist of self-pity, I took a break and went over to read the excellent and often hilarious breast cancer blog 'Boob in a Box'. And found THIS.

Trumped. It figures.

So here I am trying to hang my post off a new image. Gotta try. Five days and counting, when a post usually takes me less than an afternoon to put together.

****************

Four of diamonds. Five of spades. Six, seven, nine of hearts.

Finding that the name of my blog post was already in use is, of course, the most minor of irritations. As mock-cream icing on the sheepshit cupcake on my plate right now, it would be enough to cut through my self-pity and give me the giggles if I wasn't feeling so damn depressed. There's an awkward truth for you- depression has noooooo respect for the size of one's problems.

See, nothing that's happened to me lately is life-threatening. Very little of it, in the whole scheme of things, is earth-shattering. I feel supremely guilty for even mentioning the latest tripwires the Freeloader's laid across my path, given the genuinely deadly hurdles lying in wait for some of my friends. In my head I'm a two-year-old, protesting mama's failure to purchase a lollypop at the supermarket checkout.

I mean, I'm not dying, or not right now. I'm not in total physical agony. I know I have multiple blessings I should be counting.

But depression doesn't care about that. It just is. And on top of the screwed-up chemicals in my head, I feel like I'm being tossed hand after hand of crap. I've been stoically playing the hand I've been dealt (another of my father's favourite catch-cries) for two years now. Enough already.

So I'll play this round with cards on the table, and you can do the counting and judge for yourself whether this is really such crap after all. Just be aware that if you tell me it's nothing to be depressed about, I'll probably come after you with a length of 4x2.

Or cry, even.

Understood?

Perhaps I shall add some completely distracting photos in the margins, just to stop you being dragged into the mire with me. They represent things that have made me feel better, for however short a time. Honesty requires me not to keep the king of hearts up my sleeve.

********************

The first piece of rubbish dealt to me after the trip to Melbourne was a deep crack in one of my oldest friendships. I shall not shine a bright light on that one in public, but suffice to say that one of the two central pillars of my support system is no longer regarded by me as weight-bearing.

Cleaning out some old boxes of
photos, I found a picture of a
close friend from primary school.
We lost touch years ago.
Weirdly, within days she'd asked
to friend me on Facebook. Love
you, Viv.

Does that pillar need to be removed, replaced or repaired? I have no idea. Right now I don't much care. I'm exhausted, I'm depressed, I'm still coping with the fallout from surgery. I don't have the energy or the patience for the careful insertion of glue into the cracks of something that might, despite my best efforts, be beyond fixing. My trust has never been easy to mend once it's fractured.

It's a card that lots of us have been surprised to discover in our hand, this breaking down of supposedly secure relationships after a life-threatening diagnosis. Partners who cut and run when the Freeloader gets his hooks into their loved one. Friends who suddenly turn on you when you're at your most vulnerable. Sadly, they're a dime a dozen. But it's the first time anything of the sort has happened to me. It's a huge shock, to have the rug ripped out from under me when I haven't even walked all the way to the end of the Freeloader's stinking red carpet. I really thought that one was glued to the floor.

And that, says the little critic on my shoulder, concludes a despicably mixed metaphor- but I'm beyond caring about that, too.

********************

Then there's the small matter of living with my redesigned chest. What chest, one might ask; there's a five of spades if I ever saw one. I have a scarred hollow where the left and right bower of hearts used to be. Almost every item of summer clothing I own now looks ridiculous on me, and when 27 degree temperatures started to hit this week, I discovered that I have almost nothing cool and comfortable to wear. Or rather, nothing that isn't likely to send small children running screaming for the safety of their mothers' skirts.

Meet Suzie. She doesn't care
what my chest looks like.

Getting ready to go out now involves about eight failed costume ideas, safety pins, swearing and tears, followed by considerable discomfort for the duration for the excursion. Unless, of course, I'm prepared to feel publicly humiliated by the discovery that my newly vacant top is gaping open and showing my scars in all their puckered and tagged glory.

Or perhaps my soft tits have ridden up to my chin while I've been talking to someone. Is there any polite way to reach into one's clothing and pull one's bra back down to a semi-normal position? Discuss.

And as much as I tell myself this is only temporary, the fact remains that unless I take to the burqa, I'm going to feel ugly every time I have to go to town until after my reconstruction. Don't even start on buying myself a new wardrobe. Hours prowling the op shops resulted in more tears (there was one vertically gathered pink top which really did succeed in making me look like a turkey carcass), and finally, ONE rather formal summer top with the right cut to disguise the damage.

I suppose I could just wear that one everywhere till it stinks and falls to pieces. And even with that one, I still have to safety-pin my ah-bra to my undies to stop the pretend tits popping out the top. (Try it sometime. Wedgie city.)

Call me vain; I'm not good at feeling ugly. It just makes me want to curl up under the doona and cry. Or perhaps demolish the Swiss GNP in chocolate- I've somehow managed to gain back too many of the kilos I'd lost, in a lot less time than it took to lose them. That's what happens when I'm not able to exercise for a few weeks and feel pole-axed by misery to boot.

The wistaria and jasmine are out. The smell
is intoxicating.

Oh, I did try to get back into the exercise once I'd recovered enough from surgery. And then I turned away from the laundry sink too fast one day and banged my knee on the washing machine- another triumph of clumsiness- and could barely walk for a couple of weeks.

And did I mention falling off my bike when I tried to dismount, the first time I rode it after surgery? No? I'd forgotten how careful I had to be since Taxotere killed some of the nerve endings in my feet.

And then- probably because I was still sleep-deprived- I forgot my tablets a couple of times, which immediately gave me joint pain because there's only fish oil standing between me and screaming heap, and then when I started taking the damn Arimidex again I got all the side effects double-strength all over again. And then the friend thing with my bestie came to a head after festering for ages, and then another friend's disease progressed, which I found completely devastating because it's so fucking unfair, and then the depression came down around my ears like the sea closing over the Titanic, and all in all, well, four of fucking diamonds all round.

**********************

To top it off, when I was drying my feet after a shower the other day I glanced at my chest and realised I had what looked like a misplaced booblet growing at the bottom of my rib cage.

I distracted myself from myself
by making a mosaic panel for
the bathroom wall. Note that
the mirrors are small enough
not to reflect my chest.

Oh, relax, it's not cancer. Just bloody lymph gathering in the wrong place. But it shouldn't be there. Off I went to Miss Sunshine to get it checked out.

Yup; lymph reading up to six, still normal but as high as it's ever been. Cording in my left arm, which explains the pain shooting down my forearm when I bend my wrist backwards.

And just to make it clear to you that this is, indeed, the should-be-joker two of spades, reneged and then played illegally as a discard:

The reason for this sudden reversal of my lymphoedema fortunes is- yup, you got it! A little extra gift from my BRCA2 mutation. (All together now: Fuck you, cancer.) I spend HOURS of my life retraining the lymph from my left arm to move across my chest to my right armpit after the first mastectomy, and the second mastectomy goes and puts a bloody great wad of scar tissue in its way.

Jesus wept.

So it's back to the massages and exercises every day for me. So much for getting my life back. Oh, and did I mention wearing the damn anaconda sleeve on my arm till it settles down?

There's a fashion statement to distract you from my gaping top and wedgie.

(Just reminding myself: There are worse places to be depressed. I know I'm depressed because this doesn't fix it, and it should.)

*******************

So there you go. That's my life right now. Whatcha think of that hand?

Sorry. I know open misere is such a bore for the other players.

Look for the small joys

In the absence of before-and-after
photos of my career, here is one of
my favourite trees as I remember it.

From my cancer support group:

Forgive me sisters for it's many a month since I have been to this site. I'm back because only all of you will understand and have some insight for me as to where I go from here. I own a business or two. I love one of those businesses. On 13/3/13 I walked away from that business, returning only to do the pays and whatever else I absolutely had to do. 13/3/13 is my cancerversary. In the mean time a worthy band of stalwart staff have manned the fort and done their level best to look after my baby. However there are some serious slips in procedure and day to day running that are costing me big time. Now, a year and a bit on, I am supposed to be doing better. I should be making decisions left, right and centre and picking up slack. I am, in all reality a blubbering mess . I don't know if I used to be different or I should be listening to the angry me who says the C word a lot and wants to lay down the law. Even when I was much younger and probably really bad at it, I was super confident at staff management and HR in general. Now .............I say the C word a lot and enjoy doing so. I want someone else to solve my problems and accept that I can no longer lift heavy things. WHO IS THIS PERSON?

The same tree, destroyed by fire. Yep,
that looks a lot like my career.

Dear B,

Your question rings so true to me. I recognise where you are instantly, because I've been there too. There we were, the ones who could do it all- so competent, so confident, without a doubt the brains of the operation. And then the bomb dropped on our heads, and when the smoke cleared we truly believed that we'd be able to pick up from where we left off. It just takes time, right?

But we can't. We can't, because the person who created our empires- the career empires on which our self-esteem relies so heavily- that person has been changed forever. They're gone.

We don't, as you say, even recognise ourselves.

Cancer doesn't just rob us of our body parts. It robs us of our careers and abilities, it robs us of our self-esteem, it robs us of our sense of certainty about both the big things and the small things.

This is how your problem looks to me:

The nice round white peg has been wrenched out of its nice round white hole where it belonged, turned sideways, chopped into a weird and unrecognisable shape, bashed with a mallet till it's splayed and flattened, painted pink (god help us all, because we seem to be pink for life) and thrown into a corner.

Now you want to pick up that flattened, mangled, beaten-up peg and thrust it back into the same old hole and- holey moley, it won't fit!

Well might we throw the C-word about with aplomb.

********************

(Oh dear. All the other nice white pegs are in shock because we said the C-word. White pegs don't say that, right?)

(But pink ones do.)

********************

B, you and I and many of our friends are now splattered pink pegs for life. Being a neat, round, white peg is a distant memory. So what the roaring fuck do we do now?

I guess the first thing is to accept that we're different, and it's permanent, and it's time to grieve what we've lost. That's where counsellors come in. Find a good one, and when you do, say the C-word to her as many times and as loudly as you want.

I did.

Acceptance isn't easy. I've spent quite a few days trying to sort through my stuff from my old childcare career, trying to throw or give away the things I know I'm not ever going to need again- because that person who could lift babies and children safely and juggle five expectations at once in her head and vacuum floors and put out twenty beds is gone, gone, gone.

In her place is someone who isn't ever quite certain of her arm strength, who gets confused easily and forgets words and names, who can't do a lot of physical work without collapsing from fatigue or turning bright red and ripping off her clothes before she expires from heat exhaustion. Someone whose bullshit detector is constantly on high alert, who's impatient with the less enlightened members of the human race. Someone who really wants nothing more than her old life back, and doesn't appreciate having how changed she is rubbed in.

It has to stop, B. We have to stop trying to jam that peg back into the old hole, because it's just hurting us more.

**********************

My grandfather used to have a saying whenever one of us kids was complaining. He'd say, “Look upon the doughnut, not upon the hole.” So I am obliged to point out that sure, we've lost a lot, BUT. Because of our illness, we are better people. Not more competent, confident, capable people- but better people.

We have knowledge that you can't buy or learn from a book.

We're more compassionate to those who genuinely deserve it; we're much better at sorting those people from the wailing #firstworldproblem arrested-development pseudo-teenagers who've never had a real challenge in their lives.

We know how to really support our friends, the ones who've been through the mill alongside us, and we understand them in a way nobody else can- and vice versa.

We know how strong we are, because we walked through the fire and came out with dragons on our shoulders. (Sure, those dragons say cunt a lot. You get that with dragons.)

We don't live in denial any more, because a part of us knows how uncertain life is, and that we will die. (Perhaps soon. Perhaps not.) We know there are no guarantees, no matter how many soursop smoothies we drink and how many kilometres we run a week.

So what can we build from the wreckage of our old lives and the precious knowledge we've gained?

********************

First, we have to throw away that feeling of needing still to be competent at the old stuff. WE AREN'T. We are competent at much more important stuff now. 

Can we use that to make something better from the wreckage? Is there a way to use what you know now to improve the business you loved, while passing on the things you can't do to someone who can (and looking away till they learn to get it right)? Can you work fewer days, take a different role? Can you lose your inner control freak (yeah, yeah, I have one of those too) and let something new evolve?

And if not, can you look at it more coolly, be less involved, wave goodbye to it and find something else to make the new you feel good? Nothing stays the same forever, and it's a mistake to try to make it so. We're not indispensible, we're not perfect and neither are the people around us. Our career 'babies' eventually fall apart, even when we haven't had a life-threatening illness explode in our faces. Our replacements make horrible mistakes that make us want to cover our eyes and scream. (Think Apple after Steve Jobs.)

There was a time when I worked in one of the best music education schools in Australia, and it was my life; I loved it. It was everything to me. But the staff around me changed, ideas were manhandled and mangled, the whole thing started to build up downhill speed and there wasn't a damn thing I could do except get out of the way. I left. And I'm glad, now. Nothing stays the same forever.

The music teacher: gone, gone, gone.

Maybe it's time to open the door and get out of the way.

******************

And listen: you have permission. You have permission that you never had before. If you say it's not what I want any more, who will dare argue?

What? It IS what you want? To bay at the moon for something that's gone? I don't think so. It's gone.

What, then?

It's okay to do some of the things you'd thought about doing later. You have permission. You know, my mother was going to spend her retirement writing a book; she died 25 days before her 60th birthday, the day when she was entitled to draw her superannuation. 

Too late.

Sure, don't spend yourself into poverty. We don't want you eating cat food next week. But maybe it's time to prioritise different dreams. I don't know what your dreams are. Maybe it's time to travel the world. Maybe it's time to work on getting your relationship back to something that makes you sing inside. Maybe it's time to dump everyone who makes you miserable and start again, knowing what you know now about the human race and life itself. Wise people make better choices.

***********************

What? Not enough money?

Have you thought of downsizing? Is all your stuff really making you happy? Do you need to be where you are, spending as much as you are just to stay still, to be happy?

Is there a simpler way of life that would free you?

I don't know what your dreams are. I do know that it feels good to me (despite the manifold disadvantages of being miles from anywhere) to have no mortgage, to be in the middle of nature, to be able to spend time alone if I want, to enjoy the simple moments. The quiet at night, the bird song in the morning, running with the dogs, sitting on my veranda with a coffee in the sun. 

This morning a flock of lorikeets descended on our place, perching on a dead tree, diving into the animals' drinking trough to bathe, singing their crazy screeching song of joy the whole time. If I'd been chasing my old career I would have missed that. I would have been long gone, out of the house, on the road, heading for a place which was only going to bring home to me all over again how not me I've become.

My advice to you: stop chasing unhappiness. Accept, let go, rethink. Look for the small joys. Then the big ones might just have time to find you.

Three steps back

It's while I'm running the filleting knife down the rib cage of the freshly slaughtered turkey that the analogy hits me between the eyes. I am, for all intents and purposes, performing a posthumous mastectomy on this poor creature.

It's hard to get every last scrap of flesh off those ribs. The only thing at stake, in this case, is household economy and my own idiotic perfectionism; the older I get, the more I become aware of my underlying OCD. Dr Goodguy, on the other hand, would have been leaving me vulnerable to recurrences if he left a single strand of breast tissue in place.

Just as well he's the surgeon and I'm the amateur butcher.

The knife slips, slicing into my left middle finger. Fuck. I'm covered with little nicks, thanks to the Lyrica making me sleepy and uncoordinated. I reach for yet another Band-aid, pushing away the knowledge that I'm meant to avoid breaking the skin on any part of that arm.

This is reality. I can't sit here swaddled in cotton wool for the rest of my life. We still have to eat.

**********************

The human breast that Dr Goodguy filleted away two weeks ago is definitely better gone. My ovaries were as pure as the driven snow, and for that I'm immensely grateful; changes there are symptomless and frequently deadly. But the pathology on my right breast did show some small aberrations- not anything that could be classed as pre-cancerous, nothing to cause undue concern, but any changes at all make me damn nervous after the year and a half of crazy I've endured. I think of the white spots on my last mammogram, which didn't set off the alarm bells in anyone but me, and know that we've cut off the Freeloader at the pass this time. He won't be slipping any messages into Paul Revere's saddlebags, bound for my lymph nodes, before we even know he's arrived.

And there's that, isn't there? My last mammogram. I have no regrets about a future in which my sexual parts will not be slammed between two icy plates and flattened till I wince. For long, long minutes.

Honestly, men complain about a finger up their arse to check their prostate? Been there, mate. No comparison. Come, let me take my hair straightener out of the freezer and apply it to your nuts, and we'll talk.

But I digress.

*************************

There are things I'd forgotten about post-mastectomy recovery. The scales tip this way and that; to balance the load of crippling fear I carried through the last mastectomy, I have my brand new and total lack of tolerance for being ill or incapacitated. In hospital I ran on equal parts of adrenaline and denial, refusing pain killers completely by the second morning so that they sent me home on day three with nothing but a drain bag and a cheerful wave. It felt like a win.

Bloody-mindedness continued to be my friend for some time. I spent the first day at home sort of in bed relaxing, then normal service was resumed as I started to cook and do a few chores around the house. Realising I wasn't sleeping all that well- I blamed the annoying drain in my side, which made lying down singularly uncomfortable- I dug out an old packet of Targin and started dropping one each night.

It didn't help much, but still the penny didn't clang on the bottom of the piggy bank and bring me to my senses.

Day seven, and the drain came out with a cheerful 'see you in six months' from Dr Goodguy. I am Superwoman! Nine days out from the operation I was walking four kilometres to our creek and back on my own, bush-bashing and climbing trees on the way.

And still not sleeping.

Well, that was only to be expected, right? I haven't been able to sleep on my left side since the axillary clearance- the ache in my arm becomes unbearable within minutes if I lie on it. And obviously my right side was going to be sore after being filleted. I'm really not a back-sleeper- I've always curled up on one side or another, or even slept face-down (not an option at present). So of course I wasn't sleeping well.

Ten days out I started to crash, as the sleep deprivation hit me. It finally struck me that the pain over my new scar was getting worse, not better. I checked for redness, but no- it all looked perfectly normal. But anything touching the wound was agony, and that included clothing. (Sadly, running around nude in the middle of the Bungy winter is not a viable option unless I want snap-frozen spare ribs. Very, very spare ribs.)

But wait. Anything touching... where have I heard this before?

I'd forgotten about the nerve pain that accompanied Round One, making it impossible to even rest my poor gutted wing on the arm of a chair. I'd forgotten about it to the extent that I didn't recognise the sensation that was driving me crazy as nerve pain, simply because it was in a different place- under the arm and across my chest, rather than running down from shoulder to elbow.

And so, back to the Lyrica, which makes sleep possible at night and turns me into a zombie by day. If I only take the evening tablet, I can sleep at night and sort-of function during the day.

Sort of. If I don't count cutting my fingers to ribbons while processing a turkey.

********************

Along with the zombie mode which lasts well into the morning, along with the deep reluctance to get out of bed, comes the Black Dog sniffing around my heels. You're failing, he snuffles. You're backsliding. You're lazy. Knowing it's bollocks doesn't help me when I'm this flat. I can't even shout at him.

I know exercise would help, but I just can't find the ergs. Riding my bike seems too risky; breaking the scar open would set my reconstruction plans back to zero. Walking seems too slow to make a difference to my mood. My motivation feels like it's gone in the incinerator with my fine sections.

I get on the scales to see how much ground I've lost, but of course I'm well over a kilo lighter thanks to the missing breast; small comfort when your two steps forward are surgically achieved. Should I be trying to lose the rest of this weight? Should I say fuck it and just turn back into a pile of lard on the couch? Should I try to find the middle road and somehow maintain this weight till the reconstruction surgery?

And that, of course, is a whole new can of worms to deal with; another surgery, at this moment, seems as desirable as an anchovy and Vegemite sauce on my ice cream sundae, but I know it has to be arranged. My reconstruction requires a whole day in theatre, and if I don't book that theatre well in advance I'm screwed. Within a week of the mastectomy I'm on the phone and lining up the reconstruction for November 21st.

"What's the hurry?" grumps the Bear. "You've just been through one surgery. Why the rush to put yourself through it again?"

Because I hate the way I look. Because I'll have to pay another excess on my health insurance if I wait till next year. Because I want this to be over. I have many genuine, heartfelt and logical responses, but none of them fix the real problem at the heart of this conversation: my Bear is at breaking point. He's had enough. Three rounds with the Freeloader in his life, killing and maiming his women, and he wants it to stop. No more hospital, no more anaesthetics, no more surgery and recovery and watching people he loves in pain. He's started to believe he's cursed. He's started to believe he's caused it somehow, and seeing me go through this shit all over again is undoing him.

"You're not your boobs," he says to me. "You were blessed with wonderful breasts and I enjoyed them, but they're not you. It's you I love." And he's saying all the things a dream man would say in these circumstance, and I can't fault a word of it, and it's never going to change my mind. Because that's how I am. My body, my decision.

I'm even dreaming of having breasts again. I wake devastated to find it was just my subconscious playing tricks. I drag myself to the bathroom, look at the wasteland of my chest in horror. The slashes, the knobbly ribs- I look like a goddamned turkey carcass. I may as well feed myself to the dogs and be done with it.

Dressing to go out, I put on an ah-bra and the old teddybear tits long before I should be putting any pressure over the wound- just to feel normal, just so people don't stare, just so I don't hate my own reflection. At the end of the day they've ridden up to my chin, and it's hilarious and ridiculous, and under the laughter I feel like a freak.

And so we're sinking together, my Bear and me- him from sheer emotional exhaustion, me under the weight of our combined physical and mental pain and my desperate attempts to keep our relationship from imploding. One step forward, three steps back.

Throw me a lifejacket, someone.