Scar Tissue, Tattoos and “Are we there yet?”

“Are we there yet?” The question anyone making a long journey with a small child is sure to have heard. You don’t expect to hear it asked in many other situations but breast cancer is one where the thought occurs even if the words remain unspoken.  Pre-diagnosis I heard many media stories about how we no longer need to be afraid of  breast cancer, how treatable it’s become and how many more women survive these days. Bearing in mind none of the women in my family have survived I try to look on the bright side and hope these stories are all correct. I’d heard that treatments had moved on, surgery was less debilitating and with the help of pink ribbons the world was now full of courageous cancer warriors – previvors, survivors and thrivers.

Until I was faced with aggressive breast cancer, a type that brings a high propensity to metastasise, I had  not heard that diagnosis, surgery and treatment may well take over a year. I had not heard that diagnosis itself requires multiple steps which can (and did) include many false starts, lots of potentially conflicting information and significant additional stress. Post diagnosis I had not heard that surgery and surgical revisions, follow-up treatments and regular check-ups can extend for a minimum of half a decade – and that’s if you happen to fall into the ‘best case’ scenario.  Nor had I heard via any popular media sources that in the case of those  diagnosed at Stage 4 (or the 30% of us who go on to develop mets in spite of treatment), the journey is never complete. Check-ups, treatments and various surgeries just keep going until we ourselves come to an end. “Are we there yet?” takes on a whole new meaning in this realm.

My own breast cancer journey has been tracking along for over three years now. We are still moving forward yet still unable to answer the “are we there yet?”  question.  Major surgery is complete and I am in remission as far as we know but only time will tell if that will remain the case. Meanwhile there are a number of minor things to tackle including surgical re-work to address unintended consequences arising since the original reconstructions.  When these revisions happen depends on waiting lists, beds and Government spending reviews but in the meantime there are highly recommended ‘finishing touches’ designed to help me believe that life is as it should be.  This involves the creation of an illusion of a more normal appearance, but in truth there is nothing normal about any of this.

It is at this point that the scars and tattoos become relevant. Post-surgery, chemo and Herceptin I am the owner of a Barbie-esque chest that is almost as unnatural, shiny and pink as Barbie herself. Were it not for the scars running across the front of mine (and the vampire bites – double drain scars that adorn either side of my rib cage) my torso might be that of a plastic toy. Fortunately the vampire bites are not obvious and there’s little to be done with them in any case. The same is not true for the front facing scars and on top of all this (no pun intended) is the small issue of absent areola/nipple complexes. You won’t be surprised to learn that this tends to give the game away.

At first I didn’t think the whole Barbie/nipple thing bothered me. I was glad to be alive and still am – glad and alive. I didn’t plan to show my chest to anyone other than the person I married so missing in action areolas and nipples felt like no big deal.  But having lived with pink plastic mounds for three years I’ve come to realise the absence of those oh so common breast adornments and the obvious scars that took their place serve only to remind me of things I’d rather not dwell on.  Additionally there’s the small issue of any activity involving communal changing rooms, taking one’s top off or the dreaded but inevitable accidental reveal. Being an outdoor type that’s easier to achieve than you might at first imagine.

So after much deliberation I took my consultant’s advice and engaged in the process of additional fakery – to help disguise the fact that both breasts are completely fake.  A fake to hide a fake is pretty clever stuff but in real terms it consists of multi-pigmented tattoos designed to give the appearance of an areola/nipple complex. There is no need for more surgery to reconstruct fake nipples and as they’ll never be or behave like the originals I couldn’t see that they serve any purpose other than being there.

As with all things breast cancer the tattooing procedure is a multi-stage process and requires more than one treatment. Before commencing work the nurse tattooist gave me some anaesthetic cream. This has to go on an hour in advance in the hope it will numb the area.  On reflection I should have realised it wouldn’t be terribly effective because the same stuff is used by my dentist and never works. I normally end up with multiple doses and have to wait much longer than normal before it kicks in. So the tattoo process was not pain free and although it was reasonably quick it had me wincing and silently chanting ‘I hope this is worth it.’  The nurse did offer to stop but when you’re a third the way through that doesn’t seem like a viable option!

At the end of the process there was some blood. This was followed by more bleeding and weeping afterwards.  It’s fair to say that the area was quite sore for a few days and a little tight and swollen.  Scabs formed then became itchy and began to fall off. I left them alone because picking would cause pigment loss and possibly lead to an infection.  About a week out from the tattooing process the scabs were all gone and the resulting pigmentation is reasonable if patchy in places. This is why the procedure requires more than one attempt.

Looking closely at the scar tissue it seems the pigment struggled to take in the sharp edges of both scar lines. Incidentally this area was hyper-sensitive when the tattooing took place.  Peering less closely and looking from a small distance the scars themselves are much less noticeable and hidden by something that passes as an areola/nipple complex.  Although this is the first attempt it’s probably good enough to fool anyone who might catch a glimpse in a communal changing room – as long as they don’t stare!

The next tattooing episode will happen in about 6 weeks time when the skin is properly healed and the big question is… Is it worth it?  On balance I think it is. After breast cancer nothing is ever the same so something approximating normal is about as good as it gets.  I now know what to expect during the next round of inking and will slap the anaesthetic on well in advance. Once the soreness and scabbing subside I can look forward to having two very respectable forgeries in place of the torso of a badly treated Barbie doll.

I had to think about this long and hard because I am tired of hospital visits, surgeries, re-work, worry, stigma and prejudice. But my consult (who is a miracle worker as well as a thoroughly lovely lady) was right. Looking more normal is helping me feel more normal and that is the ultimate placebo effect.  If you’ve had surgery and are thinking about areola/nipple complex tattoos the following articles may be useful. Nancy’s post gave me the inspiration to try this for myself and like Nancy I am happy with the result

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Liberté, égalité, fraternité: when will we cure our obsession with self-destruct?

Today I’d intended to write about the never ending story that is breast cancer: discovery, treatment, reconstruction (or not), revision, reflection and resolve. Those things are, quite literally, close to my heart. But I can’t concentrate on the horrors of breast cancer because my mind has been consumed with the horrors of terrorism and my heart goes out to the people of Paris.

Credit: Skyrock.com

I’ve had two spells working in Paris. The first in the early 2000’s involved regular time in a grand office in the 10th Arrondissement. By day much of my time was spent at my desk, in meetings or running workshops somewhere inside the building. Arriving well before 9am, staying beyond 7pm and failing to stop for lunch would frequently prompt questions and jokes from my French colleagues. “Why do you English always work like donkeys? You are silly to work like this. The French way is far more civilised” they would say. As a guest in my colleagues’ country I couldn’t argue with this so would join them in the joking.

I quickly discovered that the French way was more civilised at every level. Coffee and pastries in a nearby patisserie before starting work, an hour or two for lunch in a local café and then home or more likely out for dinner by mid-evening and an opportunity to explore one of the capital’s many fine restaurants. Dinner, the pièce de résistance, presented an opportunity to partake in another leisurely meal carefully consumed so as to make the most of an evening with family or friends. My French colleagues savoured time with each other as much as they savoured the wine or the food. I didn’t need to be in Paris too long before I began to favour the French way too.

My second spell in Paris arose in the late 2000’s when I worked for France Telecom. Their offices lay just beyond the Periphique to the south of the capital but since that area was largely residential I spent my evenings in Montparnasse. The hotel was good for people-watching and the local cafes and restaurants were vibrant and welcoming. Theatre goers mingled with groups of work colleagues, families mingled with couples and local residents mingled with overseas visitors. The City of Light was a sensuous, sophisticated and sociable place to live, work and play.

Today the City of Light is shaken, sombre and trying to make sense of multiple acts of wanton violence, acts designed to kill, maim and terrorise innocent civilians during a typical Friday evening in central Paris. The faceless, nameless, shameless perpetrators no doubt believe they committed these acts in service of some greater cause, to right some deep-rooted wrong, or to demonstrate conviction to the will and way of whichever god they happen to subscribe to. Whatever the reason, the streets of the City of Light are once again stained with blood and innocent people lie dead or injured.

Modern humans evolved c.200,000 years ago and civilisation (such as it is) c. 6000 years ago. We claim to be the most intelligent species on Earth yet we appear to change at a glacial pace. Our ability to curb our most primitive, tribal and often superstitious belief systems, to learn from the mistakes of the past and fully embrace our diversity is questionable at best. Events like the one in Paris quickly become visible across the globe but look closer to home and you’ll find stories of cruelty, violence, bullying and abuse right on your doorstep.

Humanity seems destined to prove it is the most dangerous, spiteful and debased species that has ever inhabited the planet and Paris, sadly, is the most recent in a long line of atrocities. When will we learn and how many more 13/11’s, 9/11’s or 7/7’s must we endure before we finally cure our obsession with self-destruct?