We have come to the end of a historic year, the year of poignant moments far too many to mention. There are stories to tell and a whole lot of reflection to do this year from patients and physicians. In my corner of the universe, I will reflect on breast reconstruction and lessons learned from 2020.
Breast cancer, for many, brings a sense of complete loss of control, feelings of helplessness, and something you have little control over. Sound familiar to the events of 2020? There is a lot to understand about the disease of breast cancer, how it challenges scientist spending their lifetime finding a cure, and as we close out 2020, some uplifting news about a new clinical trial for a vaccine focusing on a certain type of breast cancer. A lesson we learned from 2020 and one we marveled at, scientist putting into practice the methodology they use in clinical trials but this time to fast track a vaccine for COVID. Ah were it that easy and faced-paced for other diseases. The lesson is in the number of lives lost globally in 2020 from the COVID virus.
The Parallels of Breast Cancer and Events of 2020
I hear those affected by breast cancer say, “Why am I dealing with this diagnosis when I do everything in my daily life to stay healthy? I have friends who smoke, overeat, do not exercise, and drink freely and excessively at times and they do not get breast cancer?”.
It seems to parallel the people affected, or not affected by COVID. There are those who seemingly took every precaution not to get the virus and yet became very ill or even worse, died from it. On the flip side, some threw caution to the wind, whose lives have not been altered by the virus… yet, and there are those who test positive and are asymptomatic. The lines become blurred and difficult for many of us to comprehend.
Breast Reconstruction and the Changes in 2020
When you hear the words, you have breast cancer and mastectomy is a probable or possible treatment plan, you go through the process of learning about your options for breast reconstruction. For some, the information is easy to find and understand. For others, it becomes a challenge where to find the information and who to trust. Sound familiar to the events of 2020? I hear it too often in the closed Facebook group I set up, “I simply wasn’t given all my options for breast reconstruction.”
Once the resources are provided, the planning begins. A plastic surgery consult is set up so one can be evaluated to discuss patient preferences and what the surgeon can offer for the patient. Before 2020 many of these consults were done in office with a physical exam. In the subspecialty of microsurgery, telemedicine has been used for a number of years. Why? Many patients must travel to find a microsurgeon because there are far fewer who choose this subspecialty of plastic surgery.
Telemedicine became the norm for breast reconstruction consults in 2020. Patients use ZOOM, SKYPE, or other secure methods of contacting their surgeons as one of the valuable lessons we learned in breast reconstruction this year. Adjustments were made and we marched forward… sometimes.
I heard from surgeons who contracted COVID, were hospitalized themselves, and returned to work after recovering. When surgery restrictions were lifted, they went back to their place of work running the risk of exposure themselves. They were concerned about their patients and their own families. What a cost to bear! By the end of 2020 we watched them roll up their sleeves to line up as health care workers to receive the vaccine.
The Lessons Learned as Breast Reconstruction Patients in 2020
The words that come to mind are patience, hope, and resilience. It began in early March. Surgeries first began to be cancelled and many hearts were broken over plans made for reconstruction. Family and friends were going to take time off work to support the breast reconstruction patient during their hospital stay and recovery. Patients anguished over the news of cancellations and not knowing when their surgery would be scheduled again.
There were changes in protocol. Some patients who could safely delay their reconstruction were put on Tamoxifen. Others proceeded with a lumpectomy until they could complete their reconstruction. When surgeries began to be rescheduled, for surgeons it felt like the flood gates opened as they scrambled to reschedule and appropriately prioritize surgeries. Patients anguished over changed hospital protocols. Now they would be dropped off for surgery and picked up after release with no one there by their side. They soon learned the value of the nurses and hospital staff. Patients commented on how appreciative and aware nurses were they were there alone without a friend or loved one to be by their side in hospital.
There are many breast cancer patients who have opted to have breast reconstruction and encounter uncomfortable conversations with family and friends about their choice to reconstruct. Sound familiar to the events of 2020? We have all been through the process of trying to learn what to say and what not to say during this tumultuous year. Listening has become an art and learning the power of the spoken word even more important during 2020.
2020 Comes to an End but not Breast Reconstruction
The events of 2020 for breast cancer patients and those planning breast reconstruction feels a bit like the tail wagging the dog. The COVID crisis has overshadowed many plans for patients and the work of passionate surgeons. We must remain resilient and hopeful. One woman whose surgery was cancelled just this week said to me, “Sometimes hope is all we have but I will be healthy again.”
Thus, ends an epic year in breast reconstruction and lessons learned from 2020. As the saying goes, “Hindsight is 2020.”
