Wednesday, May 26, 2010

One Foot on the Other Side

Wow, sorry I’ve been MIA lately. It’s been weird since my surgery…my brain still feels a bit muddy. I don’t feel like I am remembering things all that great – although I didn’t forget my son’s birthday last weekend so that’s a start. I think my brain gets messed up easily with hormone changes. During and since my pregnancies I have noticed an inability to remember things as easily as I used to. Since my surgery I have felt a bit like that. I bought a new book prior to my surgery figuring I would have lots of time to read, except I haven’t really felt like reading and have only read about 80 pages of my book. It’s not something I was expecting to affect me following surgery. Hopefully it gets better and goes away soon. Needless to say, I haven’t exactly been able to wrap my brain around what to write about in my next blog. So, I decided to write about some of the issues that have been on my mind post surgery.

So technically I have one foot on the other side. I have my initial surgery behind me, but still have my exchange surgery yet to come. As a reminder, that’s the surgery that involves going back through the original incision site, removing my expanders and replacing them with silicone implants. It won’t be for another couple months still. One of the strangest things is to have the mastectomy finished. What I mean by that is that this was a long time coming. I found out about my BRCA1 mutation in April 2008 and from that moment on, I pretty much knew at some point I would be having a mastectomy. But I gave myself time. Time to think, ponder, research, discuss, soul search…you name it. So it’s different to be on the other side of things. Now instead of - I’m going to have a prophylactic bilateral mastectomy because my breast cancer risk is almost 90%; it’s, I had a prophylactic bilateral mastectomy to reduce my risk of breast cancer to below normal population. “I’ve had a mastectomy.” Those words are still a bit awkward coming off my tongue. Not that I have any regrets, just that it’s almost surreal that all of this has already taken place. Prior to surgery everything feels like a huge waiting game. Waiting to see if you are positive for a mutation, waiting to discuss options with surgeons, scheduling appointment after appointment (whether for information, check-ups or preventative screenings), making well-informed thought out decisions, scheduling the surgery and then w a i t i n g for the surgery date to finally come. Now that the mastectomy is behind me, I can move forward with my life without constantly waiting for that breast cancer diagnosis.

It’s a very strange feeling physically, as well. I told my husband about two weeks post-op that it would be nice when I didn’t always “feel” my boobs. The expanders are behind my pectoral muscle stretching it in order to create a pocket for an implant to eventually sit. So the key word here is stretching. My PS apparently filled my expanders to the whopping 800cc that I was planning on being filled up to when all of my fills were complete. Normally, the expander is filled a bit during the initial surgery (my PS had originally said maybe she would be able to get 400cc or so in them at first) and then slowly filled every few weeks with usually 50-100cc each time. I guess since I did a skin-nipple-sparing surgery she wanted to fill out as much as she thought my muscle could take. Possibly in order to maintain the skin and not have it shrink and cause wrinkling and dimpling. Whatever the thought process, I am filled. There is a constant tightness and pulling on my chest, so I am always aware it’s there. It’s not something I could have imagined prior to the surgery. The expanders are also very hard themselves, so underneath a muscle and stretching it to its max makes the outer “interim” boobs feel solid, not soft and squishy like natural breasts. And it’s just a strange feeling. As my sweet husband keeps reminding me – it’s only temporary - at least the strange hardness, unevenness and outer “damage” that should be fixed by or healed before the exchange surgery.

I knew heading into this whole experience there would be unexpected outcomes, speed bumps, changes of plans and emotional and physical changes. However, everything I have to go through now is so worth what I am gaining – My LIFE. I can look toward the future and not feel like I am constantly waiting for a breast cancer diagnosis. I can know that I did everything in my power to protect myself from having to battle this terrible disease as so many brave, courageous women do. I constantly repeat back to myself the words my husband said to me right after my surgery, “You just saved your life.” He’s amazing and I love him so deeply for being my soul mate and knowing exactly how to help me through anything.

Here’s to a clear head, looking towards the future and silicone!

Tuesday, May 4, 2010

Aaaahhhhh Freedom

So today I am 11 days post-op. It is amazing the difference from last week to today. I am really only feeling tightness/stretching from the expanders and some pulling where the stitches are. I have some pain now and then in and around my breasts, but nothing like that first week. I know I said this on my last post, but it is amazing how the body heals itself!

I had my post-op appointment today with my plastic surgeon. It was a great appointment for many reasons. First, I got my drains removed! For those who want to know because they are trying to make their own surgery decisions or learn more about this surgery I will give a little detail. Sorry if it’s TMI for others who are supporting me by reading my blog – just want to give people as much info as possible if they are trying to make their own decisions! So, drains are placed during the surgery to remove excess blood, fluid etc from the surgical site and I believe I remember my surgeon saying it helps speed up the recovery process. Thin tubes are placed in the surgical site before they close up and the tubes exit the body through a small incision that has one or two sutures to hold the tube in place. The ends of the tubes have bulbs attached that create suction to withdraw the fluids. The drains have to be emptied about every 12 hours [thanks to hubby :) , but can be done by yourself ] and in order to be removed the amount of fluid draining has to be below a certain volume within 24 hours. The drains are not terrible and they’re not painful, just kind of annoying. It is a bit hard to find a place to “hide” them. I just had them pinned to the upper part of my surgical vest, but there are special bras made with places to hold them. I found myself a bit worried I would accidentally yank on the tube and cause a problem, but now that they were removed I see that it would have taken a pretty big tug to probably even budge the tube without having the sutures cut. So that’s a positive! It didn’t hurt to have them removed, but was just uncomfortable for the few seconds the plastic surgeon pulled them out after cutting the sutures. Overall, I am relieved to have them out and not have any other foreign objects protruding from my body. Now, no more IV’s, no weird tubes – well at least until my exchange surgery!

In addition, I received a phone call from my breast surgeon’s office. All of my pathology came back normal!! That was a huge relief because if I’m being totally honest, there was a part of me that truly thought they might actually find something, even if it was just really early stages, like precancerous. I know that’s not a good way to think, but obviously I didn’t think everything was always going to be hunky-dory or I wouldn’t have had the surgery. I didn’t think I already had cancer, but I did wonder about tissues beginning to show signs of turning on me. I am still 7 years away from when my mom found her breast cancer though, so I made my pre-emptive strike early enough. It was a wonderful feeling to know the results were good. That also meant there were no suspicious findings of the tissue that was directly under the nipples. The tissue removed from underneath the nipples was specially tagged for pathology to look at closely. If something suspicious was found then I would need to remove them too.

Additionally, my husband and I had about a thousand questions for the plastic surgeon today. She answered all of our questions and didn’t make us feel rushed or like we were being stupid. I really love my surgeons – they are both such wonderful women and so caring. As I mentioned in my last post, they really try to prepare you by telling you that your chest is going to look and feel like it got run over by a truck. They aren’t kidding. My skin ranged from all colors from yellow, gray, blue, purple, dark, dark purple and all colors in between! But each day it gets less and less. Also, I have a dark blue spot on my skin on the right side which was caused from dye they use to find and remove sentinel lymph nodes. Just to inform others, my doctor told me that it was nothing to worry about, but it does take a long time for the dye to fade.

Overall, I am so thankful to have my drains out and to be feeling better each day. I am regaining motion of my arms and shoulders and able to do more things for myself. That has been difficult to not be able to do things that are taken for granted when I am completely healthy, like brush and wash my own hair, or reach up for something on a shelf or even opening a car door (their heavier then you think!). But every day is an improvement from the next and I am so thankful I was healthy before the surgery so I am able to recover as quickly as I am. It’s a good day!

Until next time, here’s to no drains, washing your own hair and silicone!

Saturday, May 1, 2010

Post-Op Update

So, I know it’s been awhile since I’ve posted…since the night before my surgery. That night we didn’t get much sleep, but mostly because we chatted with my mother-in-law and sister-in-law and finished getting our stuff packed for the hospital. My surgery was scheduled for 7:30 am on Friday morning and we were supposed to check in at 5:30 am. I’m not exactly sure why that early because we had already taken care of all the necessary hospital paperwork, payments, etc. We got there right on time, got called back to a small room where we were asked more of the same questions (allergies, what I was there for, etc.). They had me change into a hospital gown, robe, tight stockings to help with circulation and non-slip socks. Then we waited and waited. Luckily I had my husband, his mom, my dad and one of my sisters to talk with and distract because I was just ready to start and it seemed to take forever for 7:30 to come around.

My breast surgeon came to say hi and made a mark or two with a purple marker close to my collar bone. Then the anesthesiologist came and after reading that I throw-up if given morphine (side note: they gave me morphine to help “move along” my labor with my first son…it didn’t work) and get nauseous if I take advil on an empty stomach, he decided to give me some pill to take prior to going under to help my tummy (it didn’t help, but more about that in a minute). Then my plastic surgeon came in and marked me up all over with a purple marker. She gave me a hug and then it was time. A nurse came to my room and walked me straight to the operating room. That was strange to me…I always figured they wheeled you in on a bed to the operating room – maybe just in the movies! It was super cold in there and the anesthesiologist made jokes about how it was too cold for him. They quickly covered me with warm blankets, wrapped things around the awesome stockings for circulation (to avoid clots) and started an IV. The nurses and anesthesiologist were so kind. The anesthesiologist kept calling me kiddo and explained everything as he went. He gave me something in my IV and said not to be alarmed if I felt a little dizzy. Promptly following that I felt dizzy, like the room was spinning. I remember saying something about how quick that started, then they put a mask over my mouth and nose, the nurses were both talking with me and holding my hands and that’s all I remember.

About 6 hours later my surgery was complete, unfortunately I woke up to terrible nausea. So bad in fact, it took them about 3 hours to get me out of the recovery room into my hospital room. They told my husband they gave me every anti-nausea medication possible. I just remember filling sooooooo sick, praying I wouldn’t throw up, and having the hardest time trying to keep my eyes open. The rest of that night did not go well unfortunately. As I said earlier, my tummy can’t handle morphine, so they were giving me something called dilaudid that just made me nauseous every time they pumped it into my IV. So not only did it make me feel terrible, it didn’t reduce my pain in the least. I don’t know if most women are in pain the first day or so or if it was just because I couldn’t take morphine and the other medication wasn’t working, but that first night was rough for me. If I am being completely honest, I did think “Why did I do this right now? I was healthy and in no pain and now I am having the most pain I’ve ever had and nothing is even diminishing my pain.” I am not saying this to discourage anybody. I just want to be perfectly honest. To my HUGE relief, when my plastic surgeon came in the next morning she suggested we try Toradal and Vicodin. Wow - something that reduced my pain and didn’t upset my stupid sensitive stomach!! Yay! It was such a sigh of relief to have the pain actually lessen. My breast and plastic surgeon said everything went great. My plastic surgeon said something about all of my bruising that made my husband and I laugh, “These are colors only a plastic surgeon would love.” She’s probably right, but thanks to all the women that shared their experiences before my surgery and my surgeons who were very honest beforehand, I was expecting my breasts to look like they were run over by a truck and they do! But the bright side is they look better and better every day.

It’s been 8 days since my surgery and I am doing great now besides feeling ridiculously tired most of the time. Today my pain is so little I have not taken a single Vicodin and have only taken Ibuprofen. It’s amazing what a week can do! The body is an amazing thing – what it can be put through and how it can heal itself…I’m so thankful to be healthy! My family and friends have been amazing through this. My mother-in-law is staying with us. She has been helping with the boys, cooking, cleaning, and anything I need. I honestly cannot thank her enough or show her how much we appreciate her help. My dad is coming to help if I still need it when she goes back home. My father-in-law just drove all the way here to help too and all of my sisters have been so caring and sweet! My sweet husband stayed with me every night in the hospital (I was released Monday) and has helped me get showers, wash my hair, and tend to my drains. Emotionally and mentally he has been my rock. The day after my first night when I had my “why?” thoughts I told my husband. His response? “Honey, you just did the bravest thing I have ever seen. You just saved your own life! ” He hasn’t even shuddered once when he’s seen the train wreck on my chest. As I wrote in my previous post – I am the luckiest – he is amazingly wonderful! I love him, love him!! :)

I don’t have any regrets and I am looking forward to life on the other side of surgery where I don’t have to worry about breast cancer. So far besides one tough night, things are looking brighter each day and I know I made the right decision.

Until next time, here’s to great surgeons, medication that works, and silicone!