Friday, August 13, 2010

Exchange Surgery Aftermath

Today is 1 week and 1 day after my exchange surgery, which was on Thursday August 5th. It is amazing the difference between this surgery and the mastectomy surgery with reconstruction. I cannot believe it is only a week post surgery. This time I was able to raise my arms enough to get a shower on my own on Friday evening (the day after surgery!). Last time it was about a week before I could even sort of lift my arms enough to wash my own hair and even then I was bending my head down and it was difficult. This time I have not needed anything to help me sleep at night, I only took pain killers a couple times during the first couple of days. The pain is nothing compared to last time though. With the mastectomy surgery, as I’ve mentioned before, I had a lot of pain the first couple days. Not just from the sutures or stretching of my chest muscle from the expanders filled with 800cc, but I think the majority of pain those early days is from the removal of all of the breast tissue, probably from all of the nerves being cut. However, this time around there was no removal of any tissue; just incisions through the original incisions on the underside of each breast. The expanders were removed from the developed pockets made by stretching my chest muscle and also using alloderm. (Alloderm is a tissue matrix that is made from donated human skin and is stripped of all characteristics except the important structural components. It was used to help create a pocket for the implant. You can get more information on Alloderm here.) Anyway, my plastic surgeon (PS) removed the expander, replaced it with a silicone implant and she also did a little work to help move the “gals” a bit more toward the center instead of under my arms as they were between these two surgeries as I described previously. So, this time my sides are very tight from the internal stitches which are trying to maintain the pockets/implants where they should be. But really overall, I have not had very much pain overall and definitely no intense pain like last time. It has been a much easier surgery and recovery compared to the mastectomy.

Also, triumphantly, I had NO nausea this time around! Hooray! Some lovely ladies on BRCA Sisterhood on Facebook mentioned a nausea patch to me after I explained my terrible nausea following the mastectomy. I asked my PS and she ordered it during my preop appointment and I picked it up at the pharmacy. The patch was called a scopolamine transdermal patch that I placed behind my ear the morning of the surgery and wore for 72 hours. It was so wonderful to wake up and not feel like absolute crap! Supposedly my PS came and talked to me afterwards and I don’t remember that at all, even though my husband says I was talking, smiling and thanking people. :)

I am very thankful to my plastic surgeon and the anesthesiologist for their hard work. My PS did a wonderful job making my “foobs” look like natural breasts. I’m pretty sure if you didn’t know any better you would think they were natural and that’s not just with clothes on! However, if I’m being totally honest I am still trying to get used to them. I feel like they are smaller than my real breasts were and my PS must have felt so as well, because she said she would have liked to have put 1000cc implants in, however, silicone only goes up to 800cc. Oh well. I also sort of feel like they need to be over toward the middle a little bit more…you know how with natural breasts there is space between them, but then when you put them in a bra they push together a bit? Well, they probably look natural because of the space which is great, but they don’t really least right now since I still have stitches and pain I haven’t exactly tried hard, but in any case I almost worry they look too far apart. Whatever. I’m sure it’s too soon to actually tell anything. I need to wait and see how they settle and what they look like in several months, so I guess I’m being too critical and picky, but that’s just kinda how I feel at the moment. Hope that’s not TMI, but just thought I’d share what I’m really feeling for those who may go through all of this at some point – trying to keep it as honest as I can!

Until next time, here’s to a quicker recovery, being healthy, and (tada!) silicone!! :)

Monday, August 2, 2010

Back on the Table

So, here it comes, the second big day. My exchange surgery is scheduled for Thursday August 5. To remind those of you unfamiliar with the process, this is the surgery where the plastic surgeon removes the expanders that are underneath my chest muscle and replaces them with the implants (silicone in my case). Some of the lovely ladies with BRCA Sisterhood on Facebook call it Operation Squishy Boobs. I love that! The expanders are very firm and are unmovable. They are not too tight or majorly uncomfortable right now for me because instead of sequential fills to slowly expand the expanders, my plastic surgeon added all 800cc right off the bat during the original surgery. So, I am fairly used to the extent to which my muscle is stretched. However, the silicone implants should feel more soft and pliable, hopefully a bit more natural. In addition, as I mentioned in my previous post right now my breasts are very uneven and under my underarms instead of towards the center of my chest as they should be. This is something else that the surgeon will take care of during the exchange surgery.

This surgery is going to be much less traumatic than the prophylactic double mastectomy with reconstruction surgery in April. For example, the surgery is going to be performed at the clinic closer to my house, as opposed to the larger clinic/hospital the initial surgery was done at. Also, the first surgery was about 6 hours long and this one is supposed to only be a couple of hours and then it is outpatient where I go home right after. I am sure I will still feel pretty beaten up, sore and tired, but nothing like how I felt after they took out all of my breast tissue from the bottom of my breasts to my collar bone. I will have lifting restrictions for 1-2 weeks, depending on how I am recovering. My plastic surgeon also told me it is a 50-50 chance of having drains, so I am keeping my fingers crossed that I get the 50% chance of NO drains! But I will deal with them of course if that’s what needs to happen. The drains, which I explained more here, are not the worst things ever, just a bit of a nuisance.

It is strange how fast this surgery snuck up on me. In some ways it felt like it was taking a long time to get here, but looking back the last 3+ months went by very fast! I was originally hoping to have the exchange surgery at the end of July, but then ended up having to wait for one part of the right side to finish healing. To explain, when I woke up from my original surgery I had a blue tattoo-looking area (if you put the tips of your thumb and forefinger together it was about the size of the space in between, just larger than a quarter). This was from the dye used to determine which sentinel lymph nodes to remove and it didn’t happen on my left side and I don’t think it is very common. My body did not take kindly to that dye and it stayed for weeks and then the top layer of skin finally started to peel, but then it turned into a thick scab. After a bit, the plastic surgeon removed the scab explaining that at a point it is doing more damage than good because water can get trapped underneath and bacteria start to grow. So, once she removed that scab I had a crater on my boob that was kinda gross and took forever to heal completely. Once it did heal about 2.5-3 weeks ago, my plastic surgeon felt comfortable with scheduling my exchange surgery. She wanted to give my skin a few weeks to be healed and give the scar a chance to shrink, etc. before she performed another surgery. Sorry if that was TMI, but I wanted to give an explanation for others who may find themselves in the same situation at some point.

So overall I am in good spirits. I am nervous, but less so than for the mastectomy. This time I already have a nausea patch that I asked my doctor to order since I had such a rough time with the anesthesia and medications last time…sensitive stomach! I am hoping I may actually be able to wake up from the anesthesia and feel well enough to even think about looking down at my chest as I have read about others doing! It is a relief to know that I am *hopefully* almost done with this portion of the prophylactic surgeries. If all goes well and I don’t need any revisions, I will be done with the breast portion and the ovaries will be next…when I’m 35.

I am very appreciative to all of my family and friends for all of their wonderful support throughout this BRCA experience. I have had such sensitive, kind responses to my decisions and I am so thankful for everyone. I am especially very grateful to my husband who has been truly amazing during, well, the entire time I’ve known him, which goes back to high school and being there for me during my Mom’s death. He is more than words can describe and I love him more deeply with each passing day!

Until next time, here’s to no more rocks on my chest, squishy boobs, and silicone!!! J